05). Conclusion The maternal serum level of ADAM 12 in the first-trimester is a potential marker for aneupolyhaploid screening and early fetal loss prediction, and is suggested to be tested at 9-12 gestational weeks as part of prenatal screening.

Objective To study the clinical effect and value of the combination of dexamethasone and calcium agent assisted oxytocin on preventing postpartum hemorrhage.Methods 128 cases of maternal of clinical information were reviewed,and which were divided into control group and observation group randomly.The control group was immediately infused muscle note 20IU of Oxytocin and the observation group(n =64) was given 5％ of glucose and 100ml 10％ of glucose acid 10ml calcium.And then give 20IU oxytocin after pending.Lastly,give the two groups comparison of blood-producing capacity and the number of cases of blood-producing.Results Ater observation groups in fetal foetus blood-producing capacity of 2h and 24h,the number of cases of blood-producing less than the control group,and both have significant statistical differences (all P ＜ 0.01).Conclusion The combination of dexamethasone and calcium agent-assisted application of oxytocin can prevent postpartum hemorrhage,better clinical effect,which should be promot in clinical application.

Objective To explore the safety and effectiveness of dexamethasone and calcium gluconate combined with oxytocin to prevent postpartum hemorrhage.Methods 128 maternal patients with full-term delivery were divided the patients into two parts randomly:the control group and the observation group,of which contained three groups(A,B,C).The patients were all given 20 u oxytocin.As to observation,group A:before 10-15min of cutting skin,give 10mg of dexamethasone and 10 ml 10％ calcium gluconate rapid intravenous infusion,group B:give 10mg intravenous infusion of dexamethasone after babies were boro,group C:before 10 ～ 15min of cutting skin,give 10mg of dexamethasone and 10ml 10％ calcium gluconate rapid intravenous infusion and then give 10mg dexamethasone after babies were born.The control group wasn't given that medicine,and only give them 20 u oxytocin when babies were born.At last,give contrast of total amount of bleeding,ill reflecting of medicine and the other symptom after 24h.Results The amount of bleeding of observation group A,B,C were (277.3 ± 44.5) ml,(286.8 ± 52.7) ml,(301.8 ±60.9) ml,respectively.The amount of bleeding of the control group was (422.9 ± 78.2) ml.The observation group and control group had significant differences(t =-0.699,0.481,-0.407,all P ＜ 0.01),and there was no significant difference between group A,B,and C (P ＞ 0.05).And this two groups had no bad reflection and the other symptoms.Conclusion Dexamethasone and calcium gluconate combined with oxytocin to prevent postpartum hemorrhage has great efficacy and safety.This method must be extended.

Objective To study the pain relief effectiveness of the combined spinal epidural analgesia(CSEA) and the inhalation of nitrous oxide, and the influences on the mothers and infants Methods The 300 cases of pregnant women were randomly divided into 3 groups: CSEA group,nitrous oxide group and control group The nitrous oxide group was that pregnant women inhaled nitrous oxide premixed with oxygen (50%∶50%),the pregnant women of the CSEA group were injected fentanyl and bupivacaine in the subarachnoid and epidural space,analgesic was not used in the control group The degree of labor pain, duration of the labor,way of delivery, bleeding volume, rate of anoxia of newborn,blood gas analysis to maternal radius artery and fetal umbilical blood among 3 groups were observed Results The effect for analgesia labor of the CSEA group was much better than that of the nitrous oxide group ( P 0 05) In the second stage of labor,the 3 groups were alike to each other The bleeding volume of caesarean section (373?77) ml in the nitrous oxide group was much more than the other 2 groups, there was no difference between the CSEA group (259?78) ml and the control group (239?89) ml The rate of obstetric forceps of CSEA group was higher than the control group ( P

The mechanisms of antidepressants are still unclear. There a re two classical theories on monoamine neurotransmitter or on neurotransmitter rec eptors, but both of them can not fully explain the delayed therapeutic action of antidepressants. Recently, many researches have focused on the postreceptor int racellular signal transduction as the mechanism of antidepressant action. G protein is the molecular basis of antidepressants. Neurotransmitter receptors and G protein are the two sectors of their therapeut ic action. They will ultimately influence intracellular signal transduction and result in relative effects such as phosphoration, the induction of neurotrophic factors and neurogenesis. This mechanism suggests a reasonable explanation for t he clinical delaying of antidepressants and it will do great help for the develo pment of antidepressants. It makes the design of novel, safe and more efficaciou s antidepressants possible and provides significant information for the elucidat ion of biology of depression.

Objective To investigate the guidance of a new classification on the treatment methods selection for cystic dilation of bile duct (CDBD).Methods The clinical data of 213 patients with CDBD who received treatment according to the Todani 2003 classification at the Peking Union medical College Hospital from September 1968 to July 2013 were retrospectively analyzed.The CDBD was reclassified with a new classification proposed by Dong Jiahong et al,and the guidance of the new classification on the treatment methods selection for CDBD was analyzed.Patients were followed up via out-patient examination and telephone interview till August 2013.Results Of the 213 patients,139 were with Todani type Ⅰ CDBD (type C CDBD of the new classification) ; 3 were with Todani type Ⅱ CDBD (type C1 CDBD of the new classification) ; 1 was with Todani type Ⅲ CDBD (type E CDBD of the new classification); 52 were with Todani type Ⅳa CDBD (35 with type D1 and 17 with type D2 CDBD of the new classification) ; 1 was with Todani type Ⅳb CDBD (type C CDBD of the new classification) ; 8 were with Todani typeⅤ-Ⅰ CDBD (type B CDBD of the new classification) ; 9 were with Todani type Ⅴ-Ⅱ CDBD (type A CDBD of the new classification).Eighteen patients did not receive the surgical treatment.Of the 195 patients who received surgical treatment,patients with type C and D CDBD of the new classification took a large proportion.Patients with type C CDBD of the new classification received cystectomy,biliary cyst resection,Rouxen-Y cholangiojejunostomy or internal drainage.Patients with type D CDBD of the new classification received extrahepatic biliary cyst resection,Roux-en-Y cholangiojejunostomy.Patients with severe intrahepatic disease and with type D1 CDBD of the new classification received concomitant left hemihepatectomy or pancreaticoduodenectomy.Patients with type A1 CDBD of the new classification received right hemihepatectomy.Patients with type A2 CDBD of the new classification were cured by conservative treatment after split liver transplantation.Patients with type B1 CDBD of the new classification received left hemihepatectomy and Roux-en-Y cholangiojejunostomy.Patients with type B2 CDBD of the new classification received bile duct stone extraction.There was 1 patient with type E CDBD,and partial resection of the CDBD ± bile duct reconstruction was carried out.Pancreatic fistula,biliary fistula,reflux cholangitis,cholangitis and anastomotic stricture were detected on 74 patients,and they were cured by conservative treatment or lithotomy.A total of 187 patients were followed up with the median time of 85 months (range,1-432 months).One hundred of seventy-five patients recovered well,and 12 patients with canceration of the bile duct died of tumor metastasis at postoperative 1-282 months.Conclusion This new classification simplifies the typing of extrahepatic bile duct dilation,refines the typing of intrahepatic bile duct dilation,and has better guidance for surgical treatment.

OBJECTIVE:To establish a method for simultaneous determination of valsartan and hydrochlorothiazide in Valsar-tan hydrochlorothiazide tablets. METHODS:UPLC was adopted. The determination was performed on Phenomenex C18 column with mobile phase consisted of [0.1% phosphoric acid solution-acetonitrile(95 : 5,V/V)]-[0.1% phosphoric acid solution-acetonitrile (5 : 95,V/V)](gradient elution)at the flow rate of 0.25 mL/min. The detection wavelength was set at 272 nm,and the column tem-perature was 35 ℃. The sample size was 1.5 μL. RESULTS:The linear range were 8.1-324.2 μg/mL for valsartan(r=0.9999)and 1.2-50.1 μg/mL for hydrochlorothiazide(r=0.9999). The limits of quantitation were 0.24,0.04 ng,and the limits of detection were 0.06,0.01 ng. RSDs of precision,stability and reproducibility tests were less than 2.0%;recoveries were 97.69%-100.35%for valsartan(RSD=1.03%,n=9)and 98.27%-100.60% for hydrochlorothiazide(RSD=0.83%,n=9). CONCLUSIONS:The method is simple,rapid and accurate,and can be used for the simultaneous determination of valsartan and hydrochlorothiazide in Valsartan hydrochlorothiazide tablets.

Purpose To analyze the image quality of brain CT with 256-slice wide detector axial scanning mode,routine axial scanning mode and spiral scanning mode,and to provide a more effective brain CT examination method for patients.Materials and Methods The prospective study was conducted on 90 patients accepting routine brain CT examination,and they were randomly divided into three groups.CT examination with 160 mm axial scanning mode,40 mm axial scanning mode and 40 mm spiral scanning mode were respectively conducted using GE Revolution CT.The scanning condition was adjusted to remain constant radiation dose,and then the image quality was analyzed.CT attenuation of gray and white matter,contrast-to-noise ratio (CNR) of white-gray matter and image noise of the three scanning modes were compared.Subjective scoring on image quality of the three scanning modes was also performed.Results On body lateral cerebral ventricle level,there were no significant difference in CT attenuation of gray and white matter and CNR (P＞0.05).On centrum semiovale level,the CT attenuation of gray matter [(31.71 ± 1.82) HU],white matter [(22.97± 1.50) HU] and CNR 2.05±0.42 of 160 mm axial scanning mode was significantly different from the other two scanning modes (F=26.74,47.16 and 3.85,P＜0.05).On centmm semiovale level,image noise of 160 mm axial scanning mode was lower than the other two kinds of scanning methods (F=6.31,P＜0.05),in the basal ganglia and posterior fossa there were no statistically significant differences in the image noise between the three scanning modes (P＞0.05).The subjective score of the three scanning modes all met the diagnostic requirements,and there was no significant difference (P＞0.05).The effective dose and scanning time of 160 mm axial scanning mode was lower than those of the other two scanning modes,and the X-ray utilization was higher.Conclusion 160 mm wide detector axial scanning mode is more suitable for brain CT scan,and it can be used as the preferred scanning mode in the emergency and among non-cooperative patients.

Adult ; Anemia, Hemolytic ; Female ; Humans

Object To investigate the features of health related quality of life ( HRQOL) among elderly hypertensive patients with different body mass index (BMI) so s to provide evidence for the health promotion of hypertensive. Methods A cross-sectional survey of health status data from a population of 1281 elderly hypertensive patients from Beijing and 8 provinces of China ( Jiangsu, Anhui, Gansu, Qinghai, Fujian, Jilin, Jiangxi, and Henan) was made in the study. Analysis of variance was applied to compare the differences in HRQOL of elderly hypertensive patients in different BMI categories. Results For the elderly hypertensive patients with low body mass index, the scores of 8 dimensions and scores in physical component summary (PCS) and mental component summary( MCS) of SF-36 were the lowest;except the role-emotional(RE) dimension,the scores of other 7 dimensions,PCS and MCS were significantly different(PF,RP,BP,GH,VT,MH, P<0.01; SF,PCS,MCS, P<0.01). Comparing the scores between any two groups in PCS, the scores of patients with low body mass index were significantly lower than normal weight group (62.30 ± 22. 12 vs72.40 ±20.86, P<0.05) .overweight group (62.30 ± 22.12 vs 74.97 ± 19.20, P<0.05 ) and obese group (62.30 ± 22.12 vs 74.57 ± 19. 22, P < 0.05 ). Comparing the scores between any two groups in MCS,the scores of patients with low body mass index were significantly lower than normal weight group (68. 81 ± 20. 48 vs 74. 70 ± 20.41, P < 0. 05), overweight group (68. 81 ± 20. 48 vs 78.08 ±18.23, P<0.05) and obese group (68.81 ±20.48 vs 78. 69 ± 17.77, P<0.05); the score of normal weight group was significantly lower than the overweight group (74. 70 ±20. 41vs 78. 08 ±18.23, P<0.05). Gender Stratification showed that females with low body mass index had worse HRQOL than males. Conclusion The HRQOL of elderly hypertensive patients with low body mass index is significantly lower than normal weight patients, overweight patients and obese patients, the health promotion of elderly hypertensive patients with low body mass index should be paid more attentions, especially females with low body mass index.