OBJECTIVE:To systematically review the efficacy and safety of misoprostol combined with 10% Calcium gluco-nate injection in the treatment of postpartum hemorrhage,and provide evidence-based reference for the clinical treatment. METH-ODS:Retrieved from PubMed,EMBase,Ovid,CBM,CJFD and VIP,randomized controlled trials (RCT) about misoprostol combined with 10% Calcium gluconate injection (test group) versus conventional oxytocin in the treatment of postpartum hemor-rhage were collected. Meta-analysis was performed by using Rev Man 5.2 software after data extract and quality evaluation by Co-chrane systematic review manual 5.1.0. RESULTS:Totally 7 RCTs were enrolled,involving 1254 pregnant women. Results of Me-ta-analysis showed,compared with conventional oxytocin,misoprostol combined with 10% Calcium gluconate injection can signifi-cantly reduce 2 h postpartum hemorrhage [MD=-76.76,95%CI(-105.73,-47.79),P<0.001],24 h postpartum hemorrhage [MD=-118.28,95%CI(-167.78,-68.78),P<0.001] and the incidence of postpartum hemorrhage [OR=0.19,95%CI(0.08, 0.46),P<0.001],and shorten the 3rd delivery process [MD=-3.52,95%CI(-4.20,-2.84),P<0.001],the differences were sta-tistically significant;there was no significant difference in the intraoperative hemorrhage [MD=-61.31,95%CI(-121.98,-0.64), P=0.05] and neonatal 1 min Apgar score [MD=0.10,95%CI(-0.38,0.59),P=0.67] in 2 groups. The incidences of chest dis-tress,breathlessness and stomach discomfort in test group were significantly higher than control group [OR=18,95%CI(2.42, 133.98),P=0.005],but it was mild,and there was no significant difference in the incidence of fver,chills and nausea,vomiting, diarrhea and other adverse reactions. CONCLUSIONS:Both the efficacy and safety of misoprostol combined with 10% Calcium gluconate injection in the treatment of postpartum hemorrhage are good. Due to low quality and small-scale of included studies, more large-scale and long-term follow-up studies with strict designed are required for further validation of the conclusions.

Objective To explore the curative effect of dynamic hip screw(DHS) and proximal femoral nail (PFN)in treatment of intertrochanteric fractures. Methods Dynamic hip screw(DHS) group is A group:30 patients, proximal femoral nail( PFN) group is B group:30 patients. In the respect of the average length of the incision, operation time,blood loss,X-ray exposure times,postoperative drainage volume,blood transfusion volume,antibiotics usage time,hospitalization time,postoperative ambulation time,healing time of fracture,criteria of Harris hip function score after half a year,complication rate,this paper made the comparative analysis of clinical efficacy and statistical analysis between the two groups. Results 60 patients were followed up for 9 months to 4 years, with the average of 2 years and 3 months and no death. The average length of the incision, operation time, blood loss, X-ray exposure times, postoperative drainage volume,blood transfusion volume, DHS group were( 13. 4 ± 1. 9) cm, (92. 8 ± 13. 0) min, (321.0±39.4)ml,(5. 8 ± 1.2)times, (84.1 ± 10. 1)ml, (316.6 ±79. 1 )ml;PFN group were(7.6 ± 1.1 )cm,(59. 0±6. 9)min, (204. 6 ±32. 7) ml, (5.0 ±0.9) times, (53. 9 ± 8. 7) ml, ( 196. 6 ± 18. 2) ml; the differences between two groups were statistically significant ( all P ＜ 0. 05 ) . Hospitalization time, postoperative ambulation time, healing time of fracture,DHS group were(6.2±3.7)d,(17.8±1.8)d,(69. 8 ± 12. 3)d, (13. 0 ± 1. 6) weeks,PFN group were(4.7 ±2. 6)d,( 16.0 ±2. 2)d, (46.9 ±4. 9)d, (11. 3 ±0.7) weeks, the difference was statistically significant (all P＜0. 05). Antibiotic use of time,hip function(Harris score standard)excellent and good rate after half a year, there's no significant difference between the two groups( all P ＞ 0. 05). Complication rate, DHS group:40% ; PFN group: 10%. The difference was statistically significant (P ＜ 0. 05). Conclusion Intertrochanteric fracture fixation PFN group had an advantage of smaller surgical trauma,less bleeding,shorter healing time,more rapid postoperative recovery,lower complication rate and other characteristics comparing with the DHS group. So it was worth being recommended for a wider use.

Objective Observing the process of cell aggregation and differentiating into myocardium after the P19 cells treated with different methods and dimethyl sulfoxide(DMSO) inducer.Methods P19 cells were cultivated with DMSO in suspension for 7 days in Petri dishes or dishes containing a thin layer of soft agar to form cell aggregation.Then the aggregates were plated on gelatin-coated culture dishes,and cultured without DMSO to 19 days.The beating of cells was observed.?-sarcomeric actin and cardiac Troponin T(cTnT) immunocytochemical stains were used to identify cell differentiation.Results Cell aggregations were cohering-cultured with growth culture medium after DMSO induced for 7days,spontaneous and rhythmically beating cells were present within the aggregation outgrowths at day 15,which were ?-sarcomeric actin-positive and cTnT-positive.By day 19,positive rates were about 26% and 15% respectively.Conclusion By using DMSO exposure combination prior aggregation can induce P19 cells differentiate into cardiac myocytes which can spontaneously and rhythmically beat.

In recent years, various network assistant teaching platforms which have flooded into universities have been well received by the majority of teachers and students and educators. Network teach-ing platforms in oral medicine education now, especially the assistant teaching and information management have gradually risen to play a decisive role position. Combined with the characteristics of oral medical un-dergraduate course and the present situation of teaching, a preliminary practical use has been made on the new digital teaching management platform of College of Stomatology, Chongqing Medical University, and the analysis based on its advantages and disadvantages has also been made, in order to make an improvement of oral medicine teaching quality and management efficiency.

OBJECTIVE: To develop software for individualized dosage regimen of valproic acid and carbamazepine according to population pharmacokinetics and Bayesian estimation method. METHODS: Based on the prior population pharmacokinetic (PPK) information, Microsoft Excel 2010 was employed as the input-output interface to run the PPK program, Nonlinear Mixed Effect Modeling (NONMEM), to estimate the PK parameters and design the regimen. RESULTS: The software fulfills the functions of patient information management, initial dosage design, dosage calculation by maximum a posterior Bayesian estimation (MAPB) and compliance assessment. CONCLUSION: The established software provides a powerful tool in the clinical settings to facilitate the individualized therapy for the epilepsy patients.

Objective To elucidate the characteristics of the apoptosis of ovarian cell in DahlS hypertensive rats .Methods Sixty DahlS hytertensive femal rats(5 weeks old) were devided into 3 experimental groups and 3 control groups randomly,then the rats fed with 8% salt and normal forage respectively.Materials were gathered at 11,13,15 weeks old sacrifice.The apoptosis characteristics of granulosa cell and corpus luteum cell were studied by light,electron microscopy in situ end labelling techriqe,flowcytometry,etc.Results As hypertensive coures prolongation resut in the following conditions:⑴By light microscope,granulosa cell(GC) of developing follicles arranged inorderly and loosing ,the number of follicle atresia increased and corpus luteum decreased.⑵In TUNEL staining,apoptosis was mainly observed in granulosa cell of developing follicles,and it could not observed in corpus luteum cells. ⑶By electron microscope,the apoptosis of granulosa cell and corpus luteum cell assume typical characteristics as cytoplasm,a little nucleous,abnormal cytoblast,chromatin condensed and edged,appeared concetraction band,etc.It could also be observed that mitochondrion ridge had dearranged,the nmuber of smooth endoplasmic reticular(SER) decreased,and the change of lipid's lamellae was serious.⑷Flow cytometry assay showed the apoptosis rate of ovarian cell increased gradually,experimental groups of 13,15 weeks old(6 42?1 06)%,(6 67?2 11)% increased significantly as compared with controls(1 26?0 57)%,(1 46?0 73)%(t=3 027,3 085,P

The autonomic nervous system contributes to prostate cancer proliferation and metastasis. However, the exact molecular mechanism remains unclear. In this study, muscarinic acetylcholine receptor M1 (CHRM1) expression was measured via immunohistochemical analysis in human prostate cancer tissue array slides. PC-3, LNCaP, and A549 cells were treated with pirenzepine or carbachol, and the cell migration and invasion abilities were evaluated. Western blotting and quantitative real-time PCR were performed to measure GLI family zinc finger 1 (GLI1), patched 1 (PTCH1), and sonic hedgehog (SHH) expression levels. High expression of CHRM1 was found in early-stage human prostate cancer tissues. In addition, the selective CHRM1 antagonist pirenzepine inhibited PC-3, LNCaP, and A549 cell migration and invasion, but the agonist carbachol promoted the migration and invasion of these three cell lines. Muscarinic signaling can be relayed by hedgehog signaling. These data show that CHRM1 is involved in the regulation of prostate cancer migration and invasion through the hedgehog signaling pathway.

Objective To explore the effects of estrogen and angiotensin Ⅱ receptor 1 inhibitor（saralasin）on cell proliferation,cell cycle and apoptosis in endometrial carcinoma cell line HEC-1A.Methods Immunocytochemical assay was applied to detect the expression of AT1-R,PI3K,p-Akt and ERK protein in HEC-1A cell.The effects of estrogen and saralasin on cell proliferation,cell cycle distribution and apoptosis of HEC-1A cell were detected by MTT assay and fluorescence activated cell sorting technique.The expression of ERK and p-Akt protein in HEC-1A cell treated with estrogen and saralasin were analyzed by Western blot.Results The expression of AT1-R,PI3K,pAkt,and ERK protein was found in HEC-1A cell.Estrogen stimulated the proliferation of HEC-1A cell,decreased G0~G1 phase proportion and increased S phase proportion significantly,minimized the number of apoptotic cells,and up-regulated the expression of ERK protein.Saralasin obviously inhibited the proliferation and induced apoptosis of estrogen induced HEC-1A cell,increased G0~G1 phase proportion and decreased S phase proportion,and down-regulated the expression of ERK protein.Conclusion Estrogen could promote the proliferation of HEC-1A cell through AT1-R.AT1-R inhibitor saralasin could inhibit the proliferation and induce the apoptosis of estrogen induced HEC-1A cell.The down-regulation of ERK protein expression by interrupting the mitogen-activated protein kinase（MAPK）signaling pathway might be involved in the possible mechanism.Thus saralasin could be a valid approach to treat ER-negative endometrial carcinoma.

Objective To investigate the molecular mechanism of Klebsiella pneumoniae resistant to imipenem.Methods Anti-microbial susceptibility was evaluated by disk diffusion test,Seven imipenem-resistant strains of Klebsiella pneumoniae were select-ed.And PCR was used to amplify so as to detect eighteen resistant genes.Results Seven imipenem-resistant strains of Klebsiella pneumoniae were more sensitive to aminoglycosides and sulfamethoxazole/trimethoprim.The positive rates of KPC,ant(3′′)-Ⅰ, SHV,CTX-Mand ant(2′′)-Ⅰin these imipenem-resistant strains were high.Conclusion Carbapenem-resistant Klebsiella pneumon-iae isolated from our hospital carries several kinds of resistant genes.Carrying KPC may be the main resistant mechanism of Kleb-siella pneumoniae resistant to carbapenem,but other mechanisms also exist at the same time.

[Objective]To introduce the surgical technique of ceramic-on-ceramic total hip replacement and discuss the difference between two implant design.[Method]From November 2001 to June 2006,123 hip in 101 patients were treated by total hip arthroplasty with Osteonics ABC and Option Hip System.The prosthesis was fixed in strict position following some special technique for ceramic components.The theoretic range of motion of two hip systems were measured from experiment in vitro.The different cup positions which impingement happened were record for each prosthesises.[Result]The clinical score and the radiographic position of implants was good without evidence of wear,loosening,osteolysis and ceramic fracture.One chipping of ceramic insert happened during operation,and two patients had temporary irritation of iliopsoas.No other sever complication were found so far such as dislocation and infection.Experiment result:The deepened cup design obviously decreased the hip range of motion and "safe zone" was narrow than the flat cup design.[Conclusion]Ceramic-on-ceramic hip implant highly demands for surgical technique especially accurate cdp position.The deepened cup design cup should be posited with large anteversion.