Objective To observe the effect of patient -controlled epidural analgesia for the postoperative pain and influence for the cytokines of delivery women with caesarean section.Methods 80 delivery women with caesarean section were selected as research objects,and they were divided into the control group(pethidine by intra-muscular injection group)of 40 cases and the observation group(patient -controlled epidural analgesia group)of 40 cases according to the random number table.Then the pain score,serum pain indexes and cytokines of the two groups before the delivery and at 24h and 48h after the delivery were analyzed and compared.Results The mild pain rates of the observation group at 12h,24h and 48h after the delivery were respectively 75.00%,80.00% and 87.50%,which were all higher than those of the control group(χ2 =6.542,732,6.141,all P <0.05),the serum pain indexes and cytokines were all lower than those of the control group too,the differences were statistically significant (all P <0.05).Conclusion The influence of patient -controlled epidural analgesia for the postoperative pain tress indexes and cytokines of delivery women with caesarean section are great,and it can effectively improve the discomfortableness and inflammatory state of delivery women after the the delivery.

Objective To observe the effect of injectable tissue-engineered bone in treating periarticular bone fracture nonunion under arthroscopy. Methods Selected 6 patients with intra-articular bone fracture nonunion:3 cases of humerus intercondylar fracture;2 cases of femoral condylar fracture and 1 cases of tibial plateau fracture. All of the 6 patients have undergone arthroscopic debridment and tissue-engi-neered bone injection in the the fracture ends with puncture needle under direct vision. Percutaneous needle internal fixation were performed if necessary. All the patients have got regular follow-up after the operation process. Check their healing condition with X-ray examination, and the healing of the bone and its complications have also been monitored. Reexamination were made 3, 6, 9, and 12 months after surgery. Results All the patients have experienced successful operation and all the fracture have healed up. The X-ray review showed that the callus healing time was (8. 34 ± 2. 4) weeks and fracture healing time was (18. 2 ± 3. 3) weeks. Accordong to Johner-Wruhs functional category, there were 5 cases of excellent recovery and 1 case of medium recovery. Among these patients, inflammatory reaction occurred in 1 case, and the symptoms disappeared after 2 weeks of Vancomycin anti-inflammatory treatment; deep venous thrombosis occurred in 1 case, and the symptoms disappeared after systematic anticoagulant therapy. Conclusion It’ s safe and effective to treat periarticular bone fracture nonunion with injectable tissue-engineered bone under arthroscopy.

Vascularization is one of the major c hallenges in tissue engineering gra ft.Vascular plexus falls into two modes which are different in recourse of endotheliocyte:vascul ogenesis and angiogenesis.Both mod es are a dynamic and complicated physiological process.Various kinds of growth factor and adhesion molecule modula te the process.Both in vitro and in vivo methods are used in vascularization research.In vitro methods are used to e-valuate biomaterials for endothelial cell attachment,cytotoxicity,g rowth,angiogenesis and its effects on gene reg-ulation.Chorioallantoic membrane(CAM)is one of the simplest and effective models in vivo.Animals are used as more advanced models.The strategie s of vascularization of tissue engin eering include:modification of the surface of the biomaterials,addition of slow-release growth factor to scaffold,e ndotheliocyte cocultured with other seed cells,wrapping by vascular net,implantin g blood vessel bundles into the graft,seeding biomaterial implants with vascular remnants as vascular template,and c reating perfused microvessels in vitro.None of these approaches,however,is satisfactory at present.We believe that an ideal method will be finally f ound for vascularization in tissue e ngineering with advancement of research on mech anism of vascularization and progre ss in techniques.[

ve To understand the indoor air quality of hotels after the openning for business and its health impacts on employees. Methods The hygienic investigation on indoor air quality was carried out in 4 newly built and decorated 2~4-star-grade hotels during the 1st week to the 4th week after openning for businesses well as the health impacts on employees. Results The levels of room temperature, relative humidity, carbon monoxide, carbon dioxide and total count of bacteria in indoor air of hotels showed no significant differences, but the concentrations of formaldehyde(HCHO) and inhalable paniculate (IP) of hotels showed significant differences compared with those of outdoor control(P

Objective To summarize the nursing points for patients with mid-stage hepatocellular carcinoma who are receiving radiofrequency ablation (RFA) combined with 131I-chTNT treatment. Methods The clinical data of 12 patients with mid-stage hepatocellular carcinoma, who were encountered at authors’ hospital during the period from Aug. 2009 to Sep. 2011, were retrospectively analyzed. RFA combined with 131I-chTNT was carried out in all patients. Preoperative prophylactic anti-allergy medication and protection measure for the thyroid were employed. After the operation strengthened radiation protection and close observation for complications were conducted. The results were analyzed. Results After active treatment and proper nursing, the tumor shrank in all patients. All the patients were followed up for 5 - 48 months with a median follow- up time of 31 months. The median overall survival time was 43 months. No serious complications such as bone marrow suppression or thyroid dysfunction occurred. Conclusion For the treatment of mid-stage hepatocellular carcinoma, 131I-chTNT combined with RFA has satisfactory therapeutic effect. Close observation for the occurrence of complications and careful nursing can improve the quality of life and prolong the survival time.

Objective To investigate the distribution characteristics and antimicrobial resistance of carbapenem-resistantAcinetobacter baumannii (CRAB),and to guide effective clinical prevention and rational antimicrobial use. Methods Data about clinically isolated CRAB between January 2009 and December 2013 were analyzed retrospec-tively,distribution and antimicrobial resistance were analyzed by WHONET 5.5 software.Results A total of 888 Acinetobacter baumannii strains were isolated,421 of which were CRAB,the isolation rate was 47.4%,the isola-tion rates in 2011 ,2012 and 2013 were all about 50.0%;CRAB strains were mainly isolated from sputum (73.4%) and mostly distributed in intensive care unit (ICU)(61 .3%),followed by neurosurgery department (12.4% ). CRAB presented highly antimicrobial resistance.Except cefotaxime and cefatriaxone,resistant rates of CRAB to the other detected antimicrobial agents(ceftazidime,cefepime,cefoperazone/sulbactam,aztreonam,imipenem,amika-cin,gentamycin,minocycline,chloramphenicol,levofloxacin,ciprofloxacin,and compound sulfamethoxazole)were all higher than non-CRAB isolates(all P ≤0.01),Compared with non-CRAB isolates,The resistant rate of CRAB to cefoperazone/sulbactam was the lowest(<15%),followed by minocycline,resistant rates to other antimicrobial agents were all >80.0%.Conclusion Surveillance of CRAB should be further strengthened.It is necessary to fo-cus on the control and prevention of healthcare-associated infection in ICU patients and respiratory system.

OBJECTIVE To explore the distribution of 16S rRNA methylase and aminoglycoside modifying enzymes in continuous isolates of Pseudomonas aeruginosa(PAE).METHODS The antibiotics susceptibility was tested by K-B method,the 16S rRNA methylase(rmtB) and aminoglycoside modifying enzymes were detected by polymerase chain reaction(PCR),the positive genes were amplified and sequenced by PCR fluorescence spectrophotometry.RESULTS Among 20 strains of PAE,the 16S rRNA methylase and 5 kinds of aminoglycoside modifying enzymes had been detected.The 5 kinds of aminoglycoside modifying enzymes were aac(3)-Ⅱ,aac(6′)-Ⅰb,aac(6′)-Ⅱ,ant(3″)-Ⅰ and ant(2″)-Ⅰ,respectively.And more,the rmtB in the first and third strains was sequenced,and translated into amino acid,and the translated amino acid sequence was compared with GenBank,suggesting there be different amino acid sequence.This was confirmed as two new subtypes.CONCLUSIONS Resistant to antibiotics PAE in our hospital is mainly related to 16S rRNA methylase and 5 aminoglycoside modifying enzymes,and 2 new subtypes of 16S rRNA methylase are discovered.

Purpose To investigate the clinicopathological and immunohistochemical features of primary small cell carcinoma of the cervix ( SCCC) and its prognosis. Methods 18 cases of primary cervical small cell carcinoma were evaluated by histopathology, in si-tu hybridization and immunohistochemistry and relevant literatures were reviewed. Results The age of the patients ranged from 30 to 69 years ( mean age, 40 years) . Major clinical manifestation was irregular colporrhagia. Colposcopy often revealed a cervical mass or cervical erosion. Microscopically, the tumor cells were small and round and arranged in a solid distribution. The cell had little cyto-plasm and increased karyoplasmic ratio with deeply stained granular chromatin and increased pathological mitosis. Immunohistochemi-cally, the tumor cells were often positive for CKpan, variable positive for Syn, NES, CgA, CD56 and p16. HPV 16/18 were positive in 4 cases. Conclusion SCCC is a neuroendocrine tumor of high malignancy and poor prognosis with a possible pathogenesis of HPV 16/18 infection. CKpan, Syn, CgA, NSE and CD56 are useful markers for the diagnosis of SCCC.

Purpose To investigate the clinicopathlogical characteristics, diagnosis and differential diagnosis of ovarian small cell car-cinoma hypercalcemic type ( OSCCHT) associated with acute renal dysfunction. Methods A case of OSCCHT associated with acute renal dysfunction was reported. The clinical and pathologic data, treatment and pathological examinations were analyzed and the related literatures were reviewed. Results A 29-year-olds women was presented to hospital with inappetence and significant weight loss for 2 months. The laboratory examination showed abnormal renal function, and pelvic cavity mass, possibly coming from adnexa of the uterus was seen by radiography. Serum levels showed significantly increased serum calcium with acute renal dysfunction. An emergency opera-tion was performed just after renal function partially recovered by 2 times hemodialysis. During surgery, right ovary tumor with a size of 12 cm × 10 cm × 10 cm was inspected. Microscopically, the tumor cells were arranged in a diffuse solid pattern, mutiple nodules were separated by fibrous tissue. some small folliculars and pseudoglandular cavities with acidophilia secretion within nodules could been ob-served. Tumor cells were medium to large with eosinophilic cytoplasm, round or oval vesicular nucleus, increased karyoplasmic ratio and pathologic mitosis. Immunohistochemistry revealed that the tumor cells expressed EMA, CKpan, C-erbB-2 ( +) , CA125 ( focal+) and Ki-67 proliferation index was about 60%, while ER, PR, Syn, CgA, PTH, Inhibin, CD99, AFP, PLAP, CD30 and CD20 were not expressed. Conclusion Ovarian small cell carcinoma hypercalcemic type with acute renal dysfunction is a very rare with a rapidly progressive and highly malignant tumor. The final diagnosis mainly lies on clinical information ( hypercalcaemia) , morphology and immunohistochemistry, combined with electron microscopy and molecular biological detection when necessary.

Purpose To investigate the occurrence of echinoderm microtubule-associated protein-like 4 (EML4) gene and the anaplas-tic lymphoma kinase (ALK) gene rearrangements in lung squamous cell carcinomas (SCC), and to provide with a test for targeted therapy of SCC. Methods In this study, we analyzed ALK protein expression with a specific rabbit monoclonal Ig antibody ( D5F3 clone) in 219 cases of lung SCC. The positive cases were confirmed with ALK fluorescence in situ hybridization ( FISH) . Results 4 out of 219 (1. 8%) cases of lung SCC were ALK positive detected by immunohistochemistry (IHC) staining, which were confirmed by ALK FISH. Conclusions There are SCC having EML4-ALK gene rearrangement. The response of SCC patients with ALK expression to targeted therapy of Crizotinib should be explored. Strong positive expression of ALK protein can be interpreted as EML4-ALK gene rearrangement.