Early mobilization is beneficial in the prevention of intensive care unit acquired weakness. This paper summarized the meth-ods, opportunity, evaluation of early mobilization intervention, and some notes.

Modified constraint-induced movement therapy (mCIMT), which is modified from constraint-induced movement therapy (CIMT), is used in hemiplegics for rehabilitation. It may be used in the selected patients in certain function and age. mCIMT is more flexible than CIMT, which is mainly consisted of intervention movement, intensity, and the time of training and limitation. mCIMT is also used with other rehabilitation methods. There are various assessment for the evaluation of upper extremity motor function. By using Contract and Mo-tor Activity Log, researchers can better guarantee the curative effect.

Objective To compare the analgesic efficacy and safety of the sole local anesthetic ropivacaine with the combination of both local anesthetic ropivacaine and opioidergic analgesic sufen-tanil given epidurally on the labor pain control.Methods After institutional review board approval and patient consent,a total of 481 nulliparas requesting epidural labor analgesia were randomized into two groups:a sole local anesthetic group (0.125% ropivacaine,group R)and a combination of local anesthetic and opioidergic analgesic group (0.125% ropivacaine+0.3 μg/ml sufentanil,group RS). Analgesic efficacy was measured using numerical rating scale (NRS)of pain and maternal visual ana-logue scale (VAS)analgesia satisfaction with regard to the first and the second stage of labor.Anal-gesic safety was measured with the Bromage scale of maternal safety and epidural labor analgesia re-lated side effects,as well as fetal safety including Apgar scoring and umbilical cord artery blood gas a-nalysis.Results A total of 346 participants completed the study,with 1 64 and 182 women in each group R and RS,respectively.The median NRS pain score during the first stage of labor was signifi-cantly lower in the combination group (2.2,IQR:1.8-2.7 )comparing to the sole local analgesic group (2.4,IQR:2-2.8)(P <0.001).No significant difference was observed in NRS pain score dur-ing the second stage of labor.Patients in both groups were rated the same VAS satisfaction of analge-sia.Patients in the sole local analgesic group experienced fewer side effects than those in the combina-tion group (37.7% versus 47.2%,P =0.082).The incidence of 1-min Apgar≤7 was lower in the sole local analgesic group 2 (1.2%) than the combination group 10 (5.5%) (P < 0.05 ). Conclusion The sole local anesthetic ropivacaine produces a comparable labor analgesic effect as the combination of both local anesthetic ropivacaine and opioidergic analgesic sufentanil but the former has less maternal side effects,and less incidence of lower 1-min Apgar scoring.

This paper reports one case of overseas imported quartan malaria and the diagnosis and treatment process. By using dihydroartemisinin combined with piperaquine,the treatment results are satisfactory.

Objective To evaluate the efficacy of programmed intermittent epidural bolus ( PIEB) for labor analgesia in parturients and the effect on neonates. Methods Two hundred primiparae with a sin?gleton fetus in vertex presentation, who requested labor analgesia, aged 21-36 yr, at 37 to 40 week gesta?tion, with cervical dilatation 1-3 cm, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, were divided into 2 groups ( n=100 each) using a random number table: PIEB group and continuous epi?dural infusion ( CEI) group. PIEB regimens were programmed as 10 ml∕h starting from 1 h after the initial bolus. The programmed bolus dose was fixed at 5 ml with the lock?out interval set at 30 min. The drugs used in the analgesic pump were 0?08% ropivacaine and 0?4μg∕ml sufentanil in both groups. From the on?set of labor analgesia until 1 h after delivery, visual analog scale score was used to evaluate the uterine con?traction pain every hour. The modified Bromage score was used to assess the degree of motor block. The up?per spread of sensory block, total consumption of drugs, the number of attempts, duration of every stage, delivery mode, postpartum hemorrhage volume, and occurrence of adverse reactions ( dyspnea, hypoten?sion, pruritus, nausea, vomiting and urinary retention) were recorded. Apgar scores of the neonates were recorded, and the degree of primiparae′satisfaction with the analgesic efficacy was scored. Results Com?pared with group CEI, visual analog scale scores at T2?5 , the total consumption of drugs and the number of
attempts were significantly decreased, and the satisfaction score was significantly increased in group PIEB ( P<0?05) . The height of sensory block in the thoracic vertebra was significantly higher, and the height of sensory block in the lumbosacral spine was significantly lower in group PIEB than in group CEI ( P<0?05) . There were no significant differences between the two groups in the duration of every stage, delivery mode, postpartum hemorrhage volume, incidence of adverse reactions and Apgar scores of neonates (P>0?05). Conclusion PIEB provides reliable efficacy for labor analgesia in parturients, the degree of primiparae′satisfaction is high without increasing the occurrence of adverse reactions, and it exerts no effect on the neonates.

Objective To study the protective effect of chlorogenic acid(CGA)on the apoptosis of PC12 cells induced byβ-amyloid protein23-35(Aβ25-35)and its mechanism. Methods The cells model of death was estab-lished by Aβ25-35 (20 μmol/L)-induced PC12 cells. The cells were interfered with 5 different concentrations of CGA. CCK-8 assay was used to detect cells viability to determine the 3 concentrations of CGA in future experi-ments. The cells were divided randomly into control group ,model group and interference groups with 3 different concentrations of CGA. Cells apoptosis rates were detected by flow cytometry;colorimetry method was used to detect MDA,SOD and GSH-Px. The mitochondrial membrane potential(MMP)was detected by fluorescent staining and the expression of caspase-3 by western blot. Results Compared with model group,the cells viability of CGA groups were increased but the apoptosis rates were reduced;the activity of SOD and GSH-Px were increased but the level of MDA,MMP and caspase-3 were decreased(P<0.05). Conclusions CGA has a protective effect on Aβ25-35-induced PC12 cells apoptosis and it may be related to the improvement of cellular antioxidation capacity and mitochondrial damage.

Objective To study the effects of remifentanil with propofol and no positive pressure ventilation induction of anesthesia in 5 minutes-cesarean section on parturients and neonates. Methods Sixty pregnant women were randomly divided into ketamine anesthesia group (group L) and remifentanil anesthesia group (group R).In group L,anaesthesia was induced with ketamin 0.5 mg/kg+propofol 2 mg/kg and group R with remifentanil 1 μg/kg+propofol 2 mg/kg.Blood pres-sure,heart rate,oxygen saturation and pulse rate of maternal were recorded at intubation (T1 ),inci-sion (T2 ),and cutting the umbilical cord (T3 ).The infant Apgar scores at 1 minute and 5 minute af-ter birth,the delivery time of the fetus and umbilical blood gas values were recorded.Results The systolic blood pressure (SBP)and heart rate (HR)were significantly higher at T1 and T2 in group L than those in group R (P <0.05).The SBP,DBP and HR had not significant difference at T3 .The delivery time of the fetus and the infant Apgar scores at 1 minute and 5 minute between the two groups had no statistically significant differences.Conclusion Remifentanil combined with propofol and without positive pressure ventilation induction of anesthesia can be safely used in 5 minutes-cesar-ean section.The maternal hemodynamics is more stable without increasing the risk of neonatal respira-tory depression.

Objective To observe the analgesic efficacy of epidural morphine for postpartum perineal pain in patients undergoing episiotomy.Methods After institutional reviewing board approval and patient consent,a total of 145 parturients requesting epidural labor analgesia and under-going episiotomy were randomized into three groups:M1,M2,and C,where in morphine 1 mg dis-solved in saline 10 ml,morphine 2 mg dissolved in saline 10 ml,or sole saline 10 ml was epidurally given immediately after umbilical cord clamp,respectively.Perineal pain at rest and movement within 24 hours after vaginal delivery were evaluated with present pain intensity (PPI).Further,the time in-terval between a moderate or severe PPI and epidural drug treatment were recorded.Besides,epidural morphine related side effects including nausea,vomiting,pruritus,and urinary retention were ob-served as well.Results The proportion of patients with moderate or severe pain at rest was signifi-cantly lower in group M2 (2.1%)compared to group M1 (15.7)and group C (19.1%)(P <0.05). Further,the time interval between a moderate or severe PPI and epidural drug treatment was signifi-cantly longer in group M2 (15.7±1.4 h)compared to group M1 (11.0±0.9 h)and group C (11.0 ±1.0 h)(P <0.05).No significant difference was found between groups M1 and group C with regard to morphine efficacy.However,the accumulated side effects including nausea,vomiting,pruritus, and urinary retention prominently increased in group M2 (102.1%)compared to group M1 (43.1%) and group C (12.8%)(P <0.05).Conclusion Although epidural morphine 2 mg may significantly decrease and postpone the occurrence of moderate or severe postpartum perineal pain,however,it de-serves consideration before clinical use owing to the increased side effects.

Objective To investigate the effects of programmed intermittent epidural bolus (PIEB) with continuous epidural infusion (CEI) at different time intervals for epidural labor analgesia.Methods One hundred and eighty-six nulliparous parturients were randomized to the groups P1, P2 and C.Epidural infusion was given initial loading dose: 10 ml (0.125% ropivacaine with 0.4 μg/ml sufentanil), followed by maintaining dose: 0.08% ropivacaine with 0.4 μg/ml sufentanil.Group P1 was given basal infusion 5 ml per 30 min, 30 min after the initial dose;group P2 was given basal infusion of 10 ml per 60 min, 60 min after the initial dose;CEI basal infusion of 10 ml/h immediately after the initial dose;PCEA (patient-controlled epidural analgesia dose) 5 ml (lockout interval: 30 min).The baseline maternal heart rate, noninvasive arterial blood pressure, SpO2, respiratory rate, and fetal heart rate tracing were recorded.The visual analog scale (VAS) was recorded during the first stage of labor and at full cervical dilation.The degree of motor block was assessed in both lower extremities using the modified Bromage score (MBS).The maximum blocked segment, the consumption of anesthetic, delivery mode, amount of oxytocin, The number of cases of motor block and intrapartum fever, the fetal Apgar scores,adverse reactions,maternal satisfaction score were recorded.Results The VAS obviously decreased in the three groups since receiving labor analgesia (P<0.05).The ratio of VAS score more than 3 scales in group PIEBⅡ was significantly lower than that in groups P1 and C (P<0.05).The maximum blocked segment increased in group P1, while The incidence of unilateral block was significantly decreased in group P2 (P<0.05).The total drug consumption.And the toatal number of PCA were decreased obviously in group PIEB (P<0.05).The initial PCA time was significantly prolonged in group P2 (P<0.05).The number of instrumental midwifery and intrapartum fever in group P2 were significantly lower than that in group C (P<0.05).Conclusion Programmed intermittent epidural bolus at the beginning 60 min intervals after the initial dose for epidural labor analgesia is scientific and effective.

Objective To investigate the effect of preemptive parecoxib on blood coagulation in patients undergoing abdominal hysterectomy. Methods This was a randomized, double-blind controlled study. Seventy ASA Ⅰ or Ⅱ patients aged 38-56 yr weighing 50-75 kg undergoing abdominal hysterectomy under combined spinal-epidural anesthesia were randomized to one of 2 groups (n=35 each): parecoxib group (group P) received intravenous parecoxib 40 mg/2 ml at 20 min before anesthesia and control group (group C) received normal saline 2 ml instead of parecoxib. Both groups received patient-controlled intravenous analgesia (PCIA) with butorphanol after surgery. The PCIA solution contained butorphanol 0.2 mg/kg and ondansetron 4 mg in normal saline 100 ml.The PCIA was set up with background infusion 2 ml/h, incremental dose 2 ml, and lockout interval 15 min. VAS score was used to assess the intensity of pain (O= no pain, 10 = worst pain). Venous blood samples were taken before and at 30 min and 2 h after parecoxib or normal saline administration for coagulation test and platelet count.The postoperative ambulation time and adverse response were recorded. Butorphanol consumption per hour during postoperative analgesia and total consumption of butorphanol within 24 h after operation were also recorded. Results Compared with those before parecoxib administration, prothrombin time and thrombin time in group C and thrombin time in group P were significantly prolonged and fibrinogen concentration was significantly lower in group C at 30 min after parecoxib administration (P＜ 0.05), but no significant difference was found in the other parameters of blood coagulation and platelet count at 30 min after parecoxib administration in group P ( P＞0.05).The fibrinogen concentration was significantly higher, the incidence of postoperative nausea and vomiting was significantly lower, the postoperative ambulation time was significantly shorter, and butorphanol consumption per hour during postoperative analgesia and total consumption of butorphanol within 24 h after operation were significantly lower in group P than in group C ( P＜0.05 ), but there was no significant difference in the other parameters of blood coagulation and platelet count between group P and group C ( P ＞ 0.05 ). Conclusion Preemptive parecoxib 40 mg can enhance blood coagulation in patients undergoing abdominal hysterectomy.