Objective To find out the rate of deterioration of systemic lupus erythematosus (SLE) during pregnancy,the incidence of co-existing pregnancy induced hypertension (PIH) and the ways of antepartum treatment.Methods A retrospective analysis of the clinical data was performed in 19 cases of SLE with pregnancy from 1998 to 2003.Results SLE with pregnancy had an acute deterioration rate of 52.6% and incidence of co-existing PIH of 52.6% and 31.6%,which were related to patients'condition and remissions.Conclusion When SLE happens in pregnancy,it is more likely to get worse and complicated with PIH.It is necessary to enhance the antepartum monitoring and treatment for these patients.

The paper first expounds the features of current ideological and political work in hospitals, viz. the selectivity of the central task, the complexity of customers, the possession of knowledge by the majority of the staff and the openness of their ideology. Then it sets forth 6 methods of conducting ideological and political work in hospitals at present: ①combination of one way inculcation and infiltration in length and breadth; ②emphasis on both practical results and efficiency; ③attention to both poverty relief and self enhancement; ④persistence in both education and strict management; ⑤unity of retrospective summary and perspective study; and ⑥stress on relying on the professional contingent as key members and adopting the operational mechanism of joint control.

Objective To investigate the relationship between the apparent diffusion coefficient(ADC) value,portal hypertension and hypersplenism.Methods 52 cases underwent MR imaging (including DWI) examination,among them,included normal group(18 cases) hepatic cirrhosis without portal hypertension group(24 cases) and hepatic cirrhosis with portal hypertension group(10 cases).The ADC values of spleen were calculated and compared between groups.The relationship between target of hypersplenism——cells in peripheral blood(RBC/WBC/PLT) and spleen’s ADC values was also analyzed.Results With the appearance of portal hypertension,spleen’s ADC values decreased.The significant difference was found among these 3 groups(P

Objective: To compare the advantage of tympanogram, Morimitsu＇s method and Tubotymanoaerodynamic graphy (TTAG) in the confirmation of patulous eustachian tube syndrome. Method :Twenty ears with patulous eustachian tube syndrome diagnosed clinically were selected. The tympanogram, Morimitsu＇s method and TTAG were examined in these ears and the positive rate was estimated. Result:The confirmation of patulous eustachian tube syndrome by tympanogram,Morimitsu＇s method and TTAG was 5,12 and 20 ears in 20 ears with patulous eustachian tube syndrome. The positive rate was 25％,60％ and 100％ respectively. TTAG also was useful in following-up. Conclusion:TTAG is an important method for diagnosis and following-up in patulous eustachian tube syndrome.

Objective In this study we discussed the training method for skills of evidence-based nursing(EBN)for nurses in surgical department.Methods We selected 43 nurses in two surgical department as training objects.The trainging procedure was established according to the four steps of evidencebased nursing,putting forward questions,searching for evidences,making observations and applying evidence-based nursing.The nurses were trained according to the procedure.The skills of EBN,ability of obtaining information and satisfaction degree of nurses was evaluated after training.Results The skills of EBN and the ability of obtaining information after training Was statistically different from those before training(P ＜0.01).95% nurses considered that their EBN ability was improved after training. Conclusions The skills of EBN and the ability of obtaining information increased after EBN training in nurses of surgical department.This had instructive significance for the application of evidence-based nureing.

Objective To study the clinical effect of pedicle screw fixation in treatment of unstable upper and middle thoracic vertebrae fractures. Methods A retrospective study was performed on 17 cases of unstable upper and middle thoracic vertebrae fractures treated with vertebral pedicle screw system (GSS 全称in 11 cases and USS 全称in six) fixation, posterolateral bone grafting and fusion from March 2001 on. There were one case of T_3, two T_4, two T_5, four T_6, six T_7 and two T_8. Of all, nine cases were with compression fractures, five with fracture-dislocation and three with burst fractures. Results All cases were followed up for 10-38 months (average 21.1 months). During the follow up, the anterior vertebral body height was restored from preoperative 40% to postoperative 91%. Except for four screw malpositions, there was no postoperative neurologic deterioration, screw loose or breakage of the internal fixation, or loss of the normal spine curve and the spinal height of the injured vertebra. Conclusions Pedicle screw fixation is an effective way for treating unstable upper and middle thoracic vertebrae fractures. Correct placement depend on a comprehensive familiarity of pedicle anatomy, appropriate pedicle diameter and entry point and depth can avoid potential risks in placing pedicle screws into the upper and middle thorax.

Objective To establish gastric bypass surgery model with SD rat and analyze the influence factors and preventive measures so as to accumulate experience and skills for further developing gastric bypass surgery model on diabetic rat( GK rat) . Methods Gastric by-pass surgery was operated on 30 SD rats. Summarized modeling experience and analyzed various factors affecting modeling success. Results 17 rats weresuccessfully survived after surgery and 13 failed, with the mortality rate 43. 3%. Three rats died during operation, including two for anesthesia and one for heart failure;one died due to anastomotic bleeding two hours after surgery. Eight died in the third day after surgery, including two for infection, two for intestinal necrosis, four for anastomotic stenosis or obstruction. One died because of anastomotic leakage caused by mistaking and satiety the fifth day after surgery. There were no other complications such as wound dehiscence occurred in this group . Conclusion Establishing models of gastric bypass surgery with SD rats which is regarded as pre-experiment of building models of gas-tric bypass surgery with GK rats is economical and feasible. Anesthesia and perioperative management, surgical techniques and infection pre-vention and control are the main factors affecting modeling. The survival rate of rat model could be increased if related factors well controlled.

Objective To explore the MRI features of pelvic endometriosis outside the ovary.Methods 13 patients with pelvic endometriosis outside the ovary were imaged.Their clinical and imaging data were reviewed retrospectively.All cases were con-firmed by pathology.An enhanced MR using T1 WI sequence both in sagittal and transverse position was performed after T2 WI fat-suppression sequence and T1 WI sequence.Our MRI study was focused on the distribution of lesions locating in the deep pelvic cavity and abdominal wall,and the features of MRI signals .Results 13 lesions were found,in which 4 lesions located in the rectouterine pouch of Douglas,2 cases the bladder wall,2 cases the unilateral cystic inlet of ureter,1 case the anal canal wall,and 4 cases the ab-dominal wall.10(10/13)lesions were shown as solid nodules while 3(3/13)lesions as cyst-solid ones.All lesions showed moderate-ly heterogeneous enhancement.Conclusion Pelvic endometriosis outside the ovary mainly shows solid or cyst-solid lesions that lo-cates in the urinary,uterus,rectal wall and spaces around them.MR images show a higher value for the detection of the lesions out-side the ovary.

Objective To construct shifting mutant of cysteine-rich region to 3?@terminal of Tat gene of human immunodeficiency virus type-1 (HIV-1) HXB2 strain, and to analyze the immunogenicity of mutant protein (Tat-cct) after prokaryotically expressed and purified. Methods The cysteine-rich region (nucleotides 64--111) of Tat gene was shifted to 3'terminal of Tat of HIV-1 HXB2 strain by polymerase chain reaction (PCR) and Tat mutant DNA sequence was obtained. Prokaryotie express plasmid pET32a-Tat-cct was constructed and transformed into E. coli BL21 (DE3), then Tat-cct protein was expressed and purified. BALB/c mice were immunized with the fusion protein Tat-cct, and immunogenicity of the immunized serum was detected by enzyme-linked immunosorbent assay (ELISA). Results The recombinant plasmid pET32a-Tat-cct expressed in E. coli BL21 (DE3) and the relative molecular mass of the purified fusion protein was 31 000. The serum antibody titer of mice immunized with Tat-cct recombinant protein was 1 : 1600, which binded specifically with both Tat-ect protein and Tat protein (amino acids 1-101). Conclusions The recombinant protein Tat-cct of Tat mutant strain can be expressed efficiently in E. coli and well retains immunogenicity, which provides valuable information for basic research of HIV-1 Tat vaccine.

Objective To evaluate the influence of ultrasound-guided transverse abdominis plane (us-TAP) block on intraoperative and postoperative analgesia at different time points in total abdominal hysterectomy.Methods 46 patients undergoing total hysterectomy under general anesthesia were selected,randomly divided into two groups,group A and group B,with 23 cases in each group.Group A received bilateral us-TAP block after induction of general anesthesia and before operation;Group B received bilateral us-TAP block after operation and before anesthesia recovery.In both groups,the anesthesia was adjusted according to the bispect ral index (BIS) and hemodynamics.Sufentanil was used for patient-controlled intravenous analgesia (PCIA) after operation.The mean blood pressure (MBP),heart rate (HR) at T0(preanesthesia),T1 (skin incision),T2 (postoperation),T3 (tracheal extubation),T4 [leave the post anesthesia care unit (PACU)] in both two groups were recorded.The dosage of anesthetics during operation and the recovery time after operation were recorded.Visual analogue scores (VAS) at 2 h,6 h,12 h and 24 h after operation were observed in the resting and coughing state of the patients in the two groups.The total consumption of analgesics 24-h after surgery and the side effects of nausea and vomiting were recorded.Results MAP and HR in group A were significantly lower than that in group B at T1 (P ＜ 0.05),but there was no statistical difference at other time points (P ＜ 0.05).The dose of sufentanil used in group A was less than that in group B (P ＜ 0.05).The recovery time in group A was shorter than that in group B (P ＜ 0.05).At 2 h,6 h,12 h and 24 h post operation,there was no significant difference at rest and coughing VAS between the two groups (P ＜ 0.05).There was no difference in the consumption of analgesics 24 hours after operation between the two groups (P ＜ 0.05).The incidence of postoperative nausea and vomiting in group A was lower than that in group B (P ＜ 0.05).Conclusions In open hysterectomy,although the analgesic effect of us-TAP blockade before and after operation is not significantly different,preoperative TAP blockade under ultrasound can effectively reduce the amount of intraoperative general anesthetics and accelerate the recovery of patients,effectively reducing the incidence of postoperative nausea and vomiting.