Objective To investigate the efficacy of intermittent epidural bolus ( IEB) for patient?controlled epidural analgesia ( PCEA) during delivery. Methods Eighty?five parturients requesting epi?dural analgesia, who were at full term ( 37-42 weeks of gestation) with a singleton fetus in vertex presenta?tion, of American Society of Anesthesiologists physical statusⅠorⅡ, with body mass index< 35 kg∕m2 , were divided into either IEB group ( n=42) or continuous epidural infusion ( CEI) group ( n=43) using a random number table. The analgesia solution contained 0.08% ropivacaine and 0.4μg∕ml sufentanil in both groups . IEB settings were a 6 ml bolus every hour at the rate of 400 ml∕h with a bolus dose 6 ml and lockout interval 30 min. CEI settings were background infusion 6 ml∕h with a bolus dose 6 ml and lockout interval 30 min. Numeric rating scale score was maintained≤5, and if the efficacy was not satisfactory, a bolus of pump solution 5-10 ml was added. The consumption of analgesics per hour, initial PCA time, and occur?rence of lower extremity numbness, motor block, nausea and vomiting, and pruritus were recorded. Pa?tients′satisfaction with analgesia was scored, and the duration of labor and mode of delivery were recorded. Results Compared with group CEI, the initial PCA time was significantly prolonged, the satisfaction score was significantly increased, the incidence of lower extremity numbness was significantly decreased ( P<0.05) , and no significant change was found in the consumption of analgesics per hour, incidence of motor block, nausea and vomiting, and pruritus, constituent ratio of mode of delivery, and duration of la?bor in group IEB ( P>0.05) . Conclusion IEB can be safely and effectively used for PCEA during deliver?y, and the efficacy is better than that of CEI in the parturients.

BACKGROUND:The Coflex is widely used in China, but it has a high complication rate of spinous process fracture. OBJECTIVE:With the help of finite element analysis, to verify if rigid restriction of spinous process contacts in modified Coflex design is semi-rigid restriction so as to reduce the stress of spinous process in spine flexion and extension, lateral bending and rotation and to decrease the risk of spinous process fracture. METHODS:The images were extracted from patients who had undergone abdomen CT scans in the Beijing Chaoyang Hospital affiliated to Capital Medical University. Three-dimensional finite element model of lumbar spine was established. The Coflex model and the corresponding modified Coflex model were established and then simplified in the SolidWorks software of CAD. Tensile force, shearing force and axial rotating force in resting state were analyzed in ANSYS software. RESULTS AND CONCLUSION:Under tensile force, transversal shearing force and axial rotating force, compared with Coflex system, the stress of spinous process model was reduced in the modified system (P < 0.01). These findings indicate that the forces of the modified model are superior to the force of Coflex. It can reduce stress in the spinous process under stresses and diminish the occurrence of spinous process fractures.

Objective To study the relationship of expression of central cortex glucocorticoid receptor (GR) at protein level with GR expression in the liver at protein level and with changes of serum cortisol and adrenocorticotropic hormone (ACTH) following severe closed traumatic brain injury (TBI) in mice. Methods Severe TBI was established in awake mice by using a BIM-Ⅲ biomechanical machine. At 0.5, 2, 8, 24, 48 and 72 hours after TBI, the total cytosolic GR in the cortex and liver were detected with Western blotting. Levels of serum ACTH and cortisol were measured by ELISA technique and radio-immunological assay (RIA) respectively. Results The expression of GR both in the cortex and liver were obviously down-regulated at protein levels at 2-72 hours after TBI and increased slowly eight hours after injury. The GR in the liver showed no recovery at 72 hours after injury and that in the cortex was decreased continually at 24 hours after injury. Serum ACTH and cortisol levels were increased markedly compared with control group, when there were two different peaks in the observation curve.Conclusion There is glucocorticoid resistance both in the central and peripheral tissues after severe closed TBI in the awake mice, which changes in a time-dependent manner.

Objective To investigate the expression levels of Ezrin and AnnexinⅡ in gallbladder carci-noma and their association with clinicopathologic parameters and metastasis potential. Methods The tissue mi-croarray consisted of 59 gallbladder carcinoma tissues and 6 normal gallbladder tissues were examined for the ex-pression of Ezrin and AnnexinⅡusing immunohistochemistry technique. The expression of Ezrin and AnnexinⅡin 20 cases of fresh gallbladder carcinoma and 6 cases of normal gallbladder were measured with western blot. Results The expression of Ezrin and AnnexinⅡ were higher in the gallbladder cancer than those in the normal gallbladder tissue. The positive rate of Ezrin and AnnexinⅡ were 47.5% and 50.8% respectively. The expression of Ezrin was significantly correlated with live metastasis , lymph node metastasis and Nevin stages. The expression of AnnexinⅡwas significantly correlated with live metastasis , differentiation levels and Nevin stages. The expres-sion of Ezrin was correlated with AnnexinⅡ. Results of western blot suggested that Ezrin and Annexin II were highly expressed in gallbladder carcinoma tissues. The high expression of Ezrin and Annexin is closely related with liver invasion. Conclusion Measurement of the expression of Annexin and Ezrin II have important clinical significances to evaluate the malignant biological behavior of gallbladder carcinoma.

OBJECTIVE:To establish a RP-HPLC method for the determination of glycyrrhizic acid in sulfonamideglycyrrhiza mixture METHODS:Lichrosorb RPC18 analytical column was used The mobile phase was composed of methanol-(CH)4NH4OH(65∶35) The pH of the mobile phase was adjusted to 6 5 with 10% phosphoric acid Detection wavelength was 254nm RESULTS:Linearity was good in the range of 0 5～50?g/ml(r=0 9 996);the average recovery was 99 75%,RSD=1 87% CONCLUSION:The method is simple and convenient

Atopic dermatitis (AD) is closely related to many systemic diseases, such as other allergic diseases, autoimmune diseases, infectious diseases, cardiovascular diseases and mental disorders, and the underlying mechanism is very complex. AD is considered to be a starting point of the allergy march, and affects the occurrence of various allergic diseases such as food allergies, allergic rhinitis and allergic asthma. AD is associated with the occurrence of many autoimmune diseases, decreased incidence of some malignant tumors and low serum levels of vitamin D. AD is not only a potential risk factor for multiple organ infections and osteoporosis, but also increases the risk of cardiovascular diseases, nephrotic syndrome, and skin dryness. In addition, mental disorders such as anxiety and depression are also common complications of AD. To recognize and investigate into the associations between AD and systemic diseases is of great significance for improving the prognosis and quality of life of AD patients.

The paper described practices in QC management pathway of death cases of the hospital.These refer to intensive education,clarification of access standard,death cases quarterly readings and administrative investigation,strict supervision among others.Authors pointed out that QC pathway can improve quality of care significantly,yet QC pathway calls for fair accountability,systemic care for patient safety,and all-staff involvement in QC improvement.

To establish a pig kidney cell line LLC-PK1/BCRP in which human breast cancer resistance protein was highly expressed, the expression vector pcDNA3.1(+)-BCRP which contained BCRP gene was constructed and transfected into LLC-PKI cells via liposomes. After selecting with G418, population doubling time, flow cytometry and Western blotting analysis were used to evaluate the cell line. MTT assays were employed to determine the drug resistance index of mitoxantrone and doxorubicin. Invert fluorescent microscope was used to observe the efflux of fluorescence dye Hoechst 33342 by BCRP, furthermore, the BCRP's inhibitor GF120918 was applied to reverse the efflux of Hoechst 33342. The experiment results showed that the expression of BCRP protein increased in LLC-PK1/BCRP cell. The population doubling time of LLC-PK1/BCRP cell was a little longer than that of the parental cell LLC-PK1. The resistance indexes to mitoxantrone and doxorubicin were 51.95 and 6.09 times, respectively, higher than LLC-PK1 cell. The efflux of Hoechst 33342 was significantly enhanced and could be reversed by GF120918. So a LLC-PK1/BCRP cell line was established, which highly expressed BCRP protein successfully. This cell line could be a valuable model to further investigate the biological profile of BCRP and select the substrate and inhibitor of BCRP.

Objective To investigate the significance of total bilirubin/albumin in predicting bilirubin neurotoxicity.Methods Eighty-three cases with hyperbilirubinemia who treated from May 2007 to August 2010 were selected,the serum total bilirubin and albumin were detected and total bilirubin/albumin was calculated.According to brainstem auditory evoked potential(BAEP)results,the patients were divided into normal BAEP group and abnormal BAEP group and compared.Results There were 27 cases of abnormal BAEP group and 56 cases of normal BAEP group.Total bilirubin and total bilirubin/albumin in abnormal BAEP group were higher than those in normal BAEP group[(356.50±59.23)μmol/L vs.(318.70±55.12)μmol/L,(5.02±0.49)×10-3 vs.(4.56±0.43)×10-3],the differences were significant (P<0.05).Multiple regression analysis showed:abnormal BAEP was closely related to total bilirubin/albumin(r=0.72,P<0.05),whih abnormal BAEP was not obviously related to total bilirubin(r=0.19,P>0.05).Conclusion Total bilirubin/albumin can reflect serum unconjugated bilirubin level of neonatus with hyperbilirubinemia better than total bilirubin,and it can can be taken as one index to evaluate the risk factors of bilirubin neurotoxicity.

Objective To evaluate and explore the Patients with acute cerebral infarction P-selectin and C-reactive protein (CRP) clinical significance.Methods According to the degree of neurological deficit scores were divided into light group (38 cases),medium group (35 cases) and severe group (25 cases),30healthy subjects were selected as the control group,measured at different time levels of P-selectin and CRP.Results Light group,medium group,severe group admitted 24 h P-selectin levels were higher,the difference was statistically significant (P ＜ 0.05).Light group,medium group,severe group admission decreased after 3 d P-selectin levels were highest; mild group admitted 24 h,7 d P-selectin levels and medium-sized group and severe group differences were statistically significant (P ＜ 0.05).Light group,medium group,severe group admission 3 d P-selectin levels were statistically significant differences (P ＜ 0.05) among the three groups.Light group,medium group admitted 14 d P-selectin levels and heavy group differences were statistically significant (P ＜ 0.05).Light group,medium group,severe group admitted 24 h CRP levels were higher,the difference was statistically significant (P ＜ 0.05).Light group,medium group,severe group admitted 24 h,3 d,7 d,14 d CRP levels decreased,comparing the differences among the three groups were statistically significant (P ＜ 0.05) at the same time point.Linear correlation analysis showed that P-selectin hormone levels and CRP levels were positively correlated (r =0.493,P ＜ 0.05).Conclusions Serum P-selectin and C reactive protein may be involved in the pathological process of ACI.The changes of serum P-selectin and C reactive protein levels were contributed to judge severity of pathological changes,focus range and prognosis assessment.It is an important biochemical observational indicator,and it's worthy recommending in clinic.