Objective To investigate the effect of pregnant women with hypertensive disorders of COOK cervical dilatation balloon and Dinoprostone Suppositories on the gestation effect and safety of induction.MethodsThe research object from June 2013 to June 2015 in our hospital for pregnant women with hypertensive disorders in pregnancy in 68 cases (all patients with gestational hypertension and mild preeclampsia) were randomLy divided into the observation.Group and control group, 34 cases in each group.The observation group received COOK cervical dilatation balloon induced labor, the control group to implement Dinoprostone Suppositories induction, comparative analysis of observation group and control group, maternal and perinatal situation, mode of delivery, the cervical Bishop score, the degree of pain.Resultsabnormal fetal heart and uterine hyperstimulation, uterine tonic contraction rate of observation group were significantly lower than the control group(P<0.05).The cesarean section rate in the observation group and the control group had no significant difference.After placement, the cervical Bishop score of observation group was significantly higher than that of control group(P<0.05).The pain degree of observation group was significantly lower than that in control group(P<0.05).ConclusionCOOK balloon dilatation of the cervix and Dinoprostone Suppositories, fewer complications, can significantly improve maternal, perinatal and cervical ripening score of Bishop.

Objective To investigate the serum levels of fatty cytokines in hepatitis B patients with liver fibrosis.Methods Fifty six hepatitis B patients with liver fibrosis admitted in Wenzhou Central Hospital from April 2014 to March 2016 were recruited as case group and 65 healthy subjects as control group.Serum cytokines including omentin,leptin,adiponectin and visfatin were detected in both two groups and glutamyl endopeptidase (ALT),aspartate aminotransferase (AST) and hepatitis B virus DNA were detected in the case group.Liver biopsy was performed in the case group and histologic activity (HA) and histologic fibrosis (HF) stage were evaluated.Results The level of omentin in the case group was significantly higher than that in the control group [(358-119) vs.(305 ± 108) μg/L,t =2.236,P =0.037].Serum omentin,visceral fat hormone,leptin and adiponectin were not associated with liver function and HBV-DNA (P ＞0.05).There was no significant difference in adipocytokines levels between the low and high HA group (P ＞ 0.05).The level of omentin in high HF stage group was significantly higher than that in low HF stage group [(398 ± 130) vs.(292 ± 120) μg/L,t =2.648,P =0.009],while the other fatty cytokines did not show significantly differences between high and low HF groups (P ＞ 0.05).Conclusion Serum omentin level is elevated in hepatitis B patients with liver fibrosis and is associated with liver fibrosis severity.

Objective Analysis the clinical data of high-EuroSCORE 114 patients due to ronary surgery to elucidatethe surgical advantages between on-pump and off-pump CABG.Methods From September 2008 to March 2011,114 highEuroSCORE patients due to coronary surgery were randomly divided into off-pump group 48,and on-pump gronp 66 cases.Preoperative,intra-operative and peri-operative clinical data of all the patients were collected.All patients were followed up for 1 month postoperatively.Results The baseline of the two groups had no significant difference.Application of internal mammary artery,positive inotropic drugs and IABP assistance between the two groups were similar,P ＞0.05,Compared with the offpump group,patients in on-pump gnup had longer operation time,hut more graft counts and a higher rate of revascularization [ (3.71±0.55)gnifis vs.(2.82±0.39)grafts ],P ＜ 0.05.There were no significant differences of peri-operative mortality and post-operative complications between the two groups,P ＞0.05.The patients in on-pump group had more post-operative chest drainage in the first 24 hours[ (875.0±134.2)ml vs.(589.4±102.5)ml] and blood transfusion[ (656.3±84.4)ml vs.(433.3±62.9) ml ] compared with the off-pump group,P ＜ 0.05.The data of l-month follow up denonstrated that echocardiographic data,NYHA and symptoms of angina of the two groups had no significant difference,P ＞ 0.05.Conclusion Compared with OPCAB,CCAB did not increase postoperative renal failure,neurological complications and lung injury in highrisk patients,but had more complete revascularization.The disadvantage of CCAB was postoperative bleeding,blood productsuse.

Objective To explore the effect of positive end expiratory pressure (PEEP) on arterial oxygenation and intrapulmonary shunt during one-lung ventilation (OLV) and pulmonary function during perioperation. Methods Forty patients with normal pulmonary function,ASA I - II :scheduled for pulmonary lobectomy, were divided into control group and PEEP group by random digits table with 20 cases each. Patients were induced by double-lumen tubes under intravenous anesthesia and were received 10 ml/kg tidal volume, 12 frequents/min breathing rate during the two-lung ventilation (TLV), secondary reduced to 6 ml/kg tidal volume, 16-18 frequents/min breathing rate without PEEP (control group) or with 5 cm H2O cm H2O =0.098 kPa) PEEP (PEEP group) during OLV.Hemodynamics and respiratory mechanical parameters were continuously monitored, lung function before operation and at 72 h after operation was detected. Results Compared to before OLV,arterial oxygen tension (PaO2), arterial oxygen saturation (SpO2), oxygenation index (OI) were decreased and intrapulmonary shunt ratio (Qs/Qt) was increased in control group and PEEP group at 30 min after OLV (P < 0.01 or < 0.05). However,PaO2 and SpO2 and OI were higher and Qs/Qt was lower in PEEP group than that in control group at the same time point (P<0.05). In addition, FEV1%, FVC% and FEV1/FVC were (121.8 ± 25.0% ,(117.2 ± 24.3)% , (87.6 ± 15.7)%before operation and (84.9 ± 21.6)%, (77.2 ± 18.3)% , (70.5 ± 12.5)% at 72 h after operation respectively in control group, (116.9 ±24.5)% , (112.1 ±23.6)% , (85.3 ± 13.8)% before operation and (96.3 ± 20.4)%, (88.1 ± 19.8)% , (78.4 ± 10.2)% at 72 h after operation respectively in PEEP group. Although decreased in control group and PEEP group at 72 h after operation comparing with preoperation (P< 0.01 or < 0.05 ), FEV1%, FVC% and FEV1/FVC were higher in PEEP group than those in control group at 72 h after operation (P<0.05). Conclusion Appropriate PEEP increases arterial oxygenation,reduces Qs/Qt and improves pulmonary function during OLV,reduces the risk of hypoxernia and lung injury induced by OLV during perioperation.

Objective To observe the mechanism of Siwu Decoction (Decoction of four ingredients) on blood deficiency syndrome.Methods Wistar rats were randomized into 3 groups: model group, treatment group, and normal group, 6 ones in each. Rats of the model group and the treatment group were injected 2% acetylphenylhydrazine (APH) saline subcutaneously on the first, forth and seventh day. From the forth day, the model group was treated with saline by gavage, the treatment group was treated with Siwu Decoction by gavage, and the normal group was treated with saline for 7 days in succession. Then the amount of peripheral blood cells, wet weight of liver and spleen were detected. Liver mitochondrial proteome of all rats were extracted. Proteomic technology was used to measure the regulated proteins by Siwu Decoction.Results In the model group, the rats had decreased general status significantly such as pale, enlarged liver and spleen, lowered red blood cells (RBC) and hemoglobin (HGB), increased white blood cells (WBC) and reticulocyte (RCT) (P

Background and purpose:At present, color Doppler ultrasound scoring and radionuclide imaging are two important imaging methods for diagnosing thyroid nodules, but their checking principle is different. Which method is better? Or combining them will be the best method for diagnosing thyroid nodules? This study aimed to compare the value of99mTcO4- combined with99mTc-methoxyisobutylisonitrile (MIBI) imaging, ultrasound scoring method and ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging in diagnosis of thyroid nodules.Methods:The results of ultrasound scoring method and99mTcO4- combined with99mTc-MIBI imaging were compared in 50 patients with 54 thyroid nodules, and then compared with pathological findings. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the methods were calculated.Results:A total of 54 thyroid nodules were found pathologically including 20 malignant and 34 benign nodules. The sensitivity, specificity, accuracy, PPV and NPV of99mTcO4- combined with99mTc-MIBI imaging were 80.00% (16/20), 70.59% (24/34), 74.07% (40/54), 61.54% (16/26), 85.71% (24/28), re-spectively. Those of ultrasound scoring method were 80.00% (16/20), 88.24% (30/34), 85.16% (46/54), 80.00% (16/20), 88.24% (30/34), respectively. And those of ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging were 100.00% (20/20), 64.71% (22/34), 77.78% (42/54), 62.50% (20/32), 100.00% (22/22), respectively. The sensitivity of ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging was higher than ultrasound scoring method or99mTcO4-+99mTc-MIBI imaging along (100.00%vs 80.00%, 100.00%vs 80.00%,χ2 value was 4.444 4 and 4.444 4,P value was 0.035 0 and 0.035 0, respectively). The specificity of ultrasound scoring method was higher than those of two methods combined together (88.24%vs 64.71%,χ2 value was 5.230 8,P value was 0.022 2). However, no factorial negative thyroid nodule was found by ul-trasound scoring method+99mTcO4-+99mTc-MIBI imaging.Conclusion:Ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging can offer comprehensive diagnosis of thyroid nodules from their structure and function to avoid missed diagnosis.

Objective To study cinical features of patients with idopathic submitral left ventricular aneurysm(ISLVA) and evaluate their global and segmental systolic function as well as diastolic function through echocardiography.Methods Clinical features of eight patients with ISLVA were analysed retrospectively.Standard 2-dimentional and real-time 3-dimentional echocardiography were performed in all the eight cases and other twenty subjects with normal left ventricular(LV) function (defined as control group).Results Two patients were diagnosed as ISLVA due to ventricular arrythmia and the other six case sowing to congestive heart failure.Coronary angiography was normal in all patients.Apical systolic murmur was audible in 6 cases.Four patients received mitral valve surgical repair,one underwent aneurysm resection and radiofrequency ablation,implantable cardioverter defibrillator was implanted in one case,one was only treated by medication.One case died.Patients with ISLVA demonstrated significanly larger left atrium(LA) and LV diameter (both end-diastolic and end systolic),thinner LV posterior wall,and lower LV ejection fraction (LVEF) than controls (P ＜0.05).Indexes of the LV 17 segments time-volume curves including the time to minimal systolic volume(Tmsv) 16-SD,Tmsv 12 SD,Tmsv 6-SD,Tmsv 16-Dif,Tmsv 12-Dif,Tmsv 6-Dif,Tmsv 16-SD％,Tmsv 12-SD％,Tmsv 6-SD％,Tmsv 16-Dif％,Tmsv 12-Dif％,Tmsv 6-Dif％ were significantly higher in patients with ISLVA than those in controls(all P ＜0.05).All patients with ISLVA showed mitral regurgitation and decreased LV diastolic function in varying degrees,five patients accompanied by elevated LA pressure.Conclusions Clinical features of patients with ISLVA are nonspecific.Echocardiography can evaluate systematically their functional and structural abnormalities.

Objective To explore the clinical effect of anteromedial thigh perforator flap for repairing soft tissue defect in lower extremity.Methods From January 2009 to December 2012,12 patients with soft tissue defect of lower extremity were treated with free anteromedial thigh perforator flap.Among them,there were 5 cases of wound in front of tibia,4 cases of dorsal foot wound,3 cases of heel wound;the wound size was 3.0 cm ×3.5 cm-7.0 cm × 9.5 cm;3 cases were repaired with free perforator flap of descending genicular artery,2 cases with free anteromedial thigh perforator flap,and 7 cases with medial vastus muscle perforator flap.Results All the transplants survived.Among them,1 case of anteromedial thigh perforator flap and 1 case of descending genicular artery perforator flap appeared vascular crisis postoperative.After anticoagulation and antispasmodic treatment aggressively,the flaps survived.One case of descending genicular artery perforator flap necrosis in edge,and then were cured by changing dressing.Twelve cases were followed up 6-12 months after operation (average 8.6 months),and the texture of flaps were good,the appearance appropriate ;7 sensation of 5 free flaps after nerve anastomosis came back to S; the donor sites in all cases were sutured directly and healed,leaving only the linear scar,and no effect on function.Conclusion The anatomy of anteromedial thigh perforator flap is constant,and the operation is convenient.The clinical result of repairing soft tissue defect of lower extremity is satisfying.

BACKGROUND:Foreign studies have found that the magnesium alloy stent is safe and effective, but there are few studies on the degradation performance of magnesium alloy stents in China.OBJECTIVE:To investigate the degradation of degradable AZ31 magnesium alloy stent in the rabbit abdominal aorta and the effect of degradation process on vascularization.METHODS:Twenty-eight rabbits were enrolled, and the degradable AZ31 magnesium alloy stent was implanted into the rabbit abdominal aorta. Postoperative abdominal aortic X-ray examination and histological observation were done at 30, 60, 90, 120 days after implantation.RESULTS AND CONCLUSION:(1) X-ray examination: 30 days after implantation, the stent expanded completely with structural integrity; 60 days after implantation, the stent deformation, partial stent fracture, and lose of support were found; 90 days after implantation, only a small amount of support rod residues were found, and the majority of the stent was degraded; and 120 days after implantation, there was no support rod residual, and the stent was degraded completely. (2) Histological observation: 60 days after implantation, the number of residual support rods was less than that 30 days after implantation (P< 0.05), the number value at 90 days after implantation was lower than that at 30 and 60 days after implantation (P< 0.05), and the number value at 120 days after implantation was lower than that at 30, 60, 90 days after implantation (P < 0.05), indicating that the number of residual support rods was negatively correlated with post-implantation days. The time for complete stent degradation was 124.8 days. The intimal area at 90 days after implantation was higher than that at 30, 60, 120 days after implantation (P < 0.05), while the lumen area was smaler than that at 30, 60, 120 days after implantation (P < 0.05). There was no significant difference in the intimal area and lumen area at latter three time points after implantation. To conclude, the degradation of the degradable AZ31 magnesium alloy stent in the rabbit abdominal aorta can be completed within 124.8 days, and at 90 days after the stent is implanted, vascular intimal hyperplasia and lumen stenosis are most serious, and then gradualy reduced.

To identify adulterants from medicinal plants of Bletilla H. G. Reichenbach, the suitable candidate DNA barcoding of Bletilla was evaluated. In this study, the internal transcribed spacer (ITS) of nuclear ribosomal DNA, the LFY homologous gene intron 2 and chloroplast ycfl gene were amplified and sequenced from forty-one samples. The intra-specific and inter-specific divergences of Bletilla were calculated, and the identification efficiency was assessed using Barcoding Gap, NJ tree by K2P distance and BLAST1 method. The result showed the intra-specific divergence of nrDNA ITS and ycJfl (0.022-0.106 and 0.017-0.106) were obviously higher than the inter-specific divergence (0-0.012 and 0-0.015), and four species of Bletilla were also accurately distinguished in NJ trees. Whereas, there was no Barcoding Gap on LFY homologous gene intron 2, thus it cannot effectively identify species of Bletilla. Using NJ tree of nrDNA ITS and ycfl gene, powdery medicine and the adulterants of Bletilla were successfully unidentified. In conclusion, nrDNA ITS and ycfl can be used as a potential DNA barcoding to identify the medicinal plants in Bletilla and its adulterants. There were only three basic differences on nrDNA ITS between "Jujing baiji" and Bletilla striata of Lu'an in Anhui province, and two basic differences in ycfl. Based on morphological and molecular data, "Jujing baiji" could be recognized as the species of Bletilla striata.