Objective: To investigate the effect of epidural block analgesia on childbirth, mother and child. Methods: A retro-spective study was used. Totally 200 primipara were divided into two groups according to the analgesia method. The 100 cases in the observation group was undergone lumbar epidural puncture and cathetering at the 2-3 section when the cervix was with 2-3cm opening, 0. 075% ropivacaine hydrochloride and sufentanil 10ml was infused firstly, and then 0. 075% ropivacaine and sufentanil was infused continuously through a self-control analgesia pump at the speed of 6-8ml·h-1 till the cervix was nearly all opened. The other 100 cases in the control group were without anesthesia when the cervix was with 2-3cm opening. The analgesia effect, labor time, delivery mode, postpartum hemorrhage amount, fetal distress and postpartum hemorrhage of the two groups were compared. Results:The analgesic ef-fective rate of the observation group was 97. 0%, which was significantly higher than that of the control group (10. 0%, P<0. 05). The first stage of birth process in the observation group was significantly shorter than that in the control group (P<0. 05), and the va-ginal delivery rate was significantly lower than that in the control group (P<0. 05). The incidence of neonatal asphyxia, 1min Apgar score, 24-hour postpartum hemorrhage amount and bleeding rate showed no statistically significant difference between the two groups (P>0. 05). Conclusion:Ropivacaine at low concentration combined with sufentanil used in epidural block analgesia has promising analgesic effect, which can shorten labor time to promote the smooth delivery.

Objective To observe the long term results of intertrochanteric varus medial displacement osteotomy(IVMDO) for Perthes disease. Methods Thirty eight patients with Perthes disease treated with IVMDO were reviewed. The results were evaluated based on a criteria made by the authors including clinical and radiographic parameters. The duration of follow up ranged from 3 to 15 years, with an average of 7 years. Results Fifteen patients were evaluated as having excellent result, 17 good, 3 fair and 3 poor respectively. The overall excellent or good rate was 84.2%. Considering the relationship between the outcome and staging of the disease, the overall excellent or good rate was 94.7% in stage Ⅱ lesion, 85.7%in stage Ⅲ lesion, and 40.0% in stage Ⅳ lesion. Conclusion The treatment of Perthes disease with IVMDO has the advantages of simple manipulation, less trauma and good results, and is worthy of populariztion.

ObjectiveTo explore the imaging characteristics and the clinical and pathological diagnosis of gliomatosis cerebri in order to raise the awareness of the disease.MethodsThe images of 26 patients with gliomatosis cerebri were analyzed retrospectively.ResultsEight patients were treated with partial excision and 18 patients got stereotactic biopsy.The radiography examination included the plain and enhanced scan of CT and MRI.Twelve patients received 1H magnetic resonance spectroscopy (MRS).The disease in all the patients involved at least two cerebral lobes.There were 22 cases whose CT and MRI manifestations showed that there were large-sheet symmetry low-density image in brain and slightly long T1 and long T2 abnormal signals.And the enhanced scan showed that 20 cases had no obvious enhancement,2 cases had slight enhancement.There were 4 cases with large-sheet asymmetry lesions and no enhancement in enhanced scan.1H MRS examination of 12 cases showed that choline( CHO )/creatine(Cr) and CHO/N-acetyl aspartic acid (NAA) increased,NAA/Cr decreased with different degree,and 8 patients had lactate peak.ConclusionsMRI is the first choice to diagnose gliomatosis cerebri.1H MRS is very helpful for the diagnosis and pathological classification of the disease.MRI combined with biopsy can give out a definite diagnosis.

Teaching in the course of anesthesiology for college students not majoring in anesthesiology was reformed and optimized by inducing various approaches such as development of interest,heuristic teaching,multimedia teaching,clinical simulation teaching and anesthesia experience in the First Affiliated Hospital,Sun Yat-sen University.Students' fundamental knowledge of clinical anesthesiology and abilities of clinical thinking and active learning were improved.Based on the summary of teaching practice,teachers should cultivate students' interest in anesthesiology,emphasize interactive teaching and learning and take fundamental knowledge of clinical anesthesiology as main teaching objectives in the clinical practice course of anesthesiology.

Objective To evaluate the feasibility and efficiency of laparoscopic-guided radiofrequency ablation on advanced prostate cancer.Methods From March 2003 to December 2008,a total of 6 previous prostate cancer patients who had been diagnosed with pathological results were treated by laparoscopic-guided radiofrequency ablation.All patients underwent pre-and post-operative IPSS,serum PSA,MRI and normal blood biochemistry examination.The treatment outcome,surgery-related complications were also recorded.Results All operations were successfully completed,no serious intra-and post-operative complications happened.Although there was no significant difference of IPSS between pre-operative [ ( 19.05 + 4.28 ) scores ] and 1 month after operation [ ( 19.87 + 5.72) scores ],but there were significantly decreased in 3 months [ (9.45 ± 2.03 ) scores ] and 6 months [ (6.18 + 1.79) scores ] after operation (P ＜0.05).Also being followed up to 6 months after operation,the serum PSA was significantly decreased compared with the pre-operative value [from(24.80 ± 14.56) μ g/L reduced to( 13.79 ± 7.76) μ g/L](P＜0.05).Conclusion Laparoscopic-guided radiofrequency ablation on advanced prostate cancer is safe and feasible,and can be used as an effective treatment in selective cases.

Objective T0 investigate the effects of transforming growth factorβ1 ( TGFβ1 ) and its receptorβ2 (TGFβR2) gene single nucleotide polymorphisms on the risk of intracranial hemorrhage in patients with brain arteriovenous malformation (BAVM).Methods Fifty-three BAVM patients of both sexes aged 18-64 yr who were genetically unrelated native HAN of Guangdong province were divided into 2 groups:patients with and without intracranial hemorrhage ( n =30:23).Venous blood samples were collected and anti-coagulated with ethylene diaminetetraacetic acid for genomic DNA extraction.TGFβ1-509C/T (rs1800469) and TGFβR2 875A/G (rs3087465) gene SNPs were genotyped by using PCR-RFLP.Results There were no significant differences in genotype and frequency between the 2 groups.The G carrier frequency of the TGFβR2 genotype was significantly higher in patients with intracranial hemorrhage than in patients without intracranial hemonrhage.The G carrier of the TGFβR2 genotype was associated with intrarcranial hemorrhage in patients with BAVM.Conclusion TGFβ1 gene polymorphism is not relevant to the intracranial hemorrhage in patients with BAVM,but polymorphisms of TGFβR2 could be a risk factor.

Objective To assess the analytical performance of hs-cTnT and biological variations in healthy population as well as establish hs-cTnT reference intervals. Methods The serum samples from 100 acute myocardial infraction patients and 474 apparently healthy subjects were collected. The functional sensitivity,within- and between-run imprecision were determined. The hs-cTnT assay and con-cTnT assay were evaluated. The serum hs-cTnT levels were detected in apparently healthy subjects to establish reference intervals. Moreover,the long-term and short-term biological variations for hs-cTnT in healthy volunteers were assessed. Results The functional sensitivity of hs-cTnT was 0. 005 μg/L. The within- and between-run precision for lower level control(0. 014 μg/L) and higher level control(2. 500 μg/L) was 2. 97% vs 3. 64%and 0. 66% vs 1.01% ,respectively. The correlation between hs-cTnT assay and con-cTnT assay was good ( R2 =0. 972 ,P ＜0. 01 ). The 99th percentile in apparently healthy subjects was 0. 003 μg/L for women less than60 years, 0.008 μg/L for men less than 60 years, 0.015 μg/L for women above 60 years and 0. 021 μg/L for men above 60 years. The CVa, CVi, CVg and CVt of short-term biological variations in detecting hs-cTnT from 22 apparently healthy subjects were 3.8%, 4. 8%, 49.9% and 58.5%,respectively. The CVa,CVi ,CVg and CVt of long-term biological variations were 5. 3% ,6. 4% ,56. 6% and 68. 3% respectively. Conclusions The analytical performance of the hs-cTnT is better than con-cTnT assay,achieving acceptable level according to guideline. Our experimental result could provide the basis for the new high sensitivity cTnT assay in the diagnosis of acute myocardial infarction.

Objective To investigate the effects of propofol on brain injury induced by intestinal ischemia-reperfusion (I/R) in rats.Methods Forty-eight adult male Sprague-Dawley rats,weighing 250-300 g,were randomly allocated to one of 3 groups (n =16 each) using a random number table:sham operation group (group Sham),I/R group,and propofol group (group P).Intestinal I/R was produced by occlusion of the superior mesenteric artery for 90 min followed by reperfusion.In group P,propofol 50 mg/kg was injected intraperitoneally at 30 min before reperfusion,and the equal volume of fat emulsion was given in the other two groups.Blood samples were collected at 24 h of reperfusion for determination of serum tumor necrosis factor-alpha (TNF-α) and interleukin-1beta (IL-1β) concentrations.The cerebral cortex and hippocampus were isolated for measurement of TNF-α and IL-1β mRNA expression (by real-time reverse transcriptase-polymerase chain reaction) and myeloperoxidase (MPO) activity (using colorimetric method).Morris water maze test was carried out at 1,3 and 5 days of reperfusion.Results Compared with group Sham,the serum TNF-α and IL-1β concentrations were significantly increased,the expression of TNF-o and IL-1β mRNA in the cerebral cortex and hippocampus was up-regulated,the MPO activity was increased,and the escape latency was prolonged,and the frequency of crossing the original platform was decreased during reperfusion in group I/R (P＜0.05).In group I/R,the concentrations of serum TNF-αand IL-1β were significantly decreased,thc cxpression of TNF-α and IL-1β mRNA in the cerebral cortex and hippocampus was down-regulated,and the escape latency was shortened,and the frequency of crossing the original platform was increased during reperfusion (P＜0.05),and no significant change was found in MPO activity in group P (P＞0.05).Conclusion Propofol reduces brain injury induced by intestinal I/R through inhibiting systemic and local inflammatory responses in rats.

Objective To investigate the changes of QT dispersion and heart rate variability in children with ventricular contraction. Methods 50 healthy children who came for medical examinations at Chengdu Women′s and Children′s Central Hospital from January 2012 to January 2014 were selected as control group. 147 children with ventricular contraction admitted in Pediatric Intracardiac Department of Chengdu Women′s and Children′s Central Hospital from January 2012 to January 2014 were divided them into Benign Group (LownⅠ&LownⅡ) and Malignant Group(LownⅢ, LownⅣA, LownⅣB&LownⅤ) according to the results of Lown classification. Benign Group contained 90 cases while Malignant Group contained 57 cases. Difference in QT dispersion and indices of heart rate variability of the three groups were compared. Results There were no statistically differences between control group and benign group in QT dispersion (P > 0.05). QT dispersion of malignant group was much longer than that of control group and the differences had statistically meaning(P<0.001). SDNN(standard deviation of NN intervals) , SDANN (standard deviation of the averages of RR intervals ), SDNN index (index of standard deviation of the averages of NN intervals), rMSSD(root mean square of successive differences) and PNN50(percentage of successive normal sinus RR intervals>50 ms) of malignant group was much shorter than that of control group and benign group and the differences had statistically meaning (P< 0.01). SDNN, SDANN and SDNN index of benign group was shorter than that of control group and the differences had statistically meaning (P<0.05). Conclusions Heart rate variability of children with malignant ventricular contraction becomes significantly shorter and QT dispersion becomes significantly longer. Detection of QT dispersion and heart rate variability can effectively predict the risky degree of ventricular contraction in children.

Objective To evaluate the performance of serum small dense low-density lipoprotein cholesterol(sdLDL-C)kit using enzymic method and evaluate the relationship with the severity of coronary heart disease.Methods Performance verification methodology. The analytical performance consisted of accuracy, precision and linearity of serum sdLDL-C kit using enzymic method was assessed. One hundred and twenty healthy persons were recruited to establish serum sdLDL-C reference interval. Two hundred and twelve patients underwent coronary angiography were enrolled in the study.Among them 110 cases were positive for coronary angiography, where as 102 cases were negative. We examined serum levels of sdLDL-C in 110 patients with positive angiography, 102 patients with negative angiography and 120 healthy volunteers. Positive group was classfied into severe group(Gensini score>30) and mild group (Gensini score≤30).Results The accuracy and precision of sdLDL-C examination were in compliance with manufacturer′s statement and there was a good linear correlation(Y=0.9937X-0.1063,R2=0.99) in range of 0.06-2.45 mmol/L. The reference interval of sdLDL-C was 0.15-0.97 mmol/L and without gender and age specificity. The level of sdLDL-C was higher in positive angiography group than in negative angiography group and healthy control group(P<0.01). The level of sdLDL-C was higher in severe group than in mild group(P<0.05). Binary stepwise regression analysis demonstrated that sdLDL-C was independently associated with the severity of coronary heart disease(OR=3.101,P<0.05).ConclusionsExperiment data demonstrated that serum sdLDL-C kit using enzymic method has good performance in the accuracy, precision and linearity. SdLDL-C that plays an important role in the occurrence and progression of coronary heart disease, is an independent important risk of the severity of coronary heart disease.