Objective To observe the influence of combined spinal and epidural anesthesia( CSEA) of different po-sitions on the anesthesia effect, anesthesia operation and hemodynamic index during cesarean section of obese par-turients. Methods Eighty obese parturients[BMI≥30] undergoing cesarean section were randomly divided into two groups, that was group A and B, with 40 cases each. In group A, the parturients were required to undergo lat-eral decubitus position with 0.5% ropivacaine hydrochloride of 2. 4 ml. In group B, the parturients were required to undergo sitting position with the same ropivacaine hydrochloride as group A. The following data was recorded, which were the percentage of one-attempt's successful epidural needle placement, the anesthesia level,the anesthe-sia effect and the hemodynamic change. All the complications were also observed,such as the supine hypotension syndrome during operation,headache after spinal anesthesia and postoperative spinal nerve stimulation. ResultsThe difference of anesthetic effect between the two groups was insignificant in statistics while group B's rate of one-attempt successful puncture was higher than gruop A ( P <0.05 ) . The difference of hemodynamic index between them was significant in statistics ( P<0.05 ) with group B's rate of supine hypotension syndrome lower than group A. Conclusion Both body positions have the same anesthtic effect for obese parturients during cesarean section while the puncture operation of sitting positon is easier than lateral decubitus position and the hemodynamic change is also more stable.

[Objective]To discuss the surgical technique and clinical effects of open reduction and internal fixation with T style plate in the treatment of Die-punch fracture of distal radius.[Method]From August 2003 to October 2007,twenty-nine patients diagnosed as Die-punch fracture according to X-ray and computerized tomography were treated with open reduction through volar approach and internal fixation with T style plate and bone-grafts to support the articular surface of impacted fractures.There were 20 males and 9 females,with an average of 40.5 years(range 19-62 years).The fractures were caused by falling(n=23),traffic(n=4) and by athletics(n=2).There were 6 cases of open fracture.Eighteen cases were in the right wrist,and 11 in the left wrist.The displacement of articulatzons was from 1.5 to 3.5 mm.[Result]Twenty-six patients were followedup for 9 to 45 months,with an average of 28 months.Posteroanterior and lateral radiographs were taken periodically and fracture healing occurred all within 12 weeks.According to ADL standard and radiographs,21 cases were excellent(ADL scores:38-40),3 cases were good(scores:35-37).The excellent to good rate was 92.3%.No infection occurred.[Conclusion]Open reduction and internal fixation can help restore the smoothness of the articular surface and reduce the incidence of traumatic osteoarthritis.It is effective against the Die-punch fractures of distal radius.

BACKGROUND: The inheritance tendency and immunity imbalance of atherosclerotic brain infarction (ABI) have attracted the attention of many scholars at home and abroad, which suggests that immune mechanism plays a key role in ABI development. It has been found that ABI is related to polymorphism of human immune inheritance gene (HLA), particularly HLA-DR gene.OBJECTIVE: To investigate the correlation between HLA and ABI immune heredity.DESIGN: Single sample and single factor analysis.SETTING: Sino-Japanese Friendship Hospital of Jilin University; Neurological Department of the First Hospital of Harbin City.PARTICIPANTS: Totally 31 patients in experimental group and 30 healthy people in control group, whose three generations were of the Han Nationality in north China and who had no blood relation, were selected from Department of Neurology in First Hospital of Harbin between January 1998 and December 2000.METHODS: The experiment was conducted in the Blood Research Center of Department of Neurology in First Hospital of Harbin between June and December 2003.5 mL peripheral blood in both groups was taken to extract genome DNA with the previous method. Human HLA gene map had been described at gene bank in the Internet, in which mono-nucleic acid obtained from HLA of the sixth chromosome were retrieved. Each DR and DQ allele, sense primer and antisense primer were composed selectively. Amplification of DNA fragment was checked respectively and specifically. The primer was provided by Shanghai Gene Research Institute. PCR instrument (4 800) and its related reagents produced by PE Company (the US) were used. Fourfold table exact probability method was used to calculate the relative risk (RR) and P value.which was obviously higher than that of other sites (P ＜ 0.05). However,associated with the ABI susceptible gene of the Han Nationality in north China.

Objective To study the effects ofautologous bone marrow mononuclear cells (BMMCs)transplantation during coronary artery bypass gafting (CABG) on myocardial infarct size. Methods Forty myocardial infarction patients diagnosed by coronary angiography (CAG) and SPECT and confirmed at surgery were enrolled and randomly assigned CABG alone (group Ⅰ) or CABG with intramyocardial or intracoronary injection of autologous BMMCs (group Ⅱ), 20 cases in each group. Baseline and followed up evaluations included SPECT and NYHA-FC before and after 6 months operation, recorded the major adverse cardiac events (MACE) at the same time. The number of autologous BMMCs injected was (6.84 ± 2.88) ×107 in group Ⅱ. Results There was no procedure-related complication during 6 months followed up in all patients. After 6 months operation,left ventricular ejection fraction in group Ⅱ was significantly higher than that in group Ⅰ [(57.40 ±5.21)% vs. (50.75 ±5.88)%,t =3.79,P＜0.05],NYHA-FC in group Ⅱ was significantly improved than that in group Ⅰ [(1.30 ± 0.47) grades vs. (1.85 ± 0.59) grades, t = 3.27, P ＜0.05],SPECT showed myocardial infarct size in group Ⅱ was significantly lower than that in group Ⅰ[(14.57 ±5.20)% vs. (20.45 ±5.18)% ,P ＜0.05]. Conclusion Autologous BMMCs transplantation during CABG is safe and feasible, which can reduce the myocardial infarct size in patients with myocardial infarction.

ObjectiveTo observe the effect of Qishen Tongluo Zengzhi decoction on cognitive impairment in patients with acute phase of ischemic stroke.Methods A prospective randomized controlled trial was conducted, and 130 patients with acute phase of ischemic stroke and cognitive impairment accompanied by Qi deficiency and blood stasis and stagnationof phlegm-dampness syndrome admitted into the Neurology and Rehabilitation Departments of Rizhao Hospital of Traditional Chinese Medicine(TCM) Affiliated to Shandong University of TCM were randomly divided into treatment group and control group, 65 cases in each group. In the two groups, conventional internal treatment was given to all patients, and in the treatment group, additionally the Qishen Tongluo Zengzhi decoction was administered orally(composition: astragalus membranaceus 30 g, radix pseudostellariae 30 g, notoginseng 10 g,spatholobus stem 25 g, hirudo 3 g, pberetima 10 g, radix paeoniae rubra 12 g, Chinese angelica 12 g, peach kernel 10 g, carthamus tinctorious 10 g, achyranthes 12 g, radix rhapontici 10 g, rhizoma alismatis 6 g, Acorus gramineus Soland 9 g, polygala root 9 g, rhizoma cyperi 10 g, herba siegesbeckiae 15 g),one dose a day. While in the control group, oxiracetam 4.0 g intravenous drip was given, once a day. The whole course was 21 days in both groups. Before and after treatment, the cognitive function of all the patients in two groups was assessed by Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA) scores, and incubation period and amplitude of P300 wave were recorded.Results Finally 62 cases were in treatment group and 63 cases in control group. Before treatment, the comparisons of the MMSE score, MoCA score and P300 latent period and amplitude between the two groups had no statistically significant differences(allP>0.05). After treatment in the two groups, the MMSE score, MoCA score and P300 wave amplitude were elevated, P300 latency period was shortened compared with those before treatment, and the changes were more prominent in treatment group〔score of MMSE: 25.33±2.32 vs. 21.68±2.29, score of MoCA(score): 26.61±3.06 vs. 22.40±2.93, P300 wave incubation period(ms): 349.62±20.01 vs. 371.87±19.63, P300 wave amplitude(μV): 8.70±2.92 vs. 5.72±2.33,allP<0.01〕.ConclusionQishen Tongluo Zengzhi decoctioncan effectively intervene cognitive impairment in patients with acute phase of ischemic stroke, and improve their cognitive function.

BACKGROUND:Fluorouracil sustained-release agent is a commonly used anti-cancer sustained-release drug, which has a good anti-tumor effect.
OBJECTIVE:To explore the effect of fluorouracil sustained-release agent in the treatment of gastric cancer. METHODS:Literatures concerning the effect of fluorouracil sustained-release agent in the treatment of gastric cancer were retrieved and analyzed. In the paper, we investigated the preventive effect of fluorouracil sustained-release agent against tumor recurrence and metastasis after radical resection, and fol owed up the patients who underwent clinical peritoneal implantation of fluorouracil sustained-release agent. We could determine the effect of fluorouracil sustained-release agent in the treatment of advanced gastric cancer by observing the patient’s symptoms and signs, expression of tumor markers, tumor size and survival rate.
RESULTS AND CONCLUSION:After combination therapy of fluorouracil sustained-release agent and arterial infusion chemotherapy adjuvant therapy, the patient’s symptoms and tumor resection rate were significantly improved. The levels of CEA, CA19-9, CA72-4 in the serum of patients significantly reduced, while the apoptosis and necrosis of tumor cells significantly increased. Fluorouracil sustained-release agent could also reduce tumor metastasis and local recurrence, and improve patient survival.

Following the requirements for libraries in the Implementing Rules for Evaluation Standards of Tertiary Hospitals in Guangdong Province and taking municipal or above occupational disease prevention and control institutions as objects,the paper analyzes the construction situations,current collections and operating modes of libraries and discusses the setting of the occupational health information service function from 6 aspects of information sources,service objects and function setting,book retrieval,inter-library loan,service feedback and occupational health information service for labor.

Objective:To study the predictive value of red cell distribution width (RDW)on poor myocardial perfu- sion in patients with acute myocardial infarction(AMI)treated by percutaneous coronary intervention (PCI).Meth-ods:From August 2013 to August 2015,a total of 212 ACS patients undergoing PCI in our hospital were selected. According to RDW of blood analyzer,patients were divided into RDW<13.0% group (n=115)and RDW≥13.0%group (n=97).According to ST segment regression rate (STR)on single lead of ECG 1~2h after PCI,patients with STR≤50% were enrolled as poor myocardial perfusion group (n=78)and those with STR>50% were regar- ded as good myocardial perfusion group (n=134).Clinical data were compared between two groups,and single fac- tor and multi-factor analysis were used to analyze influencing factors for myocardial perfusion.Results:Compared with RDW<13.0% group,there were significant rise in age [(62.85±5.23)years vs.(67.33±6.17)years],and significant reductions in left ventricular ejection fraction [LVEF,(52.37±6.14)% vs.(50.55±5.53)%]and STR [(0.73±0.26)vs.(0.57±0.39)]in RDW≥13.0% group,P<0.05 or <0.01. Compared with good myocardial perfusion group,there were significant reductions in percentage of RDW<13% (59.70% vs.44.87%)and LVEF [(52.25±3.81)% vs.(50.29 ± 4.08)%],and significant rise in age [(63.29 ± 1.93)years vs.(66.42 ± 2.15) years]in poor myocardial perfusion group,P<0.05 all.Multi-factor Logistic regression analysis indicated that age, LVEF and RDW were independent predictors for poor myocardial perfusion (r=3.826~6.525,P<0.01 all).Con-clusion:Red cell distribution width possesses good predictive value for poor myocardial perfusion in patients with a- cute myocardial infarction undergoing percutaneous coronary intervention,which is worth extending in clinic.