Objective To investigate the effect of ropivacaine and sufentanil alone or in combination with continuous subarachnoid block for labor analgesia.MethodsIn this experiment, 63 cases of spontaneous delivery of labor in First People's Hospital Jiande City from June 2015 to December 2016 were randomly divided into experimental group and control group according to the time of hospitalization.Each 21 cases.In the control group, 1 mg of ropivacaine was treated with 1 mg of ropivacaine (15 mg) and 5μL of sufentanil.The control group 1 was treated with 1% ropivacaine alone.The control group 2 was treated with 6μl of sufentanil.ResultsIn this experiment, the effect of subarachnoid analgesia was VAS score≤3 points, the experimental group was significantly faster than the control group 1, 2 (P<0.05), the first PCEA administration time is subarachnoid The effective duration of analgesia in the experimental group was statistically significant (P<0.05).In addition, VAS score was statistically significant.There was no significant difference between the three groups.In addition, the three groups of maternal active period, the second labor time difference was not statistically significant.ConclusionCompared with the original single use of agents, ropivacaine and sufentanil continuous subarachnoid analgesia for labor analgesia had better effects on maternal effects on labor.

Autogenous vein graft is one of the frequent methods to treat ischemia in Vascular Surgery.However, the patency rate of vein grafts is unhappy because of the injury, the difference structure between arteries and veins, and the change of hemedynamics after grafted. The restenosis of vein graft contains three syntrophic component elements-thrombosis, intima hyperplasia, and scleratheroma. In this article, we will discuss the relationship between the changed hemodynamics and the restenosis of the vein grafts.

Objective To investigate the incidence and influence factors of stress ulcer SU) in traffic injury patients. Methods Clinical data of 362 traffic injury patients were studied retrospectively.Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score was carried out for all the patients.All the patients had gastroscopy and a comparative analysis was done on the SU patients with or without bleeding and the patients without SU. Results The patients with extensive burn in traffic injury were more susceptible to SU as compared with other trauma patients,with statistical difference ( X2 =7.028,P ＜ 0.05 ).The incidence of SU or hemorrhage was increased with higher APACHE Ⅱ score.The incidence of SU hemorrhage in patients with diabetes or cardiopulmonary disease was significantly higher than that in patients without diabetes or cardiopulmonary disease ( P ＜ O.05 ). Conclusions Traffic injury patients should receive routine gastroscopy.APACHE Ⅱ score has some predictive value for SU or hemorrhage.The incidence of SU hemorrhage is also determined by combined factors of underlying diseases and treatment methods.

Rhabdomyosarcoma is the most common soft tissue sarcoma in childhood.Radiation therapy has been integrated into the primary treatment of most patients with rhabdomyosarcoma, but which in turn potentially induces severe acute and late toxicities.Proton therapy in recent years has been more and more used in the treatment of rhabdomyosarcoma, which is safe and effective, with no serious adverse events.Compared with conventional photon therapy, proton therapy has distinct physical advantages and enables greater precision in the delivery of tumoricidal radiation doses with reduced irradiation of normal tissues, and improves quality of life for patients.Additional follow-up and prospectively studies are needed to determine whether proton therapy truly reduces the incidence and severity of late effects in comparison to patients treated with modern photon techniques.

ObjectiveTo explore the diagnostic and differential diagnostic points in a patient with rheumatoid arthritis (RA) complicated with fever and pulmonary diseases. MethodsFull clinical analysis was performed for a 55-year old patient with arthritis, fever, and wheeze. ResultsThe clinical pictures of the patient were consistent with those of RA. Computed tomography(CT) revealed interstitial lung diseases and intrapulmonary cavities. Antifungal agents were given experimentally, and the intrapulmonary cavities disappeared finally, thus the patient was diagnosed as RA, concurrently complicated with interstitial lung disease and pulmonary fungal infection. ConclusionThe possibility of pulmonary fungal infection should be considered in RA patients who presented with fever and intrapulmonary cavities.

Objective To discuss the necessity and rationality of regional pancreatoduodenectomy combined vas-cular reconstruction in the treatment of chronic pancreatitis with lump in the head. Methods Thirteen patients who suffered from pancreas with lump in the head, were operated in our department from January 2000 to March 2006. The clinical data were analyzed retrospectively,there were 10 men and 3 women with an age ranging from 37 to 71 (mean = 51 ), all the patients underwent pancreatoduodenectomy combined PV and SMV reconstruction. Results All thirteen patients were pathologically confirmed chronic pancreatitis without postoperative deaths, in which stom-ach empty disorder and pancreatic fistula occurred and were cured conservatively in one case. All the 13 patients who were followed up 19～86 months had no pain and jaundice at all after the operation. Conclusion Combined vascular reconstruction to treat the lump in the head of the pancreas that packages blood vessel and hard to separa-tion is proved to be a safe and reliable method, being capable of raising lump resection rate, which can improve quality of life of patients remarkably to avoid omit minimum cancer in lump to result in lose the curative opportunity.

Objective To observe the function improvement of deep venous valve after superficial vein surgery of lower extremity by ultrasound.Methods Sixty patients(70 lower limbs)with primary deep venous insufficiency were enrolled tO accept surgical management of vein systems.All Datients were detected with color Doppler ultrasonography,their deep venous hemodynamics indices were measured and recorded before operation and 6 months after operation. Results The total improvement rate of the deep venous hemodynamics after superficial vein surgery was 65.7%.The valve function of suPerficial femoral vein and popliteal vein were improved after operation,and there was no significant difference between the two veins in effectiveness.The improvement for deep venous reflux had no significant difference between two surgical methods. Conclusions The superficial vein surgery of lower extremity can improve deep vein valve function in some extent.

Background: Chronic obstructive pulmonary disease (COPD) is an important clinical disease, and its global prevalence and mortality rates are high. It is meaningful to investigate the efficacy of integrative respiratory rehabilitation training in quality of life and respiratory physiology of COPD patients in stable phase. Objective: To observe the efficacy of integrative respiratory rehabilitation training in exercise ability and quality of life of COPD patients in stable phase. Design, setting, participants and interventions: Eighty outpatients and inpatients with COPD from Department of Respiratory Medicine, Taihe Hospital, Yunyang Medical College were randomly divided into 4 groups, with 20 patients in each group. The patients in group A only received drug therapy, the patients in group B received traditional qigong training, the patients in group C received modern rehabilitation training, and the patients in group D received integrative respiratory rehabilitation training. Main outcome measures: Chronic respiratory questionnaire (CRQ), 6-minute walking distance and Borg score in each group were examined before and after one-, three-, and six-month and one-year treatment. Results: The 6-minute walking distance, Borg score and CRQ score in group A had no significant changes after treatment (P>0.05). After one-month treatment, there were no significant differences in 6-minute walking distance and Borg score in groups B, C and D as compared with those before treatment (P<0.05). After three-month treatment, 6-minute walking distance and Borg score were improved in groups B, C and D (P<0.05). After six-month and one-year treatment, 6-minute walking distance, Borg score and CRQ score in groups B, C and D were improved as compared with those before treatment (P<0.05), and there were significant differences between group D and any of groups A, B and C (P<0.05). Conclusion: Modern rehabilitation training, traditional qigong training and integrative respiratory rehabilitation training programs all can improve the quality of life and exercise ability of COPD patients, and integrative respiratory rehabilitation training program is better than modern rehabilitation training and traditional qigong training programs. The efficacy of respiratory rehabilitation training is time-dependent, and need long-time adherence to the therapy.

BACKGROUND: The study of isolation, purification, culture, cell labeling, inducing factors, effects of gene transfection on cytobiology, cell carrier construction, and time window for back transplantation of cell compound pertaining to marrow stromal cells (MSCs) is still in its infancy. OBJECTIVE: To search for an in vitro culture method that can be simply and effectively obtained. DESIGN, TIME AND SETTING: The present cytological in vitro experiment was performed at the Beijing Institute of Genome, Chinese Academy of Sciences between June 2006 and July 2007. MATERIALS: Eight specific pathogen-free New Zealand rabbits, aged 6 weeks, were provided by the Laboratory Animal Center, Institute of Genetics and Development, Chinese Academy of Sciences. METHODS: Under sterile condition, 1 mL rabbit bone marrow was taken and diluted with D-Hanks solution. Following centrifugation and subsequent supernatant removal, bone marrow was re-suspended using dulbecco's modified eagle's medium (DMEM) for single cell suspension. Next, single cell suspension was dropped onto the liquid surface of equal-volume lymphocyte separation medium (density: 1.077). Subsequent to centrifugation, cloudlike mononuclear cell layer was collected and re-suspended with DMEM containing 20% fetal bovine serum. The cells were inoculated at lxl0/cm2 and purified by adherent method. When 70%-80% of flask bottom was covered, cell digestion and passage was performed.MAIN OUTCOME MEASURES: Cell growth was observed with an operating microscope. Surviving cells were counted by Trypan blue viability test. Cell identification was performed by hematoxylin-eosin staining. Through the use of 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide assay, cell viability was detected to observe the cellular resuscitation of the cultured cells following cryopreservation. RESULTS: Twenty-four hours after inoculation, cells began to adhere to the wall, exhibiting short shuttle- or triangle-shaped appearance with different sizes of cellular processes. Three days later, adherent cells began to divide, and cell clusters could be found in some areas; One week later, most of cells exhibited scattered fibroblast-like growth; After passage, cells were evenly distributed with long shuttle-shaped appearance and arranged orderly. Following 3 passages, there wound be 5×106-1×107 adherent cells in 1 mL MSC suspension. Approximately 90% of MSCs survived and identified as mononuclear cells. Cells vigorously grew at days 1-6 after inoculation and reached a peak level at day 8, followed by a viability decline. After 56 days of resuscitation, frozen cells displayed a good and rapid growth. CONCLUSION: Highly purified MSCs can be acquired by gradient centrifugation of lymphocyte separation medium. Enough seeded cells can be obtained by in vitro culture and the cellular viability does not change after frozen preservation and resuscitation.

BACKGROUND: SOX-9 plays an important role in occurrence and development of cartilaginous tissues,enhances agglutination of mesenchymal cells,has structural domains of transcriptional activation,and can directly regulate the transcription,OBJECTIVE: To construct pDC316-SOX-9 plasmid for transfection of rabbit bone marrow stromal cells (BMSCs) using SOX-9 gene,and to investigate the effects of SOX-9 gene on growth characteristics of BMSCs and product expression. DESIGN,TIME AND SETTING: The cell gene engineering in vitro experiment was performe,d at the Beijing Institute of Genome, Chinese Academy of Scienees from June 2006 to January 2007.MATERIALS: Eight SPF New Zealand rabbits aged 6 weeks were used for culture of BMSCs.METHODS: pDC316-SOX-9 plasmid was used for transfection of rabbit BMSCs by liposome mediated method,Cell transfection included a SOX-9 plasmid transfection group,a blank plasmid group and a blank control group (only treatment of liposome). MAIN OUTCOME MEASURES: Cell morphology; growth activity; The SOX-9 protein expression in rabbit BMSCs were detected by immunohistochemistry,hematoxylin-eosin staining,reserve transcriptase-polymcrase chain reaction (RT-PCR) and enzyme-labeled immunosorbent assay (ELISA). RESULTS: Some cell colonies were detected at 4 days after pDC316-SOX-9 plasmid transfection.Spindle-shaped cells were collected after clone amplification.Cells in the blank control group gradually died over time.Cell activities in the SOX-9 plasmid transfeetion group and the blank plasmid group significantly prolonged,reached a peak at 2 weeks of transfection,and then gradually decreased.At 6 days,BMSCs were yellow in the SOX-9 plasmid transfection group following immunohistochemistry,expressing SOX-9 protein.Hematoxyliu-eosin staining showed many dikaryocytes,rich cell proliferation,similar to chondroblasts.No SOX-9 protein expression and unproductive cell proliferation in the blank plasmid group.SOX-9 mRNA was detected in the SOX-9 plasmid transfection group,but SOX-9 mRNA was not detected in the blank plasmid group and blank control group.SOX-9 levels were significantly higher in the SOX-9 plasmid transfection group than in the blank plasmid group and blank control group at 24,48 and 72 hours,1,2 weeks (P＜ 0.01).CONCLUSION: Rabbit BMSCs were successfully transfected with pDC316-SOX-9 plasmid to enhance cell growth activity and to persistently stably secrete SOX-9 protein,resulting in the differentiation of BMSCs into cartilages.