Objective To investigate the effect and safety of combined spinal-epidural analgesia (CSEA) with different doses of ropivacaine during labor. Methods One hundred ASA Ⅰ -Ⅱ full term primigravidae were randomly divided into 5 groups: group Rl (n =20), R2 (n =21), R3 (n = 21), group Y ( n = 19) and group C ( n = 20) . When the external cervical os was dilated to 3-4cm lumbar puncture was performed at L2-3 or L3-4 with a special CSE needle. 0.75% ropivacaine 0.33ml (2.5mg), 0.5ml (3.75mg) or 0.67ml (5mg) was added to 5% glucose with a total volume of 2.5ml and injected into subarachnoid space in group R1, R2 and R3 respectively. When subarachnoid block was wearing off, patient controlled-epidural analgesia (PCEA) with 0.175% ropivacaine was started (background infusion 6ml/h, bolus 2ml, lock-out time 15min) . In group Y patients received only PCEA with 0.175% ropivacaine and in group C patients received neither CSEA nor PCEA and served as control. Level of pain (VAS scores), degree of motor block (modified Bromage scores), Apgar scores and neurological and adaptive capacity scores (NACS), the progress of labor, the amount of ropivacaine used and side effects were recorded and compared. Blood samples were taken from umbilical vein for blood gas analysis immediately after delivery. Results Demographic data were comparable between groups and there were no significant differences in the progress of labor, Apgar score, NACS and blood gases of umbilical venous blood between groups. The onset of analgesia was significantly faster in group R1, R2 and R3 than that ingroup Y(P

Spread into regional lymph node is the major route of metastasis in cervical cancer.Although lymph node status is not involved in the International Federation of Gynecology and Obstetrics stagingsystem of uterine cervical cancer,the presence or absence of lymph node metastasis provides important information for prognosis and treatment.In this review,we have attempted to focus on the incidence and patterns of lymph node metastasis,and the issues surrounding surgical assessment of lymph nodes.In addition,the preoperative prediction of lymph node status,as well as the intraoperative assessment by sentinel nodes will be reviewed.Finally,lymph node micrometastasis also will be discussed.

Objective: To investigate whether endothelial progenitor cells (EPCs) involved in the early healing process of aneurysms with flow diverting stents and the mechanisms. Methods: Five clean rabbits were chosen to prepare the animal model of aneurysm on the right carotid artery. After EPCs were cultured autologously, they were double labeled by Hoechst 33342 and carboxyfluorescein diacetate succinimidylester (CFSE). The aneurysms of rabbits were treated using flow diverting stents. The labeled EPCs were retransfused autologously via veins. EPCs involving in the intimai repair of aneurysms were observed with Cell tracking technology after 2 weeks. In combination of scanning electron microscopy, pathology and immunohistochemistry, EPCs involving in the process of intimal repair were analyzed. Results: Circled digit oneTwo weeks after simple flow diverting stents treatment, the rabbits were reexamined. Their aneurysms did not visualized completely (5/5). The aneurysms were obliferated completely, and the aneurysm necks were covered with neointima. Circled digit twoHoechst33342 and CFSE double-labeled positive cells were found in aneurysm sections. In the aneurysm sections of 2 experimental animals (2/5) , the positive cells were in the neointima. Circled digit threeScanning electron microscopy and immunohistochemistry results suggested that only a few amount of endothelial cells repaired the intimai surface. Conclusion: EPCs involved in the process of early intimal healing of aneurysms.

The metabolism study of radiolabeled drugs plays an important role in the development of new drugs. It provides information on drug absorption, metabolism, tissue distribution and excretion, and plays an irreplaceable role in the metabolite safety evaluation and mass balance of new drugs. The new guidance draft on clinical trials of radiolabeled drugs recently released by the US FDA puts forward higher standards and has been widely concerned by the industry. In recent years, in the research and development of new drugs in China, ¹⁴C labeled drugs have been used to carry out clinical metabolism studies, which has overcome key technical bottlenecks and accumulated experience. This paper summarizes the above research progress, analyzes the existing problems, and preliminarily looks forward to the future technological development and application.

Objective To explore the clinical application of improved thoracic closed drainage tube vacuum aspiration in treatment of elderly patients with trachea foreign body.Methods 32 elderly patients with trachea foreign body were divided evenly into group A and group B.Group A received treatment of improved thoracic closed drainage tube aspiration,while group B received treatment of bronchoscopy.One-time success rate of removing foreign body,operation duration,length of stay and occurrence of complications were compared between group A and group B.Results One-time success rate of removing foreign body in group A was significantly higher than group B (100.00％ vs 81.25 ％,x2 =6.720,P ＜ 0.05) ;operation time of group A was (1.79 ± 1.25)min,which was significantly shorter than (13.18 ± 4.37) min of group B (t =4.31,P ＜ 0.05).Conclusion The clinical effect of improved thoracic closed drainage tube vacuum aapiration in treatment of elderly patients with trachea foreign body was positive and better than treatment with bronchoscopy,it is worthy of clinical application.

Objective To evaluate the fetal cardiovascular function in selective intrauterine growth restriction (sIUGR)in monochorionic diamniotic(MCDA)twins by using 2D and color Doppler ultrasonography. Methods Twenty - four sIUGR pregnancies and 20 normal MCDA twins pregnancies were enrolled at the First Affiliated Hospital of Sun Yat - Sen University from December 2013 to September 2014,and cardiac structure of fetus and Doppler patterns of the umbilical artery(UA),umbilical vein(UV),pulsatility index of ductus venosus(DV - PI),atrioventricular valve, semilunar valve,tricuspid annulus systolic displacement(TAPSE),fractional shortening of left ventricle short axis(FS) and myocardial performance index(Tei index)of both ventricles were assessed. Results Cardiothoracic ratio,heart rate,DV - PI,FS,TAPSE,Tei index of the left ventricle(0. 34 ± 0. 03,0. 34 ± 0. 04),Tei index of the right ventricle (0. 35 ± 0. 03,0. 35 ± 0. 03)were not significantly different compared with those of the normal MCDA twins(all P ﹥0. 05). Cardiothoracic ratio,ventricular wall thickness,isovolumetric relaxation time( IRT),isovolumetric contraction time(ICT),TAPSE and tricuspid regurgitation(TR)in the larger twins of sIUGR were significantly bigger than those in the smaller twins of sIUGR(all P ﹤ 0. 05),Tei index of both ventricles in the larger twin of sIUGR was significantly higher than that in the smaller twins of sIUGR(Tei index of left ventricle:0. 43 ± 0. 06 vs 0. 35 ± 0. 04,Tei index of right ventricle:0. 43 ± 0. 06 vs 0. 34 ± 0. 04,P ﹤ 0. 05),the peak E in early diastolic / the peak A in atrial contraction (E/ A),the percentage of inflow during of cardiac cycle length(inflow/ CCL)in larger twin of sIUGR were significantly lower than those in smaller twin of sIUGR(all P ﹤ 0. 05). Conclusions There was no difference of cardiac function in normal MCDA twins,at the beginning of the diagnosis of sIUGR,cardiac dysfunction were found in larger twin,follow -up examination are helpful to clinical decision.

Objective To evaluate the effect of Jianpi Bushen Formula(Formula for Invigorating Spleen and Nourishing Kidney) combined with moxibustion on quality of life(QOL) and maturation degree of vaginal exfoliate cells(MDVEC) in premature ovarian failure(POF) patients.Methods Totally 55 POF patients were randomized into treatment group(33 cases,treated by Jianpi Bushen Formula with moxibustion) and control group(22 cases,treated by Premarine).Menopause-specified quality of life(MENQOL) was adopted to evaluate QOL of the patients.Maturation index(MI) and maturation value(MV) were applied to evaluate MDVEC.Results The scores of MENQOL of both groups were improved and the effect of the treatment group(except sexual life dimension) was superior to that of the control group(P

Objective To explore the image characteristics and clinical application of the optical coherence tomography (OCT) in patients with epiretinal membranes of the macular(ERMM). Methods 38 patients, who were diagnosed as or suspected as ERMM, were examined with OCT before and after operation from November, 2002 to October, 2003 in our hospital. Results Macular epiretinal membranes were visible on OCT as high reflective tissues, which were thin or thick, and contiguous to or anterior to the retinal surface. In most fovea, the depth decreased and the thickness increased. ERMM disappeared after operation. Conclusion OCT can display the macular epiretinal membrane and the pathological changes of macular tissues before and after operation. OCT can provide accurate information on the clinical diagnosis and operative efficacy of ERMM.

Objective To research the association of IR and β-cell function with MS in T2DM.Methods 116 T2DM subjects were divided into two groups:MS(n=60)and T2DM(n=56),and FIns,FPG,BP and other items were measured.Results HOMA-IR was significantly higher in MS than in T2DM and control group(P<0.05).HOMA-β was significantly lower in MS than in T2DM and control group(P<0.05).And FPG,waist circumference(WC)in MS group were positively correlated with the IR level(P<0.05).Conclusions The HOMA-IR was highest in T2DM with MS,and HOMA-β was lowest in T2DM with MS