Objective To investigate the technical success rate of operation,safety,efficacy and clinical value of super-selec-tive uterine arterial embolization(SSUAE)in the treatment of massive postpartum hemorrhage.Methods The clinical data of 65 patients with massive postpartum hemorrhage who were not cured by medical treatment were retrospectively analyzed.Forty-one patients who underwent successful SSUAE were set as research team (group A)and 24 patients who underwent hysterectomy were set as control group (group B).The indications,success rate of hemostasis,bleeding volume and postoperative complications were compared.Results In group A,1 1 patients were in a critical condition and couldn′t tolerate the hysterectomy (26.8%),success rate of hemostasis was 95.1% (39/41 ),and 2 patients who with a poor outcome of embolization underwent hysterectomy after SSUAE (4.9%).In group B,the success rate of hemostasis was 95.8% (23/24),there was no statistical significance of hemostasis success rate between the two groups (P >0.05).There was significant statistical significance between the two groups in average operation time and bleeding volume in surgery,which were 33.8 min and 61.5 min,2 1 55.5 mL and 3 21 5.7 mL respectively(P <0.01).No postoperative complications occurred in group A,but 3 postoperative complications occurred in group B,which had signif-icant statistical significance (P <0.01).Conclusion SSUAE performed its excellent advantages,such as wide indications,minimal trauma,high success rate of hemostasis,low complications and reach the purpose of reserving uterus.

Objective To observe the influence of direct peritoneal resuscitation on liver function in hemorrhagic shock rabbits with pyruvate peritoneal dialysis solution instead of lactate peritoneal dialysis solution. Methods 48 hemorrhagic shock rabbits were randomly divided into conventional intravenous resuscitation group (group A),intravenous resuscitation plus intraperitoneal injection of lactate peritoneal dialysis solution group (group B),intravenous resuscitation plus intraperitoneal injection of pyruvate peritoneal dialysis group(group C), intravenous pyruvate peritoneal dialysis resuscitation plus intraperitoneal injection of pyruvate peritoneal dialysis group(group D). The hemodynamic changes were observed and the AST and ALT were measured respectively before and 60 min after shock ,60 min and 180 min after resuscitation. The dry/wet weight ratio ,MDA and SOD of liver tissue were measured,and the liver morphological changes were observed. Results After the completion of shock resuscitation,MAP of all groups were almost restored to the basal level. 180 min after resuscitation,the MAP of animals in group A was lowered than that in group B,C and D(P<0.05). After shock,ALT and AST were signifi-cantly higher than those before shock ,but no significant difference was found between groups (P > 0.05). After resuscitation,ALT and AST continued to decline in all groups,but the decline range increased with the order of A, B,C,D group(P < 0.05). The water content and MDA in liver tissue decreased with the order of A,B,C,D group,while the SOD increased and the differences between groups were significant(P<0.05). And the degree of liver tissue morphological injury also relieved correspondingly. Conclusion Pyruvate substituting lactate peritoneal dialysis solution peritoneal resuscitation can be more effective in reducing liver damage of hemorrhagic shock rabbits.

Objective To observe the effects of peritoneal resuscitation by pyruvate replacing lactate peritoneal dialysis solution on the intestinal mucosal barrier in rabbits with hemorrhagic shock.Methods The hemorrhagic shock model was prepared in 48 healthy male rabbits by adopting the improved Wiggers method.Then the rabbits were randomly divided into the conventional intravenous resuscitation group (group A),conventional intravenous resuscitation plus intraperitoneal injection of lactate peritoneal dialysis solution group (group B),conventional intravenous resuscitation plus intraperitoneal injection of pyruvate peritoneal dialysis solution group (group C) and intravenous pyruvate peritoneal dialysis solution resuscitation plus intraperitoneal injection of pyruvate peritoneal dialysis solution group (group D).The levels of diamine oxidase (DAO) and lipopolysaccharide (LPS) were measured before shock,at 60 min after shock,at 60,180 min after resuscitation.At the end of observation,the ileum tissues were taken from the 5 cm away from the ileocecal region for measuring the dry/wet ratio,malondialdehyde (MDA) level and superoxide dismutase (SOD) activity and their morphological changes was observed.Results There was no statistical difference in the plasma levels of DAO and LPS before shock among the four groups (P＞0.05);which at 50 min after shock were increased,but the comparison among the groups had no statistical difference (P＞0.05);the plasmas levels of DAO and LPS at 60,180 min after resuscitation in the group A,B,C and D were decreased in turn (P＜0.05).The MDA levels of ileum tissues after 180 min of resuscitation in the group A,B,C and D were decreased in turn (P＜0.05),but the SOD activties and tissue dry/wet mass ratios were increased in turn (P＜005),moreover the tissue injury degrees were also relieved in turn.Conclusion The peritoneal resuscitation by pyruvate replacing lactate peritoneal dialysis solution can more effectively protect the intestinal tissue cells and reduce intestinal mucosal damage in hemorrhagic shock rabbits.

Objective:To understand the iodine nutrition states of children in Dongtai City Jiangsu Province by analyzing the urinary iodine level of children aged 0 - 12 years old (prepubescent children), so as to provide scientific reference for prepubescent children's reasonable iodine nutrition intake.Methods:Under the guidance of the "National Iodine Deficiency Disorders Monitoring Program" (2016), Dongtai City was divided into 5 districts according to the east, west, south, north and middle locations. In each district, children aged 0 - 7 years old who underwent physical examination in township hospitals and prevention and health centers were selected to collect urine samples for urine iodine testing. One township was selected from each district, and one primary school was selected from each township. At least 90 children aged 8 to 12 (half boys and half girls) were selected from each primary school to collect urine samples for urine iodine testing. The urinary iodine levels of children of different genders, ages and regions were compared and analyzed.Results:A total of 2 934 urine samples were collected. The median of urinary iodine was 191.9 μg/L, ranging from 1.4 to 627.9 μg/L, the proportion of urine iodine content < 50 μg/L was 5.5% (162/2 934), the proportion of 50 - 99 μg/L was 10.9% (319/2 934), the proportion of 100 - 199 μg/L was 37.4% (1 096/2 934), the proportion of 200 - 299 μg/L was 28.3% (829/2 934), and the proportion of ≥300 μg/L was 18.0% (528/2 934). A total of 1 535 and 1 399 urine samples of boys and girls were collected. The medians urinary iodine of boys and girls were 202.3 and 177.7 μg/L, respectively, and the difference was statistically significant ( Z = - 5.487, P < 0.05). There were 106, 1 539, 753 and 536 cases of infants (0 - 12 months old), early childhood (1 - 3 years old), preschool children (4 - 6 years old), and school-age children (7 - 12 years old), the medians urinary iodine were 169.8, 189.6, 169.9 and 243.7 μg/L, respectively, the difference was statistically significant ( H = 127.395, P < 0.05). There were 642, 699, 422, 738 and 433 cases in different regions (east, west, south, north and middle) and the medians urinary iodine were 194.2, 172.7, 196.8, 200.5 and 196.6 μg/L, respectively, the difference was statistically significant ( H = 29.461, P < 0.05). Conclusions:Children aged 0 - 12 years old in Dongtai City are not deficient in iodine on the whole, but those with urinary iodine value higher than 200 μg/L account for a large proportion. Therefore, a reasonable iodine nutrition plan should be implemented according to the actual situation. In addition, individual iodine deficiency and excess should also be paid attention to.