Objective To evaluate the effect of nitrous oxide-inhale combined with lidocaine-injection by Ciliao and Uterine points and single therapy in labor analgesia,and the impact on maternal and child.Methods 400 cases were randomly divided into four groups.Observation group:100 cases take the therapy of Nitrous oxide-inhale combined with lidocaine-injection in Ciliao and Uterine points in the time of active period.Control group 1:100 cases take the therapy of gas mixture-inhale( 50％ Nitrous oxide and 50％ Oxygen) in the time of active period.Control group 2:100 cases take the therapy of lidocaine-injection in Ciliao and Uterine points in the time of active period.Control group 3:100 cases do not take any analgesia.Analgesic effects,labor time,mode of delivery,neonatal conditions,the amount of bleeding in every group were observed.Results There was statistically significant differences between the observation group with the control group 1,2,3 on analgesic effects ( x2 =48.513,P ＜ 0.05 ) labor time( F =782.88,1120.81,1104.57,all P ＜ 0.05 ),mode of delivery ( x2 =85.715,P ＜ 0.05 ),neonatal conditions,the amount of bleeding( F =422.66,P ＜ 0.05 ).Conclusion Combination therapy was more effective than the single treatment.

Objective: To classify the AngleⅠ malocclusion subgroups using lateral radiographic films according to their ordinary coordinates and standardized coordinates converted by general procrusts analysis (GPA), and to compare the two kinds of classifications and their valne in diagnosis of malocclusion. Methods: 946 pretreatment lateral radiographic films of patients with Angle'I malocclusion were chosen and their ordinary coordinates were acquired via soft ware. The ordinary coordinates were then converted into standardized coordinates by GPA. All of the films were classified by cluster analysis and discrimination analysis applying the upper two kinds of coordinates respectively. Results: (1) Twenty one subgroups were identified according to the ordinary coordinates of the chosen films with the total differentiate rate of 92.7% and leave-one-out differentiate rate of 68.4% (Classification A). Correspondingly, 20 subgroups were identified according to the standardized coordinates with the two differentiate rates of 87.8% and 71.9% (Classification B). (2) If the ordinary coordinates were discriminated by Classification B, the total differentiate rate and leave-one-out differentiate rate were 79.8% and 60.2 % respectively. If the standardized coordinates were discriminated by Classification A, the two differentiate rates were 79.8% and 60.2 % respectively. (3) There were some subgroups having the similar form in Classification A and their difference mainly arose from the difference of the patient age, while there were no such subgroups like that in Classification B. (4)The proportion of the largest subgroup in total subjects is 15.9% and there were 8 subgroups having the number of subjects over 40 in Classification A, whilethe corresponding proportion and number of subgroups were 74.7% and 2 in Classification B.(5)Classification A and Classification B were both suitable to classify a new subject, but Classification B was required to standalize all of the subjects onc again, which was very complex, while Classification A was more simplified. Conclusion: Classification A and Classification B are interelated. GPA could concentrate the subjects in cluster analysis, which reduces some influence of the age to the classification, but the process to classify a new subject is very complex. Thus if quick diagnosis is needed in clinics, Classification A should be recommended, but the influence of the age should be noted.

Objective To explore Fms-like tyrosine kinase 3(FLT3)gene internal-tandem duplications(ITD)mutation in hematologic malignancy.Methods FLT3/ITD gene mutation was analyzed by polymerase chain reaction(PCR)amplification on the DNA samples from 332 patients with hematologic malignancies at the Nanfang Hospital from 2001 to 2005.Results The mutation of FLT3/ITD gene was detected in 22.3% acute myeloid leukemia(AML)cases,in 6.5% chronic myeloid leukemia(CML)-blast crisis(BC)cases,in 5.6% myelodysplastic syndromes(MDS)cases and in 2.6% acute lymphoblastic leukemia(ALL)cases;FLT3/ITD gene mutation was not detected in CML-chronic phase(CP),multiple myeloma(MM),non-Hodgkin lymphoma(NHL)and chronic lymphocytic leukemia(CLL)cases.FLT3/ITD+ AML indicate high white blood cell count and high percentage of bone marrow blast cells and had a unfavourable cumulative relapse rates.Conclusion AML patients with FLT3/ITD have a poor prognosis.Detection of FLT3/ITD gene mutation may be valuable in hematologic malignancy.

Objective To study the quantification of MDR1 and WT1 gene expression in patients with de novo acute myeloid leukemia(AML)and to explore the role of these two genes in clinical drug resistance and their correlation with risk stratification. Methods A real time quantitative reverse transcriptase polymerase chain reaction method was established for detecting MDR1 and WT1 gene expression levels in 63 de novo AML patients.Resuits The expression of WT1 and MDR1 was significantly higher in de novo AML patients than in normal controls (P＜0.001).WT1 levels were significantly correlated with corresponding levels of MDR1 gene in de novo AML patients(P=0.004).Expression levels of WT1 and MDR1 gene were not associated with FAB subtype and risk stratication(P＞0.05).AML patients with FLT3-ITD mutations had a significantly higher WT1 expression level as compared to with those without(P＜0.05),on the contrary MDR1 expression was not associated with FLT3-ITD mutations(P＞0.05).Patients with co-expression of high levels of WT1 and MDR1 had a significantly lower complete remission rate after induction therapy than those with low levels(P＜0.05).Conclusion There is a positive correlation between MDR1 gene expression and WT1 gene expression in AML.Quantification of the two gene expression together is more effective for judgement of prognosis in AML.

BackgroundMonocyte chemotactic protein-1 (MCP-1)plays an important role in the tumor,inflammation,diabetic retinopathy and other neovascular disease,but the expression and the role of MCP-1 in the oxygen induced retinopathy(OIR) model have rarely been reported. Objective This study was to investigate the expression of MCP-1 in the retina development of newborn mouse and in mouse models with OIR.Methods C57BL/6J newborn mice were divided into two groups and 60 mice in each group.Mice in OIR group were exposed to 75％ oxygen for 5 days and then to room air.All mice in normal control group exposed to room air only.Ten mice in each group were randomly chosen and sacrificed at postnatal 5,7,12,14,17,21 days.The expression of MCP-1 in mouse retina was detected with the method of immunohistoehemistry and reverse transcription polymerase chain reaction(RT-PCR).Results MCP-1 positive cells were seen in normal mouse retina.Up-regulation of MCP-1 positive cells was detected both in 12 days in normal control group and in 14 days in OIR group.MCP-1 mRNA was detected in mouse retina at 5 days,and a transient up-regulation of MCP-1 mRNA was observed in 12 days in normal control group.MCP-1 mRNA in OIR group significantly increased in 14 days in comparison with the normal control group( P =0.028,P =0.001 ). Conclusions Expression of MCP-1 is detectable in whole retinal development procession of mice.A transient up-regulation of MCP-1 expression is detected in the critical period of retinal vascular development in mice models with OIR,which is closely related to the retinal vascular development and progression of retinal new vessels.

OBJECTIVETo explore the pathomorphological change of the atlanto-occipital segment of vertebral artery (V3 part) related with cervical vertigo.

METHODSFrom June 1999 to November 2011, the pathomorphological change of the atlanto-occipital segment of vertebral artery were observed in 1680 patients with cervical vertigo using 3D-CTA technology. The clinical data of these patients were analyzed. There were 783 males and 897 females, aged from 22 to 70 years old with an average of 52.8 years old. Doppler examination showed vertebral basilar artery flow velocity to speed up or slow down.

RESULTSThe blood vessel of 3360 branches were detected in 1680 patients and 2778 branches were detected out vascular anomaly. And 829 branches were in V1 segment, 421 were in V2, 328 were in V3, 1190 were in V4. The pathomorphological changes in the atlanto-occipital segment (V3) of vertebral artery included angiospasm, congenital absence, abnormal exit, localized stenosis.

CONCLUSIONThere are 4 kinds of pathomorphological changes in the atlanto-occipital segment of vertebral artery related with cervical vertigo. The 3D-CTA result can be used to judge prognosis and adopt reasonable treatment for the patients.

Adult ; Aged ; Atlanto-Occipital Joint ; Cervical Vertebrae ; Female ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Vertebral Artery ; diagnostic imaging ; pathology ; Vertigo ; pathology

Objective: To study the methylation state within MAGE 1 B′B promoter in gastric carcinoma and the association between demethylation and pathological differentiation, the association between demethylation and clinical stage. Methods: Using methylation sensitive restriction analysis followed by polymerase chain reaction (PCR),we studied 80 specimen that were obtained from surgical samples (including 40 gastric carcinoma and 40 matched adjacent normal gastric mucosae).Results: An demethylation state was identified in DNA from gastric carcinoma specimens.The demethvlation rate is 25%(10/40).In contrast,no demethylation state was identified in DNA from matched adjacent normal gastric mucosae. The differences were Significant statistically. ln our study, the demethylation in poorly, moderately, and well differentiated glandulous cell carcinoma were detected at frequencies of 50%,18.7% and 8.3%,respectively, The differences were significant statistically ( P

OBJECTIVETo research the application and clinical effect of titanium elastic nails (TEN) for the treatment of closed clavicular fracture in elder children.

METHODSFrom October 2010 to December 2012,16 elderly children with clavicular fracture of elder children were treated with internal fixation, including 9 boys and 7 girls with an average age of 14.2 yeats old ranging from 9 to 17 years. The mean time between injury and surgery was 2 to 6 days. Thirteen patients had a transverse fractures; 3 patients had a oblique fractures, excluding the long-oblique patients. Neer function score after 3 months follow-up and the shoulder activity degree after 3 weeks followed were compared respectively between the injured side and healthy side. Fracture reduction and healing were followed up by X-rays to analyze internal fixation with TEN technique.

RESULTSAll patients were healed well after surgery. There were 2 cases with soft tissue irritation. No cases of infection, TEN broken, delayed healing or skin bursting were observed. All patients were followed up for 3 to 10 months,with an average of 7.2 months. There were no significant differences (t=2.12, P>0.05) between the healthy side (98.75±2.70) and injured side(96.69±6.22)of Neer score at 3 months during followed up. The shoulder activity at 3 weeks during followed up was different between both sides (P<0.05). The intramedullary nail was removed after X-rays at 12-18 weeks during followed up showed good bone healing,and the shoulder function was recovered well.

CONCLUSIONInternal fixation with TEN for the treatment of clavicular fracture has advantages of a limited invasion, beauty, safety and reliability. This technique provides an ideal fixation option for the treatment of clavicular fracture in elder children.

Adolescent ; Bone Nails ; Child ; Clavicle ; injuries ; surgery ; Elasticity ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Titanium

In the present study, a risperidone loaded microsphere/sucrose acetate isobutyrate (SAIB) in situ forming complex depot was designed to reduce the burst release of SAIB in situ forming depot and to continuously release risperidone for a long-term period without lagime. The model drug risperidone (Ris) was first encapsulated into microspheres and then the Ris-microspheres were embedded into SAIB depot to reduce the amount of dissolved drug in the depot. The effects of different types of microsphere matrix, including chitosan and poly(lactide-coglycolide) (PLGA), matrix/Ris ratios in microspheres and morphology of microspheres on the drug release behavior of complex depot were investigated. In comparison with the Ris-loaded SAIB depot (Ris-SAIB), the complex depot containing chitosan microspheres (in which chitosan/Ris = 1 : 1, w/w) (Ris-Cm-SAIB) decreased the burst release from 12.16% to 5.80%. However, increased drug release rate after 4 days was observed in Ris-Cm-SAIB, which was caused by the high penetration of the medium to Ris-Cm-SAIB due to the hydrophilie of chitosan. By encapsulation of risperidone in PLGA microspheres, most drugs can be prevented from dissolving in the depot and meanwhile the hydrophobic PLGA can reduce the media penetration effect on the depot. The complex depot containing PLGA microspheres (in which PLGA/ drug=4 : 2, w/w) (Ris-Pm-SAIB) showed a significant effectiveness on reducing the burst release both in vitro and in vivo whereby only 0.64% drug was released on the first day in vitro and a low AUC0-4d value [(105.2± 24.4) ng.mL-1.d] was detected over the first 4 days in vivo. In addition, drug release from Ris-Pm-SAIB can be modified by varying the morphology of microspheres. The porous PLGA microspheres could be prepared by adding medium chain triglyceride (MCT) in the organic phase which served as pore agents during the preparation of PLGA microspheres. The complex depot containing porous PLGA microspheres (which were prepared by co-encapsulation of 20% MCT) (Ris-PPm-SAIB) exhibited a slightly increased AUC0-4d of (194.6±15.8) ng.mL-1d and high plasma concentration levels from 4 to 78 days [Cs(4-78d)=(7.8±1.2) ng.mL-1]. The plasma concentration on 78 day C78d was (9.0 2.5) ng.mL-1 which was higher than that of Ris-Pm-SAIB [C78d= (1.6 ± 0.6) ng.mL-1]. In comparison with Ris-Pm-SAIB, the AUC4-78d of Ris-PPm-SAIB increased from (379.0±114.3) ng.mL-1.d to (465.0 ±149.2) ng.mL-1.d, indicating sufficient drug release from the Ris-PPm-SAIB. These results demonstrate that the risperidone loaded porous PLGA microsphere/SAIB in situ forming complex depot could not only efficiently reduce the burst release of SAIB depot both in vitro and in vivo, but also release the drug sufficiently in vivo, and be capable to continuously release the drug for 78 days.
Chitosan ; Drug Carriers ; Lactic Acid ; Microspheres ; Polyglycolic Acid ; Risperidone ; chemistry ; Sucrose ; analogs & derivatives ; Technology, Pharmaceutical

This article discussed on the continuing medical education for general practitioners within a nonprofit multihospital system.Literature review,statistical analysis and survey results were employed.Training situation for general practitioner at home and aboard was reviewed.Statistics on population,disease spectrum,present situation of community doctors in Luwan branch of Ruijin hospital was also analyzed.Results showed that current education system for general practitioners cannot catch up the increasing demand yet.Meanwhile patients expected well qualified and skillful physicians in the community healthcare centers.Reinforcement of continuing medical education for general practitioners was the stepping stone of a nonprofit multihospital system.Improving skills and qualifications of physician played an essential role in the urban network of medical services.