Objective To investigate the preventive effect of post abortion care(PAC) on unsafe sexual behaviors and deficiency in the knowledge of unmarried females,especially the youth in order to prevent repeated.unintended pregnancies as well as to promote the unmarried female's reproductive health.Methods During the period from Jan.2012 to Jun.2013,171 unmarried young women (＜ 24 years old) were enrolled in the study who were underwent free willed induced abortion due to unwanted pregnancy in Maternal and Child Health-Care Hospital of Huangpu District of Shanghai.Their reproductive health related knowledge,attitude and behavior were investigated by questionnaires.Based on the information above,they were provided with a series of post abortion services and improvement of reproductive health cognition and prevention effect of repeat pregnancy were evaluated after the intervention.Results After the nosocomial PAC intervention,the research objects are improved in the contraceptive knowledge and contraceptive behavior largely than before.The awareness rate on the female fertile time was increased from 53.8％ (92/171) to 80.6％ (137/170).The common contraceptive awareness rate increased from 49.1％ (84/171) to 91.8％ (156/170).The difference was statistically significant (x2 =27.30,x2 =75.69,P ＜ 0.05).After 1 year follow-up,the PAC intervention make in contraceptive behavior change.The contraception rate increased from 8.2％ (14/171) to 65.3％ (111/170).The contraceptive failure rate was reduced from 35.7％ (61/171) to 4.7％ (8/170) (x2 =165.24,36.12,P ＜ 0.05).There was not complications occurrence.Conclusion PAC can improve the contraception rate and reduce the unmarried female youth repeated abortion rate effectively.

Objective:To evaluate the clinical efficacy of Suhuang Zhike capsules combined with montelukast in the treatment of cough caused by upper respiratory infection. Methods:Totally 120 patients with cough after upper respiratory infection were randomly divided into the treatment group (64 cases) and the control group (56 cases) by the random number table. The control group received Montelukast chewable tablets alone(10 mg,po qn), while the treatment group received Suhaung Zhike capsules(1. 35 g,po,tid) com-bined with Montelukast chewable tablets. The treatment course was 2 weeks, and the efficacy and adverse reactions between the two groups after the treatment were compared. Results:The significant efficiency and the total efficiency of the observation group were sig-nificantly highter than those of the control group, and the difference was statistically significant(P<0. 05). After the treatment, the cough symptom score and the expectoration symptom score of the two groups were decreased significantly than those before the treatment (P<0.05), both scores of the observation group were significantly lower than those of the control group after the treatment(P >0. 05). The incidence of adverse reactions of the two groups had no significant differencet(P<0. 05). Conclusion: As for the clinic efficacy, the combination of Suhaung Zhike capsules and Montelukast is significantly better than Montelukast therapy, and the combina-tion is an effective and safe treatment for cough after upper respiratory infection and worthy of promotion in clinical practice.

Objective To investigate the safety,therapy and prophylactic effect of Omeprazole on stress ulcer in children with epidemic type B encephalitis.Methods Before and after medication,chest X-ray examination was performed.The result of occult blood(OB) was confirm by Colloidal gold assay in stool and/or gastric juice.Based on the result of OB,the patients were divided into therapy group[besides conventional therapy for encephalitis,Cimitidine group and Omeprazole group with positive result OB,was administered with 0.9% normal sodium 100 mL+Cimitidine 20-40 mg/(kg?d),iv,q12 h and normal sodium 100 mL+Omeprazol 0.5-0.8 mg/(kg?d),iv,qd,respectively] and prophylaxis group(Cimitidine group,Omeprazole group and control group,with negative result OB,were administered with same medicines as therapy group,respectively.Except control group being administered only 0.9%NS 100 mL,iv,(q12 h)).The effects of drugs on hemostasis,preventing hemorrhage,and the potential risk of acquired pneumonia result from drugs used were observed.Results In therapy group,the average time of hemostasis in Omeprazole group was obviously shorter than that of in Cimitidine group,there was significant difference between two groups(P0.05).Conclusions Both of the drugs is safety and effect to therapy or prophylaxis for the latent stress ulcer in short term.The effect of Omeprazole is better than those of Cimitidine.Using Cimitidine and Omeprazole,neither therapy nor prophylaxis for stress ulcer increaseds the potential risk of acquired pneumonia in children with epidemic type B encephalitis in this study.

Objective To investigate the changes of cognitive function after major non-cardiac surgery and the relationship between the postoperative cognitive dysfunction(POCD)and the intraoperative cerebral oxygen metabolism in the elderly.Methods Sixty-four patients(49 male,12 female)aged 65-85 yr undergoing elective major non-cardiac surgery were enrolled in this study.A battery of four neuropsycbological tests was administered 2-3 days before and 7 days after surgery by an experienced psychometrician.A postoperative deficit in any test was defined as a cognitive decline by more than or equal to the preoperative standard deviation of that test in all patients.As long aft any patient showed cognitive decline in two or more tests.this situation was defined as POCD.Blood samples were taken from radial artery and internal jugIIlar vein simultaneously for blood gas analysis immediately (T1) and 2 h (T2) after induction of anesthesia,and just before leaving postanesthesia care unit (T3).The ratio of cerebral blood flow to cerebral oxygen metabolic rate(CBF.CMR02)was calculated.Results Sixty-one patients completed postoperative neuropsychological tests and 10 cases(16.4%)had POCD.Logistic regression analysis showed that the abnormality of CBF/CMR02 during operation was associated with the occurrence of POCD.Conclusion The occurrence of POCD after major non-cardiac surgery is related to the abnormality of cerebral oxygen metabolism during operation.

Objective To investigate the protective effect of desflurane preconditioning on human umbilical vein endothelial cells against anoxia-reoxygenation(A/R)injury.Methods The human umbilical vein endothelial cell line(ECV304)was provided by the Liver Cancer Institute,Zhongshan Hospital,Fudan University.ECV304 cells were randomly divided into 5 groups:group Ⅰ normal control;group Ⅱ A/R;group Ⅲ A/R+rhTNF-α;group Ⅳ Des + A/R and group Ⅴ Des + A/R + rhTNF-α.In group Ⅱ-Ⅴ the cells were exposed to 95% N2 + 5% CO2 in an incubator for 30 min followed by 60 min reoxygenation.In group Ⅲ and Ⅴ rhTNF-α(10 ng/ml)10 μl was added to the cells as soon as reoxygenation was started,while in group Ⅳ and Ⅴ the cells were pretreated with 7.2% desflurane for 30 min followed by 10 min washout before A/R.Apoptosis in endothelial cells was detected by fluorescence flow cytometry and TUNEL.Endothelial cells were examined with electron microscope for apoptosis and necrosis.Results The rates of apoptosis in the endothelial cells were significantly higher in A/R group and A/R + rhTNF-α group than in control group.Desflurane preconditioning significantly attenuated apoptosis in the endothelial cells induced by A/R and A/R + rhTNF-α respectively.Electron microscopy showed that there were significantly more necrotic cells in A/R group and A/R + rhTNF-α group.However in the two desflurane preconditioning groups(Ⅳ and Ⅴ)the cells were in a state of duplication and self-repairing.Conclusion Preconditioning with 30 min 7.2% desflurane can attenuate the A/R-induced injury to human umbilical vein endothelial cells.

Objective To observe the efficacy of invasive ventilation (Ⅳ) in treatment of acute pulmonary edema (APE), and to explore the factors associated with prognosis. Method From March 2005 to December 2007, 23 APE patients, who were hospitalized in the EICU of People' s Hospital of Peking University and the con-ventional treatment and noninvasive ventilation were not effective, were treated by Ⅳ (PEEP 5～18 cmH2O). Blood pressure, heart rate, respiratory rate, and arterial blood gas values were recorded accurately before and after ventilation and compared with each other. Regression analysis was used to analyze the factors associated with prog-nosis. Resets Three hours after Ⅳ, the blood pressure, heart rate, respiratory rate, arterial blood gas were sig-nificanfly improved (P <0.01). Among the 23 patients, 11 survived, and the other 12 patients died. Nine pa-tients died of MOF. Among 16 patients with cardiac function Ⅲ-Ⅳ, 10 died. Among 15 patients with acute my-ocardial infarction, 9 died. Among 11 patients with renal insufficiency, 9 died. The multivariate logistic regression analysis showed that the reduced left ventricular ejection fraction, the lower mean arterial pressure, and the in-creased creatinine were the independent predictor of prognosis. Conclusions Invasive ventilation is an effective method of treating patients with acute pulmonary edema. Proper ventilation may improve the cardiac function and clinical symptoms, but it's not the fundamental measure for increasing cure rate. 1he renal insufficiency and heart failure are the independent predictor of prognosis.

Objective To investigate the change of peripheral blood CD4+CD25+ regulatory T cells (Tr) in patients with idiopathic thrombocytopenic purpura (ITP), and to analyze its role in the pathogenesis of ITP.Methods Anticoagulated venous blood was collected from ITP patients (ITP group,n=35) and healthy controls (healthy control group,n=35). T lymphocytes were isolated and purified with human CD3+ T cell enrichment columm. The percentage of peripheral blood CD4+CD25+ regulatory T cells was detected by immunofluorescence staining (PE-anti-CD4 monoclone antibody and FITC-CD25 monoclone antibody) and bicolor flow cytometry by CD25/CD4 gating.Results The number and constituent ratio of CD4+CD25+T cell were significantly lower in ITP group than those of healthy control group (P<0.05).Conclusion There is peripheral blood celluar immunological function disorder in ITP patients, and decrease of CD4+CD25+ T cell population may be involved in the pathogenesis of ITP.

Objective To explore the therapeutic value of hemoperfusion combined with daytime high capacity hemofiltration in the treatment of severe acute pancreatitis.Methods The clinical data of 25 patients with severe acute pancreatitis treated by hemoperfusion combined with daytime high capacity hemofiltration(the observation group) were retrospectively analyzed,and compared with 30 severe acute pancreatitis patients without blood purification treatment(the control group).Results After the treatment,the biochemical indicator of the observation group was improved obviously compared with pre-treatment.Of the observation group,the hospital slaying time was shorter [(21.6±12.3) d vs(30.8±15.6) d],and the cure rate was higher(72％ vs 40％),and the death rate was lower (16％ vs 30％),compared with the control group(all P ＜ 0.05),but the treatment costs had no difference between the two groups.Conclusion Patients with severe acute pancreatitis on the basis of conventional treatment should conduct as early as possible hemoperfusion combined with daytime high capacity hemofiltration,and it could improve the success rate of the rescue and shorthen the length of hospital stay,and its curative effect was accurate.

Objective To investigate the mechanism of cytokines in brain pathologic changes caused by lipopolysaccharide(LPS).Methods A rat model of LPS was established by injection with a dose of 5mg/kg LPS into thigh vein.60 SD rats were randomly divided into three groups:control group,LPS group,naloxone+LPS group,each group included 20 rats and was subdivided into 4 subgroups(1h,2h,4h,6h respectively).In each subgroup,cerebral pathological changes and concentrations of TNF-α,IL-1β,IL-6 in brain homogenate were investigated.Results Brain homogenate concentration of TNF-α in subgroup LPS 2h was higher than control group[(9 30±0.57) ng/g vs(8.00±0 79)ng/g,P＜0.01],other subgroups have no significant difference from control group. Naloxone group had lower TNF-α level than LPS group.Brain homogenare concentration of IL-1β in subgroup LPS 1h increased apparently[(0.56±0.08)ng/g,P＜0.01],subgroup LPS 2h had no significant change;other subgroups have no significant difference from control group.Natoxone group had lower IL-1β level than LPS group(P＜0.01).but no difference from control group.Brain homogenate concentration of IL-6 in subgroup LPS 2h and 4h were respectively(459.68±79.15)ng/g,(816.07±111.31)ng/g,significantly higher than control group[(377.22±63.73)ng/g,(369.98±34.35)ng/g,respectively].Control group had no significant cerebral pathologic changes,while LPS group showed apparent changes:edema,interstitial substance and mening vessels expanding and hyperaemia,neurosome minification,Nissl's body lost,karyopycnosm,and nucleoli abolition.Naloxone group had lighter neurocyre injuries and brain edema,especially at 2h and 4h.Conclusions After LPS injection,the level of cytokines changed as time goes by,and this fits the brain pathologic changes.Naloxone has protecnve effect on brain tissue in LPS treated rats.Inflammatory cytokines play an important role in the mechanism of cerebral damage in LPS rats.

Objective:To compare the antihypertensive effects of tuina at Taichong (LR 3),Neiguan (PC 6) and Qiaogong (Extra) to screen the best tuina protocol for primary hypertension due to liver-fire flaming-up.Methods:A total of 102 patients with primary hypertension due to liver-fire flaming-up were randomly divided into a Taichong (LR 3) group,a Neiguan (PC 6) group and a Qiaogong (Extra) group according to the random number table,with 34 cases in each group.Patients in the three groups received 4-week tuina treatment with the corresponding acupoint respectively.The blood pressure was recorded by benchtop mercury sphygmomanometer before tuina,immediately after tuina treatment,30 min and 60 min after tuina treatment with the patient in a supine position in a quiet treatment room.The total effective rate was observed.Results:The systolic and diastolic blood pressures of the three groups all decreased after treatment (all P＜0.05).The decrease of systolic and diastolic blood pressure at different time points after treatment in the Qiaogong (Extra) group and the Taichong (LR 3) group were better than those in the Neiguan (PC 6) group (all P＜0.05).Qiaogong (Extra) group had the highest total effective rate though there was no statistical difference in the total effective rate among the three groups (P＞0.05).Conclusion:Treating primary hypertension due to liver-fire flaming-up with tuina at Taichong (LR 3),Neiguan (PC 6) and Qiaogong (Extra) can reduce systolic and diastolic blood pressure respectively,among which Qiaogong (Extra) has the highest total effective rate.