Objective To evaluate the efficacy of ultrasound?guided transversus abdominis plane ( TAP) block with different concentrations of ropivacaine for analgesia after cesarean section. Methods A total of 120 parturients, aged 24-31 yr, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, weighing 64-73 kg, at 35 to 41 week gestation, scheduled for elective cesarean section, were randomly di?vided into 3 groups ( n= 40 each) using a random number table: 0?25% ropivacaine group ( group Ⅰ) , 0?20% ropivacaine group ( groupⅡ) , and 0?15% ropivacaine group ( groupⅢ) . A patient?controlled an?algesia pump was connected at the end of surgery, and the corresponding concentration of ropivacaine 1?5 mg∕kg was injected into the bilateral TAP under the guidance of ultrasound in each group. Visual analogue scale score was maintained ≤3. The number of attempt and the number of patients requiring rescue analge?sic were recorded at 48 h after surgery. The occurrence of TAP block?related complications was observed and recorded. Results Compared with groupⅢ, the number of attempt and the number of patients requi?ring rescue analgesic were significantly decreased in Ⅰ and Ⅱ groups ( P<0?05 ) . Compared with groupⅡ, the number of attempt and the number of patients requiring rescue analgesic were significantly de?creased in group Ⅰ (P<0?05). No TAP block?related complications were detected in the three groups. Conclusion Ultrasound?guided TAP block with 0?25% ropivacaine is helpful in improving the analgesic efficacy after cesarean section without serious complications.

Objective To establish the quality control standard for Shuanggen Qingnao Granules.Methods TLC was used to identify Yiyiren SEMENCOICIS,Yujin RADIXCURCUMAE,Banlangen RADIX ISATIDIS. HPLC was used to determine the content of Puerarin in Shuanggen Qingnao Granules.Results The TLC spots developed were fairly clear,and the bland test showed no interference.Puerarin showed a good linear relationship in the range of 5.184～40.50?g/mL,the average recovery of Puerarin was 99.93%,and RSD=1.81%.Conclusion The method is accurate and quick,and can be used for the quality control of Shuanggen Qingnao Granules.

Objective To investigate the origin of prostatic blood-supply by digital subtraction angiography (DSA) and provide references for the arterial embolization of prostatic hyperplasia. Methods A total of 72 male patients with successful selective and super-selective prostatic arterial catheterization angiographies were observed and recorded the original arterial blood-supply of the prostate, number of the prostatic arteries and the predominant blood supply. Results The blood-supply of prostate is very complicated including the original prostatic arterial supply from the inferior vesicle arteries (69); the internal iliac arteries (63); the internal pudendal arteries (52); the inferior rectum arteries (29); the superior vesicle arteries (14). The predominant arterial supply include the internal iliac arteries (37); the inferior vesicle arteries (20); the internal pudendal arteries (6) and the inferior rectum arteries (2). Conclusion Arterial contrast medium angiography can correctly demonstrate and assess the original arterial supply of prostate, providing significant guidance for further interventional embolization.

Diagnostic Errors ; Encephalocele ; diagnosis ; Female ; Humans ; Meningocele ; diagnosis ; Middle Aged ; Mucocele ; diagnosis ; Sphenoid Sinus ; pathology

Objective To investigate the clinical significance of thyroglobulin antibody (ATG) and thyroid peroxidase antibody (ATPO) in patients with vitiligo. Methods Venous blood samples were obtained from 87 patients with vitiligo and 90 age- and sex-matched normal human controls. Chemiluminescence was applied to measure the serum levels of ATG, ATPO, free triiodothyronine, free tetraiodothyronine and thyroid stimulating hormone (TSH). Results There was a significant increase in the positivity rates of ATG (23.0% vs 6.7%, P < 0.01) and ATPO (24.1% vs 7.8%, P < 0.01) as well as the serum level of TSH (3.4 ± 2.4 vs 2.4 ± 1.2 pmol/L, P < 0.05) in the patients with vitiligo compared with the normal human controls. It is worth mentioning that all patients positive for ATG or ATPO were diagnosed with vitiligo vulgaris. The positivity rates of ATG and ATPO in patients with vitiligo aged from 11 to 20 years and 21 to 40 years were significantly higher than those in age-matched normal controls (all P < 0.05). Also, female patients had a higher positivity rate of ATG and ATPO than female controls did (34.1% vs 8.5%, χ2 = 8.90, P < 0.01; 34.1% vs 10.6%,χ2 = 7.29, P < 0.05). The highest positivity rates of both ATG and ATPO were 53.3%, which were observed in vitiligo patients aged from 11 to 20 years, followed by patients from 21 to 40 years (ATG 34.5%, ATPO 34.5%). In patients with vitiligo positive for both ATG and ATPO, the occurrence of autoimmune thyroid disease was 70% (14/20), significantly higher than that in ATG- and ATPO- positive healthy controls (16.7%, χ2 = 5.4, P < 0.05). Conclusions ATG and ATPO were observed in young female patients with vitiligo vulgaris, and they may be associated with the development of autoimmune thyroid diseases.

0.05) ,but the differences reached statistical significance compared the positive ratios of two index together to urine NAG and ?2 - MG (X2 = 4.41,7.28 P

Objective To investigate the effect and mechanism of exogenous leptin on liver injury in severe acute pancreatitis rat .Methods Thirty male SD rats were randomly divided into the sham operation group ,SAP group and leptin intervention group . The SAP rat models was established by retrograde injection of 3 .5% sodium taurocholate into the biliopancreatic duct .The leptin intervention group was intraperitoneally injected with leptin 20 μg/kg .The rats in each group were sacrificed at 12 h after model‐ing .The pancreas and liver tissues were taken for HE staining and detecting the nuclear factor kappa B (NF‐κB) .The cell apoptosis in situ labeling method was adopted for detecting the liver tissue cell apoptosis index .ALT ,AST and AMY were detected . Results Compared with the sham operation group ,the liver tissue pathology score in SAP group and leptin intervention group were significantly increased(P<0 .05) .The liver tissue pathology scores in the leptin intervention group were lower than those in the SAP group(P<0 .05) .The NF‐κB expression of liver tissue in the SAP group and leptin intervention group was obviously increased compared with the sham operation group ,the expression in the leptin intervention group was decreased compared with the SAP group (P<0 .05) .The liver cell apoptosis index in the leptin intervention group and SAP group was significantly higher than that in the sham operation group (P<0 .05) ,and which leptin intervention group was decreased compared with the SAP group (P<0 .05) . The results of ALT ,AST and AMY in the SAP group and leptin intervention group were increased significantly compared with the sham operation group(P<0 .05) ,while which in the leptin intervention group was decreased compared with the SAP group (P<0 .05) .Conclusion The exogenous leptin may play the protective effect on SAP complicating liver damage by lowering the liver tis‐sue NF‐κB expression and reducing the liver cell apoptosis index .

Objective To evaluate the effectiveness of repeated intravitreal conbercept injection in patients with macular edema (ME) of retinal vein occlusion (RVO),guided by optic coherence tomography (OCT).Methods It is a retrospective case study.Forty patients (40 eyes) diagnosed as ME secondary to RVO were enrolled in this study.There were 19 males (19 eyes) and 21 females (21 eyes),with the mean age of (53.58 ± 13.19) years and the mean course of 1.5 months.The best corrected visual acuity (BCVA),indirect ophthalmoscopy,fundus fluorescein angiography (FFA) and OCT were performed.The mean baseline of BCVA,central macular thickness (CMT) were 0.25 ± 0.18 and (509.48 ± 170.13) μm respectively.All the patients were treated with 10.00 mg/ml conbercept 0.05 ml (including conbercept 0.5 mg).Follow-up of these patients was 1 to 6 months after treatments,the BCVA,fundus manifestations,OCT were retrospectively observed by every month,the FFA was retrospectively observed by every 3 months.When there was retinal edema or CMT ≥ 50 μm by OCT during follow-up,those patients were retreated with intravitreal conbercept injection.The changes of the BCVA,CMT were evaluated before and after treatment.Meanwhile,complications in eyes related to medicine and treatment methods were evaluated too.Results At the 6 months,the BCVA was improved (increase≥2 lines) in 25 eyes (62.50％),stabilized (± 1 line) in 13 eyes (32.50％) and decreased 2 lines in 2 eyes (5.00％).Retinal hemorrhage and exudates were absorbed in most patients.FFA showed no fluorescein leakage in 1 1 eyes (27.50％),minor fluorescein leakage in 26 eyes (65.00％),and retinal capillary non-perfusion in 3 eyes (7.50％).OCT showed absorption of the subretinal fluid.The mean CMT were (235.20± 100.44) μm at 6 months.Intravitreal injection of conbercept was applied for 4 times in 8 eyes (20.00％),3 times for 18 eyes (45.00％),and 2 times for 14 eyes (35.00％).The mean number of intravitreal injection was 2.85 times.There were no ocular or systemic adverse events observed in all patients.Conclusion Intravitreal conbercept injection is an efficacy and safe treatment for the patients with ME of RVO guided by OCT.It can stabilize and improve the visual acuity.

Objective To assess the correlation between time during admission to percutaneous coronary intervention (PCI) and left ventricular function recovery of acute myocardial infarction (AMI) by two-dimensional speckle tracking imaging (STI).The clinical value of STI in assessing therapeutic effect of AMI treated by PCI and estimation of the prognosis were discussed.Methods Sixty-one AMI patients who had AMI for the first time and had been treated by primary PCI were enrolled.Dynamic images were acquired before PCI,at 7 days after PCI and 30 days after PCI and analyzed by STI.The time during admission to PCI of AMI patients was recorded accurately.Dynamic images were analyzed for longitudinal peak systolic strain (LPSS) values (global,infarcted area) by STI.According to the comparison of left ventricular ejection fraction(LVEF) before PCI and 30 days after PCI,patients were divided into left ventricular function improved group (ΔLVEF≥5 ％) and not-improved group,and the values of LPSS and time during admission to PCI were compared between the two group respectively.Results Compared to not-improved group,the time during admission to PCI in improved group was lower ( P ＜0.001),infarcted segmental LPSS at 7 days after PCI ( P ＜0.05) and both global ( P ＜0.001) and infarcted segmental LPSS ( P ＜0.001) at 30 days after PCI in improved group were higher than those in not-improved group.Linear regression analysis showed that both global and infarcted segmental LPSS were significant correlated to LVEF respectively ( P ＜0.001,all).Infarcted segmental LPSS at 7 days after PCI were correlated to the time during admission to PCI ( P ＜0.05).LVEF ( r =0.303,P ＜0.05),global ( r =0.300,P ＜0.05)and infarcted segmental LPSS ( r =0.590,P ＜0.001) at 30 days after PCI were correlated to the time during admission to PCI.Conclusions STI provides reliable and useful clinical information for the assessment of therapeutic effect of AMI treated by PCI and estimation of the prognosis by sensitively presenting the close correlation between time during admission to PCI and left ventricular function recovery of AMI patients.

Objective To assess left ventricular(LV) longitudinal strain in patients with coronary heart disease by two-dimensional speckle tracking imaging (2DSTI),and to explore the clinical value of 2D longitudinal strain in detecting myocardial ischemia. Methods Forty-four patients with coronary heart disease (CHD group) and 28 age-matched subjects (control group) were enrolled into this study. The two-dimensional data were obtained in apical 4-chamble, 2-chamber and long axis view. And the longitudinal strains of every segments, the average longitudinal strain of LV 18 segments (SL18), the average longitudinal strain of 12 segments (SL12,excluded the 6 apical segments) were analyzed. Results In the patients with CHD, the longitudinal strain of ischemia segments and the global LV longitudinal strain were significantly decreased than that of the control subjects. Both in patients with CHD and in control subjects,the longitudinal strains in apical segments were higher than that of middle and basal segments. There was significant difference between SL18 and SL12 ( P=0.027 in CHD group and P =0.003 in control group).Receiver operating curve (ROC) analysis demonstrated that the cutoff point of SL18 to detect myocardial ischemia was - 18.8％ (sensitivity 80.2％ and specificity 74.1％ ) ,and the cutoff point of SL12 to detect myocardial ischemia was - 17.8％ ( sensitivity 81.7％ and specificity 85.6％ ). Conclusions 2D longitudinal strain was sensitive to detect myocardial ischemia, SL12 was better than SL18 in detecting myocardial ischemia. 2DSTI might be useful for identifying patients with severe CHD.