Objective: To summarize the efficacy of nape multiple acupuncture for treating vertebral artery type of cervical spondylosis. Methods: Patients with vertebral artery type of cervical spondylosis who visited from 2001 to 2004 were randomly divided into a control group of 50 cases receiving simple medication and an acupuncture plus medication group of 50 cases receiving medication plus nape multiples acupuncture. Results: Compared with the control group, the clinical cure rate was significantly increased in the acupuncture plus medication group (P＜0.05). Conclusion: Medication plus nape multiple acupuncture can obviously improve the therapeutic effect on vertebral artery type of cervical spondylosis.

Based on the professional characteristics of obstetrics and gynecology department,teaching reform should take clinical manifestations of diseases as the main direction of clinical probationary teaching,stress the formation cultivation of medical students' clinical logic,add human-oriented thought into clinical teaching and stress medical ethics education,and construct a novel teaching mode in the clinical probationary practice in department of obstetrics and gynecology so as to improve clinical teaching of obstetrics and gynecology.

OBJECTIVE:To prepare transferrin(TF)modified tetrandrine(TET)and vincristine(VCR)active targeting lipo-somes,and to optimize its formulation. METHODS:TF modified TET and VCR liposomes were prepared by ammonium sulfate gradient method. Using comprehensive score of encapsulation efficiency of TET and VCR as index,central composite design-re-sponse surface method was used to optimize and validate mole ratio of EPC/Chol,mole ratio of EPC/PEG2000-DSPE and TF mass fraction. RESULTS:The optimal formulation was that the mole ratios of EPC/Chol and EPC/PEG2000-DSPE were 1.5:1 and 20:1, TF mass fraction was 0.10%. The encapsulation efficiency of TET and VCR were 97.80% and 93.00%,respectively. The compre-hensive score was 94.44(n=3)which was close to the predicted value of 93.81. CONCLUSIONS:The optimal formulation is sta-ble and can be used for the preparation of TF modified TET and VCR liposomes.

Objective:To investigate the occurrence of antenatal anxiety and possible influencing factors,and analyze its relationship with spontaneous delivery.Methods: 590 healthy puerperal women who delivered in Taihe hospital during Dec 2007 and Dec 2008 were randomly selected and investigated for their psychological status,with T-A1 anxiety scale and SDS depression scale employed.Results: 569 effective questionnaires were gathered,with 114 cases divided into the anxiety group and 159 cases into the depression group.Influencing factors of antenatal anxiety include fear of delivery,worry about the safety of babies,understanding of delivery knowledge,puerperal age,and the family financial status.Conclusion: Factors including a relatively older age of primipara,poor financial status,insufficient support from family,worry about the safety of oneself and baby,and fear for delivery pain all have close connections with antenatal mental disorders.Meanwhile,antenatal mental disorders have a direct influence on delivery quality and the choice of delivery modes,and increase the failure rate of spontaneous delivery.

OBJECTIVE To analyze the results of antimicrobial susceptibility for clinically isolated Corynebacterium striatum strains and investigate the distribution of minimal inhibitory concentration(MIC) of the antibiotics commonly used in clinic against C.striatum.METHODS C.striatum was identified with API Coryne System(bioMerieux,France).Antimicrobial susceptibility test was conducted by agar dilution method.RESULTS MIC90 of imipenem,vancomycin and rifampin against C.striatum was 8,0.5 and 2 ?g/ml,and that of amikacin,gentamicin,tobramycin,and minocycline was 8-16?g/ml,but MIC90 of the other antibiotics was 32-≥256 ?g/ml.The main source of 32 isolates was from bronchofibroscopic secretion.CONCLUSIONS The activity of vancomycin,rifampin and imipenem against C.striatum shows stable susceptibility,but of amikacin,gentamicin,tobramycin and minocycline shows inferiority.However,the susceptibility to other antibiotics is low.So vancomycin,rifampin and imipenem are the optimal antibiotics to treat the infections caused by C.striatum.

Objective To establish a method for detecting Aspergillus spp.by Loop-mediated isothermal amplification.Methods Aspergillus spp.specific primers were designed from the relative conservation region of the published sequence of 28S rRNA genes of A.fumigatus (GenBank accession number AY660917),A.terreus (GenBank accession number AF454183),A.flavus (GenBank accession number AF454158),and A.niger (GenBank accession number AF454169).Genomic DNA were extracted from Aspergillus standard strains,clinical control strains and clinical samples,and amplified by LAMP.The amplified results could be read with the naked eye by the coloring effect of fluorescent nucleotide dye without the DNA electrophoresis.Approximately 103 each Aspergillus conidia suspension was added to the serum from healthy volunteers,and detected these simulative clinical samples bv LAMP assay.Results The LAMP and PCR assays obtained positive results for all four Aspergillus species and 8 simulative clinical samples (double samples for each Aspergillus species) including 103 conidia,but negative in the remaining 15 non-Aspergillus species,human total blood genomic DNA,30 clinical serum samples infected with non-Aspergillus and 10 healthy volunteers.The LAMP assay had a minimum detection of 0.05-0.5pg,by means of detect different levels of 500,50,5,0.5,0.05 pg template in each reaction tube.Conclusion The results confirm that LAMP is a simple,rapid,sensitive and specific method,and can be used for detection of Aspergillus strains in clinical and environmental specimens.

Objective To investigate and evaluate the effectiveness and safety of continuous local incision infiltration anesthetic analgesia after total knee arthroplasty(TKA).Methods Forty-eight patients with initial unilateral TKA in the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University from August 2015 to May 2016 were allocated to three groups according to systematic random sampling methods:16 cases in the control group received continuous local incision infiltration anesthesia and femoral nerve block analgesia,16 cases received continuous femoral nerve block analgesia after TKA(CFNB) and other 16 cases received local ropivacaine continuous local incision infiltration anesthesia analgesia(CWI).The preoperative general situation,visual analogue scale (VAS) score of operative site in movement and rest on postoperative 1-3 d,postoperative early function recovery and postoperative complication were compared among 3 groups.Results All cases were followed up.There was no statistically significant difference in the general situation postoperative complications among 3 groups(P＞0.05).the VAS score under movement status on postoperative 1-3 d and rest status in the CWI group and CFNB group were similar,which were lower than those in the control group,the difference was statistically significant(P＜0.05);the postoperative early function recovery in the CWI group was superior to that in the control group and CFNB group.Conclusion local incision infiltration anesthetic analgesia after TKA can relief postoperative pain,facilitate patient's early function exercise and rehabilitation,and improves patient's satisfaction.

Objective To analyze the outcome of children with juvenile idiopathic arthritis (JIA) treated with recombinant human tumor necrosis factor receptor antibody fusion protein (rhTNFR:Fc) for 2 years,and to evaluate the long-term efficacy and safety as well as the related factors that affect the curative effect of rhTNFR:Fc.Methods Fifty-seven JIA patients treated with rhTNFR:Fc were followed up for 2 years.Clinical data were registered including age of onset,disease duration before rhTNFR:Fc treatment,disease activity assessment,medication before treatment,dosage regimen of infection or adverse reactions.Pearson Chi-Square statistical test and logistic regression model of binomial classification were used for statistical analysis.Results ①Twenty-two JIA cases completed 2-year therapy.Some were in the process of dosage tapering.Eight cases reached ACR Pedi 50,14 cases reached ACR Pedi 70.All of them were included in the clinical effectiveness analysis.Thirty-five cases withdrawal in 2 years because of disease remission or treatment failure or side effects or infection.Seven who withdrew and then maintained with DMARDs under the supervision of doctors were evaluated by assessment of ACR Pedi 70.They were stable at the end of 2 years,and were included for the clinical effectiveness analysis group.Nineteen cases were withdrew by the doctor because they failed to reach ACR Pedi 30 within 3 months.They were included in the treatment failure analysis.Seven cases were lost during the follow up.② The remission rate (ACR Pedi 50,70) of SO-J1A in 2 years was 33％.Oligoarthritis rate was 60％,while that of polyarthritis rate was 79％.The statistical analysis showed that different categories and RF level were significantly different in effectiveness and treatment failure (x2=31.6,P＜0.05; x2=5.488,P＜0.05).There was no significant difference in age,sex,duration before treatment,AKA,CCP,ANA between the two groups (P＞0.05).③ Logistic regression analysis showed that different categories of JIA and RF levels were correlated with therapy,P＜0.05.The relative risk (OR) value of different categories of JIA was 2.983 (P＜0.05).Negative RF might be the predictive factor for treatment response (OR =0.029,P＜0.05).④ Eight cases (2％) had recurrence and other adverse reations during treatment,the majority (7 cases) was SO-JIA.Conclusions ① The long-term therapeutic effect and safety for oligoarthritis and Polyarthritis by rhTNFR:Fc are better than SO-JIA.② Negative RF maybe the factor associated with favourable rhTNFR:Fc efficacy.③ The long-term safety of rhTNFR:Fc for SO-JIA is good.Physicians should be cautious to infection and other adverse reactions.

Objective To investigate the predictive value of fluid overload for mortality in children with severe sepsis.Methods In this retrospective study,the children with severe sepsis who were admitted to the Pediatric Intensive Care Unit (PICU),Children's Hospital of Soochow University between January 2011 and March 2015.Fluid accumulation was calculated in the first 72 hours after admission.Pediatric index of mortality Ⅱ (PIM2) score was calculated during the first 1 hour after admission.Multivariate Logistic regression analysis assessed the relationship between fluid overload and mortality after adjustment for confounding factors.The predictive value of fluid overload for mortality was assessed by the receiver operating characteristic curve and au area under the receiver-operating-characteristic curve (AUC).Results Of the 199 children admitted,62 cases (31.2％) died during PICU stay.Among the children,133 cases (66.8％) had fluid overload of＜5％,55 cases (27.6％)had fluid overload of≥5％-10％,and 11 cases (5.6％) had fluid overload of≥ 10％.Multivariate regression analysis showed that a high fluid overload percent (OR =1.263,95 ％ CI:1.113-1.434,P ＜ 0.001),a high PIM2 score (OR =1.028,95 ％ CI:1.012-1.043,P ＜ 0.001) and multiple organ dysfunction syndrome(OR =4.160,95％ CI:1.728-10.012,P =0.001) were independent risk factors for mortality in children with severe sepsis.The fluid overload was significantly associated with mortality (OR =1.309,95％ CI:1.158-1.480,P ＜0.001),even after adjustment for age and illness severity assessed by PIM2 scores.Fluid overload achieved AUC of 0.741 (95％ CI:0.661-0.820,P ＜ 0.001) for predicting mortality in children with severe sepsis.Conclusion Fluid overload developed during the first 72 hours after admission is independently associated with and predictive of PICU mortality in children with severe sepsis.

Objective Data on applications and grants of general program on health science of National Natural Science Fund from Shanghai First People's Hospital,Shanghai Jiao Tong University (SFPH) during 2011-2014 were analyzed with an attempt to explore the ways to promote the funding rate.Methods x2 test and t test were performed,and a binary Logistic regression model was established to determine variables influencing the results of applications.Results There were 367 applications in SFPH during 2011-2014,86 of which were granted.The funding rate was higher than that of Department of Health Science.The total and highest impact factor of SCI articles published by applicants of granted programs were both higher than those of non-granted programs.The significance of these two factors in predicting whether an application will be granted was confirmed by the results of Logistic regression analysis.Conclusions SCI article is an important aspect of academic achievements of applicants,which is a prerequisite for an application to be granted.However,a scientific and innovative project may be critical for the outcome of an application.