Objective To explore the efficacy of prophylactic bilateral internal iliac arteries balloon occlusion in treatment of women with pernicious placenta previa complicated with placenta accreta.Methods A retrospective analysis was conducted on 41 cases of pernicious placenta previa with placenta accreta admitted to Guangzhou Women and Children's Medical Centre from January 2010 to December 2012.The study group (n=13) underwent prophylactic bilateral internal iliac arteries balloon placement before cesarean section and occlusion after delivery.The control group (n =28)received conventional haemostasis during cesarean section.The amount of blood loss and blood transfusion during the operation,the perioperative hemoglobin level,operation time and duration of hospitalization of the two groups were compared with t test or Chi square test.Results The volume of intraoperative hemorrhage of the study group was lower than of the control group [(1429±875) ml vs (4600± 2090) ml,t=6.840,P=0.000],the amount of intraoperative blood transfusion in the study group was also lower [(920±438) ml vs (3600± 1225) ml,t=10.251,P=0.000].Operation time and postoperative duration of hospitalization of the study group were shorter than those of the control group [(197±45) min vs (284±44) min,t 5.850,P=0.000; (6.7±1.3) d vs (8.2± 2.2) d,t=2.272,P=0.029].There was no statistical difference on hysterectomy rate between the two groups [11/13 vs 89％(25/28),x2=0.181,P 0.670)].In addition,two cases of reoperation,one case of pulmonary edema,two cases of coagulation disorder,one case of venous thrombosis in lower limbs,one case of renal dysfunction and pulmonary edema were reported in the control group,but none in the study group.Conclusions.Prophylactic bilateral internal iliac arteries balloon occlusion is effective in reducing intraoperative blood loss,transfusion,and relative complications in patients with pernicious placenta previa complicated with placenta accreta.

OBJECTIVE： To observe the changes of insoluble particles of shuanghuanglian in quantity after mixed with benzylpenicillin,cefradine and dexamethasone in normal saline.METHODS： Using ZWF-4D particle counter,the number of insoluble particles in sizes of ≥ 2.0μ m,≥ 5.0μ m,≥ 10.0μ m and ≥ 25.0μ m was counted and compared before and after mixed with above-mentioned three drugs.RESULTS： The insoluble particles of Shuanghuanglian were obviously increased after mixed with benzylpenicillin,the particles in sizes of ≥ 5.0μ m,≥ 10.0μ m and ≥ 25.0μ m increased twice,23 and 94 times respectively.The insoluble particles were also increased after mixed with cefradine or dexamethasone,however,the increase rate was lower in comparison with that mixed with benzylpenicillin.CONCLUSION： Shuanghuanglian,used in combination with above-mentioned drugs,should be put into separate infusion bottle to avoid the increase of insoluble particles and ADRs.

This retrospective analysis showed that the most frequent pathogen causing bacterial liver abscess was Klebsiella pneumoniae in 138 patients.Compared with the patients without diabetes mellitus,it was found that:( 1 ) the percentage of diabetic patients having typical abdominal pain was lower ( P ＜ 0.05 ) ; ( 2 ) neutrophilic granulocytosis was more marked,but albumin and hemoglobin levels were lower in diabetic patients( P＜0.05 ) ; ( 3 )more diabetic patients were complicated with urinary tract infection and suffered from septicemia( P＜0.05 ) ; (4) the clinical course of treatment in diabetic patients was much more prolonged( P＜0.05 ).

Objective To study the effect of Bi-level positive airway pressure (BiPAP) on hemodynamics in patients with the chronic obstructive pulmonary disease (COPD) combined coronary heart disease.Methods One hundred patients with COPD combined coronary heart disease treated by BiPAP ventilation were enrolled.The blood gas analysis and the hemodynamics were monitored and analyzed in patients with the COPD combined coronary heart disease before treatment and after BiPAP ventilation treatment for 2 hours,24 hours,72 hours and 1 week.Results PaCO2 decreased significantly after 2-hour's treatment by BiPAP ventilation( P ＜ 0.05) and the heart rate and systolic blood pressure also decreased significantly after 24-hour's treatment by BiPAP ventilation.The left ventricurlar ejection fraction( [ 65.63 ± 6.86 ] ％ vs.[ 56.21 ±5.26]％,P ＜ 0.05 )was significantly improved after BiPAP reatilation treatment for one week.The mean pulmonary arterial pressure ( [ 3.74 ± 0.96 ] vs [ 5.12 ± 1.12 ] kPa,P ＜ 0.01 ),angina pectoris ( [ 0.20 ± 0.01 ]time/d vs [ 0.69 ± 0.03 ] time/d,P ＜ 0.05 ) were significantly decreased.Conclusion COPD combined coronary heart disease patients may achieve an optimal effect by BiPAP ventilation.BiPAP ventilation has no impact on the hemodynamics in patients with the COPD combined coronary heart disease.

Objective To investigate the efficacy of ambroxol combined with penehyclidine hydrochloride for prevention of pulmonary complications after surgery due to acute abdomen in pediatric patients with upper respiratory tract infection.Methods Fifty pediatric patients with acute abdomen complicated with respiratory infection,of ASA physical status Ⅰ or Ⅱ,aged 6 months-5 yr,were randomly divided into test group (group A) and control group (group B),with 25 cases in each group.Immediately after admission to the operating room,ambroxol 1 mg/kg and penehyclidine hydrochloride 0.02 mg/kg were injected intravenously in group A,and atropine 0.02 mg/kg was given in group B.Extubation time and development of laryngospasm,bronchospasm and hypoxemia were recorded.The patients were followed up for 72 h after surgery and the development of postoperative pulmonary complications was recorded.Results Compared with group B,the incidence of hypoxemia and pulmonary complications was significantly decreased,and extubation time was shortened in group A.Conclusion Ambroxol combined with penehyclidine hydrochloride can prevent pulmonary complications after surgery due to acute abdomen and is helpful for prognosis in pediatric patients with upper respiratory tract infection.

Clinical pharmacology is a cross subject of clinical medicine sciences and basic pharmacology.Only by making a lot of efforts to teach clearly,newly and lively,can we increase the students'interest and improve the teaching quality.

Objective To detect the change and clinical significance of homocysteine (Hcy),hypersensitivity C response protein (hs-CRP) and hypersensitivity troponin I (hs-TnI) in patients with acute myocardial infarction (AMI).Methods Ninety-six cases of AMI were selected as the research group and 60 cases of coronary heart disease without AMI were enrolled in the control group.Blood samples were collected to measure the contents of serum Hcy,hs-CRP and hs-TnI.ROC curve was drawn and Logistic regression model was established to analyze the role of each index alone and combined detection in the diagnosis of AMI.Results The levels of Hcy,hs-CRP and hs-TnI in the research group were significantly higher than those in the control group (Hcy: (29.29±7.65) mol/L vs.(17.23±4.68) mol/L;hs-CRP: (15.47±5.01) mg/L vs.(9.21±3.15) mg/L;hs-TnI: (40.88±9.18) ng/mL vs.(7.34±2.12) ng/mL,t=2.78,8.66,34.36,P<0.05).The area under the ROC curve of Hcy,hs-CRP,hs-TnI were 0.802 (95%CI(0.729~0.874)),0.71(95%CI(0.62~0.792)),0.929 (95%CI(0.891~0.967)),respectively.The area under the combine detection curve was 0.971 (95%CI,0.950~0.992).The sensitivity of Hcy,hs-CRP and hs-TnI in the diagnosis of AMI were 79%,57%,87%,respectively,the specificity of the three groups were 72%,70%,90%,the sensitivity and specificity of combined detection were 96% and 88%.Conclusion Combined detection of Hcy,hs-CRP and hs-TnI plays a better role in the diagnosis of AMI than that of Hcy,hs-CRP,hs-TnI alone and has a high specificity and sensitivity in the diagnosis of AMI.

AIM: To explore the cytokines level and the discrepancy of reaction to dexamethasone (Dex) in ALI rats induced by hydrochloric acid (HCl) and lipopolysaccharide (LPS). METHODS: Ninety-six SD rats were divided into six groups at random (n=16 in each group): NS group, HCl group, LPS group, NS+Dex group, HCl+Dex group and LPS+Dex group. Every group was divided into two subgroups: the bronchoalveolar lavage (BAL) subgroup and no bronchoalveolar lavage (NBAL) subgroup. The total leukocytes, PMN%, macrophage%, lymphocyte%, total protein in BALF and the wet/dry of the lung weight were measured. The concentrations of TNF-?, IL-1?, IL-4 and IL-10 in serum and BALF in every group were compared. RESULTS: (1) In the groups of LPS and HCl, the total leukocytes, PMN numbers, the protein concentration in the BALF and W/D were higher than those in control group (P

Objective To explore the effect of atorvastatin application on serum ferritin(SF)levels in elderly male patients with acute coronary syndrome(ACS)and its clinical significance. Methods 120 elderly male patients treated in Department of Cardiology in Cangzhou People's Hospital were randomly divided into treatment group and control group(60 cases in each group). All the patients in the two groups took the standard treatment of coronary heart disease,and the patients in treatment group were additionally given atorvastatin 20 mg orally,once-daily for 1 month. After 1 month of treatment,the changes in SF and lipid levels before and after treatment were determined. Results The total cholesterol(TC),low density lipoprotein(LDL)and SF levels of the two groups after treatment were significantly decreased compared with those before treatment. After treatment,triacylglycerol (TG)was decreased,and high-density lipoprotein(HDL)was increased significantly in treatment group,while in the control group,after treatment TG was increased and HDL was decreased. Compared between treatment and control groups after treatment,the differences in SF,TC,TG,HDL and LDL levels were statistically significant〔SF(μg/L):174.33±99.87 vs. 255.66±100.34,TC(mmol/L):4.23±0.60 vs. 5.15±0.56,TG(mmol/L):1.98±0.64 vs. 2.00±1.03,HDL(mmol/L):1.13±0.14 vs. 1.09±0.22,LDL(mmol/L):2.45±0.33 vs. 3.35±0.50,P<0.05 or P<0.01〕. Conclusion In elderly male hospitalized patients with ACS,the level of SF is significantly higher than normal,after atorvastatin specification treatment,the blood fat and SF levels are significantly lower,thus the SF inducing myocardial damage may be reduced and the risk of recurrence of acute coronary events can be decreased.

Objective To investigate the effect of choledochoscopic gallbladder-preserving cholecystolithotomy combined with traditional Chinese medicine treatment.Methods A randomized controlled clinical study was conducted to analyze the 91 patients who were treated with choledochoscopic gallbladder-preserving cholecystolithotomy and 92 patients who underwent the same operation combined with subsequent treatment of traditional Chinese medicine.Intraoperative,postoperative and follow-up data were compared between the 2 groups (including operation time,blood loss,the rate of biliary fistula and common bile duct injury during the operation,gallbladder contraction function,the recurrence rate of gallstone,etc).Results In the simple choledochoscopic gallbladder-preserving cholecystolithotomy group,rate of gallstone recurrence was 7.7％ (7/91),the gallbladder wall was (3.5 ±0.6) mm,the gallbladder contraction function was (34.0 ± 3.6)％.However,the comprehensive treatment group,the rate of gallstone recurrence was 1.1％ (1/92),the gallbladder wall was(2.5 ±0.5) mm,the gallbladder contraction function was(48.0 ±4.5)％.There were significant differences between the two groups respectively (P ＜ 0.01,respectively).Conclusion Choledochoscopic gallbladder-preserving cholecystolithotomy combined with traditional Chinese medicine treatment is a safe,feasible,and minimal invasive approach for gallstone,and it can be considered as a alternative treatment of gallstone.