Objective To study the effect of morphine used in epidural anesthesia on puerpera after cesarean section and the safety of morphine to neonate. Method One hundred puerpera undergone cesarean section were randomly divided into test group and control group with continuous 2% lidocaine epidural anesthesia, as soon as the operation were finished, 2 mg morphine was injected into vacum epidurale for test group, nothing for control group. Colostrum and plasma, urine samples of puerpera and neonate were collected, morphine and metabolite level were tested by GC-MS and FPIA. Result Morphine concentrations ranged from 0.05). Conclusion As the epidural analgesia medicine after cesarean section, morphine has no side-effect to neonate and is safe to neonate.

Objective To investigate the effects of hypertonic saline/hetastarch solution (HHS) on stress hormones and glucose metabolism in hemorrhagic shock rabbit.Methods Fourteen rabbits of both sexes weighing 2.2-2.6 kg were randomly divided into 2 groups : HHS group ( n = 7) and lactated Ringer's solution (LRS) group ( n = 7). The animals were anesthetized with intravenous 20% urethane 5 ml? kg-1 . Femoral artery was cannulated for BP monitoring and femoral vein was cannulated for removal of blood and fluid infusion. Hemorrhagic shock was induced according to Wiggers. MAP was maintained at 45 mm Hg for 45 min. Then the animals in HHS group received HHS 6 ml? kg-1 and those in LRS group LRS 6 ml? kg-1 . Venous blood samples were taken before shock (baseline), during shock before resuscitation, and 30, 60, 120 min after fluid resuscitation for determination of plasma epinephrine, glucagon, insulin and blood glucose concentration. The insulin sensitivity index (ISI) was calculated.Results After resuscitation MAP returned to baseline level in HHS group while in LRS group MAP was still lower than the baseline. The plasma epinephrine, glucagon and blood glucose concentration increased significantly while plasma insulin concentration decreased significantly during shock before fluid resuscitation compared to the baseline in both groups. After fluid resuscitation plasma epinephrine and glucagon concentration decreased significantly and plasma insulin concentration increased significantly in HHS group whereas in LRS group plasma epinephrine, glucagon and insulin concentration kept increasing. The blood glucose level was significantly lower at 60 and 120 min after resuscitation in HHS group than in LRS group. ISI was decreased after resuscitation in both groups but was significantly lower at 60 and 120 min after resuscitation in LRS group than in HHS group.Conclusion Resuscitation with HHS can reduce the stress response and ameliorate the decrease in insulin sensitivity during hemorrhagic shock.

OR group,moreover the differences were significant(P0.05),however,both genes in the 2 groups′ expression level significantly were lower than that in control group(Pa

Objective To analyze the relationship between CT characteristics of chronic subdural hematoma (CSDH) and its recurrence, as well as relevant pathological mechanism. Methods The study involved 178 patients with CSDH who underwent surgery, of whom 38 patients (40 lesions) experienced recurrence of CSDH. Univariate and multivariate logistic analyses were performed to assess the correlation among CT characteristics ( including side, density, width, subtype and midline shift of the hematoma) and CSDH recurrence. Results ( 1 ) The width of hematoma, midline shift, type of hematoma were found to be correlated with the recurrence of CSDH in the univariate analysis. The odds ratio (OR)and 95% confidence interval (CI) value of patients with hematoma width ＞30 mm, midline shift ＞10 mm and the separated type were 18. 400 (2.024-167. 301 ), 4. 643 ( 1. 815-11. 877 ) and 14. 385 (3. 601-57.467 ), respectively. (2) The midline shift and type of hematoma were found to be correlated with the recurrence of CSDH in the multivariate analysis, when the OR and 95% CI value of patients with hematoma midline shift ＞ 10 mm and separated type were 5. 280 ( 1. 339-20. 823) and 19. 125 (4. 175-87.619), the OR and 95% CI value of patients with hematoma width ＞30 mm was 14. 838 ( 1. 353-162.698). Conclusions Type of hematoma and midline shift are found to be independently correlated with the recurrence of CSDH, and the width of hematoma is also related with its recurrence.

Objective To evaluate the relationship between combined muhigene detection and response to chemotherapy and prognosis in epithelial ovarian carcinomas(EOCS).Methods A total of 80 ovarian tissue samples taken from the surgical specimens of patients with EOCS of our hospital in the last two decades who had received chemotherapy "after surgery were paraffin-embedded.The samples were divided into 2 groups,good prognosis group(patients who survived more than 2 years,n=46)and poor prognosis group(patients who survived less than 2 years,n=34).The expression levels of ToPo-Ⅱ,Ki-67,MGMT, PCNA,p27,p53,pl6,P-gp,LRP,GST-?,bcl-2,C-myc,Fas,bax,MSH2,MRP and BCRP were investigated by the combination of tissue arrays and immunohistoehemical streptavidin-biotin peroxidase(SP) method in all samples.Data were analysed with SPSS 12.0 for windows.Results There were statistically significant differences in the positive expression levels of P-gp,BCRP,MGMT,MSH2,p27 and p16(62%, 50% and 50% in poor prognosis group vs 33%,28% and 28% respectively,P

Trypanosoma is a human parasite severely affecting poor tropical areas.However,current frontline drugs for Trypanosoma treatment have severe side-effects with decreased effectiveness.Based on the fact that aminoacyl-tRNA synthetase is a bonafide drug target for several microorganisms,including bacteria and fungi,it is plausible that it may also be effective target of Trypanosoma.The Trypanosoma brucei leucyl-tRNA synthetase(tbLeuRS)was cloned,expressed and purified to develop an in vitro enzymatic assay system.The assay conditions were further optimized for the effective screening of tbLeuRS inhibitors thus establishing an anti-Trypanosoma drug screening system targeting tbLeuRS.The results indicated that this system can be employed for the effective screening of anti-Trypanosoma drugs with satisfactory specificity.In addition,this system can also be used for compound optimization,as well as IC50 testing.Using this system a series of compounds are identified that are effective Trypanosoma inhibitors without toxicity to human cells.Therefore,targeting tbLeuRS may represent a new venue for the development of anti-Trypanosoma drugs.

Baekground:Obstetric hemorrhage is a major cause of maternal death during cesarean delivery.The objective of this retrospective observational study was to evaluate the efficacy and safety of intra-operative cell salvage (IOCS) in cesarean section.Methods:We included a total of 361 patients diagnosed with central placenta previa who underwent cesarean section from May 2016 to December 2018.In this study,196 patients received autologous transfusion using IOCS (IOCS group) and 165 patients accepted allogeneic blood transfusion (ABT group).Propensity score matched analysis was performed to balance differences in the baseline variables between the IOCS group and ABT group.Patients in the IOCS group were matched 1:1 to patients in the ABT group.Results:After propensity score matching,137 pairs of cases between the two groups were successfully matched and no significant differences in baseline characteristics were found between the IOCS group and ABT group.Patients in the IOCS group were associated with significantly shorter length of hospital stay,compared with ABT group (8.9 ±4.1 days vs.10.3 ± 5.2 days,t=-2.506,P =0.013).The postoperative length of hospital stay was 5.3 ± 1.4 days for patients in the IOCS group and 6.6 ± 3.6 days for those in the ABT group (t =-4.056,P ＜ 0.001).The post-operative hemoglobin level in the IOCS group and ABT group was 101.3 ± 15.4 and 96.3 ± 16.6g/L,respectively,which were significantly different (t=2.615,P=0.009).Allogeneic red blood cell transfusion was significantly lower at 0 unit (range:0-11.5 units) in the IOCS group when compared with 2 units (range:1-20 units) in the ABT group (P ＜ 0.001).Condusions:This retrospective observational study using propensity score matched analysis suggested that IOCS was associated with shorter length of postoperative hospital stay and higher post-operative hemoglobin levels during cesarean delivery.

Objective To define the questions and outcomes included in the Practice Guidelines for Individualized Medication of voriconazole and their importance ranking.Methods Using the Delphi method , experts were consulted in three rounds.Enthusiasm index , conformity indexes and authority indexes were calculated for quality control.Results Eighteen questions and 10 outcomes were defined.Recommendations of seven questions must be developed in the guideline.Four outcomes were ranked as “critical outcome”.Enthusiasm index was 90.5%.Authority indexes were all >0.75.Conformity indexes of only 2 questions and 2 outcomes were ≤15%.Conclusion Through Delphi method , questions and outcomes included in the Practice Guidelines for Individualized Medication of voriconazole were defined , which gives directions to guide-line development.

Background The diagnosis of central serous chorioretinopathy (CSC) is mainly dependent onfluorescine fundus angiography (FFA). However, the combination of optical coherence topography (OCT) with FFA offers a new approach to the research of the pathogenesis of CSC. Objective This clinical study was designed to study the combined application of the FFA and OCT for the research of the pathogenesis of central serous chorioretinopathy (CSC). Methods Forty-four eyes of 44 patients with CSC were included in this study with 36 cases of males and 8 cases of female. The patients were aged 39.3 ± 5.3 years and the visual acuity was 0. 64 ±0. 27. FFA and OCT examinations were performed in all patients and the FFA images were imported into the Topcon 3D OCT 1000 device to locate the conformity of OCT lesions with the leakages of FFA. The neuroepithelial layer thickness at the fovea and the height of the neuroepithelial layer detachment were measured using 3-D OCT. Results OCT showed serous REP detachment in 34 eyes (77.3%) and rough surfaces of RPE in 10 eyes (22. 7% ). In thirtyfour eyes with RPE detachment, the OCT lesions and FFA leakage spots conformed to the same locations in 31 eyes, but the other three eyes did not. The mean foveal neuroepithelial thickness was (138.5±19.4) μm in CSC eyes and that of normal eyes was ( 131.35±5. 01 ) μm ,showing a significant difference between them( t=0. 39 ,P＞0. 05 ). The mean height of neuroepithelial detachment was (263.3 ± 126.7 ) μm in CSC eyes. Conclusion RPE detachment occurs in CSC eyes and further induces macular neuroepithelial detachment. Leakage lesion of fluorescine corresponds to RPE detachment. CSC without RPE detachment may be related to the increase in RPE permeability. OCT can accurately measure the thickness of the macular neuroepithelial layer and the height of the neuroepithelial detachment.

Objective To investigate the duodenum absorptive character of monosialotetrahexosylganglioside sodium (GM1) in rats.Methods The contents of phenolsulfonphthalein (as indicators) and GM1 were determined with ultraviolet-visible (UV) method and high performance liquid chromatography (HPLC) method in rats with in situ cycle intestinal perfusion model.Results The ratio of duodenum absorption of GM1 was 10％ in 2 h after cycle and 22％ in 6 h after cycle,respectively.The Ka was (0.030± 0.012)h,and absorption t1/2 was (25.50 ± 8.56)h in 8 h after cycle.Conclusions GM1 is absorption in rat duodenum,and the accumulate absorption of GM1 is almost linearly related to the cycle time.The absorption dynamics of GM1 may be first-order kinetic process.