Objective To assess the effect of Ambroxol combined with Naloxone on respiratory insufficiency on premature infants. Methods A total of 168 premature infants treated from 2006 to 2009 in our hospital were divided into two groups randomly. Additionally to the conventional treatment, Ambroxol (5 mg pertime) combined with Naloxone (0.1mg pertime) intravenously injected 2 to 3 times one day for 3 to 5 days in the treatment group(86 cases). The control group (82 cases) was treated by routine Aminophylline injection,3- 5 mg/kg pertime, 2 to 3 times one day. Respiratory rates, regulately or not,breathholding, cyanosis and apnea,mechanically ventilated time,time of oxygen inhaling, time of hospital stay and the overall response rate were measured. Results The overall response rate was 80% (69/86) in the treatment group and 56% (46/82)in the control group, with significant difference between the two groups ( P ＜ 0. 05 ). Mechanically ventilated time,time of oxygen inhaling and hospital stay in the treatment group was (110.5±45.1) hrs, (169.3±58.6) hrs and ( 12±3) days, which were all significantly lower than that in the control group ( 181.1±81.2) hrs, (236.6±87.8)hrs and (16±5)days,respectively(P＜0.01 or 0.05). Conclusion Ambroxol and Naloxobe additional to conventional treatment could improve the respiratory function in premature infants with respiratory insufficiency safely with less side effects. Moreover,breathing machine could be removed to some extent,which made it more applicable in primary hospitals.

ObjectiveTo investigate the expression of hypoxia inducible factor 1 (HIF-1α) in rats' retinae during the embryonic and earlier postnatal period.MethodsThe retinal expression patterns of HIF-1α protein and mRNA of embryonic day 12 (E12), E16, E20, and postnatal day 1(P1) and P5 rats were determined by immunohistochemical staining and reverse transcription polymerase chain reaction (RT-PCR).ResultsHIF-1α protein was detected in the neural epithelial layer and the pigment epithelial layer at all those 5 timepoints, with higher expression in the ganglion cell layer and the inner plexiform layer, and seems limited to the ganglion cell layer when retina became more mature. Embryonic rat retina had higher expression of HIF-1α protein and mRNA than postnatal retina, the difference was significant (P<0. 01). ConclusionThe expression of HIF-1α in rats' retinae differs from embryonic to earlier postnatal stages.

Objective To observe the efficacy of palace production technique of Puerpera with gestational hypertension by ropivacaine combined with sufentanil and epidural anesthesia.Methods77 cases with hypertensive disorders in pregnancy from January 2014 to January 2015 hypertensive, 39 cases were randomly divided into observation group and the control group of 38 patients, the control group received ropivacaine anesthesia, the observation group received ropivacaine combined with sufentanil and epidural anesthesia, observed two groups of mothers onset time of anesthesia, operative time, pain duration, neonatal apgar score, postoperative pain scores and adverse reactions.ResultsThe onset time of anesthesia, analgesia duration, and postoperative pain scores were significantly better than the control group, the difference was significant (P<0.05);two groups of mothers in the operation time, score and adverse neonatal apgar, the total incidence the difference was not statistically significant.ConclusionRopivacaine combined with sufentanil CSEA anesthesia for hypertensive disorders in pregnancy cesarean exact effect is better than alone ropivacaine spinal anesthesia program, and no obvious side effects and is worthy of further promotion and application.

BACKGROUND: Hypoxia inducible factor-1 α(HIF-1 α) is not only related to physiological reaction of hypoxia,but also takes part in normal embryonic development.OBJECTIVE: To study the alteration of HIF- 1 α in retina during rat development.DESIGN,TIME AND SETTING: Randomized contrast animal study,which was performed in the Shandong Provincial Molecular Virus Key Laboratory,Medical College of Qingdao University between January and September 2007.MATERIALS: Adult Wistar rats,nulliparity,clean grade,and weighing 200 250 g were used in this study.METHODS: Male and female rats were caged as the ratio of 1 : 1.Embryos were obtained at 12-day,16-day,and 20-day pregnancy.Eyeballs were obtained from newborn rats by anesthesia at 1-day,5-day,10-day,and 12-month birth.Retina was separated and made into paraffin section.MAIN OUTCOME MEASURES: Expressions of HIF 1 α protein and HIF-1 α mRNA in retina were measured by immunohistochemistry and semiquantitative reverse transcription-polymerase chain reaction at various dine points of embryonic development.RESULTS: HIF-1 α positively expressed at stratum neuroepitheliale retinae and purpurogenous membrane in the embryonic phase.Additionally,HIF-1 α still positively expressed at stratum neuroepitheliale retinae and purpurogenous membrane,especially in ganglionic cells and inner plexiform layer,in early development.With the gradual development,the positive expression was mainly located at stratum ganglionare retinae.HIF-1 α protein and mRNA expressions were the highest in the embryonic phase,lower in the development,and the lowest in the adult period.There were significantly differences among these three phases (P ＜ 0.01).CONCLUSION: HIF-1 α decreases gradually in retina and its expression is mainly located at stratum ganglionare retinae.

Medial pancreatectomy has been gradually used in the treatment of benign tumors in neck and body of pancreas since less removal of the pancreas and the retainment of the duodenum,spleen and functional pancreas,it is less harmful to the endocrine and exocrine function of the patients.Seventeen patients received medial pancreatectomy for benign tumors in neck and body of the pancreas in the China-Japan Union Hospital of Jilin University from November 2005 to December 2010.Fifteen patients received the closure of broken ends of pancreatic head,pancreaticojejunostomy,and the other 2 received pancreaticojejunostomy.No perioperative death was found.All the patients were followed up for 2 to 45 months,and no death was recorded.No patient got new-onset diabetes and pancreatic pseudocyst,and their tumors were not relapsed.Now the retrospective analysis was carried out to this group of patients and to further regulate the surgical operation of the medial pancreatectomy.

Aim To explore the relations between anti-apoptotic role of dipfluzine (DIP) and the death signaling transduction pathway initiated by CD95 molecules, and the transcription factor involved in the transcription regulation of CD95 molecules in the hippocampal CA1 region after transient forebrain ischemia. Methods The rat forebrain transient ischemia model was established through 15 min ischemia followed by 3 days reperfusion by using the four-vessel method. The rats were divided randomly into five groups: sham control group, ischemia / reperfusion (I/R) group, DIP treated groups (20, 40 and 80 mg·kg-1 body weight, ig, separately). Western blotting and RT-PCR were performed to detect the expression changes of Fas, FasL, caspase 10 p20, caspase 8, I-κB-α, and p-I-κB-α molecules in protein and mRNA levels, separately, and immunohistochemistry for molecular localization of Fas and FasL in rat hippocampus. Results The expression of Fas, FasL, and caspase 10 p20 in protein and mRNA levels increased after I/R, which was inhibited significantly after treatment with 20 and 40 mg·kg-1 of DIP (P<0.01). In 80 mg·kg-1 of DIP group, the expression of Fas and FasL protein was not significantly different from that of I/R group (P>0.05). The expression of caspase 8 and I-κB-α showed no significant differences in all groups (P>0.05), and no gene expression was observed for p-I-κB-α protein in the study. DIP significantly affected molecular distribution of Fas and FasL protein in CA1 subregion of hippocampus. Conclusion DIP inhibits the death signaling transduction pathway initiated by CD95 molecules in rat hippocampal CA1 subregion, and NF-κB transcription factor may not be involved in the transcription regulation of CD95 molecules after transient forebrain ischemia.

Objective To understnad the defense mechanisms of patients with borderline personality disorder (BPD) and to explore its relationship with childhood abuses.Methods One hundred and forty-two outpatients with BPD (group A),63 outpatients with other personality disorders (group B) and 20 outpatients without any Axis Ⅱ diagnoses (group C) were enrolled and completed Chinese versions of the Childhood Experience of Care and Abuse Questionnaire (CECA.Q) and the Defensive Style of Questionnaire (DSQ).Multivariate analysis of variance and Pearson correlation analysis were used for data analysis.Results Compared to group B and C,the score of defense mechanisms reported by group A were significantly increased in all eight premature defense mechanisms,such as projection(F =26.5,P ＜ 0.05),passive aggression (F =18.1,P ＜ 0.05),acting out (F =28.3,P ＜ 0.05),complaint (F =16.7,P ＜0.05),fantasy(F =16.3,P ＜ 0.05),splitting (F =28.8,P ＜ 0.05),withdrawal (F =8.3,P ＜ 0.05),somatization(F=7.6,P ＜ 0.05),and part of the middle defense mechanisms,such as omnipotence-devaluation(F =9.2,P ＜ 0.05),isolation(F =4.7,P ＜ 0.05) and identification (F =10.0,P ＜ 0.05).At the same time,the BPD patients got lower scores in the mature defense mechanisms,such as sublimation (F =4.1,P ＜ 0.05) and repression(F =3.9,P ＜ 0.05).Those who experienced physical abuse use more complaint (F =6.9,P ＜ 0.05),denial mechanisms (F =5.2,P ＜ 0.05) and less anticipation one (F =4.6,P ＜ 0.05).Those who experienced sexual abuse use more somatization (F =4.4,P ＜ 0.05) and isolation mechanism (F =3.6,P ＜ 0.05).Conclusions BPD patients would like to use more immature and middle defense mechanisms and less mature ones.Emotional,physical and sexual abuse from parents and other adult care takers have a correlation with immature defense mechanisms,which indicates the importance of care about parental rearing patterns and mental health of children.

Objective:To investigate the feasibility and safety of fetal intravascular transfusion via the intrahepatic vein in the treatment of fetal anemia.Methods:This was a retrospective analysis of all fetuses requiring intrauterine transfusion (IUT) in the Shanghai First Maternity and Infant Hospital between January 2010 and December 2019. According to the different ways of IUT, they were divided into intrahepatic venous transfusion group and umbilical venous transfusion group, fetal outcomes and the incidence of procedure-related complications between the two groups were compared.Results:A total of 97 IUTs were performed on 48 fetuses. Among them, 16 cases were performed in the intrahepatic vein (31 transfusions), 32 cases were performed in the cord of the umbilical vein (66 transfusions).There were no significant differences between the two groups in age, labor history and the proportion of fetal hydrops before the first transfusion. In the intrahepatic venous transfusion group, the posterior placenta was 14/16, which was significantly higher than 78% (25/32) in the umbilical venous transfusion group ( P<0.01). The live-birth rates of the two groups were 13/16 and 75% (24/32). There was no significant difference between the two groups ( P>0.05). Before intrahepatic venous transfusion, the proportion of fetal hydrops was significantly higher than that of umbilical venous transfusion [55% (17/31) vs 24% (16/66), P<0.05]. Puncture success rate of intrahepatic venous transfusion and umbilical venous transfusion were both 100%. In the umbilical venous transfasion group, the incidence of needle slippage (5%, 3/66) and the abnormality of fetal heart rate (11%, 7/66) were higher than those in the intrahepatic venous transfasion group [0 and 3% (1/31)], but there were no significant differences between the two groups (all P>0.05). There were no cases of fetal loss within 24 hours, premature rupture of membranes, infection within 7 days and emergency cesarean section after IUT in both groups. Conclusions:Fetal intravascular transfusion via the intrahepatic vein is safe and feasible in the treatment of fetal anemia. But the requirements of puncture technique are relatively high, so it is recommended to be carried out in experienced fetal treatment center.

Objective To observe the effectiveness and economic evaluation of appropriate technique for hypertension in community.Methods Systematic management,behavioral intervention and drug intervention were promoted for a period of 2 years in the community and the related index changes were observed after 2 years.Results After promoting appropriate technique,the hypertension knowledge,skill level in medical staff were improved (P ＜ 0.01).The treatment rate,control rate of hypertension were higher than 2 years ago (P ＜ 0.01).The average monthly cost of hypertensive patients was reduced(P ＜ 0.05).Conclusion It is effective to promote appropriate technique of hypertension in community.

Objective To explore the characteristics of nosocomial infection and its related factors among those very low birth weight infant(VLBWI)for coming up with appropriate preventive measures.Methods Fifty-eight infants with birth weight of 1500 g or below in the hospital from January to June in 2012 were studied actively and retrospectively about their nosocomial infection and related risk factors.Results Thirty-five cases of nosocomial infection occurred among the 58 infants with a prevalence of 60.34%. The mainly pathogenic bacteria was Gram-positive bacteria(88.47%)and mostly,infections presented with lung infections(82.90%) within 21 days after birth.The risk factors included mechanical ventilation,PICC,Apga score<7,fluconazole administration and premature rupture of membranes of VLBWI.Conclusion VLBWI are prone to nosocomial infections,mostly lung infection on day 21 after birth.Management should be strengthened within 3 weeks after birth of VLBWI to minimize infections.Reduction of invasive procedures on children and antibiotic use is particularly important.On the other hand,strengthening the health care in the perinatal period and reducing the incidence of preterm birth cannot be ignored.