Objective To observe the clinical effect of modified B-lynch suture in the treatment of patients with pernicious placenta pre-via.Methods A total of 46 patients with pernicious placenta previa in our hospital were randomly divided into the modified B-lynch suture treatment group(modified group)and the conventional therapy group(convention group),with 23 cases in each group.The operation time, menstrual recovery time and lochia sanguinea time,postpartum hemorrhage,intraoperative blood soss,abnormal temperature time,placenta ac-creta,hysterectomy and neonatal asphyxia between the two groups were compared.Results The intraoperative blood soss and postpartum hemorrhage of modified group was less than those of convention group,the menstrual recovery time was shorter than that of convention group and the rate of resection of uterine was lower than that of conventional group,with significant difference (P <0.05).There was no statistically significant difference in operation time,abnormal temperature time,lochia sanguinea time,placenta accreta and neonatal asphyxia between two groups (P >0.05).Conclusion The clinical effect of modified B-lynch suture in the treatment of dangerous placenta previa is significant.

Objective To decrease the unhappiness of children and make them happy to the utmost in their process of seeking medical help by constructing a clinical nursing model of happiness and natural affection. Methods During the clinical process of setting up a suitable surrounding for children's hospi-tal visit and hospitalization, and finding a pleasant method to meet children's psychological needs, indexes of physiological response pre and post admission, discharge and painful operations including surgeries were recorded. Parameters of psychological reactions such as facial expressions, movement reactions and emo-tions were observed and changes of medical compliance were analyzed. We also evaluated variation of fear, time of disease rehabilitation, the satisfaction degree of parents and doctors. Results Child's fear was lowered obviously, cooperation and compliance of treatment were improved remarkably, time of disease re-habilitation was shortened to different degree, the satisfaction degree of patients and doctors had been im-proved to above 98%. Conclusions The clinical nursing model of happiness and natural affection for children can decrease the unhappiness of children and make them happy to the utmost in their process of seeking medical help.

Graft vs Host Disease ; drug therapy ; Humans ; Tumor Necrosis Factor-alpha ; antagonists & inhibitors ; therapeutic use

Objective To investigate the serum level of visfatin, C-reactive protein (CRP) and monocyte chemoattractant protein-1 (MCP-1) in patients with polycystic ovarian syndrome (PCOS), and provide the basis for understanding the pathogenesis of PCOS. Meth-ods 94 patients with PCOS and 100 healthy subjects were divided into 4 subgroups according to their body mass index(BMI), including obese PCOS subgroup(n = 52), non - obese PCOS subgroup (n = 42), obese healthy subject subgroup (n = 43) and non - obese healthy subject (n = 57). Serum visfatin, CRP, MCP-1, sex hormone levels and metabolic parameters were measured by enzyme-linked immu-nosorbent assay (ELISA), automatic chemistry analyzer or chemiluminescent immunoassay. Results Serum levels of testosterone (T), lu-teiizing hormone (LH) and prolactin (PRL) in the PCOS group were significantly higher than those in healthy subjects group(P <0.05～0.01), and follicle-stimulating hormone (FSH) levels were significantly decreased in PCOS group(P<0.01). Serum levels of Visfatin, CRP, MCP-1,fasting insulin(Fins) and insulin resistance homa model (HOMA-IR) in the obese or non - obese PCOS subgroup were signif-icantly increased than that in the obese or non - obese healthy subjects subgroup respectively (P<0.01). Pearson correlation analysis showed that the visfatin, CRP and MCP-1 levels were positively related to BMI, FINS and HOMA-IR(r=0.323～0.675, P<0.01). Par-tial correlation showed that serum visfatin levels were correlated with HOMA-IR(r=0.491, P<0.01), and serum MCP-1 levels were cor-related with LH (r=0.267, P<0.05) in the PCOS group. Conclusion The patients with PCOS had higher visfatin, CRP and MCP-1 lev-els, and visfatin levels were positively correlated with insulin resistance. Obesity were involved in the chronic inflammation course in patients with PCOS.

Background:Cytapheresis has been used gradually in the treatment of ulcerative colitis( UC),however,its efficacy is still controversial. Aims:To systematically evaluate the efficacy and safety of cytapheresis on UC. Methods:PubMed, Embase,Web of Science,Cochrane Library,CNKI,Wanfang and VIP database were retrieved to collect the randomized controlled trials( RCTs)using cytapheresis for UC. Article selection,data extraction and quality evaluation were conducted independently by two reviewers. Meta-analysis was conducted by using RevMan 5. 3 software. Results:A total of 20 RCTs involving 1 354 UC patients were included. The results of the meta-analysis showed that cytapheresis was superior to conventional therapy or sham procedure in inducing clinical response(RR=1. 36,95% CI:1. 20-1. 55,P﹤0. 000 01), clinical remission(RR=1. 38,95% CI:1. 15-1. 66,P=0. 000 5)and maintenance of remission(RR=2. 92,95% CI:1. 40-6. 08,P=0. 004 ),and no differences in adverse events were found( RR =0. 37,95% CI:0. 11-1. 24,P =0. 110). Conclusions:Cytapheresis has porfound effect on induction of clinical response, clinical remission and maintenance of remission,and is safe as well. However,the conclusion should be verified by more large-scale and multi-center RCTs.

Objective To census the preoperative prevalence rate of deep venous thrombosis (DVT) and to evaluate the risk factors of DVT in senile osteoporotic hip fractured patients.Methods The object of study were patients aged 60 and above, and osteoporotic hip fracture by low energy injury in 2013.Based on medical records, all the patients with osteoporotic hip fracture were evaluated the signs and symptoms of DVT in 24 h, D-dimer test and underwent Doppler ultrasound screening of bilateral venous system in lower extremity after admission, and all the patients received preoperative prophylactic anticoagulation.Patients with popliteal and proximal level thrombus or floating thrombus underwent inferior vena cava (IVC) filter insertion.Outcome measures: age, gender, fracture type, D-dimer value in 24 h preoperatively, occurrence time of DVT and region, grade of preoperative American Society of Anesthesiologists, preoperative medical diseases.Results 702 of 946 hip fracture inpatients were comprised in this retrospective study.All were not founded any symptom or signs of DVT.All patients were took preoperative Doppler ultrasound screening and the results as follows: 36 of 302 patients (11.9％) with femoral neck fracture were proved preoperative thrombosis(13 male, 23 female), the average age was 72.7 year-old(range from 62-90 year-old), on the same side as the fractured hip in 31 patients, bilateral thrombosis in 5 patients.74 of 400 patients (18.5％) with intertrochanteric fracture were proved preoperative thrombosis(38 male, 36 female), the average age was 76 year-old (range from 60-95 year-old), on the same side as the fractured hip in 68 patients, bilateral thrombosis in 6 patients.The most prevalence rate of DVT were in the first day after osteoporotic hip fracture, 15 patients (41.7％) with femoral neck fracture and 38 patients (51.40％) with intertrochanteric fracture.There were more proximal level and multiple level involment thrombosis over 5 days after injury.The most thrombosis were proven at calf and popliteal vein.Conclusion The prophylaxis of DVT should be started even in the emergency department in senile patient with osteoporotic hip fracture.To avoid the risk factors, early surgery and early postoperative mobilization will be effective.

The Australian emergency medical system has transformed over the last thirty years with the development of pre-hospital care services, hospital Emergency Departments and the development of new professional roles of Emergen-cy Physician and Paramedic. This transformation which has reflected those in many other countries has occurredbecause of increasing accountability by health services for the quality of emergency health care and increased pro-fessional commitment.

Objective To analyze the correlative factors of peptic ulcer recurrence in the elderly. Methods From January to December 2009,169 elderly patients (≥ 60 years old)with peptic ulcer delected by edoscopy were enrolled,whose treatment and usage of medication were analyzed.Data of treatment and recurrence in 3-year follow-up were recorded.Mann-Whitney rank sum test and Logistic regression analysis were performed to analyze the correlated factors.Results The potential risk factors associated with recurrence of peptic ulcer in the elderly were screened and analyzed by single factor analysis,and ulcer size, ulcer location, concomitant usage of drugs, smoking and condition of Helicobacterpylori (H .pylori )infection at the end of follow-up were found to be correlated with recurrence of peptic ulcer in the elderly.After adjusting age and gender,the potential risk factors were analyzed by a Logistic stepwise regression model.Smoking (OR = 1 .788,P = 0.001 ),combined medication (OR=6.202,P =0.015 ),ulcer size (OR =2.697,P =0.032 )and condition of H .pylori infection at the end of follow-up (OR=43.784,P =0.007)were found to be correlated with recurrence of peptic ulcer in the elderly.Conclusion Smoking,combined medication,ulcer size and condition of H .pylori infection at the end of follow-up have an impact on peptic ulcer recurrence in the elderly.

Objective To evaluate the changes in the expression of acetylated histone H3 (Ac-H3) and deacetylase silent information regulator 1 (SIRT1) in dorsal root ganglions in a rat model of negative phenotype neuropathic pain.Methods Forty-eight male Sprague-Dawley rats,weighing 250-300 g,were randomly divided into 2 groups (n =24 each):sham operation group (group S) and C-fiber dysfunction group (group CFD).The rats were anesthetized with 10％ chloral hydrate 3 ml/kg.C-fiber dysfunction was induced by exposing sciatic nerve to 8％ capsaicin for 30 min in group CFD.The thermal withdrawal latency (TWL) and mechanical withdrawal threshold (MWT) were measured before and on 1,3,7 and 14 days after CFD.Six rats were then sacrificed at each time and the lumbar segments (L5) of the dorsal root ganglions were removed for detection of SIRT1 mRNA expression (by RT-PCR) and Ac-H3 and SIRT1 protein expression (by Western blot).Results Compared with group S,TWL was significantly increased at 1,3,7 and 14 days after CFD,SIRT1 mRNA and protein expression was up-regulated and Ac-H3 expression was down-regulated at 3,7 and 14 days after CFD (P ＜ 0.05),while no significant change was found in MWT at each time point in group CFD (P ＞ 0.05).Conclusion The mechanism of negative phenotype neuropathic pain is related to up-regulation of deacetylase SIRT1 expression and decreased acetylation of histone H3 in rat dorsal root ganglions.

Objective To compare the effects of every-other-day dose simvastatin administration with that of daily therapy of same dose.Methods This was a randomized,prospective,nonblinded clinical trial.The 186 patients with high low-density lipoproteim cholesterol(LDL-C) and/or high total cholesterol (TC),triglycerides (TG),low high-density lipoprotein cholesterol(HDL-C)was studied.All patients were randomized into two groups.The every-other-day do- sing group recerived 20mg of simvastatin in alternate-day and daily dosing group received 20mg of simvastatin every day.Before and after 6 weeks,12 weeks of treatment,serum lipoprotein,Live function tests and ereatine kinase con centra- tion and so on were drawn and bad-side effect were studies.Results The two groups significantly reduce LDL-C,TC, TG and a little increased HDL-C compared with baseline.No stalistically significant differences existed between the two groups in percentage in decrease in lipoprotain at 6 weeks,12 weeks compared with baseline.The bad-side effect in the two groups also had not a singnificant different.Conclusion The every-other-day dose of simvastatin have similar effi- cacious and safe to daily dosing in patients with hyperlipidemia and some cost savings.It can take a primary prevention to coronary heart disease in patients with relatively low-risk hyperlipidemia.