Objective To investigate the efficacy of intermittent epidural bolus ( IEB) for patient?controlled epidural analgesia ( PCEA) during delivery. Methods Eighty?five parturients requesting epi?dural analgesia, who were at full term ( 37-42 weeks of gestation) with a singleton fetus in vertex presenta?tion, of American Society of Anesthesiologists physical statusⅠorⅡ, with body mass index< 35 kg∕m2 , were divided into either IEB group ( n=42) or continuous epidural infusion ( CEI) group ( n=43) using a random number table. The analgesia solution contained 0.08% ropivacaine and 0.4μg∕ml sufentanil in both groups . IEB settings were a 6 ml bolus every hour at the rate of 400 ml∕h with a bolus dose 6 ml and lockout interval 30 min. CEI settings were background infusion 6 ml∕h with a bolus dose 6 ml and lockout interval 30 min. Numeric rating scale score was maintained≤5, and if the efficacy was not satisfactory, a bolus of pump solution 5-10 ml was added. The consumption of analgesics per hour, initial PCA time, and occur?rence of lower extremity numbness, motor block, nausea and vomiting, and pruritus were recorded. Pa?tients′satisfaction with analgesia was scored, and the duration of labor and mode of delivery were recorded. Results Compared with group CEI, the initial PCA time was significantly prolonged, the satisfaction score was significantly increased, the incidence of lower extremity numbness was significantly decreased ( P<0.05) , and no significant change was found in the consumption of analgesics per hour, incidence of motor block, nausea and vomiting, and pruritus, constituent ratio of mode of delivery, and duration of la?bor in group IEB ( P>0.05) . Conclusion IEB can be safely and effectively used for PCEA during deliver?y, and the efficacy is better than that of CEI in the parturients.

Objective: In order to implement effectively on-scene medical response to a nuclear or radiological emergency, and also keep track of relevant on-scene audio and video information and monitoring data, we have designed and developed a monitoring platform for medical response to nuclear or radiological emergency. Methods:Based on relevant national standards for emergency response and the features of nuclear or radiological emergency, exploiting modern information technology and monitoring equipments, we formulate the design idea, characteristics, functions and framework of the platform. This platform takes treatment centers for nuclear or radiological injuries, designated medical institutions and medical response teams as main users. Results:We have developed the monitoring platform for medical response to nuclear or radiological emergency. Conclusion:Through the application of this platform, we hope to enhance the preparedness and on-scene response capability for nuclear or radiological emergency, and also provide information support for disposal of nuclear or radiological emergency in the future.

Atomoxetine as a nonstimulant medicine was approved by the Chinese Food an Drug Administration and provide a new selection of treatment drugs for attention deficit hyperactivity disorder (ADHD). Tomoxetine is a noradrenaline transmitter reuptake inhibitor which can selectively inhibit synapsis noradrenaline transport protein, strengthen noradrenaline's resupination effect, and increase noradrenaline's activity released by synaptic cleft to improve the symptoms of the ADHD patients. Compared with methylphenidate, atomoxetine does not affect the concentration of the neurotransmitter dopamine and does not induce or increase the Tourettes' syndrome, therefore atomoxetine is more suitable to treat ADHD together with Tourettes syndrome. In this article the treatment of atomoxetine for ADHD, including the indications, dosage as well as adverse reactions and efficacy assessment are reviewed.

Objective To observe the changes of serum CRP and plasma Fg in patients with chronic renal failure(CRF),to explore the effect of statins on inflammaory reaction in CRF patients.Methods 54 patients with CRF were randomly divided into non-statins group(routine therapy);atstina group(routine therapy plus simvastatin 20mg/d or pravastatin 20mg/d).Besides,a healthy control group consisted of 20 subjects was set up as control group.The changes of serum of CRP and plasma Fg of all groups before and four weeks after treatment were recorded.Results The serum CRP and plasma Fg levels increased in CRF patients,Which were significantly higher as compared to the control group.After treatment for four weeks,the level of CRP,Fg of matins group decreased significantly.The levels of CRP,Fg had no statistical changes in non-statins group.As compared to non-statins group,the differences of CRP,Fg levels after treatment in statins group were statistically significant respectively.Conclusions(1)Inilammaory reaction is a common condition in non-dialysis patients with CRF;(2)ststins show effects on decrease of CRP,Fg level in CRF patients,independently on the effect of decreasing hypedipemia.

Objective To improve the probability of early diagnosis and treatment on leukemia combined with hepatosplenic abscesses and to reduce the mortality of leukemia in relation to infection.Methods Nineteen children,who were diagnosed and treated as leukemia combined with hepatosplenic abscesses in Hematology Center of Beijing Children′s Hospital from Jan.2000 and Dec.2007,were selected.Data of them including presenting signs and symptoms,proof of diagnosis,culture data,treatment modality,opportunity of recovering chemotherapy,following up data and so on were reviewed.Results The neutrophil counts were more than 1.0?109 L-1 in all children when hepatosplenic abscesses were diagnosed by means of images.Positive blood cultures were found in 7 children and positive pharyngeal or stool cultures were found in 8 children.Sonographic-guided hepatic abscess biopsies were operated in 3 children,but microbiologic and histologic examination were negative.According to the positive cultures or the validity of empirical antimicrobial or antifungal therapy,7 cases of fungal,7 cases of bacterial and 5 cases of bacterial/anaerobic hepatosplenic abscesses were diagnosed.During follow-up period from 10 days to 2 years and 11 months(median time was 9 months),images improved in 17 children,abscesses disappeared in 10 children and chemotherapy restarted in 84% children.Conclusions The images should be taken opportunely when neutropenia recovered in neutropenic patients with prolonged fever.As blood cultures were often negative,the clinician must pay more attention to the other positive cultures involvement.Early biopsy is advised in order to obtain positive results.The prognosis of bacterial/anaerobic hepatosplenic abscesses is good by adopting an extended spectrum antimicrobial treatment.Antifungal therapy must last enough time in children with fungal hepatosplenic abscesses.Chemotherapy was advised when manifestations of hepatosplenic abscesses improved significantly,neutrophil counts recovered and images did not deteriorate.

Objective: To observe the effects of low concentration of CGP57380, an inhibitor of mitogen-activated protein kinase-interacting kinase 1 (MNK1) on the proliferation and apoptosis of human lung adenocarcinoma A549 cells. Methods: A549 cells were treated with low concentrations (1-4 μmol/L) CGP57380 for 24-72 hours, then the cell proliferation was assessed by MTT assay, and the apoptosis and cell cycle distribution were detected by flow cytometry. The expression levels of phosphorylated MNK1 (p-MNK1) and phosphorylated human eukaryotic translation initiation factor 4E (p-eIF4E) proteins in A549 cells treated with 1 μmol/L CGP57380 for 48 hours were examined by Western blotting. Results: Comparing to the control, the proliferation of A549 cells was inhibited after treatment with different concentrations of CGP57380 for 48 hours (all P < 0.05). A549 cells treated with 2-4 μmol/L CGP57380 for 72 hours were induced G2/M cell cycle arrest (both P < 0.05). CGP57380 at different concentrations could induce dose-dependent apoptosis in A549 cells. The expression levels of p-MNK1 and p-eIF4E were significantly lower in A549 cells treated with 1 μmol/L CGP57380 than those in the control (P < 0.05). Conclusion: Low concentration of CGP57380 can inhibit the proliferation of human lung adenocarcinoma A549 cells and induce their apoptosis, implying that MNK1 gene may be a candidate target for the treatment of lung cancer. Copyright © 2013 by TUMOR.

Background Free-flap Epi-LASIK surgery show a fast epithelial healing and mild trauma responses.Its mechanism is notable. Objective The aim of this study was to compare the corneal epithelial healing response following photorefractive keratectomy(PRK)and flap-free Epi-LASIK surgery. Methods Twelve experimental rabbits were randomly assigned to high cutting group(-10.00 D)and low cutting group(-3.00 D),and 2 normal matched rabbits were used as controls.PRK was performed in lateral eyes and flap-free epipolis laser in situkeratomileusis(Epi-LASIK)surgery was curried out in the fellow eyes.The corneal wound healing response in early stage of post-operation was examined under the slim lamp,and the inflammatory cells infiltration in cornea,basic fibroblast growth factor(bFGF)and nuclear transcription factor(NF-KB)expressions in corneal stroma were detected by hematine-eosin staining and immunohistochemstry in the seventh day after operation. Results The inflammatory reaction was milder in the eyes with Epi-LASIK than ones of PRK under the slim lamp.No significant difierences were found in numbers of inflammatory cells in cornea.expressions of bFGF and NF-κB in corneal stroma between two types of surgeries in low cutting group(P＞0.05).In high cutting group,the numbers of inflammatory cells were(12.25±1.22)/400 field in PRK eyes,and those of free-flap Epi-LASIK eyes were(6.67±0.31)/400 field,showing obvious difference between them(t=-8.87,P＜0.01).Expressions of NF-κB(A value)in cornea were 6.11±1.36 and 41.82±8.7 1 in PRK eyes of low cutting group and high cutting group.and those in free-flap Epi-LASIK were 3.01±0.81 and 11.59±4.55.indicating a drastically increase in PRK eyes(P＜0.05).The expressions of bFGF(A value)in corneal stroma were 33.59±6.98 and 123.68±18.81 in PRK eyes and those in free-flap Epi-LASIK eyes were 69.20±8.85 and 123.68±1 8.81 in low cutting group and high cutting group,presenting a considerably decrease in PRK eyes (P＜0.05).The corneal epithelial healing was faster in free-flap Epi-LASIK eyes than that in PRK eyes.and deeper cutting slowed the healing procedure. Conclusion In low cutting group,healing time of corneal epithelium is close between PRK and flap-free Epi-LASIK.But in high cutting group,epithelial healing is faster and inflammatory reaction is lighter in flap-free Epi-LASIK compared with PRK.

Cardiovascular disease is the first cause of death in Chinese residents. Arterial elasticity is an important and independent predictor for mortality of cardiovascular disease, and pulse wave velocity (PWV) is the most frequently used measurement index. It has been widely used in clinical practice. Traditional methods detecting PWV have some disadvantages, such as arteries distribution not clear, branch affect and only obtain global and average, instead of regional PWV. Now, the measurement of local pulse wave velocity has played an important role in the study of arterial elasticity. The common methods of detecting regional pulse wave velocity include echo tracking technique, UltraFast imaging technique and pulse wave imaging technique. This article reviews the recent advances in pulse wave velocity evaluating vascular elasticity.

Objective:To analyze the effects of rational intervention on prophylactic antibiotics use in typeⅠIncision. Methods:A retrospective investigation method was used. Totally 170 cases with typeⅠIncision undergone in the hospital from April to Decem-ber 2013 were selected as the non-intervention group, and 173 cases with typeⅠIncision undergone in the hospital from April to De-cember 2014 were selected as the intervention group. The prophylactic antibiotics use, medication time, drug selection and duration of drug treatment were analyzed. Results:After intervention, the use rate of antibiotics was decreased from 67. 65% to 26. 59%, the ir-rational rate of use time was decreased from 15. 88% to 4. 63%, the irrational rate of treatment course was decreased from 30. 58% to 8. 09%, and the combination rate was declined from 10. 59% to 5. 20%. Conclusion:The rational prophylactic use of antimicrobial in type Ⅰ incision is improved through the intervention, and further efforts are still needed to improve the reasonable use.