Objective To investigate the value of combined use of misoprostol and intravenous mixture of pethidine and droperidol during operative hysteroscopy. Methods A total of 168 cases scheduled for hysteroscopy were divided into 4 groups: Group Ⅰ (42 cases) was transvaginally given 0.4 mg misoprostol as monotherapy; Group Ⅱ (41 cases) was given 0.4 mg transvaginal misoprostol in combination with intravenous mixture of 50 mg pethidine and 2.5 mg droperidol; Group Ⅲ (43 cases) was given 0.4 mg transvaginal misoprostol combined with intravenous mixture of 100 mg pethidine and 5 mg droperidol; and Group Ⅳ (42 cases), intravenous mixture of 100 mg pethidine and 5 mg droperidol. The heart rate, breath rate, blood pressure, oxygen saturation, cervical responses, VAS scores and complications were assessed respectively. Results There were statistically significant differences regarding the degree of cervical dilatation, the operation time, and the used volume of cavity-distention media between the Group Ⅳ and the Group Ⅰ, Group Ⅱ, and Group Ⅲ, respectively (P0.05). Significant differences were observed in the analgetic effect in the 4 groups (?~2=86.325,P=0.000), among which the Group Ⅱ and Group Ⅲ were superior to the other two. All patients in the 4 groups represented a stable respiratory process and blood circulation, with no significant differences in the rate of adverse effects (?~2=1.649, P=0.648). Conclusions Transvaginal application of misoprostol offers a convincing effect for cervical dilatation. Combined use of misoprostol and mixture of 50 mg pethidine and 2.5 mg droperidol gives a satisfactory analgetic effect during operative hysteroscopy.

Objective To observe dynamic responsive regularity of specific IgM and IgG antibodies in SARS patients. Methods 145 specimens of plasma from 25 cases of clinically diagnosed SARS patients were examined in the study. ELISA was employed to detect IgM and IgG antibodies against SARS coronaviral antigens. Nested RT-PCR was used to qualitatively determine SARS coronavirus (SARS-CoV). Results 49.0% (71/145) and 54.5% (79/145) of the samples were positive for IgM and IgG antibodies, respectively. Both antibodies were found to be detected in 84.0% of the patients. The antibodies were found to be detectable from the 2nd to 4th week after the onset of disease in most patients, and there was a fendeney of sising in positive rate until the 5th week after the onset. Thereafter, the detectable rate of IgM antibody began to decline, while that of IgG antibody remained to rise. Positive rate for serum SARS-CoV was 15.8% (18/114) for all samples or 40.0% (10/25) of patients. Most virus-positive samples were those which were collected within 4 weeks after disease onset. Conclusions Anti-SARS-CoV IgM/IgG antibody and detection of virus in plasma could serve as practical diagnostic indicators for SARS. In most cases, when the serum was pasitive for antibody the serum virus positive rate would soon declined. However, concomitant existence of antibody and viral sequence in plasma was observed in a few patients.

Objective To analyze the early clinical efficacy of alendronate sodium on residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures.Methods By drug single treatment method,a total of 30 elderly patients with residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures were included.Patients were randomly divided into 2 groups:the treatment group and the control group.All patients were given calcium carbonate D3 treatment,and the treatment group was given alendronate sodium treatment additionally.6 weeks after the treatment,visual analogy score (VAS) was used for the evaluation of pain relief.Results All patients were followed up for 6 weeks.At the end of follow-up,the rates of pain relief were 86.8％ in treatment group and 13.2％ in control group.There was a significant difference in visual analogy scores between the treatment group and the control group[(0.51±0.32),(1.59±1.21) ; t=3.4,P＜0.001],which showed the degree of pain relief was higher in the treatment group than in control group.Conclusions Alendronate sodium is effective and reliable for the treatment of residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures.This study provides the scientific reference for the treatment and research of residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures.

Objective To discuss the radiological characteristics and improve the diagnostic ability of SARS in children. Methods The clinical data and X-ray findings of 35 SARS cases who hospitalized during Jan, 2003～Apr, 2003 were retrospectively analyzed. Results Chest X-ray features were as follows: massive consolidation (27 cases, 77.1%), pulmonary interstitial infiltration (6 cases, 17.1%), and mixed pattern (2 cases, 5.7%). There were two patients with emphysema, but no patient with lung abscess or pleural lesion. The radiological dynamic changes showed that the lesions of lung appeared early, the severest period was between the fifth day and the seventh day, the X-ray findings were not consistent with physical sign, and the absorption of lesion was slower than the clinical process. Conclusion There are some certain radiographic characteristic in children with SARS. A correct diagnosis can be made by closely combining the X-ray findings with clinical and laboratory results.

Objective To develop an assay of PCR-produet direct sequencing to detect hepatitis B virus (HBV) YMDD mutation, and compare the results gained by the sequencing and traditional real-time fluorescent PCR assays. Methods Serum samples were collected from 103 patients with chronic hepatitis B. HBV DNA were extracted from sers. YMDD mutation was detected by a commercial real-time PCR assay. Meanwhile, HBV reverse transcriptase-encoding gene was amplified by a nested PCR assay. The PCR products were directly subjected to sequencing at two directions, and the sequencing results were analyzed by NTI program. Using Kappa test, comparison was made between the results of rtM204-site mutations obtained by the direct sequencing and YMDD mutations by the real-time fluorescent PCR. Results The direct sequencing assay proved to be highly effective with bread range of detection in viral load from 500 to 1010copies/ml. And it may simultaneously avoid inhibitory effect caused by high viral load. The coincidence rates between two assays were 100% for YIDD, 97. 1% for YVDD, 76. 2% for YIDD/YVDD coexistence (Kappa = 0. 853, P < 0. 01). Conclusions The direct sequencing assay for HBV drug-resistant mutation detection is highly sensitive with broad dynamic range. It has high coincidence rate with real-time fluorescent PCR assay with advantage of detecting YMDD, YIDD and YVDD mutations simultaneously.

Objective To evaluate the levels of serum TAM and Cyfra21-1 in diagnosis and chemotherapeutic efficacy assess-ment of patients with esophageal cancer.Methods The serum TAM and Cyfra21-1 levels were measured in 92 patients with initially diagnosed esophageal cancer or postoperative recurrence of esophageal cancer from September 2012 to September 2013 and 50 cases of healthy people in the same periods as control.The sensitivity and specificity of TAM and Cyfra21-1 were analyzed.Moreover,60 patients with high TAM and Cyfra21-1 levels before chemotherapy from September 2012 to A-pril 2014 were detected TAM and Cyfra21-1 levels after two cycles of chemotherapy.Relation between changes of TAM or Cyfra21-1 and chemotherapeutic efficacy were investigated.Results The diagnostic sensitivity of TAM for esophageal canc-er was 71.7%,which was higher than that of Cyfra21-1 (51.1%,P = 0.004).The diagnostic specificity of TAM and Cy-fra21-1 for esophageal cancer was 94.0% and 92.0% respectively.There were no significantly different between TAM and Cyfra21-1 (P =0.695).Of patients undergoing chemotherapy,the overall response was 25 cases,progress was 11 cases. There was no statistically significant difference in the coincidence rate of TAM and Cyfra21-1 (77.8% vs 75.0%,P =0.781).Conclusion Detection of serum TAM and CYFRA21-1 was valuable in the diagnosis and assessment of the thera-peutic efficacy of chemotherapy in patients with esophageal carcinoma.TAM was better than Cyfra21-1 in the diagnosis of e-sophageal carcinoma.

Objective To investigate the efficacy and safety of low-dose rituximab therapy and sequential maintenance for patients with refractory idiopathic thrombocytopenic purpura. Methods Thirty-three patients with refractory idiopathic thrombocytopenic purpura received intravenous rituximab at the dose of 100 mg once a week for 4 consecutive weeks. Complete blood cell count and serum concentrations of immunoglobulin (IgG,IgM and IgA) were monitored regularly. The numbers of CD3+ and CD19+ CD20+ lymphocyte cells were assayed by flow cytometry before and after therapy. Twenty-five patients with responses(complete response and response) were divided into maintained group (12 patients) and control group (13 patients) by random digits table method. The patients in maintained group were treated with rituximab 100 mg every 6 months. The efficacy of maintenance therapy was evaluated through long-term follow-up. Results The complete response(CR) rate, response (R) rate and no response(NR) rate were 48.48%(16/33), 27.27%(9/33) and 24.24% (8/33), respectively. As a result, total effective rate was 75.76% (25/33). There were no significant changes of peripheral blood white blood cell count,hemoglobin,serum immunoglobulin and CD3+lymphocyte counts before and after treatment (P>0.05). However, CD19+ CD20+ cells were almost depleted in patients treated with rituximab: (3.71±2.64)×106/L vs. (279.33±92.78)×106/L, P<0.01. Five patients suffered from allergic response, and 1 patient developed pneumonia and respiratory failure. The relapse rates of maintained group and control group were 1/12 and 4/13, respectively. Conclusions Treatment with low-dose rituximab may be an effective and safe approach in patients with idiopathic thrombocytopenic purpura. Relapse rates can be decreased through maintenance therapy with refractory low-dose rituximab. However, the optimal therapeutic schedule need further investigation.

Objective o evaluate the association between IL-28B ( rs12979860 ) polymorphism andantiviraltherapeutic effectbydetecting the genotype of interleukin-28B( IL-28 B) in patients with hepatitis C ( HCV ) .Methods Of total 1153 HCV patients, 303 diagnosed with CHC had been treated with pegylated interferon plus ribavirin for 24-48 weeks.IL-28B ( rs12979860 ) was genotyped by two-color fluorescent TaqMan assay.Results Among 1153 patients, CC, CT and TT genotype frequencies of IL-28B rs12979860 are 83.26%, 16.22%and 0.52%respectively.The results of HCV genotypingof 580 in 1153 cases, the frequencies of 1b, 2a and their non-1b/2a type are 63.45%, 35.00%and 1.55%respectively;In 303 CHC patients with clear medical history, the proportion of SVR was71.98% in patients with CC genotype and 16.90%in those with either the CT or TT genotypes.Logistic regression model was adopted to analyze the association of rs12979860 with SVR while adjusting for age, gender, viral load and HCV GT factors.Populations carrying combined genotype ( CT +TT) are making it harder to get SVR compared with those with CC genotype (OR, 95%CI:11.10,5.35-23.04;P<0.000 1).The percentages of SVR in HVC patients with 1b and 2a genotypeare 48.02% and 81.19% respectively.there is a statistically significant difference between these subgroups (χ2 =30.639,P<0.000 1).Conclusion IL-28B rs12979860 genotype is closely related to SVR in CHCpatients.Patients with CC genotype have a higher virus sustained response rate than those carrying CT or TT genotype.The SNP , rs12979860, might be applied as a predictor of clinical antiviral efficacy in the furture.

Objective? To investigate and analyze the domestic and oversea studies on heart failure symptom clusters through a bibliometric analysis, and provide evidence basis for future clinical nursing research. Methods? The CNKI the Wanfang Science and Technology Journal Full-text Database, the China Biomedical Literature Database (CBM), the PubMed, and the Web of Science database were searched for the articles both in Chinese and English about heart failure symptom clusters published from database establishment dates to August 31st, 2018 and analyzed on their published years, distribution of journals, and research content. Results? A total of 21 articles complied with the standard were retrieved with the first published article dated back to 2009. Among them, there were 13 cross-sectional studies, 4 longitudinal studies, 3 reviews, and 1 tool development. Although different studies had differences in research design, sample characteristics, assessment tools, and analytical methods, the main findings were basically the same: somatic symptom cluster and emotional symptom cluster were common symptom clusters in patients with heart failure; somatic symptom cluster mainly included shortness of breath, dyspnea, fatigue, declined physical strength, dyscoimesis; emotional symptom cluster mainly included anxiety, depression, cognitive disorder; there was still controversy about the classification of edema. Conclusions? At present, the research on heart failure symptom clusters in China and abroad is still at the initial exploration stage, and the research results are still unstable. In the future, we can further develop long-term dynamic observation of heart failure symptom clusters and explore corresponding symptom management strategies.

Objective To investigate the efficacy of heated humidified high-flow nasal cannula (HHHFNC) as the primary means of respiratory support for preterm infants with mild or moderate respiratory distress syndrome (RDS).Methods Randomized controlled trials (RCTs) about HHHFNC and/or nasal continuous positive airway pressure (nCPAP) in preterm infants with RDS were searched in PubMed,EMBASE,Cochrane library,Chinese Journal Full-text Database (CJFD),Wanfang Data base,VIP Database and China Biology Medicine disc (CBM).Meta-analysis was conducted with Review Manager 5.2 software to compare HHHFNC and CPAP groups in the outcomes ofpreterm infants with RDS,which included initial support failure,nasal trauma,pre-discharge mortality and incidences of bronchopulmonary dysplasia (BPD) and patent ductus arteriosus (PDA) before discharge.Results Eight randomized trials,including 1 400 preterm infants with RDS were included.Results of the meta-analysis demonstrated that no significant difference in the percentage of initial support failure was observed between the two groups (RR=1.22,95％CI:0.94-1.59,P=0.13),and HHHFNC was associated with decreased risk for nasal trauma (RR=0.35,95％CI:0.24-0.52,P＜0.001).There was no significant difference in the incidence of death,BPD,PDA or gas leaking before discharge between the two groups.Conclusions HHHFNC is an efficient respiratory support for preterm infants (gestational age over 28 weeks) with mild or moderate RDS.