Objective To compare the safety and efficacy of whole stage and first stage of labor analgesia on puerperas with pregnancy-induced hypertension syndrome.Methods From March, 201 5 to November,201 5,1 96 single fetus,aged 22-35 years,term pregnancy,primipara,ASA physical status Ⅰ or Ⅱ, diagnosed pregnancy-induced hypertension syndrome, were randomly divided into the whole stage of labor analgesia group (group T)and the first stage of labor analgesia group (group F).Patients in group T received labor analgesia after uterine contractions regularly,and continued the labor analgesia to the end of the delivery;patients in group F received labor analgesia after uterine contractions regularly and the uterus cervix was 3 cm,in the end of the first stage of la-bor,using the normal saline instead of the medicine.The MAP and VAS score were recorded before analgesia and 10 minutes,60 minutes after the beginning of analgesia,when the uterine cervix dilated absolutely,the second stage of labor and when the fetal is delivered.The Bromage scores were recor-ded at the second stage of labor.The time for the first stage of labor,the second stage of labor and the third stage of labor were recorded.The mode of delivery,the incidence of eclampsia,postpartum hemorrhage,the use of oxytocin and antihypertensive in the delivery progress were recorded.The ne-onate weight,Apgar score and the cord blood gas analysis were recorded.Results At the uterine cer-vix dilated absolutely and the second stage of labor,the MAP [(106.0±7.0)mm Hg vs.(1 1 5.4± 7.3)mm Hg,(106.2 ± 7.2 )mm Hg vs.(1 1 6.0 ± 7.6 )mm Hg]and VAS score [(2.0 ± 1.1 ) scores vs.(5.1±1.2)scores,(1.9±1.2)scores vs.(5.2±1.3)scores]in group T were lower than those in group F (P <0.05).The patients who received oxytocin in group T were more than that in group F [50(5 1%)vs.35(35%),P <0.05].Conclusion The whole stage labor epidural analgesia is safe and effective for puerperas with pregnancy-induced hypertension syndrome.

Purpose　The aim is to study the inhibiting effect s of nineteen amino acids to E.coli,St.aureus and B.Subtilis.Metho ds　The qualitative inhibition of nineteen amino acids on E.coli ,St.aureus and B.Subtilis was determined using filter papers treated by saturated amino acids placed on the bacteria medium dish.The quantitative inhibi ting effects of the amino acids which were proved to have inhibition to these th ree bacteria were determined in the bacteria LB medium with different concentrations of amin o acids.Results　It was indicated that cysteine was used to in hibit St.aureus.The best inhibiting time was 6 hours,and the optimum of concentrat ion was 0.625% in which the inhibiting rate was 92.62%.Conclusion　 Cysteine could inhibit St. aureus.

ObjectiveTo investigate mutations in exons 19, 20 and 21 of epidermal growth factor receptor (EGFR) gene in elderly patients with non-small cell lung cancer (NSCLC). MethodsEGFR gene mutations in exons 19, 20 and 21 were detected by nested PCR amplification and DNA sequencing in 46 elderly patients with non-small cell lung cancer. The relationship between mutations and clinical characteristics of these patients was analyzed. ResultsEGFR gene mutations were found in 56.5% (26/46) patients and 41.3% (19/46)were non-silent mutations. Mutation of exon 19 was detected in 6 cases (13.0%), mutation of exon 20 in 13 cases(28.2%) and that of exon 21 in 14 cases (30.4%). Seven patients among them had double mutations and the rest only had a single mutation. The incidence of EGFR gene mutations was higher in non-smokers than in smokers(P＜ 0.01). Higher EGFR mutation rate in exon 19, 20 and 21 were found in patients with clinical benefit who were treated with tyrosine kinase inhibitor(TKl)(P＜0.05). There was no difference in EGFR mutation rate between 60～69 age group and 70～85 age group. ConclusionsThe data suggest that the characteristics of EGFR gene mutations in elderly patients with NSCLC is the same as in the general NSCLC patients. The forecast informations of TKI treatment can be obtained by gene detection in elderly NSCLC patients.

OBJECTIVE:To observe the efficacy and safety of carbamazepine combined with topiramate in the treatment of par-tial epilepsy. METHODS:130 patients with partial epilepsy were randomly divided into observation group and control group. Con-trol group was orally treaed with carbamazepine 100 mg,3 times a day. Based on the treatment of control group,observation group was orally treaed with topiramate initial dose of 25 mg,once a day,and then increased 25 mg every week,the maximum dose was no more than 200 mg,once a day. After 6 months,the efficacy was evaluated,frequency of epileptic seizures,EEG epileptiform discharges wave and incidence of adverse reactions were observed. RESULTS:The total effective rate in observation group was sig-nificantly higher than control group(P<0.05). After treatment,the frequencies of epileptic seizures in 2 groups were significantly lower than before,6 months<3 months<1 month,and observation group was lower than control group(P<0.05).The EEG epilep-tiform discharges wave were in observation significantly better than control group(P<0.05). There were no significant differences incidence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:Carbamazepine combined with topiramate has better efficacy than carbamazepine alone in the treatment of partial epilepsy,with similar safety.

The treatment results of radiofrequency ablation (m) were analyzed in l5 patients with the complicated Supraventricular tachycardia(SVT)． The causes of SVT were dual accessory pathway(AP) in 9 patients, single M with slow-fast atrioventricular junctional reentrant tachycardio (AVJRT) in 5 patients and single AP with slow fast/fast-slow AVJRT in l patient． Results: 24 APs and 6 slow pathways of atrioventricular node were abl a ted． All patients were successful． During the follow-up of 6～48 months, there were no recurrence in l5 patients, also there were no occurrence of atrioventricular block and other complications． Conclusion: Using the proper methods of m of the complicated SVT would have a h igher successful rate, a lower recurrent rate and lower complications．

Objective To study the dynamics changes of cerebrospinal fluid (CSF) bacterial load within 48 h after infection in a rabbit meningitis model, and provide information for diagnosis,treatment and prognosis of this disease. Methods Taking New Zealand white rabbit as the study object, meningitis model was established via cerebellar cistern puncture with different concentrations of Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) to explore the relationship between the mortality of animals and the subarachnoid inoculation dosage. The dynamics study of CSF bacterial load was conducted with proper inoculation bacterial dosage. Forty-eight rabbits were separated into four groups (12 each group): E. coli meningitis model group, E. coli meningitis + ceftriaxone treated group, S. aureus meningitis model group and S. aureus meningitis + vancomycin treated group. At 0,12, 24, 36 and 48 h of inoculation, CSF and blood samples were obtained for CSF bacterial quantitative culture, CSF leukocyte count and peripheral blood leukocyte count. Finally, the relationships between the early mortality of animals, the efficacy of antibiotics, CSF leukocyte counts and the dynamics changes of CSF bacterial load were analyzed in the bacterial meningitis rabbit model.The CSF bacterial load and the white blood cell count curve were compared by analysis of covariance (ANOVA). Correlation test was done using correlate partial analysis. Results The relationship between subarachnoid inoculation dosage and the mortality of rabbits presented S-curve correlation.The bacterial load in subarachnoid space peaked in 12-24 h after infection and then gradually decreased. Effective antibiotic therapy could significantly speed up the decline of this process. There were significantly different between E. coli meningitis model group and E. coli meningitis+ceftriaxone treated group (F= 27. 10, P<0. 01), between S. aureus meningitis model group and S. aureus meningitis + vancomycin treated group (F=5. 97, P = 0. 016). There was a positive correlation between CSF bacterial load and CSF leukocyte count in E. coli and S. aureus meningitis model groups (r=0. 89, 0.84, respectively; P = 0.046, 0.049, respectively). Conclusions In the treatment of bacterial meningitis, effective and sufficient antibiotics should be used as soon as possible to control the CSF bacterial load and reduce the mortality. The CSF leukocyte count can be used as indicator of CSF bacterial load and guide the antibiotic treatment in clinical bacterial meningitis.

Objective To evaluate the application of clinical cases related problem-based-learning (PBL) method in critical care medical standardized resident training program. Methods 84 residents were randomly divided into experimental group (n=42) and control group (n=42) by lottery way. The experimental group received PBL process during clinical case analysis while the control group learned completely through traditional teaching method . The residents' clinical competence were assessed by multiple scale mixed method including question bank examination (QBE), case-based discussion (CBD), direct observation of procedural skills (DOPS), simulation etc, and Likert-type scale questionnaire was used to evaluate the feedback of training residents. SPSS 17.0 was used to do line t test to the data of both groups. Results Finally 84 residents finished the study. There were no difference in the general conditions in two groups. The PBL group achieved higher examination score during QBE [(80.26 ±8.89) vs. (86.10 ±9.32)], CBD [(84.83±5.43) vs. (75.36±6.06)], DOPS [(88.81±6.68) vs. (82.70±6.98)], simulation [(79.86±10.09) vs.(72.71±9.30)]. Except two groups residents all gave high scores in enhancing cross connection in clinical knowledge [(4.786±0.470) vs. (4.571±0.859), P=0.16], and the questionnaire results showed that the resi-dents of PBL group gave higher points in exciting autonomous learning, improving clin-ical analysis ability, accelerating clinical thinking establish, developing independent thinking habits, improving the clinical communication skills and teamwork ability (P<0.05). Conclusion The clinical cases related PBL method can improve the training effects during critical care medical standardized resident training program. It can be used broadly after adapting modification in critical care medical education.

Objective To analyze pharmacologic action features of single Chinese herbal medicine for the treatment of fatty liver based on literature; To provide references for clinical treatment of fatty liver.Methods Animal research literature about single Chinese herbal medicine for the treatment of fatty liver in CNKI, Wanfang database, and VIP from January 2003 to December 2014 was retrieved by computers. The number of single Chinese herbal medicine and the pharmacologic action features of active ingredients (or extracts) were statistically concluded. Results A total of 279 articles were retrieved, including 67 kinds of single Chinese herbal medicine, among which 8 were used to treat AFLD, 45 were used to treat NAFLD, and 14 were used to treat AFLD and NAFLD simultaneously. Pharmacologic action features of the medicine for AFLD mainly included reducing lipid, protecting liver, antioxidation, and anti-inflammation. Pharmacologic action features of the medicine for NAFLD had the effects of improving insulin resistance additionally.Conclusion Chinese herbal medicine for the treatment of AFLD and NAFLD shows significant efficacy, having the features of multiple pathways and liver damage resistance, which provide references for clinical treatment of fatty liver.

Objective To study the effect of different breast milk enhancement strategies and the incidence of complications in premature infants.Method Premature infants whose gestational age less than 34 weeks and birth weight less than 2 000 g were prospectively enrolled from January 2017 to February 2018 at the Department of Neonatology of Huangshi Maternal and Child Health-Care Hospital.According to the odd even number at the end of the hospitalization admission number,participants were assigned into 50～＜70 ml/(kg· d) group and 70～＜90 ml/(kg· d) group,When the children reached the corresponding amount of breast-feeding to be given breast milk fortifier.The demographic information,incidence of complications,rate of weight gain,percentage of extrauterine growth retardation (EUGR) and decrease of Z score at discharge were compared between groups.Result A total of 140 cases were included,with gestational age (31.4±1.9) weeks and birth weight (1 402±213) grams.Among the participants,67 infants were assigned to 50～＜70 ml/(kg·d) group,and 73 infants were assigned to 70～＜90 ml/(kg·d) group.There was no statistical difference between two groups in gender,gestational age,birth weight,length,head circumference,rates of asphyxia,ratio of intrauterine growth retardation,Z score of weight at birth,age at which breast milk fortifiers were added,full enteral feeding time,duration of parenteral nutrition,average length of hospital stay and the time of restoration of birth weight (P＞0.05).The proportion of feeding intolerance in 50～ ＜70 ml/(kg· d) group was higher than that in 70～＜90 ml/(kg· d) group (11.9％ vs.4.1％),the difference was statistical significant (P=0.013).There was no statistical difference in other complications between the two groups (P＞ 0.05).The body weight increase rate of premature infants in 50～＜70 ml/ (kg· d) group was higher than that in 70～＜90 ml/(kg· d) group,and decrease of Z score at discharge in 50～＜70 ml/(kg· d) group was lower than that of 70～＜90 ml/(kg· d),the difference was significant (P＜0.05).Conclusion Adding breast milk fortifier earlier——when the breast feeding amount of 50～＜70 ml/(kg· d)——is more beneficial to the growth and development of premature infants,it also reduces the incidence of EUGR on discharge.However,during the feeding process,it was necessary to be aware of the complications.

Objective:To analyze the conventional quality control result of Leksell Icon Gamma Knife cone-beam CT and evaluate long-term stability of cone-bem CT.Methods:QA TOOL Plus was used to verify the accuracy of cone-beam CT. The phantom Catphan 503 was scanned, and the image spatial resolution, contrast to noise ratio and homogeneity were analyzed.Results:The maximum deviation in image volume of cone-beam CT was 0.09-0.17 mm, which passed the accuracy test. At the scanning patterns with CT dose index of 2.5 and 6.3 mGy, the spatial resolution was very stable at 7 and 8 lp/cm respectively. The contrast noise ratio and uniformity meet the reference requirements.Conclusions:The conventional quality control results of Leksell Icon Gamma Knife cone-beam CT are stable in 12 months. In addition to referring to the manufacturer′s baseline value, the unified analysis and evaluation standard for Gamma Knife need to be further improved for the quality control of cone-beam CT.