Objective To analysis pudendal nerve block anesthesia combined with noninvasive delivery on maternal vaginal delivery quality.Methods 60 primipara who were received vaginal delivery in our hospital were collected.All primipara were randomly divided into anesthesia group and no anesthesia group by the order of entry, 30 cases in each group.The no anesthesia group was given noninvasive delivery operation, and the anesthesia group received unilateral or bilateral nerve block anesthesia.Perineal laceration degree and incidence rate, time of the second stage of labor, neonatal asphyxia and two groups of maternal postpartum recovery were compared after the treatment.Results After the birth of a child, Compared with no anesthesia group, the incidence of maternal perineal laceration was lower in the anesthesia group, and the difference was statistically significant(P<0.05);the second stage of labor time of primipara was shorter in the anesthesia group(P<0.05); the pain score,getting out of bed activity time,average length of hospital stay,and incidence of postpartum complications of primipara were lower in the anesthesia group(P<0.05).Conclusions Pudendal nerve block anesthesia combined with noninvasive delivery operation can improve vaginal delivery quality, and have a guiding significance to clinical.

Objective To analyze the outcome of patients with acute obstruction of left colorectal cancer treated by modified antegrade colonic lavage with primary tumor resection and anastomosis.Methods From April 2002 to April 2007,112 patients with acute obstruction of left colorectal cancer underwent surgery.During the operation the left colon was exteriorized and placed into a sterilized plastic bag to protect the surgical field from contamination,then a catheter was inserted via the appendix,and after antegrade colonic lavage,primary resection and anastomosis was performed.Results Tumor resection and primary anastomosis was successfully done in the 112 cases.Postoperatively,1 case had anastomotic leak which healed after reoperation with proximal colostomy,and one patient died.Conclusions Modified antegrade colonic lavage is a simple procedure,the bowel can be rapidly decompressed with essentially no contamination,and has a high level of bowel cleansing.It is possible to safely perform primary resection and anastomosis for left colon cancer after the modified antegrade lavage.

Objective To determine whether autologous skeletal myoblasts implantation improves the cardiac function after myocardial infarction and the possible mechanism. Methods Myocardial infarction was induced by ligation of the left anterior descending coronary artery in rabbits. At 2 weeks, 1. 34 × 107 to 1.75 × 107 autologous skeletal myoblasts were infused into the lesion via direct intramuscular injection. In the control group, the postinfarction hearts were infused with medium alone. Buxco invasive cardiac function testing and histopathological examination were utilized to evaluate the functional and structural changes in the myocardium 4 weeks later. Results Both maximum rising rate of the left intraventricular pressure [+dp/dtmax,( 1 217.77 +89.91 )mmHg/s vs. (897.83 ±70.04) mmHg/s] and maximum falling rate of the left intraventricular pressure [- dp/dtmax,( -1174.58 ± 91.5 ) mmHg/s vs. ( - 753.67 ± 69.66 ) mmHg/s] were improved in the myoblast transplanted group compared with medium infusion group. The positive desmin immunostaining skeletal myofibers in the myocardium were found throughout the infracted areas and the border zone. Conclusion Autologous skeletal myoblasts can establish muscle tissue when transplanted into postinfarction hearts, and this mucle can treat myocardiac infarction effectively.

ObjectiveTo explore the role of risk management in reducing the nursing risk of junior nurses in operation room. Method The risk management was implemented among junior nurses in operation room including establishing training groups for risk management,establishing instructor system,classifying nursing risk events and formulating operation room nursing risk monitoring. Result After risk management,the rate of risk events in the junior nurses was lowered as compared to pre-enforcement of the risk management(P<0.001).Conclusions The risk management can improve the risk awareness of junior nurses in operation room and reduce the incidence of nursing risk events.

Objectives:Using IE 1 gene promoter of Autograph californica nuclear polyhedrosis virus(AcNPV),a transfer vector with an immediately early gene promoter was constructed.　Methods:Transfer vector pAcPIneo which contains neomycin resistance gene(neo)coding sequence downstream of IE 1-promoter was constructed and cotransfected with the wild type of AcNPV DNA into Sf9 insect cells.Recombinant virus was selected by G418 resistance since the neo gene can be expressed in Sf9 cells.　Results:Northern blot hybridzation with 32　P labeled neo gene fragement as probe showed that the neogene was integrated in plogene of AcNPV genome.　Conclusions:Transfer vector with an immediately early gene promoter of baculovirus was constructed successfully,the neo gene was transcribed from the immediately early phase to the very late phase in infected cells.

Objective To observe the curative effect of the treatment of serious femoral neck fractures with vascularized great trochanter bone flap transposition in young adults.Methods Twenty-nine cases were investigated.In which Garden type Ⅲ were 10 and type IV 19.There were 12 ca$,e8 of fresh fractures and 17 old fractures.According to the X-ray films of old fractures,caput femoris necrosis occurred in 7 patients.Tibial tubercle traction was carried out as preoperative preparation as soon as the patients were sent to hospital.The operation was performed by combining hollow-lag-svcrews fixing with vascularized great trochanter bone flap transposition.Results The foUow-up lasted 39 to 84 months,with an average of 54 months.The patients suffering from fresh femoral neck fractures all recovered and no necrosis WaS found.The healing time was between 4 to 6 months,with an average of 4.5 months or so.And old fractures were all healed up almost within the same time.The recovery time of patients who suffered from fractures and necrosis was with an average of 12.5 months.Of 10 cases of old fractures without caput femoris necrosis prior to operation,necrosis occurred in 3 c88es.The functions of hip joints of 15 cases completely recoveTed,and 12 patients were partially restricted.Another 2 patients could not squat because the flexion function was seriously restricted.The crispation of limbs was well corrected.According to Harris standard.the postoperative mean SCOre is 89.2.Concision It is good for treatment of serious femoral neck fractures with vascularized great trochanter bone flap transposition in young adults.

Objectives: To express HBeAg in prokaryotic and eukaryotic cells and compare the two types of HBeAg in the anti-HBeAg testing. Methods: HBeAg was expressed both in E.coli cells and in silk worm cells, purified by Sephacryl S-200.HBeAg protein concentration and antigenic titer were determined respectively by ultraviolet-spectroscopy and EIA. Results: HBeAg produced by E.coli cells: Activation ratio was 10 000/mg, HBeAg/HBcAg = 50; The specificity in testing anti-HbeAg was 96%;HBeAg produced by silk worm cells: Activation ratio was 160 000/mg, HBeAg/HBcAg = 5 000, The specificity in testing anti-HbeAg was 100%. Conclusions: HBeAg produced by eukaryotic cells contained much lower proportion of HbcAg and higher activation ratio, which therefore bring about a possibility to improve the quality of the kit for testing Anti-HBe.

Objective To evaluate the accuracy of image registration based on bony structure (RBS) and grey-scale (RGS) in positioning correction of radiation treatment,and their reliability in clinical application.Methods Setup errors of anthropomorphic phantom (chest& abdomen,head& neck) were simulated with x-,y-,z-directions.CBCT images were acquired for each simulation and registered with planning CT.using bony structure and grey-scale registration separately.Geometry accuracy of all registration were then obtained and analyzed.Results The errors of RBS and RGS in x-,y-,z-directions were (-0.65 ±0.22) mm and (-0.70±0.17) mm (P=0.00),(1.02 ±0.27) mm and (0.90±0.20) mm (P =0.00),(1.46 ± 0.53) mm and (1.47 ± 0.47) mm (P =0.54) for head& neck positioning; with (0.82±0.33) mm and (0.79±0.18) mm (P=0.03),(2.45±1.17) mm and (1.61 ±0.84) mm (P =0.00),(1.44 ± 3.25) mm and (0.19 ± 1.11) mm (P =0.00) for chest& abdomen positioning.Conclusions RGS is more accurate and stable than RBS.The accuracy of image registration is a little better for head& neck than that for chest& abdomen.The algorithms of image registration used in clinical application needs to be tested independently and the systematic error needs to be corrected before applying in different treatment techniques according to their accuracy requirement.

ACTH Syndrome, Ectopic ; diagnosis ; epidemiology ; etiology ; metabolism ; Adrenocorticotropic Hormone ; metabolism ; Humans ; Lung Neoplasms ; complications

Objective To examine the application of On-Board Imaging (OBI) system-based image-guided radiotherapy (IGRT) in the improvement of the precision of intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma.Methods Ten patients with nasopharyngeal carcinoma were treated with IMRT using the OBI system. The IGRT images after positioning, position adjustment, and treatment were observed and recorded to investigate the image difference between CT simulation and IGRT. Results The deviations in the x (lateral), y (cranial-caudal), and z (ventral-dorsal) directions between CT simulation and IGRT images were 0.22±1.00 mm,-0.37±1.28 mm, and 0.04±1.36 mm, respectively, after positioning, 0.29±0.76 mm,-0.04±0.78 mm, and -0.01±0.92 mm, respectively, after position adjustment, and 0.20±0.78 mm, 0.16±0.80 mm, and 0.05±0.92 mm, respectively, after treatment. The probabilities of a ≤1 mm deviation in the x, y, and z directions were 81.0%, 77.6%, and 88.2%, respectively, after positioning, 92.5%, 96.4%, and 96.4%, respectively, after position adjustment, and 91.7%, 94.9%, and 96.8%, respectively, after treatment. Conclusions The application of OBI system-based IGRT is very important in the improvement of the precision of fractionated IMRT for patients with nasopharyngeal carcinoma. The position of the patient should be adjusted based on the IGRT image after positioning in order to correct set-up error and effectively increase the precision of fractionated IMRT.