Objective To evaluate factors associated with labor pain and delivery outcomes.Methods From Jul.to Dec.2009,111 normal singleton cephalic presentation pregnancies (including 5 elderly parturient) who delivered at the Department of Obstetrics and Gynecology,Second Affiliated Hospital,Zhejiang Chinese Medical University were enrolled in this study to evaluate the relationship between factors of labor pain and delivery outcomes.The labor pain of latent phase and active phase were scored by the visual analogue scale (VAS).Factors associated with pain included the age of parturient,the number of gravidity and parity,occupation,education profile,dwell location,etc.The questionnaire was designed by ourselves.Childbirth awareness,psychological preparation of delivery,emotional controllability,couple relationship,the relationship of parturient and mother-in-law,the relationship of parturient and parents,family economic status,use of sedative during the labor process and delivery outcomes were collected and analyzed.Results (1)Factors associated with pain:in the latent phase,the rate of moderate labour pain of 1/5 in women with more than 35 years old was statistically lower than 76.4％ ( 81/106 ) in suitable age group (P＜0.05 ).The women with a good understanding about delivery had a statistically lower rate of moderate pain of 64.7％( 44/68 ) than 88.4％ ( 38/43 ) of those having a poor understanding( P＜0.05 ).The women who had a better couple relationship had a significandy higher rate of moderate pain of 77.2％ (78/101) than 4/10 of those who had a general couple relationship ( P＜0.05 ).There was significant difference in rate of moderate pain between pluripara group ( 50.0％,11/22) and primipara group(79.8％,71/89;P＜0.01 ).In the active phase,women with tense,scared or a poor emotion control expressed significantly severe labour pain(59.0％,36/61 ) than 35.6％ ( 16/45 ) in well-prepared group.The rate of severe labour pain in good control of emotion group of 44.8％ (43/96) was a statistically lower than 9/10 in poor control group.There was a statistically lower severe labour pain in women given by sedatives ( 29.2％,7/24 ) than 54.9％ (45/82) in women without sedatives treatment (P ＜ 0.05).(2) Delivery outcomes:in latent phase,the rates of fetal distress and cesarean section were 36.6％ (30/82) and 39.0％ (32/82) in moderate pain group,which were significantly higher than 13.8％ (4/29) and 17.2％ (5/29) in mild pain group.In active phase,the rate of fetal distress,cesarean section and postpartum hemorrhage were 36.5％ ( 19/52),40.4％ (21/52) and 13.5％ (7/52) in severe pain group,which were significantly higher than [18.5％ (10/54) ;20.4％ (11/54) ;0] in moderate pain group (P＜0.05).Conclusions Women with poor understanding of delivery,tense,scared,poor emotion control,young age and uniparous have severe labour pain.Sedative use could alleviate pain in active phase.Women with mild labour pain have good delivery outcomes.

Objective To explore clinical effect of Chinese herbal immersion combined with Beecher's exercise for prevention and treatment of grade-0 diabetic foot.Methods A total of 107 patients who were diagnosed with grade-0 diabetic foot were selected in Department of Endocrinology of our hospital from July 2009 to October 2013.In addition to regular treatments,their feet were immersed in Chinese herbal liquid,and then were taken care by doing Beecher's exercise.The symptoms of diabetic foot were self-rated by each individual patient and mastering of knowledge about diabetic foot was evaluated both before the intervention and after three courses of treatment.Results After three courses of treatment,the self-rating symptom scored (4.37±1.45) totally,significandy lower than that before the intervention,(5.62±1.55),t=7.91,P ＜ 0.05.The mastering of six testing indexes about diabetic foot obviously improved compared between those before and after three courses of treatment [62.62％ (67/107)],23.36％ (25/107),30.84％ (33/107),46.73％ (50/107),57.94％ (62/107),50.47％ (54/107) vs.96.26％ (103/107)],86.92％ (93/107),89.72％ (96/107),85.98％ (92/107),94.39％ (101/107),87.85％ (94/107),x2=37.78,87.35,77.46,36.92,39.16,35.05,all P ＜ 0.05.Conclusions For grade-0 diabetic foot,Chinese herbal immersion treatment combined with Beecher's exercise can be applied straight forwardly on the disease focus;it's clinically safe and effective,and easy to be operated.It improves clinical symptoms of grade-0 diabetic foot by taking advantages of traditional Chinese medicine,prevent and control further development of diabetic foot and is valuable to be applied in clinical work.

Objective To investigate the potential mechanism of inhibition of ursolic acid(UA) on growth of human gastric cancer cell lines SGC7901 in vitro.Methods SGC7901 cells were cultured in vitro,MTT assay was used to observe the effect of UA on growth of SGC7901 cells in various concentrations for different times.After SGC7901 cells were treated by 0—40 ?mol/L UA for 24 h,morphological changes were observed by inverted microscope.Apoptotic changes were detected by fluorescence microscopy and flow cytometry (FCM).Protein expressions of Bcl-2 and Bax were determined by Western blotting.Results UA(20—40 ?mol/L) could significantly inhibit the growth of SGC7901 cells in a(dose-and) time-dependent manner,the IC_(50) value of UA for SGC7901 cells for 12,24,36,and 48 h were((57.50?)1.18),(34.28?2.05),(27.54?1.11),and(24.83?1.02) ?mol/L,respectively.After UA((20—)40 ?mol/L) treatment for 24 h,SGC7901 cells turned round and floated at different levels;SGC7901 cells were arrested at G_0/G_1 phase and apoptosis was induced,and the apoptotic rate was increased along with the increase of UA concentration.Meanwhile Bcl-2 protein expression decreased,whereas Bax protein expression unchanged.Conclusion UA has a stronger antitumor effect on SGC7901 cells.Cytotoxic effect,proliferation inhibition,and apoptosis may be involoved in the mechanism of UA,and the apoptosis caused by UA may be enhanced by decrease of Bcl-2 protein expression.

AIM To study the effects of Lotusine(Lot), a pure alkaloid extracted from the green seed embryo of Nelumbo nucifera Gaertn, on the action potentials(APs) in myocardium and slow inward current(Isi) in cardiac Purkinje fibers(PF). METHODS standard microelectrode and two microelectrodes voltage clamp techniques were used. RESULTS Lot 1～100 ?mol?L -1 could concentration dependently prolonged APD 20 and APD 90 of fast AP and increase the contractile force(Fc) in guinea pig papillary muscles. In papillary muscles pretreated with reserpine, similar results were also observed but the effect of Lot was weaker than those pretreated without reserpine. In guinea pig left atria, Lot 30 ?mol?L -1 could partly antigoniste the shortening APD effect of acetylcholine. Lot 3～100 ?mol?L -1 could enhance the action potential amplitude(APA)and maximal velocity of phase 0 depolarization ( V max ) of slow AP of papillary muscles induced by high K + (24 mmol?L -1 )and isolated sinoatral node(SAN) pacemaker cells of rabbits with dose dependent manner,But not obvousely short the sinus cycle length of SAN. Moreover, Lot increased the Isi of in canin cardiac PF with with time dependent and dose dependent manner. CONCLUSION The results suggest that Lot has effect of prolongation of APD and increase of Ca 2+ influx and these are very important in contribution to its positive inotropic effect, which may be related to inhibition of phosphodiesterase Ⅲ.

Objective: To clone and express Treponema pallidum (TP) specific antigens P15 and P47 and use them in clinical examination. Methods: P15 and p47 genes synthesized were inserted into a GST fusion expression vector. The recombinant antigens were purified by affinity chromatography and then coated on microplates to establish an ELISA kit. Using this kit, national TP standards, sera of normal persons and patients with TP and other diseases were tested. Results: The synthesized p15 and p47 genes sequenced were identical with those of GenBank. National TP standards were tested by ELISA kit which coated with these recombinant antigens, and the results accorded with the standards. High sensitivity and specificity was showed when 2 recombinant antigens were used in ELISA to detect the sera of normal persons and patients with TP and other diseases. Conclusion: The recombinant TP specific antigen P15 and P47 are suitable for establishment of ELISA kit in clinical examination.

Objective To understand the distribution and antimicrobial resistance of pathogens isolated from patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)in Ordos area,so as to provide guidance for rational antimicrobial use.Methods Sputum culture and antimicrobial susceptibility testing results of 372 patients with AECOPD in Ordos area in 2013-2015 were analyzed,and the quality of life before acute exacerbation was assessed.Results A total of 296 strains of pathogens were isolated from 372 patients,252(85.14%)of which were gram-negative bacteria,the major were Pseudomonas aeruginosa(n=58,19.59%),Klebsiella pneumoniae(n=51,17.23%),Acinetobacter baumannii(n=50,16.89%),Stenotrophomonas maltophilia(n=22,7.43%),Escherichia coli(n=19,6.42%),and Enterobacter cloacae(n=16,5.41%);27(9.12%)were fungi,the major was Candida albicans(n=19,6.42%);17(5.74%)were gram-positive bacteria,the predominant species was Staphylococcus aureus.Patients with CAT(COPD assement test)score≥10 had higher proportion of isolating Pseudomonas aeruginosa and Acinetobacter baumannii than those with CAT score<10.Conclusion The main pathogens from patients with AECOPD are gram-negative strains,CAT score prior to exacerbation may be related to the emergence of pathogens at AECOPD.

Objective To investigate the clinical features, the video electroencephalography ( V-EEG) and synchronous electrocardiography ( ECG) changes in non-epileptic seizures and the significance of ECG monitoring in the diagnosis of epilepsy.Methods We collected 3 patients who came in a chief complaint of“episodes of unconsciousness with limbs twitch”, whose clinical features and EEG, ECG in longterm VEEG monitoring were analyzed.The 3 patients were followed up for at least 6 months.Results The 3 patients were all diagnosed as epilepsy in other hospital,and during the 24-hour VEEG monitoring in our hospital,2 patients showed abnormal cardiac rate and arrest during the attack and corresponding EEG changes after cerebral ischemia and hypoxia.After consultation with the department of cardiology, they were diagnosed as cardiac syncope episode and no attack showed up after the placement of pacemaker.The Q-T interval was prolonged in the other patient during the longterm ECG monitoring, after the coherence check who was diagonsed as severe hypocalcemia combined with myocardial damage due to a lower parathyroid function and had no attack after symptomatic treatment.Conclusions The synchronous ECG monitoring during the attack is of great significance in the differential diagnosis of epileptic and non-epileptic seizures. The ECG changes in patients with longterm VEEG monitoring should be focused on.It is necessary to add the early warning function to prevent the occurrence of accidents.

Objective To investigate the mechanism and effect of the spinal cord outlet of the skull base on Chiari Ⅰ malformation with syringomyelia.Methods The cervical spinal cord stem angle (Anbc),slope angle of cervical vertebra (Ansc) of Chiari Ⅰ malformation were measured.In foramen magnum (Llf) and anterior vertebral canal level (Laf),spinal canal(Ac),spinal cord (As) and inferior hernia area (Ah) were measured.Angle,area and ratio were compared in Chiari Ⅰ malformation with syringomyelia,Chiari Ⅰ malformation without syringomyelia and normal control group.Results Ansc,Anbc-Ansc had significant differences among control group and Chiari Ⅰ malformation patients (all P＜0.001).In Llf,Laf,As had significant differences among three groups (all P＜0.05),further comparison of the two showed there were significant differences between Chiari Ⅰ malformation with syringomyelia patients and control group,Chiari Ⅰ malformation without syringomyelia patients and control group in Llf(all P＜0.05).In Llf,Laf,Ac in Chiari Ⅰ malformation with syringomyelia was smaller than control group (P＜0.05).Ah in Llf,Lafand Lh in Llf had no statistical significant difference between Chiari Ⅰ malformation with and without syringomyelia patients (all P＞0.05).In Llf,Laf,As/Ac had statistical significant difference among Chiari Ⅰ malformation with and without syringomyelia patients,control group (all P＜0.001),further comparison of the two showed As/Ac in Llf had statistical significance difference between Chiari Ⅰ malformation with syringomyelia patients and control group (P＜0.05),As/Ac in La had statistical significance difference between Chiari Ⅰ malformation with syringomyelia patients and control group,between Chiari Ⅰ malformation without syringomyelia patients and control group (all P＜0.05),Conclusion The cervical spinal cord,Ansc reducing,narrow vertebral proportion increase are important factors to promote Chiari Ⅰ malformation syringomyelia.

Objective Few studies are reported on the construction of a finite element model of human complex knee joint using multimodality CT and MRI images.In this study, we developed a finite element model of the knee joint for total knee arthroplasty (TKA) using matched and fused CT and MRI data, hoping to provide a useful tool for the simulation study of knee joint biomechanics of TKA.Methods The CT and MRI image data about an intact knee of a 26-year-old male volunteer were imported into the Mimics software for the establishment of 3D models of bony and soft-tissue structures.A complete knee model was developed following the registration and fusion of the constructed 3D models based on the external landmarks.After the simulated implantation of TKA components, a finite element model of the TKA knee was constructed with the Hypermesh software.Then the finite element model was analyzed following the definition of its material behavior, boundary conditions and loading.Results The finite element model of the TKA knee, which was composed of bones, ligaments, components, polyethylene insert and bone cement, was developed from CT-MRI image registration and fusion and maintained its important spatial relationship among different structures in the TKA knee.The results obtained from the finite element analysis showed the characteristics of stress distribution in the TKA knee.Conclusion The finite element model of the knee joint for TKA can be established by matching and fusing CT and MRI image data, which can be employed as a useful tool for the study of knee joint biomechanics of TKA.

BACKGROUND:Hematopoietic reconstruction of malignant tumor in hematopoietic system is related to disease itself,pretreatment program and therapeutic tool after transplantation;especially,mobilization.collection and cryopreservation of auto-peripheral blood stem cell play a key role in successful reconstruction of hematopoietic system after transplantation.OBJECTIVE:To investigate the reconstruction of hematopoietic system through mobilization, collection and cryopreservation of auto-peripheral blood stem cell in patients with malignant tumor and analyze the effective factors on quantity and quality of auto-peripheral blood stem cell.DESIGN:Case analysis based on malignant tumor in hematopoietic system.SETTING:Department of Blood,Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA;Department of Blood,Zhujiang Hospital,Nanfang Medical University.PARTICIPANTS:A total of 18 patients with malignant tumor in hematopoietic system were selected from Department of Blood,Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA.Their ages ranged from 1 6to 56 years.Among them,2 patients had acute myelogenous leukemia(AML),1 acute lymphoblastic Ieukemia(ALL),2 lymphoblastic Ieukemia (LL),2 chronic granulocytic leukemia(CGL),4 multiple myeloma(MM),and 7 non.Hodgkin lymphoma.Granulocyte colony-stimulating factor(G-CSF)was made by Chugai Pharmaceutical Company Limited (batch number:N3G31).METHODS:①All patients were mobilized with associated chemotherapy+G-CSF.Associate chemotherapy:Patients with leukemia were given 2 g/m2 arabinosyl cytosine every 12 hours from lhe first to the third days and 200 mg/m2 etoposide or 50 mg/m2 fludarabine from the first to the fifth days. In addition patients with MM were treated with arabinosyl cytosine as the same way mentioned above and with 1 g/m2 cyclophosphamide from the first to the second days. And patients with lymphoma were given 2 g/m2 cyclophosphamide from the first to the second days. When numbers of leucocyte of all patients decreased below 1.0×109L-1 after chemotherapy.G-CSF started mobilization and the collection was stopped with 5μg/(kg·d)subcutaneous injection.②When numbers of leucocyte increased to (4.0-10.0)×109 L-1,hemopoietic stem cells of peripheral blood were collected till the amount of mononuclear cells≥4.0×108/kq or numbers of CD34+ cells≥2.0×108/kg.And then,the samples were dealt with cooling device.maintained in liquid nitrogen at-196℃ and defrosted in water bath at 37-40℃.③Focal sites of patients were pretreated with local irradiation with 200 cGy/time and 5 times/week for 4 successive weeks.The total dosage was 40 Gy.At 48 hours later,(55.3±28.7)mL hemopoietic stem cells of peripheral blood were transfused back. And the duration from transfusion to collection was about(56.5±22.3)days.300 μg/d G-CSF was subcutaneously injected into all patients at 1 day after transplantation and the reaction was stopped at the phase of neutrophil≥0.5×109L-1. Finally. Refusing-staining rate of trypan blue of peripheral blood stem cell, amount of mononuclear cells, number of granulation-monophyly progenitor cell colony and percentage of CD34+ cells were detected before and after thaw.MAIN OUTCOME MEASURES:①Collection of auto-peripheral blood stem cell;②survival rate and related markers of auto-peripheral blood stem cell after cryopreservation;③hematopoietic reconstruction of auto-peripheral blood stem cell after transplantation.RESULTS:All 18 patients with malignant tumor in hematopoietic system were involved in the final analysis.The mean collection time of auto-peripheral blood stern cell was 12.6 days after chemotherapy.the collection times were 1.9.total number of leucocyte was(8.93±1.27)×1 0.L-1 on the first day,and collection rate of mononuclear cell was (138.33±28.61)%. ②Refusing-staining rate of trypan blue of auto-peripheral blood stem cell was similar before and after cryopreservation[(96.26±1.33)%, (92.75±2.04)%,P＞0.05].in addition,after cryopreservation,recovery rates of mononuclear cells,CD34+ cells and granulation-monophyly progenitor cell were(91.96±1.37)%, (85.94±0.64)%and (87.69±4.53)%,respectively.Collection rate of mononuclear cells,number of granulation-monophyly progenitor cell colony and percentage of CD34+ cells were lower in patients with myeloma than in those with leukemia and lymphoma (t=2.524-3.268.P＜0.05).③At 15 days after transplantation,15 patients had the neutrophil≥0.5× 109L-1;at 20 days after transplantation,blood platelet was≥20 × 100 L-1.granulation-monophyly progenitor cells[(18.67-26.82)× 105/kg] of 5 patients grew poorly if the course of chemotherapy was more than 10 times.Among them,3 patients had delayed hematopoietic reconstruction after transplantation of auto-peripheral blood stem cell.CONCLUSION:①High-dose chemotherapy combined with G-CSF can shorten collection time of peripheral blood stem cell and improve collection rate of mononuclear cells.②Increase of chemotherapy times before transplantation can affect quantity and quality of auto-peripheral blood stem cell and cause delayed hematopoietic reconstruction.