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OBJECTIVE To investigate the effects of 0.2% chloroprocaine combined with ropivacaine on epidural labor analgesia and median effective concentration （EC50） of ropivacaine. METHODS Totally 67 parturients who scheduled for vaginal delivery and required epidural labor analgesia were collected from our hospital from July to October 2023 and randomly divided into RL group （33 cases） and R group （34 cases）. The concentration of ropivacaine was determined by modified Dixon sequential method. RL group was given 0.2% Chloroprocaine hydrochloride injection+Ropivacaine hydrochloride injection+0.4 μg/mL Sufentanil citrate injection； R group was given Ropivacaine hydrochloride injection+0.4 μg/mL Sufentanil citrate injection. EC50 of ropivacaine， analgesic effect during delivery， total dosage of analgesic drugs， analgesic satisfaction score， the incidence of adverse reactions， delivery status， and Apgar score of newborns were observed in two groups. RESULTS EC50 of ropivacaine， onset time， remedial analgesia rate， the incidence of perineal distension and breakthrough pain and total dosage of analgesic drugs of RL group were significantly lower than R group， and analgesic satisfaction score was significantly higher than R group （P＜0.05）. There was no statistical significance in the incidence of adverse reactions such as numbness， weakness， and chills in the lower limbs， or the duration of labor， amount of bleeding， mode of delivery， and Apgar score of newborns between 2 groups （P＞0.05）. CONCLUSIONS For epidural labor analgesia， 0.2% chloroprocaine combined with ropivacaine can reduce EC50 of ropivacaine， improve analgesia effect and have good safety.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

{L-End}Objective To establish the construction of intelligent management system for equipment and supplies of medical rescue teams for provincial nuclear and radiation accidents, based on modern Internet+ Internet of Things. {L-End}Methods The current status and requirements of emergency equipment and supplies allocation and management of medical emergency teams for provincial nuclear and radiation accidents were analyzed. Utilizing technologies such as Internet of Things, low-power Bluetooth, and radio frequency identification, an intelligent management system for medical rescue teams, its equipment and supplies for provincial nuclear and radiation accidents was designed. {L-End}Results The intelligent management system for medical rescue teams, its equipment and supplies for nuclear and radiation accidents was able to perform the inventory warning, expiration date warning, maintenance alert, and warning for emergency personnel health status, based on dynamic management of rescue personnel, equipment and supplies. It provided an effective support for on-site commanders in making emergency decisions. {L-End}Conclusion The use of Internet+Internet of Things technology can achieve intelligent management for medical rescue teams and its equipment and supplies can effectively improve the level of personnel and equipment support for the rescue of nuclear and radiation accidents at the provincial level.

Objective To observe the antitumor activity of sedum lineare thunb(SLT) and it′s affection on antioxidation and tumor immunology in S180‐bearing mice .Methods S180‐bearing mice model were established by subcutaneously inoculating S180 ascitic tumor into the right armpit .From the second day ,the mice were treated with normal saline ,cyclophosphamide (50 g/kg) or two doses of SLT (4 ,8 g/kg) through intragastric administration ,and the process extent 14 d .After the last administration ,the mice body weight and the index of tumor ,spleen and thymus were calculated ,classification of white blood cells in peripheral blood was tested ,and the activity of SOD and GSH‐Px as well as the content of MDA and NO in serum were measured .Results The body weight of mice treatmented with SLT was dramaticlly higher than those of the CTX (P< 0 .05) .Compare with the model group ,SLT groups showed decreases in tumors index (P<0 .05) ,spleen index (P<0 .05) ,percentage of peripheral blood neutro‐phil (P<0 .05) and monocyte (P<0 .05) ,and increases in thymus index (P<0 .05) and percentage of lymphocyte (P< 0 .05) . The activity of SOD and GSH‐Px and NO level in the SLT groups mice′s serum were significantly higher than those of the model group (P<0 .05) ,while the content of MDA in the SLT groups mice′s serum was markedly lower than those of the model and CTX groups(P<0 .05) .Conclusion SLT has antitumor activity in S180‐bearing mice bysuppressing oxidative stress and modula‐ting tumor immune .

Objective To explore the development of disaster nursing in undergraduate courses . Methods Measures were done in writing program , course design , textbook writing , determining the content , theoretical teaching and experimental teaching .Results In 2012, 51 among 60 students (85.00%) selected the course of disaster nursing .In 2013, 40 among 60 students ( 66.67%) selected the course of disaster nursing.During the two years of course development , 75.83% students selected the disaster nursing courses . The class hour increased from 24 to 30 .The textbook of disaster nursing was edited and published as the nursing teaching materials of the twelfth five-year plan .Conclusions It is necessary to develop the disaster nursing in undergraduate education .We recommend promoting the disaster nursing in medical colleges and universities .

Objective To summarize the etiological,clinical and imaging characteristics of cerebral venous sinus thrombosis (CVST) in children so as to provide the basis for early diagnosis and prompt treatment.Methods All the medical records including clinical manifestations,laboratory data,neuroimaging changes,treatment and short-term prognosis were analyzed retrospectively in 12 cases of CVST hospitalized in Children' s Hospital of Fudan University from Aug 2008 to May 2012.Results (1) Regarding the etiology:of the 12 cases,the causes of CVST were infection (2/12),intracranial tumor (1/12),nephrotic syndrome (2/12),cryptogenic disease (7/12).Seven out of all 12 cases without definite cause were presented subacute or chronic headache associated with progressive or acute exacerbation.Seven cases had been misdiagnosed.(2)Diagnosis:All 12 cases were made a definite diagnosis as CVST after neuroimaging examination of brain magnetic resonance imaging combined with magnetic angiography venography.(3) Short-term prognosis:all the patients were treated with anticoagulation,and 11 cases improved.Four of 7 cases with cryptogenic disease had different degrees of visual impairment,and no improvement were found after the treatment; One patient died although accepted digital subtraction angiography and balloon catheter technique.Conclusions Cerebral venous sinus thrombosis has no specific clinical manifestations and a high rate of misdiagnosis.Increased consideration and prompt magnetic angiography venography play a key role in the accurate diagnosis.Anticoagulation is safe and effective.

Objective To investigate the changes to eotaxin,tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) in plasma from patients with chronic urticaria treated with the combination of polysaccharide nucleic acid fraction of bacillus Calmette-Guerin (BCG-PSN) and cetirizine.Methods Totally,123 patients with chronic urticaria were enrolled into this study,and classified into two groups:the combination therapy group (n =60) treated with intramuscular BCG-PSN 2 ml every other day and oral cetirizine 10 mg once daily,and the monotherapy group (n =63) treated with oral cetirizine 10 mg once daily alone.The treatment lasted 54 days.Clinical efficacy was evaluated.Venous blood samples were collected from the patients before and after the treatment,as well as from 56 healthy controls.Enzyme-linked immunosorbent assay was performed to quantify the plasma levels of eotaxin,TNF-α and IFN-γ.Results At the end of the treatment,the total response rate was significantly higher in the combination therapy group than in the monotherapy group (88.3％ vs.63.4％,P ＜ 0.05).Before the treatment,no significant differences were observed in the plasma levels of eotaxin,TNF-α or IFN-γ between the two treatment groups,whereas the patients showed higher plasma levels of eotaxin and TNF-α but lower plasma level of IFN-γ compared with the healthy controls (all P ＜ 0.5).Both the combination therapy and monotherapy resulted in a statistical decrease in plasma eotaxin and TNF-α but an increase in plasma IFN-γ (all P ＞ 0.05),and the absolute values of changes in the three parameters were significantly higher in the combination therapy group than in the monotherapy group (eotaxin:(13.27 ± 4.11) μg/L vs.(8.12 ± 2.58) μg/L,t =8.3654,P ＜ 0.05; TNF-α:(12.38 ± 3.95) ng/L vs.(10.32 ± 3.41) ng/L,t =3.1005,P ＜ 0.05; IFN-γ:(17.06 ± 5.24) μg/L vs.(12.54 ± 4.07) μg/L,t =5.3573,P ＜ 0.05).Further more,the differences between the patients and healthy controls in the three parameters disappeared at the end of the treatment (all P ＞ 0.05).Conclusion BCG-PSN combined with cetirizine seems superior to cetirizine alone for the treatment of chronic urticaria.

OBJECTIVETo study the relationship between endothelial nitric oxide synthase (eNOS) Glu298Asp gene polymorphism and chronic periodontitis (CP) with type 2 diabetes mellitus (T2DM).

METHODSDNA from patients' buccal swabs of CP, CP with T2DM, T2DM and health was isolated and extracted. The eNOS Glu298Asp gene polymorphism were assessed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) respectively.

RESULTSThe distribution of eNOS Glu298Asp genotype in CP group, T2DM group, CP with T2DM group and health group showed statistical differences (chi2 = 18.503, P = 0.005), and the gene frequency showed statistical differences (chi2 = 8.243, P = 0.041). Compared health group to CP with T2DM group, OR value of the genetype T was 0.962, 95% confidence interval lay in between 0.737 to 1.256, which showed T maybe a protective factor. While OR value of the genetype G was 1.043, 95% confidence interval lay in between 0.781 to 1.391, which showed G maybe a risk factor. However, neither T nor G was statistically significant.

CONCLUSIONBased on these findings, there are some association between eNOS Glu298Asp polymorphism and the risk of CP group, T2DM group, CP with T2DM group.

Chronic Periodontitis ; Diabetes Mellitus, Type 2 ; Gene Frequency ; Genotype ; Humans ; Male ; Middle Aged ; Nitric Oxide Synthase Type III ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Risk Factors

Objective To investigate the effect of cigarette smoke exposure on the interleukin-17-producing CD4+T helper lymphocyte( Th17 ) in peripheral blood and lungs of cigarette smoke-induced emphysema mice. MethodsForty male BALB/c mice were randomly divided into 4 groups, including a control group C12, a control group C24, a smoke-exposure group S12 and a smoke-exposure group S24, 10 mice each group. Morphological changes were evaluated by mean linear intercepts (Lm) and destructive index (DI). The concentration of IL-17, IFN-γ and TNF-α in bronchoalveolar lavage fluid(BALF) and the concentration of IFN-γ and TNF-α in lung homogenates were measured by enzyme-linked immunosorbent assay (ELISA). The proportion of CD4+IL-17+ Th17 cells in peripheral blood and lungs of mice was determined by flow cytometry. The mRNA expressions of RORγt and IL-17 in peripheral blood and lungs were evaluated by real-time PCR. ResultsLm and DI were significantly higher in S12 and S24 groups [(39.19±3.51)μm vs (46.87±7.16) μm, 39.13±1.57 vs 45.16±3.13]than that in C12 and C24 groups [(32.60± 3.21 ) μm vs (32.38±3.73) μm, 28.23± 1.62 vs 28.86±2.07], all P＜0.05. IL-17, IFN-γand TNF-α in BALF of S12 and S24 groups [(119.72±10.72) ng/L vs (296.40±14.00) ng/L,(129.7±22.2) ng/L vs(251. 1±62.4) ng/L, (17.35±1.60) ng/L, (36.35±1.43) ng/L]were higher than those in C12 and C24 groups [(52.06±4.70) ng/L vs (51.89 ±6.82) ng/L, ( 85.8 ±26.8) ng/L vs ( 88.9 ± 11.5 ) ng/L,(6.41 ±0.90) ng/L vs (5.85±0.92) ng/L], IFN-γ and TNF-α in lungs of S12 and S24 groups [( 1124.3±174.4) ng/L vs (1342.7±206.1) ng/L, (77.2±13.7) ng/L vs (101.7±19.0) ng/L, (129.7±22.2)ng/L vs (251.1 ±62.4) ng/L]were higher than those in C12 and C24 groups[(946.2±81.9) ng/L vs (1027.2±188.3) ng/L, (62.1±16.1) ng/L vs(64.4±15. 1) ng/L], all P＜0.05. The percentage of Th17 cells in lungs of S12 and S24 groups [(3.27±1.12)％ vs (7.19±2.24)％, ( 1.96±0.61 )％ vs (3.82±1.26)％]was significantly increased as compared with that of C12 and C24 groups [(1.80± 0.75)％ vs (1.99±0.59)％], all P＜0.05. And the percentage of Th17 cells in peripheral blood of S12 and S24 groups [(1.96±0.61)％ vs ( 3.82± 1.26)％]was also significantly higher than those in C12 and C24 groups [(0.90±0.37)％ vs (0.97±0.32)％], all P＜0.05. In peripheral blood and lungs,the mRNA levels of RORγt and IL-17 in S12 and S24 groups were higher than in C12 and C24 groups, all P＜0.05.Moreover, the frequency of Th17 cells in peripheral blood and lungs had a positive correlation with Lm and DI( r=0.706-0.772 ,all P＜0.05 ). ConclusionAn up-regulation of proportions Th17 in peripheral blood and lungs of cigarette smoke-inducsed emphysema mice were detected. It may be involved in the amplified and persistent inflammation.