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Objective:To investigate the effect of hydromorphone combined with ropivacaine on hemodynamics, maternal and infant outcomes in labor analgesia.Methods:From April 2018 to April 2020, 150 pregnant women with single full-term pregnancy undergoing labor analgesia in Meishan Hospital Affiliated of West China Hospital, Sichuan University were randomly divided into two groups, with 75 cases in each group. The control group was given ropivacaine for labor analgesia, while the observation group was given hydromorphone combined with ropivacaine for labor analgesia. The scores of visual analogue scale (VAS), heart rate (HR), mean arterial pressure (MAP) and blood oxygen saturation (SpO 2) at the time of entering the room (T 1), after the first dose for 5 min (T 2), 10 min (T 3), after delivery for 30 min (T 4) and 60 min (T 5) were compared between the two groups. Results:The scores of VAS at T 2, T 3, T 4, T 5 in two group were decreased, and the scores of VAS in the observation group were lower than that in the control group: (5.12 ± 0.98) scores vs. (7.11 ± 1.10) scores, (4.39 ± 0.61) scores vs. (5.77 ± 0.75) scores, (3.12 ± 0.38) scores vs. (4.88 ± 0.91) scores, (2.12 ± 0.37) scores vs. (3.98 ± 1.11) scores, the differences were statistically significant ( P<0.05). The levels of HR, MAP, SpO 2 in two groups at different time point had no significant differences ( P>0.05). There were no significant difference between the first stage of labor, the second stage of labor and the third stage of labor ( P>0.05). There was no significant difference in the 5 min Apgar score of newborns and the incidence of maternal adverse reactions between the two groups ( P>0.05). Conclusions:Hydromorphone combined with ropivacaine for labor analgesia effect is ideal, and has little impact on hemodynamics of patients, and will not increase the safety risk of mother and infant.
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Objective To apply color Doppler flow imaging (CDFI) and transcranial Doppler (TCD) to the follow-up observation of the changes of cervical vessel,intracranial hemodynamics and cerebrovascular reserve capacity (CVR) of the patients after carotid artery stent implantation.Methods Totally 96 patients with carotid artery stent implantation underwent CDFI and TCD examinations,and the changes of hemodynamics were compared before and 1 month,6 months,1 a and 2 a after implantation.Results The values of peak systolic velocity (PSV) and resistance index (RI) at the areas of carotid stenosis were lower significantly than those before implantation,while the values of PSV,pulsatility index (PI) and CVR of the middle cerebral artery were obviously higher than those before implantation (P＜0.05).There were no significant differences between the cervical and intracranial hemodynamics indexes 1 month,6 months,1 a and 2 a after treatment.Two-year follow-up found 4 cases of restenoses after implantation,and the rate for restenosis was 4.2％.Conclusion Carotid artery stent implantation improves significantly cervical and intracranial blood supply as well as CVR of the carotid stenosis patient,and CDFI combined with TCD can be used for the accurate evaluation of the efficacy and postoperative follow-up of carotid artery stent implantation.
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ObjectiveTo assess the effects of intra-articular Hydromorphone with Ropivacaine for postoperative analgesia after arthroscopic knee surgery.Methods 90 patients undergoing arthroscopic knee surgery were randomly divided into 3 groups. Group R: 0.375% Ropivacaine 20ml; group H1: Hydromorphone 0.3 mg and 0.375 % Ropivacaine 20 ml; group H2: Hydromorphone 0.6 mg and 0.375 % Ropivacaine 20 ml. The visual analogue scale (VAS) at rest were recorded at 6, 12, 18 and 24 h after surgery, Duration of analgesia, number of patients and frequency requiring Parecoxib at 24 h after surgery were observed.Results Compared with group R, VAS of group H1 and group H2 were signiifcantly lower at 12 and 18h after the operation, duration of analgesia was much longer, number of patients and frequency requiring Parecoxib was lower in group H1 and H2 (P < 0.05); Compared with group H1, No signiifcant differences of VAS, duration of analgesia and number of patients and frequency requiring Parecoxib of group H2.Conclusions After knee arthroscopic surgery, intra-articular 0.3 mg Hydromorphone can signiifcantly improve the efifcacy of Ropivacaine for postoperative analgesia; the efifcacy of Hydromorphone can’t increased with the increase of dosage.
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Objective To evaluate the diagnostic value of multi-slice computed tomography (MSCT)for incisional hernia of ab-dominal wall before operations.Methods Thirty patients with incisional hernia in abdominal wall confirmed by the pathology were enrolled in this study.All patients underwent MSCT examination with sagittal and coronal MPRs,and 21 cases underwent ultra-sound (US)examinations.The value of transverse scan and MPRs & MSCT and US on demonstrating the number,location,con-tents of incisional hernia,and accompanying intestinal obstruction or other complications were retrospectively evaluated and com-paired.Results Of 30 cases,there were 40 hernias,the rate of MSCT and US in detecting incisional hernias were 97.5% and 56.0%, respectively.MSCT performed better than US on demonstrating the incisional hernias (P =0.000).On MSCT,there was no signif-icant difference in the detection for isolated incisional hernia between the MPRs and axial scans (P = 1.000 ).However,MPR showed a more accurate rate for two or multiple incisional hernias diagnosis (P =0.006),and the sagittal reconstruction displayed more correct than coronal reconstruction on two or multiple incisional hernias (P =0.01 9).Furthermore,MSCT can exactly reveal the complications of incisional hernias (7 cases of intestinal obstruction,5 cases of intestinal ischemia and edema,and 1 case of me-tastasis in incisional hernia),which were not detected by US.Conclusion MSCT can correctly demonstrate the incisional hernia of abdominal wall and its complication,it can provide important imaging reference for clinical therapy.
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Objective To explore comparison between methotrexate and uterine arterial embolization in β-HCG, bleeding volume and success rate of women with cesarean scar pregnancy after cesarean section.Methods 42 patients who were diagnosed with cesarean scar pregnancy after cesarean section were collected.All patients were randomly divided into uterine arterial embolization group and methotrexate group,21 cases in each group corresponding treatment were given respectively, after the treatment, the serum levels of β-HCG, bleeding volume and success rate were detected in all patients.Results After treatment, compared with methotrexate group, the serum level ofβ-HCG was lower in the uterine arterial embolization group,and the difference was statistically significant(P<0.05); the bleeding volume was lower in the uterine arterial embolization group(P<0.05); the success rate was higher in the uterine arterial embolization group(P <0.05).Conclusion Compared with methotrexate,the uterine arterial embolization can significantly reduce the serum level ofβ-HCG in patients with cesarean scar pregnancy after cesarean section,reduce the amount of bleeding, improve the success rate of treatment.
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Objective To establish the breastfeeding evaluation indicator system for preterm infants and to provide theoretical basis for breastfeeding implementation and evaluation.Methods Based on literature review,clinical on-spot investigation and experts consultation,the evaluation system frame was initially formed.With specialists meeting method and Delphi study,the evaluation indicator system for preterm infants was established.Results The breastfeeding evaluation indicator system for preterm infants comprised 3 levels,with 3 indicators in level 1,7 indicators in level 2 and 18 indicators in level 3.Conclusions It is emphasized that the purpose for breastfeeding evaluation of preterm infants is to continuously improve the breastfeeding quality for preterm infants.
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Objective To investigate the senescence of rat mesangial cells induced by Tert-Butyl hydroperoxide (tBHP) and the protective effect of probucol on senesecence. Methods Human glomerular mesangial cells(hGMC) were cultured in vitro and intervened by tBHP. The cell survival rate was observed by methyl thiazolyl tetrazolium( MTT). β-gal staining and cell cycle analysis were used to identify cell senescent status;transmission eletric microscopy was used to evaluate the ultra-microstructure of hGMC. Senescent-related indexes were detected after treatment with probucol. Results The cell survival rate with 30 μmol/L tBHP was (80. 12 ± 3. 25 ) % , the positive rate of β-gal staining was significantly higher in tBHP-induced cells (about 81% )than that of the control cells( P <0. 01). 86% of the cells was arrested at G0-G1 phase. Invagination of nucleus membrane and chromatin condensation at the nuclear margin in tBHP-induced cells was observed through transmission eletric microscopy. In the probucol intervented cells, the cell survival rate was higher than that of tBHP-induced cells (92. 68 ± 5.03) % vs. ( 80. 12 ± 3. 25) % (P < 0. 05 ). The positive rate of β-gal staining decreased to 45. 2%. The proportion of cell cycle stage was similar to the control cells.The change of morphous and ultrastructure was relieved. Conclusions tBHP can induce hGMC senescence in vitro and probucol may play a role in preventing hGMC senescence.
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OBJECTIVE To study the aminoglycosides modifying enzyme genes and intⅠ gene in Stenotrophomonas maltophilia in Chinese Armed Police Forces General Hospital.METHODS The samples of 27 multi-resistant S.maltophilia were collected from inpatiens from Jan 2006 to Oct 2007 in this Hospital.The sensitivity of the isolates to 14 antibacterial agents was determined using a broth induction method.The aminoglycosides modifying enzyme genes and intⅠ 1 gene were detected by PCR.RESULTS The multi-drug resistance of S.maltophilia was a serious problem.In 27 strains of S.maltophilia,the positive ant(2″)-Ⅰ were in 5 strains(18.5%),aac(3)-Ⅱ in 3 strains(11.1%)and aac(6')-Ⅱ in 1 strain(3.7%).The positive intⅠ gene was found in 11 strains(29.6%).CONCLUSIONS Multi-resistant S.maltophilia resistant to aminoglycosides mainly due to the presence of aminoglycoside modifying enzymes ant(2″)-Ⅰ,aac(3)-Ⅱ and aac(6')-Ⅱ.The aminoglycoside modifying enzymes ant(3″)-Ⅰ and aac(6)-ⅠZ were not detected carrying IntⅠ would be the reason of S.maltophilia resistant to aminoglycosides.