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Objective:To evaluate the effect of dual-tube epidural segmental injection of lidocaine analgesia on the delivery outcome and maternal and infant complications of persistent posterior occipital position postpartum or lateral occipital position postpartum patients with protracted active phase.Methods:The full and single-term primiparas ( n=216, 37 to 42 weeks gestation, 22 to 35 years) diagnosed as persistent posterior or lateral occipital position during the active period were selected from the Department of Obstetrics of Qingdao Municipal Hospital from January 2015 to October 2019. The subjects were randomly assigned into two groups: double-tube epidural block group ( n=108) and single-tube epidural block group ( n=108), 1% lidocaine was used for epidural analgesia respectively under ultrasound guidance. Senior midwife or obstetricians implement new partogram, and guide women to perform position management, and push or rotate the fetal head in a timely manner. Observation indicators: general condition, the use of non-pharmacological analgesic measures, analgesia related conditions and pain visual analogue scale (VAS) score, delivery-related indicator, cesarean section indication, anesthesia-related indicator, maternal and child complications. Results:(1) General condition: the age, weight, height, gestational age, the ratio of persistent lateral or posterior occipital position, cephalic score, and neonatal birth weight between the two groups of women were not statistically significant (all P>0.05). (2) The use of non-pharmacological analgesic measures: the women’s Lamaze breathing method, Doula delivery companionship, percutaneous electrical stimulation, and other measures between two groups were compared, and there were not significant differences (all P>0.05). (3) Analgesia related conditions and VAS scores of women undergoing vaginal delivery: compared with the single-tube epidural block group ( n=40), the second-partum time of the women in the double-tube epidural block group ( n=59) was significantly shortened [(124±44) vs (86±33) minutes, P<0.01]; after 30 minutes of analgesia (4.4±0.5 vs 0.9±0.5, P<0.01), during forced labor in the second stage of labor (5.7±0.6 vs 1.3±0.4, P<0.01), the VAS scores of pain were also significantly reduced ( P<0.01). (4) Labor-related indicators: compared with the single-tube epidural block group, the natural delivery rate (21.3% vs 49.1%) and the delivery experience satisfaction rate (51.9% vs 98.1%) of women in the double-tube epidural block group were significantly increased (all P<0.01), cesarean section rate (63.0% vs 45.4%), instrument assisted rate (15.7% vs 5.6%) decreased significantly (all P<0.05). (5) Cesarean section indications: compared with the single-tube epidural block group, the cesarean section rate caused by prolonged labor or protracted active phase of women in the double-tube epidural block group was significantly reduced (38.0% vs 22.2%； P<0.05), and the fetal distress, intrauterine infection, and social factors caused by cesarean section between the two groups were compared, while the differences were not statistically significant (all P>0.05).(6) Anesthesia related indexes: the block planes of the maternal upper tube administration in the double-tube epidural block group were mostly T7, T8, T9-L2 and L3,While,the block planes in the single-tube epidural block group were mostly T10, T11-S1, S2, S3, and the modified Bromage score were all 0. (7) Maternal and child complications: compared with the single-tube epidural block group, the postpartum hemorrhage rate (18.5% vs 7.4%), the perineal lateral cut rate (20.4% vs 5.6%), the neonatal asphyxia rate (12.0% vs 3.7%), ICU rate of transferred neonates (13.9% vs 4.6%) in the double-tube epidural block group were significantly reduced (all P<0.05). Soft birth canal injury rate, puerperal disease rate and neonatal birth rate between two groups were compared, and there were not statistically significant differences (all P>0.05). Conclusion:Dual-tube epidural segmental injection of lidocaine analgesia could increase the natural delivery rate of women with posterior occipital or lateral occipital position with active stagnation, reduce the rate of cesarean section and the rate of transvaginal instruments, and reduce the complications of mother and child.
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Objective To study the relationship between the positive expression of human leukocyte antigen B27 (HLA-B27) in different age groups and genders in Uygur and Han nationality in Xinjiang,and explore the clinical value of HLA-B27 in different ethnic groups.Methods From January 2013 to November 2016,1 416 cases of Uygur and Han patients with positive expression of HLA-B27 were detected by flow cytometry.There were 369 cases of Uygur and 1 047 cases of Han.Results Independent samples t-test showed that the positive expression of HLA-B27 in Uygur and Han population was statistically significant (165.22±8.262 vs 163.99±8.113,t=2.479,P=0.013).In male,there was a significant difference in the positive expression of HLA-B27 between Uygur and Han population (165.40 ± 8.237 vs 163.99 ± 8.164,t =2.187,P =0.029).In the age of 41～60 years old and ＞60 years old,the positive expression of HLA-B27 in Uygur was higher than that in Han nationality (166.18 ± 7.650 vs 164.53 ± 8.018,t =2.215,P =0.027;171.63 ± 8.134 vs 167.40 ± 9.469,t =2.126,P=0.035).There was no significant difference in the positive expression of HLA-B27 between Uygur and Han nationality in women,as well as in the age of 20 years and 21～40 years (t=-0.029～1.257,all P＞0.05).Conclusion The investigation showed that the positive expression of HLA-B27 in Uygur was higher than that in Han nationality.The content of HLA-B27 positive expression has racial difference.
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ObjectiveTo evaluate the effect of shenfu injection on airway resistance and oxygenation during one-lung ventilation (OLV) in patients undergoing lobectomy.MethodsSixty ASA Ⅱ patients of both sexes,aged 50-80,BMI 20-29 kg/m2,scheduled for lobectomy under thoracic epidural block combined with general anesthesia,were randomly divided into 2 groups( n =30 each):normal saline control group (group C) and shenfu injection group (group S).In group S,shenfu injection was infused intravenously at 4.5 ml·kg-1 ·h-1 for 20 min before anesthesia induction.In group C,equal volume of normal saline was infused instead of shenfu injection.Airway peak pressure was recorded and arterial blood samples were taken for determination of PaO2 before OLV,at 30,60 min of OLV and the end of surgery.Oxygenation index was calculated.ResultsCompared with group C,airway peak pressure was significantly decreased and oxygenation index increased at 30,60 min of OLV in group S ( P ＜ 0.05).ConclusionShenfu injection can decrease airway resistance and increase oxygenation during OLV in patients undergoing lobectomy,indicating that shenfu injection has a lung-protective effect.
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BACKGROUND: At present, many scholars make improvements to the UW solution composition, aiming to further explore the principle of organ preservation, improve preservation techniques and to extend the preservation time limit; simplified composition of UW solution can further meet the clinical transport, storage and ease of use; suitable alternatives should be found to reduce the cost of UW solution to satisfy the needs of the market.OBJECTIVE: To discuss the effectiveness of self-prepared PV solution for preserving rat's liver at a lower temperature, and to compare the results with UW solution.METHODS: A total of 90 Wistar rats were randomly divided into three groups: UW group, PV group and normal saline (NS) group. Rats in each group were prepared for non-circulated isolated perfused rat liver models, and preserved for 0, 6,12, 18, and 24 hours respectively, with 6 animals in each subgroup. The changes of hepatic enzymology (alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase) in corresponding time period, amount of metabolic production of oxyradicals from perfusion effluent liquid, and the bile secretion and changes in hepatic morphology under the microscope were observed. RESULTS AND CONCLUSION: Amounts of alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase and superoxide dismutase in perfusion effluent liquid were close between the PV group and UW group, and the difference was not significant (P > 0.05). After 6 hours of preservation, tumor necrosis factor a titre in the PV fluid group was greater than that in the UW group (P< 0.05); after 12 hours of preservation, amount of malonaldehyde in the UW group was evidently increased than that in the PV group (P < 0.05); after 18 hours of preservation, bile secretion in the PV group was lower than that in the UW group (P < 0.05); morphological changes of hepatic cells were similar in the two groups under the optical and electron microscope. The results demonstrated that PV solution and UW solution have a similar effect on protecting Wistar rat's liver function, and PV solution is superior to UW solution in antioxidation and scavenging oxygen free radicals.
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Objective To study the clinical efficacy of Reinforcing Kidney Decoction for the treatment of metabolic syndrome diagnosed as traditional Chinese medicine (TCM) syndrome of phlegm-blood stasis due to kidney deficiency. Method 42 recipients who volunteered to accept the TCM therapy were up to the inclusion criteria and finally fulfilled this study. Of all the cases, there were 26 males and 16 females, their old years ranged from 39 to 60, which were divided into obesity type diabetics group and metabolic syndrome group, both of which were treated with oral Reinforcing Kidney Decoction combined with western medicine therapy, with a course of 4 weeks. The changes of clinical symptoms, body weight index (BMI), fasting blood glucose (FBG), 2 h post prandial glucose (2hFBG), total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL-C) levels, and serum uric acid were analyzed. Results Therapeutic effect in two groups ranked as significant, general and null effect, 14/5/2 vs 8/11/2, respectively. Dizziness and heaviness feeling of limbs have been improved. Rate of syndrome scores and laboratory parameters descended great significant, Hotelling's Trace, F =16.51, P =0.00. Compared with pretreatment, the levels of TC, TG, SUA obviously descended (P
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Objective To investigate a superior therapeutic method of chloasma with traditional Chinese medicine (TCM) in women of reproductive age. Methods Two stage cross trial were employed in this study. Valuable labels were included pharmaceutical, periodical and layover effect, clinical symptoms, chloasma area, and correlation of them. Therapeutic course had 4 weeks in the first and the second stage, respectively. Clinic final effect was valued by intentional methodology. Results 106 recipients who fulfilled with inclusion criteria were divided into two groups, therapeutic group and controlling group, respectively. Effect rate of treating group arrived at 60.4% after and before the cross treatment. Therapeutic effect in the treating group was significantly superior to that in the controlling group in the end of clinic final. The pharmaceutical and the periodical effect also manifest markedly difference in this study. But there was not cross effect between the pharmaceutical and periodical effect in each group. The symptom effect has no relation with chloasma area effect, both of them also manifests line relation. Conclusion On the basis of pathological factors such as heat-damp, blood stasis and phlegm, harmonizing liver and reinforcing kidney is good way to improve therapeutic effect.
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The study process of TCM syndrome spectra of hemopathy is the process to recognize the syndrome characteristics of the onset, development of hemopathy, it bases on norm of TCM symptoms and syndrome. In this course, it could not only find common feature of syndrome,but also analyze distribution regularity of TCM syndrome. Thus to establish sequence of hemopathic syndrome, and to provide the basis for clinic determination of treatment based on syndrome differentiation, and provide the foundation for finding correlation of TCM syndrome and target tests.
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Tissue factor pathway inhibitor (TFPI) is one of the major physiological inhibitors of the human blood coagulation cascade and may have great potential in the prevention and therapy of diseases caused by thrombus formation. In this study, recombinant human tissue factor was generated in E. coli containing a recombinant vector constructed by inserting TFPI cDNA into pGEX-2T vector. The generated recombinant TFPI (rTFPI) could be simply purified with glutathione-agarose affinity method and maintained its biological function in terms of inhibition of tissue factor and factor Xa.