[Influence of combined spinal-epidural analgesia and epidural analgesia on the progress of labor].

OBJECTIVE: To investigate the influence of combined spinal-epidural analgesia (CSEA) and epidural analgesia (EA) and patient-controlled epidural analgesia (PCEA) on labor progress. METHODS: The partograms of 722 healthy vaginal delivery nulliparas were retrospectively analyzed in Department of Obstetric and Gynecology, First Hospital of Peking University. Three groups were divided among all subjects: CSEA group (259 cases) receiving CSEA + PCEA, EA group (215 cases) receiving EA + PCEA and control group (248 cases) without any analgesia method. RESULTS: The duration of active phase in the first stage and the second stage in the CSEA group [(272 +/- 127) min and (57 +/- 36) min] and in the EA group [(305 +/- 133) min and (59 +/- 39) min] were significantly longer than that of control group [(188 +/- 110) min and (45 +/- 32) min]. No significant difference was found in the three groups in the duration of the third stage [CSEA: (9 +/- 6) min; EA: (8 +/- 6) min; CONTROL: (9 +/- 6) min. P > 0.05]. The dilatation curve of the cervix in CSEA group and EA group was plotted on the right side of the Friedman curve while that of the control group on the left, reflecting a slower progress in the former two groups than the control during the active phase. The average speed of cervical dilatation in CSEA and EA groups (1.5 cm and 1.4 cm) was significantly slower than that of the control (1.8 cm) in the active phase (P < 0.01). CONCLUSIONS: CSEA + PCEA or EA + PCEA during labor might slow down the progress of the active phase and lead to a prolonged labor in the end. Therefore, the management of these parturients may vary based on Friedman partogram.

A sequence investigation on Wallerian degeneration after pontine infarction with diffusion tensor imaging / 中华神经科杂志

Objective To investigate the Wallerian degeneration of neural fiber tract in medulla and bilateral middle cerebellar peduncle following pontine infarction and to explore its impacts on neurological recovery.Methods Fourteen patients with a recent unilateral pontine infarct underwent the diffusion tensor imaging(DTI)and evaluations with the NIH stroke scale(NIHSS),the Fugl-Meyer motor scale(FM), ataxia rating scale(ARS)and the Barthel index(BI)at the first week(W1),the fourth(W4)and twelfth week(W12)respectively.Mean diffusivity(MD)and fractional anisotropy(FA)were measured at pons, medulla and middle cerebellar peduncle.Fourteenth age and gender matched volunteers underwent a DTI were studied as controls.Results Compared with the matched regions in controls,the FA values of infarct side medulla and bilateral middle cerebellar peduncle in patients significantly decreased at W1,W4 and W12(on the infarct side of medulla:W1:0.43?0.01;W4:0.37?0.02;W12:0.30?0.02;on the infarct side of middle cerebellar peduncle:W1:0.50?0.01;W4:0.43?0.02;W12:0.35?0.04;on the opposite side of middle cerebellar peduncle infarction:W1:0.54?0.02;W4:0.52?0.03;W12:0.47?0.04,t values are 1.92 to 28.56,P0.05 respectively).The absolute value of percent reduction of FA in infarct side medulla and bilateral middle cerebellar peduncle was correlated negatively to the absolute value of percent change of NIHSS and BI score(P

Study on exons 3 and 4 of alpha-synuclein gene in Chinese familial Parkinson disease patients / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To study the relationship of Chinese familial Parkinson disease with alpha-synuclein gene.</p><p><b>METHODS</b>Polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) and polymerase chain reaction-heteroduplex analysis(PCR-HA) were employed to detect the abnormal mobilization in the familial Parkinson disease and sporadic Parkinson disease patients, then it was verified by gene sequencing.</p><p><b>RESULTS</b>No mutation was found in alpha-synuclein gene exons 3 and 4 by PCR-SSCP together with PCR-HA. An inserted c and an inserted t were found in intron 4, position 23 and position 67 respectively.</p><p><b>CONCLUSION</b>(1) Exons 3 and 4 of alpha-synuclein gene are not the mutational hot spots of Chinese familial Parkinson disease. (2) Two polymorphisms were found in intron 4 of alpha-synuclein gene. They are 23 ins c and 67 ins t.</p>