[Effects of double-catheter epidural analgesia by lidocaine injection respectively on the delivery outcomes and maternal-infant complications for persistent posterior or lateral occipital position of protracted active phase]

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.

[Clinical Values of Combined Detection of CRP and D-D for AL Patients Complicated with DIC]

OBJECTIVE

To explore the clinical values of the combined detection of C-reactive protein (CRP) and D-dimer (D-D) for acute leukemia (AL) patients complicated with disseminated intravascular coagulation (DIC).

METHODS

Among 52 cases of AL, 20 cases of AL complicated with DIC were selected as AL+DIC group, 32 cases of AL were selected as AL group, 30 healthy volunteers were used as control group; the detected values of CRP and D-D in 3 groups were compared.

RESULTS

The CRP and D-D levels in AL+DIC group were significantly higher than those in AL and control groups (P < 0.05); the CRP and D-D levels in AL group were significatly higher than those in control group (P < 0.05). The D-D level and complicated DIC rate in patients with CRP < 10 mg/L were significantly lower than those in patients with CRP 10-100 and >100 mg/L (P <0.05), while the D-D level and complicated DIC rate in patients with 10-100 mg/L were significantly lower than those in patients with CRP > 100 mg/L (P <0.05). After treatment of patients, the CRP and D-D levels in AL and AL+DIC groups were obviously reduced as compared with levels of these 2 groups before treatment (P <0.05); the CRP and D-D levels in AL+DIC after treatment were significantly higher than those in AL group (P <0.05).

CONCLUSION

The combined detection of CRP and D-D possesses a higher reference value for diagnosis and differentiation of AL and AL complicated with DIC, thus also has an important role in evaluation of therapeutic efficacy of AL.

[Glucocorticoid combined with ulinastatin in treatment of Kawasaki disease in children: a non-randomized controlled clinical trial]

OBJECTIVE

To investigate the clinical efficacy of glucocorticoid combined with ulinastatin in the treatment of Kawasaki disease (KD) in children.

METHODS

A total of 104 children who were admitted and diagnosed with typical KD between January 2011 and December 2013 were assigned to ulinastatin group (methylprednisolone+ulinastatin; n=46) and intravenous immunoglobulin (IVIG) group (n=58) according to the severity of KD and the willingness of their parents. Observations for the two groups were performed to compare the changes in coronary artery diameter before and at 1 week, 3 months, and 6 months after treatment, fever clearance time, retreatment condition, changes in white blood cells (WBC), platelets (PLT), hemoglobin (HB), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) at 1 week and 3 weeks after treatment, and total in-hospital cost.

RESYLTS

There was no significant difference in the coronary artery diameter between the two groups before or at 1 week, 3 months or 6 months after treatment (P>0.05). All the patients (100%) in the ulinastatin group vs 83% in the IVIG group had a normal body temperature after 48 hours of treatment (P<0.01). Two patients (4%) in the ulinastatin group and 10 patients (17%) in the IVIG group received retreatment. Significant differences were observed in ESR, WBC, and HB between them (P<0.01). The total in-hospital cost in the ulinastatin group was significantly lower than that in the IVIG group (P<0.01).

CONCLUSIONS

For children with KD, methylprednisolone combined with ulinastatin does not increase the risk of coronary artery aneurysm, decreases in-hospital costs, is superior in controlling laboratory markers and shortening the duration of fever during the acute phase compared with the IVIG therapy.

Mapping of quantitative trait loci for the bolting trait in Brassica rapa under vernalizing conditions

Premature bolting can occur occasionally during spring cultivation of heading Chinese cabbage in East Asia when the plants encounter low temperatures (vernalization), leading to economic loss. Breeding bolting-resistant cultivars is the best choice for solving this problem. We looked for QTLs responsible for varietal differences in the bolting trait in Brassica rapa under environmental conditions that promote vernalization. To achieve this goal, we constructed a linkage map with 107 simple sequence repeats and 54 insertion/deletion markers based on a segregating population of 186 F2 individuals. The resulting map consisted of 10 linkage groups and covered a total length of 947.1 cM, with an average genetic distance of 5.84 cM between adjacent markers. QTL analysis of the bolting trait was performed by two phenotypic evaluations (bolting index and flowering time) based on the scores in an F2 population in the spring of 2010, and scores in F2:3 families in autumn 2010 and spring 2011, respectively. Twenty-six QTLs that controlled bolting were detected, accounting for 2.6 to 31.2% of the phenotypic variance. The detected QTLs with large effects co-localized mainly on linkage groups A02, A06, and A07. These QTLs may provide useful information for marker-assisted selection in a breeding program for late bolting or bolting-resistant cultivars in B. rapa crops.

Relationship between urinary iodine and goiter prevalence: results of the Chinese national iodine deficiency disorders survey

BACKGROUND

In 1984, Yu Zhiheng proposed the "U-curve" regularity between urinary iodine (UI) and goiter prevalence (GP). However, along with the adjustment of salt iodine and iodine deficiency disorders (IDD), and surveys followed, some defects were found in the research. As a result, it is time to test and enrich the theory as a series of large sample survey data from China would be helpful.

AIM

To test and enrich the theory of "U-curve" relationship between UI and GP.

SUBJECTS AND METHODS

Based on the Chinese national IDD surveys (1999, 2002, 2005), the High Water Iodine survey of 2005, and the High Risk endemias survey of 2007, this article analyzed the relationship between UI and GP. The UI was grouped according to the World Health Organization (WHO) standard, self-defined (5 microg/l), and Yu Zhiheng's level, separately, the GP was calculated for population with different UI level, the tendency curve was drawn and the fitting curve model was estimated by SPSS.

RESULTS

For the 2005 Chinese national survey and 2005 High Water Iodine survey, we finally got the fitting curves and corresponding UI reference limits.

CONCLUSIONS

The UI and GP formed a "U curve" relationship. It varied with some reasons and fell into an accurate U shape step by step. For High Water Iodine endemias survey, the relationship changed to "power curve". Regarding the WHO recommended GP<5%, the UI range of school-age children in normal district should be 110-315 microg/l, whereas, in high water iodine district should be <80 microg/l.

Effects of Tripterygium wilfordii saponins and interleukin-10 on dendritic cells from human peripheral blood

AIM

To study the effects of Tripterygium wilfordii (TII) and IL-10 on human leukocyte antigen-DR (HLA-DR) and CD80 expressions and IL-12 p40 subunit production and transcription of dendritic cells (DC) in human peripheral blood from healthy volunteers in vitro.

METHODS

DC were generated by culturing plastic-adherent peripheral blood mononuclear cells with GM-colony stimulating factor (GM-CSF), IL-4, and TNFalpha. The expressions of HLA-DR and CD80 were examined by flow cytometry after the cells were stained with immunofluorescence antibodies. Enzyme-linked immunosorbent assay and reverse transcriptase polymerase chain reaction analysis were used to detect IL-12 p40 protein level and mRNA transcription, respectively.

RESULTS

TII 5 - 20 mg/L and IL-10 50 - 200 microg/L greatly down-regulated the membrane expressions of HLA-DR and CD80 on DC in a concentration-dependent manner. IL-12 p40 production and mRNA transcription were also inhibited in DC both by TII and by IL-10.

CONCLUSION

TII and IL-10 exert immunosuppressive role via inhibiting membrane expressions of HLA-DR and CD80 and synthesis of IL-12 p40 subunit in DC.

Effects of rhM-CSF expressed in silkworm on cytokine productions and membrane molecule expressions of human monocytes

AIM

To study the effects of recombinant human macrophage colony-stimulating factor (rhM-CSF) expressed in silkworm on cytokine productions and membrane molecule expressions of monocytes.

METHODS

The rhM-CSF was added to the human peripheral blood monocyte cultures and 3 d later, the culture supernatants and cells were collected, respectively. TNF-alpha, IL-6, IL-8, and IFN-alpha levels in the supernatants were detected by biological activity test or ELISA and expressions of CD11b, CD16, HLA I, and HLA II on the cellular surface were examined by the method of alkaline phosphatase anti-alkaline phosphatase complex (APAAP).

RESULTS

The rhM-CSF promoted TNF-alpha, IL-6, and IL-8 inductions of monocytes and increased the percentages of CD11b, CD16, HLA I, and HLA II molecule expression on monocytes.

CONCLUSION

The rhM-CSF plays a role in monocyte function up-regulation and has a certain practical value in immunological therapy.

The Size-Dependence of 1,5-Diphenyl-3-naphthyl-2-pyrazoline Nanocrystals

1,5-Diphenyl-3-naphthyl-2-pyrazoline nanocrystals with different sizes from 400 to 20 nm were prepared by the reprecipitation method. As the nanocrystal size decreased, the nanocrystal absorption peak was observed to shift to high-energy side due to size effect, and in the same period the peak shape changed from asymmetric to symmetric due to the gradual disappearance of the aggregate absorption. Copyright 1999 Academic Press.

The use of dot-immunogold-silver staining (dot-IGSS), dot-ELISA and dot-IGSS to detect serum antibodies from clonorchiasis patients: a comparative study

We report the use of immunogold-silver staining (IGSS), dot-ELISA and dot-IGSS methods in the study of clonorchiasis in China. These methods were employed to detect the antibody in sera from 40 clonorchiasis patients. The positive rates were 100%, 90.0% and 95.0%, respectively. When the three methods were used to examine 40 normal sera, the negative rates were 100%, 97.5% and 97.5%, respectively. These results suggest that IGSS, dot-ELISA and dot-IGSS are highly specific and sensitive in detecting anti-Clonorchis antibody in patients.

[Effects of extracts from Phyllanthus urinaria L. on HBsAg production in PLC/PRF/5 cell line]

Experiment on the effect of extracts from Phyllanthus urinaria on HBsAg production in PLC/PRF/5 human hepatoma cell line showed that the production was decreased markedly 48 hours after the treatment of cells with 2-4 mg/ml Phyllanthus urinaria, especially in combination with 10(-5) mol/L of Ara-A. The decrease of extracellular HB-sAg excretion seems to stem from the inhibition of intracellular HBsAg formation.

Structure and intramolecular hydrogen bonding of 1-phenazinecarboxylic acid

C13H8N2O2, Mr = 224.22, monoclinic, P2(1)/n, a = 18.149 (2), b = 14.2768 (9), c = 3.8191 (3) A, beta = 92.029 (6) degrees, V = 988.95 A3, Z = 4, Dx = 1.51 g cm-3, lambda (Cu K alpha) = 1.54178 A, mu = 7.61 cm-1, F(000) = 464, T = 163 (1) K, R = 0.037 for 1479 data with I greater than or equal to 2 sigma (I). An intramolecular hydrogen bond is observed between the carboxyl hydrogen atom and the nearby nitrogen atom with the N...O distance being 2.67 A.

Novel heteroarotinoids: synthesis and biological activity

In this study, 13 heteroarotinoids were synthesized. The key step in each preparation was the condensation of the appropriate chroman-, thiochroman-, or benzothienyl-substituted phosphorus ylide, obtained from the independent synthesis of the corresponding phosphonium salts, with selected polyene-substituted aldehyde esters. Nine of these heterocycles contained a thiochroman group, two had a chroman group, and two others had a benzothienyl system. Screening of the compounds was with one of two assays. One assay measured the ability of a retinoid to inhibit the phorbol ester induced increase of mouse epidermal ornithine decarboxylase (ODC) activity. The other assay measured retinoid-induced differentiation of the human myoloid leukemia cell line HL-60. In the ODC assay, all thirteen compounds were screened. The most active heteroarotinoids were ester 10 [methyl (E)-4-[2-(2,2,4,4-tetramethylthiochroman-6-yl)-1- propenyl]benzoate] and acid 11 [(E)-4-[2-(2,2,4,4-tetramethyl-3,4- dihydro-2H-1- benzothiopyran-6-yl)-1-propenyl]benzoic acid]. Both of these retinoids had ID50 values (dose required for half-maximal inhibition of phorbol ester induced ODC activity) of about 0.3 nmol. In comparison, the ID50 value for trans-retinoic acid (1) was 0.12 nmol while the ID50 values for acids 7 and 9, namely (2Z,4E,6E)-3,7-dimethyl-7-(4,4-dimethyl-thiochroman -6-yl)-2,4,6-heptatrienoic acid and (2E,4E,6E)-3,7-dimethyl-7-(2,2,4,4-tetramethylthiochroman -6-yl)-2,4,6- heptatrienoic acid, respectively, were about 3.5 nmol. Heteroarotinoids 8 and 12-17 had ID50 values of 35 nmol or greater. With a thiochroman unit, the most active acids in decreasing order of activity in the ODC assay were 7 greater than 9 greater than 8. Thus, simple replacement of the terminal propenyl system [C(16,17,18)] in 7 with a cyclopropyl group produced acid 8 [(2E,4E,6E)-7-methyl-7-(4,4-dimethylthiochroman-6-yl)- 2,3-methylene-4,6-heptadienoic acid with markedly reduced activity. With a benzoic acid group as part of the structure attached to the thiochroman unit, the ODC activity was enhanced as shown in 10 and 11. The combination of the 2,2,4,4-tetramethylthiochroman group and the benzoic acid (or ester) terminal group seemed to enhance the biological action which resembles that found with (E)-4-[2-(5,6,7,8-tetrahydro-5,5,8,8-tetramethyl-2-naphthalenyl)- 1-propenyl]benzoic acid (TTNPB, 6b), a well-known model system.(ABSTRACT TRUNCATED AT 400 WORDS)