Objective To explore the impact of throughout patient-controlled epidural analgesia(PCEA) on labor progress and delivery mode. Methods We enrolled 120 nulliparous women with term cephalic singleton preg-nancies. They were divided into two groups ,throughout analgesia group(n=60):when they are in labor,we started an-algesia and continued to the end of second stage of labor. While 60 nulliparous were selected to non-analgesia group as the control group. Data were collected about duration of the first, second stage of labor, oxytocin dosage, postpartum hemorrhage,outcome of delivery, neonatal Apgar scores, umbilical cord vein and artery blood gas analysis and the effect of epidural analgesia, etc. Results There wsa is significant difference in the duration of the first stage delivery, the utilization rates of oxytocin, delivery mode (P<0.05) ;and there was no remarkable differences in the second stage of labor process, postpartum hemorrhage, neonatal Apgar scores, umbilical cord vein and artery blood gas analysis (P>0.05) Conclusion The throughout patient-controlled epidural analgesia can shorten labor progress, cut down uterine-incision delivery and reach satisfying analgesis effect, without commidng any impact on the outcome of delivery.

0.05),while the difference of dynamic HCO3-,BE in the umbilical blood gas analysis was significant statistically in the three groups(P

Objective To explore ultrasonographic characteristics and prognosis of cesarean scar pregnancy in the ultrasound.Methods To conducted a retrospective study of 8 cases of diagnoses of cesarean scar pregnancy in ultrasound in our hospital from January 2013 to August 2015.All cases had ultrasonographic examinations regularly during the pregnancy and were confirmed placenta increta by cesarean section or prenatal MRI (6 cases).The imaging characteristics of 8 cases of pregnant women in early pregnancy by transvaginal ultrasound,and the positions of gestational sac and chorion frondosum were observed.Ultrasonic follow-up results,numbers of cesarean delivery,final diagnosis,and pregnancy outcome were analyzed.Results Eight cases of patients were diagnosed cesarean scar pregnancy,and all of ceses were diagnosed placenta increta by ultrasound from 11 weeks to 24 weeks of gestation.It was found that the positions of chorion frondosum were located in the lower edge of gestational sac in Two-dimensional ultrasound and the chorion frondosum was covered in cesarean section scar.The echoes of proliferous chorion frondosum were stronger than the rest of chorion leve and decidua reflexa,and the thickness of proliferous chorion frondosum were thicker than the rest of chorion leve and decidua reflexa.In the follow-up ultrasound of 8 cases in the second trimester,the original position of chorion frondosum which covered and the position of placenta were roughly similar.The position of placenta did not move up with the gestational weeks,in addition,appeared as placenta previa and covered in cesarean section scar.Five patients had strong childbearing willing of continue to conceive,one case of which needed hysterectomy,four of which underwent cesarean section delivery with alive births after using bilateral iliac arteries balloon occlusion.The rest 3 cases underwent induction of labor after using bilateral iliac arteries balloon cclusion.Conclusions Cesarean scar pregnancy in first pregnancy may be develop as placenta accreta in second and third trimester pregnancy.If chorion frondosum was observed to cover cesarean section scar by ultrasound in early pregnancy,scar pregnancy diagnosis was established.Pregnant women who have strong willing to continue their pregnancy should be pay more attentin to thiers placenta previa and placenta percreta in second and third trimester pregnancy.Close follow-up are needed.

Objective To discuss the clinical features of behavioral and psychological symptoms of demen-tia(BPSD)and the relation between different sub-clinical syndromes and cognition. Methods One hundred and sixteen dementia patients were assessed with neuropsychiatric inventory and mini-mental state examination (MMSE)and made factor analysis according to DSM-IV-R. Results Twelve common behavioral and psychological symptoms could be further divided into five sub-syndromes,including disinhibition behavior,psychosis,agitation, emotion and apathy factors. MMSE total score and years of education entered regression equation of apathy factor (P<0.05). Conclusion BPSD can be divided into five factors and apathy factor are related with cognitive function.

Objective To investigate the relationship between the 5-hydroxytryptamine (5-HT)1A receptor gene C(-1019)G polymorphism and geriatric depression and Alzheimer′s disease (AD) with depressive symptoms in Han Chinese. Methods The case control study was used in the study among 106 patients with geriatric depression, 72 AD patients with depressive symptoms and 150 healthy old individuals in China. The C(-1019)G polymorphism of 5-HT1A was analyzed with the technique of polymerase chain reaction-restriction fragment length polymorphism. Results The frequencies of 5-HT1A genotype C/G (39.6%), G/G(24.5%) and allele G (44.3%) in the patients with geriatric depression were significantly higher than those in the controls (respectively 35.3%, 13.3%, 31.0%, P < 0.05). The frequencies of 5-HT1A G allele in the AD patients with depressive symptoms (41.0%) were significantly higher than those in the controls (31.0%,X2=4.2879, P<0.05). No significant difference in distribution of (5-HT)1A C (-1019) G polymorphism between the patients with geriatric depression and the AD patients with depressive symptoms was observed (P > 0.05). Conclusion The 5-HT1A gene C (-1019)G polymorphism may be associated with geriatric depression and AD with depressive symptoms and (-1019)G allele may be a risk factor for them.

Objective To identify the differences inneuropsychological characteristics between amnestic(AMCI)and vascular mild cognitive impairment(VMCI).Methods Totally 297 old community residents with mild cognitive impairment(MCI)were divided into amnestic MCI(AMCI)and vascular MCI(VMCI)subgroup from Guangzhou MCI prevalence survey.The elderly with MCI were interviewed and tested with the Chinese version of Montreal Cognitive Assessment(MoCA),the Mini-Mental state examination(MMSE),Auditory Verbal Learning Test(AVLT),the Clinical Dementia Rating scale(CDR),Functional Activity Questionnaire(FAQ),the Modified Hachinski Ischemic Scale(M-HIS),Center for Epidemiologic Studies(CES-DC)to evaluate neuropsychological characteristics.Results AMCI versus VMCI group showed that the total scores of MoCA were(9.63±5.17 vs.9.98±6.02),total scores of MMSE were(16.90±4.84 vs.16.90±6.19),AVLT immediate memory was(2.35±1.39 vs.2.91±1.84),AVLT delayed recall was(2.23±2.09 vs.2.47±2.20),AVLT delayed recognition was(7.33±3.98 vs.6.85±4.02)and total scores of CDR(0.5 vs.0.5),with no differences between the 2 groups(all P>0.05).Based on MoCA survey,AMCI versus VMCI group showed statistically significant differences(all P<0.05)in parameters of visual space and execution(0.71±1.02 vs.0.92±1.26),language function(0.34±0.56 vs.0.50±0.80)and abstract thinking(0.25±0.49 vs.0.15±0.43),but based on MMSE survey,no difference was found in the various cognitive domains between the two groups.The AMCI versus VMCI group showed statistically significant differences(all P<0.05)in parameters of CES-DC scale(1.75±4.27 vs.2.76±6.72),FAQ scale(4.42±4.66 vs.8.71±7.03),M-HIS scale(0.40±0.64 vs.7.59±3.53).Conclusions There is no significant difference in general cognitive impairment between AMCI and VMCI,but the visual space and execution,language function are more impaired in AMCI than VMCI,and the abstract thinking,social function are more impaired with more depressive symptoms in VMCI than in AMCI.