Objective To investigate the impact of the different mode of delivery on postpartum lactation.Methods 1 678 pregnant women in our hospital were divided into cesarean section group(798 cases) and natural delivery group(880 cases).Open milk after delivery,breast fullness,the number of neonatal sucking and post-natal self-assessment milk water were compared between the two groups of pregnant women,and the impact of the mode of delivery on postpartum lactation was analyzed.Results Whether or not began to lactation (721/77cases),and the time of labor to beginning to lactation [(33.45 ± 9.68) h],and whether or not having breast fullness feeling (512/286 cases),and the time of labor to breast fullness feeling[(57.12 ± 13.90) h] in cesarean section group had significant difference with those of spontaneus labor group [(845/35 cases),(30.12 ± 10.25) h,(690/190 cases),(52.98 ±15.09) h] (x2 =21.613,t =2.452,x2 =41.813,t =2.818,all P ＜ 0.05).There was no significant difference in selfrating milk score [(2.02 ± 0.45) points vs (2.45 ± 0.51) points],and newborn sucking times 4 ～ 6d postpartum [(5.21 ±1.21) times vs (5.89± 1.82)times](t =2.012,2.532,all P ＜0.05).Conclusion Efficiency of the breast-feeding was affected by the impact of the mode of delivery.Rationalized breastfeeding guidance was necessary to strengthen for pregnant women by cesarean section.

Objiective:to summarize the early treatment of severe bifrontal intraparenchyma contusion associated with central herniation. Mehthod:clinical presentation of 41 cases of secere bifrontal contusion associated with central herniation were analyzed retrospectively. Resolts:12 cases had good overcome,13 mild morbidty,2 severe mordity,1 were in persistent vegetative state,3 mortality.Conclusions: Attaches great importance to patients with severe bifrontal brain contusion associated with central herniation,close observation of patients with their consciousness,pupil and changes in vital signs;attend that it is premature to stop dehydrating agent,too fast,to review the head dynamic CT,the right to master surgical indications.Early removal of necrotic brain tissue and cranial decompressive craniectomy to be effective in improving the cure rate of patients.

Objective To study butylphthalide on acute cerebral infarction with leukoaraiosis patients cognitive function. Methods 80 patients with acute cerebral infarction combined with leukoaraiosis in Yuncheng Central Hospital from June 2014 to June 2015 were selected, all patients had cognitive dysfunction, and randomly divided into study group and control group with 40 cases in each group. The two groups were given conventional treatment of cerebral infarction, the study group was given the butylphthalide soft capsules two tablets, three times once day orally for three months, we used MMSE and MoCA scale to assess the cognitive status of the patients in the two groups at four, eight, and 12 weeks after treatment. The changes of liver function during treatment were analyzed. Results In the treatment, the two groups of patients with MMSE were improved, in four weeks of treatment, the MMSE scores of the study group was higher than the control group, but there was no significant difference between the two groups, eight weeks and 12 weeks, the MMSE scores of the study group was significantly higher than the control group, and the difference between the two groups was statistically significant (P<0.05), the MOCA score of patients in the study group gradually become normal, and significantly higher than the control group, after treatment for four weeks, eight weeks and 12 weeks the difference was statistically significant (P<0.05), the study group patients first had abnormal liver function in the treatment, recovered after stopping the medication. Conclusion Butylphthalide can improve the cognitive function of patients with acute cerebral infarction combined with leukoaraiosis, the increase of transaminase caused by treatment has no significant effect on clinical medication, which is worthy of further popularization and application.

Objective To explore the changes of the levels of CA-125 antigen(CA125) and vascular endothelial growth factor (VEGF) in serum and peritoneal fluid in patients with endometriosis (EMT), and the relationship with EMT. Methods One hundred and twenty patients with EMT (EMT group)and 98 patients with uterine fibroids (control group) were enrolled in this study. The levels of CA125 and VEGF in serum and peritoneal fluid were detected by enzyme linked immunosorbent assay (ELISA), and the results were compared. Results The levels of serum CA125,VEGF in EMT group were significantly higher than those in control group:(40.31±11.14) kU/L vs.(24.71±9.19) kU/L,(59.75±6.87) ng/L vs. (36.38±8.12) ng/L, there were significant differences(P<0.05). The levels of serum CA125,VEGF inⅠ-Ⅱphase andⅢ-Ⅳphase in EMT group had no significant differences ( P>0.05). The levels of peritoneal fluid CA125,VEGF in EMT group were significantly higher than those in control group:(311.46± 107.29) kU/L vs.(158.17± 55.42) kU/L,(73.28 ±10.40) ng/L vs. (40.21 ±9.84) ng/L, there were significant differences (P<0.05). The levels of peritoneal fluid CA125,VEGF in Ⅲ-Ⅳ phase were significantly higher than those in Ⅰ-Ⅱ phase in EMT group:(387.41±70.91) kU/L vs. (308.42±81.21) kU/L, (69.22±7.13) ng/L vs. (55.44±8.23) ng/L, there were significant differences (P<0.05). In EMT group, the levels of CA125 and VEGF in serum were significantly lower those in peritoneal fluid:(40.31±11.14) kU/L vs. (311.46±107.29) kU/L, (59.75±6.87) ng/L vs. (73.28 ±10.40) ng/L, there were significant differences (P<0.05). Conclusions The levels of CA125 and VEGF in serum and peritoneal fluid are closely related to EMT. Peritoneal fluid in monitoring of EMT may be more sensitive and reliable than serum.

Osteoarthritis (OA) is the most common form of arthritis, and is the major cause of pain and chronic disability worldwide, causing enormous social and economic burden.Once OA was considered as a 'wear-and-tear' condition and obesity is considered to be one of the most powerful predisposing factors of OA in the weight-bearing joints.However, studies have also linked obesity to OA in non-weightbearing areas, suggesting systemic effects exerted by metabolic factors other than simple local biomechanics perhaps play a role in the high prevalence of osteoarthritis in obese population.Recent studies have shown that systemic metabolic abnormalities, including obesity, diabetes, hypertension, lipid metabolism disorders, atherosclerosis and cardiovascular disease, play an important role in OA pathological process.Metabolic diseases promote the incidence and development of OA through a variety of ways, inducing causing low-grade systemic inflammation, increasing release of adipokines, anabolic cytokines and inflammatory mediators, leading to glucose and lipid metabolism disorders of chondrocytes, upregulating of cartilage extracellular matrix degrading enzymes, raising oxidative stress injury, increasing apoptosis of articular chondrocytes and reducing the cartilage and subchondral bone nutrition supply.These metabolic changes ultimately accelerate the damage of cartilage and promote the incidence and development of OA.Further research on OA and metabolic diseases, has the potential to provide new ideas and methods for the prevention and treatment of OA.

Objective To systematic evaluate the prevalence of secondhand smoke among Chinese mainland rural residents by meta?analysis,so as to provide reference for making relevant smoking control regulations and the carry out of targeted tobacco control action. Methods The related stud?ies were searched and collected from PubMed,CNKI,Wanfangdata,VIP and CBM database,which were published between 2001 and 2015 about the prevalence of secondhand smoke among Chinese mainland rural residents. Meta?analysis was tested by software CMA V2. Results The pooled prevalence of secondhand smoke among Chinese mainland rural residents was 46.6%(95%CI 40.5%?52.8%). Stratified analysis showed that the prevalence of secondhand smoke were 45.7%and 47.5%for male and female,45.7%and 51.1%for eastern and midwest China,22.1%、34.2%and 71.3%for public place,workplace and family,respectively. The prevalence among sex,regions,and places were statistically significant. Conclusion The prevalence of secondhand smoke among Chinese mainland rural residents was relatively high,and the prevalence of secondhand smoke was higher in women than in men,in midwest area than in eastern area,and at family than at public place and at workplace.

Objective To determine the risk factors for postoperative acute kidney injury (AKI) in the patients undergoing cardiac transplantation.Methods Forty patients with end-stage heart failure (both sexes) , aged 13-66 yr, weighing 45-84 kg, of ASA physical status Ⅳ or Ⅴ (NYHA Ⅲ or Ⅳ), undergoing heart transplantation, with normal kidney function before operation, were selected.According to whether or not AKI occurred within 7 days after operation, the patients were divided into either AKI group or non-AKI group.Factors including age, gender, body weight, complications (including hypertension and diabetes mellitus), preoperative blood glucose, hemoglobin, serum creatinine, cardiac output, ejection fraction, pulmonary arterial systolic pressure, intraoperative cardiopulmonary bypass (CPB) time, transfusion of allogeneic red blood cells, and urine volume within 24 h after operation were recorded.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify postoperative AKI-related risk factors for this type of patients.Results A total of 39 patients were enrolled in this study.Of the 39 patients, 14 patients suffered from AKI after operation, and the incidence was 36％.The results of logistic regression analysis showed that preoperative pulmonary hypertension and CPB time ＞ 180 min were the independent risk factors for AKI after cardiac transplantation.Conclusion Preoperative pulmonary hypertension and CPB time＞180 min are the independent risk factors for postoperative AKI in the patients undergoing cardiac transplantation.

There is no specific diagnostic tools or marker for detection of asthma in children.However,A large number of studies have shown that atopic disease and positive family history are the important risk factors.It is helpful for the asthma early diagnosis,proper management and prevention through the analysis of the relationship between childhood asthma and atopic disease as well as positive family history.

Objective To explore the influencing factors of heart failure among patients with continuous ambulatory peritoneal dialysis(CAPD).Method Clinical data were collected from the histories of 158 patients receiving CAPD to investigate the factors inducing heart failure for the purpose of finding out the potential independent influencing factors using t test or chi-square test for univariate analyses and logistic regression in multivariate analyses.Results The incidence of heart failure was 36.71%among the enrolled CAPD patients.Single factor analysis showed that level of volume management,age,hemoglobin,serum pre-albumin, cholesterol and c-reactive protein were related to heart failure.Analysis of multiple variables logistic regression revealed that levels of volume management,serum pre-albumin and blood urea nitrogen were related to heart failure.Conclusions It is an easy,effective and cheaper way for nurses to increase patients’ability of volume control.The strategy including remedying malnutrition and decreasing the level of uremic toxins might be effective for delayed exacerbation of cardiac function among CAPD patients.

Objective To investigate the difference of TCM body constitution betweenpeople of the Shimian county and Chengdu city. Methods 200 sub-health patients in clinic of Shimian TCM Hospital were selected randomly. Another 200 sub-health patients in clinic of the Second Sichuan Province Hospital of TCM wererandomly selected. The two groups were identified with TCM body constitution based on the clinical symptoms, tongue, pulse condition, etc. Comparisons on body constitution were made between the two groups. Results In Chengdu, patients withbalance constitution and Qi deficiency constitution (respectively have the proportion of 33.0% and 20.0%)were significantly higher than thoseof Shimian County(the proportion of the two wererespectively 4.0% and 6.0%);while Shimian County have a significantly higher ratio of phlegm dampness and blood stasis constitution(43.5% and 13.0%)than those in Chengdu city(the proportion of the two wererespectively 8.0%and 4.0%), P<0.01. Conclusion Because of different regions, the population constitution ratio wasdifferent, so the disease tendency wasalso somewhat different. Therefore, physicians should give full consideration to the regional factors in diagnosing and treating patients.