Objective To explore the risk management factors and preventive measures in obstetric care. Methods The implementation of risk management in our hospital was retrospectively analyzed. Results Maternal satisfaction degree was significantly increased, complaints and errors of nursing care were significantly decreased. Conclusions Strengthening of risk management in obstetric care can benefit to eliminate and prevent unsafe factors, so that obstetric care quality is improved.

Objective:To verify the applicability of Dynamic Contrast Enhanced Magnetic Resonance Imaging(DCE-MRI)to evaluate the breast cancer therapy using the high intensity focused uhrasound(HIFU).Methods:Both DCE-MRI and conventional T_1W/T_2W images were acquired for the total 8 subjects.Two consecutive scans were performed for every patient(before operation and 2 weeks after operation)while four were performed for only 2 patients(additional for 6 months and 12 months after operation).The breast cancer therapy by HIFU was assessed hy comparing the changes of signal,the dynamic patterns of time-signal intensity curve,the early-phase contrast enhancement ratios and vessel anatomies around cancer focuses.Results: The shortened T_2 signals were observed in cancer focuses of 5 subjects while 3 still showed longer T_2 values which were differentiated by the high intensity in T_2W images.The early-phase contrast enhancement ratios of those 5 subjects decreased from 60%～80% to

Objective:To investigate the effects of soluble factors secreted by MCF-7 breast cancer cells on the differentiation,maturation and function of DCs.Methods:Mononuclear cells were cultured with the culture supernatants from primary MCF-7 cells.Combination of granulocyte-macrophage colony stimulating factor(GM-CSF),interleukin 4(IL-4) and tumor necrosis factor-a(TNF-a) was used to stimulate the cultured mononuclear cells.Then DCs and CTL assays were analyzed.Results:MCF-7 cell supernatant-treated DCs resulted in low expression of CD80,CD83,CD86 and HLA-DR,and the inhibition rate of CTL was 17.35% significantly lower than 56.14% induced by the control DCs(P＜0.01).IL-12 secreted by DCs and IFN-γ produced by PBMNC were all significantly lower than those in the control group (P＜0.01).Conclusion:Experiments in vitro shows that the culture supernatants from MCF-7 breast cancer cells could inhibit the development and functions of DCs.

Microscopic polyangiitis (MPA) is an anti-neutrophil cytoplasmic antibody (ANCA) associated systemic small vessel vasculitis and is uncommon in children.Pathologically characterized by paucity immune deposition,fibroid necrosis and crescent formation in glomeruli.MPA is a multi-organ involvement disease.Renal is the mostly involved and commonly manifested as aggressive glomerulonephritis.Lung is the most common involved extrarenal organ.Most MPA patients have positive myeloperoxidase-ANCA and positive perinuclear-ANCA.The onset of MPA is usually obscure,which makes early diagnosis difficult.Detection of ANCA is performed in order to discriminate suspected MPA patients earlier.Confirmed diagnosis relies on pathology.Early standardized treatment is a key factor in prognosis.Standard inductive treatment is currently the combination of corticosteroids with the cytotoxic agent cyclophosphamide.Azathioprine is suggested as the first-choice medication in maintenance therapy.Bio-agents,such as Rituximab,have shown good curative effect both in the inductive treatment and maintenance therapy.

Objective To compare the clinical effect of erythromycin and azithromycin in the treatment of mycoplasma pneumonia.Methods 120 children with mycoplasma pneumonia were randomly divided into study group and control group according to digital table method,60 cases in each group.The control group was treated with erythro-mycin,while the study group used azithromycin treatment.Clinical curative effect was compared between the two groups.Results The disappearing time of cough[(4.58 ±0.75 )d],fever[(4.75 ±1.74)d],pulmonary rales [(7.84 ±2.85)d]of the study group were significantly shorter than those in the control group[(4.58 ±0.75)d, (4.75 ±1.74)d,(7.84 ±2.85)d],and the differences were statistically significant (t =7.54,385,5.93,all P <0.05).The total effective rate in the study group (95.00%)was significantly higher than that in the control group (83.33%),and the difference was statistically significant (χ2 =8.08,P <0.05).There was no significant difference in the incidence of adverse reactions between the study group and the control group (χ2 =0.64,P >0.05 ). Conclusion Mycoplasma pneumonia in children for early diagnosis and treatment of dry,use of azithromycin curative effect was better than that of erythromycin.It could effectively relieve patients of fever,and alleviate the clinical symptoms of cough,pulmonary rales.

Through analyzing the ethical status quo in reproductive medicine treatment unit, this article dis-cussed the social ethical issues brought by ART technology development related to the reproductive medical treat-ment unit. Then it put forward the measures to solve those ethical problems: strengthening the ethical principles and ethical committee construction, sharing data information, fully informed consent, and suggestions to improving ethics education.

Objective: To evaluate the nutritional markers in peritoneal dialysis patients. Methods: We examined SGA, dietary diaries, direct anthropometry, biochemical indices in 90 continuous ambulatory peritoneal dialysis (CAPD) patients. Then, the normalized protein equivalent of total nitrogen appearance (nPNA), lean body mass (LBM) and %LBM were calculated. Results: These patients were classified to three nutritional categories based on SGA (i.e. normal nutrition, mild to moderate malnutrition, severe malnutrition). The dietary protein intake(DPI), dietary energy intake(DEI), serum albumin(Alb), nPNA, LBM and %LBM were significantly different among three groups (P

Objective To compare the diagnostic values of different parameters for neonatal sepsis by observing clinical presentations and laboratory tests of hospitalized newborn infants and to find out the the early and fast way in neonatal sepsis diagnosis. Methods Newborn infants admitted to NICU from Sept.2007 to Feb.2008,who met all inclusion and exclusion criteria,were enrolled.The situations in perinatal period,exact time of the onset of infection,clinical manifestations and laboratory indexes were recorded.Infants were classified into 3 groups:septic group(n=13),nonseptic group(n=12) and noninfectious group(n=12).Sensitivity,specificity,false positive rate,false negative rate,Youden's index and positive and negative predictive values(PPV and NPV) were calculated for each test. Receiver-operating characteristic curves were analyzed to determine the optimal thresholds. Results Among all the clinical manifestations,abnormal reaction had the hightest specificity(84.6%) and accuracy(67.9%) in diagnosing neonatal sepsis.SIRS criteria,with the specificity of 95.8%,was helpful in clinical suspected eases.However,routine laboratory tests,such as WBC,PLT and GLU,had poor sensitivity or specificity;I/T had better specificity(100%),but was subject to discrepancy among different observers.The area under the ROC for CRP and PCT were 0.734 and 0.878,with the optimal threshold of 15 mg/L(P=0.020,Youden's index=45.5%) and 0.81 ng/ml(P-0.000,specificity=100%,Youden's index=75.0%),respectively.Conclusions Careful clinical inspection warrants early detection of sick infants.Evaluation of SIRS criteria in clinical suspected septic infants may help in early diagnosis.WBC,I/T,PLT can be used as routinely monitoring indexes for high risk neonates.CRP and PCT concentrations also have significant diagnostic values.

Intra-vital organ transplantation is an advanced medical technique for the treatment of patients with terminal stage organ failures.However,related ethical issues arise with the development and application of the technique.Some research has been done on relevant ethical issues in intra-vital organ transplantation with certain ethical principles and regulations arisen,which are discussed in this article.

Objective To investigate the relationship between human albumin stimulation and MCP-1 production of human renal tubular epithelial cells. Methods Thirteen patients with minimal change disease (MCD) were enrolled into the study. MCP-1 expression and M? infiltration in renal biopsy tissues were studied by immunohistochemistry (IHC) and in situ hybridization (ISH). In vitro experiment, proximal tubular epithelial HK-2 cells were stimulated by human serum albumin in different concentration, then MCP-1 production was detected by Western Blot. Results In renal tissues of MCD, focal positive MCP-1 was found in tubular walls and a few M infiltrated in every area including tubular walls , meanwhile a correlation of M? infiltration between interstitium and tubular lumen was studied. In cell culture experiment, with its concentration more than 2 g/L. human serum albumin could stimulate HK-2 cells to produce MCP-1. Conclusions MCP-1 expresses in the tubules of MCD patients with massive proteinuria. A few M?infiltrate in the renal tissue and move between the interstitium and the lumen of tubules. Human serum albumin can stimulate human tubular epithelial cells to produce MCP-1.