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 analyze distribution and drug resistance of MRSA separated,to probe into a treat method for MRSA infection and offer scientific gist for reasonable use of clinical antibiotic. Methods 568 MRSA separated from clinic were measured and a drug sensitivity test was performed by means of Kirby-Bautr agar diffusion method. Results 370 individual plants were filtered, the rate of inspection was 65.1%. MRSA was 36.2 % among them,MRSCON was 77.5% ,the drug resistance of MRSA to quinolones(21% ～48% ) was below MRSCON(84 %～89 % ). The drug resistance of MRSA and MRSCON obviously excelled MSSA and MSSCON ( P＜0.05 ). VRS was undiscovered. Conclusion Severe infection caused by MRS should choose vancomycin resistant enterococci to cure at fist. Staphylococcus was one of primary pathogenic bacterium caused infection in hospital, MRS had multiple drug resistance and measure range about drug resistance should be extended, which would advance the cognition about the drug resistance of antibiotic and cut off the transmitted path, reduce the drug resistance of bacteria and the infection rate in hospital.

ObjectiveTo investigate the effect of gentle moxibustion on hemorheology in cervical spondylotic vertebral arteriopathy of qi-blood deficiency type.MethodSixty patients diagnosed with cervical spondylotic vertebral arteriopathy of qi-blood deficiency typewere randomly allocated to treatment and control groups, 30 cases each. The control group received conventional acupuncture at cervical Huatuo jiaji(Ex-B2)points and the treatment group, gentle moxibustion in addition. TCD was performed before and after treatment to observe hemorheological changes in the two groups. The clinical therapeutic effects were evaluated.ResultThe total efficacy rate was 96.7% in the treatment group and 90.0% in the control group. There was a statistically significant difference in therapeutic effect between the two groups (P<0.05). There were statistically significant pre-/post-treatment differences in TCD indicators in the two groups (P<0.05). Vertebrobasilar blood flow was improved more in the treatment group (P<0.05).ConclusionGentle moxibustion can improve vertebrobasilar blood flow to a greater extent in cervical spondylotic vertebral arteriopathy. It is clinically an effective way to treat cervical spondylotic vertebral arteriopathy.

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.

Objective To identify the relationship among chronic inflammatory state, malnutrition and cardiovascular diseases in peritoneal dialysis patients. Methods Cardiovascular diseases and dialysis regime in 90 clinically stable continuous ambulatory peritoneal dialysis (CAPD) patients were investigated. Then, dietary energy intake (DEI) and protein intake (DPI) through dietary diaries were measured. The serum albumin (Alb), prealbumin(PA), transferring (TF), lean body mass (LBM), LBM% and the normalized protein equivalent of total nitrogen appearance (nPNA) were examined or calculated. Subjective global assessment (SGA) was also evaluated. Serum interleukin-6 (IL-6), tumor necrotic factor-?(TNF-?) and C-reactive protein (CRP) were measured as markers of chronic inflammation. Serum leptin and plasma NPY were detected too. Results Serum IL-6 and TNF-? levels of CAPD cases were (17. 17?27.72) pg/ml and (34. 21?25. 92) pg/ml, which were significantly higher as compared to control group. Serum CRP level in CAPD patients was (9. 88?20. 93)mg/L. There were 24 patients(26. 67% ) with CRP above normal level. 55 patients(61. 11% ) had cardiovascular diseases. The patients with angina pectoris, old myocardial infarction and chronic heart failure had higher CRP levels than those without above complications ( P

Mast cells (MCs) play a key role in the pat hogenesis of allergic diseases. Tissue MCs are originated from hematopoietic ste m cells in bone marrow. In recent years, it was reported that human mast cells c ould be differentiated from stem cells of umbilical cord blood. In this review, we summarize the development in this novel area.

AIM: To investigate the actions of trypsi n on the secretion of monocyte chemoattractant protein-1 (MCP-1) from human lung e pithelial cells. METHODS: A549 cells were cultured in a 12-well culture plate. Th e challenge was performed by addition of various concentrations of trypsin or tr ypsin inhibitor into each well, respectively. After 2 h, 8 h or 16 h, the reacti ons were terminated by removal of the supernatant from each well. A sandwich ELI SA was used to determine the levels of MCP-1 in supernatants. RESULTS: Following 16 h incubation, trypsin was able to induce c oncentration-dependent secretion of MCP-1. As low as 3 ?g/L trypsin was able to induce MCP-1 release from epithelial cells, and the maximum of accumulated rele ase of MCP-1 was observed with 100 ?g/L trypsin, which was 3 fold more than bas eline release. However, trypsin at 300 ?g/L did not induce significant MCP-1 se cretion. Soybean trypsin inhibitor (SBTI) inhibited trypsin-induced MCP-1 secret ion, but ? 1-antitrysin (? 1-AT) did not. The time course showed that the actions of trypsin initiated at 2 h and reached their peak at 16 h. CONCLUSION: Trypsin is a potent secretogogue of MCP-1 release fr om cultured human lung epithelial cells, and itself action can be inhibited by S BTI.

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 effects of pre-emptive epidural analgesia and postoperative epiclural analgesia on stress response to upper abdominal surgery. Methods Thirty ASA Ⅰ or Ⅱ patients undergoing elective upper abdominal surgery performed under general anesthesia were randomly divided into 2 groups (n = 15 each): Ⅰ pre-emptive epidural analgesia group (group P) and Ⅱ postoperative epidural analgesia group (group C). A mixture of 0.5 μg/ml sufentanil and 0.15% ropivacaine 250 ml was used for epidural analgesia in both groups. The epidural catheter was placed at T_(10-11) interspace. The epidural regimen included a loading dose of 15 ml followed after 30 min by continuous epidurai infusion at 5 ml/h for 50 h. In group P the epidural analgesia was started at 20 min before skin incision, while in group C after operation when the patients emerged from general anesthesia and were extubated. The depth of general anesthesia was monitored using CSI and maintained at 45-55. Vcnoas blood samples were taken before epidnral catheter was placed (T_0, baseline), at 2 h (T_1) and at 18 h (T_2) after operation for determination the concentrations of ACTH and cortisol (Cor) and C reaction protein (CLIP). Results Blood Cor, ACTH and CRP concentrations were significantly increased after operation as compared with the baseline values at T0 and were significantly lower at T_1 and T_1 in group P than in group C. Conclusion Pre-emptive epidural analgesia can more effectively inhibit stress response than postoperative epidural analgesia to upper abdominal surgery.