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 study the relationship between neural apoptosis and the expression of Bcl-2,Bax proteins in the perihematomal brain tissue of patients with intracerebral hemorrhage(ICH).Methods The rate of neural apoptosis of perihematomal brain tissue was examined by TUNEL method and the Bcl-2,Bax proteins expression were detected by immunohistochemisty method. Correlation analysis was done not only for the expression of Bcl-2,Bax proteins and apoptosis rate with hematoma volume but also for the apoptosis rate with hematoma volume, the scores of clinical nervous impairment and the course of disease.Results The apoptosis rate and the expression of Bcl-2,Bax proteins in the perihematomal brain tissue of ICH patients significantly increased in comparison with the control group (all P

Attention is being paid to the treatment of hyperopia(presbyopia) with laser thermokeratoplasty.This article mainly presents the theory of laser thermokeratoplasty(LTK),equipment configuration and some key techniques in laser delivery system.

Objective To study the pharmacological action and clinical application of flavonoids.MethodsThe pharmacological effects of flavonoids were analyzed, and the related literatures were searched and analyzed.This paper describes the pharmacological action mechanism and clinical application of flavonoids, analyzes its biological activity, combined with the related structure and function, and gives a more detailed description of the study of flavonoids.ResultsAfter analysis, the pharmacological effects of flavonoids on human cardiovascular system, digestive system, nervous system, immune system, and so on have a certain impact.The effect of flavonoids on the nervous system is mainly manifested in the analgesic, anti-inhibition and anti-aging.The antibacterial and antiviral effects of flavonoids are mainly antibacterial, antiviral activity and anti HIV activity.Flavonoids have good protective effects on liver injury, such as chemical liver injury, alcoholic liver injury, immunological liver injury, reperfusion liver injury and so on.Flavonoids can inhibit the growth and reproduction of tumor cells, and can promote the expression of tumor suppressor genes and promote the proliferation of tumor cells.The chemical structure of flavonoids is similar to that of estrogen, which is a kind of isoflavone, which has the physiological action of estrogen, and has a certain effect on estrogen.ConclusionThe flavone is extracted from various plants, belonging to the polyphenol compounds, with certain biological activity, were analyzed for the clinical application of its pharmacological action, has many applications of anti-inflammatory, anti-tumor, immunoregulation and liver protection and analgesic, a variety of biological activity, is widely applied in clinical.

Objective To discuss the diagnostic value of procalcitonin and C reactive protein in the acute exacerbation period of chronic obstructive pulmonary disease in elderly patients .Methods Patients ages 75 or more with AECOPD were selected ,and the PCT and CRP in blood serum were detected before treated with antibiotics ,then their sensibility and dependability were analyzed . Results Patients were concluded ,the sensibility for CRP>10 mg/L was 92 .19% ,for PCT>0 .05 ng/mL was 43 .75% ,for PCT>0 .25 ng/mL was 28 .13% .The three groups had statistics difference .Patients were divided into three groups according to PCT lev‐el ,CRP had significant difference in the three groups (P<0 .05):the mean value of CRP in PCT<0 .05 ng/mL group was 42 .86 mg/L ,the mean value of CRP in 0 .05 ng/mL

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.

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.

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.

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.