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 effect of letrozole plus metformin on infertility of polycystic ovary syndrome(PCOS).Methods According to the digital table,90 patients with infertility of PCOS were randomly divided into the control group(n =45 cases) and the treatment group(n =45 cases).The patients of the control group were treated though clomiphene,while the patients of the treatment group were treated though letrozole plus metformin.The ovulation rate,pregnancy rate,sex hormones and insulin resistance were detected.Results The homeostasis model assessment of insulin resistance index (HOMA-IR) was (5.72 ± 2.37) before treatment and (3.16 ± 1.39) after treatment in the treatment group.HOMA-IR was (5.69 ± 2.40) before treatment and (4.81 ± 2.06) after treatment in the control group.There was a significantly decrease in the treatment group (t =3.7246,P ＜ 0.05).The ovulation rate was 80％ in the treatment group,while 60％ in the control group,the difference between the two groups was significant(x2 =4.06,P ＜0.05).The pregnancy rate was 48.9％ in the treatment group,while 28.9％ in the control group,the difference between the two groups was significant (x2 =5.77,P ＜ 0.05).Conclusion Letrozole plus metformin could promote the ovulation and decrease insulin resistance.

AIM: To investigate the effect of adrenomedullin on the fibrogenic action of TGF? 1 and the cellular mechanism in renal tubular epithelial cell line (HK-2). METHODS: Total collagen synthesis and secretion were reflected by -proline incorporation and the radioactivity of -hydroproline in the culture medium; ELISA method was used to detect the level of secreted fibronectin (FN); the expression of FN mRNA, collagen IV mRNA and TIMP-1mRNA were determined by RT-PCR; western blot was used to detect the expression of Smad2 and Smad6 proteins. RESULTS: (1) AM could antagonize the expression of collagen and FN stimulated by TGF? 1 in both transcription and translation level; (2) AM down-regulated the TGF? 1-induced TIMP-1 mRNA expression; (3) AM had no effect on the over-expression of Smad2 stimulated by TGF? 1; but could up-regulate the expression of Smad6 inhibited by TGF? 1. CONCLUSION: AM could antagonize the fibrogenic effect of TGF? 1 through up-regulating Smad6 expression in HK-2 cell line.

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.

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 acknowledge the psychological authority status under the foundation of autho0rization management,in order to analyze the effectiveness of authorization management.Methods 364 clinical nurses were investigated with Psychological Empowerment Scale and the results were performed statistic analysis through descriptive statistical method and variance analysis.Results The average score of clinical nurses was(3.22±0.70),which was at the moderate point.The four dimensional scores listed in descending order were self efficient,career significance,autonomy and job influence.Clinical nurses of different ages,different ranking,different working period,different marriage status had statistical outstanding variance.But nurses of different education background showed no significant difference in score of each dimension.Conclusions The nursing management shall not only focus on the authorization management itself,but also on the psychological authority status of clinical nurses.Through an efficacious incentive,we can enhance the psychological recognition and experience on authorization and activate the working motivation,maximize the working initiative and thus promote the innovation and expansion of nursing work.

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 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.