Objective To observe the occurrence of nosocomial infection in maternal hospital cesarean deliv-ery situation,analyze risk factors of hospital infection,and to explore the corresponding prevention measures.Methods The clinical data of 943 lying -in women with cesarean section were retrospectively analyzed.The conditions of hospi-tal infection occurred were observed,the risk factors for nosocomial infection were analyzed.Results 73 cases occurred maternal hospital infection,the infection rate was 7.74%.The infection occurred at surgical site in 41 cases, 11 cases occurred in urogenital system,6 cases occurred in the respiratory system,10 cases occurred respectively in the digestive system,skin and nervous system.More than 2 times of cesarean delivery operation,too large age,with basic diseases,low medical staff operation proficiency,not using antibiotics,too long time of hospital stay,too long time of placing a urinary catheter were independent risk factors of hospital infection after cesarean section(OR =0.223, 0.670,1.850,6.062,0.302,2.190,3.583,all P <0.05).Conclusion The incidence rate of hospital cesarean sec-tion maternal hospital infection are rising year by year,so the medical personnel should aim at the risk of infection fac-tors,take corresponding prevention measures,so as to effectively reduce the incidence of infection.

The innervation and distribution of 5-HT cells in gastric wall of rabbit and rat were studied by means of histochemical techniques of monoamine fluorescence and cholinesterase. And the morphological relation between them was investigated using the consecutive method for demonstrating the fluorescence and ChE on the same section. At the fundic gland, 5-HT cells were in contact with both the adrenergic and cholinergic axonal terminals. There are adrenergic and cholinergic terminals to innervate the gland cells of fundic gland, partial fundic gland the dual axonal terminal are identical in their localization and morphological outline. The loyer of muscle and smooth muscles surrounding the arteriole in various stomach layers were innervated by both adrenergic and cholinergic terminals, some of them are superimposed at the samelocalization. There are a lot of nsChE nerve ending network in gastric lamina propria beneath epithelium of gastric mucous membrane, it was discussed about their sensory nature in this paper.

Objective To investigate the effects of co-exposure to LPS and heat on plasma tumor necrosis factor-? (TNF-?), interleukin-6 (IL-6), malondialdehyde (MDA) and activity of superoxide dismutase (SOD) in rats. Methods Male pathogen-free Wistar rats were randomly assigned to the following groups: saline-injected normothermic control (Group C), saline-injected heat exposure (Group H), LPS-injected normothermic control (Group L), LPS-injected heat exposure (Group HL). Mean arterial pressure (MAP) was continually monitored. Plasma levels of TNF-?, IL-6, MDA and SOD were determined at 0, 40, 80, 120 min. Results The rats in Group HL displayed much lower MAP, higher MDA and lower SOD than the other 3 groups. The rats in Group HL displayed an early rise in plasma TNF-?, IL-6 at 40 min, the peak values of both at 80 min significantly higher than the other three groups at the same time piont. Conclusion Co-exposure to LPS and heat primes the rats to advance and augment systemic inflammatory response syndrome.

Objective To explore an approach to identifying the plant source of Flos Lonicerae and Lonicera confusa rapidly, precisely, and efficiently. Methods Using LM and SEM to observe and compare the characters of leaf epidermis of the five species of Lonicer L. including L. japonica, L. confuse, L. hypoglauca, L. dasystyla, and L. macrantha. Results There are obvious differences in leaf epidermis among the five species of Lonicera L. under LM and SEM. Conclusion The characteristics of leaf epidermis can be used to identify the plant source of Flos Lonicerae and L. confusa. According to their characteristics under LM and SEM, the retrieval keys to the five species of Lonicera L. have been compiled.

Objective To analyze the clinical features and factors associated with knee osteonecrosis in patients with systemic lnpus erythematosus (SLE).Methods Medical charts of Peking Union Medical College Hospital from 2000 to 2013 were reviewed to identify patients who were diagnosed as SLE with kuee osteonecrosis.Controls were selected and matched to the cases by age and sex.The clinical and laboratory variables were compared between SLE patients who were with and without knee osteonecrosis.Numerical data and categorical data comparisons were analyzed using t-test,x2-test,respectively.Results Sixteen patients developed knee osteonecrosis that constituted 0.37％ of all the 4 301 hospitalized SLE patients during the same period.Fifteen patients were female,who developed knee osteonecrosis with an average age of 36 years (range:17-67 years).The mean duratiou of SLE before the diagnosis of knee osteonecrosis was 64±40 months (range:16-120 months).The interval from onset of symptoms to diagnosis was 0.5 to 24 months.The distal end of femur was involved in all 16 patients,while the proximal tibia necrosis also occurred in 8 patients.The detection rate of knee osteonecrosis by MRI was 100％,while it was only 19％ by plain radiography.The incidence of skin vasculitis,myositis,osteoporosis,hyperlipidemia,hypoalbuminemia and elevated serum immunoglobin G levels were significantly higher in SLE patients with knee osteonecrosis than in controls (P＜0.05).In addition,the use of anti-malarials was significantly lower in SLE patients with knee osteonecrosis than in controls (P＜0.05).Conclusion The knee osteonecrosis in SLE patients is affected by multifactors.The risk factors include skin vasculitis,myositis osteoporosis,hyperlipidemia,hypoalbuminemia and the elevated immunoglobin G level.The use of antimalarial drugs in SLE patients may protect against knee osteonecrosis development.Knee osteonecrosis coull be diagnosed early by MRI.

The out-patient and emergency department is the window of a hospital open to the society,also is the most direct social image of the hospital.So,we must insist on the moral principle of the "ten needs" in the work of the out-patient and emergency department in order to establish a healthy and harmonious physician-patient relationship.The "Ten needs" includes a proper attitude,a sincere communication,a quick response,a correct diagnosis,a flexible treatment,a reasonable prescription,a steady action to the emergency,a well nursing,complex skills and a standard management.

Objective To retrospectively analyze the diagnosis and treatment of multicentric Castleman's disease (MCD) ,and review related literatures. Methods A total of six patients were first-ever diagnosed as MCD and treated with combination chemotherapy and/or interferon α. The clinical manifestation, laboratory findings and therapeutic strategies were recorded in detail. Results In the six HIV-negative patients, histologically, four of them were diagnosed with plasma cell type of Castleman's disease, two with mixed type. All the six patients showed multiple lymphadenopathy, polyclonal hypergammaglobulinemia and hypoalbuminemia. One of the two patients treated with interferon α achieved complete remission, and the other,who showed no effects with hormone and combination chemotherapy ,achieved sustained partial remission after treatment with interferon α for 3 months. Of the four patients treated with combination chemotherapy, three achieved partial remission, and one died of no effects. Conclusions Interferon α and combination chemotherapy might be the most effective and convenient therapeutic methods for MCD. Serum albumin level may be used as a diagnostic and monitoring index for MCD.

Objective To study the ocular manifestations in patients with Behcet's disease (BD).Methods Medical records at Peking Union Medical College Hospital from 2002 to 2012 were reviewed to identify the patients who were diagnosed as BD with ocular involvement.Results One hundred and eleven BD patients developed ocular involvement.Males were more frequently involved,and the male/female ratio was 2.08∶ 1.The age at the onset of BD and the time of ocular involvement were (27.6-± 10.8) and (31.5 ± 10.7) years,respectively.The median interval between the diagnosis of BD and ocular disease was 24 (0,372) months.Ocular involvement was bilateral in 85.6％ patients.About two thirds patients (66.7％) had impaired vision,for example,visual acuity of 0.1 or less was detected in 60.4％ patients.Uveitis (90.1％) was the most common findings in BD patients with ocular involvement and the most frequent type of uveitis in both sexes was panuveitis (62.16％).Vision loss,proliferative retinopathy and cataract were more common in men.There was a statistically significantly higher frequency of positive human leukocyte antigen(HLA)-B51 in the male BD with ocular involvement than in the female.All BD patients with uveitis were given systemic corticosteroid or combined immunosuppressive agents.The improvement of visual acuity was seen in 77％ BD patients,but the recurrent attacks occurred in 49％ patients,resulting in blindness in 25.5％ of them.TNFα blockers were given to 19 recurrent uveitis patients,12 patients improved while two had no response.Conclusions The most common ocular involvement in BD was uveitis.Males were more frequently involved with a more severe disease,higher complications and positive HLA-B51 than in females.Glucocorticoids and immunosuppressants were effective to uveitis,but high rate of recurrent inflammatory ocular attacks led to high risk of blindness.TNFα blockers may improve the outcome of recurrent BD uveitis.

Objective To explore the effect of continuity of care in reducing domestic symptomatic hypoglycemia of children with type 1 diabetes. Methods A total of 50 first diagnosed type 1 diabetic children who were admitted in a classⅢgrade A hospital from May 2014 to December 2015 were selected and divided into observation group and control group randomly with 25 cases in each. The two groups were given the same clinical nursing, while the observation group was given continuity of care after discharge. The observation period last for 12 months from the time of discharge. Observed the average weekly incidence of symptomatic hypoglycemia, admission, HbA1c. Results A total of 45 cases completed the research, 21 of which were from the control group, and the last were from the observation group. Compared with the control group, the occurrence of domestic symptomatic hypoglycemia in observation group was significantly reduced (P< 0.05). Meanwhile, the number of readmission in the observation group was significantly lower than that in the control group (P< 0.05). Conclusions Continuity of nursing can effectively reduce the symptomatic hypoglycemia occurrence of type 1 diabetic children who were first diagnosed within 12 months. It can also reduce readmission rate, medical expenses and family financial burden.

Objective To compare the efficacy and adverse effects of bortezomib+adriamycin+dexamethasone (PAD) and vincristine + adriamycin + dexamethasone (VAD) regimens in untreated multiple myeloma (MM). Methods There were 26 and 28 new diagnosed MM patients in PAD and VAD groups. Both clinical effects and adverse effects were observed. Patients accepted VAD or PAD regimens for 2-4 cycles and followed up for 7-27 months. Results There were 10, 5 and 11 patients accepted 2, 3 and 4 cycles in PAD group, and 6, 11 and 11 in VAD group. In PAD group, there were 2, 14, 9, 1 and 0patients achieved complete remission (CR), very good partial remission (VGPR), partial remission (PR),stable disease (SD) and progressive disease (PD); in VAD group, the number were 0, 4, 12, 10 and 2.The rate of patients who achieved good efficacy (CR+VGPR) in PAD group was 61.5%, which was higher than that in VAD group (14.3%).The incidences of infection and gastrointestinal symptoms were similar in the two groups, while the incidences of peripheral neuropathy, thrombosis and Herpes Zoster infection in PAD group were higher than those in VAD group. Conclusions Compared with the conventional VAD chemotherapy, PAD may improve CR and VGPR rates in new diagnosed MM, while it may bring more and severer toxicities in peripheral neuropathy, thrombosis and Herpes Zoster infection. Preventive medical care is necessary in PAD protocol.