Objective To evaluate the influence of gestational diabetes mellitus (GDM) on maternal and perinatal outcomes in twin pregnancies. Methods We retrospectively analyzed the clinical features of both twin and singleton pregnancies, which delivered in Guangzhou Women and Children's Medical Center between January 1, 2012 and December 31, 2013. The twin pregnancies were divided into two groups:those with (GDM-T, n=51) and without GDM (non-GDM-T, n=130), which were matched by maternal age and delivery time (within one month) in a ratio of 1∶2 among singleton pregnancies with (GDM-S, n=102) and without GDM (non-GDM-S, n=102), respectively. The differences of adverse maternal and perinatal outcomes among these four groups were examined. The overall assessment of pregnancy outcomes was completed using Delphi method. Statistical analysis was performed with one-way analysis of variance, t test, Kruskal-Wallis test, rank test, Chi-square test or Fisher's exact test. Results (1) When compared to GDM-S and non-GDM-S group respectively, less women conceived with the help of assisted reproductive technology, higher proportion of women underwent and gestational age at delivery tend to be earlier in GDM-T and non-GDM-T group (all P<0.01). In oral glucose tolerance test,the fasting blood glucose level of GDM-T group was higher than the other three groups (F=21.716, P<0.01), the glucose levels at 1 and 2 h were higher than non-GDM-T and non-GDM-s respectively (both P<0.01), but no significant difference was found when compared with GDM-S group (P>0.01). Similarly, no significant difference was found in prenatal glycosylated hemoglobin value between GDM-T and GDM-S group (P>0.01). (2) There was no significant difference in the incidences of hypertensive disorders of pregnancy, anemia, premature rupture of membranes, oligohydramnios, placental abruption, postpartum hemorrhage, asphyxia neonatorum, small for gestational age, hypoglycemia of newborn, hyperbilirubinemia of newborn and perinatal death between GDM-T group and the other three groups(all P>0.01). Higher incidences of hypertensive disorders of pregnancy and postpartum hemorrhage were shown in the GDM-T group than in the GDM-S and non-GDM-S groups, respectively (both P<0.01). The incidences of preterm birth in GDM-T and non-GDM-T group were both higher than that in GDM-S and non-GDM-S, respectively [54.9%(66/102), 53.8%(140/260), 5.0%(10/102) and 3.0%(6/102), all P<0.01], while no significant difference was found between GDM-T and non-GDM-T group (P>0.01). (3) The overall assessment of pregnancy outcomes did not show any difference between GDM-T group and the other three groups (χ2=6.707, P>0.01). However, the score for fetal outcomes in the GDM-T group was higher than in the GDM-S and non-GDM-S group, but lower than in non-GDM-T group [M(Q)=1.0(2.3), 0.0(3.0), 0.0(0.0), 1.0(2.8) score, χ2=122.818, P<0.01]. Conclusions GDM does not increase the risk of adverse pregnant outcomes in twin pregnancies.

OBJECTIVE:To observe the efficacy and safety of oxaliplatin,mitomycin and doxorubicin combined with three-di-mensional conformal radiotherapy for patients with lack of blood supply hepatocellular carcinoma. METHODS:62 patients with lack of blood supply hepatocellular carcinoma who lose the opportunity of operation were randomly divided into control group(31 cas-es)and observation group(31 cases). Control group received puncture through the femoral artery by Seldiner,selectively interven-ing in hepatic arteries for DSA angiography,then intravenously injected 130 mg/m2 Oxaliplatin for injection via the catheter,once every 2 weeks+Mitomycin for injection 10 mg,intravenously,once every 1-3 week(s)+Doxorubicin for injection 1.2 mg/kg,once every 3 weeks,then giving Iodinated oil emulsifier and Gelatin sponge particle for hepatic artery embolization,appropriate Iodinat-ed oil emulsifier and Gelatin sponge particle once a month,for 3 times. Observation group was additionally received three-dimen-sional conformal radiotherapy 2 Gy,for 25-30 times with total dose of 50-60 Gy,once every 3 days. They were treated for 3-month. Clinical efficacy,the survival rate and median survival time after the first administration of drug for 1,2 and 3 years in 2 groups were observed,and the incidence of adverse reactions was recorded. RESULTS:The total effective rate,the survival rate and median survival time in 1,2 and 3 years in observation were significantly higher than control group,with statistical signifi-cance (P<0.05). The incidences of neutropenia,thrombocytopenia,hemoglobin decreased and radioactive disease in observation group were significantly higher than control group,with statistical significances(P<0.05). CONCLUSIONS:Oxaliplatin,mitomy-cin and doxorubicin combined with three-dimensional conformal radiotherapy have good efficacy for patients with hepatocellular lack of blood supply carcinoma,also can prolong the survival time,they show poor safety.

Objective:To investigate the anti-syphilis treatment status among pregnant women with syphilis and its influencing factors, and to explore the relationship between the treatment status and pregnancy outcome.Methods:Through the National Information System for the Prevention of Mother-to-child Transmission of acquired immune deficiency syndrome (AIDS), Syphilis and Hepatitis B, the demographic data, anti-syphilis treatment status during pregnancy and pregnancy outcomes of 1 614 pregnant women with syphilis who gave birth in Guangzhou City from January 2013 to December 2016 were collected. Chi-square test was used for comparison between groups and logistic regression method was used to identify influence factors of syphilis treatment and adverse pregnancy outcomes.Results:A total of 1 614 pregnant women with syphilis were included. The rates of standard treatment, general treatment and no treatment were 37.17%(600/1 614), 40.77%(658/1 614) and 22.06%(356/1 614), respectively. Logistic regression analysis showed that the rate of standard treatment was lower in the women with nonlocal registered permanent residence (adjusted odds ratio ( aOR)=0.670, 95% confidence interval ( CI) 0.523-0.858, P=0.002), unmarried ( aOR=0.582, 95% CI 0.393-0.863, P=0.007), education level of high school ( aOR=0.691, 95% CI 0.507-0.943, P=0.020), education level of junior middle school or below ( aOR=0.607, 95% CI 0.459-0.803, P<0.01), diagnosis after 28 weeks ( aOR=0.088, 95% CI 0.062-0.125, P<0.01) and unknown non-treponema pallidum antigen serologic test result at the time of diagnosis ( aOR=0.459, 95% CI 0.297-0.710, P=0.001). After controlling other related factors, compared with standard treatment group, the risk of adverse pregnancy outcome was increased in general treatment and untreated group, with aOR of 1.553 (95% CI 1.079-2.234, P=0.018) and 2.097 (95% CI 1.347-3.267, P<0.01), respectively. Compared to mothers with non-treponema pallidum antigen serologic test result ≤1∶4 at the time of diagnosis, the risk for adverse pregnancy outcome was significantly increased in mothers with non-treponema pallidum antigen serologic test result ≥1∶8 ( aOR=1.542, 95% CI 1.105-2.152, P=0.011). Compared to mothers with negative non-treponema pallidum antigen serologic test result at the last test during pregnancy, the risk for adverse pregnancy outcome was significantly increased in mothers with non-treponema pallidum antigen serologic test result ≥1∶8 ( aOR=2.063, 95% CI 1.151-3.700, P=0.015). Conclusion:Early diagnosis of syphilis, standard treatment and follow-up during pregnancy can effectively improve the pregnancy outcomes of pregnant women with syphilis.

Objective To explore the systematic nursing intervention for patients with artificial anal bowel habit of effect.Methods Our hospital from May 2020 to select-treated 100 cases of artificial anal in May,2022 patients as the research object,the patients were randomly divided into control group and research group of consent of all the 50 cases,control group adopted routine nursing care,the team take systematic nursing intervention,compare the effect of two groups of patients with bowel movements.Results The team bowel habit each index compared with control group,difference has statistical significance(P<0.05).Conclusion Systematic nursing intervention to actively promote the use of clinical nursing work in the future.

OBJECTIVETo understand the incidence rates of agricultural profession-related injuries and the relationship to alcohol consumption.

METHODSA multistage sample of 2366 villagers was selected from Minority Nationality Villages, Heilongjiang province. Face-to-face interviews were conducted by trained interviewers during May 2008. 2198 (92.9%) of the eligible questionnaires were available.

RESULTSIncidence rate of agricultural profession-related injury rate was 11.8% (260/2198) from May 2007 to April 2008. Higher proportions of injuries were seen for males, 30 - 49 year olds, farmers and among those people working on farms for 10 years or more, smoking during farm work, with sleeping disorder, using motor vehicles, and those using agricultural machinery. Rate of alcohol drinking was 29.1% (640/2198) in the month prior to the investigation. Results from logistic regression models showed that alcohol consumption patterns and other alcohol-related behavior were examined in separate logistic models because of collinearity by controlling the variables that were associated with agricultural profession-related injury including sex, age, years of farm work, driving a motor vehicle, and agricultural machinery use etc. In each model, the reference group was those villagers who did not drink in the past month. The odds of injury among villagers with history of past month drinking, who drank distilled spirits, and alcohol drinking at breakfast and lunch were 1.80 (95%CI: 1.24 - 2.62), 2.09 (95%CI: 1.38 - 3.15), 2.15(95%CI: 1.43 - 3.22) respectively. The odds of agricultural injury also significantly increased with greater average amounts of pure alcohol per day, with increased frequency of drinking per week, and reported years of drinking.

CONCLUSIONIntervention efforts should include increasing awareness about alcohol drinking as a major risk factor causing agricultural injuries as well as controlling alcohol drinking, improving knowledge about driving motor vehicle and using agricultural machinery.

Accidents, Occupational ; statistics & numerical data ; Adult ; Agriculture ; Alcohol Drinking ; epidemiology ; Alcoholic Intoxication ; epidemiology ; China ; epidemiology ; Female ; Humans ; Incidence ; Logistic Models ; Male ; Middle Aged ; Minority Groups ; Risk Factors ; Rural Population ; Surveys and Questionnaires

Objective:To explore the differences between impaired perspective-taking and executive function in children with attention deficit hyperactivity disorder(ADHD).Methods:From January 2019 to December 2020, according to DSM-5 diagnostic criteria, thirty-two cases of ADHD children aged 6 to 16(ADHD group) and twenty-six cases of typical development children and adolescents matched with age and intelligence (TD Group) were included. The response time and accuracy rate in dilemma stage and probe stage to self-oriented, maternal perspective-taking and other perspective-taking were measured using perspective-shifting task, and the executive function was evaluated by the behavior rating inventory of executive function (BRIEF). Repeated measurement analysis of variance was used to compare the difference of response time and accuracy rate between the two groups. Pearson correlation analysis was used to explore the correlation between the perspective-taking behavior characteristics and the BRIEF total score and subscale scores of ADHD group.Results:The total score and subscale scores of BRIEF scale in ADHD group were significantly higher than those in TD group (all P<0.01). The interaction between group and task type was significant during the task dilemma stage of perspective-shifting task ( F(2, 106)=4.365, P<0.05). Simple effect analysis showed that in other-perspective-taking task, the response time of ADHD group ((2 305.48±464.27)ms) was significantly longer than that of TD group ((1 971.13±462.95)ms) and the difference was statistically significant ( t=2.870, P<0.01). Pearson correlation analysis showed that the response time of ADHD group to other perspective-taking in dilemma stage was positively correlated with working memory, organization and inhibition index in EF ( r=0.401, 0.432, 0.342, all P<0.01). Conclusion:The ability of the perspective taking is closely related to impaired executive function, which seem to share a common neuropsychological basis.

Objective:To compare the efficacy and safety between WangShiBaoChiWan and mosapride in the treatment of functional dyspepsia (FD).Methods:From September 2019 to September 2020, patients with postprandial fullness and early satiation who met the Rome Ⅳ criteria for FD diagnosis were enrolled from 15 hospitals, including the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical College. The subjects were randomly divided into WangShiBaoChiWan (experimental) group and mosapride (control) group in the ratio of 1∶1. The treatment regimens were WangShiBaoChiWan+ mosapride simulator, WangShiBaoChiWan simulator+ mosapride, respectively with a treatment period of 2 weeks. The primary efficacy outcome was the improvement rates of main symptoms before and after treatment, the secondary efficacy primary efficacy outcome was the total clinical effective rate and the change of the single symptom score. And the safety indicator included adverse events. Independent sample t-test, paired t-test and chi-square test were used for statistical analysis. Results:A total of 251 FD patients were enrolled in the full analysis set, including 124 in the experimental group and 127 in the control group; 241 FD patients were in the per-protocol analysis set, including 117 in the experimental group and 124 in the control group. The analysis of per-protocol analysis set showed that the improvement rates of the main symptoms of the experimental group and the control group were (66±29)% and (60±30)%, respectively, and the difference was not statistically significant ( P>0.05). The improvement rate of the main symptoms of the experimental group reached 117% of that of the control group, which exceeded the expected non-inferiority standard of 80%. The total clinical effective rates of the experimental group and the control group were 76.07% (89/117) and 75.81% (94/124), respectively, and the difference was not statistically significant ( P>0.05). The results of full analysis set showed that the incidence of adverse events of the experimental group and the control group was 1.62% (2/124) and 1.57% (2/127), respectively, and the difference was not statistically significant ( P>0.05). There were no serious adverse events in the two groups. Conclusion:The improvement rate of the main symptoms of WangShiBaoChiWan is not inferior to that of mosapride in the treatment of FD, and it has good safety.