Objective To study the efficiency of inhaling nitrogen monoxide in labor on pain relief and its effect on mother and fetus. Methods Two hundred term primiparas were randomly divided into the observational and control group.The control group was given the same treatments as that in the observational group except for inhaling of nitrogen monoxide. The degree of labor pains, duration of labor, mode of delivery, Apgar scores, the volume of intrapartum bleeding, the rate of postpartum hemorrhage and other outcomes were compared between the two groups. Results The scores of labor pains in the observational group was significantly lower(P

Objective: To observe the survivability of Lactobacillus acidophilus in short peptide enteral nutrition liquid.Methods: 5% fermentative medium of Lactobacillus acidophilus was added in 12% short peptide enteral nutrition liquid.The preparations were cultured at 37℃ anaerobic condition.Samples were taken from culture at 0,4,8,12,14,16,20,24 h during fermention.The living bacteria counts,A_600,acidity and pH values were examined respectively.Results: The number of Lactobacillus acidophilus increased at 0 to 16 h.A_600 ascended during the time.Acidity ascended with time.Conclusion: The present study demonstrated that Lactobacillus acidophilus had better survivability in 12% short peptide enteral nutrition liquid,and the terminal time should be controlled during 12~14h.

Objective To investigate the effect of psychological intervention on patients with non-small cell lung cancer treated with cisplatin or gemcitabine or Changchun vinorelbine. Methods 64 cases of patients with non-small cell lung cancer after surgery, nursing for patients in the group given basic treatment, routine care control group, the observation group based on routine nursing and psychological nursing effects were compared between the two groups. Results No significant difference of anxiety and depression in the patients of the two groups before nursing, after grouping nursing, the observation group improved significantly; compared two groups of patients with quality of life score, visible two group before the intervention had no significant difference after intervention group was clearly observed after the patients in the observation group were higher than that of the control group, comparison between groups were indicates that the difference is obvious (P<0.05). Conclusion Chemotherapy in non-small cell lung cancer after surgery for patients with psychological intervention, compared to conventional nursing, can improve the psychological status of patients with better, improve the quality of life of patients, so it is worthy of reference in clinical use.

Objective To investigate the relativity for weight of macrosomia predicted by ultrasound and clinical measurements . Methods 1 037 subjects who were delivered in May to November 2012 ,in Chongqing Health Center for Women and Children ,were collected and analyzed satistically .The parameters for the comparisons included maternal abdominal circumference (MAC) ,fundal height(FH) ,and fetal diameters measured by ultrasonic imaging such as biparietal diameter (BPD) ,head circumference(HC) ,femur length(FL) ,and abdominal circumference(AC) .The coincidence was calculated with real weights and compared with clinical predic-tions .Results When FH+ MAC 134 cm ,the accuracy of preliminary screening for macrosomia is the highest ,the area under the ROC curve is 0 .895 .Combining with the abdominal circumference(AC) by prenatal ultrasound ,the highest prediction rate of mac-rosomia is 75 .2% .when Fetal AC≥37 cm ,macrosomia incidence rate took 91 .7% .Conclusion Pregnant women with FH+MAC<134 cm ,whose incidence of Macrosomia is low .While if the FH+MAC≥134 cm ,combining with the prenatal ultrasound whose fetal AC>36 cm ,especially ≥37 cm ,the possibility of macrosomia is very high .

The ongoing pandemic in Singapore is part of a global pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To control the spread of COVID-19 and prevent the healthcare system from being overwhelmed, 'circuit breaker' measures were introduced between 7 April and 1 June 2020 in Singapore. There is thus a crucial need for innovative approaches to the provision and delivery of healthcare in the context of safe-distancing by harnessing telemedicine, especially for patients with chronic diseases who have traditionally been managed in tertiary institutions. We present a summary of how the Virtual Monitoring Clinic has benefited the practice of our outpatient rheumatology service during the COVID-19 pandemic. The virtual consultations address the need for safe-distancing by limiting face-to-face appointments and unnecessary exposure of patients to the hospital where feasible. This approach ensures that the patients are monitored appropriately for drug toxicities and side-effects, maintained on good disease control, and provided with patient education.
Ambulatory Care/methods* ; Antirheumatic Agents/therapeutic use* ; COVID-19 ; Delivery of Health Care ; Humans ; Nurse Practitioners ; Pharmacists ; Rheumatic Diseases/drug therapy* ; Rheumatology/methods* ; SARS-CoV-2 ; Singapore ; Telemedicine/organization & administration* ; Tertiary Care Centers

STUDY DESIGN: Retrospective case series PURPOSE: This study aims to present the early clinical and radiological outcomes of anterior longitudinal ligament (ALL) reconstruction following disc arthroplasty. OVERVIEW OF LITERATURE: Although cervical and lumbar disc arthroplasty have entered the clinical setting, there are still concerns regarding the short and long term complications arising from hypermobility of current prosthesis designs. Reconstruction of the ALL is a potential solution to disc arthroplasty hypermobility. METHODS: ALL reconstruction following disc arthroplasty have been performed by the senior author over a 24 month period. Ligament replacements used include allograft and synthetic, ligament advanced reinforcement system (LARS) ligaments. Methods of fixation used include titanium staples, bone anchors and suture fixation. Radiological follow-up pre- and postoperative Oswestry disability index, Neck Disability Index, Patient Satisfaction index scores were recorded on all patients. RESULTS: A total of 18 ALL reconstructions were performed. There have been no cases of early complications, revision surgery for recurrent symptoms or implant failure. Of the 6 patients receiving a minimum of 15 months follow-up, 4 patients received an allograft, 2 patients received the LARS ligament. Favourable, postoperative clinical and radiographic outcomes have been demonstrated. CONCLUSIONS: ALL reconstruction following cervical and lumbar disc arthroplasty is a promising solution to addressing non-physiological kinematics of current disc arthroplasty devices. Randomized, controlled studies with larger study samples and long-term follow-up are required to establish these conclusions.
Allografts ; Arthroplasty* ; Biomechanical Phenomena ; Cervical Vertebrae ; Female ; Follow-Up Studies ; Humans ; Ligaments ; Longitudinal Ligaments* ; Lumbar Vertebrae ; Neck ; Patient Satisfaction ; Prosthesis Design ; Retrospective Studies ; Spondylosis ; Suture Anchors ; Sutures ; Titanium

INTRODUCTIONThe aims of this study were to cross-culturally adapt and evaluate the validity of the Singaporean Malay and Tamil versions of the EQ-5D.

MATERIALS AND METHODSThe EQ- 5D was cross-culturally adapted and translated using an iterative process following standard guidelines. Consenting adult Malay- and Tamil-speaking subjects at a primary care facility in Singapore were interviewed using a questionnaire (including the EQ-5D, a single item assessing global health, the SF-8 and sociodemographic questions) in their respective language versions. Known-groups and convergent construct validity of the EQ-5D was investigated by testing 30 a priori hypotheses per language at attribute and overall levels.

RESULTSComplete data were obtained for 94 Malay and 78 Indian patients (median age, 54 years and 51 years, respectively). At the attribute level, all 16 hypotheses were fulfilled with several reaching statistical significance (Malay: 4; Tamil: 5). At the overall level, 42 of 44 hypotheses related to the EQ-5D/ EQ-VAS were fulfilled (Malay: 22; Tamil: 20), with 21 reaching statistical significance (Malay: 9; Tamil: 12).

CONCLUSIONIn this study among primary care patients, the Singapore Malay and Tamil EQ-5D demonstrated satisfactory known-groups and convergent validity.

Acculturation ; Cohort Studies ; Female ; Health Status ; Humans ; India ; ethnology ; Language ; Malaysia ; ethnology ; Male ; Middle Aged ; Primary Health Care ; Psychometrics ; instrumentation ; Quality-Adjusted Life Years ; Retrospective Studies ; Singapore ; Surveys and Questionnaires ; standards

INTRODUCTION: To describe the maternal and fetal outcomes in systemic lupus erythematosus (SLE) pregnancies followed-up in a single tertiary referral centre. METHODS: We performed a retrospective cohort study of 75 SLE pregnancies who were followed up in Singapore General Hospital over a 16-year period from 2000 to 2016. Adverse fetal and maternal outcomes including preterm delivery, miscarriages, fetal growth restriction, congenital heart block, neonatal lupus, pre-eclampsia and SLE flares were obtained from the medical records. RESULTS: The mean age at conception was 32 years old (SD 3.8). The mean SLE disease duration was 5.9 years (SD 5.2). The majority (88%) had quiescent SLE disease activity at baseline. Most pregnancies resulted in a live birth (74.7%). The mean gestational age at birth was 37.4 weeks (SD 3.4). Adverse fetal outcomes occurred in 53.3%. Preterm delivery (33.9%), miscarriages (20%) and fetal growth restriction (17.3%) were the most frequent adverse fetal outcomes. There was 1 neonatal death and SLE flares occurred in a third (33%). In the subgroup of SLE pregnancies with antiphospholipid syndrome, there were higher SLE flare rates (40%) and adverse fetal outcomes occurred in 8 pregnancies (80%). There were no predictive factors identified for all adverse fetal and maternal outcomes. In the subgroup analysis of preterm delivery, anti-Ro (SS-A) antibody positivity and hydroxychloroquine treatment were associated with a lower risk of preterm delivery. CONCLUSION Although the majority had quiescent SLE disease activity at baseline, SLE pregnancies were associated with high rates of adverse fetal and maternal outcomes.