Objective To know the awareness level of patient-controlled epidual analgesia in labor related knowledge,and to provide evidence for health education,develop a comprehensive intervention program to reduce the rate of cesarean section.Methods Investigation on knowledge of patient controlled epidural analgesia during labor for a total of 400 pregnant women on Maternal and Child Health Hospital of Taiyuan City,MCH Hospital of Shanxi Province by questionnaire.Compared different characteristics of the pregnant women's scores about control epidural analgesia childbirth knowledge by nonparametric test,knowledge score of multi-factor analysis by multiple linear regression analysis.Results The maximum score of pregnant women-controlled epidural analgesia delivery knowledge was 13,the minimum score was 0,the median score was 4,range interquartile was 5.Different pregnant women with different age,education level,number of weeks of gestation,pregnancy,family income,and condition of parnatal care had different scores of knowledge of patient-controlled epidural analgesia,the difference was significant,P＜0.05.Multiple linear regression analysis showed that:pregnant women's education,gestational age,the average monthly household income can be explained by maternal knowledge score of 61.4％ of the variation.Conclusions The level of pregnant women-controlled epidural analgesia childbirth knowledge is low,we need to strengthen the natural childbirth education,and take a variety of modes of propaganda and increase their level of knowledge,enhance confidence of natural childbirth in pregnant women,so as to achieve the purpose of reducing cesarean section rate.

Objective To study the association between the CTLA-4 gene polymorphism and Graves disease.Methods A total of 120 unrelated patients with Graves disease southern Han nationality of China were recruited from clinics in the Department of Endocrinology and Metabolism,the First Affiliated Hospital of Sun Yat-sen University from 2001 to 2003.Ethnically matched 123 control subjects with no history of autoimmune disease were from Guangdong.We investigated the polymorphism of the cytotoxic T lymphocyte antigen 4 gene on chromosome 2q33.1 microsatellite markers of CTLA4 were chosen,this was done by PCR amplification of marker sequences using fluorescently labeled primers and subsequent analysis of the PCR products on ABI prism 377.Results Twenty alleles were observed in the population,with sizes ranging from 84 to 144 bp.There was no significant difference when compared with controls in the distribution of the genotypes(?2=21.428,P=0.208).This investigation indicated that the gene of CTLA4 was not susceptible gene for Graves disease.Conclusion This study suggests that CTLA4 gene may not be susceptible gene to Graves disease for the Chinese southern Han population.

Microtox technology is one of quick toxicity test methods for determining the poisonous or toxic substances in the environment by luminous bacteria as a indicator organism.This paper reviewed the appearance and development of microtox technology.Besides,we expounded the methods and stepwise technique map and addressed key questions of microtox technology for the evaluation of the comprehensive toxicity of Chinese medicinal materials.In conclusion,microtox technology is a promising method from a vantage point of the toxicity detection of Chinese medicinal materials.

Objective To investigate the significance of DNA ploidy analysis in diagnosis of atypical squamous cell of undetermined significance ( ASCUS).Methods From Jan.2009 to Jul.2011,875 women with ASCUS confirmed by liquid based thin layer cytology technique underwent DNA ploid analysis in Hubei Maternal and Child Health Hospital.Among 294 women underwent high risk HPV detection.All subjective were examined colposcopy directed biopsy at day 3 to 10 after menstruation.Results Among 875 ASCUS cases,553 cases with histologically as chronic cervicitis (63.2％),165 cases with cervical intraepithelial neoplasia (CIN) Ⅰ (18.9％ ),45 cases with CIN Ⅱ (5.1％),79 cases with CIN Ⅲ (9.0％) and 33 cases with cervical invasive cancer (3.8％) were confirmed by colposcopy.Totally 532 cases were observed with DNA heteroploid,and 343 were not observed with DNA heteroploid.When DNA heteroploid negative and more than or equal to three ploid were used to predict CIN Ⅱ or more severe cervical diseases,the sensitivity,specificity,positive predictive values and negative predictive values were 98.7％ and 90.3％,47.5％ and 46.1％,29.1％ and 40.8％,99.4％ and 92.1％,respectively.The amount of heteroploid cells ＞2.5c and ＞ 5c among every 100 detected cells in chronic cervicitis and CIN Ⅰ,CIN Ⅱ,CIN Ⅲ and cervix cancer were respectively 2.53 ± 1.99 and 0.10 ±0.07,2.24 ± 1.69 and 0.20 ±0.11,4.10 ± 1.91 and 0.28 ±0.19,7.97 ±7.33 and 1.27 ± 1.23,8.99 ±7.33 and 0.36 ±0.33,there was no statistical difference in amount of heteropolid cells between ＞ 2.5c and ＞ 5c at group of chronic cervicitis and CIN Ⅰ,CIN Ⅲ and cervix cancer (P ＞ 0.05).However,the amount of heteroploid cells at ＞2.5c and＞ 5c at group of chronic cervicitis,CINⅠ,CIN Ⅲ and cervical were higher than that of CIN Ⅱ significantly (P ＜0.05).Among 294 cases with high risk (HR) HPV detection,216 cases were HR-HPV positive,and 78 cases were HR-HPV negative.The pathology result by colposcopy at group of negative heteroploid,heteroploid ＜ 3,or ≥ 3 showed statistical distribution (x2 =115.2775,P ＜ 0.01).ConclusionDNA ploidy analysis can be used for ASCUS diagnosis,which can avoid excessive biopsy under colposcopy,in the mean time,CIN and cervical cancer could decrease missed diagnosis.

Objective To study the repeat pregnant women′s awareness level of delivery mode knowledge after cesarean section, in order to provide a basis for making effective intervention programs and reduce the cesarean delivery on maternal request rate. Methods Investigated on the knowledge of delivery mode after cesarean section for 330 repeat pregnant women on Maternal and Children Healthy Hospital of Shanxi Province by questionnaire. Results This study investigated 330 repeat pregnant women, recycling effective questionnaire 318, and the recycling effective rate was 96.4%. Different pregnant women with different education level, the number of weeks of gestation, the doctors′recommendations on the delivery had different scores of knowledge of delivery mode after cesarean section. The difference was significant (P < 0.05). The Multi-factor Logistics regression analysis showed that the repeat pregnant women′ s education and the doctors′recommendations on the delivery are associated with the scores of knowledge of delivery mode after cesarean section (P<0.05). The more higher level of their education, and if the doctor had provided the advice of delivery mode to repeat pregnant women before, the more higher scores the repeat pregnant women got. Conclusions The level of the knowledge of delivery mode after cesarean section is low. It′s time to take appropriate health education intervention strategies to reduce the rate of cesarean delivery on maternal request.

Objective: To determine 17 types of phthalic acid esters (PAEs) in drinking water using solid-phase extraction coupled with gas chromatography-mass spectrometry (GC-MS) in multiple reaction monitoring (MRM) mode. Methods: One litre of commercially available bottled water was purified using an HLB solid-phase extraction column, and was eluted with ethyl acetate, dichloromethane and average methanol. Seventeen types of PAEs were detected using a triple quadrupole gas chromatography-mass spectrometer in MRM mode. By optimizing the temperature programming and adjusting the mass spectrometry collision energy, collection efficiency was improved and matrix interference was reduced. The precision and accuracy of this method were assessed by determining the standard curves, detection limits, quantification limits, relative standard deviations (RSD) and average spiked recovery rates for the 17 types of PAEs. Results: The 17 types of PAEs showed good linear relationships between mass concentration and chromatographic peak areas in the range of 0.02 to 1.0 mg/L, with correlation coefficients all greater than 0.999 1. The detection limits ranged from 0.002 9 to 0.009 7 mg/kg, the quantification limits ranged from 0.008 7 to 0.029 1 mg/kg, the RSD ranged from 0.8% to 3.0%, and the average spiked recovery rates ranged from 88.8% to 111.8%. Conclusion Solid-phase extraction coupled with MRM of GC-MS can better determine low concentrations of PAEs in drinking water.

Objective To observe the effect of irbesartan on the expression of angiopoietinlike protein 2 (ANGPTL2) in the diabetic rats kidney and explore the underlying mechanism.Methods A total of sixty male SD rats were divided into normal control group (NC group,n=15) and experimental group (n=45) randomly.The experimental group was fed with high sugar-fat diet and given a low dose streptozocin (STZ 30 mg/kg)to establish type 2 diabetic model.Rats successfully induced diabetes were randomly divided into 2 groups:diabetes group (DM) and irbesartan group (DI).Weight,blood pressure,blood glucose,serum creatinine (Scr),blood urea nitrogen(BUN),24 hour urinary albumin(UAL) and renal histomorphology were observed after drug intervention at the 4th,8th and 12thweeks.The expression of ANGPTL2 in renal tissue were detected by immunohistochemistry,real-time PCR and Western blotting.Results The levels of Scr,BUN,TG,TC and UAL in group DM were higher than in group NC at the 4th,8th and 12th week (all P ＜ 0.05).Compared with that in group DM,above indexes were lower in group DI at the 4th,8th and 12th week (all P ＜ 0.05).The pathological changes of the kidney in group DM were more serious than that in group DI.The expression of ANGPTL2 in group DM was much higher than that in group NC at the 4th,8th and 12th week (all P ＜0.05),and irbesartan treatment inhibited the up-regulation of ANGPTL2 in group DI(all P ＜ 0.05).Conclusion The expression of ANGPTL2 increases in T2DM rats kidney tissue with time and irbesartan can inhibit the up-regulation of ANGPTL2 in T2DM rats.

Objective To evaluate the performance of homocysteine(Hcy)test kit produced by a domestic company and to inves-tigate its feasibility in clinical application.Methods A series of methodological evaluation experiments including the accuracy,re-peatability,stability and linear range of the Hcy reagent kit were carried out on the Olympus Au640 biochemistry analyzer.Results The experiments showed that the relative biases of detection results of normal value quality control serum and pathological value quality control serum were 0.2% and 4.9%,respectively,which were far less than 15% of the reagent instruction.The intra-assay coefficients of variation(CV)of normal and pathological quality control serum were 2.6% and 2.3% respectively,which were less than 5% of the reagent instruction.While the inter-assay CV of normal and pathological quality control serum were 4.4% and 4.1% respectively,which were less than 10% of the reagent instruction.The experiments for the linear range evaluation showed that R 2 was 0.997 in the concentration range of 0 -66 μmol/L,which suggested that the correlation between expected value and measured value was very well.Otherwise,the slope rate b1 of 0.979 9 and the intercept b0 of 0.151 8 were both showed that the de-tection results of Hcy reagent were linear in the concentration of 0-66 μmol/L.Conclusion The performance of Hcy kit produced by a domestic company is very good in the performance indexes of accuracy,repeatability,stability,and linear range and suitable for the clinical application.

Objective: To investigate the effect and mechanism of Astragalus Injection (Radix Astragali) on acute murine myocarditis caused by Coxsackievirus B 3. Methods: Acute viral myocarditis was induced in 24 Balb/c mice by injection of Coxsackievirus B 3m (CVB 3m ) intraperitoneally. Half of the mice were administered Astragalus Injection(10g/kg?d). Heart and blood samples were obtained from all mice on the 8th day after CVB 3m infection for histopathological study, detection of myocardial perforin expression by reverse transcription polymerase chain reacton(RT PCR) and measurement of serum CK MB level, respectively. Results: (1) Astragalus treated mice showed a significant reduction in myocardial lesion compared with that in untreated mice. (2) Myocardial perforin expression by semi quantitative RT PCR in Astragalus treated mice was much lower than that in controls(1.10?0.07 vs 1.31?0.12, P

Objective To investigate and analyze application of syndrome-differentiated nursing care in the hospitals of TCM in Hunan. Methods A self-designed questionnaire was used to investigate and analyze 485 nurses-in-charge or higher positions in 116 hospitals of TCM in Hunan. Results 90.93% of nursing staff hold that syndrome-differentiated nursing care benefits patients' health; 32.37% of nurses were not familiar with syndrome-differentiated nursing care, and the rate of familiarity was higher among the nurses in municipal and provincial hospitals of TCM than those in county and district hospitals of TCM; hospitals of TCM that carry out syndrome-differentiated nursing care exceeding 70% accounted for 12.37%, with municipal and provincial hospitals of TCM higher than county and district hospitals of TCM. Conclusions Application of syndrome-differentiated nursing care in the hospitals of TCM is of concern. Reform of management model, training system, regulations and laws is needed to encourage nurses' application of syndromedifferentiated nursing care.