OBJECTIVE To know the status of nosocomial infection control of epidemic measles in medical units at all levels of the epidemic area.METHODS The scene of the correlated medical units by cross-sectional study was investigated.RESULTS There were 7 children cases included 1 case of measles,4 cases with fever and 2 ordinary childrens cases in a local city general hospital.At the rural health clinic,a total of 19 cases were studied,including 3 cases with measles infection,2 cases of suspected measles cases,10 cases of children with fever and other children 4 cases.CONCLUSIONS The infected sources concentrate in grass roots medical unit relatively,The problem of isolating infected sources,protecting high risk crowd and measures for medical staff in grass roots medical unit should be improved.

Objective To investigate the possibility of reserving uterus during severe postpartum hemorrhage. MethodsA retrospective analysis was conducted on the clinical data of 138 cases of severe postpartum hemorrhage (blood loss ≥2000 ml) from January 1, 2003 to December 31, 2009. Results Among 138 cases of severe postpartum hemorrhage, uterine atony (n= 60, 43. 38 ％ ) was the first cause and the second was placental factor (n= 55, 39.86 ％). The blood loss varied from 2000 ml to 10 000 ml and the mean level was about (3004± 1473) ml. The volume of blood transfusion for these patients varied from 800 ml to 7200 ml. Among these patients, the blood loss of 108 cases reserved uteri was from 2000 ml to 7500 ml, with the average of (2564±932) ml； while for 30 cases performed with hysterectomy, the blood loss was about 2500 to 10 000 ml averagly (4653± 1857) ml (t=8. 57, P=0.00). These patients were divided into two groups according to time series. Twelve cases of hysterectomy were performed during 2003to 2005, and the hysterectomy rate was 0. 47‰; 18 cases of hysterectomy were performed during 2006 to 2009, and the hysterectomy rate was 0. 36‰. The average blood loss of the above two groups was (3783±861) ml and (5233±2124) ml respectively (t=2. 234, P=0. 034). Among all the cases with blood loss ≥ 3000 ml, uteri were reserved in 24 cases with the average blood loss of (3818 ± 1284) ml； while hysterectomy were performed in 27 cases with average blood loss of (4900 ± 1789) rnl (t = 2. 453, P =0. 018). The time for blood loss to 3000 ml in the two groups was (160±129) min and (100±67) min,respectively, and the difference was significant (t=2. 113, P = 0.04).The uteri of six cases with postpartum hemorrhage over 4000 ml were successfully reserved, and average bleeding amount was 5570 ml.Two patients among the 138 women died of amniotic fluid embolism.The perinatal mortality rate was 3. 73％.ConclusionsThe postpartum hemorrhage volume and velocity is the key point to decide whether to reserve the uterus or not.For the population with high risk factors,prophylaxis treatment with prostaglandins should be initiated to reduce the bleeding volume.Uterine packing might be an effective treatment to stop postpartum hemorrhage, especially for those bleeding due to placenta previa.

This article reviewed the digestive system characteristics,enteral nutrition style,milk choice,the starting time of enteral nutrition,the velocity of milk volume increased and the ideal growth velocity of very low birth weight infants.The aim was to investigate the effect of the different starting time of enteral nutrition on their digestive function and the growth velocity,in order to find the suitable starting time of enteral nutrition,providing the basis for clinical enteral nutrition program of very low birth weight infant.

Objective To investigate the suitable mode of induced termination of pregnancy at second and third trimester for women with scarred uterus. Methods A retrospective study was performed in 90 cases of second and third trimester pregnant women with scarred uterus, who requested termination of pregnancy due to medical indications in Beijing Obstetrics and Gynecology Hospital from September 2002 to June 2009. The indications of termination of pregnancy were fetal anomaly, serious pregnant complication and intrauterine fetal deaths. 72 second trimester pregnant women and 18 third trimester pregnant women were included in this study. The interval time of previous operation to this pregnancy were recorded. And it was <2 years in 20 cases and ≥2 years in 70 cases. The patients with normal Hepatic function began to take mifepristone and had an allergic test of Ethacridine Lactate. The method of mifepristone combined with Ethacridine Lactate were adopted when the allergic test was negative (group A, 54 cases). The method of mifepristone combined with earbeprost methylate suppositories were used in the patients who had a positive reaction to the allergic test of Ethacridine Lactate, or who failed to amniotomy to inject Ethacridine Lactate because of oligohydramnios or small gestational age(group B, 36 cases). Record the detail information of every patient. (1) Age, gestational weeks, gravidity and parity. (2) The mode of previous operation (inducing the scar of uterus), previous operation time and indication. (3) The mode of induced labor in this pregnancy, the interval time from administration to uterine contraction, delivery or not and the interval time from induction to delivery. (4) Postpartum hemorrhage, the successful rate of induce labor, placental retention ratio and rupture of uterus or not. Results (1) It had no significant difference between group A and group B in age, gravidity, parity and the interval time of previous operation to this pregnancy (P> 0.05). But there was significant difference between two groups in gestational weeks of induction(16 weeks vs. 25 weeks,P<0.01). (2) It had no significant difference between two groups in successful rate of induction and postpartum hemorrhage(P>0.05), but the time from induction to regular uterine contraction and delivery in group B was significant shorter than that of group A(P<0.01). The rate of delivery with 24 hours in group B was 94%. It was significant higher than that of group A(13%, P<0.01). (3) The rate of retained placenta in group B (31%, 11/35) was significant higher than group A (10%, 5/52), but the ratio of residual of placenta and membranes in group A was significant higher than that of group B(54% vs. 34% ). It was no significant difference in total rate of postpartum complication between two groups. Further analysis was done in relationship of complication and the time of previous operation. It was no significant difference between the over 2 years group and the less 2 years group in the incidence rate of complications including placental retention, residual of placenta and membranes, rupture of uterus, placental abruption and postpartum hemorrhage. (4) There was 1 case of uterine rupture in group B and 1 case of placental abruption in group A. Conclusions Both of methods of mifepristone combined with carboprost methylate suppositories and the mifepristone combined with Ethacridine lactate are feasible to induced second trimester and late trimester termination of pregnancy for women with scarred uterus. But sufficient preoperation preparation and the course of induction and labor careful monitoring must be done to prevent the uterine rupture.

Objective To investigate and analyze the structure change of professional title and educa-tion background of nursing human resourse in Liaoning province in recent 3 years and raise up suggestions which suit for the structure and development of human resource of current nursing model. Methods Investi-gation scales for nursing human resource in Liaoning province were sent out to 85 hospitals in Liaoning province.SPSS 12.0 software was used to carry out statisdcal discription for these data. Results The main professional fide was primary. The main education background was junior college and technical secondary school in third-class hospitals and technical secondary school in second-class and first-class hospitals. Conclusions The professional title and education background of nursing human resourse in Liaoning province was not reasonable with imbalanced structure in various level of hespitals.The countermeasures included reform of nursing education, reasonable allocation and effective utilization of current nursing human resource and sys-tematization of continuing education.

With the deepening of professional nursing, refinement will be the development trends of nursing in the future. This thesis proceeds from the angle of ethical relations, focus on the special characteristics and specific social relations of clients with gynecological tumor diseases on the basis of ethics of Chinese traditional culture and Maslow′s theory. This thesis digs deeper into intrinsic ethical relations from gynecology clinical nursing to seek the key to solving gynecology tumor patients′ humanistic care, position accurately to determine the perspective of health care providers, deepen the connotation of humanistic care.

Objective To investigate the association between the duration of second stage of labor and maternal and neonatal outcomes in pregnant women complicated with hypertensive disorders,dysglycaemia (including gestational diabetes mellitus and diabetes mellitus complicating pregnancy) or primipara-inadvanced-age,and in normal pregnant women after implementation of new partogram.Methods A retrospective analysis was performed on all nulliparous women with the duration of second stage of labor ≥2 h at Beijing Obstetrics and Gynecology Hospital,Capital Medical University between October 1,2014 and March 31,2015.Women with preterm labor,multiple gestation,noncephalic presentations,fetal malformations,placenta previa,or induction of labor after fetal death were excluded.And 279 women who met the inclusion criteria served as study group.Among the 279 women,25 had hypertensive disorders (hypertension group),46 had dysglycaemia (dysglycaemia group),and 35 had primipara-in-advanced-age (primipara-in-advanced-age group),and the remaining 177 women served as ordinary study group.According to the duration of second stage,the ordinary study group was divided into three subgroups:≥ 2-＜2.5 h (n=90),≥ 2.5-＜3 h (n=51),and ≥ 3 h(n=36).And 340 women with the duration ＜ 2 h were selected randomly as control group,including 24 with hypertensive disorders (hypertension control group),61 with dysglycaemia (dysglycaemia control group),and 41 with primipara-in-advanced-age (primipara-in-advanced-age control group);the remaining 226 women served as ordinary control group.Maternal and neonatal outcomes in these two groups were analyzed with Rank sum test,Chi-square test or Fisher's exact test.Results (1) Dysglycaemia group had a longer first stage of labor,lower rate of spontaneous labor and higher rate of forcep-assisted delivery than its counterpart control group [11.88(8.42-16.06) vs 8.17(5.00 14.12) h,67.4％(31/46) vs 91.8％(56/61),and 30.4％(14/46) vs 8.2％(5/61),respectively,all P＜0.05].Primipara-in-advanced-age group had a longer first stage of labor,higher intervention rate,lower spontaneous labor rate and higher rate of forcep-assisted delivery than its counterpart control group [12.33(7.17-20.50) vs 7.50(4.00-15.12) h,61.8％(21/34) vs 36.6％(15/41),60.0％(21/35) vs 90.2％(37/41),and 34.3％(12/35) vs 9.8％(4/41),respectively,P＜0.05].Compared with ordinary control group,women in the ordinary study group,≥ 2-＜2.5 h,≥ 2.5-＜3 h and ＞3 h subgroup had a longer first stage of labor,higher labor intervention rate,and lower spontaneous labor rate (all P＜0.05).Ordinary study group and ≥ 3 h subgroup had higher rates of labor analgesia and forcep-assisted delivery than the ordinary control group.The forcepassisted delivery rate in ≥ 2.5-＜3 h subgroup and cesarean section rate in ≥ 3 h subgroup were all higher than in ordinary control group (P＜0.05).(2) Hypertension group had a higher incidence of postpartum hemorrhage than its corresponding control group while primipara-in-advanced-age group had a higher incidence [48.0％(12/25)vs 20.8％(5/24),and 34.3％(12/35) vs 7.3％(3/41),both P＜0.05).Ordinary study group,≥ 2.5-＜3 h subgroup and ≥ 3 h subgroup had higher rates of postpartum hemorrhage and adverse wound healing than the ordinary control group (all P＜0.05).(3) Compared with ordinary control group,≥ 2-＜2.5 h subgroup had a higher rate of neonatal asphyxia,≥ 2.5-＜3 h subgroup had higher fetal macrosomia proportion,and ≥ 3 h subgroup had a higher rate of admission to neonatal intensive care unit (all P＜0.05).In ordinary study group,6(3.4％) out of the 177 cases had neonatal asphyxia,all in the ≥ 2-＜2.5 h subgroup [6.7％(6/90)],which was higher than in the ordinary control group [0.9％ (2/226)],P＜0.05.Conclusions With the prolonged duration of the second stage,the risk of adverse matemal and neonatal outcomes increases.For pregnant women complicated with hypertensive disorders,dysglycaemia or primipara-in-advanced-age,the duration of the second stage of should not be prolonged.

Objective To investigate the difference in detection results of electrolytes and glucose among arterial blood plasma , venous blood plasma ,arterial blood serum and venous blood serum .Methods Arterial and venous anticoagulation blood and coagu‐lation blood were collected from 54 patients at the same time ,1 tube for each blood sample .The corresponding plasma and serum were isolated .The levels of K+ ,Na+ ,Cl-and glucose(GLU) were determined by using the Johnson VITROS 5600 automatic dry biochemical analyzer .The detection results were performed the comparative analysis by using the statistical method .Results When the sample was serum ,the concentrations of Na+ ,Cl- ,GLU and serum K+ had statistically significant difference between arterial and venous blood(P<0 .05) ,when the sample was plasma ,the concentrations of Na+ ,Cl- and GLU had statistically significance between arterial and venous blood(P<0 .05);but the K+ concentration had no statistically significant difference between serum and plasma(P>0 .05) .In addition ,the GLU and K+ detection results had statistical difference between arterial serum and plasma(P<0 .05) ,while the Na+ and Cl- detection results had no statistically significant difference(P>0 .05);similarly ,the GLU and K+ de‐tection results had statistical difference between venous plasma and serum (P<0 .05) ,while the Na+ and Cl- detection results had no statistical difference(P>0 .05) .Conclusion Some differences in the detection results of electrolytes and glucose exist among ar‐terial plasma ,venous plasma ,arterial serum and venous serum ,clinic should pay attention to make a difference among different types of sample and establish the suitable reference ranges .have certainly difference in different types of specimens even detected by the same system .So we recommend that appropriate reference range is necessary for various kinds of specimens .

Objective To study the perinatal outcomes of pregnant women when their total stage of labor over 24 hours after the application of new partogram.Methods A retrospective case-control study was conducted on 3 991 pregnant women who received routine prenatal care and intrapartum management according to new partogram and delivered at full-term with alive babies at Beijing Obstetrics and Gynecology Hospital from October 1,2014 to January 31,2015.Among these 3 991 women,85 delivered after 24-hours' labor and all were nulliparas,while five of the 85 converted to cesarean section (CS group) and 80 delivered vaginally (study group).Another 160 primigravidas were randomly selected from those vaginal deliveries with the total stage of labor less than 24 h as control group.The general conditions,maternal and fetal perinatal outcomes were compared between the study and control group and between the study and CS group.The duration of labor was compared among different groups of women in the study group.Independent sample t-test,Rank-sum test,Chi-square test or Fisher's exact test were applied for statistics.Results The durations of first stage,second stage,third stage and total stage of labor were all longer in the study group than in the control [25.7(23.8-26.8) vs 10.4(5.9-13.9) h,1.4(0.6-1.8) vs 0.8(0.4-1.0) h,0.14(0.08-0.17) vs 0.11(0.07-0.13) h,27.2(24.9-26.8) vs 10.4(5.9 14.0) h,Z=12.525,4.359,3.528 and 12.588,all P＜0.01].The proportions of intrapartum interventions and application of labor analgesia were both higher in the study group than in the control [97.5％(78/80) vs 32.5％(52/160),42.5％(34/80) vs 11.9％(19/160),x2=90.764 and 29.071,both P＜0.01].Higher incidences of intrapartum fever [18.8％(15/80) vs 5.6％(9/160),x2=10.208],episiotomy [50.0％(40/80) vs 25.6％(41/160),22=14.172],assisted vaginal delivery [26.3％(21/80) vs 10.0％(16/160),x2=10.800],postpartum hemorrhage [32.5％(26/80) vs 8.1％(13/160),x2=23.284],and cervical laceration [15.0％(12/80) vs 3.1％(5/160),~=11.427] were shown in the study group than in the control (all P＜0.01).There was no statistically significant difference was found in the rate of fetal distress,neonatal asphyxia and neonatal intensive care unit (NICU) admission between the study and control group (all P＞0.05) except for newborns' birth weight [(3 542±388) vs (3 431 ±368) g,t=2.162,P=0.032].However,the incidences of postpartum hemorrhage,intrapartum fever and neonatal admission to NICU were comparable between the study (n=20) and CS group (both P＞0.05).Within the study group,the durations of second stage of labor in women with postpartum hemorrhage,assisted vaginal delivery and episiotomy were significantly longer than those without [1.8(0.9-3.1) vs 1.2(0.5-1.5) h,2.0(0.8-3.4) vs 1.2(0.5-1.6) h,1.7(0.6-2.6) vs 1.1(0.5-1.5) h,Z=2.168,2.756 and 1.891,all P＜0.05].Conclusions After the application of new partogram,vaginal delivery remains possible for pregnant women whose total stage of labor over 24 hours without increase of neonatal morbidity.However,the incidences of postpartum hemorrhage,episiotomy and assisted vaginal delivery may rise up.

Objective To investigate the effect of different analgesia during labor and their side effect to the neonates. Methods Totally 130 puerperas were randomly divided into three groups: group A included 50 puerperas with analgesia by GT-4A workstation; group B included of 40 puerperas with mixed gas analgesia consisted of 50% of nitric oxide and 50% of oxygen; and group C(40 gravidas) as control group. The analgesic effect, duration of labor, mode of delivery and the amount of postpartum hemorrhage were observed. Results The analgesic effect in group A was significantly better than group B ( P