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 analyze the characteristics of patients involved in identification error events,try to recognize patients group who had high risk of being wrongly identified.Methods 68 patient identification error events in 64 hospitals in Liaoning province from 2007 to 2011 were investigated.The results were analyzed from four aspects,which were education,age,consciousness and sensory disability state of patients.Results 68 identification error events were investigated.Among these events,patients who graduated from middle school or less constituted 79.41％ ;patients older than 60 years old constituted 55.88％;patients with hearing and speaking inability constituted 41.18％;patients without clear consciousness constitutes 14.70％ Conclusions Patients who graduated from middle school or less,older than 60 years old,with heating and speaking inability constitute the group who has high risk of being wrongly identified.Enhancing the education of patients,promoting the use of wrist band,and decreasing the dependence on hearing and speaking ability during identification process constitute the main reformation aspect of new patient identification rules.

Objective To investigate the relationships between fasting plasma glucose (FPG) level in early pregnancy and gestational diabetes mellitus (GDM).Methods Data of 11 477 pregnant women who accepted prenatal care in Beijing Obstetrics and Gynecology Hospital from October 2011 to September 2012 were collected.FPG was tested during 8 to 12 weeks of pregnancy in all women and those with FPG＜7.00 mmol/L were recruited.Women accepted 75 g oral glucose tolerance test (OGTT) during 24 to 28 weeks of pregnancy.The GDM diagnostic criteria was with reference to the criteria of International Association of Diabetes and Pregnancy Study Group.Mann-Whitney U test was used to analyze the difference of early pregnancy FPG between normal pregnant women and GDM women.Receiver operating characteristic (ROC) curve was used to analyze the validity and applicability of using early pregnancy FPG in GDM diagnosis.Chi-square test was used to analyze the relationship between the FPG levels and GDM diagnosis.Results There were 1 535 (13.4％) women diagnosed as GDM in 24 to 28 weeks of pregnancy (the rest 9 942 normal cases were taken as the controls).The median FPG level of the GDM group was 4.89 mmol/L (4.62-5.15 mmol/L),which was higher than that of the controls [4.75 mmol/L(4.53-4.98 mmol/L)] (Z=-13.994,P=0.000).The maximum area under curve (AUC),which was used to predict GDM with early pregnancy FPG,was 0.599 (95％ CI:0.582-0.617).Taking FPG 4.88 mmol/L as the cutoff value,the sensitivity was 0.523 and the specificity was 0.645.While taking FPG 5.10 and 5.60 mmol/L as the cutoff value,the sensitivity was 0.334 and 0.068,and the specificity was 0.811 and 0.983,respectively.When the FPG level ≤ 4.09,-4.60,-5.10,-5.60,-6.10 and ≥ 6.10 mmol/L,the GDM diagnostic rate gradually increased [8.5％(23/212),9.9％(335/3 379),12.3％(719/5 858),20.7％(359/1 734),40.2％ (78/194) and 52.5％ (21/40)] (x2=300.523,P=0.000).GDM diagnostic rate in FPG ≤ 4.09,-4.60,-5.10 and-5.60 mmol/L group were lower than that in FPG ≥ 5.60 but ＜6.10 mmol/L group and ≥ 6.10 mmol/L group (x2 were 67.242,164.680,128.125,37.860,55.843,76.856,58.589 and 23.484,all P=0.000) ; GDM diagnostic rate in FPG ≤ 4.09,-4.60,-5.10 mmol/L group were lower than that in FPG ≥ 5.10 but ＜5.60 mmol/L group (x2 were 22.877,113.717 and 78.040,all P=0.000); GDM diagnostic rate in FPG ≥ 4.09 but ＜4.60 mmol/L group was lower than that in FPG ≥ 4.60 but ＜5.10 mmol/L group (x2=11.803,P=0.001).When using abnormal fasting and postprandial OGTT level as GDM diagnostic criteria,the ratio of GDM in early pregnancy FPG level ≥ 5.60 but ＜6.10 mmol/L group and FPG ≥ 6.10 mmol/L group were higher than that of the FPG level ＜5.60 mmol/L group [50.0％ (39/78) and 71.4％ (15/21) vs24.1％ (346/1 436),x2 were 12.456 and 21.443,all P＜0.003].Conclusions Early pregnancy FPG level is not proper to be used as an early diagnostic tool of GDM.However,when early pregnancy FPG level is equal to or greater than 5.60 mmol/L,the incidence of GDM in late pregnancy will increase significantly.

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 discuss the application effect of real time ratio of patients and nurses in nursing human resource dynamic management.Methods Our hospital made full use of the information platform,inquiring the real time ratio of patients and nurses,in combination with mobile nurse library,implement dynamic vertical management of nursing human resources on the level of the hospital-wide nursing management.The overall manpower cost remained the same through internal reasonable adjustment to achieve the best configuration of human resources and met the clinical needs effectively.Results The running effect was satisfactory from July 2012 till now.All the mobile nurses allocated were 71 person-times and the satisfaction degree of patients increased to 97.96％ in the first half of 2013.Conclusions Application of real time ratio of patients and nurses shows good effect,which is worthy of wide application.

Objective To investigate the relationship between absent end-diastolic velocity (AEDV) in umbilical artery and perinatal outcome,and to explore the effect of termination time of pregnancy on perinatal outcome. Methods Data of thirty five pregnant women with AEDV admitted into Beijing Obstetrics and Gynecology Hospital from January 2008 to December 2009 were retrospectively analyzed.According to gestational age and treatment,they were divided into four groups.Group 1:AEDV was identified before 28 weeks without treatment (n=5); Group 2:AEDV was found before 28 weeks,and then was treated (n=13); Group 3:AEDV was found after 28 weeks,and was not treated (n=11); Group 4:AEDV was found after 28 weeks,and then was treated (n=6). Except for three patients in Group 2,all patients had complications.Data were presented by frequency,rate or mean±SD. Results Among the 35 patients,19 (54.3％) delivered and 23 living children were born.When AEDV was found,the gestational age was less than 28 weeks and the mean gestational age was (22.8 ± 2.2) weeks in Group 1,(24.2 ± 2.0) weeks in Group 2,however,the gestational age was over 28 weeks and the mean value was (30.9± 2.8) weeks in Group 3 and (29.5±0.8) weeks in Group 4.Treatment was given to women in Groups 2 and 4,but not in Group 1 and 3.In Group 1,one patient complicated with twin-twin transfusion syndrome; one with hemolysis,elevated liver enzymes and low platelet syndrome and placental abruption; three recovered after two weeks and babies survived.In Group 2,the termination time was (31.4 ± 5.5)gestational weeks and the duration of treatment was (10.7± 5.5) days.AEDV of six patients were not improved after treatment,among which five accepted induced abortion,one had preterm delivery.The rest six women underwent cesarean section and one term delivered.Babies survived except for one preterm neonate and one lost in follow-up.In Group 3,the termination time was (31.2 ± 2.9)gestational weeks.Five patients accepted artificial abortion for severe complications of mother or babies; the other six patients accepted cesarean section,among which one complicated with placental abruption and baby died.The rest five babies survived.In Group 4,the pregnancies were terminated at an average of (32.8±2.9) gestational weeks and the duration of treatment was (10.8±6.7) days.Two accepted induction after treatment and four recovered to normal after treatment and accepted cesarean section with four wellbeing babies. Conclusions Perinatal outcomes of patients with AEDV complicated with severe complications after active treatment might relate to the termination time.Some patients with AEDV without severe complications might recover spontaneously with good prognosis.

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.

Objective To study the clinical effects of breast-preserving surgery in early-stage breast cancer. Methods From March 2002 to March 2007, 27 cases of early-stage breast cancer were treated with breast-preser-ving surgery. The control group had 28 cases, treated with radical mastectomy. Survival rate and recurrence rate were observed. Results The short-term progress of breast-preserving surgery in early-stage breast cancer had no significant difference with that of radical mastectomy. Plastic effects of breast were satisfied. Conclusion Breast- preserving surgery in early-stage breast cancer had favorable effects both in progress and in plastic. Therefore, it is warranted for wide use.

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 observe the clinical efficacy and safety of herbs-partitioned moxibustion combined with curcumin in the treatment of Crohn's disease. METHODS:80 patients with mild and middle Crohn's disease were randomly divided into ob-servation group and control group with 40 patients in each group. Both groups were given western medicine treatment,such as sul-fasalazine;control group was additionally given curcumin,and observation group were given curcumin combined with herbs-parti-tioned moxibustion. 2 months later,Therapeutic efficacy,ADR and complications of 2 groups were observed after treatment. RE-SULTS:The total effective rate of control group and observation group were 87.50% and 95.00%,respectively;that of observa-tion group was better than that of control group,with statistical significance(P<0.05). The incidence of ADR in control group and observation group were 22.50% and 7.50% respectively;that of observation group was significantly lower than that of control group,with statistical significance(P<0.01). The incidence of complications in control group and observation group were 22.50%and 7.50%,respectively;that of observation group was significantly lower than that of control group,with statistical significance (P<0.01). CONCLUSIONS:The clinical efficacy of herbs-partitioned moxibustion combined with ccurcumin is effective in the treatment of Crohn's disease,and can reduce the incidence of ADR and complications.