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 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.

Objective To analyze the changes of cesarean section rate (CSR) and indications of cesarean section (CS) after implementation of responsible system of attending physician (RSAP) and new partogram.Methods Totally,11 814 women,who delivered in the Department of Obstetrics,Beijing Obstetrics and Gynecology Hospital,Capital Medical University in the fourth quarter of 2012,2013 and 2014,were chosen.The mode of delivery,CSR,CS indications and matemal and fetal outcomes of these women were analyzed with Chi-square test.The RSAP was started in 2013,and both RSAP and the new partogram were applied in 2014 in our hospital.Results The CSRs in the fourth quarter of 2012,2013 and 2014 were 46.4％(1 502/3 235),40.4％(1 524/3 770) and 33.5％(1 612/4 809) (x2=138.312,P＜0.05),and the converting CSR in the delivery room were 10.9％(212/1 945),7.8％(189/2 435) and 6.1％(208/3 414),respectively (x2=39.765,P＜0.05).The proportion of assisted vaginal delivery in the fourth quarter of 2014 was higher than those of the former two years [4.9％(237/4 809) vs 3.4％ (108/3 235) and 3.5％(131/3 770),x2=17.041,P＜0.05].More and more CS deliveries emerged due to scarred uterus,multiple pregnancy,comorbidities and complications during pregnancy year by year,while those CS deliveries because of macrosomia,narrow pelvis,social factors,elderly primipara,umbilical cord entanglement,precious fetus and high myopia gradually decreased (all P＜0.05).In the fourth quarter of 2014,the proportions of CS with fetal distress,abnormal labor,cephalopelvic disproportion and intrauterine infection were lower than those in 2013 (all P＜0.05).No significant difference was shown in the proportion of postpartum hemorrhage and neonatal asphyxia among the three years (both P＞0.05).In 2014,smaller percentage of neonates were transferred to the Pediatrics Department after birth than in 2012 and 2013 [10.2％(491/4 809) vs 12.0％(388/3 235) and 13.7％(516/3 770),x2=24.681,P＜0.05].Conclusions The implementation of RSAP and the application of new partogram effectively reduce the CSR through strict control on indications of CS.

ObjectiveTo investigate the effect of preoperative sleep disturbance on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.MethodsNinety-six ASA Ⅰ or Ⅱ patients of both sexes aged 20-60 yr weighing 50-80 kg undergoing endoscopic nasal surgery were enrolled in this study.Pittsburg sleep quality index was used to evaluate long-term sleep quality before hospitalization and Athens sleep quality index was used to evaluate short-term sleep quality in hospital.The patients were divided into 4 groups according to the types of preoperative sleep disturbance ( n =24 each):group Ⅰ no sleep disturbance;group Ⅱ long-term sleep disturbance; group Ⅲ acute short-term sleep disturbance; group Ⅳ long-term + acute short-term sleep disturbance.Anesthesia was induced with sufentanil,propofol and cis-atracurium and maintained with iv infusion of remifentanil and propofol.The patients were intubated and mechanically ventilated.PETCO2 was maintained at 30-35 nun Hg.Controlled hypoteasion was performed with nicardipine,MAP was maintained at 50-70 mm Hg and HR at 60-90 bpm during operation.The patients received iv flurbiprofen 50 mg at 15 min before the end of operation for postoperative analgesia.When VAS score was more than 3 during the fnrst 6 h after operation,flurbiprofen 50 mg was given iv as rescue analgesic.ResultsThe incidence of rescue analgesic administered after operation was significantly larger in groups Ⅱ,Ⅲ and Ⅳ than in group Ⅰ,and in group Ⅳ than in groups Ⅱ and Ⅲ.There was no significant difference in the incidence of rescue analgesic administered during the first 6 h after operation between groups Ⅱ and Ⅲ.ConclusionPreoperative sleep disturbance has adverse effect on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.

Objective:To analyze the detection of gallbladder polyps among shift nurses in Shengjing Hospital of China Medical University in physical examination and its related influencing factors, so as to provide scientific basis for shift nurses to prevent gallbladder polyps.Methods:A total of 1 119 shift nurses who had physical examination in Shengjing Hospital of China Medical University from January 1 to March 31, 2018 were selected. The patients with gallbladder polyps diagnosed by ultrasound were included in the case group, and those without gallbladder polyps were taken as the control group. Age, gender, body mass index (BMI), night shift frequency, education level, Department, meal regularity, drinking history, smoking history, serum triglyceride, serum total cholesterol, hepatitis B surface antigen, serum alanine aminotransferase and serum aspartate aminotransferase levels were compared between the two groups.Results:Univariate analysis showed that age ( P<0.001), gender ( P=0.028), BMI ( P=0.005), night shift frequency ( P=0.021) were the factors with statistically significant difference between the case group and the control group. There were no statistically significant differences between the case group and the control group in terms of education level, department, dining regularity, drinking history, smoking history, hepatitis B surface antigen, serum triacylglycerol, serum total cholesterol, serum alanine aminotransferase, serum aspartate aminotransferase levels ( P>0.05). Logistic regression analysis showed that age, BMI and night shift frequency were the influencing factors in the regression equation ( P<0.05). Conclusion:Age, BMI and night shift frequency may be related risk factors of gallbladder polyps in shift nurses.

Objective To investigate the effect of smoking on large arterial stiffness in patients with essential hypertensive.Methods The aortic,carotid and brachial arterial dimension,intimal-medial thickness were determined by vascular ultrasound technique.Wall cross sectional area and indices of compliance and distensibility were calculated in essential hypertensive patients with smoking(n=75) or without smoking(n=70).Results Hypertensive patients with smoking have increased wall intimal-medial thickness and wall cross sectional area in aortic,carotid and brachial arteries associated with decreased compliance and distensibility.After adjusting for the confounding effects of other variables including Age,BMI,HR,BP,PP,FPG,LDL-C and TG,covariance analysis show smoking remained as predisposed factors for vascular remodeling.Conclusion Smoking aggravates large arterial stiffness in essential hypertensive patients.

Objective To investigate the effects of preoperative sleep disturbance on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.Methods Ninety-six ASA Ⅰ or Ⅱ patients of both sexes (aged 20-60 years and weighing 50-80 kg) undergoing endoscopic nasal surgery were enrolled in this study.Pittsburg sleep quality index was used to evaluate the long-term sleep quality before hospitalization and Athens sleep quality index was used to evaluate the short-term sleep quality in hospital.The patients were divided into four groups according to the types of preoperative sleep disturbance (n =24 each):no sleep disturbance (group Ⅰ),long-term sleep disturbance (group Ⅱ),acute short-term sleep disturbance (group Ⅲ),and long-term + acute short-term sleep disturbance (group Ⅳ).Anesthesia was induced with sufentanil,propofol and cis-atracurium and maintained with intravenous infusion of remifentanil and propofol.Then the patients received endotracheal intubation and mechanical ventilation.The end-tidal pressure of carbon dioxide was maintained at 30-35 mm Hg.Controlled hypotension was performed with nicardipine,and the mean arterial blood pressure was maintained at 50-70 mm Hg and heart rate at 60-90 bpm during operation.The patients received intravenous injection of flurbiprofen 50 mg 15 minutes before the end of operation for postoperative analgesia.When the visual analogue scale score was more than 3 during the first 6 hours after operation,flurbiprofen 50 mg was given intravenously as rescue analgesia.Results The incidence of rescue analgesia administered after operation was significantly greater in groups Ⅱ,Ⅲ and Ⅳ than in group Ⅰ,and greater in group Ⅳ than in groups Ⅱ and Ⅲ.There was no significant difference in the incidence of rescue analgesia administered during the first 6 hours after operation between groups Ⅱ and Ⅲ.Conclusion Preoperative sleep disturbance has adverse effects on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.

OBJECTIVE:To establish the quality creteria of Dendrobium denneanum cultivated in Sichuan.METHODS: The reference substance had been isolated and identified.HPLC and TLC were applied for determination and identification respectively.RESULTS: The coumarin control had been successfully isolated and the TLC spots were clear.The linear range of coumarin was 0.096～0.480 ?g with an average recovery of 99.1%(RSD=1.44%,n=6).CONCLUSION: The results can overall reflect the internal quality of D.denneanum cultivated in Sichuan and provide basis for quality evaluation and development of D.denneanum from Sichuan.

OBJECTIVE:To study the chemical constitutes of Ligusticum chuanxiong and to establish the method for the content determination of ligustilide. METHODS:The compounds were extracted and percolated by ethanol. Then the samples were separated using silica gel and identified by 1H-NMR,13C-NMR data.HPLC was used to assay the contents of ligustilide. RESULTS:Three compounds were isolated and their structures were identified as Z-ligustilide,Z-6,8',7,3'-diligustilide and Z,Z'-6,6',7,3'a-diligustilide. The contents of ligustilide were no less than 0.70%.CONCLUSION:The separation method can be used to prepare high-purity ligustilide reference substance. And the determination method can be used for quality control of L. chuanxiong.

Objective To explore the clinical significance of preserving the intercostobrachial nerve (ICBN) in the radical resection of breast cancer. Method All of 140 cases of breast cancer with Ⅰ - Ⅲ a stage operable eligible,were randomly divided into the experimental group with 79 cases (7 cases were rejected, 1 case was lost) that patients received radical resection of breast cancer with preservation of ICBN,and the control group with 61 cases (2 cases were lost) that patients received routine radical resection of breast cancer based on the time of admission. Analyzed postoperative local recurrence and compared to sensory dysfunction of the two groups. Results There was no significant difference between the two groups of patients in the rate of postoperative local recurrence [0-4.2% ( 3/71 ) vs. 0-3.4% (2/59)] ( P ＞ 0.05 ). The local sensory disturbance of the experimental group [2.8% (2/71 )-11.3% (8/71)] was significantly lower than the control group [54.2%(32/59)-71.2%(42/59)], there was significant difference between the two groups (P ＜ 0.01 ). Conclusion Radical resection of breast cancer with preservation of ICBN is an ideal operation in breast cancer.