Objective To evaluate the effect of IKAP(Information-Knowledge-Attitude-Practice) theory on twin pregnancy women′s psychological states, satisfaction and childbirth outcomes. Methods One hundred twin pregnancy women who had made registrations and antenatal examination were divided into the intervention group and the control group with 50 women in each group according to randorn digit table. The twin pregnancy women in the control group received routine antenatal examinations. In addition, the twin pregnancy women in the intervention group received a special health education with IKAP theory. The twin pregnancy women′s anxiety, depression, birth outcomes and satisfaction were measured and compared between the two groups. Results The score of Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) in the intervention group was 27.64±2.86 and 26.53±2.96 one week after delivery, significantly lower than those upon admission, 44.18 ±2.53 and 47.42 ±4.82, the difference was statistically significant (t=5.41, 4.49, P<0.01), also lower than those of the control group, 46.53±2.39 and 39.68±3.78, the difference was statistically significant (t=3.63, 6.82, P<0.01). No significant difference was seen in SAS and SDS scores between upon admission and one week after intervention in the control group (P>0.05). In the intervention group the rate of cesarean section was 29.17% (14/48), and the score of satisfaction was (9.01±0.78), they were also significantly higher than those of the control group, 53.06%(26/49), (7.82±1.44), the difference was significant (χ2=7.701, t=4.806, P<0.05). There were no significant differences in the delivery pregnancy week, volume of bleeding 2 hours postpartum and Apgar score between the two groups (P>0.05). Conclusions The IKAP theory on twin pregnancy women can decrease the anxiety, depression and the rate of cesarean section, and increase patient satisfaction.

Objective To investigate the relationship of thyroid hormones and serum lipid profile during Pregnancy. Methods 30 cases of healthy pregnant women were recruited in the study. The thyrotropin (TSH), free triiodothyronine (FT3), free thyroxine (FT4) and serum lipid profile were examined at 9 ~ 12, 14 ~ 17, 23 ~ 26 and 37 ~ 40 weeks of gestation and the correlations between them were analyzed. Results Positive correlation could be found between serum TSH and total cholesterol (CHOL), triglyceride (TRIG), low density lipoprotein cholesterol (LDL-C), ApolipoproteinA-I (APOA-I), ApolipoproteinB (APOB). Negative correlations could be found between serum FT3, FT4 and total cholesterol (CHOL), triglyceride (TRIG), low density lipoprotein cholesterol (LDL-C), ApolipoproteinA-I (APOA-I), ApolipoproteinB (APOB). And no correlation was found between serum thyroid hormones and high density lipoprotein cholesterol (HDL-C). Conclusion The thyroid hormones were closely related to serum lipid profile except of HDL-C.

Objective:To study the metabolism of high density lipoprotein cholesterol ( HDL-C ) and apolipoprotein A-Ⅰ( ApoA-Ⅰ) in different thyroid function status during pregnancy. Methods:This study re-cruited thirty cases of euthyroid, with nineteen cases of subclinical hypothyroid and eight cases of subclini-cal hyperthyroid pregnancy. The concentrations of fasting serum HDL-C and ApoA-Ⅰwere detected and ana-lyzed from 9-12, 14-17, 23-26, and 37-40 gestational weeks. Friedman repeated measures ANOVA on ranks was adopted to analyze the changes of serum HDL-C and ApoA-Ⅰat different stages. General line-ar model ( GLM) was adopted to analyze the differences of serum HDL-C and ApoA-Ⅰin different thyroid function status during pregnancy. Results:There were no significant differences of maternal serum HDL-C among different stages (χ2 =5. 428,P=0. 143,χ2 =2. 027,P=0. 567,χ2 =2. 885,P=0. 410). There were significant differences of serum ApoA-Ⅰduring euthyroid and subclinical hypothyroid pregnancies (χ2 =46. 343, P<0. 001,χ2 =35. 984, P<0. 001), and no significant difference during subclinical hyperthy-roid pregnancy (χ2 =6. 750, P=0. 080). There were significant differences of serum HDL-C and ApoA-Ⅰbetween euthyroid and subclinical hyperthyroid pregnancies (P=0. 025,P=0. 027), and no significant differences between euthyroid and subclinical hypothyroid pregnancies (P=0. 378,P=0. 549). Conclu-sion:Subclinical hyperthyroidism affected the metabolism of maternal serum HDL-C and ApoA-Ⅰ, which could affect the fetal growth and development. Subclinical hypothyroidism ( after treatment with drugs) had no obvious effect on the metabolism of maternal serum HDL-C and ApoA-Ⅰ.

Objective To investigate the mental health state of twin pregnancy women and influencing factors,so as to provide reference for measures to improve their mental condition.Methods Sixty twin pregnancy women who have made regular antenatal examination received the investigation of Self-Rating Anxiety Scale (SAS),Self-Rating Depression Scale (SDS) and self-designed questionnaire.Results The score of SAS for twin pregnancy women was (52.87±10.19) points,SDS was (50.61±4.31) points.There were significant differences in twin pregnancy women degree of anxiety with different age,gestational weeks,and pregnancy way and degree of depression with different gestational weeks,pregnancy way and abortion,reproductive history (F/t=12.74-54.93,P ＜ 0.05 or 0.01).Regression analysis showed that gestational weeks and pregnancy way were the main factors of anxiety and depression influencing twin pregnancy women.Conclusions The anxiety state of twin pregnancy women is in a moderate level,and the depression is mild.It is influenced by the factors of gestational weeks and pregnancy way.Some aspects should be improved:such as strengthen psychological care,establish standardized management model,twin pregnancy women are encouraged to self-control,the use of high qualification by social and family support system,and so on.

Objective To study the ultrasonographic characteristics of Wilms′tumor (WT), aims at elevating the diagnostic level.Methods We retrospectively studied sonographic features in 30 cases of WT proved by operation and pathology.Results The tumors with heterogeneous pattern of solid and cystic tissue were shown in 22 cases.Seven cases demonstrate predominantly echogenic tumor. A huge cystic mass with numerous septas was shown in 1 case. The tumor extended into renal pelvis in 4, into renal vine in 1.The tumor metastasized to lymphnod in 1, to bilateral lungs in 1. Among 30 cases, the tumor was huge and grew beyond the renal profile in 26 cases, in 3 cases the tumors took up the renal sinus and made its structure turbulence, the renal shape was approximately normal.One case was extrarenal WT,the tumor located in retroperitonemu.Conclusions Sonographically, typical WT is a large heterogeneous mass within or without cystic areas, it also can be a pure cyst. It is easy to diagnose. When the tumor is limited to renal outline, it is easy to confusion with renal cancer. In addition, there are bilateral WT and extrarenal WT. The sonographic characteristics is similar among WT, clear cell sarcoma of kidney, malignant rhabdoid tumor and congenital mesoblastic nephroma. It is difficult to distinguish them from ultrasonography.

Objective To evaluate the prevalence of low back pain in Chinese nurses.Methods We searched PubMed,Springer,OVID,CNKI,Wanfang,and VIP databases for relevant studies.Pooled estimates were summarized by meta-analysis.Results The pooled low back pain prevalence for all studies was 72％(65％～79％).We also obtained the estimates according to different study characteristics,such as working department,seniority,study published year and study quality.Conclusions The incidence of low back pain of Chinese nurses is high.The problem is more serious among nurses working in ICU,the longer the working years,the higher incidence of low back pain.

Objective To summarize the sonographic characteristics of Peutz-Jeghers syndrome in children and investigate the diagnostic value of ultrasound.Methods Retrospective analysis of sonographic characteristics of 19 cases with pathologically-confirmed Peutz-Jeghers syndrome were conducted.ResultsExcept for one child,other 18 patients all had more than one polyp with the maximum of sixteen.The polyp with the smallest size of 0.8 cm×0.5 cm×0.8 cm was found in left colic flexure,while the largest one was found in superior rectal with a measurement of 7.6 cm×2.7 cm×3.6 cm.The polyps showed radiatiform echotexture.And hypoechoic and hyperechoic components were present alternately.Blood flow was easily identified within these polyps by color Doppler sonography.Intussusceptions were observed in 11/19 patients.Among them,10 cases were located at small intestine.The sonographic finding was a concentric structure with a polyp at the top.Conclusions The sonographic appearence of Peutz-Jeghers syndrome is characteristic.Before surgery,ultrasonographic examination could achieve a accurate diagnosis for Peutz-Jeghers syndrome.

Objective To describe the sonographic appearance of mesenchymal hamartoma of the liver(MHL)and to analyze the diagnostic value of ultrasound.Methods Eleven surgically and pathologically confirmed cases of MHL from January 2005 to May 2011 in the Beijing Children′s Hospital were retrospectively reviewed.Results Ultrasound examinations showed 9 cystic hamartomas,including 7 multiseptate cystic and 2 monocystic lesions.Of the 7 multiseptate cystic hamartomas,4 had a honeycomb appearance and 3 had irregularly-distributed multiple cysts with varied septations.Of the 2 monocystic hamartomas,1 had a large cystic portion while the other was mainly solid with approximately 4% cystic portion of the tumor.Two cases in this group were solid,presenting with a well-defined homogenous mass.Conclusions Ultrasonography is an effective imaging modality for the diagnosis for MHL.A mixed or a mainly-cystic liver mass found in a child less than 2 years old should be suspicious for MHL.

Objective In order to get reference data for diagnosis of clinical genetic disease through analyzing chromosome ab‐normality types and rates in 885 patients who ask for cytogenetics consultation in recent years .Methods 324 newborns who asked for cytogenetics consultation because of high risk factors in down′s screening during pregnancy or found abnormality in physical ex‐amination after birth and 561 patients with history of spontaneous abortion ,infertility or fetal death ,growth or mental retardation , sexual abnormality were examined for karyotype analysis .Results 116 cases of chromosome abnormal karyotypes were detected , count for 13 .11% ,among which ,40 cases(34 .48% ) are chromosomal aberration .Chromosome abnormality types and rates are dif‐ferent in patients with different type of diseases .Conclusion Abnormalities in chromosome numbers and sex chromosome abnor‐mality account for the main causes of growth and mental retardation ,abnormalities of sexual differentiation and development ;but for couples suffered from spontaneous abortion ,polymorphism and structure abnormalities takes up the highest portion .

Objective To observe the effect of autophagy inhibitor on the activation of alcohol induced hepatic stel-late cells, and the mechanisms thereof. Methods HSC-T6 cells were cultured in vitro and divided into four groups, includ-ing blank control group, alcohol group, 5 mmol/L 3-MA+alcohol group (low alcohol group) and 10 mmol/L 3-MA+alcohol group (high alcohol group). RT-PCR was used to detect the expression levels ofα-smooth muscle actin (α-SMA) and typeⅠcollagen. The levels of LC3Ⅱ,α-SMA and typeⅠcollagen were detected by Western blot assay. The cell viability of HSC-T6 was detected by MTT assay. Results The mRNA expressions ofα-SMA, typeⅠcollagen and the protein of expressionsα-SMA, typeⅠcollagen and LC3Ⅱwere significantly up-regulated in alcohol group compared with those of control group (P<0.05), while the expressions of those parameters were significantly down-regulated in 10 mmol/L 3-MA+alcohol group (P<0.01). The mRNA and protein levels ofα-SMA and typeⅠcollagen were significantly decreased in two 3-MA-treated groups compared with those in alcohol group (P<0.05). Meanwhile, compared with the 5 mmol/L 3-MA+alcohol group,the protein expressions ofα-SMA, typeⅠcollagen and LC3Ⅱwere significantly decreased in10 mmol/L 3-MA+alcohol group (P < 0.05 ). Compared with the alcohol group,there was significantly lower proliferation activity in all two 3-MA-treated groups (P<0.05). Conclusion 3-MA can inhibit the protein expression of LC3Ⅱ,α-SMA and typeⅠcollagen induced by alcohol in HSC-T6 cells, and inhibit the proliferation of HSC cells.