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 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.

Aim The changes and characteristics of liver drug-metabolizing and antioxiditive functions in different status of hepatic injury was investigated to provide support for clinical drug treatments in hepatic fibrosis. Methods Carbon tetrachloride (CCl 4) and other mixture factors were used to make animal model of acute hepatic injury, hepatic fibrosis and cirrhosis, respectively. Subcelluar fractions of liver were prepared by differential centrifugation. Activities of drug-metabolizing and antioxidative enzymes were monitored. Results Levels of phase I enzymes-cytochrome P450 (CYP), CYP1A1 (7-ethoxyresorufin O-deethylation), CYP2E1 (aniline hydroxylation), CYP3A1/2 (erythromycin N-demethylation), and phase Ⅱ enzymes-glutathione S-transferase (GST) were reduced remarkably in hepatic microsomes in different hepatic injury status in a time-dependent manner. However, the activity of CYP2E1 came to be the lowest in acute hepatic injury and recovered gradually when injury time was prolonged. In hepatic fibrosis, the activities of CYP1A,CYP2E1,CYP3A and GST reached 68%,56%,81% and 59%, respectively, of the control, and the functions of antioxidative enzymes in cytosol GST,catalase(Cat) and glutathione peroxidase(GSH-Px) declined to 85%,76% and 54%, respectively, of the control. Conclusion The xenobiotic-metabolizing abilities in liver with hepatic fibrosis were distinctly decreased, which constantly relates with the degrees and the lengths of hepatic injury.

ObjectiveTo establish the reference value of inhibin-A in the serum of pregnant women with gestational age from 15 to 20+6 weeks in Guangdong province,and assess the efficiency of inhibin-A and quadruple test in Down syndrome screening.Methods A total of 2802 singleton pregnancies receiving triple test screening in Guangzhou Women and Children's Medical Center from March 2008 to December 2010 were included in this study.Inhibin-A was measured by automatic enzyme-linked immunosorbent chemiluminescence assay. The concentration of inhibin-A was expressed as multiples of the median (MoM),and adjusted with maternal weight and gestational age.Parameters of SURUSS were used to recalculate the risk of Down syndrome.The efficacy of single marker and combination were evaluated by receiver operating characteristic curve and the area under the curve. Results(1) In normal singleton pregnancies,the median concentration of inhibin-A was 286.60,267.10,249.10,243.40,242.30 and 256.60 pg/ml respectively for each week of gestational age from 15 to 20+6 weeks.The distribution of inhibin-A in each gestational week was relatively stable.The mean concentration [(852.83±370.04) pg/ml] and MoM (2.82) of inhibin-A in twelve pregnant mothers with Down syndrome fetuses were significantly higher than those without [(293.28±149.46) pg/ml (t=5.37,P＜0.05) and 1,respectively].(2) The detection rate was 83.3％ (10/12) by using the quadruple test including free human chorionic gonadotropin-β,alphafetoprotein,unconjugated estriol and inhibin-A at false positive rate of 5.8％; while when the detection rate of triple test including alpha-fetoprotein,free human chorionic gonadotropin-β and unconjugated estriol was 83.3％,the false positive rate was 7.7％.When the false positive rate was set to 5.0％,the area under the curve of inhibin-A,alpha-fetoprotein,free human chorionic gonadotropin-β and unconjugated estriol was 63.7％,20.5％,46.1％ and 4.8％,respectively,and the relative area under the curve of routine triple test and quadruple test was 45.5％ and 63.1％,respectively.ConclusionsInhibin-A is suggested to be the most effective marker used for secondtrimester screening,which could be used for second trimester Down syndrome screening in Chinese population combined with existing three markers.

Objective To investigate the effect of α-tocopherol on fibrosis of chronic pancreatitis (CP) rat and explore its mechanism.MethodsMale Wistar rats were randomly divided into control group,acute necrotizing pancreatitis (ANP) group,α-tocopherol group.CP was induced by dibutyltindich loride ( 8 mg/kg) infusion into the tail vein.Gastric lavage of α-tocopherol (800 mg/kg body weight,daily) was started 24 hours after dibutyhindich loride infusion for 4 weeks.The rats in ANP and control group received 0.6 ml salad oil gastric lavage.The rats were sacrificed 4 weeks later.Pancreatic tissue was harvested for histological examination and collagen staining,and measurement of the levels of hydroxyproline and malondialdehyde (MDA) of the pancreas were performed.The mRNA expression of transforming growth factor (TGF)-β１ was measured by real time PCR.ResultsAfter gastric lavage for 4 weeks,the pancreatic tissue inflammation,fiber deposition and abnormal structure in rats of α-tocopherol group were greatly reduced.The levels of MDA and hydroxyproline in rats of α-tocopherol group were significantly lower than those in ANP group [ (0.40 ±0.20) vs (1.07 ±0.41) nmol/100mg,(402.49 ±27.62) vs (664.92 ±29.04) μg/g,P＜0.05].The expressions of TGF-β1 mRNA in rats of o-tocopherol group were significantly lower than those in ANP group (2.24 ± 0.89 vs 3.35 ± 0.66,P ＜ 0.05 ).Conclusions Tocopherol gamma can improve pancreatic inflammation and fibrosis by reducing the oxidative stress level and down-regulating the expression of TGFβ1mRNA in rats with CP.

Objective: To provide basis for the preparation process study by establishing an HPLC determination method for nicotinate-curcumin ester.Methods: A C18 column(250 mm×4.6 mm,5 μm) was used at 30℃ with the mobile phase of acetonitrile-0.5% acetic acid glacial(65∶35) at a flow rate of 1.0 ml·min-1.The UV detection wavelength was 280 nm.Results: The good linear relationship of nicotinate-curcumin ester was shown within the range of 5.200-104.000 μg · ml-1(r=0.9999 4), The average recovery of nicotinate-curcumin ester and its nanoparticles was 100.1% and 100.9%with RSD of 1.260% and 0.995 0%(n=6), respectively.Conclusion: The method is convenient, accurate and reproducible, and suitable for the determination of nicotinate-curcumin ester nanoparticles and the studies on the preparation technology.

OBJECTIVE:To study the inhibition effect of spinosin on 7 subtypes (CYP2B6,CYP2C8,CYP2C9,CYP2D6, CYP1A1,CYP2C19 and CYP3A4)of cytochrome P450(CYP450)enzymes from human liver microsomes in vitro. METHODS:Tak-ing 200.00,100.00,50.00,25.00,12.50,6.25,3.13,1.56,0.78,0.39 μmol/L spinosin and human liver microsomes for incuba-tion,using daktarin,bupropion,amodiaquine hydrochloride,diclofenac sodium,mephenytoin,dextromethorphan hydrobromide and midazolam as the specific probe drugs for above-mentioned 7 subtypes of CYP450 enzymes. UPLC-Q-TOF-MS was conducted to detect generation amount of 7 probe drug metabolites,and the half inhibitory concentration (IC50) of spinosin on 7 subtypes of CYP450 enzymes from human liver microsomes was calculated. RESULTS:IC50 of spinosin on 7 subtypes of CYP450 enzymes from human liver microsomes were 1714,1158,226.1,2288,80.59,101.1,1119 μmol/L,respectively,which were higher than 50μmol/L. CONCLUSIONS:Spinosin has no inhibition effect on above-mentioned 7 subtypes of CYP450 enzymes from human liver microsomes,with very low probability of inducing metabolic drug interactions.

Objective To investigate the survival of patients with painful chronic panereatitis and evaluate the risk factors for mortality in these patients.Methods This was a historical cohort study,subjects ≥18 yr with painful chronic pancreatitis who were treated in our center from Feb.1997 to July 2007 were enrolled.A life-table method was used to estimate the probability of the cumulative survival rate.COX proportional-hazards model was used for multivariate analysis.Results Follow-up data were obtained from 346 patients (87.2%) with the ratio of male/female was 2.4:1.The age of first admission and first symptom onset was (47±14)years and (43±15 ) years.The mean follow-up period was ( 34.3±27.1 ) months.Alcoholic origin accounted for 22.2% of all the patients,while biliary origin was 26.0%.The overall mortality rate was 9.8% (34/346),which happened (62.5±61.1 ) months after abdominal pain was present.The causes of mortality included pancreatic cancer and cancers of other sites.The cumulative survival rate estimated at 2 years was 96.3%,at 5 years 93.6% and at 10 years 86.4%.COX proportional-hazards model suggested age at onset (≥51 years),no improvement of abdominal pain or increased frequency of pain,active smoking,and no diarrhea were associated with increased mortality,and the corresponding hazard rates (HR) were 3.4,3.5,4.2,2.8 and 17.7,respectively.Conclusions The mortality rate of painful chronic panereatitis in China was lower than those reported outside China.The main cause of mortality was pancreatic cancer.Great caution shall be placed on patients with age at onset ≥51 yr,no improvement of abdominal pain,increased frequency of pain,active smoking and no diarrhea.

OBJECTIVETo study the diagnosis and treatment of Colles fracture with dorsally dislocated ulna.

METHODSFrom July 2004 to November 2004, 20 cases of Colles fracture with dorsally dislocated ulna treated with supination-cast were evaluated.

RESULTSFractures were healed in all cases, and no recurrent dislocation was found in duration of 6 - 10 months follow up. Evaluation with Gartland and Werley score system showed that 100% of patient restored excellent function of wrist and forearm.

CONCLUSIONSSupination-cast is an effective option for the acute cases. Well understanding of this injury and early diagnosis are critical.

Adolescent ; Adult ; Aged ; Casts, Surgical ; Colles' Fracture ; complications ; surgery ; Female ; Follow-Up Studies ; Fracture Fixation ; instrumentation ; methods ; Humans ; Joint Dislocations ; complications ; surgery ; Male ; Middle Aged ; Wrist Injuries ; complications ; surgery

OBJECTIVETo evaluate the urodynamic characteristics of the chronic impairment of cauda equina caused by lumbar disk herniation.

METHODSClinical data and urodynamic parameters of 67 male patients with lumbar disk herniation were retrospectively analyzed. Lower urinary obstruction was excluded from the cohort using the Lin-PURR analysis. Patients were divided into group A (normal detrusor function), group B (detrusor underactivity) and group C (detrusor areflexia) according to the detrusor contraction function analyzed in Lin-PURR. Clinical data and urodynamic parameters were analyzed statistically between these groups.

RESULTSThe category of the detrusor contraction function had a significant effect on the urodynamic parameters. There were significant differences in the maximum flow rate (Q(max)), maximum pressure (P(max)), pressure at the maximum flow (P(det Qmax)) and post-voiding residual urine (PVR) among group A, B and C. There were significant differences in the first sensation volume of the bladder and the maximum cystometric capacity between group A and C, B and C, but no significance was found between group A and B. There was no significant difference in age, disease duration, and compliance of the bladder among 3 groups.

CONCLUSIONSUrodynamic study is important in exploring the severity of the chronic impairment of cauda equina caused by lumbar disk herniation. Detrusor areflexia and loss of bladder sensory indicate more severe degree of impairment of the cauda equine. Q(max) and PVR are helpful in early diagnosis of the chronic impairment of cauda equina.

Adult ; Aged ; Aged, 80 and over ; Cauda Equina ; Chronic Disease ; Humans ; Intervertebral Disc Displacement ; complications ; physiopathology ; Male ; Middle Aged ; Nerve Compression Syndromes ; etiology ; physiopathology ; Retrospective Studies ; Urodynamics