Objective To investigate postpartum family visits to the parturients in communities.Method Eighty six post-natal parturient women took part in the investigation by using a self-designed questionnaire.Results 57.0%of them received one postpartum visit and the visit time ranged between 15~30 min.72.1%of visits were about check of the wounds and lochia;23.3%of visitors were from milk companies.74.4%of mothers thought that the visitors lacked of professional knowledge.47.7%of them thought the visits lacked of professional content.24.4%of them thought that the visits were not in time.Conclusion Enriching the knowledge of postpartum care,updating visitors' knowledge,enriching the contents of health care and standardizing visit management are of importance for the increase of visits.

Objective To investigate the effect of maternal exposure to bisphenol A(BPA) via drinking water on body weight of immature offspring during pregnancy and lactation. Methods The pregnant female ICR mice were exposed to BPA groups(2. 282 9,22. 829 0,228. 290 0 μg/L) by drinking water from gestational day(GD)0 till postnatal day (PND)21,water and dimethyl sulfoxide(0. 01%) were served as blank and vehicle control. Maternal body weight was recorded every three days during pregnancy. Weight of pups per litter was measured every three days during lactation. Body weight of offspring was taken notes every week till PND 42 after delactation. ResultsThere was no significant difference in pregnant maternal body weight, average numbers and body weight of pups per litter preweaning among all groups. The offspring weight of the high-dose group at PND 42 was increased compared with control groups(P<0.05). The weight of female offspring was not significantly different among all groups at PND 28~42. The male offspring weight of the middle/high group at PND 35 and all groups at PND 42 significantly was elevated(P<0.05,P<0.01),and the high group was most significant. Conclusion Body weight of immature offspring is affected,especially male offspring after delectation by pregnant and lactational BPA exposure.

The effect of Selenium(Se) on regression of atherosclerosis(AS) induced by feeding quails -with high cholesterol diet was observed. The result indicated that serum cholesterol, triglyceride and lipid peroxide significantly decreased and the ratio of high density lipoprotein cholesterol/total cholesterol increased markedly in Se treated group, that the cholesterol content of aortic tissue and AS index were significantly reduced at the end of the 15th week. It was suggested that Se had a powerful accelerated effect on regression of experimental AS.

Objective To explore the incidences of postpartum depression as well as the influencing factors in Guangzhou.Method Nine hundred and seventy women participated in the investigation with the Edinburgh postnatal depression scale(EPDS)to analyze the influenceing factors.Results The incidence rate was 38.87%(377/970). The influencing factors included age,feeding mode,delivery mode and education level.Conclusions The incidence of postpartum depression is at a higher level.The feeding mode,delivery mode and education level are the influencing factors.

Objective To study the apoptotic induction of Aspisol on melanoma A375 cells.Methods The growth inhibition effect of Aspisol on A375 cells was evaluated by MTY assay.Morphological assay was observed by inverted microscope.Early apoptofic rate in A375 cells Was anyzed by flow cytometry.Results The results of MTT assay demonstrated that the growth of A375 cells was inhibited by Aspisol in a time-and concentration-dependence (P＜0.01).FCM analysis showed that Aspisol could markedly induce apeptosis;the early apoptotie rate of A375 cells exposed to different concentrations of Aspisol for 24 h were significant differences(P＜0.05)compared with control group.Conclusion Aspisol could inhibit proliferation and induce apoptosis of A375 cells.

Objective To evaluate the effect of global end diastolic volume index (GEDVI) on fluid resuscitation in elderly patients with septic shock. Methods A prospective randomized controlled trial (RCT) was conducted. Septic shock patients over 65 years admitted to intensive care unit (ICU) of Shandong Province, Zibo Central Hospital from January 2013 to December 2015 were enrolled. The patients were randomly divided into control group and observation group, 20 cases in each group. In accordance with the guidelines for the treatment of septic shock, early goal-directed therapy (EGDT), rehydration in the control group was treated with the guide of central venous pressure (CVP); observation group was received pulse indicator continuous cardiac output (PiCCO) monitoring, and rehydration was treated according to the GEDVI and extravascular lung water index (EVLWI), i.e. GEDVI was maintained in 650-800 mL/m2, EVLWI was not obviously increased compared with the basic value and without the emphasis of CVP. Initial acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score, sequential organ failure score (SOFA), procalcitonin (PCT), mean arterial pressure (MAP), lactic acid (Lac) and oxygenation index (PaO2/FiO2); serial Lac, central venous to arterial carbon dioxide pressure (Pcv-aCO2), fluid balance, the amount of noradrenaline accumulation, PaO2/FiO2 after 6, 24 and 48 hours resuscitation; mechanical ventilation time, incidence of acute heart failure, ICU hospitalization time and 28-day mortality were recorded. Results There was no significant difference in gender,age, APACHE Ⅱ score, SOFA score, primary disease, infection site and basal PCT, MAP, Lac, PaO2/FiO2 between the two groups. Compared with the control group, 6 hours Lac, Pcv-aCO2 recovery, positive fluid balance, noradrenaline accumulation and PaO2/FiO2 of the observation group showed no significant difference; positive fluid balance 24 hours in the recovery was significantly reduced (mL: 2919.80±986.44 vs. 3991.40±933.53), Pcv-aCO2 significantly decreased [mmHg (1 mmHg = 0.133 kPa): 5.55±1.43 vs. 7.10±2.38], PaO2/FiO2 significantly improved (mmHg: 194.80±28.57 vs. 177.65±23.46), and noradrenaline accumulation was increased significantly (mg: 40.99±20.69 vs. 27.31±19.34) with statistically significant difference (all P < 0.05); the blood level of Lac 48 hours in the recovery was significantly decreased (mmol/L: 1.16±0.89 vs. 1.85±1.01), Pcv-aCO2 (mmHg: 5.35±1.18 vs. 6.70±2.34), and PaO2/FiO2 (mmHg: 215.75±33.84 vs. 190.60±32.89) were further improved, the positive fluid balance was significantly reduced (mL: 3141.55±1245.69 vs. 4533.85±1416.67, all P < 0.05). Compared with the control group, mechanical ventilation time (days: 3.65±1.31 vs. 4.50±1.19), ICU hospitalization time (days: 5.80±1.67 vs. 7.15±2.30) was significantly shorter in the observation group (both P < 0.05), acute heart failure rate was decreased significantly (5.0% vs. 30.0%, P < 0.05), but the 28-day mortality showed no statistical significance (25.0% vs. 40.0%, P = 0.311). Conclusions Compared to the conventional EGDT methods, fluid resuscitation under the guidance of GEDVI in elderly patients with septic shock with less liquid loading, can achieve better oxygenation and reduce heart failure, shorten the duration of mechanical ventilation and ICU stay, and play an important significant guidance for elderly patients' fluid resuscitation with septic shock.

OBJECTIVE To explore the safe and effective dose of sirolimus (Rapamycin,Sir) and its effect on seizure comorbidities. METHODS Immature C57BL/6 mice at postnatal 10 d of age were administered with kainic acid(KA) 12.0 mg · kg-1 intraperitoneally by a single injection to induce acute seizure. Sir 0.3, 1.0 and 3.0 mg · kg-1 was injected 24 h after seizure every other day until 3 d, 1 week, 3 weeks, 5 weeks and 6 weeks. Western blotting analysis was used to detect the expression and phos?phorylation level of S6 protein and to determine the minimum effective dose of Sir. Effect of the mini?mum effective dose of Sir on cognitive function and body growth was observed by several evaluations. Immunofluorescent intensity of Doublecortin (DCX) immunofluorescent staining was conducted to evaluate the development of neurons in the hippocampus. Morris water maze was used to assess the cognitive function. Tail suspension test, O maze and new object recognition test were used to study the anxiety-like behaviors of mice. RESULTS The result of Western blotting showed that Sir 0.3 mg · kg-1 had no significant effect on the phosphorylation of S6 protein in normal mice or KA mice, whereas 1.0 and 3.0 mg · kg- 1 could significantly inhibit the phosphorylation of S6 protein in KA mice (P<0.05). Sir 1.0 mg·kg-1 had no obvious effect on DCX-positive cells or body wass. Morris water maze showed that KA-induced seizure resulted in prolonged escape latency and swimming length (P<0.05), and a decreased crossing number of target quadrant (P<0.05). Sir 1.0 mg·kg-1 significantly reversed the deficit of cognitive function of KA-induced seizure mice (P<0.05), whereas no significant difference was found between Sir group and normal control group. Compared with normal control group, model group showed increased freezing time in tail suspension test (P<0.05), decreased migration length and reten?tion time in open arms in O maze (P<0.05), decreased retention time and touch frequency with new objects, migration length and average speed in new object recognition test (P<0.05). Sir 1.0 mg · kg-1 significantly reversed the above anxiety and depression status, whereas no significant difference was found between sirolimus group and normal control group. CONCLUSION Sir 1.0 mg · kg-1 inhibits the abnormal activation of mTOR pathway and the formation of epilepsy comorbidity in immature mice. Along with its mild side effect in development, Sir 1.0 mg · kg-1 will be an ideal dose to be used in the treatment of seizure in immature mice.

ObjectiveTo investigate the anxiety and its interrelated factors of elderly outpatients. MethodsZung self-rating anxiety scale was used to evaluate 971 elderly outpatients, the scores between different sex, age, degree of education, etc. were compared. ResultsThe scores may become significantly different with the patients' sex, age, degree of education, satisfaction in regards to medical service and recognition of the disease(P<0.05).ConclusionFactors such as sex, age, degree of education, satisfaction of medical service, etc, deeply affect the anxiety in elderly outpatients.

ObjectiveTo explore the correlation between angiotensin converting enzyme (ACE) gene polymorphism and hypertension accompanying atherosclerosis in Li people in Hainan province. MethodsTwo hundred and sixty patients with hypertension accompanying atherosclerosis were selected as hypertension plus atherosclerosis group, while two hundred and seventy-six healthy people were regarded as healthy control group. ACE I/D gene polymorphism was detected by polymerase chain reaction (PCR), and the genotype frequencies and allele frequencies of DD, DI and Ⅱ were investigated. The carotid intimal-medial thickness(IMT)was measured by high-resolution ultrasound technique and mean IMT (MIMT) was calculated. Results(1) In the hypertension plus atherosclerosis group, the genotype frequencies of DD, DI and Ⅱ were 15.0%, 37.3%, 47.7%,respectively, and the allele frequencies of D and I were 33.70% and 66.30%, respectively. In the healthy control group, the genotype frequencies of DD, DI and Ⅱ were 17.8% , 40.6% and 41.7%,respectively, and the allele frequencies of D and I were 38.0% and 62.0%, respectively. There were no significant differences both in the genotype frequencies of DD, DI and Ⅱ, and in allele frequencies of D and I between the two groups (P>0. 05). (2) The age,total serum cholesterol(TC),triglyceride (TG), systolic pressure(SBP), diastolic pressure(DBP), apolipoprotein A(apoA) and apolipoprotein B (apoB) levels were significantly higher in the hypertension plus atherosclerosis group than in the control group(P<0. 05). The high density lipoprotein cholesterol(HDL-C) level was significantly lower in the hypertension plus atherosclerosis group than in the control group(P<0. 05). Logistic regression analysis showed that TG (OR = 2.14), apoA(OR = 360. 39), SBP(OR = 1.21), DBP (OR=1.08) and ACE DD genetype (OR = 0. 30) had correlation with hypertension plus atherosclerosis(all P<0. 05). The MIMT level was significantly higher in ACE DD subset than in DI and Ⅱ subset (P<0.05). ConclusionsThe ACE DD genotype increases the susceptibility of carotid atheroselerosis, which is the risk factor for hypertension accompanying atherosclerosis in Li people in Hainan province. It may be an early predictive factor in atherosclerosis.

Objective:To observe the application effect of formative evaluation of embedded standard patient (SP) on internal medicine practice teaching.Methods:In this study, 110 students from our school in Batch 2014 who were interned in the internal medicine of the same affiliated hospital were selected as the research objects, and they were randomized into the experimental group and the control group, with 55 students in each group. The control group was trained with traditional clinical practice teaching methods. The experimental group used SP combined mini-clinical evaluation exercise (Mini-CEX) to participate in the evaluation during the clinical practice teaching of internal medicine. After the internal medical practice, the two groups of students were evaluated by Mini-CEX, and the teaching effect of both groups was evaluated through questionnaires.Results:There was no significant difference in the degree of difficulty in the examinations ( P>0.05), but the test scores of the experimental group were significantly higher than those of the control group. The results of Mini-CEX used in inquiry skills, physical examination, humanistic care, and organizational effectiveness were significantly higher in the experimental group than in the control group. The experimental group was highly satisfied with the formative evaluation of SP participation in improving the effect of internal medicine practice, with statistical significance ( P<0.05). Conclusion:The formative evaluation with SP participation in this study can improve the clinical practice teaching effect of medical students to a certain extent.