OBJECTIVE To explore clinical results of fat liquefaction of incision wound following cesarean section for obese pregnant women.METHODS Totally 300 obese pregnant women with cesarean section were randomly divided into three groups: group A,iodine(PVP-Ⅰ) group(using PVP-Ⅰ(0.5%) after suturing the abdominal rectus sheath);group B(normal saline group);group C(control group without any liquid).All patients were preoperatively used antibiotics to control the infection.The rate of puerperal morbidity,white cell count and wound infection were observed.RESULTS All parameters of group A were lower than group B or C.There were significant differences among three groups(P

Objective To explore the perinatal outcome of vaginal birth after cesarean (VBAC) in women with advanced age.Methods Totally 2 587 women delivered after one or two prior cesarean sections (gestational age≥28 weeks) in the First Affiliated Hospital of Kunming Medical University from July 2013 to February 2017.909 trial of labor after cesarean(TOLAC) cases of singleton pregnancy with one prior cesarean section were studied retrospectively.According to the age,of the 909 TOLAC cases,237 were the advanced age group,and 672 cases were the low age group.The maternal and neonatal outcomes between the two groups were compared.Results The percentage of TOLAC in women with advanced age was 32.4％ (237/731),and VBAC rate was 88.2％ (209/237).The percentage of TOLAC in younger women was 36.2％ (672/1 856),and VBAC rate was 82.4％ (554/672).The difference of the TOLAC rate between the two groups was not significant (P＞0.05),and the VBAC rate of the advanced age group was higher than the low age group (P＜0.05).In the comparison of the two groups,the proportion of bachelor degree or above(55.7％,132/ 237),the prepregnancy BMI (22.4±3.0) kg/m2,pregnant interval time (68.5±38.3) months,the proportion of gestational hypertension (8.4％,20/237),the proportion of gestational diabetes(34.6％,82/237) and the rate of the neonatal ICU admission (18.1％,43/237) in the advanced age group were higher than those of the low age group (P＜0.05),respectively.And there were no significant differences in the rate of postpartum hemorrhage,the rate of postpartum hemorrhage≥1 500 ml,the rate of postpartum transfusion,puerperal morbidity,neonatal birth weight,neonatal 5 min Apgar score＜7 score,umbilical artery blood pH＜7.0,neonatal tracheal intubation and respiratory distress syndrome (all P＞0.05).In all TOLAC cases,the rate of uterine rupture was 0.11％(1/909) and there was no maternal and neonatal death.Conclusion VBAC is a safe and feasible way of delivery for singleton pregnancy after one prior cesarean section in women with advanced age.

OBJECTIVE:To establish a method for the simultaneous determination of chlorogenic acid,vitexin glucoside,vi-texin rhamnoside,vitexin,rutin and hyperoside in Crataegus pinnatifida. METHODS:With reference peak of vitexin glucoside, HPLC was conducted to calculate the relative correction factor(RCF)of chlorogenic acid,vitexin glucoside,vitexin rhamnoside, vitexin,rutin and hyperoside,then the contents of above-mentioned 5 components in C. pinnatifida were calculated. The column was Agilent ZORBAX SB C18 with mobile phase of 0.1% formic acid-acetonitrile-tetrahydrofuran (gradient elution) at a flow rate of 1.0 ml/min,the detection wavelength was 350 nm,column temperature was 30 ℃,and the injection volume was 10 μl. RE-SULTS:The linear range was 12.50-400.0 μg for chlorogenic acid(r=0.999 8),25.00-800.0 μg for vitexin glucoside(r=0.999 9), 31.25-1 000.0 μg for vitexin rhamnoside(r=0.999 9),6.470-260.0 μg for vitexin(r=0.999 9),2.50-80.0 μg for rutin(r=0.999 8) and 9.375-300.0 μg for hyperoside(r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 2.0%;re-coveries were 99.2%-103.9%(RSD=1.6%,n=6),97.9%-100.8%(RSD=1.2%,n=6),99.2%-100.8%(RSD=0.5%,n=6), 97.3%-101.3%(RSD=1.5%,n=6),98.0%-103.0%(RSD=1.9%,n=6)and 95.5%-101.5%(RSD=2.2%,n=6). RCFs of vitex-in glucoside with chlorogenic acid,vitexin rhamnoside,vitexin,rutin and hyperoside were 1.119,1.009,0.706,1.063 and 0.830, respectively. CONCLUSIONS:The method is simple with good precision,stability and reproducibility,and it can be sued for the simultaneous determination of 6 components in C. pinnatifida.

Objective Type 2 diabetes mellitus ( T2DM) as a common disease around the world becomes a great threat to the health of human beings.The cynomolgus T2DM model, which preferably simulates human T2DM onset and progress, can be beneficial to the drug development and clinical treatment.In the present study, 37 of T2DM-susceptibility SNPs and the extended genome sequences were used to obtain corresponding SNPs in the T2DM cynomolgus monkeys. Methods Firstly, DNA pool screening was conducted.Then, using polymerase chain reaction to amplify and to sequence the cynomolgus homologous sequences.Using DNAStar software to analyze the differences between bases.Finally, we used analysis of variance and F test to calculate the frequency of alleles.We also used the GLM models of SAS software to analyze the association of genotype with fasting plasma glucose and glycosylated hemoglobin.Results SNP661A,SNP661B, SNP343A, SNP343B, SNP343C, SNP565A, SNP565B and SNP565C were found to have a significant difference of allele frequencies between spontaneous cases and controls.Conclusions The findings of this study suggest that SNP661A, SNP661B, SNP343A, SNP343B and SNP343C may play an important role in the establishment of cynomolgus T2DM models.

To evaluate the effects of Xiayuxue Decoction, a compound traditional Chinese medicine, on liver angiogenesis in rats with carbon tetrachloride (CCl(4))-induced liver fibrosis.

Acute respiratory infection is a common infectious diseases in children.Rapid and accurate identification of pathogens is critical for targeted treatment and prognosis.Therefore, taking sensitive and effective detection methods is the key to pathogenic diagnosis.Now, the progress in the application and research of detection for respiratory pathogens in children were reviewed.

Objective:To explore the effect of training and management based on cognitive conflict on nursing ability and adverse events of nurses in Department of Interventional Therapy.Methods:Using the convenient sampling method, 90 nurses in the Department of Interventional Therapy of three Class Ⅲ Grade A hospitals in Shanxi Province from January to October 2021 and 170 patients with interventional therapy admitted to three Class Ⅲ Grade A hospitals in Shanxi Province from February 2020 to October 2021 were selected as the research object. The patients admitted before the implementation of personnel training and management based on cognitive conflict from February to December 2020 were set as the control group, and the patients admitted after the implementation of personnel training and management based on cognitive conflict from January to October 2021 were set as the research group, with 85 cases each. We compared the theoretical knowledge, nursing skills, clinical strain ability and critical thinking ability of nurses before and after the implementation of personnel training and management based on cognitive conflict, as well as the occurrence of adverse events and nursing satisfaction of patients.Results:Three and six months after the implementation of personnel training and management based on cognitive conflict, the scores of intervention theoretical knowledge, nursing skills, clinical strain ability and critical thinking ability of nurses were higher than those before the implementation, and the scores in six months after the implementation were higher than those in three months after the implementation, with statistically significant differences ( P<0.05) . The total incidence of adverse events in the research group was 11.76% (10/85) , which was lower than 23.53% (20/85) in the control group with a statistical difference ( P<0.05) . The patient satisfaction of the research group was 95.29% (81/85) , which was superior to 85.88% (73/85) of the control group, with a statistically significant difference ( P<0.05) . Conclusions:The implementation of personnel training and management based on cognitive conflict in the Interventional Therapy Department can improve the quality of nursing service of nurses, reduce the risk of adverse events, and increase patient satisfaction, which is worthy of clinical application.

Objective:To investigate the application value of 0.9% sodium chloride injection for a balloon catheter in bedside Doppler ultrasound-guided percutaneous dilatational tracheostomy in critically ill patients.Methods:A randomized controlled study was conducted involving 54 critically ill patients who were scheduled for tracheostomy at the Intensive Care Medicine, Jilin Province People's Hospital, from September 2022 to April 2024. These patients were randomly divided into a conventional group ( n = 27) and an ultrasound group ( n = 27) using the random number table method. The conventional group underwent empirical extubation, while the ultrasound group received extubation guided by a balloon catheter filled with 0.9% sodium chloride injection under ultrasound guidance. The following parameters were observed in both groups: duration of operation, incidence of blood oxygen saturation < 90%, incidence of puncturing the endotracheal tube or balloon catheter, distance from extubation site to the incisors, dosage of propofol, length of incision, and amount of bleeding. Results:Both groups of patients successfully completed the procedure on the first attempt, with no significant complications such as extensive bleeding, vascular injury, thyroid damage, or pneumothorax. In the ultrasound group, the incidence of puncturing the endotracheal tube or balloon catheter, duration of operation, and dosage of propofol were 3.7% (1/27), (6.2 ± 1.4) minutes, and 40 (40, 40) mg, respectively, all of which were superior to those in the conventional group [48.1% (13/27), (9.8 ± 2.7) minutes, 80 (70, 80) mg, χ2 = 23.19, t = 6.11, Z = -6.29, all P < 0.05]. The incidence of hypoxemia in the ultrasound group was 0, which was significantly lower than that in the conventional group [29.6% (8/27), P < 0.05]. The distance from extubation site to the incisors in the ultrasound group was 18 (17, 18) cm, which was significantly different from 18 cm of the conventional group ( Z = -2.62, P < 0.05). There were no statistically significant differences in length of incision and amount of bleeding between the two groups ( P = 0.652, 0.878). Conclusion:Performing PDT under bedside Doppler ultrasound guidance with a 0.9% sodium chloride injection-filled balloon catheter in patients requiring mechanical ventilation can reduce procedure duration, lower the incidence of hypoxemia and puncturing of the endotracheal tube or balloon catheter, decrease the use of sedative medications, and enhance the accuracy and safety of the procedure.

Background: Clinical dexamethasone (DEX) treatment or stress in bovines results in extensive physiological changes with prominent hyperglycemia and neutrophils dysfunction. Objectives: To elucidate the effects of DEX treatment in vivo on cellular energy status and the underlying mechanism in circulating neutrophils. Methods: We selected eight-month-old male bovines and injected DEX for 3 consecutive days (1 time/d). The levels of glucose, total protein (TP), total cholesterol (TC), and the proinflammatory cytokines interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α in blood were examined, and we then detected glycogen and adenosine triphosphate (ATP) content, phosphofructosekinase-1 (PFK1) and glucose-6-phosphate dehydrogenase (G6PDH) activity, glucose transporter (GLUT)1, GLUT4, sodium/glucose cotransporter (SGLT)1 and citrate synthase (CS) protein expression and autophagy levels in circulating neutrophils. Results: DEX injection markedly increased blood glucose, TP and TC levels, the Ca 2+ /P 5+ ratio and the neutrophil/lymphocyte ratio and significantly decreased blood IL-1β, IL-6 and TNF-α levels. Particularly in neutrophils, DEX injection inhibited p65-NFκB activation and elevated glycogen and ATP contents and SGLT1, GLUT1 and GR expression while inhibiting PFK1 activity, enhancing G6PDH activity and CS expression and lowering cell autophagy levels. Conclusions DEX induced neutrophils glucose uptake by enhancing SGLT1 and GLUT1 expression and the transformation of energy metabolism from glycolysis to pentose phosphate pathway (PPP)-tricarboxylic acid (TCA) cycle. This finding gives us a new perspective on deeper understanding of clinical anti-inflammatory effects of DEX on bovine.

Objective:To analyze the duration of the second stage of labor without epidural anesthesia and its association with pregnancy outcome.Methods:This retrospective study involved 12 789 women who delivered without epidural anesthesia in the First Affiliated Hospital of Kunming Medical University from January 1, 2014 to December 31, 2017. These subjects were divided into primipara group (9 517 cases) and multipara group (3 272 cases). Demographic characteristics, maternal and neonatal outcomes and the duration of the second stage of labor were compared between the two groups using two independent samples t-test, Mann-Whitney U test and Chi-square test (Fisher's exact test). Differences in the maternal and neonatal outcomes were also analyzed among different subgroups in primiparae [length of second stage: <1 h group ( n=6 265), ≥1-2 h group ( n=2 305), ≥2-3 h group ( n=831) and ≥3 h group ( n=116)] and multiparae [length of second stage <1 h group ( n=3 144), ≥1-2 h group ( n=102) and ≥2 h group ( n=26)]. The association between second stage length and pregnancy outcomes was analyzed with Cramer's V. After adjusted for maternal age, gestational weeks at delivery, body mass index before pregnancy, complications during pregnancy and neonatal birth weight, the relationship between the duration of the second stage and adverse outcomes was analyzed by binary logistic regression analysis. Results:The 95 th percentile of the second-stage labor duration was 143 min for primiparae and 52 min for multiparae. The rates of vaginal delivery, forceps delivery, cesarean section in the second stage, episiotomy, third- or fourth-degree perineal laceration, postpartum hemorrhage, grade Ⅱ postpartum hemorrhage, transfusion, umbilical arterial blood gas pH<7.15 and transferring to neonatal intensive care unit (NICU) were all correlated with the duration of second stage in primiparae (Cramer's V values: 0.22, 0.23, 0.03, 0.22, 0.05, 0.10, 0.03, 0.03, 0.03 and 0.07, respectively, all P<0.05), and so did those of vaginal delivery, forceps delivery, episiotomy, postpartum hemorrhage, grade Ⅱ postpartum hemorrhage, transfusion and transferring to NICU in multiparae (Cramer's V values: 0.18, 0.19, 0.28, 0.14, 0.09, 0.13 and 0.06, respectively, all P<0.05). Logistic analysis showed that in primiparae, the duration of second stage >1 h was an independent risk factor for episiotomy, third- or fourth-degree perineum laceration, forceps delivery, postpartum hemorrhage, admission to NICU and umbilical arterial blood gas pH<7.15 [adjusted OR (95% CI): 2.080 (1.907-2.268), 1.773 (1.080-2.911), 1.625 (1.420-1.859), 1.365 (1.231- 1.514), 1.305 (1.165-1.462) and 1.246 (1.081-1.436), respectively], while second stage length >2 h was the independent risk factor for episiotomy, forceps delivery, third- or fourth-degree perineum laceration, postpartum hemorrhage, grade Ⅱ postpartum hemorrhage, blood transfusion, admission to NICU and umbilical arterial blood gas pH<7.15 [adjusted OR (95% CI): 4.844 (4.132-5.678), 4.223 (3.571-4.993), 3.289 (1.806-5.989), 1.952 (1.675-2.274), 1.781 (1.057-3.001), 1.654 (1.025-2.668), 1.682 (1.421-1.991) and 1.298 (1.039-1.620), respectively]. In multiparae, the length of second stage >1 h was an independent risk factor for episiotomy, blood transfusion, forceps delivery, postpartum hemorrhage and admission to NICU [adjusted OR (95% CI): 8.796 (5.717-13.534), 7.469 (2.874-19.411), 6.135 (3.217-11.699), 2.697 (1.624-4.477) and 1.814 (1.063-3.097), respectively], while the duration of second stage >2 h was the independent risk factor for episiotomy, third- or fourth-degree perineum laceration, blood transfusion, grade Ⅱ postpartum hemorrhage, forceps delivery and postpartum hemorrhage [adjusted OR (95% CI): 38.868 (14.948-101.063), 28.046 (2.780-282.490), 20.076 (5.384-74.866), 16.327 (3.406-78.274), 14.337 (5.351-38.411) and 9.036 (3.880-21.011), respectively]. Conclusions:The duration of the second stage of labor without epidural anesthesia is between that reported by Friedman and by Zhang. A prolonged second stage of labor may increase the risk of adverse pregnancy outcomes.