Objective To learn the current obstetric beds allocation,obstetric service delivery and access in midwifery institutions at various levels in the localities and nationwide as well as the trends,and assess the equity of obstetric beds allocation,for the purpose of recommending on a reasonable adjustment of obstetric beds allocation in these institutions.Methods Random sampling made in 44 cities in China for questionnaire survey on obstetric beds allocation,service delivery and utilization in 2008～2010 at all midwifery institutions in these cities.Interview of health administrators and medical workers at obstetric of midwifery institutions in 6 counties.Results Every thousand square kilometers in China average 5.9 midwifery institutions,and every thousand people average 0.24 obstetric beds.During 2008 ～ 2010,the number of beds and midwifery service delivery kept a growing trend while in townships obstetric service deliveries maintain a falling trend.The fairness index of maternity beds layout nationwide is 0.021283.Obstetric beds supply and demand ratio in different regions ranges among 0.97～ 1.41.The number of deliveries made in county level hospitals is 54.1％,but the beds in such hospitals account for but 48.1％.Conclusion The equity of obstetric beds allocation is good in terms of population layout.The quantity of obstetric beds meets the current needs nationwide,while the allocation of obstetric beds is less than reasonable among obstetric institutions of various levels in the country.The authors recommend a better control and adjustment of midwifery institutions layout,especially more such hospitals at the township level to meet the need of women delivery in hospital in remote areas.

Objective To investigate the diagnosis and treatments of delayed endolymphatic hydrops(DEH).Methods A restrospective study was conducted in 37 cases of DEH.who were tested with pure tone threshold,vestibular evoked myogenic potentials,high stimulation rate auditory brainstem response audiometry and vestibular ruction test.Conservative drug therapy was the major treatment.Results All the 37 patients had sensorineural hearing loss up to the medium-severe degrees at least.Twenty-five had hearing loss and endolymphatic hydrops on the same side,nine had contralateral type and three bilateral type.Ten cases had abnormal horizontal semicircular canal(HSCC) hydrops and saccular hydrops.Nine cases had abnormal HSCC function and nomal saccular function.Fifteen cases had abnormal saccular function and normal HSCC function.Twenty-five abnomalVEMP showed of loss of p13-n23,prolonged latencies of p13 and depressed amplitude cases with of p13-n23.18 cases were completely relieved from vertigo in a week.17 cases improved until totally relieved in two weeks,while the rest 2 cases that were subject to chemistry labyrinthectomy free of vertigo attack.Conclusion Pure tone threshold,EcochG,bithermal caloric test and vestibular evoked myogenic potentials are important diagnosis methods of delayed endolymphatic hydrops.Consevative drug therapy,especially diuretics and vascular dilation may play a major role in the treatment of delayed endolymphatic hydrops.

Objective To investigate the spousal transmission of human immunodeficiency virus (HIV)and its related factors in HIV epidemic area,which can be beneficial to prevent HIV from transmitting.Methods Three hundred and forty-six couples with one spouse were anti-HIV positive were cross-sectionally investigated.Blood samples were taken from the spouse of subjects whose anti- HIV were positive to detect the anti-HIV antibody and from 70 acquired immune deficiency syndrome (AIDS)patients to do the sequencing of the serum HIV provirus DNA.Results In 346 couples,99 were infected by spousal transmission and its transmission rate was 28.6%.One spouse of 125 couples were infected with HIV by paid blood donation,14.4%(18)of the other spouse were infec- ted by spousal transmission.One spouse of 135 couples were infected by paid blood transfusion, 23.7%(32)of the other spouse were infected by spousal transmission.Eighty-six couples were infec- ted by extramarital sexual contact,49(57.0%)got spousal transmission.Thirty-seven(69.8%) subjects were infected by husband-to-wife transmission and 12(36.4%)were from wife to husband. The difference between them was significant(P

Objective To evaluate the prognostic factors in locally advanced non-small-cell lung cancer (LA-NSCLC) for selectively carrying out prophylactic cranial irradiation (PCI).Methods 114 patients with LA-NSCLC between Jun 2006 and Oct 2010 were retrospectively analyzed. Related risk factors and features about brain metastases were analyzed.Results The 2-year incidence rate of brain metastases was 31.58 ％ (36/114),the first brain metastases was 20.18 ％ (23/114),and sole brain metastases was 9.65 ％(11/114),respectively.Variables involved in the equation of binary logistic regression analysis were pathology (OR =5.892) and treatment mode(OR =2.888).The incidence rate of brain metastases in patients of non-squamous carcinoma and single treatment mode was higher than others (P ＜ 0.01) Model fitting is better (P ＞ 0.05).Overall accuracy rate of predicting brain metastases is 67.7 ％.The increased rate of lactate dehydrogenase in the patients with brain metastases or death was 17.54 ％, which was higher than that in the survival patients without brain metastases (P ＜ 0.01).At the same time,the station number and the number of mediastinal lymph node metastases were positively correlated (r =0.716, P ＜ 0.01).The incidence rate of brain metastases or mortality rate was higher in the adenocarcinoma cases than that in the squamous carcinoma cases (P ＜ 0.01,P ＜ 0.05),with more frequent occurrence of mediastinal metastases.The mean diameter of squamous carcinoma and adenocarcinoma were 5.8 cm and 3.9 cm, respectively (P ＜ 0.01).Conclusions The incidence rate of brain metastases was higher in patients with single treatment.Large primary tumors, high lactate dehydrogenase, non-squamous carcinoma, multiple stations, and multiple mediastinal lymph nodes metastases can be regarded as risk factors of brain metastases to perform PCI.

Objective To study the neuroprotective effect of erythropoietin(EPO) on neonatal rats model with hypoxia-ischemia encephalopathy(HIE).Methods HIE was induced in rats on 7th day of postnatal age by ligation of right common carotid artery,followed by 2 h of hypoxia(80 mL/L O2).The subjects were divided into sham-operated group,control group and EPO group.EPO 4 000 U/(kg?day) was injected daily from day 2 pre-surgery for 9 to 16 days and PBS was injected in the control group.The neuroprotective effect of EPO on HIE model was detected by brain weight,the difference in weights between the ipsilateral(right) and contralateral(left) brain and the function test.In vitro study,the neural progenitor cell line C17.2 under gone apoptosis following an ischemia-like metabolic inhibition.The effect of EPO on the cell line ischemia modle 17.2 was evaluated by detecting Annexin V with flow cytometry.Results The signi-ficant and sustained brain injury in the hypoxia-ischemia and vehicle-treated group was observed and measured by reduction in relative weights of ipsilateral to contralateral and compromised sensorimotor functions in response to postural reflex test,compared with those of sham-operated animals(Pa

OBJECTIVETo estimate prevalence of HIV/AIDS among children and the transmission routes in a highly endemic villages of AIDS.

METHODSTotally 208 high-risk women of child bearing age and 159 of their children aged 0 - 14 years were investigated. Their medical histories of blood donation or transfusion were collected, blood samples were taken and sera were separated for HIV test. Enzyme-linked immunosorbent assay (ELISA) and Western blot assay were performed for HIV antibody. The Nested-polymerase chain reaction (PCR) assay amplifying gag gene p17 was performed on samples of children aged less than 18 months.

RESULTSThirty-seven HIV infected cases were found among 159 children aged 0 - 14 years of whom 33 were infected by mother-to-child transmission (89.2%, 33/37), 3 by blood transfusion (8.1%, 3/37) and one by iatrogenic route (2.7%, 1/37). Sixty seven mothers who were seropositive for HIV and their 86 children who were born after 1992 were investigated, 33 cases of them were infected with HIV. The rate of vertical transmission was 38.4% (33/86). The HIV vertical transmission rate among mothers with AIDS (68.8%, 22/32) was significantly greater than that among mothers with asymptomatic HIV infection (20.4%, 11/54, P < 0.05). The number of children infected with HIV through vertical transmission increased from 1993 to 2001. Among 37 children infected with HIV, 12 cases developed AIDS and 4 of them died, of whom 2 cases died from tuberculosis. The morbidity of AIDS was 27.3% (9/33). Ninety three point nine percent (31/33) of infected mothers didn't know their HIV seropositive status before pregnancy and delivery. Of 8 pregnant women infected with HIV, one had aggravation of AIDS, 2 miscarried, 2 terminated their pregnancy and 3 continued their pregnancy.

CONCLUSIONMother-to-child transmission of HIV was the major route of HIV/AIDS transmission to the children. The main reason leading to HIV infection in children was the lack of prenatal HIV counseling and testing for the high-risk women of childbearing age and lake of interventions. The countermeasures must be taken to control the further transmission of AIDS in order to protect the health of women and children in the highly endemic areas of AIDS.

Acquired Immunodeficiency Syndrome ; diagnosis ; epidemiology ; transmission ; Adolescent ; Adult ; Antibodies, Viral ; blood ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Gene Products, gag ; genetics ; HIV Antigens ; genetics ; HIV Infections ; diagnosis ; epidemiology ; transmission ; HIV-1 ; genetics ; immunology ; Humans ; Infant ; Infectious Disease Transmission, Vertical ; Male ; Polymerase Chain Reaction ; Prevalence ; Viral Proteins ; gag Gene Products, Human Immunodeficiency Virus

Objective: To explore the effect of extended nursing service on malnutrition in patients undergoing maintenance hemodialysis combined with peritoneal dialysis. Methods: According to the formula, 124 patients with malnutrition in maintenance hemodialysis combined with peritoneal dialysis were divided into intervention group and control group by lottery, 62 in intervention group and 62 in control group. The control group received routine specialist nursing and health education during hospital dialysis, while the intervention group received extended nursing services for 6 months, including telephone follow-up, knowledge lectures and Wechat interaction. The nutritional status of two groups of patients was assessed by modified subjective comprehensive nutrition assessment (MQSGA) one day before the implementation of extended nursing service, three months and six months after the implementation of extended nursing service, and the body mass index(BMI), albumin, prealbumin, hemoglobin, serum calcium and serum phosphorus were measured at the same time. Results: There was no significant difference in nutritional status, BMI and blood index between the two groups before intervention (P > 0.05). After 3 months and 6 months of intervention, MQSGA scores of intervention group were (13.28±3.99), (10.17±3.43) respectively, which were significantly lower than those of control group (15.32±3.52), (14.37±3.73). There were significant differences between the two groups (t=2.946, 6.336, P<0.01). After 3 months and 6 months of intervention, BMI was (18.29±2.27), (20.27±2.09) kg/m², respectively, which were significantly higher than those of control group (16.41±2.32), (16.49±2.26) kg/m². The difference between the two groups was significant (t=-4.430, -9.372, P <0.01). After 3 months of intervention, albumin, preaalbumin, hemoglobin, serum calcium, and serum inorganic phosphorus in intervention group were (35.63±4.24) g/L, (277.57±29.52) mg/L, (102.03±11.21) g/L,(2.01±0.19) mmol/L, (1.74±0.37) mmol/L; and the control group were (33.19±4.89) g/L, (216.81±24.06) mg/L, (92.58±13.79) g/L, (1.91±0.21) mmol/L, (2.05±0.49) mmol/L, respectively. After 6 months of intervention, the intervention groups were (41.49±6.14) g/L, (344.60±30.56) mg/L, (111.34±10.09) g/L, (2.28±0.18) mmol/L, (1.45±0.33) mmol/L, the control group were (34.16±4.71) g/L, (218.63±24.85) mg/L, (94.36±11.21) g/L, (1.99±0.24) mmol/L, (1.95±0.41) mmol/L. There were significant differences between the two groups (t=-24.484-7.220, P<0.01). Conclusions Extended nursing service can significantly improve the nutritional status of patients undergoing maintenance hemodialysis combined with peritoneal dialysis.

BACKGROUNDNeural respiratory drive is usually measured during inspiration, even in patients with chronic obstructive pulmonary disease (COPD) in whom the primary physiological deficit is expiratory flow limitation. The purpose of the study was to test the hypothesis that inspiratory muscle neural respiratory drive could be used to assess expiratory load.

METHODSTen healthy young men, (26 ± 4) years old, were asked to expire through a tube immersed in water where an expiratory load was required. The load was judged by the depth of the tube in water and the different loads (0 cmH2O, 10 cmH2O, 20 cmH2O and 30 cmH2O) were randomly introduced. Each expiratory load lasted for 3 - 5 minutes and inspiration was unimpeded throughout. Diaphragm electromyogram (EMG) and transdiaphragmatic pressure were recorded by a catheter with 10 metal coils and two balloons. Incremental cycle exercise with and without an expiratory load at 30 cmH2O was also performed.

RESULTSNeural drive during expiratory loaded breathing was larger than during unloaded breathing but neural drive did not increase proportionally with increasing expiratory load; neural drive during expiratory loading at 0, 10, 20 and 30 cmH2O was (10.1 ± 3.1) µV, (16.7 ± 7.3) µV, (18.4 ± 10.7) µV and (22.9 ± 13.2) µV, respectively. Neural drive as a percentage of maximum at the end of exercise with or without load was similar ((57.4 ± 11.0)% max vs. (62.7 ± 16.4)% max, P > 0.05).

CONCLUSIONNeural respiratory drive measured at inspiration does not accurately quantify expiratory load either at rest or during exercise.

Adult ; Electromyography ; Exercise ; Humans ; Lung Volume Measurements ; Male ; Respiration ; Respiratory Muscles ; innervation ; Tidal Volume

Objective To investigate the effect of telmisartan on the expression of peroxisome proliferator activated receptor gamma(PPARγ)and its regulation in myocardial remodeling in spontaneously type 2 diabetic male Otsuka Long-Evans Tokushima Fatty(OLETF)rats fed with high-fat diet.Methods Twenty-eight four-week-old male OLETF rats were fed with high-fat diet. From 22-week of age, the pre-diabetic OLETF rats were randomly assigned to three groups:telmisartan-treated group[O-T group,5 mg/(kg·d),n=10],pioglitazone-treated group[O-P group,10 mg/(kg·d),n=8]and untreated group ( O-C group, equal volume of normal saline, n=10), continuously administration for 22-week. Twelve sex and age matched Long-Evans Tokushima Otsuka(LETO)rats were used as control(LETO group).At 22 and 48-week of age, the glucose tolerance of the rats was assessed by the oral glucose tolerance test(OGTT).At 48 weeks of age,five rats were randomly selected from each group,and clamp experiments were carried out.The glucose infusion rate from 60 min to 120 min(GIR60-120)was measured.All rats were sacrificed and the myocardial tissues were dissected.The ratio of heart weight to body weight(HW/BW)was calculated.Blood samples were collected,and serum PPARγ,tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6)and adiponectin were measured using ELISA and radioimmunoassay.The mRNA expressions of IL-6,PPARγ1 and PPARγ2 were measured by real-time PCR.The protein expression levels of PPARγ,adiponectin,IL-6 and NF-κB were determined by Western blot assay.The myocardial pathological changes were observed under light microscope (HE staining, Masson staining and PAS staining), and ultrastructural changes were observed under transmission electron microscope.Results At 22-week of age,neither type 2 diabetes mellitus(T2DM)nor IGT were found in three groups.At 48-week of age,T2DM was found in seven rats of O-C group,and IGT was found in two rats.T2DM was found in one rat of O-C group,and IGT was found in three rats.Neither T2DM nor IGT was found in the other two groups.GIR60-120and HW/BW were all significantly lower in the O-P group and O-T group than those of the O-C group at 48-week of age (P<0.05). Systolic blood pressure(SBP)and diastolic blood pressure(DBP)were significantly lower in O-T group than those in other three groups(P<0.05).Compared with the O-C group,the serum levels of PPARγ and adiponectin were significantly up-regulated,whereas the serum levels of IL-6 and TNF-α were down-regulated by telmisartan administration in O-T group (P<0.05).There were no significant differences in the above indexes between O-P and O-T groups.The results of real-time PCR and Westen blot assay showed that the mRNA expression of PPARγ1 was increased,and IL-6 expression decreased in O-T group compared with those of O-C group. The protein expressions of PPARγ and adiponectin were increased, and protein expressions of NF-κB and IL-6 were significantly decreased in O-P group and O-T group compared with those of O-C group(P<0.05).In the O-C group,the arrangernent of myocardial cells was irregular,myocardial fibers were swollen,a large amount of fibrotic tissue in the myocardial interstitium, and glycogen accumulation under light and electron microscope. Besides, myofibril breakage and perinuclear space expansion, myocardial mitochondria were apparently damaged or even dissolved. Compared with the O-C group, myocardial fibers arranged neatly, no obvious glycogen deposition and the ultrastructural changes of myocardium were obviously reduced in O-T group and O-P group. Conclusion Telmisartan can increase the expression level of PPARγ in the serum and myocardial tissue, reduce myocardial fibrosis and alleviate cardiac remodeling in the high-fat-diet OLETF rats.

OBJECTIVETo explore the inhibitory effect of garlic oil on cyclin E expression in gastric adenocarcinoma cells.

METHODSHuman gastric adenocarcinoma SGC7901 cells were cultured routinely and the expressions of transforming growth factor alpha (TGFalpha) and epidermal growth factor receptor (EGFR) are detected by immunofluorescent staining and flow cytometry. The SGC7901 cells were also cultured with RPMI 1640 without calf serum for 48 h, followed by further culture with RPMI 1640 in the presence of 2.5% calf serum before treatment with TGFalpha, garlic oil, or their combination, and cyclin E expression of the cells was then detected by immunofluorescent staining and flow cytometry.

RESULTSThe positivity rates of TGFalpha and EGFR expressions were 46.80% and 57.78 % respectively in SGC7901 cells cultured routinely for 48 h. The positivity rate of cyclin E expression was increased by 7.06% (P<0.001) in SGC7901 cells treated with 30 microg/L TGFalpha for 5 h, decreased by 11.75% (P<0.001) following a 5-hour treatment with 10% garlic oil, and decreased further by 17.11% (Plt;0.001) after treatment with both 30 microg/L TGFalpha and 10% garlic oil for 5 h.

CONCLUSIONSThe gastric adenocarcinoma SGC7901 cells express TGFalpha and EGFR and possess TGFalpha autocrine and paracrine loops to promote cell proliferation. Garlic oil inhibits cyclin E expression in routinely cultured SGC7901 cells and also in TGFalpha-treated ones, suggesting that garlic oil can inhibit the TGFalpha autocrine and paracrine loops, which can be one of the pathways of garlic oil to inhibit cancer cell proliferation.

Adenocarcinoma ; genetics ; pathology ; Allyl Compounds ; pharmacology ; Animals ; Antineoplastic Agents ; pharmacology ; Cell Line, Tumor ; Cyclin E ; metabolism ; Down-Regulation ; drug effects ; Gene Expression Regulation, Neoplastic ; drug effects ; Humans ; Receptor, Epidermal Growth Factor ; metabolism ; Stomach Neoplasms ; genetics ; pathology ; Sulfides ; pharmacology ; Transforming Growth Factor alpha ; metabolism