Improving the quality of newborns is a health development strategy, which has attracted global attention. Adverse pregnancy outcomes, including preterm birth, low birth weight and small for gestational age, are major causes of perinatal mortality and disability. Based on review of international and national publications pertaining to associations between stressful life events during pregnancy and adverse pregnancy outcomes from 2007 to 2023, this review summarizes the correlation between stressful life events during pregnancy and adverse pregnancy outcomes, including preterm birth, low birth weight and small for gestational age, and describes the underlying biological mechanisms. Previous studies have demonstrated the associations between maternal stressful life events during pregnancy and adverse pregnancy outcomes, and the underlying mechanisms mainly include neuroendocrine regulation, inflammation and microbiota pathways; however, the exact mechanisms remain unclear until now. Further studies to identify the critical window period for the association between stressful life events and adverse pregnancy outcomes, and unravel the pathogenesis of adverse pregnancy outcomes are warranted, so as to provide insights into reduction of adverse pregnancy outcomes.

Objective To analyze the effect of individualized care on prevention of postoperative urinary retention of malignancy patients undergoing hysterectomy and pelvic lymph node dissection.Methods 74 cases of patients with malignancies undergoing total hysterectomy and pelvic lymph node dissection in our hospital from June 2009 to December 2011 were chosen as the research object.They were divided into the control group and the observation group with 37 cases in each group.The control group was given traditional routine care,while the observation group was given individualized nursing assessment and intervention.The grasping level of knowledge about prevention of urinary retention,the cooperation degree with nursing,incidence of urinary retention,the residual urine volume and satisfaction degree of patients were analyzed and compared between two groups.Results The grasping level of knowledge about prevention of urinary retention,the cooperation degree with nursing,incidence of urinary retention,the residual urine volume and satisfaction degree of patients in the observation group were better than those of the control group,there were significant differences.Conclusions The effect of individualized care to prevent postoperative urinary retention of malignancies patients after hysterectomy and pelvic lymph node dissection is better.It plays an active role in improving mastering of knowledge about prevention of urinary retention and cooperative degree with nursing.

ObjectiveTo explore the effect of problem-based health education on self-care ability and psychological situation of gynecological cancer patients after surgery.Methods68 cases after gynecological cancer from January 2009 to December 2011 in our department for treatment were chosen.By taking mechanical sampling method,45 cases were randomly set as the observation group,which took problem-based health education.Other 23 cases were set as the control group,which adopted general health education model.The effect of health education was compared between two groups.ResultsIn the observation group,the self-care skills score was (20.4±5.8),self-responsibility score(27.6±9.4),the self-concept score (15.7±8.3) and self-care ability score (111.6± 20.3),significant higher than those of the control group,which were (11.6± 4.4 ),( 17.3 ± 6.5 ),(7.4 ± 5.1 ) and (53.2 ± 12.8).The SAS score was (1 1.6 ± 4.4) and SDS score was (17.3± 6.5) in the observation group,significantly lower than (20.4 ± 5.8) and (27.6± 9.4) of the control group.ConclusionsApplication of problem-based health education in gynecological cancer patients can significanfly improve their self-care capacity and patients＇ anxiety and depression.

Objective:To develop an HPLC-DAD-ELSD method for the determination of nitidine chloride, 5-ethoxychelerythrine, bergeninum and ardisiacrispin A in Shangtong tinctures ( STD) . Methods: A Hypersil C18 column was used as the chromatographic column, the flow rate was 0. 8 ml·min-1 . For nitidine chloride and 5-ethoxychelerythrine, the mobile phase A consisted of acetoni-trile,the mobile phase B consisted of 0. 1% formic acid-triethylamine (pH 4. 5),and the DAD detection wavelength was at 273 nm. For bergeninum and ardisiacrispin A, the mobile phase consisted of methanol-water(25∶75), the temperature of drift tube was set at 95℃, and the gas flow (N2) was set at 2. 5 SLPM·min-1. Results:There was a good linear relationship between the concentration and peak area for nitidine chloride and 5-ethoxychelerythrine within the range of 0. 021-0. 426 μg (r=0. 999 5) and 0. 075-1. 494 μg (r=0. 999 8), respectively. The average recovery was 99. 22%(RSD=0. 64%) and 98. 61%(RSD=0. 46%), respectively. There was a good linear relationship between the concentration and peak area for bergeninum and ardisiacrispin A within the range of 0. 215-4. 304 μg(r=0. 999 3) and 0. 286-5. 728 μg(r=0. 999 7), respectively. The average recovery was 99. 15%(RSD=0. 77%) and 99. 25%(RSD=0. 56%) accordingly. Conclusion:The method is accurate, sensitive and reproducible, and can be used in the de-termination of nitidine chloride, 5-ethoxychelerythrine, bergeninum and ardisiacrispin A in STD.

Objective To explore the diagnostic value of MRI on fetal congenital diaphragmatic hernia(CDH).Methods Fourteen pregnant women with gestation from 16 to 39 weeks were studied with a 1.5 T superconductive MR unit within 24 to 48 hours after ultrasound studies.Fast-imaging employing steady-state acquisition(FIESTA),single-shot fast spin echo(SSFSE)and T_1-weighted fast inversion recovery motion insensitive(FIRM)sequences were employed on the axial,coronal and sagittal planes of the fetal brain,thorax and abdomen,especially the thorax.Prenatal US and MR imaging findings were compared with postnatal diagnoses(13 fetuses)or autopsy(1 fetus).US,MR imaging and surgery were used for postnatal evaluation.Results Fourteen pregnant women(12 with a single fetus and 2 with twin fetuses)were studied.There were 12 fetuses(in 2 cases,being one of twins)with a left-sided and 2 with right-sided diaphragmatic hernias.For all cases,the prenatal MRI diagnosis Was correct when compared with postnatal diagnosis or autopsy.Two CDHs were missed and 2 were misdiagnosed by US.Intrathoracic herniated organs in 12 left CDH included the colon(n=1),the stomach(n=1),the bewel(n=5),or both the stomach and bowel(n=5).Intrathoracic herniated organs in 2 right CDH included the bowel(n=1),or the bowel and the right lobe of the liver(n=1).Conclusion Prenatal MRI is effective in the assessment of fetal congenital diaphragmatic hernia.

Objective To investigate the feasibility of ultrasound-guided interscalenus brachial plexus block used for the emergency surgery.Method From August to December 2007 80 patients from the Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou,ASA Ⅰ to Ⅲ,age 18 to 68 years old,weight 45 to 75 kg,without deformity on the shoulder or neck,without limb paresthesia,without contraindications of interscalenus brachial plexus block,were scheduled for emergency surgery of upper limb.They were randomly divided into two groups:interscalenus block guided by ultrasound group(group U,re =40)and nerve stimulator group(group N,re = 40).Patients of both groups received 20 mL mixture of 0.75%ropivacaine and 2%lidocaine.The onset time,and the analgesic efficacy of axillary nerve,lateral antebrachial cutaneous nerve,radial nerve,median nerve,median cutaneous nerve of arm,median antebrachial cutaneous nerve and ulnar nerve,and duration of anesthesia were observed.Statistical analysis was performed by t test,rank sum test and X2 test.Results The onset time of analgesia after nerve block was shorter in group U than that in group N(P＜0.01).The rate of perfect analgesia after nerve block in group U was higher than that in group N(100%vs.87.5%,X2 = 5.267,P = 0.027).The duration of anesthesia lasted in group U was(378 ± 151)minutes and that in group N was(365 ± 163)minutes(t= 0.363,P = 0.718).ConclusionsCompared with the method of nerve block guided by nerve stimulator,the ultrasound-guided interscalenus block offers faster onset and better analgesic efficacy.It is an ideal technique of brachial plexus block for the emergency surgery.

Objective To explore the diagnostic value of MRI on fetal congenital limb deformities.Methods Sixteen pregnant women,aged from 22 to 40 years (average 29 years) and with gestation from 22 to 39 weeks (average 29 weeks) were studied with a 1.5 T superconductive MR unit within 24 to 48 hours after ultrasound studies. Acquisitions consisted of coronal, sagittal, and axial slices relative to the fetal brain, spine, thorax, abdomen, especially limbs using 2D FIESTA sequences. Prenatal US and MR imaging findings were compared with postnatal diagnoses (4 fetuses) or autopsy (12 pregnant women,13 fetuses). Postnatal evaluation included US, MR imaging, computed tomography, and physical examination. Results Of the sixteen pregnant women (15 with a single fetus and 1 with twin fetuses) ,17 fetuses were found. Those limb deformities of sixteen pregnant women included congenital both upper extremities amelia (1 case), sirenomelia sequence (1 case), micmmelia (5 cases, 1 of which were twins),bilateral clenched hands (2 cases), right pelydactyly (1 case), simple right ectrodactyly (1 case), right dactylolysis(1 case), simple club foot (2 cases), hydrocele spinalis with club foot (2 cases), 1 of the 2 cases with bilateral clinodactyly. In 14 of 16 cases, the diagnoses established by MR imaging were correct when compared with postnatal diagnosis, and prenatal MR diagnosis was inaccurate in 2 cases. Conclusion Prenatal MRI is effective in the assessment of congenital limb deformities of fetuses, it can yield information additional to that obtained with US, and further correct US diagnosis.

Objective To explore the diagnostic value of MRI on fetal neural tube defects.Methods Ten pregnant women,aged from 25 to 35 years(average 28 years)and with gestation from 20-39 weeks(average 33 weeks)were studied with a 1.5 T superconductive MR unit within 24 to 48 hours after ultrasound(US)studies.The imaging protocol included fast-imaging employing steady-state acquisition,single-shot FSE and T_1-weighted fast inversion recovery motion insensitive sequences in the axial,frontal,and sagittal planes relative to the fetal brain,thorax,abdomen,and spines.Prenatal US and MRI findings were compared with postnatal MRI diagnoses(3 fetuses)or autopsy(7 fetuses).Results Ten pregnant women(9 with a single fetus and 1 with twin fetuses)were examined.For all cases,the diagnoses established by MRI were correct when compared with postnatal diagnosis or autopsy.In 7 cases,US and MRI findings were in complete agreement with postnatal diagnoses.US missed the diagnosis in 1 case and misdiagnosed in 2 cases.Ten neural tube defects in this study included anencephaly(1 case),exencephaly (1 case),meningoencephalocele associated with amniotic band sequence(1 case),meningocele(1 case),thoracic myelomeningocele(1 case),lumbar spinal bifida(1 case),sacroiliac myelomeningocele(2 cases),sacroiliac large cystic spinal meningocele(1 case),sacroiliac spinal bifida(1 case).Conclusions Prenatal MRI is effective in the assessment of fetal neural tube defects.It can exactly discriminate herniated contents and locate the spinal lesion level.

OBJECTIVE:To establish a method for simultaneous determination of the contents of ligustroflavone,specnuezhe-nide,demethylwedelolactone and wedelolactone in Zibu ganshen pill. METHODS:Dual-wavelength HPLC was performed on the column of Elite C18 with mobile phase of acetonitrile-0.5%acetic acid(gradient elution)at flow rate of 0.9 ml/min,column temper-ature was 25 ℃,detection wavelengths were 224 nm(0-30 min) and 351 nm (30-50 min),and the injection volume was 20 μl. RESULTS:The linear range was 6.75-135.00μg/ml(r=0.999 5)for ligustroflavone,6.54-130.80μg/ml(r=0.999 8)for specnuezhe-nide,4.90-98.00μg/ml(r=0.999 4)for demethylwedelolactone and 6.42-128.40μg/ml(r=0.999 6)for wedelolactone;RSDs of pre-cision,stability and reproducibility tests were no more than 1.25%;average recoveries were 96.15%-99.96%(RSD<2%,n=6). CONCLUSIONS:The method is rapid,sensitive and accurate,and can be used for the contents determination of ligustroflavone, specnuezhenide,demethylwedelolactone and wedelolactone in Zibu ganshen pill.

OBJECTIVE Through the cleaning effect of monitoring,understanding of the impact of mechanical cleaning and cleanliness factor.METHODS SonoCheck use of ultrasound to monitor the energy bottle,tcsi cleaning efficiency of the monitoring Browne STF cards and card detection cleansing effect on the ultrasonic energy and protein residue test equipment;set up observation ultrasonic cleaning time 5 to 25 minutes,cleaned 1 to 5 slot,and to observe the spray A cleansing poured procedures,according to the conventional function of the completion of cleansing,to observe the color change.RESULTS Energy in the ultrasonic testing only bottle in a clean yellow;washing machine to remove the cleaning efficiency of the red card to monitor pollution simulation,testing the effect of red cards pattern has not been completely clear.CONCLUSIONS Different cleaning supplies equipment for monitoring selective,while still concerned about the complexity of the cleaning equipment cleanliness,in order to maintain the supply of hospital centers and the quality of cleaning medical equipment unit.