Objective To explore the risk management factors and preventive measures in obstetric care. Methods The implementation of risk management in our hospital was retrospectively analyzed. Results Maternal satisfaction degree was significantly increased, complaints and errors of nursing care were significantly decreased. Conclusions Strengthening of risk management in obstetric care can benefit to eliminate and prevent unsafe factors, so that obstetric care quality is improved.

Objective:To verify the applicability of Dynamic Contrast Enhanced Magnetic Resonance Imaging(DCE-MRI)to evaluate the breast cancer therapy using the high intensity focused uhrasound(HIFU).Methods:Both DCE-MRI and conventional T_1W/T_2W images were acquired for the total 8 subjects.Two consecutive scans were performed for every patient(before operation and 2 weeks after operation)while four were performed for only 2 patients(additional for 6 months and 12 months after operation).The breast cancer therapy by HIFU was assessed hy comparing the changes of signal,the dynamic patterns of time-signal intensity curve,the early-phase contrast enhancement ratios and vessel anatomies around cancer focuses.Results: The shortened T_2 signals were observed in cancer focuses of 5 subjects while 3 still showed longer T_2 values which were differentiated by the high intensity in T_2W images.The early-phase contrast enhancement ratios of those 5 subjects decreased from 60%～80% to

Objective: To evaluate the nutritional markers in peritoneal dialysis patients. Methods: We examined SGA, dietary diaries, direct anthropometry, biochemical indices in 90 continuous ambulatory peritoneal dialysis (CAPD) patients. Then, the normalized protein equivalent of total nitrogen appearance (nPNA), lean body mass (LBM) and %LBM were calculated. Results: These patients were classified to three nutritional categories based on SGA (i.e. normal nutrition, mild to moderate malnutrition, severe malnutrition). The dietary protein intake(DPI), dietary energy intake(DEI), serum albumin(Alb), nPNA, LBM and %LBM were significantly different among three groups (P

Objective To study the effect of letrozole plus metformin on infertility of polycystic ovary syndrome(PCOS).Methods According to the digital table,90 patients with infertility of PCOS were randomly divided into the control group(n =45 cases) and the treatment group(n =45 cases).The patients of the control group were treated though clomiphene,while the patients of the treatment group were treated though letrozole plus metformin.The ovulation rate,pregnancy rate,sex hormones and insulin resistance were detected.Results The homeostasis model assessment of insulin resistance index (HOMA-IR) was (5.72 ± 2.37) before treatment and (3.16 ± 1.39) after treatment in the treatment group.HOMA-IR was (5.69 ± 2.40) before treatment and (4.81 ± 2.06) after treatment in the control group.There was a significantly decrease in the treatment group (t =3.7246,P ＜ 0.05).The ovulation rate was 80％ in the treatment group,while 60％ in the control group,the difference between the two groups was significant(x2 =4.06,P ＜0.05).The pregnancy rate was 48.9％ in the treatment group,while 28.9％ in the control group,the difference between the two groups was significant (x2 =5.77,P ＜ 0.05).Conclusion Letrozole plus metformin could promote the ovulation and decrease insulin resistance.

Objective To compare the effects of pre-emptive epidural analgesia and postoperative epiclural analgesia on stress response to upper abdominal surgery. Methods Thirty ASA Ⅰ or Ⅱ patients undergoing elective upper abdominal surgery performed under general anesthesia were randomly divided into 2 groups (n = 15 each): Ⅰ pre-emptive epidural analgesia group (group P) and Ⅱ postoperative epidural analgesia group (group C). A mixture of 0.5 μg/ml sufentanil and 0.15% ropivacaine 250 ml was used for epidural analgesia in both groups. The epidural catheter was placed at T_(10-11) interspace. The epidural regimen included a loading dose of 15 ml followed after 30 min by continuous epidurai infusion at 5 ml/h for 50 h. In group P the epidural analgesia was started at 20 min before skin incision, while in group C after operation when the patients emerged from general anesthesia and were extubated. The depth of general anesthesia was monitored using CSI and maintained at 45-55. Vcnoas blood samples were taken before epidnral catheter was placed (T_0, baseline), at 2 h (T_1) and at 18 h (T_2) after operation for determination the concentrations of ACTH and cortisol (Cor) and C reaction protein (CLIP). Results Blood Cor, ACTH and CRP concentrations were significantly increased after operation as compared with the baseline values at T0 and were significantly lower at T_1 and T_1 in group P than in group C. Conclusion Pre-emptive epidural analgesia can more effectively inhibit stress response than postoperative epidural analgesia to upper abdominal surgery.

Chronic kidney disease (CKD) has become a public health issue worldwide.A recent cross-sectional survey revealed that the prevalence of CKD in residents aged 18 years or older was 10.8％,indicating the challenge of CKD in China.The major indicators of kidney damage include estimated glomerular filtration rate (eGFR),proteinuria and hematuria.It is recommended that laboratory should report eGFR when reporting results of blood creatinine.Both of Chinese equation and Chronic Kidney Disease Epidemiology Collaboration equation could be used.The process of creatinine measurement should be standardized.For evaluation of proteinuria,urinary creatinine should also be measured when using spot urine sample.Considering the high false positive rate and low false negative rate of urine routine test for hematuria,it is recommended that microscopic examination on urinary sediment should be done for those with positive hematuria by urine routine test.(Chin J Lab Med,2012,35:769-772)

Objective To acknowledge the psychological authority status under the foundation of autho0rization management,in order to analyze the effectiveness of authorization management.Methods 364 clinical nurses were investigated with Psychological Empowerment Scale and the results were performed statistic analysis through descriptive statistical method and variance analysis.Results The average score of clinical nurses was(3.22±0.70),which was at the moderate point.The four dimensional scores listed in descending order were self efficient,career significance,autonomy and job influence.Clinical nurses of different ages,different ranking,different working period,different marriage status had statistical outstanding variance.But nurses of different education background showed no significant difference in score of each dimension.Conclusions The nursing management shall not only focus on the authorization management itself,but also on the psychological authority status of clinical nurses.Through an efficacious incentive,we can enhance the psychological recognition and experience on authorization and activate the working motivation,maximize the working initiative and thus promote the innovation and expansion of nursing work.

Objective To study the relationship between neural apoptosis and the expression of Bcl-2,Bax proteins in the perihematomal brain tissue of patients with intracerebral hemorrhage(ICH).Methods The rate of neural apoptosis of perihematomal brain tissue was examined by TUNEL method and the Bcl-2,Bax proteins expression were detected by immunohistochemisty method. Correlation analysis was done not only for the expression of Bcl-2,Bax proteins and apoptosis rate with hematoma volume but also for the apoptosis rate with hematoma volume, the scores of clinical nervous impairment and the course of disease.Results The apoptosis rate and the expression of Bcl-2,Bax proteins in the perihematomal brain tissue of ICH patients significantly increased in comparison with the control group (all P

Attention is being paid to the treatment of hyperopia(presbyopia) with laser thermokeratoplasty.This article mainly presents the theory of laser thermokeratoplasty(LTK),equipment configuration and some key techniques in laser delivery system.

Objective To analyze the application of non-protective midwifery in China so as to provide a theoretic basis for the develop-ment of this technique. Methods The full-text literatures of non-protective midwifery published in China during January 2004 and January 2014 were searched and obtained in China National Knowledge Infrastructure ( CNKI) ,Wanfang Database and VIP Database via computer. All searched literatures were analyzed with the literature study method. Results Totally 21 literatures were obtained by search. They were centrally from the coastal areas and mainly the controlled studies,and focused on the comparison of non-protective midwifery vs. protective midwifery in perineal laceration,second birth course and intrapartum bleeding volume. Conclusion The literatures show that non-protective midwifery is significantly beneficial for patients,though it develops later and concentrates at partial areas. Such midwifery technique shall be popularized all around the country.