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.

ObjectiveTo observe the efficacy and safety of inhaled tiotropium capsule on adult bronchial asthma.MethodsThirty-four adult asthma patients were randomized into two groups.We evaluated the addition of tiotropium bromide to an inhaled glucocorticoid in the treatment group( n =17 ),as compared with the addition of the LABA Formoterol in the control group ( n =17 ).Serial measurements of lung function,symptom control and quality of life were performed.ResultsAfter 8 weeks of treatment,peak expiratory flow (PEF) in the addition of tiotropium bromide group[ ( 359 ± 12 ) L/min vs.( 275 ± 5 ) L/min,P ＜ 0.05 ] and the addition of the LABA Formoterol group [ ( 346 ± 11 ) L/min vs.( 275 ± 9 ) L/min,P ＜ 0.05 ] were significantly higher than those before treatment.The forced expiratory volumes in one second ( FEV1 )were also significantly elevated in both groups [ Tiotropium bromide group:( 2.80 ± 0.28 ) L vs.( 2.30 ± 0.28 ) L,P ＜ 0.05 ; LABA Formoterol group:( 2.69 ± 0.34 ) L vs.( 2.25 ± 0.34 ),P ＜ 0.05 ] compared with pre-treatment.Average dose of emergent drug ( ventolin ) usage were decreased in both groups after treatment [ Tiotropium bromide group:(0.96 ± 0.34 ) puff/d vs.(4.11 ± 1.03 ) puff/d,t =3.05,P ＜ 0.05 ; LABA Formoterol group:( 0.88 ± 0.44 )puff/day vs.( 4.43 ± 0.87 ) puff/day,t =3.23,P ＜ 0.05 ].Meanwhile,significantly improved quality of life scores and alleviation of asthma symptom were found in both groups as compared with baseline ( P ＜ 0.05).However,no significant differences in the above variables after treatment were found between two groups( P ＞0.05 ).ConclusionWhen added to an inhaled glucocorticoid,tiotropium improved symptoms and lung function in patients with inadequately controlled asthma.Its effects appeared to be equivalent to the addition of Formoterol.

50.0% and increased year by year,the rate of aminoglycoside resistance

Objective:To observe the effect of pioglitazone on carotid artery intima-media thickness (IMT) and plaque-positive rate in patients with metabolic syndrome, and to ifnd a new way to improve arterial remodeling in patients with metabolic syndrome. Methods:Patients with metabolic syndrome were randomly divided into a control group (n=60) and a pioglitazone group (n=61). All subjects received basic therapeutic measures, i.e, appropriate medication to control blood pressure, blood sugar and cholesterol. Pioglitazone (15 mg/d) was given to patients in the pioglitazone group, and placebo (vitamin C) in the control group for 24 weeks. Color doppler ultrasound was used to measure carotid artery IMT and plaque-positive rate of patients in the 2 groups atfer the intervention. Japan’s Hitachi 7600-020 automatic biochemical analyzer was used to measure fasting serumal triglycerides, total cholesterol, high density lipoprotein cholesterol, low-density lipoprotein cholesterol, free fatty acids, fasting blood glucose, 2-hour postprandial glucose and liver and kidney function, etc. The differences between groups after the intervention were analyzed and compared in IMT, plaque-positive rate and all blood biochemical indicators. Results:Atfer the intervention, compared with the control group, carotid artery plaque-positive rate and the levels of triglyceride and free fatty acid decreased in the pioglitazone group (P<0.05), but there was no difference in IMT of carotid artery and other blood biochemical indicators between the 2 groups (P>0.05). Conclusion:Pioglitazone intervention can significantly improve pathologic artery remodeling, and it can more effectively inhibit the arterial plaque-formation than basic therapeutic measures in patients with metabolic syndrome.

Background and purpose:As a new candidate tumor suppressor gene, p33ING1b has many biological functions. This study was done to investigate its role in the regulation of the proliferation of human colon cancer cell line SW480. Methods:The pcDNA3.1(+)/p33ING1b/SW480 cells were identified by Western blot and S-P immunohistochemical method. In order to elucidate the effect of expression of exogenous p33ING1b gene on the colorectal cancer cell SW480, the proliferation rates were analyzed by growth curves and colony formation assay in soft agar for cells including SW480, pcDNA3.1(+)/p33ING1b/SW480 and pcDNA3.1(+)/SW480. At same time, the apoptotic rate of cells and the cell cycle analysis were also tested by flow cytometry.Furthermore,using western blot analysis,we detected the expression level of the protein p53, p21WAF1,Bax and Bcl-2 in those three group cells, which initially indicate the molecule mechanism of inducing apoptosis by gene p33ING1b. Results:The cell growth rates of SW480 cells transfected with pcDNA3.1 (+)/p33ING1b were slower than those transfected with pcDNA3.1(+) or untransfected.The colony formation efficiency of pcDNA3.1(+)/p33ING1b/SW480 were decreased and the apoptotic rates were increased compared with pcDNA3.1(+)/SW480 and SW480(P0.05). Conclusion:After overexpression of exogenous p33ING1b protein in SW480 cell, there were inhibition of the proliferation rate and induction of apoptosis, the molecular mechanism might be associated with up- regulated expression of Bax and down-regulated expression of Bcl-2 by p33ING1b gene.

Objective:To understand the state of Chlamydia pneumoniae (Cpn) infection in patients with coronary hear disease (CHD), and explore the relationship between Cpn infection and the gonesis and progressin of CHD.Methods:By means of PCR and ELISA, Cpn IgG antibody and nucleic acid were detected in 159 patients with CHD and 41 control subjects.Results:The positivity rate of Cpn DNA was 43 40%(69/159) in the patient group and 7 32%(3/41) in the control group, showing obvious difference between the two groups( P

OBJECTIVETo discusses the necessity and methods of replantation for complete amputation of finger composite lateral tissue.

METHODSFrom March 2012 to April 2015, 62 cases of complete amputated finger lateral tissue for various causes were retrospectively analyzed, including 34 males and 28 females with an average age of 29.1 years old ranging from 17 to 52 years old, involved 27 cases of thumb, index finger in 15 cases, 13 cases of middle finger, ring finger in 8 cases, 2 cases of the little finger, 2 fingers were injured in 3 cases, 14 cases involving the distal interphalangeal joint. The time from injury to treatment was 30 min to 2 hour with an average of 1 hour. The appearance of the fingers, finger tip sensation and the recovery of the functional of the patients were followed up and observed.

RESULTSOf 62 cases, 58 cases survived, the survival time was 3 to 15 months with an average of 6.5 months. According to the Chinese medical association upper part of replantation function evaluation standard to assess efficacy trial, 52 cases were excellent, 3 cases were good, 3 cases were good, the excellent and good rate was 94.8%.

CONCLUSIONSThe appearance and function is good after block from the broken replantation finger lateral organizations survive, as long as the patient general condition allows, away from the broken body is complete, there are available for blood vessels and nerves anastomosis, it should strive to reattach it.

Objective To identify one umbilical blood sample with abnonnal gap-PCR products of three bands of α2,-α3.7 and-SEA.further family pedigree were analyzed for the source of genetic variations,Methods One fetal umbilical blood sample was drawn from a woman of 24-weeks pregnancy.Gap-PCR for α-thalassemia was routinely conducted and abnornlal three bands of α2.-α3.7 and-SEA were observed.which could not be interpreted according to the kit manual and suspected as rare variation.With informed consen,DNA samples from the parents and grandparents were obtained for further study.Singleplex andnested PCR techniques were utilized to analyze the molecular characteristics of DNA samples from this fetus and its parents and grand-parents.Results Hematological phenotype study showed that fetal Hb Ban's was 7.6%,and its mother and maternal grandfather were both with typical α-thalassemia.while its father,grandfather and grandmother and maternal grandmother are without abnormal hematological change.Molecular study showed that fetal blood DNA was a heterozygosity for HKaa and-SEA.its father and grandfather are both HKαα/αα,its mother and maternal grandfather are both-SEA/aa,its grandmother and maternal grandmother are with both normal alleles of αα/αα.Then after genetic counseling the fetas was saved and iS a she baby now.Conclusion ThroUgh careful molecular tests one case of prenatal heterozygosity of HKαα/-SEA was identified,and the fetus is kept successfully through careful clinical counseling.

Objective To analyze a rare genotype with β-thalassemia intermadia.Methods Phenotypic analysis was performed using routine hematological tests to measure red blood cell parameters and high performance liquid chromatography (HPLC)was used to measure hemoglobin fractions.The β-globin gene mutations were conducted using reverse-dot-blot and DNA sequencing of the breakpoint region were characterized with gap-PCR.Results The proband had a trait of thalassemia intermedia with reduced hemoglobin (86 g/L).The proband's father had a trait of microcytic hypochromic with reduced mean corpuscular volume(MCV),mean corpuscular hemoglobin (MCH) (63.7 fl and 20.4 pg,respectively) and an elevated level of HbA2.He had the phenotype of heterozygosity for β-thalassemia.The preband's mother,grandmother and sister had a trait of heterezygote for hereditary persistence of fetal hemoglobin (HPFH) with elevated level of HbF,which were 28.3%,21.1% and 33.7%,respectively.After molecular characterization of the family members,the proband was identified as a patient with β-thalassemia intermedia caused by co-existence of β-thalassemia(β41-42) and HPFH-6.The father was heterozygoas for β-thaiassemia (β41-42/βN) and the mother,grandmother and sister were all heterozygons for HPFH-6.Condusions A rare β-thalassemia intermedia case resulting from compound heterezygote of β41-42 with HPFH-6 is found.This study may provide clinical experiences for antenatal diagnosis.

Objective The rapid multiplex PCR (MPCR) system for detection of genes encoding aminoglycoside resistance in Staphylococcus aureus was developed. The distribution of antibiotic resistant genes acc(6')-Ie+aph(2″), aph(3')-Ⅲa and ant(4')-Ia in Guangzhou was analyzed using the established system.Methods S. aureus strains were identified and susceptibility tests were performed using VITEK-60 or PHOENIX-100 system as recommended by the manufacturer. Aminoglycoside resistance was determined by disk diffusion method. MPCR system for detection of antibiotic resistance genes was optimized.Results The MPCR assay was established successfully. The prevalence of acc(6')-Ie+aph(2″), aph(3')-Ⅲa and ant(4')-Ia in the 124 clinical S. aureus isolates was 62.1%, 32.3% and 1.6%, respectively as analyzed by MPCR. Good correlation between antibiotic resistance phenotypes and genotypes was observed. One or more of the genes encoding aminoglycoside modifying enzymes could be detected in all gentamicin- or netilmicin- or amikacin-resistant isolates. The acc(6')-Ie+aph(2″) gene was identified in 72 of 74 mecA-positive isolates.Conclusions This MPCR system could be used for rapid and reliable analysis of the antibiotic-resistant genotypes of clinical S. aureus isolates. The gene acc(6')-Ie+aph(2″) may be the predominant determinant of aminoglycoside resistance, followed by gene aph(3')-Ⅲa. The prevalence of ant(4')-Ia gene is relatively low.