Objective To explore the application value of epidural analgesia childbirth association a care in the puerpera childbirth.Methods According to the digital table,368 cases of childbirth puerperal were divided into observation group and control group,184 cases in each group.The control group was given analgesia childbirth,the observation group was given complex nursing intervention.The maternal birth outcomes of the two groups were observed.Results In the observation group,the maternal first labor time,labor time for 2 h,the total labor time, bleeding in 2h after delivery were (5.41 ±1.21 )h,(0.89 ±0.17)h,(6.32 ±1.57)h,(232.75 ±21.87)mL respectively,which in the control group were (5.32 ±1.22)h,(0.91 ±0.18)h,(6.24 ±1.55)h,(230.96 ±21.68)mL respectively,the differences between the two groups were not statistically significant(t =0.710,1.095,0.491,0.788, all P >0.05).In the observation group,the maternal cesarean delivery rate,postpartum maternal pain score,uterine recovery time were 10.33%,(1.43 ±0.67)points,(22.18 ±2.63)d respectively,which in the control group were 19.02%,(2.89 ±1.54)points,(29.79 ±5.41)d respectively,the differences between the two groups were statistically significant(χ2 =5.556,t =11.792,17.160,all P <0.05).In the observation group,the neonatal Apgar score,incidence of fetal distress,neonatal asphyxia rate were (9.27 ±0.88)points,1.09%,0.00% respectively,which in the control group were (8.03 ±0.31)points,5.43%,2.17% respectively,the differences between the two groups were statistically significant(t =3.526,χ2 =5.513 1,4.044,all P <0.05 ).Conclusion Adopt a consortium epidural analgesia application in maternity nursing intervention can improve the success rate of vaginal delivery,does not interfere with the labor progress,ensure the safety of the maternal and infant is worth popularization and application in clinic.

BACKGROUND:Knee osteoarthritis and rheumatoid arthritis are common arthritis in the knee.In late stage of arthritis,severe deformation and activity obstacle are found,which require total knee replacement.The total knee replacement not only can significantly relieve symptom,but also correct deformation and improve joint function.OBJECTIVE:To summarize classification of knee joint,techniques of knee replacement surgery and complications following replacement.METHODS:We retrieved Vip Database (http://www.cqvip.com) for titles and abstracts with the key words of "knee replacement,prosthesis,complication".Articles concerning clinical application of knee prosthesis were included.Articles in the same field that published recently or in authorized journals were included.A total of 20 literatures were included for review according to inclusion criteria.RESULTS AND CONCLUSION:Various artificial total knee prostheses were used in different patients in accordance with patients' condition,joint limitation degree,fixation method and meniscus function.Indication of different knee prostheses depends on bone and soft tissue of the knee,and quality and status of knee ligament,joint deformation and destruction degree of articular cartilage are responsible for the choice of prosthesis.Thrombosis of deep veins of the lower limb,pulmonary embolism,infection surrounding the prosthesis and prosthesis loose are common complications in joint replacement.

Objective To discuss the effect of early combined therapy of sertraline and psychotherapy on the rehabilitation of the patients with post-stroke depression (PSD)and observe its effect on plasma and platelet serotonin(5-HT). Methods All of 130 patients with PSD were divided into sertraline treatment group (65 cases) and routine treatment group (65 eases). Every patient was given routine treatment according to treatment guideline of cerebrovascular disease after admission. The sertraline treatment group received twelve-week sertraline treatment and psychotherapy, while the routine treatment group only received psychotherapy. Patients were evaluated by HAmilton rating scale for depression (HRSD) and serf-rating depression scale (SDS) before treatment and at the ends of the 4th and 8th week treatment, respectively. Meanwhile, the levels of plasma and playlet 5-HT of every patient were measured by the enzyme immunoassay methods. Results The scores of HRSD and SDS were lower in sertraline treatment group than those in routine tretment group at the ends of the 4th and 8th week. The rate of decrease of HRSD and SDS in sertraline treatment group was higher than that in routine treatment group at the end of the 8th week (Pall<0.01).The levels of platelet 5-HT in sertraline treatment group was lower at the ends of the 4th and 8th week than those before, treatment (P< 0.01).No significant change in plasma 5- HT level could be observed before and after treatment in two groups(P> 0.05). Conclusions Early treatment by sertraline can release the symptom of PSD and promote rehabilitation of PSD patients. The sertraline treatment can reduce the level of platelet 5- HT in PSD patients. However, the effect of plasma 5-HT value is not clear.

Objective To understand physical and mental health status of children affected with AIDS and other children living in vulnerable families in a pilot county of the China /UNICEF AIDS Prevention and Care Project.Methods By random sampling,250 children of 0-17 years of age in a project county in Yunnan province were selected from 3 types of family:with family members affected with AIDS,with family members using illicit drugs,and poor family.Height were measured to all 250 children.Psychological questionnaire was used to interview 154 children over 6 years.Results There was no significant difference in height,but significant differences in psychological status among children from the 3 types of families.Among the children affected with AIDS,near 68% had difficulty or were indecisive in coping with problems in their daily life ;58% were worried about peer interaction;67% were relatively self-confident,which was lower than children affected by drug abuse,and the latter was 89%.Conclusion The mental status of children from the 3 types of family is different,and community care should be provided by considering the difference between them.

Objective: To explore the symptomatology of cluster-B personality disorders from perspective of the Five-Factor Model (FFM).Methods:PDQ +4 was administered to college students and minor criminals to screen cluster-B subjects, Cluster-B patients were then diagnosed by conducting interview using PDI-IV.FFM of the subjects are measured with NEO-PI-R.Results:Cluster-B patients scored higher in Neuroticism(62.0?10.6), and lower in, Agreeableness(38.4?11.5) and Conscientiousness (38.4?11.2)than normal adult.Extraversion(45.9?11.5)and Openness to Experience(45.0?9.3)are near the lower limits.Bivariate analysis between PDI-Ⅳ and NEO-PI-R showed that APD negatively correlated with Agreeableness (r=-0.25,P

Objective: To construct the recombinant expressive vector of HSV-2-EGFP for the primary application in rapid,direct and sensitive diagnosis of herpes simplex virus infection. Methods: The gene fragment coding for HSV-2 ICP10 promoter was amplified by PCR,and the PCR product was cloned into pEGFP-1 to construct the recombinant plasmid pICP10-EGFP,which would be identified by DNA sequencing.The recombinant plasmid pICP10-EGFP were transfected into Vero cells by cation lipoid Lipofectamine 2000,then G418 was added to screen the positive cells to obtain stable cell line Vero-ICP10-EGFP.Vero-ICP10-EGFP was infected by various titers of HSV-2,and the EGFP fluorescence was detected under inverted microscope at 6,8 and 10 h post-infection.The specificity of the cell line was detected by infection with human cytomegalovirus(HCMV) and coxsackievirus. Results: The recombinant plasmid pICP10-EGFP was proved to be correct by the double restriction enzyme digestion and DNA sequencing.The Vero-ICP10-EGFP fluorescent emitting cells can be observed as early as 6 h after infection with HSV,with pronounced increase in the intensities at later hours.No induction of detectable fluorescence was detected by infection with HCMV and coxsackievirus 6,10 and 24 h post-infection. Conclusion: This novel GFP reporter system expressing the HSV-inducible EGFP reporter gene might provide a fast,easy and sensitive model for monitoring HSV in clinical specimens.

Objective:To investigate the Psychosomatic symptoms and coping styles and their influences on quality of life in chronic Hepatitis B.Methods:The Chronic Hepatitis Disease Questionnair(CLDQ),Symptoms Checklist(SCL-90) and Medical Coping Modes Questionnair(MCMQ) were administered to 152 Chronic Hepatitis B.Results:The scores of SCL-90 of the patients were found to be different from the norm and the normal controls and negatively correlated with scores of CLDQ for all domains.The patients had a lower Confronce score and higher Avoidance and Acceptance-Resignation scores compared with the norm,and there was negative correlation between the scores of negative coping styles and the quality of life.Conclusion:The psychosomatic symptoms and the negative coping styles of chronic Hepatitis B can influence their quality of life.

Objective To explore the expression of Bcl-2 and Bax in embryonic neuroepithelial cells in Golden hamster exposured to the teratogenic dose of alcohol. Methods The experimental pregnant golden hamsters were given ethanol through intraperitoneally injected, 5.8 g/kg body weight. The Bcl-2 and Bax expressions in neuroepithelial cells of experimental and control animals were detected with immunohistochemical and image analysis at 4,8,16,24,48 and 72 h time points after treatment. Results Bcl-2 and Bax proteins distributed in nuclear membranes and cytoplasm of the neuroepithelial cells as well as mesenchymal cells. In control groups, the expressions of these two kind proteins increased as the time passed at beginning, 16 hours after, came to the summit and then descended gradually. Compared with the control, the expressions of Bcl-2 in experimental groups were down-regulated, expressions of Bax were up-regulated except at 8 h time point. Conclusion Alcohol can induce down-regulation of the expression of Bcl-2 protein and up-regulation of the expression of bax protein, which may play a an important role in regulation of apoptosis in alcohol-induced neural tube malformation.

Objective To study the genotypes and the variations of HCV isolates in some areas of Shandong province.Methods The kit of AKZO UBI EIA 4.0 assay for antibody to hepatitis C virus(HCV)was used to screen 64 clinical anti HCV Ab positive serum samples, and 54 samples of which gave positive results. With RT nested PCR that utilized highly efficient primers,a product of 319bp in the NS5 region was amplified from 12 of 28 samples.These 12 PCR products were directly cloned using TA cloning kit, and 10 independent clones were isolated and sequenced by dideoxynucleotide chain termination reaction. Ressults Every sequencing analysis followed by comparison with reported sequences in the GenBank revealed that 10 sequences were all classified as HCV type 1b. All nucleotides changes in NS5 region were due to substitution without insertion and deletion,and most of the substitution (74%)occurred in the third base of a codon; The motif of G D D and all cysteines were conserved. Conclusion The result has demonstrated that HCV 1b is predominant in some areas of Shandong province.

Objective To summarize the experience of HIV/AIDS preventive interventions among out-of-school teenagers and provide scientific evidence for the development of large-scale interventions in the future. Method Using both non-random snowball and cluster sampling approach,a total of 5,000 participants were selected from 7 provinces (9 provincial sites ) and a cross-sectional survey was conducted by employing a semi-open-ended self-administrative interview schedule to evaluate their behavioral change before and after the interventions. Results The rate of HIV related knowledge and condom use increased significantly among the participants. For instance,the rate of condom use when having sex at the last time increased by 34.86%,i.e. from 27.67% at the baseline to 59.88% after the intervention (?2=34,86,P