Objective To study the risk factors of obstetrical brachial plexus palsy (OBPP).Methods Forty-six newborn infants with OBPP were recruited between January 1997 and December 2009 from Technical Appraisement Center for Medical Malpractice of Shandong province as OBPP group.In the control group,138 newborn infants delivered in the same time,same hospital and same gender were collected,with a ratio of 1:3.All the cases were analyzed retrospectively.The newborn,maternal,childbirth data and working experience of midwives were analyzed by univariate and multivariate logistic regression analysis.Results ( 1 ) External pelvimetries of the two groups were normal.All were singleton newborns by vaginal deliveries with cephalic presentation.Twenty-two newborns had left unilateral palsies,and the other 24 had right unilateral palsies.The numbers of the whole,upper and fore arm type were 17,26 and 3,respectively.The maternal age,gravidity,parity and gestational weeks were higher in OBPP group than in the control group ( P ＜ 0.05 ).( 2 ) The maternal antepartum body mass index ( BMI ) [ ( 29.5 ± 2.4 ) kg/m2 ],height of the uterus [ (34.9 ± 2.4) cm ] and abdominal circumference [ ( 105 ± 6) cm ] in OBPP group were higher than those in the control group [ ( 26.1 ± 2.5 ) kg/m2,( 33.7 ± 2.2 ) cm and ( 99 ± 5 ) cm,respectively ] ( P ＜ 0.05 ).The newborn birth weight in OBPP group [ ( 4390 ± 489 ) g ] was significantly higher than the control group [ ( 3404 ± 360 ) g] ( P ＜ 0.01 ).The working experience of midwives in OBPP group [ ( 5.2 ± 2.3 ) years ] was less than the control group [ ( 8.9 ± 5.4) years ] ( P ＜ 0.01 ).(3) There was a higher proportion of instrumental delivery ( 28.3％ vs.3.6％ ),uterine atony (28.3％ vs.6.5％ ),prolonged second stage(8.7％ vs.0.7％ ) and fetal malposition( 10.9％ vs.2.9％ ) in the OBPP group than in the control group ( P ＜ 0.05 ).(4) Univariate logistic analysis showed that the P values of maternal age,antepartum BMI,height of uterus,abdominal circumference,newborn birth weight,gravidity,second stage duration,instrumental delivery,fetal malposition,uterine atony and working experience of midwives were all less than 0.10.And the working experience of midwives was a protective factor.(5)The factors listed above were taken as variables,selected stepwise regression for multivariate logistic regression analysis.Boundary value was 0.10.It showed that the antepartum BMI ( OR =1.733 ) and newborn birth weight ( OR =1.004 ) were related to OBPP ( P ＜ 0.10 ).The significance of maternal antepartum BMI was higher than birth weight.Conclusions The maternal antepartum BMI is the most important risk factor for OBPP,and the newborn birth weight is the other risk factor.The working experience of midwives is a protective factor.

s Objective To investigate the predictive value of maternal serum C reactive protein,IL 6 and glucose concentration for the early intrauterine infection in patients with preterm premature rupture of the membranes(PPROM).Methods Amniotic fluid(AF) was collected from patients with PPROM,IL 6,glucose concentration,anti Chlamycdia trachomatis, anti lytomegalovirus IgM and ureaplasma urealytiaum were detected and cultured.Results The most sensitive test was AF IL 6 determination(P

OBJECTIVE: To establish and improve the quality management system of drug dismounting and subpackage in hospital.METHODS: The status quo and problem of drug dismounting and subpackage were analyzed,and improvement approaches were put forward.RESULTS: The quality management system of drug dismounting and subpackage was established and improved by enhancing personnel quality,dismounting environment,material management as well as process control.CONCLUSION: The quality management system of drug dismounting and subpackage can effectively guarantee the quality of dismounted drug and is worthy of spreading.

Objective To investigate the role of soluble intracellular adhesion molecule-1(sICAM-1), corticotropin-releasing hormone(CRH)and interleukin-6(IL-6) in the pathogenesis of pregnancy-induced hypertension (PIH). Methods Maternal plasma sICAM-1, CRH and IL-6 level were determined in 81women at 26~37 gestational weeks among which 23 were normal pregnant women and 58 with PIH. The later were grouped into 21 women with mild, 19 with moderate, 18 with severe PIH. sICAM-1 and IL-6 were measured by ELISA and CRH by RIA. Results The levels of plasma sICAM, CRH and IL-6 were significantly elevated in women with moderate and severe PIH compared with control subjects(P

Objective To analyze the risk factors of postmenopausal vaginal bleeding complicating cervical cancer .Methods Totally 43 cases of postmenopausal vaginal bleeding complicating cervical cancer were selected as the observation group ,while 52 cases of postmenopausal vaginal bleeding complicating non‐organic lesions and benign lesions were selected as the control group . Through the medical records and self‐developed questionnaire ,the risk factors of postmenopausal vaginal bleeding complicating cer‐vical cancer were investigated .Results There were no statistically significant differences in age of menopause ,age of IUD place‐ment ,usage of postmenopausal estrogen drugs ,smoking history ,complicating hypertension between the two groups (t= 0 .674 , 1 .156 ,χ2 =0 .283 ,0 .425 ,0 .281 ,P>0 .05);while the years of menopause to vaginal bleeding occurrence ,endometrial thickness and duration of vaginal bleeding in the observation group were more than those in the control group ,the differences were statistically significant (t=6 .717 ,5 .000 ,10 .754 ,P< 0 .05) .The univariate and multivariate Logistic regression analysis results showed that the risk factors of postmenopausal vaginal bleeding complicating cervical cancer were the years of menopause to bleeding ,endometri‐al thickness and duration of vaginal bleeding (P<0 .05) .Conclusion For the patients with postmenopausal bleeding ,the risk of complicating cervical cancer should be considered ,especially the years of menopause to bleeding ,endometrial thickness and duration of vaginal bleeding .

Objective To explore related influencing factors for postoperative delirium in elderly patients, to provide a reference for the prevention and treatment. Methods Fifty-four patients with delirium after surgery were used as observa?tion group, and a total of 150 subjects with no delirium after surgery during the same period were selected as the control group. Data of age, gender, malnutrition, disorders of water and electrolyte metabolism, postoperative mechanical ventilation, postoperative hypoxemia, severe infection and postoperative pain degree, and the combination of basic diseases were com?pared and analysed between two groups. The binary logistic regression analysis was used to analyse the influencing factors of postoperative delirium. The outcome and prognosis were observed and analyzed in observation group. Results The average age was significantly higher in observation group than that of control group (P<0.05). The percentages of postoperative hy?poxemia and severe infection were significantly higher in observation group than those of control group ( P<0.05). Patients with higher age, postoperative hypoxemia and severe infection were risk factors for postoperative delirium. In observation group,1 case died of lung infection, 1 case died of multiple organ failure, the remaining 52 patients were improved and dis?charged from hospital after three months. Conclusion For patients with higher age, postoperative hypoxemia and severe in?fection are the risk factors for occurrence of postoperative delirium. More attention should be paid to clinical preoperative and postoperative periods.

BACKGROUND:In recent years, studies on the application of traditional Chinese medicine in bone tissue engineering are stil at the initial stage in China. Reports about psoralen antibiotic biphasic ceramic bone have not been seen in bone tissue engineering research. OBJECTIVE:To fabricate the psoralen antibiotic biphasic ceramic bone by vacuum evaporator and to observe the physicochemical properties, antibiotic activity and biocompatibility of the material. METHODS:Biphasic ceramic bone was prepared by twice low-temperature calcining pig vertebrae combined with sodium pyrophosphate, and then the ceramic bone was immersed in chitosan/psoralen compound solution to prepare psoralen antibiotic biphasic ceramic bone. The surface morphology was observed by scanning electron microscope, and the compressive strength was tested. Antibiotic activity of the psoralen antibiotic biphasic ceramic bone on Escherichia coli and Staphylococcus aureus was tested by microbiological methods. Mouse osteoblasts MC3T3-E1 were co-cultured with the psoralen antibiotic biphasic ceramic bone for 4 and 8 days, and the cel adhesion and proliferation on the scaffold surface were observed under the scanning electron microscope. RESULTS AND CONCLUSION:Psoralen antibiotic biphasic ceramic bone had natural pore structure with the trabecular bone, trabecular space and lumen system and exerted great antibiotic effect on Escherichia coli and Staphylococcus aureus. The compressive strength was (4.69±0.50) MPa. Mouse osteoblasts MC3T3-E1M could be adherent to the psoralen antibiotic biphasic ceramic bone and proliferate rapidly, suggesting the psoralen antibiotic biphasic ceramic bone has good cytocompatibility.

Objective To investigate the serum asymmetric dimethylarginine (ADMA)expression in patients with acute cerebral infarction. Methods A total of 100 patients with acute cerebral infarction admitted to the Department of Neurology,the First Affiliated Hospital of Xi′an Medical College from March 2013 to August 2015 were enrolled retrospectively. According to the National Institutes of Health Stroke Scale (NIHSS)scores,they were divided into three groups:mild infarction (n =21;<4),moderate infarction (n =49;4 -15),and severe cerebral infarction (n = 30;> 15);100 healthy subjects without cerebrovascular disease in the same period were used as a control group. Enzyme linked immunosorbent assay was used to detect the plasma ADMA concentration,and the levels of plasma ADMA among the groups were compared. Results The concentrations of plasma ADMA of the mild,moderate,severe cerebral infarction,and the control groups were 0. 80 ± 0. 16,1. 14 ± 0. 28,1. 33 ± 0. 33,and 0. 52 ± 0. 16 μmol/ L,respectively. There were significant differences among the groups (F = 2. 32,P < 0. 05). Multivariate logistic regression analysis suggested that ADMA was an independent risk factor for cerebral infarction (OR,1. 140,95% CI 1. 078 -1. 212,P = 0. 045). Conclusions The expression levels of plasma ADMA increased gradually in patients with mild,moderate,and severe cerebral infarction. The higher the ADMA levels,the severe the neurological deficit would be. ADMA might be an independent risk factor for cerebral infarction.

BACKGROUND:Recent studies have found that bone marrow mesenchymal stem cells play an important role in the development of multiple myeloma, especial y for angiogenesis, but whether the pro-angiogenesis ability of bone marrow mesenchymal stem cells in multiple myeloma in active and remissive state is different is yet unclear. OBJECTIVE:To investigate the difference in the pro-angiogenesis ability of bone marrow mesenchymal stem cells in multiple myeloma in active and remissive state. METHODS:Bone marrow samples were extracted from 13 patients with multiple myeloma before treatment and after four therapeutic cycles to isolate bone marrow mesenchymal stem cells. ELISA assay was used to detect levels of vascular endothelial growth factor, hepatocyte growth factor and basic fibroblast growth factor in the supernatant of bone marrow mesenchymal stem cells. The proliferative ability and movement of human umbilical vein endothelial cells cultured in the supernatant of bone marrow mesenchymal stem cells were detected by MTT assay and Transwel assay, respectively. The pro-angiogenesis ability of bone marrow mesenchymal stem cells was measured by Matrigel in vitro. RESULTS AND CONCLUSION:The levels of vascular endothelial growth factor, hepatocyte growth factor and basic fibroblast growth factor in the cellsupernatant were significantly higher in active myeloma than those in remissive myeloma (P<0.05). The supernatant of bone marrow mesenchymal stem cells of active myeloma more significantly promoted the proliferation, migration and blood vessel formation of human umbilical vein endothelial cells than that of remissive myeloma in a dose-dependent manner (P<0.05). These findings indicate that bone marrow mesenchymal stem cells from active myeloma have stronger pro-angiogenesis ability than those from remissive myeloma.

Objective To explore the splenic macrophages phenotype and secretory function of mice with periodontitis, so as to explore effects of periodontitis on macrophages. Methods 22 mice were randomly divided into periodental ligation group (group P10d ) and pseudo periodental ligation control group (group C), with 11 mice in each group. The experimental periodental ligation on mice lasted for 10 days before they were sacrificed. Flow cytometry was applied to detect the expression of M1 and M2 in mononuclear macrophages. Real-time PCR was applied to detect the relative expression of pro-inflammatory cytokines IL-1β and anti inflammatory cytokines IL-10. Results Compared with the control group C, the proportion of M1 macrophages in the periodontitis group decreased, and the ratio of M1/M2 was also decreased significantly, and IL-1β mRNA also down-regulated. Conclusions Chronic periodontal infection could down regulate the proportion of M1 macrophages , decrease ratio of M1/M2 and the expression of inflammatory cytokines IL-1βmRNA.