Objective:To investigate the impact of childbirth on pubococcygeal muscle of primiparous women in China,understand factors associated with pubococcygeal muscle,and investigate the muscular training in postpartum health care.Methods:We inquired 460 primiparous women delivering a live birth at the First Affiliated Hospital of Chongqing Medical University between November 1,2000 and July 31,2001.It was a cross-sectional study using obstetric records and postal questionnaire survey by outpatient consultation carried out six months after delivery.Results:At six months after delivery pubococcygeal muscle strength was significantly associated with vaginal loosening,length of perineum wound,stress incontinence( P 0.05).About 76.30% of women received information about the muscular training after delivery,and 8.57% of women were told that they should do Kegel exercise by health care personnel at 42 days after childbirth.Only 11.8% of postnatal women often did exercise.Conclusion:Health care personnel should protect pelvic floor muscle in labor,and focus on Kegel exercise after birth.

The construction and management must be unified,the teaching content must be specified and the teaching methods should be improved.Integrable ware teaching library for sexual health education was constructed taking teaching and research section as unit.In the process of teaching,initial resuhs were achieved and teaching efficiency was improved.In the future,teaching material library and platform construction should be improved in order to meet the requirements of modem teaching.

In the article, it thinks that moral lacking of advertisement is the basic reason which leads to intensified illegal medical advertisement. The main reasons for moral lacking of advertisement: imperfect legal system of medical advertisement, indifferent ethical consciousness of medical advertisement, insufficient social supervision of medical advertisement. Therefore, we should perfect the legislation, establish the correct advertising moral concept, improve the quality of advertising employees, and realize the function of social supervision fully.

Objective:To evaluate the clinical efficacy of dezocine, fentanyl and sufentanil at the equivalent dose on hemodynam-ics, sedation and analgesia in fibrobronchoscope-guided. Methods:A total of ninety patients with anticipated difficult airways expected to be nasally intubated using fibrobronchoscope were enrolled and randomly divided into three groups:dezocine group ( group D) , fent-anyl group ( group F) and fentanyl group ( group S) . Ten minutes before the intubation, each group was intravenously given dezocine 0. 15mg ·kg-1 , fentanyl 3μg ·kg-1 and sufentanil 0. 2μg·kg-1 , respectively. The values of HR, MAP and SPO2 were recorded respectively at the time when the patients entered the operation room ( T0 ) , before the bronchoscopy-guided tracheal intubation ( T1 ) , after the intubation ( T2 ) and 5 minutes after the intubation ( T3 ) . The Ramsay sedation score before the intubation and adverse reac-tions during the intubation were also observed. Results: In group F and group S, HR and MAP decreased significantly at T1 ( P<0. 05). The levels of SPO2 decreased significantly at T1 and MAP increased significantly at T2 in the three groups (P<0. 05). The levels of HR, MAP and SpO2 in group F and group S were lower than those in group D (P<0. 05). The levels of HR and MAP in group F at T2 were higher than those in group D and group S, and SPO2 was dropped significantly in group F and group S (P<0. 05). The levels of HR in group S dropped significantly, and were lower than those in the other two groups. MAP in group F was higher than those in the other two groups (P<0. 05). From the Ramsay sedation analysis, the scores of the three groups increased significantly and the score in group S was higher than that in group F (P <0. 05). The incidence of nausea and respiratory depression in group F was significantly higher than that in group D (P<0. 05). The incidence of agitation in group F was significantly higher than that of group S (P<0. 05). The incidence of respiratory depression in group S was significantly higher than that of group D and group F (P<0. 05). Conclusion:Dezocine combined with surface anesthesia has a slight effect on hemodynamics during the tracheal intubation guided by bronchoscopy in the patients with difficult airways. The incidence of reverse reactions of dezocine is lower than that of fenta-nyl and sufentanil.

Objective: To study the mechanism of electromyographic (EMG) biofeedback. Methods: The EMG and electroencephalographic (EEG) signals were recorded dynamically during the course of EMG biofeedback. Changes of EMG amplitude and frequency during EMG biofeedback were assessed with linear analysis. We also applied the nonlinear analysis, approximate entropy (ApEn) of EMG signals and Cross Approximate entropy (Cross-ApEn) between EMG and EEG signals, to assess regularities in EMG and correlation between EMG and EEG. Results: With the processing of EMG biofeedback, the maximum, minimum and mean amplitude of EMG signals decreased significantly (F=3.85~25.59,P

AIM To identify potential amino acid residues that contribute to different catalytic characteristics of CYP2A6 and CYP2A13 enzymes in nicotine metabolism. METHODSWild type of CYP2A6 and CYP2A13 and their mutants CYP2A6V117A, CYP2A6G164H, CYP2A6I208S, CYP2A6R372H, CYP2A6S465P and CYP2A13A117V, CYP2A13H164G, CYP2A13S208I, CYP2A13H372A and CYP2A13P465S, were subjected kinetic analysis in nicotine 5'-hydroxylation. RESULTS For CYP2A6, substitution of isoleucine 208 to serine caused dramatic kinetic property changes with K_m and V_( max) varied from 62.25 μmol·L~(-1) and 6.53 mol·min~(-1)·moL~(-1) to 345 μmol·L~(-1) and 2.19 mol·min~(-1)·moL~(-1). However, the corresponding serine 208 to isoleucine mutation did not heavily affect the enzyme activity in CYP2A13. The histidine 372 to arginine mutation resulted in a remarkable catalytic efficiency decrease with K_m and V_( max) changes from 26.01 μmol·L~(-1) and 24.51 mol·min~(-1)·moL~(-1) to 148.7 μmol·L~(-1) and 6.11 mol·min~(-1)·moL~(-1) in CYP2A13, but the switching of argenine 372 to histidine did not show expected corresponding crucial influence in CYP2A6 activity. Substitutions on the other positions changed enzyme activities in different rates. CONCLUSION The isoleucine 208 is crucial to human CYP2A6, while the 372 histidine is a key amino acid residue for CYP2A13 in nicotine 5'-hydroxylation.

Objective To research the endometrial receptivity by established the endometriosis rat model in intimal window period.Methods The autologous endometrial tissues of 22 sexually mature SD rats were transplanted into the homonymy abdomi-nal wall and offside uterine mesometrium.After four weeks,we randomly dissected two rats and observed the growth of etopic en-dometrium.The EMs rats were mated with male rats in the same cage and vaginal plug was observed in the next day.The histomor-phology of eutopic and ectopic endometrial was observed in the fifth day of pregnancy.Results Ectopic endometrium was grown in the abdominal wall and mesometrium,which formed a small bulge cystic mass in 20 rats.All foci was showed adhesion to the sur-rounding tissues in a different extent.In the light microscope,the morphology of ectopic endometrial was as the same as nomal en-dometrium.The establishment of the endometriosis rat mode is successful.Vaginal plug was positive the next day.Nonoperative side uterine was full of fluid in the fifth day of pregnancy.Eutopic and ectopic endometrium were in the secretory phase..Conclusion It is a successful method to establish a rat model of endometriosis by autotransplantion of endometrium.The endometrium of EMs model rats is in embryo implantation window period,and it provides a convenient model for studying endometrial receptivity.

Establishing and perfecting the family doctor system should adhere to the following ethical princi-ples:the principle of public welfare, fairness and efficiency principle, the combination of comprehensive care prin-ciple, attaches great importance to the precautionary principle, the principle of family support, social participation principle. In the horizon, life ethics, puts forward suggestions for the development of family doctor system:impro-ving humanism quality of family physicians,calling the humanistic concern in the process of family doctor service increasing the government's policy support,increase the health resources into, adjust the health insurance policies, guide the community residents in the family doctor first.

BACKGROUND: Many researchers at home and abroad think that interlocking intramedul ary nails may be more suitable for comminuted fractures of the tibia with severe soft tissue injury. Plate fixation is more advantageous for distal tibial fractures. OBJECTIVE: To compare the effects of multifunctional locking intramedul ary nail and locking plate in treatment of extraarticular proximal tibial fractures. METHODS: 156 patients with extraarticular proximal tibial fractures were included and divided into intramedul ary nail group (n=78) and the locking plate group (n=78) according to repair method. Curative effects and healing time were compared between the two groups. At 3 months after treatment, Johner-Wruh tibial fracture scores were used to assess the repair effect in both groups. In addition, operation time, blood loss, healing time and complications were compared between the two groups.RESULTS AND CONCLUSION: Mean healing time was 9.3 months in the locking plate group and 9.2 months in the intramedul ary nail group. At 3 months after treatment, the repair effect was significantly better in the intramedul ary nail group than in the locking plate group (P < 0.05). Blood loss and time were less in the intramedul ary nail group than in the locking plate group (P < 0.05), and surgical difficulty was high. At 3 months after treatment, the incidence rates of tibia eversion/inversion, neurovascular injury and nonunion/infection were significantly lower in the intramedul ary nail group than in the locking plate group (P < 0.05). These findings confirmed that the multifunctional locking intramedul ary nailing for extraarticular proximal tibial fractures obtained reliable efficacy, exact effect, reduced blood loss and low incidence of complications. Thus, it is better than locking plate.

BACKGROUND: The postnatal sexual health of women is crucial in reproductive health, due to lack of sexual knowledge and sexual heath care service as well as conventional idea, the medical staff and postnatal women themselves pay little attention and discussion on the sexual health after childbirth.OBJECTIVE; To investigate the prevalence and types of women's sexual problems after childbirth, identify the factors associated with dyspareunia and investigate the status quo of postnatal sexual health care service. DESIGN: Cross-sectional study and follow-up survey within six months after delivery.SETTING: Department of Reproductive Medicine, Chongqing University of Medical Sciences. PARTICIPANTS: A total of 798 primiparous women delivering a live birth in Department of Obstetrics at the First Affiliated Hospital of Chongqing University of Medical Sciences between November 2000 and July 2001, and 79 husbands who accompanied their wives during the follow-ups were adopted in this study.METHODS: The primiparous women after 6 months of childbirth and husbands conducted routine postnatal follow-ups and were informed of the follow-up content. The interview was used in this cross-sectional study and the questionnaires were finished under the help of health professional. And some advice, consultations and treatments can be given in time. MAIN OUTCOME MEASURES; ①main change of postnatal sexual life;②postnatal sexual problems and related factors. RESULTS: Totally 460 out of 798 primiparous women in accordance with the inclusive and exclusive criterions received follow-up surveys after telephone or letter notification. ①Main change of postnatal sexual life: Of the 460 respondents, 94.74% had resumed sexual activity within six months after delivery. Compared with one year pre-pregnancy, the number of sexual activity decreased obviously within 3-6 months after delivery, and 66.0％ of postnatal women decreased the sexual desire.②Postnatal sexual problems and related factors: Sexual morbidity increased significantly after the childbirth: In the first three months after delivery, 70.6％ of women experienced sexual problem(s), declining to 55.6％ during the 4th-6th months, and reduced to 34.2％ at the 6th month, but not reaching pre-pregnancy levels of 7.17％. The sexual problems of women after delivery included dyspareunia, vaginal dryness, orgasm disorder and vaginal relaxation, etc.4. And dyspareunia was the most common type. Between the 4th and 6th month after delivery, dyspareunia was significantly associated with the effect of traditional sexual ideas, experience of dyspareunia before pregnancy and current breastfeeding (P ＜ 0.05), while the association of dyspareunia with delivery mode was not significant.③Sexual care service and sexual counseling after delivery: Only 20.8％ of women received information about sexual health from health care personnel within 42 days after delivery, and consultation rate of sexual intercourse problems was 8.0％.④Husbands' comprehension of postnatal problems in women: Only 59.2％ of partners whose wives had postnatal sexual problem(s) knew that their wives had ever experienced sexual problem(s) and 8.1％ of partners had sought medical help. CONCLUSION; Sexual health problems are very common in women after childbirth, taking up for 70.6％. And the quality of postnatal sexual health is unrelated with delivery mode, but postnatal health care service are often overlooked, additionally lack of professional counseling and treatment. The current practices of encouraging the husband's supports after the childbirth may well influence the prevention and treatment of postnatal sexual problems in women.