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.

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.

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 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.

Through the brief introduction of the concept of the mobile medical , this paper pointed out that the ethical issues that exist:health data reliability problems , the patient′s privacy protection , the protection of intellec-tual property rights issues , is involved in the problem of illegal practice medicine , online consulting the legal re-sponsibility of the doctor -patient relationship to define problems , make the reductionism , highlighted the defect of mind-body dualism and instrumental rationality overflow problem .And from the technical level , the law , the poli-cy level and consciousness discusses the related countermeasures .

Aim To investigate the function of fenofi-brate on PAN ( puromycin aminonucleoside )-induced podocyte injury. Methods SD female rats of 18-week-old were randomly assigned into 3 groups ( n =6 ) . Mice in PAN group and fenofibrate treated group received a single intravenous injection of PAN ( 65 mg ·kg-1 ) , while those in control group received equal volume of saline. Mice in fenofibrate treated group re-ceived 40 mg · kg-1 · d-1 of fenofibrate ( intragastric administration ) on day 1 after PAN injection , while those in PAN group and control group received equal volume of vehicle. 24 hours urine samples from all group were collected on day 0(1 day before PAN injec-tion), day 6, day 10. The 24 hours urine protein was detected by Bradford assay. All the rats were sacrificed 10 days after the induction of podocyte injury, and glo-merulus sample were collected. The expression of podocyte injury marker and transcription level in apop-tosis, podocyte cytoskeleton protein, slit diaphragm protein were evaluated by Western blot and real-time PCR. Results Compared with the control group, 10 days after injection of PAN, 24 hours urine protein was obviously increased, and the expression and transcrip-tion level of podocyte injury marker desmin, apoptosis, podocyte cytoskeleton protein, slit diaphragm protein were upregulated greatly, however, those were signifi-cantly lower in fenofibrate treated group as compared with those in PAN group. Conclusions PPAR-α ago-nist fenofibrate can ameliorate PAN-induced glomerulus podocyte injury, and the mechanism involved may be associated with inhibition of the mitochondria apopto-sis, TGF-β/Smad pathway and p38 pathway.

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.

Some questions like the hardship of treatment and lacking of standard on diagnosis are existing in steroid-resistant nephritic syndrome(SRNS).This article make an ethical analysis on these questions and assumes that we should persist in treating the patients carefully with humanism,carry on informed consent principle,implement the optimal treatment and perfect the standard of diagnosis and treatment,carry on clinical ethics education and promote the judgment level of clinical ethics.