Objective To analyze the prevalence of postpartum depression in China.Methods CNKI,Chongqing VIP database,CBMDISK,Pubmed databases were searched for articles about postpartum depression prevalence in China published during 1996～2012.The random effects model was employed.Results There were 84 articles which provided 52 776 samples,and 8390 cases of depressive symptoms were detected.The pooled prevalence was 14.7％(13.1％～16.3％),The prevalence of postpartum depression was different in different regions,municipality directly under the central government was the lowest 10.9％(8.7％～12.7％),county area was the highest 16.4％ (11.9％～22.2％).From the east of China to the central and to the west,the prevalence rate assumed the trend of escalation.The prevalence which evaluated by standard of EPDS ≥ 10 was higher than the prevalence evaluated by EPDS ≥ 13 and SDS ≥50.Conclusions The prevalence of postpartum depression is high in China.More attention should be paid to the central,western of China,urban,rural and other underdeveloped areas.

Objective Controlled hypotension induced by different drugs may have different effects on splanchnic perfusion. The purpose of this study was to assess the effects of nicardipine- induced hypotension on splanchnic perfusion. Methods Twenty-three ASA Ⅰ-Ⅱ patients (14 male, 9 female) aged 21-60 yr undergoing meningioma resection were studied. The patients were premedicated with ranitidine 150 mg per os and atropine 0.5 mg i.m. Anesthesia was induced with propofol 1.5-2.0 mg?kg-1 , fentany1 2.0?g?kg-1 and vecuronium 0.1 mg? kg-1 and maintained with isoflurane inhalation and intermittent i. v. boluses of fentanyl and vecuronium. The patients were mechanically ventilated after tracheal intubation and PETCO2 was maintained at 33-35 mm Hg. Nicardipine-induced hypotension started from opening of mininges to the resection of tumor. 0.01% nicardipine infusion was started at 30 ml?h-1 and adjusted to reduce systolic blood pressure by 30% of the baseline or MAP to≥60 mm Hg. The adequacy of splanchnic perfusion was defined by gastric intramucosal CO2 tension (PgCO2), the intramucosal pH (pHi) and the difference between intramucosal and arterial PCO2(PCO2 gap) and was assessed before induction of anesthesia, the 1st, 2nd and 3rd hour during controlled hypotension and 1, 2 hour after termination of controlled hypotension. Results The MAP was maintained at about 62 mm Hg during controlled hypotension. The heart rate was stable. Hct was significantly decreased at 1st, 2nd and 3rd hour of hypotension compared with baseline but the mean Hct was greater than 30% . The intramucosal pH decreased slightly with no statistical significance and pHa, PaCO2 , PgCO2 and PCO2 gap were almost unchanged during controlled hypotension compared with the baseline values. Conclusion Nicardipine-induced hypotension is safe when MAP is maintained at≥60 mm Hg and has no adverse effects on splanchnic perfusion.

In order to observe the changes of myotension in the paralyzed limbs after subcutaneous injection(S.C)of capsaicin,we observed the changes of the spontaneous Electromyography(EMG)recorded in the quadriceps femoris before and after T-5 level spinal transection and found that the amplitude of EMG kept a low level in normal rats but increased progressively after operation.After treating the animals with capsaicin 200mg/kg(S.C)in three consecutive days,we found a much lower spontaneous EMG and a much higher pain threshold than that of the controls.Radioimmunnoassay detected that the content of SP in spinal dorsal horn was reduced by 38.4%,the general condition did not severely changed during the experiment.The results indicate that SP in the spinal dorsal horn participates in the regulation of myotension,and it is suggested that subcutancous injection of capsaicin may be one effective treatment to reduce the hypermyotension in the paralyzed limbs.

Objective To explore the effect of Toll-like receptor 4 (TLR4) on the peripheral blood mononuclear cells(PBMCs) in the development of rheumatoid arthritis (RA) by inducing the differentiation of Th17 cells.Methods Forty two subjects were recruited to the study,including 22 patients with RA and 20 healthy controls (HC).The percentage of circulating Th17 cells were analyzed using flow cytometry.PBMCs were stimulated with LPS for two days.TLR4 mRNA of the PBMCs and the concentration of IL-6 and TNF-α in the supernatants were analyzed with the real-time qPCR and ELISA respectively.Supematants was then used for CD4+ cord blood mononuclear cells (CBMCs) culture,and IL-17 in the supernatants and the expression of IL-17 mRNA in cells were detected by ELISA and real-time qPCR respectively.The statistical analysis was carried out with t-test.Results The TLR4 mRNA expression in the PBMCs and the percentage of circulating Th17 ceils of RA patients were significantly higher than that of the HC group (P＜0.01).Stimulated by LPS,the expression of TLR4 mRNA increased 3.5 times in the RA group but decreased 0.11 times in the HC group.LPS also increased cytokines production in both groups,while PBMCs from RA patients produced more IL-6 and TNF-α than the cells from healthy subjects (P＜0.01).Compared to the HC group,the IL-17 mRNA expression and IL-17 secretion of CD4+ CBMCs induced by the supematants of RA patients' PBMCs stimulated with LPS was significantly higher(P＜0.01 ); but there was no significant difference between the RA group and the HC group without LPS stimulation (P＞0.05).Conclusion The expression of TLR4 on PBMCs from patients with RA and its response to LPS stimulation are increased,and it has demonstrated high capability in inducing the differentiation of Th 17 cells.

Objective To observe the effect of non-ablative treatment combined intense pulse light (IPL) and Q switched Nd :YAG laser on hyperpigmented skin diseases. Methods Total 250 cases of Fitzpatrick skin types Ⅲ and Ⅳ with hyperpigmented skin disorders received 4 treatments with combined 560nm IPI. and 532 nm Q switched Nd :YAG laser. The interval between two treat-ments was I month. After 3 months the effect of IPL was observed. If it was not good, we used the Q switched Nd :YAG laser. Efficacy and adverse effects were evaluated 3-6 months after the final treat-ment. Results 3-6 months after the last treatment, 50%-70% of patients had their telangiectasia, enlarged pores, hyperpigmentation and wrinking of facial photoaging improved. The degree of im-provement was more than 60 %. Common side effects were minor blistering and erythema. Conclusion Combined IPI. and Q switched Nd :YAG laser treatment is an idea non-ablative therapy for telangi-ectasia, enlarged pores, hyperpigmentation and wrinking of facial photoaging in Fitzpatrick skin types Ⅲ and Ⅳ in Asian.

Objective To observe the roh of cytoimmunologic factors,careinoembryonic antigen (CEA),serum ferritin(SF)and prognostic factors in patients with Iung adenous cancer.Methods Eightyone patients with lung adenous cancer were analyzed retrospectively.The clinical features as well as the alternation of T-lymphocyte subsets and its relationship with CEA.SF,disease stage and metastasis of lymph node were studied.Results(1)The percentage of CD4+ T cell decreased and that of CD8+T cell increased,the ratio of CD4+/CD8+ went down accompanied by the increase of disease stage.CEA and SF increased as the dmease stage increased.(2)Thedecrease of percentage of CD4+ T cell and the ratio of CD4+/CD8+ was obvious in patients with metastasis of lymph nodes[LN(+)](p＜0.01).The increase of percentage of CD8+Tcell and CEA,SF level was obvious in LN(+)(P＜0.01 or＜0.05).(3)The decrease of percentage of CD4+T cell and the ratio of CD4+/CD4+ was obvious in CEA (+)(P＜0.01).The increase of percentage of CD8+ T cell and SF level was obvious in CEA (+)(P＜0.01).(4)The decrease of percentage of CD4+ T cell and the ratio of CD4+/CD8+ was obvious in SF(+)(P＜0.01).The increase of percentage of CD3+ CD8+ T cell and the CEA level was obvious in SF (+)(P＜0.05 or＜0.01).Conclusion Disorder of cytoimmunologic situation exists in patients with lung adenous cancer,and it is closely correlatod with the CEA,SF level disease stage and metastasis of lymph node.

Background:Conventional gastrointestinal endoscopy is incapable of determining the deriving layers,size and nature of submucosal lesions,however,mini probe ultrasonography(MPS)is effective for mural stratification and determining the deriving layers and nature of lesions within gastrointestinal wall,and is considered to be an optimal examination for suspected submucosal tumors before endoscopic or surgical operation. Aims:To assess the diagnostic value of MPS for gastrointestinal submucosal lesions and the significance of MPS-assisted endoscopic therapy. Methods:A total of 69 patients with presumed gastrointestinal submucosal protruded lesions were retrospectively enrolled. All of them underwent MPS and then endoscopic therapy,such as cyst incision,high frequency electric snare resection,endoscopic mucosal resection and endoscopic submucosal dissection were performed according to the deriving layers,size and nature determined by MPS. The ultimate diagnosis was confirmed by histopathological examination. Results:In the 69 cases of lesions,MPS showed that 15 were derived from muscularis mucosa,40 from submucosa,and 14 from muscularis propria;10 of them were considered as cyst,18 were stromal tumor,8 were leiomyoma,6 were ectopic pancreas,15 were neuroendocrine tumor,and 12 were lipoma. Compared with pathological diagnosis,an overall coincidence rate of 91. 3%(63 / 69)was achieved by MPS. Conclusions:The accuracy rate of MPS is high for determining the deriving layers and nature of gastrointestinal submucosal protruded lesions prior to the attempting of endoscopic removal. It might be helpful for selecting treatment modalities for this kind of lesions.

Objective To investigate the feasibility of injection of sodium hyaluronate gel to upper lacrimal puncta in locating the nasal broken end of inferior canalicular laceration.Methods Together 52 patients(52 eyes) with inferior canalicular laceration who collected from March 2013 to March 2016 in the Third Affiliated Hospital of Nanchang University underwent canaliculax laceration anastomosis combined with silicone tube.Injection of sodium hyaluronate gel to the upper lacrimal puncta was introduced in group A (n =32/32 eyes) for locating the nasal broken end of lower canaliculax laceration,while microscope for searching the nasal broken end served as group B (n =20/20 eyes).In both groups,the silicone tubes were implanted in the lacrimal passage for more than 3 months after locating the broken end successfully.All patients were followed up from 6 months to 12 months,with mean follow-up of (8.2 ± 1.6) months,and then clinical data of the distance of lower canalicular laceration between lacrimal canal,time consuming for locating the nasal broken end,effective rate and postoperative comphcations were compared between two groups.Results The procedures in all patients were successfully.In group A,23 patients were cured and 5 improved,but the operation was failed in 4 patients,of which 3 patients occurred upper or lower lacrimal punctas teax;while in group B,13 patients were cured and 4 improved,but the operation was failed in 3 patients,of which 2 patients occurred upper or lower lacrimal punctas tear.There was no significant difference in the the distance of between lower canalicular laceration and lacrimal canal in group A [6.5-8.3 (7.3 ± 0.6) mm] and group B [6.6-8.2 (7.2 ± 0.5) mm] (P =0.40).The time consuming for locating the nasal broken end in group A [1.5-5.5 (3.3 ± 1.3) min] was shorter than that in group B [5.0-26.0 (17.0 ± 6.0) min],with significant difference (P ＜ 0.001).Conclusion It is an easy and accurate method of injection of sodium hyaluronate gel to upper lacrimal puncta for locating the nasal broken end of lower canalicular laceration with less time.

Objective To investigate the prognostic value of arterial blood lactate(Lac) and lactate clearance rate(LCR) for severe neonatal asphyxia.Methods One hundred and fifteen cases of severe neo natal asphyxia admitted in NICU of our hospital from January 2011 to October 2014 were retrospectively analyzed.Lac and LCR values were measured at multiple time points and were compared between those died (27 cases,the death group) and those survived (88 cases, the survival group).The correlation between prognosis and Lac as well asLCR was investigated.Receiver operating characteristic(ROC) curves were drawn to evaluate the prognostic value of Lac and LCR at different time points.Results No significant differences in initial lactate levels and neonatal critical illness score (NCIS) were detected between the two groups (P ＞0.05), while Lac and LCR values at 1 h,2 h,and 6 h showed significant differences between the two groups (P ＜ 0.05).The low-LCR group showed a higher rate of multiple organ dysfunction syndrome and mortality rates than the high-LCR group (44.64％ vs.15.25 ％, P =0.001;32.14％ vs.15.25 ％, P =0.033, respectively).Post-treatment Lac level was positively correlated with prognosis, while LCR at 1 h,2 h, and 6 h were negatively correlated with prognosis.Areas under curve of Lac ROC at 1 h,2 h, and 6 h were 0.625,0.719,and 0.835 respectively, while areas under curve of LCR ROC at 1 h, 2 h, and 6 h were 0.676,0.784, and 0.898 respectively.Conclusion Low LCR for severe neonatal asphyxia predicts poor prognosis.Lac level and LCR at 6 h after emergency treatment is a prognostic indicator for severe neonatal asphyxia.

ObjectiveTo compare the neonatal outcomes between infants of assisted conception (AC) and natural conception (NC). Methods A prospective case-control study was conducted.Eligible mothers were invited to this study at 28 weeks of gestation and were followed up to delivery.All newborns were examined by pediatricians right after birth.Data including gestational age,birth weight,admission to neonatal intensive care unit (NICU),and presence of any major malformation were collected.Statistical analysis was performed with SPSS 13.0.Difference between two groups was compared by x2 test. ResultsSix hundred and seventy-three newborns were enrolled into this study,including 325 in AC group and 348 in NC group.There were no differences between the demographic characteristics of the two groups,including maternal age,parents' education,family income and proportion of primipara (P＞0.05).The incidences of twins (32.62％ vs 3.45％,x2 =98.88),preterm birth (30.46％ vs 7.76％,x2=56.92),low birth weight infant (32.31％ vs 8.91％,x2 =57.07)and admission to neonatal intensive care unit (27.38％ vs 8.91％,x2 =39.16) and proportion of cesarean birth (62.77％ vs 21.55％,x2=117.64) in AC group were significantly higher than in NC group (all P＜0.01),except for the incidence of birth defect (4.62％ vs 2.59％,x2=2.01,P＞ 0.05).However,no significant differences was found in the above items when only singletons were compared between the two groups (P＞0.05),except for the cesarean section rate (61.18％ vs 22.03％,x2 =100.93,P＜0.01).There were no difference in any of the above neonatal outcomes when different assisted reproductive technologies applied were compared(in vitro fertilization-embryo transfer,intracytoplasmic sperm injection and frozen embryo transfer) (P＞0.05).Conclusions Neonatal outcome after assisted conception is a bit worse than natural conception,which might mainly due to the large proportion of multiple pregnancy after assisted conception.In order to improve neonatal outcome after assisted conception,the number of embryos transferred should be limited.