The co-existence of physician-patient disharmony and the high rate of cesarean section suggest that there must be some internal relationship between the two medical phenomena.The physician-patient disharmony not only increases the rate of non-indicative cesarean section,but also leads to artificial expansion of the cesarean section indicators.Building up a harmonious physician-patient relationship is an important safeguard to reduce the rate of cesarean section and protect the benefits of mothers and infants.

Objective To investigate apoptosis of placental syncytiotrophoblast in patients with early-onset and late-onset severe preeclampsia. Methods From November 2008 to May 2009, 15 cases with early-onset severe preeclampsia and 15 cases with late-onset severe preeclampsia matched with 10 women with normal pregnancies as control at Sixth Affiliated Hospital of Shanghai Jiaotong University were enrolled in this study. Enzyme-linked immunosorbent assay was used to measure syncytiotrophoblast microparticles (STBM) levels in peripheral venous plasma. Caspase-3 were measured by western blotting.Results (1)STBM: the level of STBM of (71 ± 21 )μg/L in early-onset group were significantly higher than (42 ±30)μg/L in late-onset group and (26 ± 11)μg/L in control group(P ＜0.05). The level of STBM in late-onset group and control group did not reach statistical difference ( P ＞ 0. 05 ). ( 2 ) Caspase-3:the level of caspase-3 protein were 0. 85 ± 0. 61 in early-onset group and 0. 77 ± 0. 46 in late-onset group,which were all significantly higher than 0. 32 ± 0. 15 in control group( P ＜ 0. 05 ). However, the level of caspase-3 protein in early-onset group did not show remarkable difference compared with that in late-onset group (P＞0. 05). Conclusion STBM are shed into the maternal circulation in higher amounts in earlyonset preeclampsia, which indicated that early-onset and late-onset severe preeclampsia may have different etiology and pathogenesis.

Objective:To evaluate the application of puncturing the umbilical cord under the ultrasound guidance in prenatal diagnosis,clinical high risk factors of fetal chromosomal abnormalities were discussed.Methods:283 pregnant women who had the percutaneous umbilical cord blood sampling were recruited and the karyotyping was done.The detection rate of chromosomal abnormalities and correlate factors in different subgroups of prenatal diagnosis were analyzed.Results:The success rate of puncture was 100%.Major complications were bleeing at the puncture site(33 cases,11.67%)and fetal heart brachycadia(5 cases,1.77%).25 chromosomal abnormalities were found and the detection rate was 8.83%.There was significant correlation between the couple's chromosomal abnormalities and the fetal's(r=22.348,P=0.000).Conclusions:The ultrasound guided percutaneous umbilical cord blood sampling proves to be valid in the prenatal diagnosis,especially when couples have chromosomal abnormalities.

Objective:To investigate the effect of holistic nursing intervention in perioperative nursing for patients underwent radical hysterectomy under laparoscopy. Methods: 80patients with cervical cancer were divided into observation group (40cases) and control group (40cases), and patients of control group received routine nursing modein perioperative period while patients of observation group received holistic nursing mode in the same stage. The complication of the two groups were compared and analyzed, and the satisfaction degree for nursing mode was investigated.Results: Under the intervention of holistic nursing, the number of complication of observation group was significantly lower than that of control group (x2=8.205,P<0.05). And the satisfaction degree for nursing of observation group was significantly higher than that control group(x2=5.000,P<0.05).Conclusion: The holistic nursing intervention in perioperative nursing for patients underwent radical hysterectomy under laparoscopy can significantly improve the life quality of patients, and reduce the occurrence of complication, and enhance the satisfaction degree of patients for nursing.

Objective To explore the clinical value of autologous fat injection with platelet rich plasma in facial rejuvenation.Methods 35 female beauty seekers were collected in this study.They were divided into two groups:sample autologous fat group (FAT group,n=20) and combined autologous fat and platelet-rich plasma group (PRP group,n =15).The average level of injection was 34 ml.The fat was collected at the abdominal or thigh sites using 18 G needle connecting with negative pressure suction-pump.The fat was centrifugated 2 min to get rid of the lower layer of water and the upper layer of oil.Weigao PRP extract kit was used to obtain the PRP.The ratio of PRP to fat was 1:5.The injection technique was according to Colemen method.The survival rate,satisfaction and complication were compared between the 2 groups.Results There were no infection,hematoma,fat liquefaction necrosis occurred in the 2 groups.Compared with the FAT group,the skin texture and facial contour of the PRP group was improved.Conclusions The platelet rich plasma can improve the survival rate of fat and has a stable effect,which is one of the safe and ideal methods of facial rejuvenation.

Objective To investigate the effect of meridian exercises on blood glucose and clinical symptoms of community elderly type 2 diabetic patients.Methods Sixty elderly patients with type 2diabetes mellitus (T2DM) were selected from two communities from February to September in 2012.Thirty participants from one community received meridian excise-based group sport management (experiment group),the other 30 subjects from another community got meridian excise-based individual sport management (control group).Before and after the intervention,blood glucose and self-report symptoms were assessed.Results At baseline and after the intervention,there was statistically significant difference of postprandial blood glucose and self-symptom score between the two groups (t values were-5.954,-2.900,-4.214 and-3.798,respectively; all P＜0.05).After the intervention,experiment group showed statistically significant difference in self-assessment of symptom score from the control group (t=-5.484,P＜0.05).Conclusion Meridian exercises can efficiently improve diabetic patients' postprandial blood glucose and clinical symptons.

Objective:To evaluate the occluding effect of 2 kinds of Er laser on dentinal tubules.Methods:27 dentine discs were prepared,etched with 0.5 mol/L EDTA and then divided into 3 groups(n =9).The samples in group A without treatment were used as the controls,in group B treated with Er:YAG laser irradiation and in group C treated with Er,Cr:YSGG laser irradiation.The occluding effect was examined by scanning electron microscopy (SEM).Results:Micrographs of SEMshowed obvious occluding effect in group B and C.The dentinal tubule exposure rates of group A,B and C were 33.61 0% ±7.545%,4.1 86% ±0.723% and 3.798% ± 0.843% respectively(among 3 groups,P <0.01 ;B vs C,P >0.05).Conclusion:The 2 kinds of Er laser can block dentinal tu-bules.

Objective To investigate the teaching modes of the course of guide to learn in undergraduate nursing students in order to improve their quality of leaning.Methods Questionnaire survey and interview were conducted to collect the students'general appraisal on learning Science and teaching content and teaching modes as well as ingathering and suggestions of the course.Results Totally 79.5%among 117 students thought it necessary to open the course of Learning Science.96.6%students considered ten subjects of the course reasonable.83.8%students were satisfied with the alternate five-teachers'teaching modes.The most digestible teaching approach Was illustration,and the most valuable experience wag how to regulate the psyehology of learning.Conclusions The course of guide to learn in nursing undergraduate education has positive significance.Nursing educators should always explore and improve the teaching mode of this course so as to help students develop SOundly.

Objective To study the inhibitory effect of valdecoxib on Lewis tumor and the potential relationship with cyclooxygenase-2(COX-2).Methods HE staining was used to observe lymphocyte infiltration in tumor tissue and the cell structure of the stomach and colon.Western blotting was used to detect the expression of COX-2 in tumor tissue.PGE_2 ELISA kit was used to detect the content of PGE_2 in tumor tissue.Results ① Valdecoxib inhibited the growth of the tumor,and the survival rate was increased.②There was lymphocyte infiltration in treatment group and the content of PGE_2 was decreased.③Valdecoxib did not affect cell structure of stomach and colon,bleeding and clotting time.Conclusion Valdecoxib inhibits the growth of the Lewis tumor and enhances the survival rate.The effect of valdecoxib is related to the inhibition of COX-2.

Objective To investigate the relationship between 24-hour ambulatory blood pressure and urine microalbumin(UMA)level in the elderly with non-diabetic essential hypertension.Methods One hundred elderly cases with essential hypertension were selected from the Department of Geriatrics,the Sixth People's Hospital,Shanghai and divided into two groups,one with UMA less than 30 mg/24h,and the other with UMA equal to or greater than 30 mg/24h.Ambulatory blood pmssure,serum level of creatinine (sCr),UMA and other characteristics were measured for all the subjects studied and compared to find possible relationship between blood pressure and UMA.Results Level of sCr,diastolic blood pressure at night (nDBP),24-hour average blood pressure,average blood pressure at night were all significantly higher in the group with UMA equal to or greater than 30 mg/24h than that with UMA less than 30 mg/24h(P<0.05 or P<0.01). Multivariate logistic regression analysis indieated that both sCr and nDBP were indispensable predictors for high microalbuminuria in patients with essential hypertension.Conclusions Ambulatory blood pressure monitoring,especially blood pressure variation at night,has more important predictive value for severity of renal damage caused by hypertension in the elderly with non-diIlbetic essential hypertension.