Objective To discuss the indications for cesarean section in our hospital in recent years.Methods We retrospectively studied the indications for cesarean section of 949 caases in our hospital .Results The average rate of ceasarean section was 34.9%.The order of indications were as following;pregnancy complications(29.6%),relative cephalopelvic monosymmetry(10.6%),breech presentation(10.2%),fetal distress(9.8%),fetal macrosomia(9.2%) and scar uterus(8.9%).The correspondent rate in the diagnosis of fetal macrosomia was 67.5%.The rate of neonatal asphyxia was 6.7%.Conclusion Obstetric medical staff should improve their opinion on the cesarean section and master the indications appropriately.

Objective To explore the different doses of dexmedetomidine for prevention of shivering in cesarean section effect in patients with spinal and epidural anesthesia, summarize the clinical experience.MethodsIn 40 cases of spinal epidural anesthesia in cesarean section with large doses of dexmedetomidine for intervention, and classified into control group, according to the in the other 40 patients using small doses of dexmedetomidine for intervention, and classified as the observation group, then observe two groups of patients with chills were compared, the patients were in our hospital from February 2016 to January 2017 were found.ResultsWith comparison of two groups of patients with chills, two group in the overall number of cases no significant difference.The observation group, a total of 9 cases of patients with chills, the control group had 10 cases of chills, while no significant difference between the two groups of shivering grade;the patients in the observation group of 2 cases (5%) had adverse reaction, the control group had 9 (22.5%) cases of adverse reactions,P<0.05 between the two groups showed significant differences.ConclusionDifferent doses of dexmedetomidine on preventing shivering effect analysis of cesarean section in patients with spinal and epidural anesthesia after the discovery, which can play the effect of the intervention in patients with chills, and can reduce the incidence of adverse reactions in patients after surgery, it is worthy of reference.

Objective α?Asarone has the effect of relieving cough and asthma as well as sedative, hypnotic and anticonvul?sive function. Our study was designed to explore the effects of apoptosis induced by α? Asarone on human esophageal carcinoma Eca?109 cell line as well as the expression levels of GADD153 and Smac mRNA. Methods Human esophageal carcinoma Eca?109 cells were cultured in vitro, which were divided into blank control group, 5?FU group( 500μg/mL) andα?Asarone group of different dosages ( 25,50,100μg/mL) . After cultivation, MTT method and Annexin V?PI were used to measure cell proliferation rate and apoptosis rate. Expression levels of GADD153 and Smac protein and mRNA were detected by western blotting and real? time quantitative PCR. Results Compared with blank control group, the cell proliferation rates in other groups decreased significantly (P<0.01), and cell apoptosis rate increased significantly ( P<0.01) . Compared with blank control group, the expression levels of GADD153 and Smac pro?tein and mRNA in other groups increased significantly( P<0.05) . Conclusion α? Asarone can inhibit cell proliferation and induce the apoptosis of human esophageal carcinoma Eca?109 by regulating the expression levels of GADD153 and Smac gene.

Aim To evaluate the effects of pioglitazone,a thiazolidinedione on the heart of diabetic animals.Methods Streptozotocin(STZ)-induced diabetic rats were divided into two groups: untreated-DM and treated-DM. Pioglitazone(20 mg?kg~(-1)?d~(-1)) was mixed in water fed to the diabetic treated group.After 5 wk,the left ventricle mass index(LVI),cardiomyocytes size and diameters,the content of hydroxyproline and collagen volume fraction(CVF) were measured.The left myocardium sections were made for HE,MASSON straining to observe the level of myocardial cells' hypertrophy and the accumulation of collagen individually and were examined by light microscope.Myocardial ultrastructure was studied by electronic microscope.Results Compared with untreated-DM group,the LVI,cardiomyocytes size and diameters,the content of hydroxyproline and CVF were lower in treated-DM group(P

Objective To investigate the status and influencing factors of quality of life among diabetes patients in Nanchang,and to explore the relationships between the quality of life and community health care demands.Methods Totally 292 diabetes patients were recruited by multi-stage sampling method from thee community health service centers in Nanchang city.They were investigated with Diabetes-specific Quality of Life Scale(DSQL) and a self-designed questionnaire of community health care demands.The results underwent analysis.Results The total score of the DSQL in Nanchang was(66.88±15.44) points,which was relatively poor.The main factors affected patients' quality of life were the complications of diabetes,diabetic macroangiopathy,diabetic foot,hypertension and patients' career.The total and the every dimension of the scores of the DSQL were positively correlated with the scores of disease nursing needs and community health care demands.Conclusions To improve diabetes patients' quality of life,community diabetic care should focus on the different affected factors of patients' quality of life and the demands of patients.

Objective To observe the expressions of serum insulin-like growth factor (IGF)- Ⅰ ,Ⅱ and IGF binding protein (IGFBP) 3, 5 and to explore the clinical significances in patients with clear cell carcinoma of kidney. Methods Enzyme-linked immunosorbent assay (ELISA) methods were adopted to examine serum expressions of IGF-Ⅰ , Ⅱ and IGFBP 3, 5 in 40 cases with clear cell carcinoma of kidney (renal carcinoma group) and 16 cases with hydronephrosis (control group) from May 2007 to December 2009. Results IGF- Ⅰ , Ⅱ and IGFBP 3,5 in renal carcinoma showed higher expressions before operation (985. 7 μg/L, 1154.0 μg/L,46.6 μg/L and 9.6 μg/L, respectively)than after operation (431.4 μg/L, 632.6 μg/L, 26.7 μg/L, and 6.7 μg/L, respectively, all P＜0. 05 ～0.01). There were no significant differences in those indexes between pre- and post- operation in control group (P＞ 0. 05). Conclusions There are high expressions of serum IGF-Ⅰ , Ⅱ and IGFBP 3, 5 in renal carcinoma patients, and IGF- Ⅱ has clinical significance in diagnosis.

OBJECTIVETo guide doctors in precisely positioning surgical operation, a new production method of minimally invasive implant guide template was presented.

METHODSThe mandible of patient was scanned by CT scanner, and three-dimensional jaw bone model was constructed based on CT images data The professional dental implant software Simplant was used to simulate the plant based on the three-dimensional CT model to determine the location and depth of implants. In the same time, the dental plaster models were scanned by stereo vision system to build the oral mucosa model. Next, curvature registration technology was used to fuse the oral mucosa model and the CT model, then the designed position of implant in the oral mucosa could be determined. The minimally invasive implant guide template was designed in 3-Matic software according to the design position of implant and the oral mucosa model. Finally, the template was produced by rapid prototyping.

RESULTSThe three-dimensional registration technology was useful to fuse the CT data and the dental plaster data, and the template was accurate that could provide the doctors a guidance in the actual planting without cut-off mucosa.

CONCLUSIONThe guide template which fabricated by comprehensive utilization of three-dimensional registration, Simplant simulation and rapid prototyping positioning are accurate and can achieve the minimally invasive and accuracy implant surgery, this technique is worthy of clinical use.

Computer-Aided Design ; Dental Implantation, Endosseous ; Dental Implants ; Dental Models ; Humans ; Jaw, Edentulous ; Mandible ; Patient Care Planning ; Surgery, Computer-Assisted

Objective: To analyze the completion status, monitoring results, and existing problems of key occupational disease monitoring in Shandong, China, from 2015 to 2017, and to provide reference materials for improving monitoring quality and carrying out occupational disease prevention and control. Methods: The monitoring situation including project coverage, data collection, monitoring results, and monitoring quality of key occupational diseases in Shandong from 2015 to 2017 were described and comparatively analyzed. Results: In the past three years, the uncoverage rate of monitored counties (38.69% in 2015, 10.95% in 2016, and 5.11% in 2017) , the non-work rate of occupational health examination institutions (41.67% in 2015, 18.02% in 2016, and 8.72% in 2017) , and the non-work rate of occupational disease diagnosis institutions (42.31% in 2015, 38.46% in 2016, and 38.46% in 2017) in Shandong decreased year by year. The number of institutions with key occupational hazard factors reported to the safety supervision and management department increased year by year (it was 24140 in 2017, with an increase of 40.50% compared with 2016 and an increase of 114.62% compared with 2015) ; the key occupational hazard factors in enterprises were mainly noise (72.76%) , followed by benzene, silica dust, and coal dust. The number of workers exposed to key occupational hazard factors reported to the safety supervision and management department increased year by year; in 2017, it was 729245, with an increase of 39.78% compared with 2016 and an increase of 84.81% compared with 2015. The ratio of people exposed to key occupational hazard factors identified by the medical examination to the total people in the safety supervision system in a year decreased year by year (40.87% in 2015, 23.86% in 2016, and 17.95% in 2017) . Conclusion In Shandong, the supervision of enterprises with key occupational hazard factors and the responsibility of enterprise protection should be strengthened. The occupational health examination rate of workers should be improved. It is suggested that we should carry out the special investigations and occupational health risk assessment for key enterprises and key populations.

Objective To summarize the experience of cannulation for extracorporeal membrane oxygenation (ECMO) in infants less than 5 kg. Methods Eleven infants with ECMO support who weighed less than 5 kg were admitted to critical care medicine of Guangzhou Women and Children's Medical Center from June 2016 to June 2018 were enrolled. Retrospective analysis of support type, configuration, site of cannula and complication of ECMO was performed. Results The 11 infants consisted of 9 males and 2 females. The weight on ECMO of 1.96-4.60 kg, with an average of (3.14±0.65) kg; age 0.1-30.0 days, with a median of 5.6 (1.5, 8.3) days. Four cases were given ECMO because of congenital diaphragmatic hernia with severe pulmonary hypertension and other 7 cases were cannulated due to complication of congenital cardiac surgery. All infants were received veno-arterial (V-A) ECMO. In 4 cases, the cannulas were placed in the right internal jugular vein for drainage (8-10 French catheter with 6.0-7.5 cm depth) and the right carotid artery for infusion (6-8 French catheter with 2.5-3.5 cm depth); the average time of cannulation in right carotid and jugular vessels was (73±20) minutes (range 55-100 minutes). In other 7 cases, the cannulas were inserted into the right atrium (12-14 French catheter with 2.8-3.0 cm depth) for draining blood and returning it to the ascending aorta (6-8 French catheter with 1.0-2.0 cm depth); the average time of cannulation in central vessels was (64±31) minutes (range 35-110 minutes) with exclusion of 2 cases intraoperative cannulation. There were three infants with complications. One episode was shown in vascular rupture, one in catheter site hemorrhage and one in cannula malposition with later repositioning. There was no case of insertion site infection, cannula-related bloodstream infection and accident detached cannula. Conclusion Cannulation for ECMO can be performed in infants less than 5 kg with a high rate of success and a low rate of complication owing to appropriate catheter and skillful cannulation.

OBJECTIVETo assess the value of array-based comparative genomic hybridization (array-CGH) for analyzing tissues derived from spontaneous abortion and stillbirth.

METHODSAgilent Human Genome CGH Microarray 4×44 K chip and Affymetrix Cytoscan 750 K Array were utilized to detect genome-wide copy number variations (CNV) in 43 fetuses with spontaneous abortion and stillbirth. All identified CNV were analyzed with references from Database of Genomic variants (DGV), database of DECIPHER, ISCA and OMIM, as well as comprehensive literature review to determine whether the identified CNVs were pathogenic. Parental DNA of two cases was also analyzed with the same arrays for pathogenic or unknown significant CNVs.

RESULTSAll of the 43 specimens were successfully analyzed. Clinically significant chromosomal aberrations were identified in 32 (74.4%) of the samples, which included 26 aneuploidies and 10 pathogenic CNV.

CONCLUSIONArray-CGH is a fast and effective method for analyzing tissues derived from spontaneous abortions and stillbirths which may be difficult to culture for karyotype analysis.

Abortion, Spontaneous ; diagnosis ; genetics ; Adult ; Chromosome Aberrations ; Comparative Genomic Hybridization ; methods ; DNA Copy Number Variations ; Female ; Fetus ; chemistry ; Humans ; Karyotyping ; Pregnancy ; Pregnancy Complications ; diagnosis ; genetics ; Stillbirth ; genetics ; Young Adult