Objective To study current situations of occupational burnout and humanistic care ability of the nurses in our hospital and explore the relationship between them. Method Nursing burnout scale (NBS) and caring ability inventory(CAI) were adopted in the investigation among 542 nurses in our hospital. Results The total score on the nursing burnout of the nurses of my hospital was 96 to 214, with an average of (155.04 ± 17.01). The burnout among 245 of them (45.20%) was in mild to moderate degree and that among 155 of them (28.60%) in a severe level. The score on humanistic care ability was 94 to 253 with an average of (178.14 ± 23.66). The ability among 46.31%of them was at a middle level and that among 25.46%of them at a low level. The occupational burnout of the nurses was negatively correlated with their humanistic care ability as well as with its three dimensions of cognition, courage and patience (P<0.01). Conclusions The occupational burnout can be alleviated by reducing the pressure in their caregiving practice. Their humanistic care ability can be enhanced by improving humanistic care nursing education and bettering humanistic care system.

Objective To assess the clinical significance of fetal pyelectasis and its changing in utero. Methods One hundred and ninty-seven isolated pyelectasis cases were retrospective reviewed from Jan 2012 to Jul 2014.Isolated pyelectasis was defined as a renal pelvis anteroposterior diameter (RPAPD)of ≥5 mm without other fetal anomaly in second trimester.Persistent or progressive pyelectasis was defined as a RPAPD of ≥10 mm before delivery.They were divided into two groups according to the size of renal pelvis in second trimester:group A (RPAPD 5 - 10 mm)and group B (RPAPD ≥ 10 mm).As the same,there were two groups after 32 weeks of gestation:group C (RPAPD < 10 mm)and group D (RPAPD ≥ 10 mm).Results Totally 1 54 cases were followed up.There were 1 88 cases (95.4%)in group A,with 41 cases lost,141 cases (95.9%)RPAPD <10 mm,6 cases (4.1 %)RPAPD ≥10 mm before delivery.There were 9 cases (4.6%)in group B,with 2 cases lost,remained 7 cases RPAPD ≥ 10 mm before delivery. Conclusions Although most of the fetuses with RPAPD 5 - 10 mm in second trimester will remain the same or resolved before delivery,those with RPAPD ≥ 10 mm may persistent or progress.Prenatal assessment of fetal renal pelvis may provide properly consultation.

Objective To assess prenatal heart disease screening program by ultrasound. Methods A total of 11 544 second-trimester screening scans were performed before 24 weeks′ gestation on 11 410 women between February 2004 and May 2007 in Obstetrics and Gynecology Hospital of Fudan University. Fetal heart screening was based on four-chamber and outflow tract views( left ventricular outflow + three vessel view). The sensitivity and specificity of different views were evaluated. Follow-up data of newborns was obstained. Results (1) Among 11 544 cases, 48 cases of congenital heart disease (CHD) were diagnosed in utero. Six cases were false negative, and 2 cases were false positive. The incidence of CHD was 0.47% (54/11 544). (2) Thirty-three CHDs were detected based on the four-chamber view, including 18 ventricular septal defect (9 with conotroncal anomalies),6 anomalous atrioventricle valve, 9 disproportion of left/right ventricle. The sensitivity of the four-chamber view alone was 61.11% (33/54), and the specificity was 99. 98% ( 11 488/11 490). Fifteen CHDs were detected based on the left ventricular outflow and three vessel views, including 1 pulmonary atresia, 3 pulmonary valve stenosis, 2 transposition of the great arteries ( TGA ), 1 pulmonary stanosis with TGA, 6 tetralogy of Fallot, and 2 pulmonary stenosis. The sensitivity of the combination of the four-chamber and outflow tract views was 88. 89% (48/54), and the specificity was 99. 98% (11 488/11 490). (3)Of 48 CHDs,11 cases were eceompanied by other malformations. Eleven cases were performed amniocentesis, amony whom 5 cases were trisemy 21. Conclusion The screening program based on four-chamber and outflow tract views shows good sensitivity and excellent specificity. Our prenatal heart screening program is clinically feasible.

Objective To establish the reference ranges for fetal cardiac axis in the mid-second trimester and to evaluate the use of fetal cardiac axis in prenatal diagnosis.Methods 6744 unselected singleton pregnancies were enrolled from September 2008 to October 2010.Routine screening scan of second trimester and fetal echocardiography were performed at 18- 23+6 weeks gestation.Fetal cardiac axis was measured on the four-chamber view of the heart.Results The 6744 fetuses had a mean cardiac axis of (37.03 ± 6.10)°,ranging from 9.80° to 102.41°. Using above or below 95％ range of population (26.63° -49.40°) as a cut-off,there were significant difference of cardiac axis between normal group [(36.96 ± 5.91)°,P ＜0.01] and the group with heart defects [(43.12 ± 15.67)°,P ＜0.01],the group with intrathoricic anomalies or abdominal wall defect [(51.74 ± 15.97)°].ConclusionsThe reference ranges of fetal cardiac axis for local population in mid-second trimester may helpful for detecting congenital defects.Presence of an abnormal cardiac axis in the fetuses is associated with a substantial risk of congenital heart disease and/or other extra cardiac defects.

Cerebral microbleed (CMB) is a type of cerebral small vessel disease (CSVD). Recently studies have found that there is a certain relationship between CMB and cognitive impairment. This article mainly reviews the etiology of CMB, the relationship between CMB and cognitive impairment, CMB and cognitive disorders and the possible mechanism of CMB-related cognitive impairment, in order to improve the understanding of cognitive impairment caused by CMB.