Objective To evaluate factors associated with labor pain and delivery outcomes.Methods From Jul.to Dec.2009,111 normal singleton cephalic presentation pregnancies (including 5 elderly parturient) who delivered at the Department of Obstetrics and Gynecology,Second Affiliated Hospital,Zhejiang Chinese Medical University were enrolled in this study to evaluate the relationship between factors of labor pain and delivery outcomes.The labor pain of latent phase and active phase were scored by the visual analogue scale (VAS).Factors associated with pain included the age of parturient,the number of gravidity and parity,occupation,education profile,dwell location,etc.The questionnaire was designed by ourselves.Childbirth awareness,psychological preparation of delivery,emotional controllability,couple relationship,the relationship of parturient and mother-in-law,the relationship of parturient and parents,family economic status,use of sedative during the labor process and delivery outcomes were collected and analyzed.Results (1)Factors associated with pain:in the latent phase,the rate of moderate labour pain of 1/5 in women with more than 35 years old was statistically lower than 76.4％ ( 81/106 ) in suitable age group (P＜0.05 ).The women with a good understanding about delivery had a statistically lower rate of moderate pain of 64.7％( 44/68 ) than 88.4％ ( 38/43 ) of those having a poor understanding( P＜0.05 ).The women who had a better couple relationship had a significandy higher rate of moderate pain of 77.2％ (78/101) than 4/10 of those who had a general couple relationship ( P＜0.05 ).There was significant difference in rate of moderate pain between pluripara group ( 50.0％,11/22) and primipara group(79.8％,71/89;P＜0.01 ).In the active phase,women with tense,scared or a poor emotion control expressed significantly severe labour pain(59.0％,36/61 ) than 35.6％ ( 16/45 ) in well-prepared group.The rate of severe labour pain in good control of emotion group of 44.8％ (43/96) was a statistically lower than 9/10 in poor control group.There was a statistically lower severe labour pain in women given by sedatives ( 29.2％,7/24 ) than 54.9％ (45/82) in women without sedatives treatment (P ＜ 0.05).(2) Delivery outcomes:in latent phase,the rates of fetal distress and cesarean section were 36.6％ (30/82) and 39.0％ (32/82) in moderate pain group,which were significantly higher than 13.8％ (4/29) and 17.2％ (5/29) in mild pain group.In active phase,the rate of fetal distress,cesarean section and postpartum hemorrhage were 36.5％ ( 19/52),40.4％ (21/52) and 13.5％ (7/52) in severe pain group,which were significantly higher than [18.5％ (10/54) ;20.4％ (11/54) ;0] in moderate pain group (P＜0.05).Conclusions Women with poor understanding of delivery,tense,scared,poor emotion control,young age and uniparous have severe labour pain.Sedative use could alleviate pain in active phase.Women with mild labour pain have good delivery outcomes.

Objective To investigate the clinical features, the video electroencephalography ( V-EEG) and synchronous electrocardiography ( ECG) changes in non-epileptic seizures and the significance of ECG monitoring in the diagnosis of epilepsy.Methods We collected 3 patients who came in a chief complaint of“episodes of unconsciousness with limbs twitch”, whose clinical features and EEG, ECG in longterm VEEG monitoring were analyzed.The 3 patients were followed up for at least 6 months.Results The 3 patients were all diagnosed as epilepsy in other hospital,and during the 24-hour VEEG monitoring in our hospital,2 patients showed abnormal cardiac rate and arrest during the attack and corresponding EEG changes after cerebral ischemia and hypoxia.After consultation with the department of cardiology, they were diagnosed as cardiac syncope episode and no attack showed up after the placement of pacemaker.The Q-T interval was prolonged in the other patient during the longterm ECG monitoring, after the coherence check who was diagonsed as severe hypocalcemia combined with myocardial damage due to a lower parathyroid function and had no attack after symptomatic treatment.Conclusions The synchronous ECG monitoring during the attack is of great significance in the differential diagnosis of epileptic and non-epileptic seizures. The ECG changes in patients with longterm VEEG monitoring should be focused on.It is necessary to add the early warning function to prevent the occurrence of accidents.

OBJECTIVETo investigate the impact of long-time and short-time blood pressure variability (BPV) on glomerular filtration rate (eGFR) in elderly population.

METHODSA total of 2 464 participants aged of ≥60 years old without history of stroke and coronary heart disease were selected with random sampling method from the individuals underwent health check up in Tangshan Kailuan Hospital, Kailuan Linxi Hospital, Kailuan Zhaogezhuang Hospital between 2006 and 2013. The study participants were asked to join a face-to-face interview every two years. Long-time BPV was defined as the standard deviation of all SBP values at the baseline visit and following visits, short-time BPV was defined as the standard deviation of day time blood pressure and night time blood pressure which was derived from 24 hours ambulatory blood pressure monitoring. Multivariate linear regression models were used to test the impact of long- and short-time BPV on eGFR.

RESULTSThe study included 3 participants groups including the long-time SBPV group (2 279 participants), the short-time SBPV group (1 636 participants) and the long- plus short-time SBPV group (1 632 participants). Participants were further sub grouped by median value (NO.1median value). eGFR in the long-time SBPV NO.1 and NO.2 group was 83.19 and 81.49 ml·min(-1)·1.73 m(-2) respectively, in the short time SBPV NO.1 and NO.2 group was 83.53 and 80.81ml·min(-1)·1.73 m(-2) of the day time, and was 83.20 and 81.14 ml·min(-1)·1.73 m(-2) of the night time, respectively. eGFR in the long- plus short-time SBPV NO.1 and NO.2 group was 83.21 and 81.08 ml·min(-1)·1.73 m(-2) of the long-time SBPV, and was 83.53 and 80.75 ml·min(-1)·1.73 m(-2) of the day time, and was 83.18 and 81.11 ml·min(-1)·1.73 m(-2) of the night time. Significant linear relationship was found between higher day time SBPV and lower eGFR (P<0.05). After adjusting for confounding parameters including age, sex, body mass index, 1 mmHg(1 mmHg=0.133 kPa) of day time SBPV increase was related 0.21 ml·min(-1)·1.73 m(-2) eGFR decrease (P<0.05).

CONCLUSIONThe higher day time SBPV is associated with reduced eGFR in the elderly population.Clinical Trail Registry Chinese Clinical Trial Registry, ChiCTR-TNC-11001489.

Aged ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Coronary Disease ; Glomerular Filtration Rate ; Humans ; Time Factors