Objective To investigate the impact of the different mode of delivery on postpartum lactation.Methods 1 678 pregnant women in our hospital were divided into cesarean section group(798 cases) and natural delivery group(880 cases).Open milk after delivery,breast fullness,the number of neonatal sucking and post-natal self-assessment milk water were compared between the two groups of pregnant women,and the impact of the mode of delivery on postpartum lactation was analyzed.Results Whether or not began to lactation (721/77cases),and the time of labor to beginning to lactation [(33.45 ± 9.68) h],and whether or not having breast fullness feeling (512/286 cases),and the time of labor to breast fullness feeling[(57.12 ± 13.90) h] in cesarean section group had significant difference with those of spontaneus labor group [(845/35 cases),(30.12 ± 10.25) h,(690/190 cases),(52.98 ±15.09) h] (x2 =21.613,t =2.452,x2 =41.813,t =2.818,all P ＜ 0.05).There was no significant difference in selfrating milk score [(2.02 ± 0.45) points vs (2.45 ± 0.51) points],and newborn sucking times 4 ～ 6d postpartum [(5.21 ±1.21) times vs (5.89± 1.82)times](t =2.012,2.532,all P ＜0.05).Conclusion Efficiency of the breast-feeding was affected by the impact of the mode of delivery.Rationalized breastfeeding guidance was necessary to strengthen for pregnant women by cesarean section.

Objiective:to summarize the early treatment of severe bifrontal intraparenchyma contusion associated with central herniation. Mehthod:clinical presentation of 41 cases of secere bifrontal contusion associated with central herniation were analyzed retrospectively. Resolts:12 cases had good overcome,13 mild morbidty,2 severe mordity,1 were in persistent vegetative state,3 mortality.Conclusions: Attaches great importance to patients with severe bifrontal brain contusion associated with central herniation,close observation of patients with their consciousness,pupil and changes in vital signs;attend that it is premature to stop dehydrating agent,too fast,to review the head dynamic CT,the right to master surgical indications.Early removal of necrotic brain tissue and cranial decompressive craniectomy to be effective in improving the cure rate of patients.

Objective To explore the influencing factors of heart failure among patients with continuous ambulatory peritoneal dialysis(CAPD).Method Clinical data were collected from the histories of 158 patients receiving CAPD to investigate the factors inducing heart failure for the purpose of finding out the potential independent influencing factors using t test or chi-square test for univariate analyses and logistic regression in multivariate analyses.Results The incidence of heart failure was 36.71%among the enrolled CAPD patients.Single factor analysis showed that level of volume management,age,hemoglobin,serum pre-albumin, cholesterol and c-reactive protein were related to heart failure.Analysis of multiple variables logistic regression revealed that levels of volume management,serum pre-albumin and blood urea nitrogen were related to heart failure.Conclusions It is an easy,effective and cheaper way for nurses to increase patients’ability of volume control.The strategy including remedying malnutrition and decreasing the level of uremic toxins might be effective for delayed exacerbation of cardiac function among CAPD patients.

Pancreatic cancer is the fourth most common cause of cancer death,with a 5- year survival rate of less than 5％.The management and prognosis of the patients have remained dismal due to higher resistance of cancer cells to conventional approaches including surgery,radiation and chemotherapy.Therefore,there is a need for development of specific and sensitive tumor marker for pancreatic cancer.Caveolin- 1 is an essential constituent of caveolae and interacts with a variety of cellular proteins and regulates cell- signaling events.In this review,we survey the functional roles of caveolin- 1 in pancreatic cancer and argue that caveolin-1 regulates multiple cancer-associated processes including tumor growth,cell invasion,metastasis,cell apeptosis.However,Caveolin-1 has been reported to impact both positively and negatively on various aspects of pancreatic cancer progression.The function of caveolin- 1 is interdependent on tumor stage and the expression of some signaling pathways that impact on its role during tumor progression.

Hemodynamics is monitoring a series of physiological and pathological parameter changes such as blood flow,the chamber pressure of the heart,pressure or resistance of cardiovascular and cardiopulmonary system.Traditional hemodynamic monitoring in septic shock manily includes central venous pressure,cardiac index,blood lactate and pH.In recent years,expanded non-invasive or invasive monitoring technologies include central venous or mixed venous oxygen saturation,continuous ultrasound associated with underlying cardiac output monitoring and pulse indicator continuous cardiac output.Macro-hemodynamic,metabolic and microcirculatory parameters constitute a new hemodynamics network.In order to properly assess the patient's blood volume and circulation function and to overcome the limitations of a single parameter,it is need to emphasize analysis and integration of the various parameters.

Intracranial atherosclerotic stenosis mostly occurs in Asians,blacks and Hispanicsis,which is the most important reason for the occurrence and recurrence of ischemic stroke.The current studies mainly concentrate on the aspect of the relationship between the intracranial atherosclerotic stenosis and the traditional risk factors.With the development of genetic technology,the relationship between the genetic factors and intracranial atherosclerotic stenosis has also received increasing attention.This article reviews the advances in research on the traditional risk factors for intraeranial atherosclerotic stenosis and genetic research.

Bacause of few side effects,low expenditure,the adaptability for long－ term treatment and the ability of treating both principal and secondary aspect of disease of chinese herbs,to cure osteoporosis by chinese herbs and the combined treatment of traditional chinese and western medicine has become a hot task in china.It has been demonstrated that the chinese herbs can prevent and treat osteoprosis effectively.Many research also show that the chinese herbs can increase the intestine calcium absorption,decrease PYH and increase 1,25(OH)2D3 level.This review intends to show and summarize the progress made all those years.

Objective To investigate the difference of TCM body constitution betweenpeople of the Shimian county and Chengdu city. Methods 200 sub-health patients in clinic of Shimian TCM Hospital were selected randomly. Another 200 sub-health patients in clinic of the Second Sichuan Province Hospital of TCM wererandomly selected. The two groups were identified with TCM body constitution based on the clinical symptoms, tongue, pulse condition, etc. Comparisons on body constitution were made between the two groups. Results In Chengdu, patients withbalance constitution and Qi deficiency constitution (respectively have the proportion of 33.0% and 20.0%)were significantly higher than thoseof Shimian County(the proportion of the two wererespectively 4.0% and 6.0%);while Shimian County have a significantly higher ratio of phlegm dampness and blood stasis constitution(43.5% and 13.0%)than those in Chengdu city(the proportion of the two wererespectively 8.0%and 4.0%), P<0.01. Conclusion Because of different regions, the population constitution ratio wasdifferent, so the disease tendency wasalso somewhat different. Therefore, physicians should give full consideration to the regional factors in diagnosing and treating patients.

Objective To investigate the diagnostic method,microsurgical operation time and effect of brain arteriovenous mal-formation(AVM)rupture hemorrhage in childhood.Methods 72 children (≤16 years old)of AVM hemorrhage from 2003 to 2013 were retrospectively analyzed.Results The CT diagnosis rate was 48.6%(35/72),the MRI diagnosis rate was 78.3%(47/60),56 cases were performed the early whole brain DSA under the condition permitting,its diagnosis rate was 98.2%(55/56).All the cases were performed the hematoma clearance plus the pertinent lesion resection.70 cases were re-examined by DSA/CTA/MRA during postoperative perioperation period.The lesion resection rate was 91.5%,the partial resection rate was 8.6%.60 cases(85.7%) were successfully followed up for 6 months to 6 years and assessed by the Glasgow outcome scale,5 points in 5 5 cases,4 points in 2 cases,3 points in 2 cases and 2 points in 1 cases.Conclusion DSA is the main detection measure for early diagnosing AVM hem-orrhage and the microsurgical operation in the acute stage can reduce the fatality and improve the prognosis.

Continuous renal replacement therapy( CRRT) employs convection and adsorption to re-move pro-and anti-inflammatory mediators from plasma, helping to restore the immunologic homeostasis. CRRT also provide uninterrupted clearance of retained endogenous and exogenous toxins, along with acid-base,electrolyte,hemodynamics and volume homeostasis.CRRT may improve outcomes in critically ill pa-tients with sepsis-induced acute kidney injury,septic shock and multiple organ dysfunction syndrome.Region-al citrate anticoagulation, as compared to unfractionated heparin, report better filter survival times and less bleeding.Antibiotic dosing decisions should be individualized to take into account patient-related,CRRT-relat-ed,and drug-related factors.