Objective To study the perinatal outcomes of pregnant women when their total stage of labor over 24 hours after the application of new partogram.Methods A retrospective case-control study was conducted on 3 991 pregnant women who received routine prenatal care and intrapartum management according to new partogram and delivered at full-term with alive babies at Beijing Obstetrics and Gynecology Hospital from October 1,2014 to January 31,2015.Among these 3 991 women,85 delivered after 24-hours' labor and all were nulliparas,while five of the 85 converted to cesarean section (CS group) and 80 delivered vaginally (study group).Another 160 primigravidas were randomly selected from those vaginal deliveries with the total stage of labor less than 24 h as control group.The general conditions,maternal and fetal perinatal outcomes were compared between the study and control group and between the study and CS group.The duration of labor was compared among different groups of women in the study group.Independent sample t-test,Rank-sum test,Chi-square test or Fisher's exact test were applied for statistics.Results The durations of first stage,second stage,third stage and total stage of labor were all longer in the study group than in the control [25.7(23.8-26.8) vs 10.4(5.9-13.9) h,1.4(0.6-1.8) vs 0.8(0.4-1.0) h,0.14(0.08-0.17) vs 0.11(0.07-0.13) h,27.2(24.9-26.8) vs 10.4(5.9 14.0) h,Z=12.525,4.359,3.528 and 12.588,all P＜0.01].The proportions of intrapartum interventions and application of labor analgesia were both higher in the study group than in the control [97.5％(78/80) vs 32.5％(52/160),42.5％(34/80) vs 11.9％(19/160),x2=90.764 and 29.071,both P＜0.01].Higher incidences of intrapartum fever [18.8％(15/80) vs 5.6％(9/160),x2=10.208],episiotomy [50.0％(40/80) vs 25.6％(41/160),22=14.172],assisted vaginal delivery [26.3％(21/80) vs 10.0％(16/160),x2=10.800],postpartum hemorrhage [32.5％(26/80) vs 8.1％(13/160),x2=23.284],and cervical laceration [15.0％(12/80) vs 3.1％(5/160),~=11.427] were shown in the study group than in the control (all P＜0.01).There was no statistically significant difference was found in the rate of fetal distress,neonatal asphyxia and neonatal intensive care unit (NICU) admission between the study and control group (all P＞0.05) except for newborns' birth weight [(3 542±388) vs (3 431 ±368) g,t=2.162,P=0.032].However,the incidences of postpartum hemorrhage,intrapartum fever and neonatal admission to NICU were comparable between the study (n=20) and CS group (both P＞0.05).Within the study group,the durations of second stage of labor in women with postpartum hemorrhage,assisted vaginal delivery and episiotomy were significantly longer than those without [1.8(0.9-3.1) vs 1.2(0.5-1.5) h,2.0(0.8-3.4) vs 1.2(0.5-1.6) h,1.7(0.6-2.6) vs 1.1(0.5-1.5) h,Z=2.168,2.756 and 1.891,all P＜0.05].Conclusions After the application of new partogram,vaginal delivery remains possible for pregnant women whose total stage of labor over 24 hours without increase of neonatal morbidity.However,the incidences of postpartum hemorrhage,episiotomy and assisted vaginal delivery may rise up.

Bronchiolitis Obliterans ; diagnosis ; etiology ; therapy ; Child ; Humans

OBJECTIVE:To discuss the clinical features and the general pattern of drug-induced hepatic lesions.METHO-DS:The clinical data of 170 drug-induced hepatic lesion cases collected from Jan.2002 to Apr.2006 in our hospital were analyzed retrospectively.RESULTS:Of the 170 cases,35.29% were induced by Chinese herbal medicines,13.53% by antipsychotic drugs,12.94% by anti-tuberculosis agent;51.18% were hepatocellular damage type,14.12% cholestatic damage type and 34.71% damage of mixed type damage.CONCLUSION:Hepatic lesions resemble viral hepatitis and were of no specificity in clinical features;various drugs can lead to hepatic lesions and to which clinic should attach great importance.

Objective To analysis the serum levels of the Th1/Th2 cytokines interleukine-2 and interleukine-5 in patients with autoimmune thyroid disease(AITD) and investigate the relationship between the imbalance of Th1/Th2 cytokines and the pathogenesis of AITD.Methods 20 healthy as controls and 75 patients were studied.45 patients suffered from GD,30 patients suffered from HT.The serum concentrations of interleukine-2(IL-2) and interleukin-5(IL-5),representative cytokines of Th1 and Th2 cells respectively,were assayed by enzyme-linked immunosorbent assay(ELISA).Results(1)Compared with HT group and controls,the concentration of IL-5 in GD group was remarkably increased(P

To whether the unfinished form exist in the crime of illegal medical practice,the general theory of the criminal Law’s answer is negative.Because the crime of illegal medical practice is circumstance crime and behavior crime,its subjective motive includes indirect intent.In this article,by analyzing it,the author agrees with the common theory that preparatory crime and discontinuance of crime in the preparatory stage.do not exist in circumstance crime,behavioral offense and indirect intent ional crime,but insists thet attempted crime and discontinuauce of crime do exist.Then by comparatiae analysis on the difference beteem them and illegal medical practice,the author illustrate the identification criteria of attempting discontinuance of this crime and the actural illegal medical practice as wtll as the significance of this study.Finally,an example is given to support them.

Herpesvirus 4, Human ; Humans ; Lymphohistiocytosis, Hemophagocytic ; virology

Child ; Humans ; Pulmonary Embolism ; diagnosis ; etiology ; therapy ; Risk Factors

Bronchiolitis Obliterans ; Child ; Humans

Objective To investigate prevalence of metabolic syndrome (MS) and its related factors in patients with maintaining hemodialysis (MHD). Methods A total of 162 cases on MHD in Beijing Chaoyang Hospital during June to December 2010, were enrolled in this study and divided into MS group and non-MS group according to the diagnostic criteria for MS set by the International Diabetes Federation. Anthropometric and blood biochemical characteristics of the two groups were compared with t-test and x2 test Risk factors for MS were explored with binary logistic regression analysis. Results Prevalence of MS was 40. 7% (66/162) . There was significant difference found in body mass index [(24. 2 ±3. 1) vs. (21. 6 ±2. 7) kg/m2], waistline circumference[(93 ±8) vs. (79 ±7)cm] , white blood cell count [(6. 8 ± 1. 5) × 109/L vs. (5. 6 ± 1. 4) × 109/L] , hypersensitive serum C-reactive protein [(7 ± 5)vs. (4 ±3) mg/L], high-density lipoprotein-cholesterol [(0. 99 ±0. 26)vs. (1.39 ±0.39) mmol/L], low-density lipoprotein-cholesterol [(2. 5 ± 0. 8) vs. ( 2. 1 ± 0. 7) mmol/L], triglyceride ( TG) [( 2. 1 ±1.1 )vs. (1.3±0.8) mmol/L], fasting blood glucose [(5.9±2. 7)vs. (4.8±1.3) mmol/L], serum level of iron [(16±7)vs. (13 ±5) μmol/L], uric acid [(429±114) vs. (388±88) (μmol/L], and carbon dioxide combining power (CO2CP) [(22 ±4)vs. (23 ±4) mmol/L]between MS group and non-MS group (All P < 0.05 ) . But there was no significant difference found in subjective global assessment of nutritional status (SGA) , thickness of skin fold of the triceps muscle (TSF) between the two groups (Both P > 0.05). Binary logistic regressive analysis revealed that serum level of iron (OR = 1.058,95% CI = 1.001 -1. 119), white blood cell count ( OR = 1. 786,95% CI = 1. 346 - 2.371) and hypersensitive serum C-reactive protein (OR = 1. 101,95% CI = 1.010 - 1.201 ) were independent risk factors for MS in MHD patients. Conclusions Morbidity of MS is high in patients with MHD, involved with inflammation process. Serum level of iron, white blood cell count and hypersensitive serum C-reactive protein are independent risk factors for MS in patients with MHD and no inevitable connection between MS and nutritional status in them is found.

OBJECTIVETo verify the clinical efficacy on chronic fatigue syndrome of qi deficiency syndrome treated with acupuncture at selective time and explore the effect mechanism.

METHODSEighty patients were randomized into a selective-time-acupuncture group and an acupuncture group, 40 cases in each one. Qihai (CV 6), Guanyuan (CV 4), Hegu (LI 4), Taichong (LR 3), Sanyinjiao (SP 6) and Zusanli (ST 36) were selected in the two groups. In the selective-time-acupuncture group, acupuncture was used at 9:00am to 11:00am. In the acupuncture group, acupuncture was used at any time except in the range from 9:00am to 11:00am. No any manipulation was applied after the arrival of needling sensation. The treatment was given once every day, 10 day treatment made one session and two sessions of treatment were required. The fatigue scale was adopted to evaluate the efficacy before and after treatment in the patients of the two groups. The ratios among CD3+, CD4+ and CD8+ T cells in the peripheral blood were detected before ad b a after treatment.

RESULTSIn the acupuncture group, the total score of fatigue and the score of physical fatigue were reduced after treatment as compared with those before treatment (all P<0.05). In the selective-time -acupuncture group, the total score of fatigue, the s core of physical fatigue and the score of mental fatigue after treatment were reduced obviously as compared with those hefore treatment (all P<0. 01). The improvements in the scores of the selective-time-acupuncture group were superior to the acupuncture group (all P<0. 05). The ratio of CD3+ and CD8+ T cells was increased obviously after treatment in the two groups (all P<0. 05) and the ratio of CD4+ and CD8+ T cells was reduced obviously in the selective-time-acupuncture group (P<0. 05), which was better than that in the acupuncture group (all P<0.05). The total effective rate was 95.0% (38/40) in the selective-time-acupuncture group, which was better than 80.0% (32/40) in the acupuncture group (P<0.05).

CONCLUSIONThe acupuncture therapy at selective time is effective in the treatment of chronic fatigue syndrome of qi deficiency syndrome, which is especially better at relieving mental fatigue. The effect of this therapy is achieved probably by improving the immune function via the regulation of the ratios among CD3+, CD4+ and CD8+ T cells.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Fatigue Syndrome, Chronic ; immunology ; therapy ; Female ; Humans ; Lymphocyte Count ; Male ; Middle Aged ; Qi ; T-Lymphocyte Subsets ; cytology ; immunology ; Treatment Outcome ; Young Adult