Objective To determine the specific effect of manual removal of the placenta in the third stage of labor in the prevention of postpartum hemorrhage.Methods We searched PubMed,EMBASE,EBSCOhost databases and Chinese Academic Journal et al(inception to October August 2015).Articles database of all published.Randomized controlled trials comparing manual removal of the placenta with hands-off management inthe third stage of labor were included.Two independent reviewers assessed the included studies and extracted data.RevMan4.2 software was used for Meta-analysis.Results Six randomized controlled trials involving a total of 2 435 participants were eligible.There were five cases of cesarean section,one case of natural childbirth,and four English literatures and two Chinese literatures.Significant difference was found between manual removal of the placenta and handsoff management groups with respect to the incidence of postpartum hemorrhage.Conclusion Routine manual removal of placenta at cesarean section significantly increases perioperative blood loss.However,the effect in vaginal delivery need further research.

Objective To describe the condition of depression of the undergraduate nursing students in practice,and compare the differences of depression between male and female nursing students.Methods Using the Beck Depression Inventory (BDI) to investigate the undergraduate nursing students who were practicing in the Affiliated Hospital of Sun Yat-sen University from July 2011 to June 2012 and analyze the condition and gender-related differences of depression.Results The occurrence of depression was high in the undergraduate practical nurses(37.2％).The occurrence of depression in the male (41.2％)undergraduate practical nurses was higher than that in the female (34.6％) undergraduate practical nurses.The occurrence of depression was mostly light depression(16.3％) and middle depression (20.9％),no serious depression occurred.Conclusions The higher occurrence of depression in the undergraduate practical nurses and the gender-related differences signify the importance of psychological problems.

Objective To explore abnormalities in functional connectivity of the affective network (AN) in relapse of major depressive disorder (MDD) after antidepressant treatment combined with resting state functional connectivity analysis.Methods Eleven recurrent MDD subjects after treatment,seventeen non recurrent MDD subjects after treatment and seventy-two healthy controls underwent fMRI scan.The amygdala,the pallidum,the insular cortex and the anterior cingulate cortex of the AN were selected as the template.Group independent component analysis (ICA) was performed to decompose the fMRI images into spatially independent components and the independent component which fit this template best was selected as AN.Two-sample t-tests were performed to investigate the changes in functional connectivity of the AN.Finally,the right amygdala and the medial prefrontal cortex were defined as seed regions.Results Compared with healthy control subjects and non-recurrent MDD group,recurrent MDD group showed significantly increased functional connectivity in the right amygdala in AN(P＜0.001).Meanwhile,the functional connectivity between the right amygdala and the medial prefrontal cortex was significantly decreased in recurrent MDD group(P ＜0.05).Conclusion Abnormal resting-state functional connectivity of the right amygdala after antidepressant treatment in MDD was found,suggesting that altered amygdala functional connectivity may serve as a predicator of relapse of the MDD.