Objective To investigate the application effect of pelvic rocking with balloon bionic midwifery in head dystocia. Methods Prospective research method was selected, and 400 pregnant women with head dystocia were divided into 2 groups by random digits table method with 200 cases each. The observation group was given pelvic rocking with balloon bionic midwifery delivery, and the control group was given gauge and comfortable posture with manual rotation fetal head delivery. The labor stage and delivery outcome were observed in two groups. Results The rate of successfully correct the fetal position was 91.00%(182/200) in observation group and 65.00%(130/200) in control group,and there was significant difference between 2 groups, χ2=39.394,P<0.01. The cesarean section rate was 7.00%(14/200) in observation group and 27.00%(54/200) in control group,and there was significant difference between 2 groups, χ2=113.119,P<0.01. The first, second and total labor stage were (8.86 ±2.20), (0.72 ±0.52), (9.78 ±2.82) h in observation group and (12.60±2.10), (1.02±0.82), (13.83±3.01) h in control group, and there were significant differences between 2 groups, t=15.684,4.058,12.609, P<0.01. The incidence of episiotomy, perineal laceration of Ⅱ degree, fetal distress, neonatal asphyxia and postpartum hemorrhage were 17.20%(32/186), 6.45%(12/186), 1.00%(2/200), 0, (150.80 ±43.54) ml in observation group, and 42.47%(62/146), 41.48%(61/146), 9.00%(18/200), 3.00%(6/200), (254.60±83.50) ml, and there were significant differences between 2 groups, P <0.01 or 0.05. Conclusions Pelvic rocking with balloon bionic midwifery can effectively correct the fetal position, reduce head dystocia and cesarean section rate, shorten the first labor stage, the second labor stage, reduce the occurrence of complication of mother and infant.

ObJective To acknowledge the sleep status of infants and analyze the influencing factors of sleep problems in them. Methods The sleep status of 136 infants and its influencing factors were investigat-ed using questionnaires, the results underwent descriptive analysis, single-factor analysis and multifactor anal-ysis. Results Difficulty in falling asleep was the major sleep problems, then was frequent night awakening. The influencing factors included: family type, education degree of the parents, inhabited environment, the feed-ing mode after birth, the period of supplementary protein dietary addition, the times of taking food through the night, and the sleep position, the bed, the emotion when falling asleep, etc. Conclusions Sleep problems is ubiquity in infants,and the unproper child rearing behaviors is the major influencing factor. In order to prevent sleep problems in infants and improve the quality of sleep in them, the parents need health guidance.

BACKGROUND: Conventional endovascular stent-graft exclusion for Debakey Ⅲ type aortic dissection is complicated and the complication rates are relatively high. Moreover, their operating techniques have increased the risk of rupture of laminated break. OBJECTIVE: To evaluate the efficacy and safety of improved endovascular stent-graft exclusion for Debakey Ⅲ type aortic dissection by the innovative methods of interventional therapy. DESIGN, TIME AND SETTING: A retrospective case analysis. Cases were selected from Department of Cardiology, Affiliated Hospital of Gannan Medical College between October 2006 and March 2009. PARTICIPANTS: A total of 30 male patients with Debakey Ⅲ type aortic dissection were selected from Department of Cardiology, Affiliated Hospital of Gannan Medical College, aged 43-70(53.5±12.8) years. The time of onset was 5-45 days. METHODS: All patients underwent improved endovascular stent-graft exclusion for Debakey Ⅲ type aortic dissection by the innovative methods of intervsntional therapy. Fine wire bundled endovascular stent-graft were implanted by the innovative transmission and delivery methods in all patients, of which branch stent were implanted when the distance from the break of descending aorta to left subclavian artery was less than 10 mm. MAIN OUTCOME MEASURES: After the success of operation, aortic angiography was performed to detect stent-graft position, shape, break closure, internal leakage, and patency of the aortic arch branches. The situation of post-operative complications were observed. All cases were followed up by MRI to understand the complications such as aneurysm rupture, internal leakage and stent migration. RESULTS: A total of 33 fine wire bundled endovascular stent-graft were successfully implanted in 30 patients, including 4 branch stents. After the operation, 5 patients were verified endoleak, 3 of them were resolved by repeated stent distension and 2 were treated by implantation of another stent. Three months after the operation, 1 patient showed new rupture at the distal stent and then was successfully implanted a new stent. Three cases showed numbness of right lower extremity and 1 case showed intermittent claudication. In follow-up of 3-32 months, MRI scanning showed the reduction of the false cavity with the formation of intraluminal thrombus, the enlargement of true cavity, and no complications such as tumor rupture, internal leakage or stent displacement were found. CONCLUSION: Fine wire bundled endovascular stent-graft and the innovative methods of interventional therapy for endovascular thoracic aorta repair is an effective, less invasive and safe surgery with fast postoperative recovery, high success rate and few complications for patients with Debakey Ⅲ type aortic dissection, especially for high-risk patients.

Objective To identify the role of FOXC2 in the invasion and migration of colorectal cancer cells .Methods Stable cell lines expressing FOXC2(SW480/FOXC2) or vector (SW480/pBabe) were established using retroviral infection method .The morphology alterations of SW480 cells were observed using a microscope .Western blot analysis and immunofluorescence staining assays were performed to detect the expression of E‐cadherin ,Vimentin and N‐cadherin .The invasive and migratory abilities of colorectal cancer cells evaluated using Transwell invasion chamber experiment detection .Results The morphology of SW480 cells was significantly changed after overexpression .From the original shape typical of epithelial cells became spindle shaped growth , similar to the morphology of fibroblasts .Western blot analysis and immunofluorescence staining displayed that overexpression of FOXC2 led to significant downregulation of the epithelial marker E‐cadherin ,but upregulation of the mesenchymal markers Vimen‐tin and N‐cadherin .Transwell assay reveals that overexpression of FOXC2 strongly enhanced the migratory and invasive ability of SW480 cells .Conclusion FOXC2 induces epithelial‐mesenchymal transition and promotes the invasive ability of colorectal cancer cells .

Objective To explore the clinical value of laparoscopic-assisted vaginal hysterectomy(LAVH)in large uterus.Methods Retrospective analysis was conducted on clinical data of 94 patients(whose uterus were as big as 10-18 gestational weeks)who received hysterectomy from January 2005 to March 2007,in which 56 cases were performed laparoscopic-assisted vaginal hysterectomy(LAVH group)and 38 cases vaginal hysterectomy(VH group).The operation time,blood loss,postoperative hospital stay,and the incidence of postoperative complications were compared between the two groups.Results Compared with VH group,there were a lower chance of abdominal hysterectomy(0/56 vs 5/38,?2=5.389,P=0.020),a shorter operation time [(149?11)min vs(179?14)min,t=-11.610,P=0.000] and a shorter postoperative hospital stay [(5.8?1.4)d vs(7.3?3.6)d,t=-2.825,P=0.006] in the LAVH group.There were no significant differences in blood loss,morbidity and time to first flatus between the two groups.Conclusions The LAVH extends the indications of VH,ensuring the safety of VH for the uterus bigger than 10 gestational weeks,therefore it is an operative procedure to be recommended.

Objective To study the relationships between serum IL-18 and IL-18BP and the development,metastasis,curative effect and prognosis of primary liver cancer.Methods There were total 49 cases patients,of which 28 cases primary hepaticcarcinoma(PHC)and 21 cases liver cirrhosis(LC),and 18 cases heathy people.Their serum levels of IL-18 and IL-18BP were determined by using an ELISA assay and comparation.Results The serum IL-18 in PHC was significantly lower than that in LC and controls;the serum IL-18BP in PHC was significantly higher than that in LC and controls;the IL-18 and IL-18BP in LC were significantly higher than those in controls(P

OBJECTIVE:To study the potential of three kinds of Chinese medicines in combination with Ceftriaxone in inducing endotoxin release from Klebsiella for references of combined use of Chinese medicines and western medicines in the treatment of severe infections.METHODS:The amount of endotoxin released from Klebsiella after being treated in vitro by Ceftriaxone(high,medium and low concentrations)alone or in combination with 3 antibacterial Chinese medicines for 4 hours was compared.RESULTS:The amount of endotoxin released by Klebsiella in low concentration of Ceftriaxone either alone or in combination with Chinese medicines were the maximum but minimum in high concentration Ceftriaxone group.The amount of endotoxin released in low concentration group was larger than in blank group(without antibacterial treatment),and that released amount in Shuanghuanglian plus Ceftriaxone group was less than in Ceftriaxone alone group.CONCLUSION:Low concentration of Ceftriaxone can induce Klebsiella to release endotoxin,while Shuanghuanglian can reduce Ceftriaxone-induced release of endotoxin.

Objective: To investigate the impact of acute myocardial infarction (AMI) concurrent acute kidney injury (AKI) on major adverse cardiac events (MACE) occurrence during hospitalization.
Methods: A total of 625 AMI patients treated in our hospital from 2011-01 to 2014-03 were retrospectively studied. According to AKI incidence, the patients were divided into 2 groups: AKI group,n=86 and Non-AKI group,n=539. Based on AKI network (AKIN) criteria, AKI group was further divided into 3 subgroups as AKI-I subgroup,n=45, AKI-II subgroup,n=27, AKI-III subgroup,n=14; based on renal function at admission, AKI group was divided into another set of 2 subgroups as Normal renal function subgroup [(eGFR≥90 ml/(min·1.73m2)],n=61 and Renal dysfunction subgroup [(eGFR<90/(min·1.73m2)],n=25. The incidence of MACE was compared among different groups and the risk factors for MACE occurrence in AMI patients during hospitalization were studied by multivariate Logistic regression analysis.
Results: The incidences of MACE in AKI group and Non-AKI group was (59.3% vs 16.9%),P<0.05; in Normal renal function subgroup and Renal dysfunction subgroup was (59% vs 60%),P>0.05. Multivariate Logistic regression analysis showed that AKI was the independent risk factor for MACE occurrence in AMI patients; elevated AKI stages were accompanied with the higher incidence of MACE accordingly, compared with AKI-I subgroup, the incidences of MACE in AKI-III subgroup and AKI-II subgroup were as (OR=1.68, 95% CI 1.14-1.69),P<0.05 and (OR=2.01, 95% CI 1.35-1.84), P<0.05 respectively.
Conclusion: AKI was closely related to MACE occurrence in AMI patients, effectively preventing AKI may improve the prognosis in relevant patients.

Totally 613 specialized nurses in 14 specialty areas were successfully trained by the health department of Guangdong province and the Hong Kong hospital authority collaboratively from 2007 to 2010.There were three stages in the training program including candidate interview and preparations for inter-regional training,specialty nursing courses in Hong Kong (10 months of clinical practice and 300 hours of theoretical courses) and postgraduate courses in Guangdong (300 hours).The program explored the inter-regional joint training mode for specialized nurses; improvement mechanism for teaching management and the combination of scientific research training and working practice.The successful experience of the program may provide references to the training of domestic specialized nurses and clinical nursing postgraduates.

Objective:Cholangioduodenal reflux is still an unresolved problem in interposed jejunal choledochoduodenostomy (IJC) yet.To settle this problem,we designed IJC with distal suspending (IJCDS).Methods:IJCDS is to insert and suspend the distal end of the 25 cm-ling interposed jejunum to the duodenal cavity,which is about 2.5 cm long.The pressure of the biliary tract and the biochemical composition or the bile were measured during and after the operation and the results were compared.Barium meal and cholangiography through T tube were performed after the operation.Follow-up surveys were also done.Results:The pressure or the biliary tract decreased distinctively after the operation.Barium meals found no cholangioduodenal reflux although the patients had changed many postures.Cholangiography through T tube showed parisaltic or the interposed jejunum and the contrast medium was continuously pushed into the duodenum.Noreflux cholangitis and stone recurrence were found in the follow-up survey in 14 patients.Conclusion:IJCDS has the powerful function on preventing cholangioduodenal reflux.On the other hand,it avods the shortcomings of other reflux-preventing operative pattern.So it had the good prospect to extend its clinical usage.