ObjectiveTo probe into the maternal care utilization by minority women, for the purpose of policy recommendations on better maternal care in minority areas. MethodsA combination of stratified random sampling and typical sampling was made on 445 married women of reproductive age in six counties in Yunnan, Guizhou, Qinghai and Tibet provinces, a field survey on their utilization of maternal care services. ResultsTheir average prenatal detection rate is 78.24％, a level lower than the national rural average of 93.7％ and grade-4 rural average of 81.2％ in 2008; their post partook rate is 30.7％, lower than the national rural average of 54.3％ and grade-4 rural average of 58.9％ in the same period; their average coverage rate is 52.18％, a level lower than the national rural average of 87.1％and grade-4 rural average of 64.3％ in 2008. ConclusionThe maternal care utilization is found to be low for women in minority areas. Effective solutions are expected for payment of indirect expenditure of hospital delivery; better health education for enhancing health knowledge and health awareness of minority women; effective incentive mechanism for village doctors, consolidating the base of the three-level healthcare network.

Cerebral palsy (CP) describes a group of disorders of the development of movement and posture,causing activity limitation attributed to disturbances,which occurred in the fetal or infant brain.Early identification and intervention of CP has always been a difficult topic in the research of neuroscience.The intervention should be focused on infants showing early signs of CP.Such signs may be efficiently detected by a combination of neuroimaging and the General Movements Assessment.Besides movements,enriched environments,active participation,parental coaching have benefits to early intervention.In this investigation,the early identification and intervention in cerebral palsy were focused.

BACKGROUND: When the dynamic equilibrium between oxidation system and anti-oxidation system in the body is upset, the overly produced active oxygen-derived free radicals will attack the target organs, thus resulting in the damage to organs and big molecules, and then diseases. Total anti-oxidation capacity (T-AOC), superoxide dismutase (SOD), and nitric oxide synthase (NOS) activity are the majorindexes for the defense system of the body, and their status is closely related to diseases. OBJECTIVE:To explore the level of T-AOC, SOD and NOS in serum,and find out its relationship with lifestyle. DESIGN:Single sample investigation. SETTING:Department of Health Laboratory Technology, College of Public Health of Harbin Medical University. PARTICIPANTS:Totally 531 residents of Bin County aged 20 to 70years were recruited between September 2000 and May2001. MATERIALS:The reagents kits of T-AOC, SOD and NOS were manufactured by Nanjing Jiancheng Bio-engineering Institute. METHODS:The investigators surveyed the residents with the same questionnaire. Questionnaire was made and the investigators were trained in advance. The questionnaire was filled in item by item as required. Questionnaire items consisted of the general situation, financial status, dietary habit, hobby, status of health care, and mental factor. Finally 95 investigation indexes were completed. The activity of serum T-AOC, SOD and NOS of the 531 residents in Bin County was determined, respectively, with reagent kits produced by Nanjing Jiancheng Bio-engineering Institute. The lifestyle factors were analyzed by multivariate stepwise regression analysis,and informed consent was obtained from the participants. MAIN OUTCOME MEASURFS:① Serum T-AOC, SOD and NOS in the participants; ② lifestyle factors affecting T-AOC, SOD and NOS.RFSULTS:According to actual analysis, the 531 participants entered the results analysis. T-AOC was measured in 489 participants, SOD in 525participants, and NOS in 531 participants. ① Indexes of the participants:T-AOC of the males was obviously higher than that of the females [(20.01±7.21), (15.25±6.22) kU/L, P ＜ 0.05]. SOD of the males was slightly lower than that of the females while NOS of the males was slightly higher than that of the females, but there was no significant difference. ②Multivariate stepwise regression analysis showed that risk factors related to T-AOC were gender difference (OR=2.188), educational level (OR=1.859),and the presence of rheumatism, respectively (OR =1.142). SOD-related risk factors were educational level (OR=1.584), years of spirit drinking (OR =1.048), presence of nephritis (OR=1.093), and irradiation (OR=1.770);frequency of tea drinking was a beneficial factor (OR=0.800). NOS-related risk factors were the average amount of cigarette smoking (OR=1.194) and the times of weekly spirit drinking (OR=1.368). However, the beneficial factor that affected serum NOS was the frequency of weekly mutton eating (OR=0.458) CONCLUSION:This experiment revealed that the ability to clean free radical in the 531 subjects was good and that it was better in males than in females. The increased educational level and presence of rheumatism can decrease T-AOC. Drinking, smoking and irradiation decrease SOD activity while the frequency of tea drinking and mutton eating are beneficial factors.

Objective To analyze and compare the short-term efficacy and daverse reaction of postoperative adjuvant radio -chemotherapy versus simple chemotherapy in advanced gastric cancer .Methods A total of 64 patients with locally advanced gastric cancer were randomly but equally divided into 2 groups ,experimental group and control group .The experimental group patients ini-tially receive 4-cycles chemotherapy with Capecitabine Tablets 1 000 mg /m2 ,bid ,d1 - 14 plus Oxaliplatin 130 mg/m2 ,d1 ,and then receive Capecitabine Tablets 825 mg /m2 ,bid ,d1 - 35 plus 3DCRT 45 Gy/25 Fx /5 w concurrent radio-chemotherapy .Control group patients receive 6-cycles Capecitabine plus oxaliplatin combined chemotherapy .Then we observed the disease progression time ,toxic reaction ,1 year survival rate and 2 year survival rate simultaneously in two groups .Results The follow-up rate were 100% .The comparative results are listed as follows (experimental group and control group) :the rates of Ⅰ /Ⅱ grades of nausea and vomiting were 87 .50% and 62 .50% respectively (P< 0 .05) ,other adverse reactions were not statistically significant ;1-year overall survival rate and recurrence-free survival rate were 90 .63% ,87 .50% respectively (P > 0 .05) and 84 .38% ,62 .50% respectively (P <0 .05) ;2-year overall survival rate and recurrence-free survival rate were respectively 84 .38% ,59 .38% (P< 0 .05) and 75 .00% , 50 .00% respectively (P< 0 .05) .Conclusion The advantages of 3DCRT combined with Capecitabine Tablets chemoradiotherapy can raise the successful rate of local control in patients with advanced gastric cancer after operation and 4 cycles chemotherapy .The toxic reactions are tolerable for patients .

Objective To observe the effect of 99Tc-MDP in the treatment of metastasis bone disease pain with malignancies,and the influence of 99Tc-MDP to human body's Hb,WBC,PLT,serum calcium,and PS grade.Methods 99Tc-MDP was used for the treatment of bone metastases in 78 cases with malignancies:established the intravenous access,mairdined with the 99Tc-MDP,200mg,the diluted physiological brine,and in tWO hours,once a day for five days.After the rest of twenty one to twenty-eight days,the second cycle Was repeated,and each patient at least three cycles.Results 99Tc-MDP had no influence to the Hb,WBC and PLT in pre-treatment and post-treatment,but had obvious effeet on the serum calcium,the hypocalcaemia reduced obviously(P＜0.01).There was significant difference in ameliorating ache during the periods of pretreatment and post-treatment(P＜0.05).However,there was no marked improvement in PS,and no statistic difference(P＞0.05).Conclusion 99Tc-MDP has deftnite curative effect in the treatment of metastasis bone cancer,can ameliorate the ache induced by it,and can reduce the hypoealcaemia.There is no marrow inhibition and enteron reaction in the application.

Objective To investigate influence of ulinastation in storage period on apoptosis of suspended erythrocyte.Methods RBCs were treated with saline (control group) and different doses of ulinastatin (5,000, 10,000 and 50,000 U/mL in group C1, C2 and C3, respectively).samples were detected when stored at 0,7,14,21,28,35 d,respectively.Indicators of corpuscular volume,phosphatidylserine extroversion rate and intracellular Ca2 +concentration were analyzed by flow cytometer.Results The phosphatidylserine (PS)-exposure levels of 4 groups started to increase on 14 day(P<0.05). Cells of the control group, group C1 and C2 began to shrink remarkably on day 21, while that of Group C3 on 28 day.The intracellular Ca2 +levels of the control group and group C1 started to increase significantly on day 35, (t=16.33,t=14.66,P<0.05).one Ca2 +levels of group C1,C2 and C3 increased on day 14.From 21 to 35 day, the intracellular Ca2 +levels of group C2 and C3 were no significant compared with control group.Conclusion During the storage period, suspended erythrocyteapoptosis increase with time prolonged, adding suitable amount of ulinastatin in stock solution can inhibit apoptosis in damage at some level.

Background: Basic principles of clinical trials of nonpharmacologic treatment are similar to those of pharmacologic treatment, but its some special characteristics should be discussed. Objective: To explore the design characteristics of clinical surgery trial through the example of tunnel thread-drawing therapy for simple anal fistula. Design, setting, participants and interventions: The clinical trial was designed as a prospective, controlled, randomized multicenter trial. The patients came from Longhua Hospital, Yueyang Hospital of Integrated Traditional Chinese and Western medicine, and Affiliated Hospital of Jianxi University of Traditional Chinese Medicine. Stratified random was performed according to the subtype of anal fistula including low and high anal fistula. Full analysis set was applied to analyze the baseline data, and per protocol set was used in efficacy and safety analysis. The intervention was tunnel thread-drawing method. Classical therapy of thread-drawing method was employed as positive control. Main outcome measures: The primary outcomes were course of recovery and cure rate. Quality of life score was used as secondary outcome and anal maximum constriction pressure was considered as safety outcome. Results: Optimal efficiency testing method was used to estimate sample size. A total of 244 subjects were recruited and 236 subjects completed the trial. There was no significant difference in the cure rate of the low and high anal fistula between the treatment group and control group. There was a significant difference in the course of recovery in the patients with low and high anal fistula between treatment group and control group (P<0.01). To the patients with low anal fistula, the course of recovery in the treatment group was (22.26+/-8.67) d, and the course of recovery in the control group was (31.41+/-11.39) d. To the patients with high anal fistula, the course of recovery in the treatment group was (24.73+/-8.15) d, and the course of recovery in the control group was (32.20+/-12.60) d. There was no significant difference in the scores of quality of life in the patients with low anal fistula between the treatment group and control group (P>0.05). The trial showed that the tunnel thread-drawing therapy was significantly more effective than classical method for improving the anal sphincter function and patient satisfaction with treatment in the patients with high anal fistula. However the other items of quality of life in the two groups did not show significant difference. There was no any adverse event report in each group. There was no significant difference in the anal maximum constriction pressure in the treatment group before and after the operation. Conclusion: The trial shows that the tunnel thread-drawing therapy for simple anal fistula can shorten the course of recovery and improve the patients' quality of life. The training about surgical intervention and clinical implementation program is important in clinical surgery trial. Blind is absolutely difficult to implement and placebo cannot be used in this kind of trial.

Objective To detect mutations of p53 gene 2-4 exons from peripheral blood and to explore their relevance in HPV16-positive cervical cancer susceptibility and clinical significance. Methods Collected firstly cases from the Third Affiliated Hospital of Kunming Medical University from October 2012 to April 2014, included 167 cases HPV16-postive cervical cancer and 160 cases HPV-negative healthy women. Genomic DNA from the host peripheral venous blood was taken, mutations of p53 gene 2-4 exons were analyzed with software DNAstar after PCR and bidirectional sequencing. Meanwhile,mutations of p53 gene 2-4 exons among different clinicopathological characteristics in HPV16-postive cervical cancer were distinguished. Results (1)Three mutations and an 16-bp insertion/deletion sequences were found in p53 gene exons 2-4, included C/G mutation of single nucleotide polymorphism(SNP)11827 in intron2, A/C mutation of SNP11992 in intron3, C/G mutation in codon 72 (rs1042522) of exon4 and 16-bp(acctggagggctgggg) repeat insertion or deletion in intron3 (rs17878362), while deletion recorded as A1, insertion recorded as A2. No significant differences were found in each point allele and genotype frequency(P＞0.05). (2) Stratified analysis for cervical cancer group resulted with some differences. Compared group of non-squamous carcinoma with squamous carcinoma group, there were obviously decreased in allete A2 [11.8%(4/34) vs 3.5%(10/284); χ2=4.90,P=0.027], genotype A1A2 [4/17 vs 7.0%(10/142); χ2=5.14,P=0.023], and haplotype C-A2 [11.8%(4/34)vs 3.5%(10/284);χ2=4.91,P=0.027]. Compared with poorly differentiated group,allele C of SNP11827 and rs1042522 were obviously decreased in medium high differentiation group [50.8%(61/120)vs 38.8%(62/160);χ2=4.07,P=0.044], while haplotype G-A1 were apparently higher [49.2%(59/120)vs 61.2%(98/160);χ2=4.07,P=0.044], genotype GG of SNP11827 and rs1042522 were obviously decreased in superficial myometrial invasion depth group than that in deep myometrial invasion depth group [46.3%(25/54) vs 21.1%(8/38); χ2=7.06,P=0.029]. No significant differences were found between stage Ⅰ and Ⅱ, pelvic lymph node metastasis or not (all P＞0.05). Conclusions No obvious correlation is found between polymorphisms in exons 2-4 of p53 gene and susceptibility of HPV16-postive cervical cancer. But the patient with allete C and A2, genotype GG and A1A2, haplotype C-A2 and G-A1 may be increase risk of poorly differentiation, deep muscular invasion and bad pathological type. Analysis of p53 gene polymorphism may be provide a basis for the prognosis evaluation and individualized treatment of cervical cancer.

0.05).(3) IL-17 was positively correlated to CRP(r=0.460,P 0.05).Conclusion:(1) IL-17 in patients is much higher than that in normal people,and is positively correlated to CRP,the acknowledged marker of inflammation status,but not correlated to dialysis duration,suggesting that IL-17 plays a role in pathogenesis of immune anomaly and micro-inflammation in patients with ESRD and HD;(2) There is no correlation between IL-6 and IL-17,and the mechanism of IL-17 elevation in ESRD patients needs to be further investigated.

Objective:To investigate the clinical features, gene mutation and follow-up outcome of children with paroxysmal kinesigenic dyskinesia(PKD).Methods:Clinical data was collected at Beijing Tiantan Hospital Affiliated to Capital Medical University from November 2018 to November 2019.In total, seven children with PKD were recruited, and peripheral blood samples for gene study were collected from six patients and their parents.Mutation analysis of PRRT2 gene was performed by PCR sequencing in children and by Sanger sequencing in patients.Results:Of the seven patients, four were male and three were female, and the median age of onset was 11 years and 6 months, ranging from 5 to 14 years.Among them, two patients were family cases and the other five patients were sporadic cases.The presentation were abnormal involuntary movements provoked by sudden movements, without loss of consciousness.Five patients exhibited dystonia and two patients had dystonia and choreoathetosis.The duration of the attacks lasted for a few seconds to 40 seconds.The frequency ranged from 5 to 15 times per day.PRRT2 mutations, c.649_650insC(P.R217PfsX8), were found in two patients with PKD families and three sporadic PKD cases.Conclusion:The onset age of PKD is pre-school or school age.The attacks manifest as dystonia or mixed with dystonia and choreoathetosis.PRRT2 is the main pathogenic gene of PKD and mutation c. 649_650insC is the hotspot mutation.Low-dose Carbamazepine has good effects.