To explain the relation between diabetic vasculopathy and'Blood blocking collaterals and phlegm turbidness not being removed'proposed by Mr.ZHU Kan-yu.It is believed that the turbidness is the basic pathological product during the development of diabetes.Blood glucose remains high,which reflects the disorders of transportation and distribution of turbid yin and qi in the body.That is to say that the thick coreal nutrients in the vessels are unable to be distributed and absorbed but stay in the vessels as turbid pathologic factors.Blood stasis and phlegm is the further result of turbid pathologic factors.The TCM explanation of diabetic vasculopathy is that phlegm,turbidness,blood stasis block the meridians and collaterals.Those visible pathological factors deposit in vessels and cause narrow vessels and thick walls.Meanwhile the deposit stimulates,spreads,erodes and burns the walls and finally ruins the walls.

Objective To investigate auricle index difference in Henan residents,and to provide an additional reference for otoplasty.Methods Subjects were made up 266 healthy young of Henan residents.Their height,weight,total head height,maximum head length,maximum head breadth,vertex to tragion height,physiognomic ear breadth,morphological ear breadth,physiognomic ear length and morphological ear length were measured and calculated.All the data were analyzed by SPSS 15.0 software.Results We obtained the means,standard deviation of each items,and data were treated statistically.Height (162.9±4.1) cm,weight (55.3±6.5) kg,total head height (18.6±1.0) cm,maximum head length (17.0±0.7) cm,maximum head breadth (14.1±0.8) cm,vertex to tragion height (11.9±0.7) cm,physiognomic ear length (6.2±0.4) cm,morphological ear breadth (4.9±0.6) cm,physiognomic ear breadth (3.3±0.3) cm and morphological ear length (2.9±0.3) cm were determined.The differences among the indices mentioned above were of statistical significance (P＜0.05);the indices of female subjects of different height were significantly different (P＜0.05);the indices of female subjects of different weight were also statistically different (P＜0.05).The auricle index subjects of different height and weight were of no stistical difference.(P＞0.05).Conclusions Subjects of different height and weight have different total head height;hence,the indices are related to body height and weight.Subjects of different height have different vertex to tragion height,length-height index of the head and breadth-height index of the head.This study has certain reference values on analyzing the characteristics of the human and auricle cosmetology of henan young females.

Objective:To investigate auricular lobule index difference in healthy young female of different height or weight, and to provide an additional reference for otoplasty of auricular lobule.Methods:Subjects were made up of 266 healthy young females of Henan residents. Their height, weight, physiognomic ear breadth, morphological ear breadth, physiognomic ear length, morphological ear length, auricular lobule length, auricular lobule breadth were measured and calculated. All the data were analyzed by SPSS 15.0 software.Results:We obtained the means, standard deviation of each items, and data were treated statistically. In the 266 subjects, average height was (162.9±4.1) cm, weight (55.3±6.5) kg, morphological ear breadth (4.9±0.6) cm, morphological ear length (2.9±0.3) cm, physiognomic ear breadth (6.2±0.4) cm, physiognomic ear length (3.3±0.3) cm, auricular lobule breadth (1.6±0.3) cm, auricular lobule length (1.8±0.2) cm, lobule physiognomic ear breadth index (25.6±4.9)%, lobule-physiognomic ear length index (53.69±7.69)%, and auricular lobule index (91.4±19.3)%. The differences among the indices mentioned above were of statistical significance ( P<0.05); the indices of subjects of different height were significantly different ( P<0.05); the indices of subjects of different weight were of no statistical difference. ( P>0.05). Conclusions:The subjects of different height or weight have no different morphological ear breadth, morphological ear length, physiognomic ear breadth, physiognomic ear length, auricular lobule length, lobule-physiognomic ear length index and auricular lobule index; hence, the indices are no related to body height and weight. However, the subjects of different height have different auricular lobule breadth and lobule-physiognomic ear breadth index.

Medical simulation training as a modern medical education has been used for decades in developed countries. Simulation based team training for obstetric emergency provides opportunities to re-hearse without risks to patients and helps overcome some limitations of the current medical education to improve the ability of medical staff to deal with obstetric emergencies, and improve adverse pregnancy out-comes. Simulation training is still at early stage in China. The Simulation Training Center of Beijing Ob-stetrics&Gynecology Hospital was established in June 2013. There are 100 medical staffs from our hospital and 406 from other hospitals who are trained using simulations to respond to acute obstetrical emergencies, including postpartum hemorrhage, neonatal recovery, shoulder dystocia and amniotic fluid embolism. Through introduction—on-scene simulation training—task report, we focus on learning, practical operation, emer-gency team and multidisciplinary coordination and communication skills training and through training, help learners understand the medical simulation training mode, and improve personal and team's ability to deal with the obstetric emergency. There is no doubt that simulation training will be further developed in China. Further research is required to investigate the application significance and feasibility of simulation training and access effectiveness of it.

Objective:To analyze the maternal gestational weight gain (GWG) in women with pre-pregnancy obesity and its relationships with adverse pregnancy outcomes.Methods:This retrospective cohort study recruited 513 obese women (pre-pregnancy body mass index ≥30 kg/m 2) with singleton pregnancy in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2014 to December 2016. All participants were divided into three groups according to GWG: inadequate (GWG<5 kg, n=83), adequate (5 kg≤GWG≤9 kg, n=154), and excessive (GWG>9 kg, n=276) groups. Chi-square test, Fisher's exact test, Kruskal-Wallis test, and Mann-Whitney U test were used to compare the clinical data among the three groups, including GWG, pregnancy and neonatal outcomes, and labor process. Multivariate logistic regression was performed to analyze the association between maternal GWG and main pregnancy complications associated with obesity. Results:(1) Among 238 participants who gained more than 2.0 kg in the first trimester, 75.6% (180/238) were in the excessive group, while the rate was 34.9%(96/275) among the participants who gained less than 2.0 kg. (2) Postpartum body mass index retention (body mass index at six weeks postpartum minus pre-pregnancy body mass index) was the highest in the excessive group, followed by the adequate group and the inadequate group [0.8 kg/m 2 (0.0-2.2 kg/m 2) vs -0.7 kg/m 2 (-1.6 to 0.0 kg/m 2) vs -2.5 kg/m 2 (-3.2 to -1.5 kg/m 2), all P<0.05]. (3) The rates of primary cesarean section in the inadequate and adequate groups were 29.9% (20/67) and 32.6% (42/129), which were lower than that in the excessive group [43.3% (104/240), χ2=3.955 and 4.047, both P<0.05]. There were no statistically significant differences in the incidence of gestational hypertension, small/large for gestational age, or other major adverse pregnancy outcomes among the three groups (all P>0.05). The weight gain in the first trimester and before the oral glucose tolerance test were not correlated with gestational diabetes mellitus (GDM) ( aOR=1.038, 95% CI: 0.986-1.094, P=0.157; aOR=1.055, 95% CI: 1.000-1.113, P=0.051). The maternal weight gain of women with GDM during the 2nd, the 3rd, and the whole trimesters were lower than women without GDM respectively [3.0 kg (1.3-4.0 kg) vs 3.0 kg (2.0-5.0 kg), 4.0 kg (2.0-6.0 kg) vs 6.0 kg (4.0-8.0 kg), 9.0 kg (5.0-12.0 kg) vs 10.7 kg (7.5-15.0 kg); Z =-2.938, -6.352 and-4.104, all P<0.01]. Conclusions:In women with pre-pregnancy obesity, the first trimester is the critical window to control maternal GWG. GWG guidelines recommended by the Institute of Medicine could help to reduce the weight retention at six weeks postpartum, but couldn't reduce the risk of GDM, gestational hypertension, small/large for gestational age, or other major adverse pregnancy outcomes.

Objective To investigate the relationship between the facial morphology and the nasal shape for young women of Han nationality in Henan.Methods Aiming at the female conscripts in Henan province in 2016,210 healthy young females were enrolled in this study,and their anthropometric features were measured including height,weight,total head height,physiognomic facial height,morphological facial height,upper lip height,lip height,facial width,mandibular width,mouth breadth,nasal height,nasal length,nasal depth,and width of nose.The nasal indexes were divided into 5 groups according to different facial types.And their mean and standard deviation were calculated.The differences were analyzed by SPSS version 21.0.Results Among the indexes measured,there were significant differences in height,face height,shape face height,upper lip height,face width,mandibular width,head height/face width,face height/face width,shape face height/face width and nose index;P values were significant.The classification of facial types was based on the ratio of morphological surface index to area width,and the main types of the groups were mid-facial and narrow-facial types.The differences among different facial types were statistically significant (F =12.75,P＜0.05).The scatter plot showed that there was a linear correlation between nasal index and facial shape.Linear regression analysis showed that the linear equation Y=135.84-75.5X (X is the ratio of morphological index to facial width,Y is the nasal index).Conclusions Nasal type is related to the face type.The linear fitting equation between morphological facial height/facial width and nasal index is Y=135.84-75.5x.These findings may enrich the external nasal database,provide reference for the correction of nasal deformity and nasal reconstruction,and direct the clinical therapy.

Objective:To explore the characteristics of weekly gestational weight gain (GWG) in women with obesity and its correlation with the risk of macrosomia.Methods:Clinical data of women with singleton pregnancy and pre-pregnancy body mass index (PPBMI) ≥28 kg/m 2 were retrospectively analyzed, from January 2014 to December 2019, in Beijing Obstetrics and Gynecology Hospital, Capital Medical University (Beijing Maternal and Child Health Care Hospital). The participants were divided into three groups based on their PPBMI: group A (28-<30 kg/m 2), group B (30-<32 kg/m 2), and group C (≥32 kg/m 2). The study compared the characteristics of GWG among the three groups, explored the correlation between the weekly weight gain during each gestational stage and the risk of macrosomia, and discussed the impacts of the GWG pattern in women with different PPBMI on the risk of macrosomia. Chi-square (or Fisher's exact), Kruskal-Wallis, and Mann-Whitney U tests were performed for statistical analysis. Multivariate logistic regression was used to analyze the impact of weekly weight gain in specific gestational stages on macrosomia. Results:(1) A total of 2 046 participants were included in the study, with 982 in group A, 588 in group B, and 476 in group C. For all of the 2 046 cases, the median PPBMI was 30.1 kg/m 2 (29.0-31.9 kg/m 2), GWG was 10.5 kg (7.3-14.0 kg), and neonatal birth weight was 3 520 g (3 215-3 816 g) with 60 (2.9%) ≥4 500 g, and the biggest baby weighed 5 580 g. Out of the births analyzed, macrosomia occurred in 318 cases (15.5%). (2) Among the three groups (A, B and C), the differences in maternal age [32.0 years (29.0-35.0 years), 32.0 years (29.0-35.0 years) and 32.0 years (29.0-34.0 years), H=6.58] and women with a history of type 2 diabetes mellitus [0.9% (9/982), 0.3% (2/588) and 1.9% (9/476), χ2=6.61] were statistically significant (all P<0.05). (3) The weekly weight gain in each group exhibited a gradual upward trend before 20-24 weeks, reached a plateau at 24-32 weeks, peaked at 32-36 weeks, and subsequently declined. The weekly weight gain of group A in the pre-pregnancy to 14 weeks [0.14 kg/week (0.00-0.25 kg/week)], 14 to 20 weeks [0.25 kg/week (0.17-0.42 kg/week)], and 20 to 24 weeks [0.38 kg/week (0.25-0.63 kg/week)] were higher than those of group B [0.07 kg/week (－0.03-0.21 kg/week), 0.25 kg/week (0.10-0.42 kg/week), and 0.38 kg/week (0.22-0.60 kg/week)], respectively ( Z value was－3.73,－2.16, and－2.01, all P<0.05). Likewise, the weekly weight gain of group B in the above three stages were all higher than those of group C [0.07 kg/week (－0.10-0.21 kg/week), 0.17 kg/week (0.05-0.33 kg/week), and 0.25 kg/week (0.08-0.50 kg/week)], respectively ( Z value was－2.55,－3.28, and－3.25, all P<0.05). (4) The risk of macrosomia increased with the weekly weight gain in specific gestational stages in different PPBMI groups. In group A, the stages correlated with increased risk were 14-20 weeks [adjusted odd ratio ( aOR)=2.669, 95% CI: 1.378-5.169] and 20-24 weeks ( aOR=1.764, 95% CI: 1.143-2.723), while the stages were 20-24 weeks ( aOR=2.149, 95% CI: 1.156-3.996) and 36 weeks until delivery ( aOR=1.888, 95% CI: 1.268-2.810) in group B, and pre-pregnancy to 14 weeks ( aOR=3.515, 95% CI: 1.158-10.665) and 14-20 weeks ( aOR=3.021, 95% CI: 1.058-8.628) in group C (all P<0.05). The risk of macrosomia increased when the weekly weight gain of both risk-related stages in group A ( aOR=2.255, 95% CI: 1.029-4.940) ≥50th percentile, and group B ( aOR=4.399, 95% CI: 1.017-19.023) ≥75th percentile, and for group C ( aOR=3.404, 95% CI: 1.004-11.543) when the weekly weight gain above 25th percentile (all P<0.05). Conclusions:Weekly GWG demonstrates an observable gradual acceleration pattern in women with obesity. Therefore, clinical attention should be directed towards monitoring fluctuations in the weekly weight gain in this population, as excessive weekly weight gain before 24 gestational weeks is associated with an elevated risk of macrosomia.