Objective To detect the effect of analgesic labor with inhaling nitrous oxide gas for the duration of labor and mother and fetus. Methods Choose 220 cases of normal primipara, 120 cases were observed group, the primipara were inhaled the mixture gas(50% nitrous oxide and 50% oxygen) when the duration of labor entered the progress from active phase to the cervical dilatation were all opened, 100 cases were control group. The effect of anal-gesia, the change of breath and postpartum hemorrhage, neonatal scores were observed. Results The observed group has good effect on anlgesia, the effective rate is 93.3 % . The active phase were obviously shortened and has bad effect to mother and fetus. Conclusion It was safety and effective by inhaling nitrous oxide gas for analgesic labor and worthy to generalized and applied.

Objective To investigate the rate of lower reproductive tract infection during pregnancy and the its impact on pregnancy outcome.Methods Five hundred and twenty pregnant women were enrolled in the study who were hospitalized for delivery from Jan.2010 to Jan.2012 at Hebei Port Group Company Limited Harbor hospital.All pregnant women were performed the bacteria detection in vagina before delivery,including candida albicans,bacterial vaginosis,trichomonas,mycoplasma,trachomatis and Neisseria gonorrhoeae,group B hemolytic streptococci GBS.The pregnant outcomes were followed.According to the results of bacteria detection,107 patients (20.58％) were with varying degrees of vaginitis and they were served as positive group.Other 403 patients were served as negative group.Results (1) Of 107 vaginitis women,48 cases (44.86％) were infected with candida albicans,and 22 cases (20.56％) were with bacterial vaginosis.The infection by mycoplasma,chlamydia,group B streptococcal infections were majority,while the trichomonas vaginalis,Neisseria gonorrhoeae infection were minority.(2) Compared with the negative group,incidence of premature rupture of membranes,preterm birth,puerperal infection and fetal distress in positive group were higher and the differences were significant(15.89％ vs.5.08％,12.15％ vs.3.15％,8.41％ vs.1.94％,5.61％ vs.1.21％ ; x2 =14.642,14.498,11.264,7.934; P ＜ 0.01).Conclusion The incidence of genital tract infection is higher during the pregnancy.Bacteria infection detection should be performed and treated as early as possible in order to reduce the occurrence of adverse pregnancy outcome.

Objective To explore the effects of Baogan Jiedu Granule on lipid peroxidation of free radicals in acute liver injury mice induced by tripterygium glycosides.Methods Totally 60 mice were randomly divided into tripterygium glycosides model group,large-dose,medium-dose and small-dose groups of Baogan Jiedu Granule,Ganlixin group and control group.Each group was respectively perfused with the corresponding drug for 5 days and tripterygium glycosides were perfused once to make the model.The serum levels of ALT,AST,SOD,MDA and GSH-Px were measured.Results The serum levels of SOD and GSH-Px in model group decreased and MDA rose obviously.Compared with model group,Baogan Jiedu Granule of all doses could effectively decrease ALT,AST and MDA level and obviously improve GSH-Px level in each group.In addition,in the large-dose group SOD level was markedly improved(P

Objective To investigate the effects of different astragalosides(AST) and hydro-soluble astragali polysaccharide(APS) of Astragalus membranaceus on inducing erythroid differentiation of human leukaemic K562 cells.Methods APS and AST were extracted by alcohol or water from Astragalus membranaceus.K562 cells were treated with APS,AST and sodium butyrate(BA) respectively.The proportion of benzidine-positive cells was examined after 1-4 days culture.MTT assay was performed for evaluating the proliferation effects of APS,AST and BA on K562 cells.Results The percentages of benzidine-positive cells induced by APS,AST and BA were 13.2%,2.9% and 17.5%,respectively.The kinetic characteristics of K562 cells induced by different levels of APS(1,2,4,8mg/ml) indicated that 4 mg/ml APS was sufficient to induce K562 cells to turn to be benzidine-positive.The results suggested that APS,other than AST,could induce the K562 cells towards erythroid differentiation.Compared with BA,the percentage of benzidine-positive cells induced by APS was lower at 24h,48h and 72h(F=237.44,P=0.00),while the total number of benzidine-positive cells was higher at 96h(F=322.25,P=0.00).The results of MTT assay for Absorbance(A) showed that APS and AST had no inhibitory effects on growth of K562 cells(P=0.28,P=0.11),while BA showed an obvious inhibitory effect on K562 cells(P=0.00).Conclusion Astragalus membranaceus has pharmacological effects to induce the K562 cells towards erythroid differentiation,and its valuable constituents are contained in hydro-soluble astragali polysaccharide(APS).The induction of differentiation is most evident with a dosage of 4 mg/ml APS.The cell growth curve reveals that APS has no inhibitory effect on K562 cells.

Objective To investigate the epidemiologic factors associated with the age of natural menopause and menopausal symptoms in a large population at age of 40 to 65 years in Jiangsu Province.Methods From May 2010 to Oct.2011,a total of 20 275 women (40 to 65 years) attending health examination in Jiangsu Province were enrolled in this cross-sectional study.A structured questionnaire was used to collect data of demographics,menopausal status,chronic diseases,reproductive history.Also the menopausal symptoms were evaluated by Kupperman menopause index (KMI).Cox proportional hazards regression model and Logistic regression were performed to identify risk factors for earlier age of natural menopause and menopausal symptoms,respectively.Results The overall median age at natural menopause in Jiangsu women was 50 years.Lower educational level,poor economic status,lower body mass index (BMI),age at menarche less than 14 years,nulliparity and smoking were associated with earlier onset of natural menopause (P ＜ 0.05).The most frequently symptoms in perimenopausal women were fatigue (46.84％,1880/4014),insomnia (44.67％,1793/4014) and muscle/joint pain (43.80％,1758/ 4014),while sexual problems (57.06％,3463/6070),muscle/joint pain (53.30％,3235/6070) and insomnia (51.03％,3097/6070) were predominant symptoms in postmenopausal women.After adjusting for confounding factors,it was revealed that women with poor educational background,low income,divorce,higher BMI,higher parity,and smoking presented positive correlation with menopausal symptoms (P ＜ 0.05).Conclusions The study suggested that an estimate of median age at natural menopause were 50 years in Jiangsu women.The main factors contributing to earlier onset of menopause and menopausal symptoms were lower educational level,poor economic status,and smoking.Moreover,there were different menopausal symptoms between perimenopausal and postmenopausal women,which provided the important insights for physicians to prevent and treat menopause symptoms in their clinical practice.

Objective To evaluate the prognostic value of three different staging system based on positive lymph nodes,lymph node ratio and log odds of positive lymph nodes in breast carcinoma.Methods In 472 breast carcinoma patients,survival analysis was performed with Kaplan-Merier and COX regression model,the hazard ratio (HR) of the three staging system were compared.Results When more than 10 lymph nodes were dissected in the operation,there was statistical differences in survival among the staging systems based on lymph node ratio and log odds of positive lymph nodes (P ＜ 0.05),while the prognosis was highly homologous between the staging systems based on positive lymph nodes in stage N0 and N1.Univariate analysis showed age,tumor size,Her2 status,estrogen receptor status and the total lymph nodes dissected were related to overall survival (all P ＜ 0.05).COX multivariate analysis showed that the staging system based on lymph node ratio (5.495) and log odds of positive lymph nodes (4.662) had the higher HR than the N staging system (2.722).Conclusions Compared with the number of involved lymph nodes,the staging system based on lymph node ratio and log odds of positive lymph nodes were superior to the staging system based on positive lymph nodes for prognostic assessment of breast carcinoma.

Objective To investigate the genetic association between polymorphisms of Ser447Stop in lipoprotein lipase (LPL) gene and ischemic stroke. MethodsA case-control study was performed in 563 acute ischemic stroke patients and 320 controls. LPL Ser447Stop genotypes in the subjects were detected by polymerase chain reaction and restriction fragment length polymorphism assay. The frequencies of the alleles in each group were statistically analyzed with Student t-test. ResultsNo significant difference was found in the frequency of G allele of LPL Ser447Stop polymorphism between the case and the control. When subjects were divided into 2 subgroups of cerebral thrombosis infarction and lacunar infarction, the frequency of G allele was significantly higher in the cerebral thrombosis infarction group (9. 7％ ) than that in the control (6. 6％, χ2= 3. 99,P = 0. 045 ), and an increased risk for thrombosis infarction was suggested in the G allele ( OR = 1. 510, 95％ CI 1. 012--2. 261 ). ConclusionThe G allele in polyim Ser447Stop in LPL may be associated with increased risk of cerebral thrombosis infarction.

Objective To investigate the group B streptococcus( GBS)colonization rate and the relationship between vaginal colonization of GBS and the pregnancy outcome. Methods Five hundred and twenty cases pregnant women were selected as our subjects. Microbiological culture was used for culture of GBS in 1 / 3 of vagina and rectus before delivery,other samples from different sites after delivery(including neonatal throat,ear and placenta). Results (1)The GBS carrier rate in 520 pregnant women was 10. 19%(53 / 520). (2)GBS carrier rate in neonatal was 8. 85%(46 / 520). The carrier rate of neonatal whose mothers also carried GBS was 22. 64%(12 / 53),higher than that of non-carrier mothers(7. 28%(34 / 467),χ2 = 8. 192,P < 0. 05) . The rate of pneumonia and the upper respiratory tract infection of neonatal with GBS-carrier-mother were 20. 75%(11 / 53)and 18. 87%(10 / 53),higher than that of non-carrier mothers(8. 57%(40 / 467)and 4. 71%(22 / 467)). The pneumonia rate and upper respiratory tract infection of GBS positive neonatal were 21. 73%(10 / 46)and 19. 56%(9 / 46),higher than GBS negative one(8. 65%(41 / 474);4. 85%(23 / 474)). and there were significant differences(χ2 = 8. 121,15. 717;P < 0. 05).(3)The incidence of intrauterine infection and fetal distress of neonatal with GBS( + )mother were 47. 17%(25 / 53),15. 09%(8 / 53),significantly higher than that of negative(7. 07%(33 / 467),4. 71%(22 / 467)),and the differences were statistically significant( χ2= 77. 248,9. 440;P < 0. 05). But there were the similar incidence in term of premature rupture of fetal membranes,premature occurrence rate between GBS positive and negative mothers( 28. 30%( 15 / 53 ) vs. 28. 48%(133 / 467;3. 77%(2 / 53)vs. 2. 36%(11 / 467);χ2 = 0. 001,0. 393;P > 0. 05). The rate of GBS positive with mycotic vaginitis,placenta previa ratio were 39. 62%(21 / 53),7. 55%(4 / 53),higher than that of GBS negative one(20. 56%(96 / 467),1. 93%(9 / 467)),and the differences were statistically significant(χ2= 9. 922,6. 168,P < 0. 05). Conclusion Maternal GBS carrier at 35 - 37 weeks of gestation can lead to adverse pregnancy outcome by increasing intrauterine infection fetal distress and neonatal infections. Screening of GBS should be performed routinely in late gestation.

SUMMARY Pheochromocytomaisrareinpregn’ancy.Clinicalfeaturesofacaseofpheochromocytoma during pregnancy in the Peking University People’s Hospital was investigated and the literature reviewed to discuss the diagnosis and treatment of this disease.The patient manifested with hypertension and pro-teinuria,who was easily misdiagnosed with gestational hypertension disease.When she was transferred to our hospital,the symptoms such as,paroxysmal palpitation,dizziness,vomiting were noticed,and the possibility of pheochromocytoma was considered due to the accompanying abdominal mass.An emergent cesarean section was performed successfully due to preterm labor during the treatment of the disease.Af-ter the delivery the drug preparation continued.And the laparoscopic resection of pheochromocytoma pro-ceeded when the blood pressure was steady.The patient recovered fully after the surgery.The final diag-nosis of pheochromocytoma was confirmed with the pathology.Its diagnosis and treatment experiences could improve our understanding and treatment of secondary hypertension due to pheochromocytoma in pregnancy.

Objective To evaluate the effect about medication compliance for patients with chronic heart failure in outpatients using nursing intervention model based on Omaha system.Methods 100 patients were randomly divided into observation group(50 patients)and control group(50 patients).The two groups of patients were given routine nursing intervention,the observation group also used the Omaha system to develop care programs on this basis, and was given the implementation about continuity of care.Results On the point of the two or three months after the patients were discharged,the AHFKT -V2 questionnaire scores in the observation group[(17.690 ±1.892)points, (20.900 ±2.052)points]were significantly higher than the control group[(14.080 ±2.374)points,(18.450 ± 1.781)points],the differences were statistically significant (t =-8.488,-6.442,all P <0.05).However,the same as the points after the patients were discharged,Morisky questionnaire scores in the observation group[(1.036 ± 0.780)points,(0.487 ±0.260)points]were significantly lower than the control group[(1.54 ±1.182)points, (0.920 ±0.804)points],the differences were statistically significant(t =3.420,4.965,all P <0.05).Conclusion The use of Omaha system to develop the targeted continuity of care,can improve the patients medication compliance.