Objective To investigate the impact of the different mode of delivery on postpartum lactation.Methods 1 678 pregnant women in our hospital were divided into cesarean section group(798 cases) and natural delivery group(880 cases).Open milk after delivery,breast fullness,the number of neonatal sucking and post-natal self-assessment milk water were compared between the two groups of pregnant women,and the impact of the mode of delivery on postpartum lactation was analyzed.Results Whether or not began to lactation (721/77cases),and the time of labor to beginning to lactation [(33.45 ± 9.68) h],and whether or not having breast fullness feeling (512/286 cases),and the time of labor to breast fullness feeling[(57.12 ± 13.90) h] in cesarean section group had significant difference with those of spontaneus labor group [(845/35 cases),(30.12 ± 10.25) h,(690/190 cases),(52.98 ±15.09) h] (x2 =21.613,t =2.452,x2 =41.813,t =2.818,all P ＜ 0.05).There was no significant difference in selfrating milk score [(2.02 ± 0.45) points vs (2.45 ± 0.51) points],and newborn sucking times 4 ～ 6d postpartum [(5.21 ±1.21) times vs (5.89± 1.82)times](t =2.012,2.532,all P ＜0.05).Conclusion Efficiency of the breast-feeding was affected by the impact of the mode of delivery.Rationalized breastfeeding guidance was necessary to strengthen for pregnant women by cesarean section.

Objiective:to summarize the early treatment of severe bifrontal intraparenchyma contusion associated with central herniation. Mehthod:clinical presentation of 41 cases of secere bifrontal contusion associated with central herniation were analyzed retrospectively. Resolts:12 cases had good overcome,13 mild morbidty,2 severe mordity,1 were in persistent vegetative state,3 mortality.Conclusions: Attaches great importance to patients with severe bifrontal brain contusion associated with central herniation,close observation of patients with their consciousness,pupil and changes in vital signs;attend that it is premature to stop dehydrating agent,too fast,to review the head dynamic CT,the right to master surgical indications.Early removal of necrotic brain tissue and cranial decompressive craniectomy to be effective in improving the cure rate of patients.

Objective To explore the influencing factors of heart failure among patients with continuous ambulatory peritoneal dialysis(CAPD).Method Clinical data were collected from the histories of 158 patients receiving CAPD to investigate the factors inducing heart failure for the purpose of finding out the potential independent influencing factors using t test or chi-square test for univariate analyses and logistic regression in multivariate analyses.Results The incidence of heart failure was 36.71%among the enrolled CAPD patients.Single factor analysis showed that level of volume management,age,hemoglobin,serum pre-albumin, cholesterol and c-reactive protein were related to heart failure.Analysis of multiple variables logistic regression revealed that levels of volume management,serum pre-albumin and blood urea nitrogen were related to heart failure.Conclusions It is an easy,effective and cheaper way for nurses to increase patients’ability of volume control.The strategy including remedying malnutrition and decreasing the level of uremic toxins might be effective for delayed exacerbation of cardiac function among CAPD patients.

Objective To investigate the difference of TCM body constitution betweenpeople of the Shimian county and Chengdu city. Methods 200 sub-health patients in clinic of Shimian TCM Hospital were selected randomly. Another 200 sub-health patients in clinic of the Second Sichuan Province Hospital of TCM wererandomly selected. The two groups were identified with TCM body constitution based on the clinical symptoms, tongue, pulse condition, etc. Comparisons on body constitution were made between the two groups. Results In Chengdu, patients withbalance constitution and Qi deficiency constitution (respectively have the proportion of 33.0% and 20.0%)were significantly higher than thoseof Shimian County(the proportion of the two wererespectively 4.0% and 6.0%);while Shimian County have a significantly higher ratio of phlegm dampness and blood stasis constitution(43.5% and 13.0%)than those in Chengdu city(the proportion of the two wererespectively 8.0%and 4.0%), P<0.01. Conclusion Because of different regions, the population constitution ratio wasdifferent, so the disease tendency wasalso somewhat different. Therefore, physicians should give full consideration to the regional factors in diagnosing and treating patients.

Objective To investigate the diagnostic method,microsurgical operation time and effect of brain arteriovenous mal-formation(AVM)rupture hemorrhage in childhood.Methods 72 children (≤16 years old)of AVM hemorrhage from 2003 to 2013 were retrospectively analyzed.Results The CT diagnosis rate was 48.6%(35/72),the MRI diagnosis rate was 78.3%(47/60),56 cases were performed the early whole brain DSA under the condition permitting,its diagnosis rate was 98.2%(55/56).All the cases were performed the hematoma clearance plus the pertinent lesion resection.70 cases were re-examined by DSA/CTA/MRA during postoperative perioperation period.The lesion resection rate was 91.5%,the partial resection rate was 8.6%.60 cases(85.7%) were successfully followed up for 6 months to 6 years and assessed by the Glasgow outcome scale,5 points in 5 5 cases,4 points in 2 cases,3 points in 2 cases and 2 points in 1 cases.Conclusion DSA is the main detection measure for early diagnosing AVM hem-orrhage and the microsurgical operation in the acute stage can reduce the fatality and improve the prognosis.

LI-cadherins are a new member of cadherin superfamily,which transmembrane glycoproteins mediate Ca2 + dependent cell-cell adhesion independent of cytoplasmic interactions.They play an pivotal role during tissue development and are critical for the maintenance of junctional complexes between cells and tissues,LI-cadherin high expression in hepatocellular carcinoma results in the decrease of intercellular adhesion effect,cause hepatocellular carcinoma metastasis.

Objective To compare the diagnostic clinical significance between loop electrosurgical excision procedure (LEEP) and colposcopical biopsy for cervical intracpithelial neoplasia(CIN). Methods 130 cases of pa-tients diagnosed as CIN under colposcopical biopsy were treated by LEEP in court of gynecology clinic. The conven-tional pathologic diagnosis was recorded in all conization specimens. Results The coincidence rate between colpo-scopical biopsy and LEEP biopsy in CIN Ⅰ, CIN Ⅱ, CIN Ⅲ (not comprised carcinoma in situ) was 55.26%,66.10% ,78.79% respectively;The total coincidence rate was 66.15%. The accuracy of colposcopic biopsy for diag-nosing CINⅢ was higher than that for CIN Ⅰ and CIN Ⅱ,but there was no statistical difference. Conclusion Colpo-scopical biopsy for cervical lesions can be achieved for the frist time the results of pathology, have limitations. LEEP biopsy can compensate partially the deficiency of colposcopic biopsy. In a dear diagnosis of CIN, LEEP biopsy and colposcopical biopsy may complement each other, and achieve thcrpeutic effects.

Continuous renal replacement therapy( CRRT) employs convection and adsorption to re-move pro-and anti-inflammatory mediators from plasma, helping to restore the immunologic homeostasis. CRRT also provide uninterrupted clearance of retained endogenous and exogenous toxins, along with acid-base,electrolyte,hemodynamics and volume homeostasis.CRRT may improve outcomes in critically ill pa-tients with sepsis-induced acute kidney injury,septic shock and multiple organ dysfunction syndrome.Region-al citrate anticoagulation, as compared to unfractionated heparin, report better filter survival times and less bleeding.Antibiotic dosing decisions should be individualized to take into account patient-related,CRRT-relat-ed,and drug-related factors.

In recent years,with the continuous development of endoscopic and interventional techniques,many new devices and methods have been used in clinical practice,and the application of endoscopic retrograde cholangiopancreatography (ERCP)in biliary and pancreatic diseases has developed rapidly.This paper reviews and summarizes the recent progress in ERCP among patients with biliary and pancreatic diseases,including those with altered gastrointestinal anatomy,pregnant patients,patients with benign and malignant biliary strictures,and patients with pancreatic pseudocysts,as well as the application of SpyGlass,photodynamic therapy,and radiofrequency ablation,the man-agement of ERCP-related duodenal perforation,and the prevention of post-ERCP pancreatitis.All the progress has made a great contribu-tion to the diagnosis and treatment of biliary and pancreatic diseases.

Objective To systematic evaluate the prevalence of secondhand smoke among Chinese mainland rural residents by meta?analysis,so as to provide reference for making relevant smoking control regulations and the carry out of targeted tobacco control action. Methods The related stud?ies were searched and collected from PubMed,CNKI,Wanfangdata,VIP and CBM database,which were published between 2001 and 2015 about the prevalence of secondhand smoke among Chinese mainland rural residents. Meta?analysis was tested by software CMA V2. Results The pooled prevalence of secondhand smoke among Chinese mainland rural residents was 46.6%(95%CI 40.5%?52.8%). Stratified analysis showed that the prevalence of secondhand smoke were 45.7%and 47.5%for male and female,45.7%and 51.1%for eastern and midwest China,22.1%、34.2%and 71.3%for public place,workplace and family,respectively. The prevalence among sex,regions,and places were statistically significant. Conclusion The prevalence of secondhand smoke among Chinese mainland rural residents was relatively high,and the prevalence of secondhand smoke was higher in women than in men,in midwest area than in eastern area,and at family than at public place and at workplace.