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 study butylphthalide on acute cerebral infarction with leukoaraiosis patients cognitive function. Methods 80 patients with acute cerebral infarction combined with leukoaraiosis in Yuncheng Central Hospital from June 2014 to June 2015 were selected, all patients had cognitive dysfunction, and randomly divided into study group and control group with 40 cases in each group. The two groups were given conventional treatment of cerebral infarction, the study group was given the butylphthalide soft capsules two tablets, three times once day orally for three months, we used MMSE and MoCA scale to assess the cognitive status of the patients in the two groups at four, eight, and 12 weeks after treatment. The changes of liver function during treatment were analyzed. Results In the treatment, the two groups of patients with MMSE were improved, in four weeks of treatment, the MMSE scores of the study group was higher than the control group, but there was no significant difference between the two groups, eight weeks and 12 weeks, the MMSE scores of the study group was significantly higher than the control group, and the difference between the two groups was statistically significant (P<0.05), the MOCA score of patients in the study group gradually become normal, and significantly higher than the control group, after treatment for four weeks, eight weeks and 12 weeks the difference was statistically significant (P<0.05), the study group patients first had abnormal liver function in the treatment, recovered after stopping the medication. Conclusion Butylphthalide can improve the cognitive function of patients with acute cerebral infarction combined with leukoaraiosis, the increase of transaminase caused by treatment has no significant effect on clinical medication, which is worthy of further popularization and application.

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.

Pancreatic cancer is the fourth most common cause of cancer death,with a 5- year survival rate of less than 5％.The management and prognosis of the patients have remained dismal due to higher resistance of cancer cells to conventional approaches including surgery,radiation and chemotherapy.Therefore,there is a need for development of specific and sensitive tumor marker for pancreatic cancer.Caveolin- 1 is an essential constituent of caveolae and interacts with a variety of cellular proteins and regulates cell- signaling events.In this review,we survey the functional roles of caveolin- 1 in pancreatic cancer and argue that caveolin-1 regulates multiple cancer-associated processes including tumor growth,cell invasion,metastasis,cell apeptosis.However,Caveolin-1 has been reported to impact both positively and negatively on various aspects of pancreatic cancer progression.The function of caveolin- 1 is interdependent on tumor stage and the expression of some signaling pathways that impact on its role during tumor progression.

Hemodynamics is monitoring a series of physiological and pathological parameter changes such as blood flow,the chamber pressure of the heart,pressure or resistance of cardiovascular and cardiopulmonary system.Traditional hemodynamic monitoring in septic shock manily includes central venous pressure,cardiac index,blood lactate and pH.In recent years,expanded non-invasive or invasive monitoring technologies include central venous or mixed venous oxygen saturation,continuous ultrasound associated with underlying cardiac output monitoring and pulse indicator continuous cardiac output.Macro-hemodynamic,metabolic and microcirculatory parameters constitute a new hemodynamics network.In order to properly assess the patient's blood volume and circulation function and to overcome the limitations of a single parameter,it is need to emphasize analysis and integration of the various parameters.

Bacause of few side effects,low expenditure,the adaptability for long－ term treatment and the ability of treating both principal and secondary aspect of disease of chinese herbs,to cure osteoporosis by chinese herbs and the combined treatment of traditional chinese and western medicine has become a hot task in china.It has been demonstrated that the chinese herbs can prevent and treat osteoprosis effectively.Many research also show that the chinese herbs can increase the intestine calcium absorption,decrease PYH and increase 1,25(OH)2D3 level.This review intends to show and summarize the progress made all those years.

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.

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.

Objective To systematically analyze therapeutic effects of extracorporeal photopheresis (ECP) on refractory steroid-resistant,-dependent or-intolerant graft-versus-host disease (GVHD),to compare remission rates of skin GVHD in detail.Methods Databases were searched for studies concerning remission rates of GVHD after the treatment with ECP,and relevant data were extracted and pooled by using meta-analysis with STATA 12.0 software.Results A total of 22 literatures were reviewed,including 787 patients with refractory GVHD.Meta-analysis showed that the pooled complete remission (CR) rate and overall remission (OR) rate were 57％ (95％ CI:47％-66％) and 79％ (71％-86％) respectively in patients with acute GVHD,27％ (21％-33％) and 63％ (58％-69％) respectively in patients with chronic GVHD,77％ (71％-82％) and 87％ (82％-91％) in patients with acute skin GVHD,as well as 39％ (30％-48％) and 70％ (63％-77％) in patients with chronic skin GVHD.Conclusion ECP is an effective therapy for refractory GVHD,especially for skin GVHD.