Objective To retrospectively analyze the main factors of abnormal umbilical blood flow in different stage after 24 weeks' gestation,and to evaluate its treatment outcomes.Methods 256 cases with abnormal umbilical blood flow were selected.The abnormality happened in different stages after 24 weeks' gestation and they were inspected and treated routinely.Latency factors of the different stage were analyzed to discover the primary reason,and the treatment outcomes were compared.Results The significant differences of constructional proportion were observed in different stage(x2 =25.60,P ＜ 0.05).The influence factors of different stages were as following:hypertension relative disease (33.33 ％) between 24 and 27 weeks' gestation,the umbilical cord factor (16.67 ％) ; the incidence rate of abnormal umbilical blood was 42％ between 28 and 36 weeks' gestation,including hypertension disease(28.70％),the umbilical cord factor(15.74％) ;umbilical cord (31.37％) between 37 and 40 weeks' gestation,although gestation period hypertension disease reduced,but still accounted for 22.54％,the placenta factor was 12.74％.After treatment,the cure rate had significant differences (x2 =11.16,P ＜0.01),89.58％ (24-27 week),80.55％ (28-36 week),69.60％ (37-40 week).Conclusion The hypertension relative diseases and abnormal cord are the primary factors which caused abnormal umbilical blood,24-37 gestation week is the key stage for the inspection and treatment,especially for the hypertension relative diseases.

After several thousand years of development,TCM has formed its own sets of research methods.such as observation,comparison,classification,trial and error,and deduction,etc.Based on the unique TCM theory,experiences of clinical diagnosis and treatment of TCM,the author put forward that the research of TCM should combine macrophenomenon and microphenomenon,quality and quantity,and"Zheng"and"Xie",emphasize locality feature for the purpose of promoting the science research level.

Objective To observe the clinical application of extraperitoneal cesarean section(ECS) plus forceps vs transperitoneal cesarean sections(TCS) in repeated cesarean section.Methods 98 multiparous women with scar uterus for elective repeated cesarean sections were recruited retrospectively,47 cases for ECS plus forceps(group A),and 51 cases for TCS(group B).The multiparous women with hyperglycemia not controlled,severe preeclampsia,heart disease,placenta previa,premature rupture of membrane,a history of ＞ 1 cesarean section,myoma and/or ovarian neoplasm were excluded.Results Skin incision to baby delivery time and total operation time of group A were (7.7 ± 2.8) min and (42.8 ± 9.7) min,respectively,which were significantly shorter than (9.3 ± 3.2) min and (47.6 ± 9.4) min of group B,(t =2.700,2.497,P =0.008,0.014).There was significant difference in blood loss volume during the operation and postoperative 2 hours,which was (310.4 ± 106.3) mL,(365.3 ± 142.8) mL respectively(t =2.142,P =0.035).The Visual Analog Scale for pain (VAS pain) was (2.8 ± 1.8) in group A and (4.1 ± 1.9) in group B,respectively (t =3.252,P =0.002).The gastrointestinal function recovery mean time of group A was significantly shorter than that of group B (12.5 h versus 16.0h,t =2.771,P =0.007).And the postoperative febrile morbidity was significantly lower in group A than in group B(8.5％ versus 25.5％ ;x2 =4.918,P =0.033).The patients with chronic pelvic pain followed up after operation was 3 versus 12,and the difference was significant (x2 =5.143,P =0.026).There were no differences in neonatal Apgar score at 1 minute,birth asphyxia and wound healing rates.Conclusion ECS plus forceps can be safely used for repeated cesarean section,with the advantages of less operation time,less bleeding volume,lower postoperative morbidity,and fewer complications than TCS.

Objective To investigate the relationship between the expression of glucose regulated protein 78 (GRP78) in the placental trophoblast cells and the pathogenesis of gestational diabetes mellitus (GDM).Methods All the patients were recruited from Qingdao Municipal Hospital from May 2013 to May 2014.Among them, fifty women with GDM were assigned to the GDM group, and fifty healthy women were defined as the control group.All of them received cesarean section because of breech presentation, contracted pelvis, scarred uterus or on mother's demand.Real-time PCR was conducted to analyze the expression of GRP78 mRNA in the trophoblasts.Immunohistochemistry was performed to detect the localization of GRP78 protein in the placentasl trophoblast cells.Results (1) GRP78 mRNA expressed in the cytoplasm of trophoblasts of both the GDM group and the control group.The GRP78 mRNA levels in the GDM group and the control group were 15.6±0.4 and 6.0±0.7, respectively.The relative expression level of GRP78 mRNA in the GDM group was 2.6 times of that in the control group, with statistically significant difference (P＜0.01).(2) The expression of GRP78 protein was found in the cytoplasm of the trophoblasts of the GDM group.It showed in deep, light brown or yellow after staining, according to the expression degree.The expression of GRP78 protein was also found in the cytoplasm of the trophoblasts of the control group, but it mainly showed yellow color (38/50).The strong positive rate of GRP78 protein in the GDM group (96％, 48/50) was higher than that in the control group (22％, 11/50;P＜0.01).Conclusion The expression of GRP78 increased in the placental trophoblast cells of GDM patients.It might suggest that GRP78 had some effect on the pathogenesis of GDM.

Objective To study the related factors of postpartum depression (PPD) and the effects of intervening measures to PPD incidence. Methods 1 597 pregnant women selected from our antenatal care clinic were investigated by using the hospital anxiety and depression questionnaire (HAD) during pregnancy and the Edinburgh postpartum depression scale (EPDS) after childbirth.All the enrolled women were randomlyd divided into control group and intervening group by the proportion of 1 to 2.Six intervening measures were used in the latter group. Results (1) There were 49 women whose HAD≥11 score (anxiety-depression mood)with 28 cases (57.1%) had got postpartum depression in the control group.In the intervening group,however,there were 94 women whose HAD≥11 score with 24 cases (25.5%) had got postpartum depression.There is a significant difference between the two groups ( P

Objective To investigate the significance of metallothionein (MT) expression in the placenta of women exposed to low level lead during pregnancy. Methods Sixty-seven pregnant women with blood lead level ranging from 1.5 ?mol/L to 4.8 ?mol/L were randomly selected from the Department of Obstetrics of Qingdao Municipal Hospital between Mar 2005 and Mar 2006. Among them, 35 were with blood lead level less than 2.9 ?mol/L(group A) and 32 more than 2.9 ?mol/L(group B). Immunohistochemical streptavidin-peroxidase-biotin methods were used to observe the expression of MT in the placental tissue. Results (1)Among the 67 pregnant women,the highest level of blood lead was 4.7 ?mol/L , and the lowest level was 1.6 ?mol/L .The blood lead level of groups A and B was (1.7?0.3) ?mol/L, and (3.1?0.4) ?mol/L, with a significant difference between them(P

Objective To investigate the current situation of randomized controlled trials (RCTs) on the treatment of chronic obstructive pulmonary disease (COPD) in stationary phase with point application, and provide evidence for clinical practice. Methods Such databases as CNKI, VIP, and CBM were searched from the establishment date to October 2011 to collect the RCTs on the treatment of COPD in stationary phase with point application according to the predefined inclusion criteria. And the quality was assessed by using the Jadad scale, the revised CONSORT statement and other self-defined indexes. Results Among 32 included RCTs, 1 literature scored three points, 8 scored two points, 23 scored one point according to Jadad scale, and no RCT performed the allocation concealment. According to the CONSORT criteria, only one can be prompted randomized trials from the title of the article, 23 from abstracts, 2 literature showed how to determine the sample size, 7 described the method to generate random allocation sequence, only 1 literature mentioned blind method, 15 literature explicitly mentioned syndromes. Conclusion Currently, the methodology and reporting quality of studies on the treatment of COPD in stationary phase with point application are not good enough to provide reliable evidence for clinical practice, and we should improve the quality of our clinical research.

This study was aimed to assess the clinical evaluation of Xiaoqinglong decoction for acute exacerbation of chronic obstructive pulmonary disease (COPD). Literatures published before August 3rd, 2012 were searched in the database of CNKI, VIP, CBM and Wanfang Data to identify the randomized controlled trials (RCTs) and quasi-RCTs about Xiaoqinglong decoction for acute exacerbation of COPD in China. Literatures were screened ac-cording to the inclusive and exclusive criteria by two reviewers independently. And the methodology quality was evaluated after abstracting the data. Then, the RevMan 5.0 software was used for meta-analysis. Seventeen RCTs were included. Among 1173 patients, there were 608 cases in the clinical trial group and 565 in the control group. The meta-analysis showed that compared with western medicine (WM), the clinical effect of Xiaoqinglong decoction plus WM was significantly better [MD = 3.91, 95%CI (2.50, 6.12), P < 0.01]. The invasive ventilation plus Xiaoqinglong decoction was better than the invasive ventilation [MD = 3.48, 95%CI (1.45, 8.32), P =0.01]. The blood gas analysis showed that compared with WM, the PaO2 in the Xiaoqinglong decoction plus WM was significantly better [MD = 7.55, 95%CI (1.41, 13.68), P = 0.05]. There was statistical significance in PaCO2 of Xiaoqinglong decoction plus WM [MD = -7.11, 95%CI (-9.89, -4.33), P < 0.01]. Compared to the invasive ventilation, there was statistical significance in the invasive ventilation plus Xiaoqinglong decoction [MD = -6.66, 95%CI (-8.79, -4.54), P < 0.01]. For FEV1, compared with WM, Xiaoqinglong decoction plus WM was signifi-cantly better [MD = 6.97, 95%CI (3.60, 10.34), P < 0.01]. It was concluded that Xiaoqinglong decoction com-bined with WM methods can improve clinical efficacy of acute exacerbation of COPD in order to increase the clinical efficacy on a certain level.

Objective To investigate the correlation of IL-17 gene polymorphism with chronic obstructive pulmonary diseases (COPD) in Xinjiang area.Methods Five single nucleotide polymorphism (SNP) loci of IL-17A gene,including rs2275913,rs3819024,rs3819025,rs4711998 and rs8193036,and 4 SNP loci of IL-17F gene such as rs12203582,rs1266828,rs7771466 and rs9382084 from 149 COPD patients and 97 healthy controls were performed typing using the multiple single-base extension SNP (SNaPshot) technology,and the risk correlations of different genotypes and alleles of these loci with COPD were analyzed.Results There was no difference in the SNP of 5 IL-17A gene loci and 4 IL-17A gene loci between stable COPD patients and healthy controls,and the mutation and genotype distribution of these loci were not correlated with COPD susceptibility.However,the linkage disequilibrium analysis showed that there was significant difference in the distribution of IL-17A gene haplotype CAA between COPD patients and healthy controls (OR =0.244,95％ CI:0.057-1.043,P ＜ 0.05).Conclusion The IL-17F and IL-17A gene polymorphisms are not correlated with the risk of COPD,but the haplotype CAA of 1L-17A gene may be related to the susceptibility of COPD in Xinjiang area.

Objective To reveal the effects of cold-dryness and modified Zhisou Power on epidermal growth factor receptor (EGFR) and neutrophil elastase (NE) in rats with COPD. Methods COPD model was established with an elastase dose into the trachea combined with exposure to smoking for 90 d; cold-dryness COPD group was further developed by exposure to a cold, dry environment for 90 d. After 90 days, cold-dryness COPD rats was divided into cold-dryness group and Zhisou Power intervention group (treated with modified Zhisou Power for 7 days). On the 97th day, all rats were killed. Pathological changes in lungs were observed. mRNA and protein expression of EGFR were measured by RT-qPCR and Western blot, and the amount of NE in serum and BALF were examined by ELISA. Results EGFR mRNA and protein expression were significantly higher in COPD group, cold-dryness group and Zhisou Power intervention group than in control group. EGFR was significantly lower in Zhisou Power intervention group than in COPD group and cold-dryness group. NE was significantly higher in serum and BALF in COPD group, cold-dryness group and Zhisou Power intervention group than in control group. NE in BALF was significantly higher in cold-dryness group than in COPD group. NE in BALF was significantly lower in Zhisou Power intervention group than in cold-dryness group. Conclusion Modified Zhisou Power can down-regulate the expression of EGFR and the mount of NE in cold-dryness COPD rats to treat COPD.