Objective To investigate the effects of 3 different delivery methods on maternal and fetal complications during labor and determine better mode of delivery. Methods Sixty pregnant women with ASA class Ⅰ or Ⅱ were randomly divided into three groups with 20 cases each: the cesarean section group (group Ⅰ), the pain relief group (group Ⅱ) and normal delivery group (group Ⅲ). In group Ⅰ and Ⅱ, an epidural catheter was placed through L_(2-3) interval. 0.5% ropivacaine was injected via the epidural catheter for continuous epidural anesthesia in group Ⅰ. After a loading dose of 8-10 mL 0.125% ropivacaine+2 μg/mL fentany, the patient-controlled epidural analgesia (PCEA) during labor was started with bolus 5 mL, lockout interval 20 min and back ground infusion rate 6-8 mL/h in group Ⅱ. The level of block was controlled below T_(10). BP, HR and RR were continuously monitored during labor. Blood samples were taken from umbilical vein at delivery for blood gas analysis and determination of lactate concentration. Neonates were assessed by Apgar score and neurological and adaptive capacity score (NACS). Maternal postoperative complications were recorded. Results There was no statistical differences in plasma pH, PCO_2, PO_2, SO_2, Apgar score and NACS among 3 groups. The umbilical vein blood lactate concentration was significantly increased in group Ⅱ and Ⅲ compared to the group Ⅰ, while blood lactate concentration in group Ⅱ was lower than that in the group Ⅲ (P<0.05). Base excess (BE) was significantly higher in group Ⅲ than in group Ⅰ. Compared with group Ⅱ and Ⅲ, maternal postoperative complications such as urinary retention, postpartum hemorrhage and so on were increased significantly in group Ⅰ (P<0.05). PCEA provided satisfactory effect in group Ⅱ. Conclusions Epidural labor analgesia with 0.125% ropivacaine+2 μg/mL fentany can provide comparative and effective analgesia for pain relief during labor without adverse effects on the mothers and fetuses and may reduce the postoperative complications. It is a safer and more effective technique in pain relief during labor.

Objective To review the clinical treatment and outcome of ultrasonographic soft markers in prenatal diagnostics. Methods This study recruited 268 pregnant women who underwent prenatal diagnostics in our hospital between Jun 2005 to Mar 2009. Fetuses were followed up postnatally. The outcome and chromosomal abnormalities of ultrasonographic soft markers were assessed. Results Of 268 cases consulted, 29 cases were missed (10.8%), 34 cases (12.7%) chose abortion, and 205 cases (76.5%) delivered. The top four most common delivered isolated markers were thickened nuchal fold, mild pyelectasis, echogenic bowel and rhizomelic limb shortening. Mild ventriculomegals had the highest aborted rate (17.2%). Six chromosomal structural abnormalities and one 21-trisome were detected in 59 fetuses who received chromosomal examination. Conclusions Ultrasonographic soft markers are risks to both fetal trisome and chromosomal structural abnormalities. Owing to extinction in most cases, consultant should be strengthed to avoid unnecessary invasive examination and abortion.

Objective To investigate the correlation between vibration perception thresholds test (VPT) and simple screening tests for peripheral neuropathy in the diabetes clinic in type 2 diabetic patients. Methods VPT and three simple screening tests including 10 g Semmes-Weinstein monofilament examination (SWME), vibration test by 128 Hz tuning fork, and temperature sensation test by Tip-Therm were completed in 487 Chinese patients diagnosed with type 2 diabetes aged over 30. The relationships between these simple screening tests and VPT were evaluated by Spearman correlation and observed agreement rate. Results Abnormal VPT was significantly associated with aging and fasting plasma glucose by binary logistic regression analysis. VPT was significantly correlated with SWME, temperature sensation test, vibration test by 128 Hz tuning fork, and the correlation coefficient was 0.176, 0.152 and 0.240, respectively (P<0.01);Observed agreement between VPT and three simple screening tests including SWME, temperature sensation test, vibration test by 128 Hz tuning fork was 49.5%, 59.8% and 51.1%, respectively. The percentage of abnormal results by SWME or vibration test by 128 Hz tuning fork with normal result by VPT was very low, only 2.7% and 1.2% respectively. Conclusions VPT should also be considered as a first-choice screening test for diabetic peripheral neuropathy.

Objective To introduce the techniques and specification of complete-block radical gastrectomy, and to compare with traditional radical gastrectomy in the operative time, surgical costs and postoperative complications. Methods Thirty gastric cancer patients meet the criteria were randomly divided into 2 groups. Group A: complete-block radical gastrectomy;group B: radical gastrectomy. Analysis and comparison were made on tumor site, time consuming of block, the proportion of gastrointestinal reconstruction, operative time, cost of block, pathological TNM stage, length of stay, postoperative complications and postoperative chemotherapy. Results Group A has longer operative time than group B (P<0.05). However, there was no significant statistical difference in the other indicators between these 2 groups. Conclusions Complete-block technology can separate cancer more completely during operation with the advantage of simplicity, low-cost, little effect on the subsequent operation. The incidence of postoperative complications and length of stay with the traditional surgery there was no significant difference.

Objective To develop a liquid chromatography-mass spectrometry (LC-MS) method for the determination of S-allyl-L-cystein in extraction of garlic. Methods A LC-MS method was established on a ZORBAX Eclipse XDB-C8(4.6 mm×250 mm, 5 μm)column with the mobile phase consisting of 1‰ formic acid water-methanol (95:5), flow rate of 0.8 mL/min and detection with post-column splitting. The split ratio was 2:1, column temperature was set at 25 ℃. The mass spectrometer equipped with ESI and the ion source was operated in negative mode. The dry gas flow was 10.0 L/min, the nebulizer pressure was 30 psig, and the vaporizer temperature was 350 ℃. SIM detector, S-allyl-L-cystein m/z 160 and S-allyl-L-cystein sulfoxide m/z 176. Results The calibration curves showed good linearity in the range of 0.062 5-2 μg/mL of S-allyl-L-cystein. The detection limit was 0.01 μg/mL. The within-day RSD was 4.11% and the day-to-day RSD was 4.49%.The average recovery for S-allyl-L-cystein was 101.63%. Conclusions The method is simple and accurate. It is adapted to determine and analyze S-allyl-L-cystein in extraction of garlic and the average content of S-allyl-L-cystein is 0.514 μg/mg.

Circulating DNA is cell-free DNA existing in plasma or serum. It has already been verified that circulating DNA of cancer patients is derived from tumor cells. Therefore, it is of great value to detect the changes in the quantity and quality of the circulating DNA in cancer patients for early diagnosis and prognosis. The advantages of the detection of circulating DNA such as micro-trauma, convenient access to samples, possibility of continuous and dynamic monitoring, make it a promising tumor mark. This review recapitulates the application of circulating DNA analysis in hepatocellular carcinoma patients for diagnosis and prognosis.

Objective To identify a novel HLA allele, HLA-B*4086, in Chinese population and to investigate its pedigree. Methods An exceptional reaction pattern was detected in routine HLA typing of a CMDP (China Marrow Donor Programme) sample by PCR-sequence specific oligonucleotide primer (PCR-SSOP) assay. A new HLA-B allele was confirmed by sequence-based typing. Then family investigation was performed. Results DNA sequencing confirmed a new HLA allele. Compared with the closest macthing allele HLA-B*40060101, the novel allele has a difference at nt419 (A→T) in exon 3, which resulted in an amino acid change from Tyr to Phe at codon 140. Family investigation indicated the new allele derives from mother of the carrier. Conclusions One novel HLA allele was confirmed by sequencing based typing and it had been designated as HLA-B*4086 by the WHO Nomenclature Committee. This novel allele was inherited from mother of the carrier.

Objective To understand the epidemic characteristics of influenza in Minhang District of Shanghai during 2013-2016,so as to provide scientific basis for the prevention and control of influenza.Methods Surveillance data of influenza like illness (ILI) cases from the national influenza network and data of pathogen detection during 2013-2016 in Minhang District were selected to analyze the epidemic characteristics of influenza.Results The number of influenza like illness (ILI) was 37 738 from 2013 to 2016,which accounted for 0.90％ of the outpatients in monthly average.Meanwhile,4 094 samples were collected,among which 857 samples were virus positive.The total isolation rate was 20.93％.In 2013,the dominant strain was mainly seasonal influenza A (H3N2).Dominant strains of 2014 were influenza B (Yamagata) and seasonal influenza A (H3N2).In 2015,dominant strain was seasonal influenza A (H3N2) of summer peak,but the dominant strains of winter-spring peak were new type influenza H1N1 (H1N1 pdm09) and influenza B (Victoria) from December 2015 to April 2016.The dominant strain of winter peak in 2016 was seasonal influenza A (H3N2) popular.Spearman correlation analysis showed positive rate between ILI visiting rate (ILI％) and influenza virus (rs =0.460,P＜0.05).Conclusions The epidemic peaks of of influenza were winter-spring and summer in Minhang District,advantages strains were interaction pandemic with certain regulation.The characteristics of ILI visiting rate was coincident with influenza virus activity.

Objective To analyze malnutrition epidemiologic trend among students aged 6-18 years from 2010 to 2016 in Minhang district of Shanghai,and to provide reference for malnutrition prevention and treatment.Methods Physical examination data from healthy monitoring schools in Minhang District from 2010 to 2016 were used to screened out the malnutrition of students aged 6-18 years via National standard 2014 and analyzed the different type of malnutrition in different population.Results During the period of 2010 to 2016,malnutrition rate of students demonstrated a fluctuated trend.Malnutrition rate in 2010 was 4.0％ and 4.4％ in 2016.The major type of malnutrition is wasting with a proportion more than 88％ during these years.Rate of wasting increased from 3.5％ to 7.8％ in boys aged 13-18 years old and from 1.3％ to 3.9％ in girls aged 13-18 years old.Conclusions The malnutrition of students in Minhang District is under control,while the screening rate of wasting increased in students aged 13-18 years old.Intensified intervention of prevention and treatment should be administrated and integrated with obesity control in Minhang District of Shanghai.

Objective To investigate the epidemiological and pathogenic characteristics of viral diarrhea in Minhang District of Shanghai.Methods Random sampling on diarrhea was conducted in intestinal outpatient departments of 2 sentinel hospitals according to a certain sampling interval in Minhang District from 2014 to 2016.Real-time PCR was used to detect rotavirus (RV),norovirus (NV),adenovirus (AD),astrovirus (AstV) and sapovirus (SaV) in fecal samples.Results A total of 11 243 cases of diarrhea were monitored in 2 sentinel hospitals during 2014 and 2016,with 3 213,3 600 and 4 430 cases for each year,respectively.Out of 809 stool specimens,309 were tested positively,and the positive rate was 38.48％.All 5 pathogenic viruses were detected,mostly NV (207 cases,66.99％)followed by RV (77 cases,24.92％).Conclusions NV accounted for the majority of reported infection diarrhea cases in Minhang District of Shanghai from 2014 to 2016,with significant seasonal peaks.Tailored prevention and control measures should be carried out,particularly in risk seasons.