Objective To investigate the perinatal outcomes of twin-twin transfusion syndrome (TTTS)and the management.Methods During Nov 1, 2002 to Sep 30, 2005, 24 cases of TTTS in Beijing Obstetrics and Gynecology Hospital were analyzed.The outcomes of them were compared with the pregnancy without TTTS in all twins and in monozygotic twins.The outcomes of the blood-supplying fetus and the blood-recepter were compared.Results 6.8%cases had TTTS in all twins.The group of TTTS had more maternal,fetal and neonatal complications than twins pregnancy without TTTS :polyhydramnios [37.5%(9/24)vs 2.1%(7/328),P＜0.01],gestational hypertension[20.8%(5/24)vs 7.0%(23/328),P=0.043],premature labor[66.7%(16/24)vs 36.3%(119/328),P=0.003],perinatal dead fetus in uterus[18.8%(6/32)vs 1.1%(7/540),P＜0.01],neonatal asphyxia[73.1%(19/26)vs 3.0%(19/632),P＜0.01],the proportion of NICU[88.5%(23/26)vs 23.4%(148/632),P＜0.01],neonatal death [15.4%(4/26)vs 1.7%(11/632),P=0.002 ]and the rate of perinatal mortality [31.2%(0/32)vs 2.8%(18/632)].Compared with the monozygotic twins without TTTS,in TTTS group there were more complications of the mother,the fetus and the neonates:gestational hypertension[20.8%(5/24)vs 9.9%(14/142),P=0.224],premature labor[66.7%(16/24)vs 49.3%(70/142),P=0.115 ],perinatal dead fetus in uterus [ 18.8%(6/32)vs 0.7%(2/282),P＜0.01 ],neonatal asphyxia [73.1%(19/26)vs3.9%(11/280),P＜0.01 ],the proportion of NICU[88.5%(23/26)vs 29.3%(82/280),P＜0.01],neonatal death[15.4%(4/26) vs 2.1%(6/280),P:0.006]and the rate of perinatal mortality[31.3%(10/32) vs 3.2%(8/282)].The perinatal outcomes were better in those cases that the grades of TTTS were below 3 in the first diagnosis.Conclusions We should try to diagnose and treat TTTS as early as possible because the outcome is poor.

Objective To analyze the clinical features and diagnostic experiences of retroperitoneal neuroendocrine carcinoma (NEC).Methods Clinical data of primary retroperitoneal NEC from January 2000 to January 2012 were retrospectively collected and analyzed.Results Five candidates were included 4 male and 1 female.The median age was 53 years old.3 cases initially suffered from abdominal pain and radiative back pain,2 cases were confirmed by normal physical check.The CT scan and B type ultrasound were performed among all patients,1 case was diagnosed as pancreas head neoplasm,1 case pancreas insulinoma,which was closely associated with other tissues and the intervational therapy was performed twice preoperatively.All 5 cases were selected surgery as the main treatment,2 cases performed radical tumor resection,3 cases received bypass operation.2 cases were 3 years survival.Conclusion Retroperitoneal NEC is a rare carcinoma,characterized by seriously invasion and high malignant degree.Surgery still remains the mainstay of selections,early diagnosis can significantly improve NEC patients’ overall survival rate.But the early diagnosis rate of this rare kind of patients still need to be improved.

Objective To investigate the effect of perinatal care on the reduction of the maternal and perinatal mortality. Methods The perinatal care and the relationship between the maternal and perinatal mortality during 1980 to 1997 were analysed. The factors that related to the morality were studied. Results The maternal mortality rate was significantly decreased from 31.7/10~5 live births in 1960 to 16.1/10~5 live births in 1992～1997. The main cause of maternal deaths in 1960' was obstetrical factors, but in 1997 it was pregnancy complications. The perinatal mortality rate was 21.2‰ in 1980～1981 ,and was 10.9‰ in 1992～1997. The factors related to the maternal and perinatal mortality including the perinatal care, high risk pregnancy,and birth weight were analysed, the specific mortality rate of each factor was calculated. Conclutions The two mortalities can be used to evaluate the result of perinatal care,and are important feedback information for making health care policy. Pernatal care play an important role in the reduction of maternal and perinatal mortality.

0.05). The fungus-carrier rate of newborn skin was 16.67% (8/48) in VVC group and 37.71% (23/61) in fungus-carrier group (P0.05; in the 48 cases who had received treatment during pregnancy, there was no neonatal diseases; in the 61 cases who did not receive any treatment, the morbidity of neonatal umbilical inflammation, diaper dermatitis and thrush were 4.92% , 19.67% and 3.28%, respectively. Conclusions Vertical transmission of VVC is possible during pregnancy. Those pregnant women with VVC have a higher neonatal morbidity.

Objective To observe the effect of acupuncture analgesia on delivery and observe the result of analgesia in mother and infant.Methods Totally 324 primiparae were randomized into four groups:Electro-acupuncture group,82 cases,transcutaneous electrical nerve stimulation(TENS)group,82 cases,control group,81 cases,and spinal-epidural analgesia group,79 cases.The VAS scores of pain,degree of satisfaction of analgesia,outcome of delivery and changes of endorphin concentration were observed during the delivery and after.Results Compared with the TENS group and control group,viewing from the VAS scores of 30~120 minutes after analgesia,the effect in the electro-acupuncture group was better,but not as good as that in the spinal-epidural analgesia group,the difference was significant(P

BACKGROUND:There are few clinical control ed trials about the clinical effects in patients with pertrochanteric femur fractures after treatment with short or long proximal femoral nail antirotation.
OBJECTIVE:To compare the clinical outcomes in patients with AO/ASIF-A1/2 pertrochanteric femur fractures after treatment with short or long proximal femoral nail antirotation.
METHODS:A total of 98 patients with AO/ASIF-A1/2 pertrochanteric femur fractures were treated by proximal femoral nail antirotation. They were divided into two groups according to the type of proximal femoral nail antirotation:short nail group (n=50) and long nail group (n=48). The operative time, blood loss, and hospital stay were recorded in both groups. In fol ow-up, fracture healing time, imaging and clinical complications were evaluated. In the final fol ow-up, Harris hip score was used to evaluate functional recovery.
RESULTS AND CONCLUSION:Compared with the short nail group, operative time was shorter and blood loss was less in the long nail group (P<0.05). No significant difference in hospital stay was detected between the short nail and long nail groups (P>0.05). Average fol ow-up periods were respectively (15.8±6.4) months and (16.2±5.7) months in the long nail and short nail groups.“Cutting-out”or infection occurred in five patients in the long nail group and three in the short nail group. Besides above-mentioned patients, the remaining patients in the two groups achieved fracture healing. No significant difference in average fracture healing time was detected between groups (P=0.588). In the final fol ow-up, no significant difference in Harris hip score was detectable in the two groups (P=0.204). The incidence rates of total postoperative complications in the long and short nail groups were 31.2%and 16.0%, respectively (P=0.075). Results suggested that no differences in the union and complication rates between the two groups were identified, suggesting that long nails offer no advantage compared with short nails for stabilizing AO/ASIF-A1/A2 pertrochanteric femur fractures.

Objective To investigate the psychological characteristics and personality of perinatal women, and to provide evidence for effective psychological intervention. Methods Five hundred and seventy pregnant women were randomly selected from the out-patient department from October, 2002 to March, 2003. Eysenck Personality Questionnaire(EPQ) , Self-rating Anxiety Scale(SAS) and Self-rating Depression Scale(SDS) were applied for their personality, psychological characteristics and the influencing factors. Psychological surveys were performed in 216 cases in labor, and 300 cases were followed up during 1-5 days and 42-60 days postpartum. Results During pregnant period, the incidence of anxiety and depression was 10. 5% and 10. 2%, respectively, while 4. 0% and 5. 3% during early stage of puerperium. The rate of depression was 40. 7% and 10. 0% during late stage of puerperium and after puerperium. Pregnant women with personality of stability were less likely to have psychological disorder. Conclusions The rate of psychological disorder varies in different per sonallity. Proper intervention among high risk pregnant women is important in perinatal psychological

Objective To observe the effects of diazepam on the cervix in relieving spasm, eliminating edema and improving dilation during the latent phase of labor. Methods One hundred normal parturients were randomly devided into study group ( n =50) and control group ( n =50). The study group was injected diazepam 10 mg in the cervix during the latent phase. The control group was given 10 mg of diazepam by intravenous injection. Results The dilating speed of cervix in study group was 2.81?1.92 cm/h. The mean time of the first stage of labor was 11.13?1.21 h, while the control group was 1.98?0.92 cm/h and 13.34?0.44 h respectively. The differences between two groups were statistically significant ( P

Objective To test the effect of EPO on anemia of preterm infant. Methods Thirty preterm infants less than 35 weeks of gestational age from three different hospitals were devided ramdomly into EPO group of 16 cases and control group of 14 cases. The infants in EPO group were received rh EPO 400 IU/(kg?d) subcutaneously twice a week for 4 weeks from 7 days old, together with oral supplementation of ferrous sulfate at a dossage of 3~5 mg/(kg?d) in both groups. Hemoglobin(Hb) and reticulocytes(Ret) were measured at 42 days of age. Results The hemoglobin was higherin the EPO group[(999?29)g/L vs (905?25)]g/L, P 0.05). Conclusion The is lower EPO level in prematures and efficiency of rh EPO in the treatment of anemia of preterm infants. There is no observed substantial adverse effects.

Objective To investigate the clinical value of enhanced recovery after surgery (ERAS) in radical resection of hepatocellular carcinoma (HCC).Methods The propensity score matching (PSM) and retrospective cohort study were conducted.The clinicopathological data of 116 patients with HCC who were admitted to the Fuzhou General Hospital of Nanjing Command of PLA from June 2014 to January 2016 were collected.Fifty-eight patients using pre-,intra-and post-operative ERAS managements were allocated into the ERAS group and 58 using traditional perioperative managements were allocated into the control group.Observation indicators:(1) operation situations;(2) postoperative recovery:postoperative recovery time of bowel sound,time to initial anal exsufflation,time of drainage-tube removal,levels of alanine transaminase (ALT),total bilirubin (TBil),C-reactive protein (CRP) at 1,3 and 7 days postoperatively,postoperative complications (vomiting,abdominal distension,wound infection,intra-abdominal infection and pulmonary infection),duration of postoperative hospital stay,hospital expenses and satisfaction degree of patients;(3) follow-up situation.Followup using outpatient examination and telephone interview was performed to detect survival of patients up to March 2016.Measurement data with normal distribution were described as x±s.The comparison between groups was analyzed using the t test.Measurement data with skewed distribution were described as M (range).The comparison between groups was analyzed using the paried rank sum test.Repeated measurement data were evaluated by the repeated measures ANOVA.Results (1) Operation situations:all the patients underwent successful operations,without perioperative death.(2) Postoperative recovery:postoperative recovery time of bowel sound,time to initial anal exsufflation,time of drainage-tube removal,levels of ALT,TBil and CRP at 1,3 and 7 days postoperatively,duration of postoperative hospital stay,hospital expenses and satisfaction degree of patients were (49±10)hours,(60±10)hours,(3.3±0.7)days,(379±99)U/L,(222±65)U/L,(98±16)U/L,(20.4±4.7)μmol/L,(15.5±2.1)μmol/L,(13.4±1.8)μmol/L,(49±10)mg/L,(124±21)mg/L,(30± 5)mg/L,(9.7±0.9)days,(4.1±0.6) ×104 yuan,8.6±0.9 in the ERAS group and (53±5)hours,(64±7)hours,(6.2±1.6)days,(445± 114)U/L,(278±79) U/L,(116± 25) U/L,(18.6± 3.5) μmol/L,(17.0±2.7) μmol/L,(14.2±1.9)μmol/L,(53±11)mg/L,(135±35)mg/L,(34±6)mg/L,(10.0± 1.0) days,(4.3±0.5)x104 yuan,8.2±1.0 in the control group,respectively,with statistically significant differences between the 2 groups (t=2.537,2.479,2.065,F=20.075,14.357,13.460,t=2.060,2.197,2.370,P＜0.05).Number of patients with postoperative vomiting,abdominal distension,wound infection,intra-abdominal infection and pulmonary infection were 5,3,2,1,1 in the ERAS group and 6,6,7,5,3 in the control group,respectively,with no statistically significant difference between the 2 groups (x2=0.100,1.084,3.011,0.206,0.618,P＞ 0.05).(3) Follow-up situation:all the 116 patients were followed up for 1-20 months,with a median time of 11 months.During the follow-up,2 patients in the ERAS group died (1 dying of tumor recurrence and 1 dying of respiratory failure) and 3 in the control group died (1 dying of multiple organs metastasis,1 dying of lung metastasis of HCC and 1 dying of myocardial infarction).Conclusion ERAS in the perioperative management after radical resection of HCC is safe and effective,and it can quickly improve postoperative recovery of patients.