The status of breastfeeding and in-hospital health education during pregnancy was surveyed in 32 maternity and children health care hospitals at provincial and municipal levels.A total of 1105 cases were assigned into hospital health education (A,n =872) and control (B,n =233) groups according to whether the women received the hospital health education of breastfeeding during pregnancy.Their differences in breastfeeding knowledge,attitudes and early feeding behavior were compared and analyzed by x2 test and binary logistic regression.Mothers in the group A were at higher levels of breastfeeding knowledge and had a higher proportion of breastfeeding at Day 1 (82.3％).The rate of exclusive breastfeeding in-hospital was significantly higher in group A than that in group B (51.1％ vs.32.3％).After adjusting for in-hospital health education,health education during pregnancy had significant effects on breastfeeding in the first days for group A:breastfeeding in the first 24 hour (OR =2.076,95％CI:1.474-2.924) and exclusive in-hospital breastfeeding (OR =2.105,95％ CI:1.529-2.898).

PURPOSE To explore an efficacious therapy for liver metastasis of colorectal carcinomas. METHODS Basing on excision of primary lesions. 86 cases of colorectal carcinomas metastasize to liver were treated in four different manners, namely: sole resection of the metastasis lesions, chemoembolization-resection, sole chemoembolization. and chemotherapy. We also analyze the efficacy in curing single metastatic liver cancer, multiple metastatic cancer that is confined to one section or both left and right sections of liver. RESULTS One year survival rates in the groups of sole resection and chemoembolization-resection are better than that of sole chemoembolization P

Purpose:This study was designed to investigate the expression of p27 Kip1 and cyclin D1 in gastric carcinoma in relation to biological behavior and prognosis. Methods:p27 Kip1 and cyclin D1 expression at protein level were determined by immunohistochemistry technique in 92 patients with gastric carcinoma. Results:Of the 92 patients, p27 Kip1 expression was low in 28(71.8%) and high in 11(12%),respectively. Cyclin D1 expression was low in 32 (72.7%) and high in 12 (13%) ,respectively.p27 Kip1 expression level was correlated with histological grade, depth of invasion, lymph-node metastasis, TNM stage( P

Objective To summarize the treatment experience of supraventricular tachycardia (SVT) after coronary artery bypass graft (CABG). Methods The clinical data of 136 patients who had occurred SVT after CABG between January 2008 and December 2009 were analyzed retrospectively. Results Among 136 patients,no perioperative mortality,atrial fibrillation (AF) occurred in 110 cases (80.88%),paroxysmal supraventricular tachycardia (PSVT) occurred in18 cases ( 13.24% ), atrial flutter occurred in 8 cases (5.88%),112 of 136 cases occurred in 1-3 days after surgery,accounting for 82.35% ,24 cases occurred in 4-7 days after surgery,accounting for 17.65%. Given amiodarone in the treatment of 105 cases,100 cases reverted to sinus rhythm (cardioversion rate of 95.24% ),given esmolol in the treatment of 11 cases, 9 cases reverted to sinus rhythm( cardioversion rate of 81.82% ), synchronous direct current cardioversion in 20 cases, all transferred to sinus rhythm, all patients with improved symptoms. The remaining failed to transfer to sinus rhythm, had got normal ventricular rate, and symptoms improved significantly. Conclusions It is necessary to take effective measures to prevent SVT within 3 days after CABG. Amiodarone, esmolol and synchronous direct current cardioversion can be used effectively and safely to control SVT after CABG.

Objective To analyze the current status of neonatal resuscitation in medical institutions in China.Methods With the number of obstetric beds as the inclusion criteria,the survey was conducted in 163 medical institutions randomly selected in 11 provinces (including 51 tertiary hospitals,88 secondary hospitals and 24 primary hospitals) from October 1 to December 31 in 2011.The mail-questionnaire was sent to collect information about system establishment,personnel training,neonatal resuscitation equipment etc.Statistical data was analyzed by t-test,variance analysis and Chi-square test.Results The incidence of neonatal asphyxia among live birth babies was 2.15％ (3328/154 853) in tertiary hospitals,1.41％ (2829/200 731) in secondary hospitals and 1.50％ (701/46 695) in primary hospitals (x2=298.559,P＜0.01).The mortality rate during delivery was 0.41‰ (63/154 853),0.24‰ (48/200 731) and 0.60‰ (28/46 695) at the three different level hospitals,respectively (x2=16.993,P＜0.01).The mortality rate within 24 hours after delivery was 0.42‰ (65/154 853) in tertiary hospitals,0.24‰ (49/200 731) in secondary hospitals and 0.62‰ (29/46 695) in primary hospitals (x2 18.075,P＜0.01).About 86.5％ (141/163) of the included hospitals maintained routine neonatal resuscitation trainings,but only 73.0％ (119/163) applied resuscitation training equipments during the trainings.The outfit rate of basic neonatal resuscitation equipments (such as neonatal laryngoscope,radiant heater) was high in most hospitals,but the outfit rate of equipments recommended by the new guideline (such as umbilical venous catheter,T piece and oxygen saturation meter) was low.For example,the outfit rate of umbilical venous catheter was 23.5％ (12/51),10.2％ (9/88) and 4.2％ (1/24) in tertiary,secondary and primary hospitals respectively (x2 =6.992,P ＜ 0.05).47.9％ (78/163) of the hospitals had set up neonatal intensive care unit,with the proportion in tertiary,secondary and primary hospitals being 80.4％ (41/51),34.1％ (30/88) and 27.2％ (7/24),respectively (x2=31.677,P＜0.01).Most of the hospitals (80.4％,131/163) could ensure the pediatricians being presented in the delivery room for high risk women,and the proportion was 94.1％ (48/51),79.5％ (70/88) and 54.2％ (13/24) in tertiary,secondary and primary hospitals,respectively (x2 =16.591,P＜0.01).There were 88.3％ (144/163) of the hospitals had routine neonatal resuscitation case audit,with the proportion in the three different level hospitals being 94.1％ (48/51),92.0％ (81/88) and 62.5％ (15/24),respectively (x2 =18.388,P＜0.01).Conclusions Strengthen the training,equipment and system establishment in primary medical institutions is conducive to promote neonatal resuscitation.

Objective To evaluate total gastrectomy and regular lymph node dissection for the treatment of advanced cardiac cancer. Methods Three hundred and eighty-seven patients with advanced cardiac cancer underwent total gastrectomy D2+ procedure. The relationships between depth of invasion, lymph node metastasis,the number of metastastic lymph nodes dissected and postoperative survival rate were analyzed. Results The 3-year and 5-year survival rates were 47.3% and 34.2% , respectively. Metastatic rate of N3 lymph node was 4. 8% and 15. 2% in advanced cardiac patients of PT3 and PT4, respectively. Survival rates significantly decreased along with the increase of lymph node metastasis. The 3-year and 5-year survival of patients who had less than 15 lymph nodes dissected was significantly poorer than those who had more than 15 lymph nodes dissected, respectively. The postoperative complication rate and mortality rate of the two groups were 14. 2% and 2. 52% , respectively. Conclution To improve the quality of life and survival rate, D2 + radical total gastrectomy should be performed for advanced cardiac cancer, and when indicated resection of spleen and/or body and tail of the pancreas should be performed.

BACKGROUND: For patients with myocardial infarction occupied most of the heart, the effect of coronary artery bridge is not obvious. Currently, myocardial and vascular regeneration by stem cells has become a focus of ischemic cardiovascular disease. Myocardial survival directly correlates with improvement of blood perfusion following stem cell transplantation.OBJECTIVE: To investigate the feasibility of ~(18)F-FDG and ~(99)Tc~m-MIBI single photon emission computed tomography imaging in assessing myocardial glucose metabolism and perfusion with old myocardial infarction after coronary artery bypass grafting (CABG) and CD34~+ stem cell transplanting. METHODS: Bone marrow was extracted from the anterior superior iliac spine 1 day before surgery. Mononuclear cells were isolated by Ficoll density gradient centrifugation. CD34~+ cells were isolated and purified by immunomagnetic bead system. Coronary artery pathological changes were examined under general anesthesia. The end-to-side anastomosis of graft vessel and coronary artery was performed. 1×10~(11)/L CD34~+ cell suspension was extracted, and injected into the surrounding and center of the infarct (blood flow/metabolism matching depletion) at 6 points, with 0.2 mL in each point. According to preoperative perfusion/metabolism imaging, myocardium segments were divided into two groups: match group: blood perfusion and metabolism images were sparse or normal, i.e. infarction or normal myocardium; mismatch group: blood perfusion image displayed depletion, but metabolism images were normal or radially distributed, i.e. surviving myocardium. ~(18)F-FDG and ~(99)Tc~m-MIBI dual-isotopic imaging were performed before and 4 months after CABG. Circumferential count profiles from ~(18)F-FDG and ~(99)Tc~m-MIBI short axis slices were generated to assess myocardial blood perfusion and glucose metabolism. RESULTS AND CONCLUSION: The 31 patients were divided into 279 segments, and 145 segments were in myocardial perfusion-metabolism mismatch (MM). ~(99)Tc~m-MIBI and ~(18)F-FDG uptake fraction was significantly increased 4 months before operation (P < 0.01); match group without transplanting had 81 segments, and the ~(99)Tc~m-MIBI and ~(18)F-FDG uptake fraction remained unchanged after operation (P > 0.05). Match group undergoing transplanting had 54 segments, and their ~(99)Tc~m-MIBI and ~(18)F-FDG uptake fraction increased remarkably 4 months after operation (P < 0.01). CABG can improve the function of survival myocardial segments, but it is helpless to infraction myocardium. The autologous CD34~+ stem cell transplantation can improve myocardial blood perfusion and glucose metabolism of the distributions of infract myocardium.

Objective Lung injury occurred during cardiopulmonary bypass as a result of both ischemic-reperfusion injury and systemic inflammatory response is critical for patients' recovery. This study was designed to establish a convenient and appropriate mode for pulmonary artery perfusion and evaluate its effects on the cardiopulmonary bypass-induced lung injury.Methods Fourteen healthy mongrel dogs were randomly assigned to a control group and a perfusion group, which were designed to simulate clinical cardiopulmonary bypass-induced lung injury. Pulmonary arteries were perfused with modified low-potassium dextran solution immediately after the initiation of pulmonary ischemia and before reperfusion, with a pressure of 15 to 20 mm Hg for the perfusion group. Pulmonary arteries of animals in the control group were not perfused. After pulmonary reperfusion, changes in the pulmonary function were evaluated. Results After pulmonary reperfusion, deterioration in the pulmonary function with various severity was identified in both groups. Pulmonary injury in the control group decreased significantly as manifested by a substantial elevation in PVR [with a change of ( 76 ± 7 ) %], decreased compliance [with a change of (30 ±4) %] and decreased oxygenation index [with a change of (45 ±5 ) %]. In contrast, the injury in perfusion group, as compared with that in the control group, was relatively moderate, with a lower PVR [with a change of ( 28 ± 3 ) %, P ＜0.01 )] ,a higher compliance [with a change of ( 12 ± 2 ) %, P ＜ 0. 01] and a better oxygenation index [with a change of (19 ± 2 )%, P ＜ 0.01]. Conclusion The pulmonary perfusion mode used in this experiment could relieve the cardiopulmonary bypass-induced lung injury and preserve pulmonary function effectively. It was expected that this perfusion mode could be used in the cardiosurgery practice expediently, without interfering with the scheduled operation proceeding obviously.

Objective To analyze the causes and treatment methods of early complications after central systemic-pulmonary shunt in complex cyanotic congenital heart diseases.Methods Two hundred and twelve cases of central systemic-pulmonary shunt in complex cyanotic congenital heart diseases were retro-spectively analyzed in order to explore the early postoperative complications and related treatment measures. Results There were 61 cases(28.77%)of the early postoperative complications,including severe low car-diac output syndrome in 27 cases,acute pulmonary edema in 14 cases,24 h shunt pipe blockage in 12 cases, and supraventricular tachycardia in 8 cases.All patients got followed up,average for(2.49 ±1.21 )years.Af-ter the systemic-to-pulmonary artery shunts,pulmonary vascular had significant growth,8 patients(3.77%) of them who pulmonary hypoplasia were promoted by transcatheter aortopulmonary collateral vessels.At the end of the follow-up,77 patients(36.32%)achieved the standard of radical surgery.Conclusion The factors affecting surgical survival rate include:enhancement of patients cardiac function and strictly handle operation indication before operation a clear operational view;rational surgical methods;treatment of complication with-out delay;strict,intensive care and synthesized treatment.