ObjectiveTo determine the impact of lupus flares on maternal and fetal outcomes in pregnant patients with systemic lupus erythematosus(SLE).MethodsData was obtained from 46 pregnancies of 44 pregnant women with SLE.The relationship between lupus flares and pregnant outcomes,and the risk factors for adverse maternal and fetal prognosis were analyzed.T-test,X2 test or Fisher's exact test and Logistic regression were used for statistical analysis.Results① Lupus flares occurred in19(41％)pregnancies(group A) and stable lupus disease was observed in 27(59％) pregnancies(group B) during pregnancy.Compared to pregnancies in patients with stable lupus disease at the conception(n=32),pregnancies in patients with unstable lupus disease at the conception(n=8) had higher lupus flare during pregnancy( 100％ vs 16％,P＜0.05).(②) The common manifestations of lupus flares during pregnancy were lupus nephritis (LN) (11 cases),skin rashes (10 cases),arthritis (7 cases),and the common complication was infection ( 11 cases).(③) The incidence of premature labor,fetal growth retardation (FGR) and fetal loss in group A was 42％,47％ and 26％ respectively,which was significantly higher than that of the group B (7％,15％ and 0 respectively)(P＜0.05).There was no difference in the incidence of preeclampsia,fetal distress and neonatal asphyxia between the two groups ( 16％ vs 7％,16％ vs 19％,5％ vs O,respectively,P＞0.05).The incidence of premature labor and FGR in patients with active LN was higher than that of patients without active LN (55％ vs 11％,64％ vs 17％,respectively,P＜0.05).(④)The binary Logistic regression analysis showed that renal impairment,hypocomplementemia,aPL and serum urea nitrogen level were independent risk factors for premature delivery,FGR,fetal loss and fetal distress.Conclusion(①) Lupus flares during pregnancy increase the incidence of premature labor,FGR and fetal loss.Active LN during pregnancy can increase the incidence of premature labor and FGR.② Renal impairment,hypocomplementemia,aPL and serum urea nitrogen level are associated with adverse fetal outcomes in pregnant patients with SLE.

Objective To investigate the clinical efficacy of finger reconstruction in child with second toe transplantation,and evaluate the postoperative appearance and function regarding the reconstructed donor feet.Methods From June 2002 to May 2011,sixteen cases were reconstructed in sub-emergency with second toe transplantation.Two thumbs,eight index fingers,and 6 middle fingers were reconstructed.All patients were followed-up from 12 to 24 months.The functions of reconstructed fingers were analysed.Results All the reconstructed fingers survived.Vascular crisis occurred in 1 patient,and survived after re-anastomosis.Necrosis of skin grafts at the domon site with exposed tedons was seen in 1 ease,and healed after changing dressings.All the reconstructed fingers showed good in growth and development,and performed good functions as grabbing,grasping and nipping.Two-point discrimination was between 6 mm and 10 mm.The donor site of the foot had normal gait,without obvious influence on walking.Also,no pain was complained.Conclusion The method of transplanting the second toe can reconstruct the appearance and function of the finger defects in child,and has little effect on the appearance and motion of feet.It is an effective treatment method.

Objective To understand the prevailing status of coal-burning endemic fluorosis in Henan, and to provide scientific grounds for endemic fluorosis prevention. Methods Undertook general surveillance on factors such as coal using, living habit, main foods, the structure of the houses and the fluoride content in drinking-water among 1832 historical coal-burning endemic fluorosis villages within 13 counties in 2006 and 2007, and conducted focal point sampling survey on 216 villages which still using local high-fluoride. For all children aged 8-12 years of each village, conducted dental fluorosis examination and collected 30 immediate urinary samples for fluoride content determination. Results The fluoride content in drinking-water of all historical fluorosis villages was below 1.0 mg/L. Households having individual kitchens accounted for 93.7%(241 281/257 393), those with stoves having smoke evacuation devices accounted for 41.9% (107 917/257 393), those using local high-fluoride coal for cooking accounted for 28.6%(73 686/257 393), those using local high-fluoride coal for heating accounted for 24.1%(61 924/257 393). Villages with serf-supply of main foods accounted for 95.7%(1753/1832) of all fluorosis villages. Solar drying food was used in all households. Villages with dental fluorosis detection rate for children aged 8 to 12 years above 30.0% accounted for 16.2%(35/216), which axe all in Luoyang City. Among 77.8%(168/216) of fluorosis villages, children' s urinary fluoride concentrations were no higher than 1.50 mg/L. Conclusions Coal-burning endemic fluorosis areas in Henan Province were decreased greatly and the extent of the health hazard was becoming slightly. The detection rate of dental fluorosis for children aged 8 to 12 years of 8 counties had reached the standard for fluorosis control, whereas the other 5 counties had not yet, all located in Luoyang City.

Objective :To compare the clinical effects of vaginal dumbbell ,biofeedback combined with electrical stimulation in the treatment of postpartum pelvic floor dysfunction ,and to find the best treatment for the disease .Methods : A total of 300 primiparas ,aged less than 35 years ,with diagnosis of postpartum pelvic floor dysfunction on the period of 6 weeks after delivery ,were randomly divided into 3 groups :the first group (control group) ,only with detection of the strength of maternal pelvic floor muscle (n= 96) ;the second group (vaginal dumbbell group) ,with vaginal dumbbell exercise (n = 88) ;the third group (electrical stimulation group) ,with biofeedback treatment combined with electrical stimulation (n= 116) .The treatment lasted 6 weeks .The strength of maternal pelvic floor muscle was detected and sexual quality of life questionnaire was performed at the time of before the treatment ,after the treatment and 6 months ,later .Results : The muscle strength and sexual quality of life of vaginal dumbbell group and the electrical stimulation group was significantly higher (P< 0 .05) than that of the control group at the end of treatment and 6 months ,later .Wherein the muscle strength and sexual quality of life of electrical stimulation group was significantly higher (P< 0 .05) than that of vaginal dumbbell group at the end of treatment and 6 months ,later .But the muscle strength of both electrical stimulation group and vaginal dumbbell group decreased significantly (P < 0 .05) at 6 months after the treatment compared with at the end of treatment ,which indicated that postpartum pelvic floor dysfunction need long-term treatment to maintain a good effect .Conclusions : Either vaginal dumbbell exercise or biofeedback combined with electrical stimulation ,could safely and effectively treat postpartum pelvic floor function ,but it was clear that biofeedback treatment combined with electrical stimulation treatment was better than the therapy of vaginal dumbbell exercise .

BACKGROUND: MAVERIC (Mitral Valve Repair Clinical Trial) validates the safety and efficacy of the ARTO system. We here report the first two successful cases of utilizing the ARTO system in patients with symptomatic heart failure (HF) with functional mitral regurgitation (FMR) in Asia. METHODS: Two patients, aged 70 and 63, had severe HF with FMR. Transesophageal echocardiography confirmed that the left ventricular ejection fractions were less than 50% with severe mitral regurgitation (MR) in both patients. Optimizing drug treatment could not mitigate their symptoms. Therefore, we used the ARTO system to repair the mitral valve for these patients on March 5 and 6, 2019, respectively. RESULTS: Mitral valve repairs using the ARTO system were successfully performed under general anaesthesia for these two patients. MR was decreased immediately after the procedures in both patients. The 30-day and 3-month transthoracic echocardiography (TTE) revealed a moderate to severe MR in both patients, and the New York Heart Association (NYHA) scales were also partially improved. CONCLUSION The first two cases in Asia indicate that the ARTO system is feasible for patients with heart failure with FMR, and the patient selection appears to be crucial.

BACKGROUNDOptimizing treatment outcomes for depression requires understanding of how evidence-based treatments are utilized in clinical practice. Antipsychotic medications concurrent with antidepressant treatment are frequently used in major depression, but few studies have investigated trends and patterns of their use over time. This study aimed to examine the prescription patterns of antipsychotic medications for major depression in China from 2002 to 2012 and their association with treatment satisfaction and quality of life (QOL).

METHODSA total of 3655 subjects with major depression treated in 45 Chinese psychiatric hospitals/centers nationwide were interviewed between 2002 and 2012. Patients' socio-demographic and clinical characteristics including psychopathology, medication side effects, satisfaction with treatment and QOL were recorded using a standardized protocol and data collection.

RESULTSThe frequency of antipsychotic use was 24.9% in the whole sample; the corresponding figures were 17.1%, 20.3%, and 32.8% in 2002, 2006, and 2012, respectively (χ2 = 90.3, df = 2, P < 0.001). Multiple logistic regression analyses revealed that patients on concurrent antipsychotics had significantly more delusions or hallucinations, longer illness duration, greater side effects, and more likely to be treated as inpatients and in major hospitals (i.e., Level-III hospital). Antipsychotic use was associated with lower treatment satisfaction while there was no significant difference with respect to physical and mental QOL between the antipsychotic and nonantipsychotic groups.

CONCLUSIONSConcurrent antipsychotic use was found in about one in four treated depressed patients in China, which has increased over a 10-year period. Considering the association of drug-induced side effects and the lack of patients' and relatives' satisfaction with antipsychotic treatment, further examination of the rationale and appropriateness of the use of antipsychotics in depression is needed.

Adult ; Antipsychotic Agents ; therapeutic use ; Depressive Disorder, Major ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Personal Satisfaction ; Psychotropic Drugs ; therapeutic use ; Quality of Life