Objective To explore the relationship between mathematical characteristics of cardiotocograph in electronic fetal monitoring (EFM) and umbilical blood acidosis,and help to evaluate the clinical significance of indeterminate EFM.Methods A total of 85 vaginal delivery cases (or transfer to caesarean section during labor) hospitalized in Peking University Third Hospital during February 4 to December 5,2011 was enrolled in this retrospective study.EFM monitored 0.5-1 hour before delivery was recorded and the mathematical characteristics as the baseline,deceleration area per unit time (cm2/min),deceleration duration ratio and some other variables of EFM were analyzed.All cases were divided into acidosis (n=12) and non-acidosis group (n=73) based on the umbilical blood gas results.Rank sum test or t-test were used to compare the difference on mathematical characteristics between these two groups.Results The deceleration duration ratio and deceleration area per unit time in acidosis group were 0.56±0.17 and 0.45 cm2/min (0.38-0.79 cm2/min),which were higher than those in non acidosis group [0.42±0.14 and 0.30 cm2/min (0.19-0.40 cm2/min)],the differences were statistically significant (t=2.889,Z=2.587,both P＜0.05).There were no statistically significant differences in the number of mild variable deceleration and severe deceleration per unit time between acidosis group and non acidosis group [(0.44± 0.14)/min vs (0.41±0.13)/min,t=1.318,P＞0.05; 0.033/min (0.016-0.062/min) vs 0.016/min (0.008-0.033/min),Z=-1.596,P＞0.05].Conclusions The deceleration duration ratio and deceleration area per unit time can be used to assist the interpretation of indeterminate EFM.

Objective To explore clinical progress about the deep vein thrombosis after hip replacement at home and abroad,and discuss the preventive effect of nursing intervention.Methods The documents about the deep vein thrombosis after hip replacement were retrieved from PUBMED,China National Network Knowledge Infrastructure (CNKI),Chinese Scientific Journal Database (VIP),Chinese Bio Medical Literature Database (CBM) and Wan fang Database.And the retrieving duration was from 1st Jan.2001 to 1st Sept.2013.The research progress about prevention of deep vein thrombosis after hip replacement was analyzed through the analysis of the same and the difference of comparative literatures at home and abroad.Results There were totally 228 Chinese documents and 5 English documents of the deep vein thrombosis after hip replacement,and the number of document showed an increasing trend year by year.In the past five years,the clinical progress about the deep vein thrombosis after hip replacement was obvious,the research methods used was accurate,the involving intervention measures was continuously improved,literature quality was increased.Conclusions The quality of the documents published in domestic Chinese journals needs to be improved,and we should improve the quality of research design,research new methods of intervention,formulate the optimal nursing measures in order to achieve optimal care.

Adolescent ; Diagnosis, Differential ; Disorders of Sex Development ; Female ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal ; pathology ; radiotherapy ; surgery ; Seminoma ; pathology ; Testicular Neoplasms ; pathology ; radiotherapy ; surgery

Objective To investigate the therapeutic effect of the ligustrazine injection on rats models of experimental high intraocular pressure induced by retina ischemia-reperfusion.Methods Thirty two SD rats were divided into four groups randomly:the ligustrazine group,the model group,the normal group and the vitamine E group.The ischemia-reperfusion model is established by increasing intraocular pressure to 110mmHg in rat eyes.The ligustrazine group was treated with the ligustrazine injection,the vitamine E group with gastric gavage of vitamine E,and the model and normal groups with distilled water.The period of treatment was 7 days.The histopathologic changes were observed under the optical microscope and the electron microscope,meanwhile the SOD and MDA were measured.Results After ischemia for 60 min and reperfusion for 48 h,the cells in retinal ganglion cell layer and inner nuclear layer were thinned under optical microscope,perinuclear karyopyknosis and apoptotic bodies appeared in retinal ganglion cell layer and inner nuclear layer under electron microscope,SOD activity decreased and MDA level increased.After treatment,the morphology of retinal ganglion cell layer and inner nuclear layer was improved obviously,SOD activity increased and MDA level decreased.It is suggested that ligustrazine injection exerts anti-ischemic and anti-hypoxic and cytomembrane stabilizing effects to a certain extent.Conclusion The ligustrazine injection is an effective traditional Chinese medicine in treating retinal ischemia.

From the hospital information system (HIS) of 20 national grade III-A general hospitals, 2 960 cases of herpes zoster as the research object, analyzes the relations between the general information, syndrome of traditional Chinese medicine (TCM), western medicine combined diseases, the relationship between the solar term and the incidence of herpes zoster, and the combined use of Chinese and western medicine. Among the patients with 46-65 year old has the highest percentage of diseased; admission to general outpatient clinic is the most; the most common medical payment is medicare; combined disease such as hypertension, diabetes and coronary heart disease is more common; early treatment effect of herpes zoster is better than the sequelae; summer and autumn solar term patients is hospitalized more, TCM syndrome is damp heat of liver fire; about drugs, western medicine is the most commonly used vitamin B1 and mecobalamin, traditional Chinese medicine is the most frequently used Danhong injection, combination therapy with promoting blood circulation drugs and neurotrophic drugs. Thus, herpes zoster, more common in elderly patients, with no obvious relationship between solar term, should be early diagnosis and early treatment, often with combination of Chinese traditional and western medicine treatment.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Herpes Zoster ; diagnosis ; drug therapy ; epidemiology ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Thiamine ; therapeutic use ; Vitamin B 12 ; analogs & derivatives ; therapeutic use ; Young Adult

The purpose of the study is to find the allergic reaction types and characteristics of Chinese medicine injection ( CMI). The authors monitored patients who used Shuxuetong injection, Dengzhan Xixin injection, Shenqi Fuzheng injection, Shenmai injection, Ciwujia injection, Shuxuening injection, Tanreqing injection, Reduning injection, a total of 150,000 cases were monitored. They used a nested case-control design to group the patients and obtained the serum samples from 14 allergic patients and 55 matched patients. They used enzyme-linked immunosorbent assay (ELISA) to detect serum C3, C4, IgE, IgG, MCT-P, and judge the allergic reaction types: Shuxuetong injection hypersensitivity (1 case), can not determine (1 case); Dengzhan Xixin injection hypersensitivity (1 case), hypersensitivity & anaphylactoid reaction (1 case), can not determine (1 case); Shenqi Fuzheng injection hypersensitivity (3 cases), can not determine (1 case); Shenmai injection anaphylactoid reaction (1 case); Ciwujia injection can not determine (1 case), Shuxuening injection can not determine (1 case), Tanreqing injection can not determine (1 case), Reduning injection can not determine (1 case). The results showed that the main type of allergic reaction of CMI was hypersensitivity, the type of allergic reaction was closely related to the varieties of CMI, the hypersensitivity and anaphylactoid reaction might occur in one patient at the same time which used Dengzhan Xixin injection.
Drug Hypersensitivity ; etiology ; Drugs, Chinese Herbal ; adverse effects ; Humans ; Immune System ; drug effects ; Injections

Objective To study the relationship between self-esteem and childhood abuse, life events among male violent adolescent. Methods According to the modified overt aggression scale, juvenile delinquents were divided into violent group (n = 128 )and nonviolent group (n = 118 ). All the participants were investigated by Self-Esteem Scale (SES), Childhood Trauma Questionnaire-28 Item Short Form (CTQ-SF) and Adolescent SelfRating Life Events (ASLEC) and conducted correlation and regression analysis. Results ①Violent group had lower self-esteem scores ( 22.73 ± 3.30 ) than the nonviolent group ( 23.81 ± 3.30, P ＜ 0.05 ). Violent group had higher scores in physical abuse, sexual abuse, total life events, interpersonal relationship, punishment, and other (8.30 ±4.07, 7.23 ±2.26, 54.48 ±18.60, 10.09 ±3.84, 14.43 ±5.87, 4.93 ±3.15, 9.93 ±3.64), compared to the nonviolent group (7.27 ± 3.27, 6.60 ± 2.09, 45.40 ± 18.45, 8.42 ± 4.13, 11.07 ± 5.75, 3.66 ±2.81, 7.84 ±3.66, P＜0. 05). ②The self-esteem was significantly negative correlated with the childhood abuse and life events( r= -0. 143 ～ -0. 358, P＜ 0.01 ) among violent male adolescents. ③The physical abuse and punishment had significant prediction function of 15.6% on self-esteem. Conclusions Violent adolescents have low self-esteem, which is closely related to childhood abuse and adolescent life events.

Objective To summarize our experience in the management of cardiopulmonary bypass (CPB) with deep hypothermic circulatory arrest (DHCA) during aortic arch surgery.Methods From March 2007 to May 2010,58 consecutive patients,including 24 urgent and 34 selective operations underwent aortic arch surgery.Thirty-nine hemiarch and 19 total aortic arch replacement operations were performed.CPB was established by perfusion through femoral artery (42 cases) and right subclavian artery (RSA) ( 16 cases),of which 4 cases were carried out with antegrade cerebral perfusion (ACP).Results The mean CPB time was ( 208.88 ± 136.45 ) min.The mean cerebral circulation arrest was ( 27.36 ± 11.50 ) min.Nasopharyngeal and rectal temperature were ( 16.01 ±2.67)℃ and ( 19.72 ±2.13)℃ respectively before DHCA was initiated.The mean times for cooling and rewarming were ( 50.91 ± 16.89) min and ( 88.97 ± 43.68 ) min.The mean time of intubation was (56.70 ± 45.19 ) h.The time in ICU was ( 5.68 ± 5.31 ) d,and the time of hospitalization was (30.11 ± 22.27 ) d.Acute renal failure,hypoxemia,and paraplegia occurred post-operatively in 4,19,and 2 patients,respectively.Four patients died post-operatively with a mortality of 6.90％.Compared with those received hemiarch replacement operation,the patients received total aortic arch replacement had statistically longer time of CPB([262.16 ±219.97]min vs [182.92 ±53.81] min,t =2.14,P ＜0.05),cerebral circulatory arrest ( [30.47 ± 15.86 ] win vs [25.85 ± 8.48 ] min,t =2.40,P ＜ 0.05 ),rewarming ( [110.00 ± 68.66 ] min vs [78.72 ± 17.31 ] min,t =2.69,P ＜ 0.05 ),and intubation ( [93.95 ± 131.89 ] h vs [38.08 ± 30.70 ] h,t =2.50,P ＜ 0.05 ).There was no significant difference in the times of these procedures between emergency surgery group and elective surgery group,between RSA and femoral artery cannulation groups.Conclusion It is crucial that the cooling and re-warming procedures during aortic arch surgery should be carried out slowly,gradually,and completely when DHCA was adopted alone.conclusion through right axillary artery or RSA was preferred for ACP,in order to accomplish the body circulation arrest at a relative high temperature,to shorten the CPB time,and to alleviate potential harmful effects of hypothermia.Meticulous management of CPB is one of the most important measures to improve the patients' outcome.

Objective To study the characteristics of the transcranial electric stimulation(TES)-elicited motor evoked potentials(MEP)recorded from different points of the diaphragm,and to determine the optimal record- ing site in the diaphragm.Methods One EEG electrode was placed subcutaneously in the midline of the skull as stimulation electrode and another EEG electrode was inserted into hard palate submucously as cathode in 30 male rats.And single square wave electrical pulse was used for stimulation.The stimulation intensity was 15 mA,the du- ration of the pulse was 0.2 ms,and the stimulating interval was 200 ms.The concentric needle electrode were insert- ed into the following eight sites:the medial,intermediate,lateral crura of the diaphragm,the junction of the posterior axilla line and the inferior border of the eleventh rib,the junction of the anterior axilla line and the inferior border of the ninth rib,the junction of the intermediate line of the clavicle and the inferior border of the eighth rib,the junction of the para-sternal line and the inferior border of the seventh rib,the pars sternalis.The MEP was recorded from each point,respectively.The optimal sites of the diaphragm MEP were found and recorded.Results The MEPs were re- corded from each of the 8 sites of the diaphragm in all the rats after TES.There was no statistically significant differ- ence among the latencies of every site.But the amplitude varied from 6.08?0.46 mV in maximum along the inferior border of the ninth rib at the anterior line of the axilla to the minimum of O.91?0.03 mV at the pars sternalis. Conclusion It is safer to insert the needle along the inferior border of the ninth rib at the anterior line of the axilla, because there was certain distant from the folding part of the pleura and the amplitude of the recorded wave at this point is maximal.

Objective To discuss the relationship between repetitive variable deceleration with a short interval (RDSI) in labor and neonatal acidosis.Methods One hundred and seventy-seven electronic fetal heart monitoring (EFM) patterns within one hour preceding delivery in term singleton pregnancies were collected in Peking University Third Hospital between February 2011 to October 2013.Continued EFM were recorded before delivery.Analysis was conducted on general information of both mothers and babies,including pregnant complications,duration of labor,cord and placental factors,nature of amniotic fluid,Apgar score and neonatal cord blood gas.RDSI was defined as that over 50％ intervals between two decelerations (the end of the last deceleration to the beginning of the next one) ≤ 60 s which appeared repetitevly in a period of 20 minutes.Independent sample t test,rank sum test,Chi-square test and Fisher's exact test were applied for statistics and receiver operating characteristic curve was obtained from the information of those with RDSI.Results Twenty-four of the 177 women with RDSI were assigned to the study group (24 cases,13.6％) and the rest 153 cases without RDSI to the control group.Background information of women in the two groups was comparable according to the maternal age,gestational weeks at delivery and duration of labor (all P ＞ 0.05).The occurrence of meconium stained amniotic fluid in the study group was higher than that of the control group [16.7％ (4/24) vs 5.2％ (7/153),x2=5.204,P=0.045],while the pH and base excess value of the neonatal blood gas in the study group were lower [7.20 (7.13-7.28) vs 7.29 (7.25-7.33),Z=-4.490;-6.10 (-4.67 to-9.62) mmol/L vs-3.20 (-4.90 to-1.55) mmol/L,Z=-5.044;P ≤ 0.01] resulting a higher rate of neonatal acidosis [50.0％(12/24) vs 7.8％ (12/153),x2=31.456,P ＜ 0.01].No significant difference was found in the incidence of neonatal asphyxia between the two groups.The area under the curve was 0.774 (95％CI:0.579-0.969).Conclusion RDSI in labor might indicate a high risk of neonatal acidosis.