OBJECTIVE To know the status of nosocomial infection control of epidemic measles in medical units at all levels of the epidemic area.METHODS The scene of the correlated medical units by cross-sectional study was investigated.RESULTS There were 7 children cases included 1 case of measles,4 cases with fever and 2 ordinary childrens cases in a local city general hospital.At the rural health clinic,a total of 19 cases were studied,including 3 cases with measles infection,2 cases of suspected measles cases,10 cases of children with fever and other children 4 cases.CONCLUSIONS The infected sources concentrate in grass roots medical unit relatively,The problem of isolating infected sources,protecting high risk crowd and measures for medical staff in grass roots medical unit should be improved.

Objective To investigate the relationships between fasting plasma glucose (FPG) level in early pregnancy and gestational diabetes mellitus (GDM).Methods Data of 11 477 pregnant women who accepted prenatal care in Beijing Obstetrics and Gynecology Hospital from October 2011 to September 2012 were collected.FPG was tested during 8 to 12 weeks of pregnancy in all women and those with FPG＜7.00 mmol/L were recruited.Women accepted 75 g oral glucose tolerance test (OGTT) during 24 to 28 weeks of pregnancy.The GDM diagnostic criteria was with reference to the criteria of International Association of Diabetes and Pregnancy Study Group.Mann-Whitney U test was used to analyze the difference of early pregnancy FPG between normal pregnant women and GDM women.Receiver operating characteristic (ROC) curve was used to analyze the validity and applicability of using early pregnancy FPG in GDM diagnosis.Chi-square test was used to analyze the relationship between the FPG levels and GDM diagnosis.Results There were 1 535 (13.4％) women diagnosed as GDM in 24 to 28 weeks of pregnancy (the rest 9 942 normal cases were taken as the controls).The median FPG level of the GDM group was 4.89 mmol/L (4.62-5.15 mmol/L),which was higher than that of the controls [4.75 mmol/L(4.53-4.98 mmol/L)] (Z=-13.994,P=0.000).The maximum area under curve (AUC),which was used to predict GDM with early pregnancy FPG,was 0.599 (95％ CI:0.582-0.617).Taking FPG 4.88 mmol/L as the cutoff value,the sensitivity was 0.523 and the specificity was 0.645.While taking FPG 5.10 and 5.60 mmol/L as the cutoff value,the sensitivity was 0.334 and 0.068,and the specificity was 0.811 and 0.983,respectively.When the FPG level ≤ 4.09,-4.60,-5.10,-5.60,-6.10 and ≥ 6.10 mmol/L,the GDM diagnostic rate gradually increased [8.5％(23/212),9.9％(335/3 379),12.3％(719/5 858),20.7％(359/1 734),40.2％ (78/194) and 52.5％ (21/40)] (x2=300.523,P=0.000).GDM diagnostic rate in FPG ≤ 4.09,-4.60,-5.10 and-5.60 mmol/L group were lower than that in FPG ≥ 5.60 but ＜6.10 mmol/L group and ≥ 6.10 mmol/L group (x2 were 67.242,164.680,128.125,37.860,55.843,76.856,58.589 and 23.484,all P=0.000) ; GDM diagnostic rate in FPG ≤ 4.09,-4.60,-5.10 mmol/L group were lower than that in FPG ≥ 5.10 but ＜5.60 mmol/L group (x2 were 22.877,113.717 and 78.040,all P=0.000); GDM diagnostic rate in FPG ≥ 4.09 but ＜4.60 mmol/L group was lower than that in FPG ≥ 4.60 but ＜5.10 mmol/L group (x2=11.803,P=0.001).When using abnormal fasting and postprandial OGTT level as GDM diagnostic criteria,the ratio of GDM in early pregnancy FPG level ≥ 5.60 but ＜6.10 mmol/L group and FPG ≥ 6.10 mmol/L group were higher than that of the FPG level ＜5.60 mmol/L group [50.0％ (39/78) and 71.4％ (15/21) vs24.1％ (346/1 436),x2 were 12.456 and 21.443,all P＜0.003].Conclusions Early pregnancy FPG level is not proper to be used as an early diagnostic tool of GDM.However,when early pregnancy FPG level is equal to or greater than 5.60 mmol/L,the incidence of GDM in late pregnancy will increase significantly.

This article reviewed the digestive system characteristics,enteral nutrition style,milk choice,the starting time of enteral nutrition,the velocity of milk volume increased and the ideal growth velocity of very low birth weight infants.The aim was to investigate the effect of the different starting time of enteral nutrition on their digestive function and the growth velocity,in order to find the suitable starting time of enteral nutrition,providing the basis for clinical enteral nutrition program of very low birth weight infant.

Objective To investigate the possibility of reserving uterus during severe postpartum hemorrhage. MethodsA retrospective analysis was conducted on the clinical data of 138 cases of severe postpartum hemorrhage (blood loss ≥2000 ml) from January 1, 2003 to December 31, 2009. Results Among 138 cases of severe postpartum hemorrhage, uterine atony (n= 60, 43. 38 ％ ) was the first cause and the second was placental factor (n= 55, 39.86 ％). The blood loss varied from 2000 ml to 10 000 ml and the mean level was about (3004± 1473) ml. The volume of blood transfusion for these patients varied from 800 ml to 7200 ml. Among these patients, the blood loss of 108 cases reserved uteri was from 2000 ml to 7500 ml, with the average of (2564±932) ml； while for 30 cases performed with hysterectomy, the blood loss was about 2500 to 10 000 ml averagly (4653± 1857) ml (t=8. 57, P=0.00). These patients were divided into two groups according to time series. Twelve cases of hysterectomy were performed during 2003to 2005, and the hysterectomy rate was 0. 47‰; 18 cases of hysterectomy were performed during 2006 to 2009, and the hysterectomy rate was 0. 36‰. The average blood loss of the above two groups was (3783±861) ml and (5233±2124) ml respectively (t=2. 234, P=0. 034). Among all the cases with blood loss ≥ 3000 ml, uteri were reserved in 24 cases with the average blood loss of (3818 ± 1284) ml； while hysterectomy were performed in 27 cases with average blood loss of (4900 ± 1789) rnl (t = 2. 453, P =0. 018). The time for blood loss to 3000 ml in the two groups was (160±129) min and (100±67) min,respectively, and the difference was significant (t=2. 113, P = 0.04).The uteri of six cases with postpartum hemorrhage over 4000 ml were successfully reserved, and average bleeding amount was 5570 ml.Two patients among the 138 women died of amniotic fluid embolism.The perinatal mortality rate was 3. 73％.ConclusionsThe postpartum hemorrhage volume and velocity is the key point to decide whether to reserve the uterus or not.For the population with high risk factors,prophylaxis treatment with prostaglandins should be initiated to reduce the bleeding volume.Uterine packing might be an effective treatment to stop postpartum hemorrhage, especially for those bleeding due to placenta previa.

OBJECTlVE To investigate the improvement effect of rosigIitazone(ROm)against cis-pIatin(DDP)-induced nephropathy in rats and its mechanim of resistance to oxidative stress. METHODS Invitro:the survivaI rate of HEK293 ceIIs was measured with mTT assay incubated with DDP 0.4 -100 μmoI·L-1 aIone or with DDP 25 μmoI·L-1 and ROm 0.01-1000 μmoI·L-1 for 48 h. Then the content of maIondiaIdehyde(mDA)and the activity of gIutathione(GSH)in HEK293 ceIIs co-incubated with DDP 25 μmoI·L-1 and ROm 100 μmoI·L-1 were assayed using chromatometry. In vivo:sixty maIe SD rats were randomIy divided into normaI controI group,modeI group(DDP 5 mg·kg-1 )and modeI+ROm 5,10 and 20 mg·kg-1 groups. The modeI of DDP-induced nephropathy was estabIished by taiI vein injection of DDP 5 mg·kg-1 ,once a week,for 3 times. After the first injection,the rats in modeI+ROm 5,10 and 20 mg·kg-1 groups were ig given ROm 5,10 and 20 mg·kg-1 ,once a week,for 8 weeks. The bIood urea nitrogen(BUN)and creatinine(Cr)were assessed with an automatic biochemicaI anaIyzer. Nitric oxide(NO)and mDA content,GSH and superoxide dismutase( SOD)activities in the kidney tissue were determined using chromatometry and histopathoIogicaI changes in renaI tissues were detected by hematoxyIin-eosin staining. RESULTS In vitro:IC50 of DDP to HEK293 ceII survivaI for 48 h was 21.0 μmoI·L-1 . Co-incubation with ROm 1-1000 μmoI·L-1 and DDP 25 μmoI·L-1 for 48 h couId signifi-cantIy increase the totaI ceII survivaI rate compared with DDP 25 μmoI·L-1 group(P﹤0.05,P﹤0.01), whiIe co-incubation with ROm 100 μmoI·L-1 and DDP 25 μmoI·L-1 for 48 h couId significantIy decrease the IeveI of mDA(P﹤0.01)and increase GSH activity(P﹤0.01),respectiveIy. In vivo:compared with normaI group,serum BUN and Cr content in modeI group were significantIy increased(P﹤0.01),renaI tissue GSH and SOD activities decreased(P﹤0.01),renaI tissue mDA content increased(P﹤0.01), and renaI tissue NO IeveI and NOS activity aIso decreased significantIy(P﹤0.05). Compared with modeI group,serum BUN content in modeI+ROm 5,10 and 20 mg·kg-1 decreased from(17.0±1.3)mmoI·L-1 to 14.0±4.1,11.2±1.8 and(6.1±1.0)mmoI·L-1(P﹤0.01),serum Cr content in modeI+ROm 10 and 20 mg·kg-1 decreased from(124.6±39.8)mmoI·L-1 to 49.0±5.2 and(47.1±2.9)mmoI·L-1(P﹤0.01), renaI tissue GSH and SOD activities in modeI+ROm 10 and 20 mg·kg-1 group increased significantIy (P﹤0.05,P ﹤ 0. 01),mDA IeveI decreased(P﹤0.05,P ﹤ 0. 01),NO IeveI and NOS activity aIso increased(P﹤0.05,P﹤0.01),and renaI pathoIogicaI tissue damage couId be improved. CONCLUSlON ROm pIays a protective roIe in rat kidney damage caused by DDP,which may be reIated to improving oxidative stress resistance of the kidney.

Objective To discuss the application effect of real time ratio of patients and nurses in nursing human resource dynamic management.Methods Our hospital made full use of the information platform,inquiring the real time ratio of patients and nurses,in combination with mobile nurse library,implement dynamic vertical management of nursing human resources on the level of the hospital-wide nursing management.The overall manpower cost remained the same through internal reasonable adjustment to achieve the best configuration of human resources and met the clinical needs effectively.Results The running effect was satisfactory from July 2012 till now.All the mobile nurses allocated were 71 person-times and the satisfaction degree of patients increased to 97.96％ in the first half of 2013.Conclusions Application of real time ratio of patients and nurses shows good effect,which is worthy of wide application.

Objective To analyze the characteristics of patients involved in identification error events,try to recognize patients group who had high risk of being wrongly identified.Methods 68 patient identification error events in 64 hospitals in Liaoning province from 2007 to 2011 were investigated.The results were analyzed from four aspects,which were education,age,consciousness and sensory disability state of patients.Results 68 identification error events were investigated.Among these events,patients who graduated from middle school or less constituted 79.41％ ;patients older than 60 years old constituted 55.88％;patients with hearing and speaking inability constituted 41.18％;patients without clear consciousness constitutes 14.70％ Conclusions Patients who graduated from middle school or less,older than 60 years old,with heating and speaking inability constitute the group who has high risk of being wrongly identified.Enhancing the education of patients,promoting the use of wrist band,and decreasing the dependence on hearing and speaking ability during identification process constitute the main reformation aspect of new patient identification rules.

Objective To investigate the suitable mode of induced termination of pregnancy at second and third trimester for women with scarred uterus. Methods A retrospective study was performed in 90 cases of second and third trimester pregnant women with scarred uterus, who requested termination of pregnancy due to medical indications in Beijing Obstetrics and Gynecology Hospital from September 2002 to June 2009. The indications of termination of pregnancy were fetal anomaly, serious pregnant complication and intrauterine fetal deaths. 72 second trimester pregnant women and 18 third trimester pregnant women were included in this study. The interval time of previous operation to this pregnancy were recorded. And it was <2 years in 20 cases and ≥2 years in 70 cases. The patients with normal Hepatic function began to take mifepristone and had an allergic test of Ethacridine Lactate. The method of mifepristone combined with Ethacridine Lactate were adopted when the allergic test was negative (group A, 54 cases). The method of mifepristone combined with earbeprost methylate suppositories were used in the patients who had a positive reaction to the allergic test of Ethacridine Lactate, or who failed to amniotomy to inject Ethacridine Lactate because of oligohydramnios or small gestational age(group B, 36 cases). Record the detail information of every patient. (1) Age, gestational weeks, gravidity and parity. (2) The mode of previous operation (inducing the scar of uterus), previous operation time and indication. (3) The mode of induced labor in this pregnancy, the interval time from administration to uterine contraction, delivery or not and the interval time from induction to delivery. (4) Postpartum hemorrhage, the successful rate of induce labor, placental retention ratio and rupture of uterus or not. Results (1) It had no significant difference between group A and group B in age, gravidity, parity and the interval time of previous operation to this pregnancy (P> 0.05). But there was significant difference between two groups in gestational weeks of induction(16 weeks vs. 25 weeks,P<0.01). (2) It had no significant difference between two groups in successful rate of induction and postpartum hemorrhage(P>0.05), but the time from induction to regular uterine contraction and delivery in group B was significant shorter than that of group A(P<0.01). The rate of delivery with 24 hours in group B was 94%. It was significant higher than that of group A(13%, P<0.01). (3) The rate of retained placenta in group B (31%, 11/35) was significant higher than group A (10%, 5/52), but the ratio of residual of placenta and membranes in group A was significant higher than that of group B(54% vs. 34% ). It was no significant difference in total rate of postpartum complication between two groups. Further analysis was done in relationship of complication and the time of previous operation. It was no significant difference between the over 2 years group and the less 2 years group in the incidence rate of complications including placental retention, residual of placenta and membranes, rupture of uterus, placental abruption and postpartum hemorrhage. (4) There was 1 case of uterine rupture in group B and 1 case of placental abruption in group A. Conclusions Both of methods of mifepristone combined with carboprost methylate suppositories and the mifepristone combined with Ethacridine lactate are feasible to induced second trimester and late trimester termination of pregnancy for women with scarred uterus. But sufficient preoperation preparation and the course of induction and labor careful monitoring must be done to prevent the uterine rupture.

Objective To investigate and analyze the structure change of professional title and educa-tion background of nursing human resourse in Liaoning province in recent 3 years and raise up suggestions which suit for the structure and development of human resource of current nursing model. Methods Investi-gation scales for nursing human resource in Liaoning province were sent out to 85 hospitals in Liaoning province.SPSS 12.0 software was used to carry out statisdcal discription for these data. Results The main professional fide was primary. The main education background was junior college and technical secondary school in third-class hospitals and technical secondary school in second-class and first-class hospitals. Conclusions The professional title and education background of nursing human resourse in Liaoning province was not reasonable with imbalanced structure in various level of hespitals.The countermeasures included reform of nursing education, reasonable allocation and effective utilization of current nursing human resource and sys-tematization of continuing education.

Objective To study the perinatal outcomes of pregnant women when their total stage of labor over 24 hours after the application of new partogram.Methods A retrospective case-control study was conducted on 3 991 pregnant women who received routine prenatal care and intrapartum management according to new partogram and delivered at full-term with alive babies at Beijing Obstetrics and Gynecology Hospital from October 1,2014 to January 31,2015.Among these 3 991 women,85 delivered after 24-hours' labor and all were nulliparas,while five of the 85 converted to cesarean section (CS group) and 80 delivered vaginally (study group).Another 160 primigravidas were randomly selected from those vaginal deliveries with the total stage of labor less than 24 h as control group.The general conditions,maternal and fetal perinatal outcomes were compared between the study and control group and between the study and CS group.The duration of labor was compared among different groups of women in the study group.Independent sample t-test,Rank-sum test,Chi-square test or Fisher's exact test were applied for statistics.Results The durations of first stage,second stage,third stage and total stage of labor were all longer in the study group than in the control [25.7(23.8-26.8) vs 10.4(5.9-13.9) h,1.4(0.6-1.8) vs 0.8(0.4-1.0) h,0.14(0.08-0.17) vs 0.11(0.07-0.13) h,27.2(24.9-26.8) vs 10.4(5.9 14.0) h,Z=12.525,4.359,3.528 and 12.588,all P＜0.01].The proportions of intrapartum interventions and application of labor analgesia were both higher in the study group than in the control [97.5％(78/80) vs 32.5％(52/160),42.5％(34/80) vs 11.9％(19/160),x2=90.764 and 29.071,both P＜0.01].Higher incidences of intrapartum fever [18.8％(15/80) vs 5.6％(9/160),x2=10.208],episiotomy [50.0％(40/80) vs 25.6％(41/160),22=14.172],assisted vaginal delivery [26.3％(21/80) vs 10.0％(16/160),x2=10.800],postpartum hemorrhage [32.5％(26/80) vs 8.1％(13/160),x2=23.284],and cervical laceration [15.0％(12/80) vs 3.1％(5/160),~=11.427] were shown in the study group than in the control (all P＜0.01).There was no statistically significant difference was found in the rate of fetal distress,neonatal asphyxia and neonatal intensive care unit (NICU) admission between the study and control group (all P＞0.05) except for newborns' birth weight [(3 542±388) vs (3 431 ±368) g,t=2.162,P=0.032].However,the incidences of postpartum hemorrhage,intrapartum fever and neonatal admission to NICU were comparable between the study (n=20) and CS group (both P＞0.05).Within the study group,the durations of second stage of labor in women with postpartum hemorrhage,assisted vaginal delivery and episiotomy were significantly longer than those without [1.8(0.9-3.1) vs 1.2(0.5-1.5) h,2.0(0.8-3.4) vs 1.2(0.5-1.6) h,1.7(0.6-2.6) vs 1.1(0.5-1.5) h,Z=2.168,2.756 and 1.891,all P＜0.05].Conclusions After the application of new partogram,vaginal delivery remains possible for pregnant women whose total stage of labor over 24 hours without increase of neonatal morbidity.However,the incidences of postpartum hemorrhage,episiotomy and assisted vaginal delivery may rise up.