Objective To investigate the maternal nutritional status and its influences on pregnancy outcomes in order to provide evidence for possible prenatal interventions.Methods A survey was conducted in 800 pregnant women,who presented at Xiamen Maternal and Child Healthcare Hospital between January 2006 to April 2008.The information of knowledge,attitude and behavior towards maternal nutrition were collected in 734 women and 571 women were followed up before 20 weeks of gestation,at 26-27 weeks,and 35-36 weeks to analyze the relationship between different nutrients and the pregnant outcomes.Results The questionnaire survey showed that women who had received higher education presented with better knowledge,attitude and behavior on maternal nutrition (P<0.05).Among the 734 women,39.2%(288) had poor knowledge,44.5%(326) were lack of knowledge,and 44.8%(358) with poor behavior.Prenatal diet analysis found that the percentage of these women with milk,fish and beans intake daily was 52.2%,34.3%,and 29.5%,respectively.Before 20 weeks of gestation,significant difference was identified only in the level of triglyceride among different BMI groups,and the higher the BMI,the higher the level of triglyeeride (P<0.01).With the progress of pregnancy,the level of serum ferritin and folic acid was decreasing (P<0.05),while the level of triglyceride and cholesterol was increasing (P<0.01).The newborn's birth weight was positively correlated to maternal BMI before 20 weeks (r=0.23,P<0.05),and higher BMI was a risk factor for abnormal birth weight (OR=4.051,95%CI:1.085～15.117,P<0.05) and also complicated with higher cesarean section rate than those women with lower or normal BMI (60.3%vs 29.4%and 34.7%,P<0.05).The rate of postpartum hemorrhage was increased with the reduced ferritin level (P<0.05).Conclusions The pregnancy outcomes can be improved through the following measures:appropriate control of the maternal weight before and during the pregnancy,increased intake of milk,fish,beans and so on,reduced intake of food containing abundant fat and sugar,more intake of red animal foodstuff,supplementation of folie acid,iron and calcium throughout the pregnancy,and prevention against high level of triglyceride and cholesterol.

Objective To provide valuable references for ultrasonic diagnosis of pelvic organ prolapsed (POP) by finding an eas ily detecting referential line based on MRI.Methods Data of 107 patients who underwent pelvic MRI were retrospectively analyzed.All the patients were divided into 6 groups according to age:Group 1 (20 29 years old),group 2 (30-39 years old),group 3 (40-49 years old),group 4 (50-59 years old),group 5 (60-69 years old) and group 6 (≥70 years old group).Four reference lines were set basing on the median sagittal view of T2WI:PS-PS line (the line connecting the two endpoint of the pubic symphysis),PIAS line (the line connecting the inferior margin of pubic symphysis and the bottom of sphincter internal anal sphincter),PPC line (the line connecting of the inferior margin of pubic symphysis and the point of the pubococcygeous attached on the rectum) and PM line (the line connecting of the inferior margin of pubic symphysis and the M point [the midpoint of the line from the crosspoint of PPC line and the front wall of the rectum mucosa to the bottom of sphincter internal anal sphincter]).The angles between the horizontal line and PS-PS line,PIAS line,PM line,PPC line (angle 1,angle 2,angle 3,angle 4) were measured,respectively.The differences of the angle among various age-groups were compared.The consistency between the two observes were evaluated.Results PM line was the closest line to the horizontal line.There was no statistical differences of angle 1,angle 2 and angle 3 among the 6 groups (all P＞0.05).The difference of angle 4 among the 6 groups were significant (F=3.42,P=0.01).Intergroup pairwise comparisons showed that significant differences were found between group 1 and group 4,group 5,group 6,between group 2 and group 4,group 5,group 6,between group 3 and group 4,group 5,group 6,respectively (all P＜0.05).And no significant difference was found in the other comparisons.The consistency of the two observers in meaning angle 1,angle 3 and angle 4 were good,but the consistency of angle 2 was poor.Conclusion Of all the referential lines,PM is the closest to the horizontal line and is less influenced by the patient's age.However,the feasibility of using PM lines as the ultrasound referential line is still unclear.

Objective To evaluate the pelvic floor function in post-hysterectomy patients. Methods Transperineal pelvic ultrasound was used to observe the pelvic organs in post- hysterectomy patients, and parameters of pelvic floor were measured. Taking the inferior margin of public symphysis as the reference plane,the shape and motion of the proximal urethra and bladder neck were observed at rest and on maximum Valsalva maneuver. Bladder neck-symphyseal distance(BSD) and retrovesical angle were measured. And the bladder neck descent(BND),urethral rotation angle and the rotation angle of the bladder neck were also calculated. Interclass correlation coefficients were calculated to evaluate the consistency of data. Results At rest,the BSD and retrovesical angle were (-2.73±0.37)cm and (119.00±22.40)°, while on maximum Valsalva maneuver was (-0.25±0.67)cm and (114.74±21.50)°,respectively. BND was (2.46±0.59)cm,the urethral rotation angle and the rotation angle of the bladder neck was (70.68±19.91)° and (60.81±17.34) °,respectively. Combined with pelvic ultrasound and clinical manifestations,29 cases of pelvic floor dysfunction after hysterectomy were diagnosed (58.00%, 5 cases of stress urinary incontinence, 8 cases of proctoptoma and 16 cases of bladder prolapse). The consistency was very high in measuring BNS, retrovesical angle at rest and on maximum Valsalva maneuver and BND by different observers. The interclass coefficient was 0.90,0.89,0.91,0.88,0.92,respectively. And the interclass coefficient of urethral rotation angle and the rotation angle of the bladder neck was 0.79, 0.88,respectively. These results showed a good interobserver agreement. Conclusion Transperineal pelvic ultrasound is a simple,reproducible and noninvasive imaging method, which can reveal the position and function of female pelvic organ dynamically and evaluate postoperative pelvic floor function.

Objective In comparison of the performances for the detection of Clostridium difficile toxin B genes from stool between BD MAX Cdiff assay and a laboratory-developed (LD) assay.The LD assay was evaluated in clinical application.Methods This study was a clinical application research.A total of 147 stool specimens from patients with diarrhea in Hangzhou First Hospital affiliated with Zhejiang Chinese Medical University were detected by the two assays from 1 July to 30 September 2014.DNA extraction and amplification of the tcdB gene were performed automatically on the BD MAX platform.Meanwhile, the tcdA and tcdB gene were detected by the LD real-time PCR assay after DNA extraction.Then, the results were analyzed by use of SPSS 10.0.Results A total of 147 stool samples were collected.There were 33 C.difficile positive cases and 114 negative cases detected by both of two assays.However, there were four stool samples had incongruent results.In comparison with BD MAX, the LD assay had a sensitivity of 93.94% (31/33), a specificity of 98.25% (112/114), a positive predictive value of 93.94% (31/33), and negative predictive value 98.25% (112/114).Furthermore, the results of the LD assay were statistically coherent with that of the BD assay (Kappa=0.922, P<0.01).Conclusions The LD assay was highly sensitive and accurate as BD MAX Cdiff assay in the detection of toxigenic Clostridium difficile.Furthermore, this LD assay could be also applied to detection of clinical stool samples directly with low cost.The assay will be more promising in diagnosis of toxigenic C.difficile in clinical application in China due to no additional instrument needed.

Objective:To investigate the effect of estrogen on the expression of P2X7 receptor ( P2X7R) in the cerebral cortex and neuroinflammation after subarachnoid hemorrhage ( SAH) in rats.Methods:The rat model of SAH was induced by modified mono-filament puncture method.Sixty male SD rats were divided randomly into three groups:sham group;SAH group and estrogen-treatment group.The local cerebral blood flow was detected with laser doppler blood flow meter.The content of tumor necrosis factor alpha ( TNF-α) and interleukin-6 (IL-6) were measured by ELISA analysis.The expression of P2X7R in the cerebral cortex was tested by immuno-histochemical and Western blot methods.Results:Compared with that in Sham group,cerebral blood flow was significantly decreased after SAH (P<0.05),the content of TNF-αand IL-6 in the cerebral cortex were significantly up-regulated at each time point after SAH (P<0.05),peaked at 24 h,and the expression of P2X7R significantly increased at 6 h,12 h and 24 h after SAH (P<0.05),peaked at 12 h.Compared with that in SAH group,cerebral blood flow was significantly increased in estrogen-treatment group (P<0.05),the levels of TNF-α,IL-6 and P2X7R were down-regulated in estrogen-treatment group ( P<0.05).Conclusion: Estrogen could attenuate neuroinflammation in the cerebral cortex after subarachnoid hemorrhage in rats, which may be associated with the down-regulation in P2X7R proteins.

Objective To investigate the effect of mild hypothermia on expression of autophagyrelated proteins LC3 and Beclin-1 in the hippocampus of rats with traumatic brain injury (TBI).Methods Sixty healthy male adult SD rats were divided into sham group, TBI group, hypothermiatreated group (31-33℃) according to the random number, with 20 rats per group.Rat models of TBI were established using the Marmarou's method.After 4 h of normothermia or hypothermia, the rats were killed 6, 12, 24, and 48 h later.Co-localization of LC3 with neuron specific protein (NeuN) or mammalian target of rapamycinm (mTOR) was determined by double immunofluorescence.Levels of LC3, Beclin-1 and p-mTOR proteins were detected by Western blot analysis.Results LC3 co-localization with NeuN (or mTOR) was observed under confocal laser scanning microscope.In TBI group LC3 and Beclin-1 levels were seen to rise at 6 h, peaked at 24 h and fell slightly at 48 h, but the levels were still higher than these in sham group (P ＜ 0.05).In TBI group p-mTOR level began to decrease at 6 h, reached the lowest point at 12 h, and then ascended at 24 and 48 h, but the level was still lower than that in sham group (P ＜0.05).Mild hypothermia contributed to remarkable decreases in LC3 and Beclin-I expressions, while up-regulating p-mTOR after injury (P ＜ 0.05).Conclusion Mild hypothermia appears to be neuroprotective as it inhibits autophagy in hippocampal neurons after TBI in rats through activation of mTOR signaling pathway.

Purpose: This study explored the direct and indirect effects of risk factors of work-related musculoskeletal disorders (WRMDs) in nurses working in intensive care units (ICUs). Methods: A cross-sectional study design was used. ICU nurses from 28 tertiary hospitals in the Hunan and Guangdong provinces participated in a survey conducted via a self-reported online questionnaire. A structural equation model was used to fit the data and to evaluate associations among WRMDs and risk factors. Results: Valid questionnaire samples were submitted by 984 ICU nurses. The prevalence of WRMDs within the previous year among ICU nurses was 96.8%. A valid structural equation model was constructed, and a good fit was shown: Chi-square value/degrees of freedom = 2.248; comparative fit index = .931; normal fit index = .905; goodness-of-fit index = .978; adjusted goodness-of-fit index = .966; and root mean square error of approximation = .036. All regression coefficients for direct effect reached significant levels (critical ratio > 1.96 and p < .05). In the structural equation model, the occurrence of WRMDs was directly affected by the following: physical factors, risk perception, and job stress. Physical factors and a safe environment indirectly affected WRMDs through risk perception and job stress. The strongest correlations with WRMDs were physical factors. Conclusion The model provided a new perspective for understanding the associations among physical factors, workplace safety environment, risk perception, job stress, and WRMDs. To improve the practice setting of the ICU, efforts should be made to help prevent WRMDs from physical, psychosocial, and environmental factors.

Purpose: This study explored the direct and indirect effects of risk factors of work-related musculoskeletal disorders (WRMDs) in nurses working in intensive care units (ICUs). Methods: A cross-sectional study design was used. ICU nurses from 28 tertiary hospitals in the Hunan and Guangdong provinces participated in a survey conducted via a self-reported online questionnaire. A structural equation model was used to fit the data and to evaluate associations among WRMDs and risk factors. Results: Valid questionnaire samples were submitted by 984 ICU nurses. The prevalence of WRMDs within the previous year among ICU nurses was 96.8%. A valid structural equation model was constructed, and a good fit was shown: Chi-square value/degrees of freedom = 2.248; comparative fit index = .931; normal fit index = .905; goodness-of-fit index = .978; adjusted goodness-of-fit index = .966; and root mean square error of approximation = .036. All regression coefficients for direct effect reached significant levels (critical ratio > 1.96 and p < .05). In the structural equation model, the occurrence of WRMDs was directly affected by the following: physical factors, risk perception, and job stress. Physical factors and a safe environment indirectly affected WRMDs through risk perception and job stress. The strongest correlations with WRMDs were physical factors. Conclusion The model provided a new perspective for understanding the associations among physical factors, workplace safety environment, risk perception, job stress, and WRMDs. To improve the practice setting of the ICU, efforts should be made to help prevent WRMDs from physical, psychosocial, and environmental factors.

This paper introduces an adaptive filtering algorithm based on the LMS principle to inhibit the ventricular interference in the atrial epicardial mapping experiments.
Algorithms ; Electrocardiography ; Epicardial Mapping ; Heart Ventricles

In order to realize real-time sampling and display in 128-channeled Epicardial Mapping System whose sampling frequency is 2 kHz per channel, the article introduces a mapping software and preliminarily validates its practicability. The software is designed in MFC, using multiple-thread technology and buffering and pumping values method.
Epicardial Mapping ; Signal Processing, Computer-Assisted ; Software ; Software Design