Objective To observe the effect of application of Lamaze childbirth method in childbirth. Methods The observation group(110 cases)was trained by Lamaze childbirth method in late pregnancy period. The control group (110 cases) was not trained by Lamase childbirth method in antepartum period, and were given regular observation and nursing. Mastering of natural childbirth knowledge, pain intensity, childbirth time, mode of delivery and amount of bleeding post- childbirth 2h were observed in the two groups. Results The observation group mastered more natural birth knowledge than the control group, childbirth pain was obviously reduced, natural birth rate was higher than the control group, the first and second labor time was shorter than the control group, the amount of bleeding was obviously less than the control group 2 hours post childbirth. Conclusions Pregnant women need Lamaze childbirth method training before childbirth and instruction of maternity nurses. These may relieve pain, shorten childbirth time and reduce amount of bleeding post childbirth by application of Lamaze childbirth method.

Objective:To research and compare the therapeutic effect of oxycodone hydrochloride controlled—release tablets and morphine sulfate controlled—release tablets on the visceral cancer pain.Methods:Total of 72 patients with visceral cancer pain were randomly assigned into two groups:OO group was treaded by oxycodone hydrochloride controlled—release tablets,MO Group was given morphine sulfate controlled—release tablets.According to the principle of NCCN(2008),the two groups were titrated by morphine,and then diverted to controlled-release agent.The visual analogue scale(VAS)was kept smaller than 4.The side effects of two groups'and the rescue analgesic doses were recorded after the application of the controlled-release agent for 15 days,and the cost-effectiveness was analysed.Results:The rescue analgesic doses of the OO group were smaller than that of the MO group (P0.05).Conclusion:The two drugs have notable analgesic effect in the visceral cancer pain.Considered gastrointestinal tract side effects and the rescue analgesic dose,Oxycodone hydrochloride controlled—release tablets surpass the Morphine sulfate controlled-release tablets.Oxycodone hydrochloride controlled-release tablets may be a potential regimen for visceral cancer pain.

Objectives To analyse the etiology and clinical characteristics of syncope in children. Methods The clinical data of 128 children with syncope were retrospectively analyzed. Results According to the definition of syncope and supporting test results, 20 cases of non-syncopal conditions were excluded. In 108 cases of syncope, there were 70 cases (64.81%) of neurally mediated syncope, 8 cases (7.41%) of cardiogenic syncope, and 24 cases (22.22%) of unexplained syncope. Eighty-five cases (78.71%) had incentives before the onsets. Twenty-one cases (19.44%) had the family histories of syncope. One case (0.93%) had the family history of sudden death. The neurally mediated syncope and cardiogenic syncope had the feature of recurrent attacks. The VVS were preceded by limbs weakness, pale complexion, darkness in front of eyes, hearing loss, nausea and chest pain, the POTS by palpitation, chest pain and weakness, the OH by darkness in front of eyes, pale complexion and hearing loss, and the car-diogenic syncope by precordial discomfort, pain and chest pain. Conclusions The VVS is one of the most common cause of syn-cope in children. The onsets of the various types of syncope often have incentives and are preceded by some symptoms. Most of them have the feature of recurrent attacks.

Background Hyperuricemia is frequently present in patients with heart failure. Many pathological conditions, such as tissue ischemia, renal function impairment, cardiac function impairment, metabolic syndrome, and inflammatory status, may impact uric acid (UA) metabolism. This study was to assess their potential relations to UA metabolism in heart failure. Methods We retrospectively assessed clinical characteristics, echocardiological, renal, metabolic and inflammatory variables selected on the basis of previous evidence of their involvement in cardiovascular diseases and UA metabolism in a large cohort of randomly selected adults with congestive heart failure (n = 553). By clustering of indices, those variables were explored using factor analysis. Results In factor analysis, serum uric acid (SUA) formed part of a principal cluster of renal functional variables which included serum creatinine (SCr) and blood urea nitrogen (BUN). Univariate correlation coefficients between variables of patients with congestive heart failure showed that the strongest correlations for SUA were with BUN (r = 0.48, P < 0.001) and SCr (r = 0.47, P < 0.001). Conclusions There was an inverse relationship between SUA levels and measures of renal function in patients with congestive heart failure. The strong correlation between SUA and SCr and BUN levels suggests that elevated SUA concentrations reflect an impairment of renal function in heart failure.

BackgroundThe relationship between lipids and coronary artery disease has been well established. However, this is not the case between lipids and heart failure. Ironically, high lipid levels are associated with better outcomes in heart failure, but the mechan-isms underlying the phenomenon are not fully understood. This study was performed to test the hypothesis that reduced intestinal lipid absorption due to venous congestion may lead to low lipid levels.MethodsWe collected data of clinical characteristics, echocardio-graph, and lipid profile in 442 unselected patients with congestive heart failure. Correlations between lipid levels[including total cho-lesterol(TCL), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), and triglycerides(TG)]and right ventricle end diastolic diameter (RVEDD), left ventricle end diastolic diameter (LVEDD), right atrium diameter (RA), left atrium diameter (LA), or left ventricle ejection fraction (LVEF) were analyzed using Pearson correlation and partial correlation. RVEDD, LVEDD, RA, and LA were indexed to the body surface area.ResultsThere was a significantly inverse correlation between TCL le-vels and RVEDD (r=-0.34,P<0.001) and RA (r=-0.36,P<0.001). Other lipids such as LDL-C, HDL-C, and TG had asimilar inverse correlation with RVEDD and RA. All these correlations remained unchanged after adjusting for age, gender, smoking status, physical activity levels, comorbidities, and medication use.ConclusionsLipid levels were inversely correlated to RVEDD in patients with congestive heart failure; however, because this was an observational study, further investigation is needed to verify our results as wellas identify a causal relationship, if any.

Objective To explore the clinical significance of non-invasive prenatal genetic testing to screen prenatal fetal chromosomal abnormalities. Methods Peripheral blood was collected from 6 283 pregnant women who underwent non-invasive prenatal genetic testing at our hospital, and fetal DNA was extracted and purified for analysis. The complementary base principle of semiconductor chip technology was used to analyze all sequenced signals with BioelectronSeq 4000. Invasive prenatal diagnosis was performed in high-risk pregnant women according to the results of the sex chromosome sequencing signal analysis. Results Of the 6 283 pregnant women screened, 14 were found to have chromosomal abnormalities, and the positive rate was 0. 22％. Karyotype analysis was performed on 11 of the women; the remaining 3 refused to be diagnosed. Of these 11 women, 2 of the 5 patients with a high risk of XO were diagnosed with fetal chromosomal abnormalities (diagnosed as XO/XXX chimera and XO, respectively), and 3 were diagnosed with a normal karyotype; 5 patients with a high risk of XXY were diagnosed as XXY; and 1 patient with a high risk of XXX was confirmed as XXX. NIPT accuracy was measured to be 73％ (8/11). The detection rate of fetal chromosomal abnormalities by non-invasive prenatal genetic testing was significantly higher in the years 2015-2016 than in 2011-2014 (P ＜ 0. 05). Conclusion Non-invasive prenatal genetic testing for screening chromosomal abnormalities has a high accuracy rate and could improve the detection rate of fetal chromosomal abnormalities.

Objective To investigate the distribution features of TCM patterns and differentiation method of thyroid cancer through cluster analysis on data of TCM four examinations after surgery.Methods The data of TCM four examinations were collected from 304 patients by applying cross-section epidemiological survey,and then given quantitative classification and a database was established.The quantitative scores of each patient were given cluster analysis by using sample clustering analysis method (Q clustering) for getting the proportion of each category of four examination information.The preliminary criterion for patterns of thyroid cancer was made according to the proportion of four examinations information and expert survey of Delphi method at earlier stage,which was combined with clinical practice to determine the patterns.Results All 304 patients were clustered into 9 categories indicated by from A1 to A9.The frequency of A1 was 77 cases;A2,7;A3,1;A4,7;A5,105;A6,7;A7,87;A8,11 and A9,2.Based on clinical practice and experts' experiences,A1 and A7,A5 and A6,and A3 and A4 were merged and evaluated respectively as pattern of dual deficiency of qi and yin (164 cases,53.9％),pattern of liver depression and qi stagnation (112 cases,36.8％) and spleen-kidney yang deficiency pattern (8 cases,2.6％).A2 was evaluated as pattern of yin damaged by stasis heat (7 cases,2.3％).The proportions of four examination information of A8 and A9 were disperse and evaluated as other patterns (13 cases,4.4％).Conclusion The distribution of TCM patterns in the patients with thyroid cancer after surgery has its regularity.It is feasible to evaluate TCM patterns with cluster analysis combining with experts' experiences.

Objective To investigate the changes and clinical significance of serum tumor markers in patients with non-small cell lung cancer before and after gefitinib targeted therapy.Methods 80 cases of non-small cell lung cancer patients in our hospital from June 2015 to May 2017 were divided into control group and observation group randomly,40 cases in each group.The control group were treated with docetaxel conventional chemotherapy,and the observation group were treated with gefitinib targeted therapy.The clinical treatment effect,changes of serum tumor markers cancer antigen125 (CA125),carcinoembryonic antigen (CEA),neuron specific enolase (NSE) and adverse reactions were observed and compared between the two groups before and after treatment.Results The effective rate and disease control rate of the observation group were higher than that in the control group,with statistically significant difference (P ＜ 0.05).The levels of serum tumor markers CA125,CEA and NSE in the control group and the observation group before treatment were not significantly different (P ＞ 0.05).After 1 months of treatment,the levels of serum tumor markers CA125,CEA and NSE in the two groups were all decreased,and the level of serum tumor markers,CA125,CEA and NSE in the observation group were lower than those in the control group,with statistically significant difference.The incidence of adverse reactions in the observation group was lower than that in the control group (P ＜ 0.05),with statistically significant difference.Conclusions Gefitinib is effective in the treatment of non-small cell lung cancer.It reduces the level of serum tumor markers CA125,CEA,NSE,and reduces postoperative adverse reactions.It is worthy of clinical application.

This study was designed to evaluate the effect and mechanism of mitogen-activated protein kinase(MAPK)activated protein kinase 2(MK2)in Angiotensin Ⅱ(AngⅡ)-induced mouse renal damage.Total of 16 wild type C57BL/6J mice were randomly divided into MK2+/+control group and MK2+/++AngⅡ group,while 16 MK2 knockout C57BL/6J mice were randomly divided into MK2-/-control group and MK2-/-+AngⅡ group.Kidney damage was induced by subcutaneous injection of AngⅡ for 4 weeks.Then corresponding methods were carried out to detect systolic pressure,serum creatinine,24h urinary albumin,glomerulosclerosis index,renal tubulointerstitial injury score,the expression level of phosphorylated MK2(p-MK2),p-p65 nuclear factor-κB(NF-κB),the contents of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),reactive oxygen species(ROS),superoxide dismutase(SOD)and malondialdehyde(MDA).Compared with the MK2+/+control group,MK2+/++AngⅡ group demonstrated significant increase in systolic blood pressure,serum creatinine,24h urinary albumin,glomerulosclerosis index,renal tubulointerstitial injury score,the expression levels of p-MK2,p-p65 NF-κB expression,and the contents of TNF-α,IL-6,ROS,MDA,while significant decrease in the level of SOD in kidney(P<0.05).Compared with the MK2+/++AngⅡ group,MK2-/-+AngⅡ group showed no significant difference in systolic blood pressure(P>0.05),significant decrease in the serum creatinine,24 h urinary albumin,glomerulosclerosis index,renal tubulointerstitial injury score,the expression levels of p-MK2,p-p65 NF-κB and the contents of TNF-α,IL-6,ROS,MDA,while significant increase in the content of SOD in kidney(P<0.05).In conclusion,MK2 knockout significantly alleviates AngⅡ-induced renal damage and inhibits inflammatory and oxidative stress responses.MK2 is involved in AngⅡ induced renal damage.

The course, progression, and prognosis of fetal congenital cystic adenomatoid malformation (CCAM) depend on the size of the mass, whether the mediastinum is displaced, changes in fetal hemodynamics, and the occurrence of fetal hydrops, with large CCAM being relatively rare. In this case, a fetus was suspected of having a large CCAM with fetal hydrops and cardiac insufficiency at 27 weeks of gestation. After multiple imaging evaluations and multidisciplinary consultations, a delivery plan and neonatal resuscitation plan were formulated. At 31 +4 weeks of gestation, in-utero thoracentesis and drainage were performed. Postoperatively, the fetal CCAM was reduced compared to before, and the maternal symptoms of chest tightness and shortness of breath were also improved. Three days after the procedure, the mother experienced premature rupture of membranes and delivered a male infant vaginally at 32 weeks of gestation. On the fifth day after birth, the newborn underwent resection of the pulmonary cystic adenomatoid malformation, confirming the diagnosis. Follow-up for two years post-birth showed good prognosis for both the mother and the child. Therefore, when CCAM is detected during pregnancy, thorough in-utero evaluation should be conducted, and a monitoring plan should be developed based on potential perinatal conditions to avoid unnecessary termination of pregnancy. If the pregnancy continues, multidisciplinary evaluation and preparation for perinatal surgery are necessary.