Objective To investigate and analyze the monitoring status of birth defects of perinatal infants in Hakka of Guangxi Zhuang Autonomous Region,and to provide evidence for reducing the incidence of birth defects and improving prevention decision for the quality of birth.Methods The data of 51 528 cases of perinatal birth defects monitoring were analyzed in Bobai and Luchuan counties in 2015.Results The distribution of birth defects in the perinatal infants of Hakka was more than 75.14%,28.8% of the birth defects occurred in 28 weeks,51 528 cases of perinatal birth in hospital,birth defects of ≥28 weeks in 384 cases.The incidence rate of birth defects was 28.5%, the rate of birth was 7.45‰.The birth defect of ≥28 weeks was diagnosed,35 cases were fetal edema syndrome, accounted for 9.11%.34 cases were congenital heart disease,accounted for 8.85%,30 cases were cleft lip with cleft palate,accounted for 7.81%.Congenital hydrocephalus in 5 cases,accounted for 1.30%;other in 251 cases,accoun-ted for 65.35%.The diagnosed time distribution of birth defects of ≥28 weeks:prenatal diagnosis accounted for 21.18%,postnatal 7 days accounted for 78.82%.The outcome of ≥28 weeks of perinatal birth defects in Hakka:live birth accounted for 73.18%,fetal death accounted for 20.57%,stillbirth accounted for 1.30%,seven days of death accounted for 4.94%.Conclusion The perinatal birth defects in Hakka is live births to the main,the prevention of perinatal birth defects in children live birth measures should be strengthened,the detection of birth defects should be strengthened and the pregnancy of artificial birth defects should be terminated,so as to improve the quality of the birth population.

Objective To understand and explore the feelings and viewpoint of obstetrics and gynecology nursing professional degree postgraduates′core competency. Methods This study used semi-structured focus group to interview 3 obstetrics and gynecology department nurse specialists and 6 nursing postgraduates who work in the obstetrics and gynecology department. The data was transcribed based on the tape and were analyzed by software Nvivo 10.0. Results A comprehensive analysis of the five core competencies: clinical practice competency, research ability,clinic thinking ability, interpersonal communication and psychological counseling skills, self- planning ability. Conclusions Setting curriculum on basis of core competency. Quantify the clinical practice plan. Exploring the pattern of clinical education. Tamp the foundation, pay attention to practice, a positive attitude.

Objective To explore the lived study feeling and experience of nursing upgrade students during blended learning model so as to provide the evidence of reforming teaching model of nursing educators.Methods Phenomenological research of qualitative research was used.Four focus groups,25 upgrade nursing students were interviewed in-depth.Results Six themes were sublimated:relief the contradiction between work and study,promote communication in double interaction,improve self-learning ability,improve selfconfidence as learning controllability,online courses lack a sense of belonging,lack of skills support.Conclusions Blended learning model meets students,needs,provides students with personalized learning and improves comprehensive quality.However,the development of blended learning model in China is in the primary stage,we should combine conditions and reference foreign experience to develop it.

The three-dimensional organization and anastomoses of lymphatics in the rabbit stomach were demonstrated by scanning electron microscopy of lymphatic corrosion casts. Casting medium is the diluted low viscosity Mercox used for intraparenchymatous injection into the mucosal, submucosal, muscular and serous layers of the stomach. The lymphatic capillaries with blind ends were found in the deep mucosa and the lymphatic capillary networks and lymphatic plexus were observed in all the submucosal, muscular and serous layers. The distinct imprints which correspond to the bicuspid valves of lymphatics and the oval or fusiform impressions of the endothelial nuclei were seen on the casts.

By using 5'-nucleotidase-alkaline phosphatase (5'-Nase-AlPase) double staining method, the fine distribution of the lymph vessels in the stomach wall of the rabbit, guinea pig and rat has been observed. Under light microscope lymph capillaries showed strongly 5'-Nase positive reaction with brown or dark brown staining. However blood capillaries revealed significantly A1Pase activity with blue staining. The lymph capillaries were seen in all layers of the stomach wall in three species, but the lymph vessels were only shown in the submucosa, muscularis and serosa. In the mucosa lymph capillaries could be found in the deep layer of the lamina propria. In the submucosa there were lymph vessels and capillaries. In the muscularis lymph capillaries and vessels not only could be found between oblique and circular muscle or between circular and longitudinal muscle, but also among muscle fiber bundles of each layer. In the serosa there were larger lymph vessels situated near the muscularis. The observation on semithin and ultrathin sections also shown the similarity in the lymph vessels distribution. There was no difference in the distribution of lymph vessels in the stomach wall between rabbit, guinea pig and rat.

OBJECTIVETo lay a foundation for the study on good variety selection of Isatis indigotica, comparison of plant traits and quality evaluation of Isatis germplasm resources from different production area was conducted.

METHODField cultivation and randomized block experiment were adopted to compare those plant traits of leaf, root, silique and seed of Isatis from different production area and the content of R,S-goitrin and polysaccharide in the root was determined.

RESULTDifferent cultivation forms of Isatis had significant difference from each other in leaf, root, silique and seed, content of R,S-goitrin and polysaccharide in the root were also different. R,S-goitrin content in Isatis of Chinese cabbage leaf type ( production area: Yunnan ) was comparative higher, 0.59% , while polysaccharide content in autotetraploid Isatis was comparative higher, 8.68%.

CONCLUSIONAccording to the plant traits, Isatis were classified into three types: Chinese cabbage leaf type, cabbage leaf type and mustard leaf type, of which R,S-goitrin content in Chinese cabbage leaf type (production area: Yunnan) was comparative higher, while polysaccharide content in autotetraploid Isatis was comparative higher.

China ; Drugs, Chinese Herbal ; analysis ; Isatis ; chemistry ; growth & development ; Phenotype ; Plant Leaves ; chemistry ; growth & development ; Plant Roots ; chemistry ; growth & development ; Seeds ; chemistry ; growth & development

Objective To investigate the application of the repeated expanded bilateral deltopectoral flap for resurfacing severe facial cervical scar, with review of relating articles to discuss issue of repeated expanding flap.Methods Nine patients suffered from hyperplastic facial and cervical scar.Two soft tissue expanders were implanted into the anterior chest region at both sides of sternum.The center of inner border of the expander was at the cross of second intercostal and parasternal line, and the lengthways axe of the expander was located at the ligature of the second intercostals and mammary areola.After two weeks when the expander was filled, expanded flap was transferred to cervical defect.The transferred flap was repeated expanded after half a year and transferred to resurface facial defect.Results In the first expansion stage, 600 or 800 ml expander were implanted in each side of sternum.In the second stage, 400 or 500 ml were used.The first stage of expanding process was smooth, and 2 of the expanding flaps were ruptured during the second expansion period.400-520 cm2 (average 440 cm2) additional expanded flap was acquired during two stages of expanding.Conclusions The repeated expanded bilateral deltopectoral flap gives us greater opportunity to repair severe facial-cervical scar.The best interval time of the two-stage expansion is over half a year.The speed of second expansion should be lower than that in the first stage, and protecting the expanding flap carefully from external force compression is needed during the second expasion.

OBJECTIVETo discuss the methods for urethral external meatus and glanuloplasty after correction of hypospadias.

METHODSThe V shape flap on the dorsal side of glan, combined with the bilateral glan flaps were moved to the ventral side. The flap at the ventral side of urethral external meatus was turned over. Then the urethral external meatus was repositioned to the top end of glan with the ventral defects covered by the dorsal flaps. Then the coniform glan was reconstructed.

RESULTSFrom January 2008 to December 2013, 28 cases were treated, including glandular hypospadias, postoperative retraction of external urethral meatus and meatal stenosis. 21 patients were followed up for 1 -12 months (average, 1 month) with marked improvement of glan appearance and retraction of external meatus. No meatal stenosis happened.

CONCLUSIONSPostoperative retraction of urethral external meatus and meatal stenosis can be corrected by V shape flap on the dorsal side of glan combined with the bilateral glan flaps. The flat appearance of glan can be improved. It is an ideal method for glandular hypospadias.

Humans ; Hypospadias ; surgery ; Male ; Penis ; surgery ; Postoperative Complications ; surgery ; Postoperative Period ; Surgical Flaps ; Urethra ; surgery ; Urethral Stricture ; etiology ; surgery

Objective:To compare the effects of pressure controlled ventilation (PCV) and volume controlled ventilation (VCV) on respiratory mechanics, hemodynamics and biochemical metabolism in patients undergoing laparoscopic colorectal cancer surgery.Methods:The clinical data of 78 patients underwent laparoscopic colorectal cancer surgery from August 2019 to June 2020 in Inner Mongolia People′s Hospital were retrospectively analyzed. Among them, 39 patients were treated with PCV (PCV group), and 39 were treated with VCV (VCV group). The respiratory mechanics, hemodynamics and biochemical metabolism indexes 10 min after anesthesia induction (T 1), 10 min after pneumoperitoneum + low head and foot height (T 2), 60 min after pneumoperitoneum + low head and foot height (T 3) and 120 min after pneumoperitoneum + low head and foot height (T 4) were recorded. The respiratory mechanical indexes included mean airway pressure (P mean), airway peak pressure (P peak), pressure of end tidal carbon dioxide (P ETCO 2) and dynamic lung compliance (C Ldyn); hemodynamic indexes included mean arterial pressure (MAP) and heart rate; and biochemical metabolic indexes included base excess, serum natrium, serum potassium, negative logarithm of the hydrogen ion concentration (pH) and blood glucose. Results:The P mean, P peak and P ETCO 2 T 1 to T 4 in PCV group were significantly lower than those in VCV group, P mean: (7.12 ± 1.37) cmH 2O (1 cmH 2O = 0.098 kPa) vs. (8.54 ± 1.84) cmH 2O, (9.80 ± 2.26) cmH 2O vs. (11.63 ± 2.87) cmH 2O, (9.51 ± 2.17) cmH 2O vs. (11.72 ± 2.90) cmH 2O, (7.04 ± 1.34) cmH 2O vs. (8.65 ± 1.88) cmH 2O; P peak: (13.41 ± 2.68) cmH 2O vs. (15.06 ± 3.05) cmH 2O, (20.92 ± 3.11) cmH 2O vs. (23.45 ± 4.02) cmH 2O, (21.14 ± 3.50) cmH 2O vs. (23.69 ± 4.26) cmH 2O, (15.03 ± 2.74) cmH 2O vs. (16.45 ± 3.21) cmH 2O; P ETCO 2: (30.59 ± 1.57) mmHg (1 mmHg = 0.133 kPa) vs. (32.04 ± 2.11) mmHg, (35.02 ± 4.15) mmHg vs. (39.88 ± 4.76) mmHg, (35.90 ± 4.22) mmHg vs. (40.11 ± 4.87) mmHg, (34.33 ± 4.17) mmHg vs. (37.65 ± 2.69) mmHg; the C Ldyn was significantly higher than that in VCV group: (40.68 ± 3.98) ml/cmH 2O vs. (35.47 ± 2.56) ml/cmH 2O, (30.25 ± 3.21) ml/cmH 2O vs. (22.40 ± 2.75) ml/cmH 2O, (29.78 ± 3.06) ml/cmH 2O vs. (22.60 ± 2.81) ml/cmH 2O, (40.32 ± 4.25) ml/cmH 2O vs. (33.61 ± 2.81) ml/cmH 2O, and there were statistical differences ( P<0.01 or <0.05). The MAP and heart rate T 1 to T 4 in PCV group were significantly lower than those in VCV group, and there was statistical difference ( P<0.01 or <0.05). The base excess, serum natrium, serum potassium and pH T 1 to T 4 in PCV group were significantly higher than those in VCV group, while the blood glucose was significantly lower than that in VCV group, and there was statistical difference ( P<0.01 or <0.05). Conclusions:Compared with VCV, PCV can promote the recovery of respiratory mechanics index, stabilize hemodynamics and improve biochemical metabolism index in patients undergoing laparoscopic colorectal cancer surgery.

Objective To evaluate the efficacy of endoscopic ultrasonography-guided celiac plexus radiation with iodine-125 (125I) seeds and celiac plexus neurolysis with absolute ethanol for pain relief secondary to advanced pancreatic cancer.Methods A retrospective analysis of 43 patients of advanced pancreatic cancer with moderate to severe abdominal pain in the Department of Gastroenterology,Shanghai Changhai Hospital from January 2017 to April 2018 was performed.20 patients underwent EUS-guided celiac plexus neurolysis (CPN),and 23 patients underwent EUS-guided celiac plexus radiation (CPR) with the implantation of 125I seeds around the celiac ganglia.The postoperative VAS score of abdominal pain,mean analgesic (MS Contin [morphine sulfate]) consumption and complications were compared between the two groups.Results There were no statistically significant differences between the two groups in the sex ratio (male/female,10/10 vs 14/9),average age [(64 ± 11) vs (64 ± 12)],lesion location (head/tail,7/13 vs 8/15] and TNM stage (Ⅲ/Ⅳ,9/11 vs 7/16),and the two groups were comparable.Compared with preoperative ones,the VAS score (3.0 points vs 5.5 points) and morphine dosage (30 mg vs 52.5 mg) were significantly lower in the CPN group one week after operation.In the CPR group,the VAS score (5.0 points vs 6.0 points) and morphine dosage (50 mg vs 55 mg) at 2 weeks after the operation were lower than those before the operation;the VAS scores of 4,8 and 12 weeks after the operation decreased to 3.0 points,and the dosage of morphine decreased to 30 mg,25 mg and 30 mg,respectively.The differences were statistically significant (P＜0.0001).Compared with the CPR group,at 2 weeks postoperatively the CPN group demonstrated a significantly higher decrease of VAS score (3.0 points vs 2.0 points),degree of morphine reduction (30 mg vs 10 mg) and rate of partial pain relief (70.0％ vs 4.3％).However,from 4 to 12 weeks postoperatively,the decrease in VAS score,the decrease in the dosage of MS Contin and the rate of partial pain relief in the CPR group were all significantly higher than those in the CPN group (P ＜ 0.05).There was no complete relief of pain in the two groups.No procedure-related deaths or serious complications were observed and only mild gastrointestinal adverse reactions occurred.Conclusions Two methods can both relieve abdominal pain in patients with advanced pancreatic cancer safely and effectively.CPR takes effect late but has advantages of good extent and long duration of pain relief.