[Objective]To discuss the effect of post-natal depression on vaginal bleeding and lactation.[Methods]A retrospective analysis of 100 cases with complete information,including 66 cases of the control group,34 cases of post-natal depression,record the post-natal vaginal bleeding and lactation situation.[Results]The post-natal depression group 24h amount of vaginal bleeding after childbirth and lactation period was significantly higher than control group,while the volume of lactation was significantly lower than control group(P

Objective To study the diagnostic value of color Doppler ultrasonography in hematoma of soft tissues, and compare the images of different period of hematoma. Method Analyzed and compared the size,shape and sonographic characteristic of 46 cases with hematoma. Results The images of hematoma were round or oval in shape, more than 2.0 cm in trans-diameter, and were isoechoic or hypocchoic in the early stage, then anoechoic areas increased with hyperechoic septum and irregular hypoechoic, with posterior enhancement and hyperechoic boundary. A part of muscle fibres raptured and were occupied by the hematoma if the muscle tore. Conclusion Color Doppler ultrasonography can be the first choice and reliable imaging method to diagnose hematoma of soft tissues.

OBJECTIVE:To observe therapeutic efficacy and safety of paroxetine combined with flupentixol melitracen in the treatment of post-stroke major depressive disorder(PSMDD). METHODS:120 PSMDD patients were randomly divided into group A(40 cases),group B(40 cases)and group C(40 cases). All patients received routine stroke treatment;group A was additionally given Paroxetine hydrochloride enteric-coated sustained-release tablet 25 mg orally,once a day;group B was additionally given Flu-pentixol melitracen tablet 20 mg orally twice a day;group C was additionally given Paroxetine hydrochloride enteric-coated sus-tained-release tablet (same usage and dosage as group A)+flupentixol melitracen (same usage and dosage as group B). Three groups were treated for 28 d. Clinical efficacies of 3 groups were observed as well as NIHSS,ADL,HADM,SS-QOL score,hos-pitalization stay and the occurrence of ADR. RESULTS:Total response rate of group C was significantly higher than those of group A and B;hospitalization day was significantly less than those of group A and B,with statistical significance(P<0.05);there was no statistical significance between group A and B(P>0.05). There was no statistical significance in the incidence of ADR among 3 groups (P>0.05). Before treatment,there was no statistical significance in NIHSS,ADL,HADM,SS-QOL score among 3 groups(P>0.05). After 10,28 d of treatment,NIHSS,HADM,SS-QOL score of 3 groups were significantly lower than before, above indexes were decreased gradually as time,and the group C were lower than the group A and B;ADL score of 3 groups were significantly higher than before,this index was increased gradually as time,and the group C were lower than the group A and B with statistical significance (P<0.05);there was no statistical significance between group A and B (P>0.05). CONCLUSIONS:Based on routine treatment,paroxetine combined with flupentixol melitracen in the treatment of PSMDD can relieve neurologic function injury,improve depression condition and the quality of life without increasing the occurrence of ADR.

Objective To evaluate the prevalence of low back pain in Chinese nurses.Methods We searched PubMed,Springer,OVID,CNKI,Wanfang,and VIP databases for relevant studies.Pooled estimates were summarized by meta-analysis.Results The pooled low back pain prevalence for all studies was 72％(65％～79％).We also obtained the estimates according to different study characteristics,such as working department,seniority,study published year and study quality.Conclusions The incidence of low back pain of Chinese nurses is high.The problem is more serious among nurses working in ICU,the longer the working years,the higher incidence of low back pain.

目的观察中药汽化熏蒸加肩关节运动治疗肩周炎的疗效。方法将128例肩周炎患者分成治疗组68例和对照组60例,前者采用中药汽化热疗加肩关节运动疗法治疗,后者采用口服止痛药加外贴止痛膏治疗。结果治疗组有效率97%,对照组有效率80%,两组间有显著性差异(P<0.05)。结论中药汽化熏蒸加肩关节运动疗法治疗肩周炎可获得明显疗效。

Objective To explore the clinical manifestations and recovery from neuroimaging abnormalities of acute disseminated encephalomyelitis (ADEM),in order to improve the understanding of ADEM.Methods A total of 47 children with ADEM in Department of Neurology,Children′s Hospital of Soochow University were followed up for 1 year.The clinical manifestations,auxiliary examination (especially neuroimaging),treatment and prognosis were analyzed.The recovery conditions from clinical and neuroimaging abnormalities were summarized.Results Among 47 cases,37 cases (78.72%) had prodromic infection history,and 5 cases (10.64%) had the history of vaccination.The clinical manifestations were varied,including 36 cases (76.60%) with somatic discomfort,30 cases (63.83%) with fever,30 cases (63.83%) with disturbance of consciousness,28 cases (59.57%) with epileptic seizure,24 cases (51.06%) with headache and dizziness,22 cases (46.81%) with nausea and vomiting,15 cases (31.91%) with dyskinesia,15 cases (31.91%) with cranial nerve injury,9 cases (19.14%) with incoordination,and 8 cases (17.02%) with mental and behavior disorders.Abnormal lesions presented multiple,asymmetric patchy and large patchy signal image showed by brain magnetic resonance imaging (MRI),and 7 cases (14.89%) involved the spinal cord.All patients received the treatment of Methylprednisolone [15-20 mg/(kg·d)] combined with intravenous gamma globulin (total 2 g/kg,3 to 5 days).The dose of Methylprednisolone gradually decreased after it had been used for 3 days.In the end,it was replaced by an oral administration of Prednisone [1.0-2.0 mg/(kg·d)],and the total treatment period was for 2-3 months.The follow-ups of 47 children with ADEM showed that the MRI lesions of all the children were reduced and the MRI lesions in 4 (8.51%) of them disappeared completely after 0.5 month of follow-up;the lesions disappeared completely in 13 cases (27.66%) after 1 month of follow-up;the lesions disappeared completely in 23 cases (48.94%) after 3 months of follow-up;the lesions disappeared completely in 32 cases (68.09%) after 6 months of follow-up;the lesions disappeared completely in 43 cases (91.49%) after 1 year of follow-up;and finally there were 4 cases (8.51%) with residual lesions.Conclusion The clinical manifestations of children with ADEM are varied.Most children with ADEM have a favorable prognosis.Imaging lesions of 68.09% of the cases completely disappeared after the onset of 6 months.Imaging lesions in 91.49% of the cases completely disa-ppeared at the onset of 1 year.Only a small fraction of patients present permanent lesions.

Objective To investigate the prevalence of year-round respiratory viral infection in children with lower respiratory tract infection (LRTI), and the relationship between respiratory viral infection and allergen sensitization in exacerbating asthma. Methods A total of 231 hospitalized children with acute LRTI were investigated from May 2013 to April 2014. The 5 most common respiratory viruses were isolated from nasopharyngeal aspirate using multiplex reverse transcription-polymerase chain reaction, including respiratory syncytial virus (RSV), adenovirus (AV), parainfluenza virus (PIV), influenza virus (IFV) and rhinovirus (RV). Atopic sensitization was defined if more than 1 serum specific immunoglobulin E level measured using immunofluorescence experiment was over 0.35 IU/mL. Results RSV was the most common pathogen of bronchiolitis in hospitalized children through the year. RV or IFV infections were more prevalent in asthma exacerbations compared to other LRTIs. AV was more likely to cause pneumonia. RV and IFV were associated with asthma exacerbations in children with atopic sensitization, but not in nonatopic children. Conclusion RV and IFV are associated with hospitalization for asthma exacerbation in children with atopic sensitization.

Objective To report secondary paroxysmal sympathetic hyperactivity in a patient with tuberculous meningitis and to review the diagnostic criteria, clinical features, possible pathogenesis and management of this condition. Methods The clinical data of a case with paroxysmal sympathetic hyperactivity secondary to tuberculous meningitis was retrospectively analyzed and related literature was reviewed. Results A 1-year-old boy was admitted to our institute with a history of lethargy and vomiting for 3 days. Neurological examination revealed abnormalities. A lumbar puncture revealed the evidence of meningitis. PPD test, T-SPOT.TB and radiological examination revealed tuberculous meningitis. Later, when stayed in the intensive care unit, he developed paroxysmal hypertension, sinus tachycardia, tachypnea, dystonia, and high fever. These episodes improved after administration of propranolol, benzodiazepines and artane. Conclusions Paroxysmal sympathetic hyperactivity is a rare manifestation of tuberculous meningitis, early recognition is very important for avoid misdiagnosis and overtreatment.

Objective To identify the risk factors for severe acute lower respiratory infections (ALRI) in children and to provide scientific basis for prevention and treatment of ALRI. Methods Several databases including Pubmed, Databases-Medline (Ovid), Embase, CINAHL and Global Health Library, CNKI, VIP and Wanfang Date were searched (1990.1-2014.12) for references. All selected studies were about risk factors of ALRI in children. The screening and quality evalua? tion of the literature data was conducted independently by two reviewers according to the inclusion and exclusion criteria. Stata 11.0 software was used for Meta-analysis. Results Meta-analysis of 27 included literature showed that seven risk fac?tors were significantly associated with severe ALRI:low birth weight, lack of exclusive breastfeeding, crowded household, ex?posure to indoor air pollution, malnutrition, living in a house with smokers or smoking in pregnant and HIV-exposed unin?fected condition. Conclusion The above seven risk factors play the important role in the development of ALRI in children. Furthermore, it emphasizes the need for further studies investigating other potential risk factors to decrease the possibility of childhood ALRI.

BACKGROUND:There are two types of epithelial stem cells in the ocular surface tissue:corneal epithelial stem cells and conjunctival epithelial stem cells. The corneal epithelial stem cells play an important role in renewal of corneal epithelial cells and maintenance of corneal transparency.
OBJECTIVE:To study the location of corneal epithelial stem cells using laser in vivo confocal microscopy and immunofluorescent staining.
METHODS:Patients with unilateral limbal stem celldeficiency who went to Henan Eye Institute from September 2009 to September 2012 were enrol ed in this study. Bilateral eyes were scanned by laser in vivo confocal microscopy, and the healthy eye was imaged as a control. The central cornea and limbus were scanned and images were recorded for statistical analysis. The eye bal s were obtained from Henan Eye Bank, China. Central cornea and limbus were dissected and embedded in the OCT compound for frozen section and the proper thickness of the section was 5-7μm. Immunofluorescent staining was used to detect the expression of p63, ABCG2, K3 and Connexin 43 in the epithelial layers of central cornea and limbus.
RESULTS AND CONCLUSION:Twenty-four patients diagnosed with unilateral limbal stem celldeficiency were recruited. Under confocal microscopy, in the affected eyes, the typical morphology of conjunctival epithelial cells and goblet cells was detected instead of corneal epithelial cells;in the limbus, a great amount of fiber scarring tissue was detected instead of Vogt palisade, rete pegs and pigment cells. Immunofluorescent staining showed the expression of p63, ABCG2 was mainly in the basal layer of limbal epithelium, especial y in the outer and middle parts, but the expression of p63 and ABCG2 was not detected in the epithelial celllayers of central cornea. K3 and Connexin43 were not expressed in suprabasal layers of limbal epithelium, but in central cornea, they were expressed highly in the whole epithelial celllayers. Laser in vivo confocal microscopy and immunofluorescent staining showed the corneal epithelial stem cells were located in the basal layer of outer and middle limbal epithelium, mainly in Vogt palisade and rete pegs.