Objective To evaluate the effects of pregnancy weight control program based on structure- process- outcome model to improve women′s health status and pregnancy outcomes. Methods On the basis of Donabedian′s structure- process- outcome quality of care model, a pregnancy weight control program designed and carried out for the middle and late pregnancy. The structure, process and outcome of the pregnancy weight control program were evaluated to ensure the quality of the pregnancy weight control program. In addition, the women′s pregnancy outcomes were investigated after intervention. Results the prenatal BMI in the intervention group [ (23.06±1.11) kg/m2 ] were lower than those in the control group [(25.52±1.89) kg/m2 ], and the incidence of cesarean section (including cesarean section without indication), neonatal macrosomia, labor block, neonatal asphyxia, postpartum hemorrhage, pregnancy induced diabetes and hypertension in the intervention group were significantly lower than those in the control group, P<0.01 or 0.05. Conclusion Donabedian′s structure- process- outcome quality of care program is an effective approach to improve women′s pregnancy outcomes.

Objective:To investigate the mechanism of liver and lung injury in mouse septic models.Methods:Twenty-four male Kunming mice were subjected to cecal ligation and puncture(CLP)or sham operation.The permeability of microvasculature,water contents,activities of myeloperoxidase(MPO)and the apoptosis of microvascular endothelial cells in lung microvasculature and liver sinus were examined 3 h and 12 h after operation.Results:Both the liver and lung showed a significant increase in microvessel permeability at 12 h in CLP group compared with sham operation group.MPO activity and water content in CLP group were obviously higher than those in the sham operation group.The apoptosis of lung microvascular endothelial cells at 12 h in CLP group(5.03?0.92)% was significantly higher than that of control group(3.48?1.21)%(P

Objective To evaluate the treatment of hypervascular hepatic metastasis with TACE. Methods One hundred and twenty nine cases of hepatic metastasis treated by TACE were selected retrospectively and then analyzed the survival rate,clinical effectiveness and lipidol deposition quantity in tumor.Results Malformation of tumor vessels and rich blood supply were found in all cases of this study.The survival rates of 6 months,1 year and 3 years were 100%,73.6% and 26.4% respectively.The clinical effective rate was 68.2%(88/129)and no-progress rate was 23.3%(30/129).The satisfactory lipidol deposition quantity was obtained in 80.9%(97/129).Conclusions TACE is a favorable method for hepatic metastasis,and discerning the hypervascular subgroup could improve the treating effectiveness and be useful to make an appropriate planning.

Objective To investigate the characteristics of pathogen distribution and drug resistance of pulmonary infection in hemorrhagic brain injury patients from neurosurgical intensive care unit (NICU).Methods Clinical data of 234 patients with hemorrhagic brain injury hospitalized in NICU from March 2013 to September 2014 were retrospectively analyzed.According to the incidence of pulmonary infection,the patients were divided into pulmonary infection group and non-pulmonary infection group.Parameters estimated were admission GCS,sex,age,history of smoking,time of coma,duration of mechanical ventilation,NICU length of stay.Patients in pulmonary infection group were analyzed on the distribution of pathogens and incidence of drug resistance.Results A total of 158 patients (67.5％) had pulmonary infection.Among them 60 cases (38.6％) were found to be co-infected including infection with two pathogens in 26 cases (16.5％),three pathogens in 19 cases (12.0％),and four and more pathogens in 16 cases (10.1％).Age and smoking increased the incidence of pulmonary infection (P ＜ 0.05).Time of coma,duration of mechanical ventilation,and NICU length of stay were prolonged in pulmonary infection group than in non-pulmonary infection group (P ＜ 0.05).A total of 219 strains of pathogens were isolated from the patients in pulmonary infection group.Specifically,there were 193 strains of gram negative bacteria (88.1％),13 strains of gram positive bacteria (5.9％),and 13 strains of fungi (5.9％).Gram negative were sensitive to amikacin,imipenem,cefoperazone/ sulbactam and ciprofloxacin.Staphylococcus aureus isolated were 100％ sensitive to vancomycin,linezolid and teicoplanin,and were completely penicillin resistant.Fungi were not resistant to voriconazole,itraconazole,ketoconazole,fluconazol,and amphotericin B.Conclusions High incidence of pulmonary infection is noted among the hemorrhagic brain injury patients in NICU,and the pathogens are diverse dominated by Gram negative bacteria.Incidence of multi-drug resistant pulmonary infection is high,indicating that the key point is to choose antibiotics rationally based on drug sensitivity test.

Objective To investigate the effect of social support and childbirth self-efficacy-enhancing intervention on primiparas' childbirth self-efficacy,coping ability and pain during labor.Methods A randomized controlled trial was used with double blindness design.One hundredand six primiparas were recruited as the intervention group and control group,53 cases in each group.The two groups adopted the routine prenatal care.In addition,the intervention group participated in twice childbirth self-efficacy-enhancing educational courses.The Chinese Childbirth Self-Efficacy Inventory (CBSEI) was used to conduct the comparison between before and after intervention;the interventional effects in the natural childbirth pregnant women were compared between the two groups by adopting the Visual Analogue Scale (VAS) and Childbirth Coping Behavior Scale (CCB);the Multidimensional Scale of Perceived Social Support (MSPSS) was adopted to analyze correlation between the social support level with the CBSEI and CCB.Results The intervention group finally had 52 cases of effective sample and the control group had 51 cases of effective sample.The CBSEI score after intervention in the intervention group was 282.04± 27.38,which was higher than 236.69± 45.39 before intervention.The CCB score in the intervention group was 56.78 ± 6.95,which was significantly higher than 48.03 ± 6.26 in thecontrol group,and the VAS score in the intervention group was 6.96 ± 1.39,which was lower than 8.35 ± 1.43 in the control group,the difference was statistically significant(P＜0.01).The MSPSS score in the two groups was positively correlated with the OE score,efficacy expectancy (EE) score and CBSEI score before intervention(r=0.269,0.289,0.317,P＜0.01).Conclusion Launching the childbirth self-efficacy-enhancing educational intervention of the social support system can effectively improve the childbirth self-efficacy and coping ability of primiparas,and reduce the intrapartum pain level.

BACKGROUND: Fish oil is one of mainly natural resources of n-3 fatty acids, which can inhibit cardiac allograft vasculopathy (CAV) and prolong the survival of cardiac allograft. But, the mechanism is unclear. Recent in vitro data suggested that n-3 fatty acids could inhibit the release of inflammatory transmitter by the activation of peroxisome proliferator-activated receptor-y (PPARy). OBJECTIVE: To test the hypothesis that n-3 fatty acids from fish oil ameliorates CAV development via activating PPARy. METHODS: A total of 6 Lewis rats and 18 Fisher344 rats were randomly selected as heart donors. An additional 24 Lewis rats were randomly and equally divided into 4 groups. In isograft group, heart transplantation was performed among Lewis rats, without any drug. In low-dose fish oil-treated group, F344→Lewis transplantation was performed. At 1 day following surgery, 0.03 mL/kg fish oil was treated by gavage for 8 weeks. In high-dose fish oil-treated group, F344→Lewis transplantation was conducted. At 1 day following surgery, 0.06 mL/kg fish oil was treated by gavage for 8 weeks. In control group, F344→Lawis transplantation was conducted. Cyclosporine A was administrated by gavage for 8 weeks. In the low-dose and high-dose fish oil-treated groups, cyclosporine A (1.5 mg/kg) was given daily by intramuscular injection for 2 weeks following surgery. CAV was evaluated by histological examination. Activity of nuclear factor (NF) k-B and PPARy was assessed in homogenate. Contents of monocyte chemoattractant protein-1 and interferon-inducible protein 10 were measured by enzyme-labeled immunosorbent assay (ELISA). Chemokine receptor CCR2 and CXCR3 expression was determined by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR). RESULTS AND CONCLUSION: All 24 receptor Lewis rats were survived following surgery. The donor heart could regularly beat at 8 weeks following transplantation. Compared with the isograft group, severe CAV was detected in the control group al 8 weeks. Compared with the control group, CAV was significantly relieved, the activity of PPARy was significantly elevated, the activity of NF k-B was significantly decreased, levels of intragraft monocyte chemoattractant protein-1 and interferon-inducible protein-10 were significantly reduced in the low-dose and high-dose fish oil-treated groups (P < 0.001, P < 0.05), especially in the high-dose fish oil-treated group (P < 0.05). There was no significant difference in expression of chemokine receptors CXCR3 in the low-dose and high-dose fish oil-treated groups and control group. Our results demonstrated that n-3 fatty acids from fish oil can attenuate CAV development, possibly through activating PPARy and subsequently inhibiting the NF-kB activation, the chemokines secretion and its receptor expression in a dose-dependent fashion in rat models.

Objective To evaluate the short-term and long-term efficacy of interventional therapy for acute hepatic artery thrombosis.Methods We analyzed retrospectively the interventional treatment and long-term follow-up data of 34 patients with acute hepatic artery thrombosis in Zhongshan hospital of Fudan University from March 2003 to October 2015.Results Thirty-four patients with acute hepatic artery thrombosis were performed with urokinase thrombolytic therapy.Twenty-one patients were implanted stents in the thrombolytic therapy.Splenic artery embolization were performed in 3 patient with splenic artery steal syndrome.Technical and clinical success rates were 91％ (31/34).The complication associated with interventional procedures were observed in 2 patients.The patency rates of hepatic artery in 1,2,3 and 5 years were 82％,73％,57％ and 57％ respectively.The median obstruction free time was 94 months.Conclusions Good short-term and long-term effect have been obtained in interventional treatment for acute hepatic artery thrombosis,which can be used as the first treatment for acute hepatic artery thrombosis after liver transplantation.

Objective To investigate the clinic characters and diagnosis of superficial siderosis in the central nervous system (SSCN).Methods One patient was systematically studied by the authors. Results SSCN was a rare entity,resulting in the deposition of ferric pigments and ions on the surface of the central nervous system.The clinical features included progressive sensorineural hearing loss,cerebellar ataxia and pyramidal sign,widespread hypointensity band at surfaces of the cerebral or cerebellar hemispheres,the brain stem and the spinal cord on Gradient Echo T_2~*-weighted images (GRE-T_2~* WI) of MR,elevation of the levels of ferritin in the cerebrospinal fluid.Conclusions This disease can be identified at early stage with history and physical examination.GRE-T_2~* WI and some related cerebrospinal fluid tests will contribute to diagnosis.

Objective To assess the treatment effects of As_2O_3-PLGA microspheres on VX2 rabbits liver tumor models.Methods Thirty-two New Zealand white rabbits were involved with formation of VX2 rabbits liver tumor models,and randomly divided into 4 groups of 8 each.(a)As_2O_3 plus 0.9% NaCl solution group:3 F co-catheter was plugged into hepatic artery,and then As_2O_3(3 mg/kg)plus 10 ml 0.9%NaCl solution was injected into the tumor through the feeding artery;(b)As_2O_3-PLGA microspheres group :As_2O_3- PLGA microspheres(3 mg/kg)was injected into the tumor through the feeding artery;(c)PLGA mierospheres group:Injection of PLGA microspheres(3 mg/kg)injected into the tumor through the feeding artery;(d) control group:0.9% NaCl solution(10 ml)was injected into the feeding artery.Dual phase helical CT scans were performed the day before treatment,20 days after treatment and finally the rabbits were sacrificed.The sizes of the tumor were measured and followed by histopathological analysis and HE staining.Results The volumes of tumors post operatively of group a,b,c and d were(31.08?11.15)cm~3,(3.82?2.537)cm~3, (13.22?4.665)cm~3 and(115.8?62.01)cm~3 respectively.The most significant treatment effect was available in group b,with more coagulation necrosis and fibrotic tissue formation.Statistical analysis indicated that the treatment effects of group a,b,c were better than that of group d with significant difference which can be also seen between group a and b,group b and c.Conclusion As_2O_3-PLGA microspheres shows rather excellent chemoembolization effects on VX2 rabbit liver tumor model with safely.