Objective To study the effect of non-invasive low frequency nerve and muscle stimulator on labor analgesia. Methods Four hundred primigravida in our hospital were randomized into the control and observation group in equal number:The deliveries of the former group were accompanied with full-process Doula and those of the latter with Doula-assisted analgesia besides Doula accompany.The two groups were compared in terms of analgesic effect,labor progress,delivery method,post-partum hemorrhage and neonatal conditions. Results The observation group was significantly better than the control group in terms of analgesic effect,active phase,total labor and spontaneous delivery(all P<0.05).There was no significant difference between them in occurrence of neonatal asphyxia and hemorrhage 2h after labor(both P>0.05). Conclusion Doula-assisted analgesia plus Doula accompany for the full labor process is effective for alleviating labor pains,accelerating labor process and spontaneous delivery.

Objective To explore the effect of spa with free position on parturition of primipara.Methods One hundred and thirty-eight primiparas were equally randomized into control group and observation group. The control group conducted Doula delivery,which means a delivery at recumbent or semi-recumbent position when mouth of the uterus opened by 3 cm and the primiparas in the observation group took free position with spa based on Doula delivery. The two groups were compared in terms of the durations of each labor and total labor, postpartum bleeding 2 h after delivery and neonatal Apgar score,delivery way,pains,anxiety and feeling of control at delivery.Results The postpartum bleeding in the observation group was significantly lower than that in the control group(P<0.05). The durations of first labor, second labor and total labor in the observation group were all significantly shorter than those of the control. The degrees of pain and anxiety were lower than those of the control group,while the control sense at delivery was better than that of the control group(P<0.05,for all). There were no differences in the rate of spontaneous delivery,the rate of uterine-incision delivery,the rate of episiotomy and scores on 1 min Apgar scales(P>0.05).Conclusion Aided delivery by spa with free position can reduce labor pain and anxiety levels,improve the birth control and comfort and ultimately enhance the sense of delivery control and comfort.

OBJECTIVE To analyze the epidemiological characteristics,the efficiency of the surveillance system for nosocomial infections in our hospital,the sensitivity,specificity and timeliness of case reporting and to evaluate the efficiencies of the monitoring and reporting system.METHODS We reviewed the nosocomial infection reporting data in the year of 2005 and identified all the reported cases,confirmed cases and under-reported cases.Sensitivity and specificity of the reporting system were calculated based on these data.RESULTS The incidence of nosocomial infection was 3.04% in 2005.A majority(72.07%) of the cases were reported within 7 days of occurrence.Respiratory tract infection accounted for 57.75% of all nosocomial infections and was by far the most common site of concern.The rates of false positive reporting ranged from 14-37% and were statistically significantly associated with the sites of the infection(P

Objective To understand the occupational exposure among medical laboratorians in a hospital,and put forward prevention and control measures.Methods Occupational exposure among medical laboratorians in the department of laboratory medicine of a hospital from January 2011 to December 2014 were analyzed statistically.Results A total of 72 cases of occupational exposure occurred among 217 laboratorians during 4 years,occupational exposure rate was 33.18％,the occupational exposure rate in interns was 46.23％,and in laboratorians with working seniority＜ 1 years was 49.56％.Occupational exposure mainly occurred in outpatient blood collection room(accounting for 38.89 ％),the main occupational exposure types were injuries by blood collection needles,skin contaminated by blood and body fluid(76.39 ％).Occupational exposure rates in medical laboratorians in this hospital during 2011-2014 were 53.66％(22/41),41.67％(20/48),26.23％(16/61),and 20.90％(14/67),respectively,which presented a declining tendency(x2 =12.286,P＜0.01).After occupational exposure,only 23 cases were reported according to the requirements of infection management department,the missing report rate was 68.06％ (49/72),correct handling rate was 80.56％ (58/72).Conclusion Laboratorians should strengthen education and training of healthcare-associated infection management,improve safety and prevention consciousness,standardize handling process,improve consciousness of reporting,so as to reduce the occurrence of occupational exposure and post exposure infection.

Objective To investigate the effects of different treatment modes on the prognosis of patients with severe trauma.Methods The general data of 396 patients with severe trauma [injurey severity scores (ISS) ≥25] in our hospital emergency for treatment from January 1,2008 to January 1,2012 was collected.The trauma patients were divided into study group and control group.In the study group,the trauma patients were cared by emergency physician of our hospital for pre-hospital treatment during transportation by ambulance since January 1,2010.In the control group,the trauma patients were served with traditional pre-hospital emergency care by the 120 and 999 before January 1,2010.The injury severity score,medical care and outcomes were recorded in trauma database and the efficiency and quality of medical care were compared between two groups.Results The emergency treatment time,length of hospital stays,ICU admission rate,prehospital mortality rate,long-term (6 months) disability rate,and complication rate in the study group were lower than those in the control group,presenting (78.23 ± 21.57) min vs.(96.45 ± 35.14) min,(23.55±12.46) dvs.(28.67±20.72) d,8.1％ (18/222)vs.65.5％ (114/174),13.3％ (34/256) vs.21.6％ (48/222),4.1％ (9/222)vs.9.2％ (16/174),8.1％ (18/222)vs.18.4％ (32/174),in which the differences were statistically significant (P ＜ 0.05).Hospital mortality in the study group was also lower than that in the control group,showing 8.1％ (18/222) vs.12.6％ (22/174),but there was no statistically significant difference (P ＜ 0.05).There was no significant difference in time from occurrence of injury to receiving treatment between the two groups.Conclusion Emergency physicians-cared mode had advantages to improve treatment success rates and reduce mortality in patients with multiple trauma compared with the current conventional emergency mode.It is a good alternative emergency mode.

Objective To investigate the influencing factors and preventive measures of postoperative wound infection in patients who undergo the aseptic surgery of urinary system.Methods Clinical data of 302 cases of patients underwent the aseptic surgery of the urinary system between January 2011 to May 2013 were reviewed and studied by Logistic regression analysis.Results Wound infection occurred in 17 cases,the incidence of wound infection was 5.6％ among 302 patients in this study.Postoperative wound infection risk factors were open surgery,operative time ≥ 2 h,to replace the drainage bag every one or two days once,and with some other underlying diseases.Conclusions To strengthen the basic disease treatment,select endoscopic operation if the surgery and treatment of disease allowed,shorten the operation time,reduce the number of drainage tube and reduce the frequency of replacement of drainage bag may effectively prevent postoperative wound infection in patients who undergo the aseptic surgery of the urinary system.

Objective To discuss the application effects of CBI teaching method in medical English Teaching of respiration medicine. Methods Dividing 120 students of Grade 2009 in Jining Medical College into two groups including control group (60) and experimental group (60). The tradi-tional teaching method was adopted in the control group and CBI teaching method was adopted in the experimental group. After finishing the courses, medical professional English level test and standard-ized patients test were applied in the two groups. Students' English studying interests and autonomous English learning ability were also investigated by questionnalres. SPSS 17.0 software was used for sta-tistical analysis, and the data were processed by t test and 字2 test, with the level of a test equal to 0.05. Results The medical professional English level test scores, standardized patients test scores and the total average scores of autonomous English learning ability in experimental group were respectively [(81.97±4.91), (80.33±5.85), (3.88±0.38)], and they were significantly higher than those in the control group [(70.40±4.78), (70.48± 4.79), (2.98±0.26), with P values below 0.01]. Satisfaction degrees in the improvement of learning motivation, learning time, learning method, learning attitude and dealing with study difficulties in experimental group were better than those of control group (χ2=13.084, 8.000, 13.297, 11.627, 13.374, P=0.000). Conclusion CBI teaching method is better than traditional teaching method and it transfers English learning into the learning of professional knowledge and skills of respiratory medicine, stirs the interests of students, improves their autonomous English learning ability and strengthens their abilities to learn and apply English language.

Objective To investigate the effect of pentoxifyccine (FIX) on the pathway of high glucosd-induced expression of CTGF in mesangial cells. Methods Cultured rat mesangial celld were used to study the influence of different concentration of high glucose on the expression of TGF-β, CTGF, p-Smad2/3, Smad7 and FN in different exposure time. Furthermore the effect of high glucose plus TGF-β neutral antibody and different concentration of FIX on the obove expression was evaluated as well. Results High glucose could increase TGF-β, CTGF mRNA and protein expression in mesangial cells (P<0.05) in time-and dose-dependent manner, and at the same time p-Smad2/3 expression increased and Smad7 expression decreased (P<0.05).The blockage of TGF-β could decrease high glucose-induced CTGF mRNA and protein expression by 86.4% and 91.8%. PTX could suppress high glucose-induced CTGF expression in mesangial cells. When the PTX dosage increased, the suppressive effect became more remarkable, but PTX had no influence on the TGF-β expression. Conclusions High glucose up-regulates CTGF mRNA and protein expression mainly through TGF-β-Smads pathway. PTX can suppress CTGF expression effectively, but has no direct inhibition of TGF-β expression.

Objective To investigate the current status of type 2 diabetic patients who failed to achieve the glycemic control target, and provide theoretic evidences for making corresponding strategies. Methods The 2 diabetic patients who failed to reach the glycemic target were recruited from 181 hospitals in 26 cities and received a standard questionnaire, the conditions of their blood glucose level, lifestyle intervention, blood sugar monitoring, and drug therapy were recorded. Totally 3 861 questionnaires with complete information were collected. And the causes which account for glycemic control status were analyzed. Results Among these patients, the mean HbA1c was 7.9%, the mean fasting plasma glucose was 8.2 mmol/L, and the mean postprandial plasma glucose was 11.5 mmol/L. Only 25.6% of patients take their diet control strictly as prescribed and 44. 5% of patients have little exercise. 35. 8% and 47.8% of patients did not monitor their fasting and postprandial plasma glucose,respectively. Glycemic control in the patients aged ＞ 60 years was similar to the younger patients, but the hypoglycemia incidence in the elder group reached 35.5%, which was higher than those in the other 2 groups (20.8% and 21.4%, both P＜0. 05 ). The proportion of patients with mono-therapy and combination therapy was 46. 1% and 51.7%, while the proportion with combination therapy rose in the patients aged ＞60 years (58.7%;Compared with the other age-groups, all P＜0.05 ). 75 % of patients have adjusted their drug administration regimen since initial treatment. Conclusions Inadequate or inappropriate drug therapy regimen is a major cause responsible for this poor glycemic control status. In addition, the unhealthy life styles, insufficient blood sugar monitoring, and poor compliance were also important causes. Thus, for these patients, it is necessary to further enhance patients' education, to improve life style intervention, as well as to select more effective, safer, and compliant drug therapy regimens. Finally, the glycemic control target for the elder patients should be more flexible.

Objective To observe the effect of adding on glimepiride in treating type 2 diabetic patients who had suffered the disease for more than 10 years and were poorly controlled with insulin combined with nonsulfonylureas drugs. Methods Seventy-five type 2 diabetic patients poorly controlled with insulin combined with non-sulfonylureas drugs were randomly divided into glimepiride-added group (INS+GM, n = 39 )and continuation of insulin group ( INS, n = 35 ). HbA1c, plasma glucose, daily insulin dose, number of hypoglycemic events, body weight, plasma lipid concentration,and high-sensitive C-reactive protein (hs-CRP)were recorded at weeks 0, 12,and 24. The levels of plasma free fatty acid ( FFA), adiponectin, and tumor necrosis factor-α ( TNF-α ) were measured before and 24 weeks after the therapy. Results At 12 and 24 weeks, fasting blood glucose, 2 h postprandial blood glucose,and HbA1c were improved in INS+GM group more markedly than in INS group, and daily insulin dose and body weight were decreased in INS+GM compared with INS ( P＜0. 05 ). The number of hypoglycemic events and plasma lipid concentration did not differ between two groups ( P＜0.05 ). The levels of plasma FFA,TNF-α,hs-CRP, and HOMA-IR were lower in INS+GM than INS ( P＜0.05 ), the adiponectin was higher in INS + GM than INS ( P ＜ 0.05 ). Conclusion Adding glimepiride to insulin therapy resulted in a sustained better glycemic control with less insulin daily dose, decresed body weight, and no increase in hypoglycemic events as compared with the continuing insulin therapy group. Increased adiponectin, as well as decreased plasma FFA and TNF-α may underlie the improvement of insulin resistance with glimepiride treatment.