Objectives To study the roles of Th17 cells in peripheral blood and the serum level of IL-17 in children with acute respiratory syncytial virus (RSV) bronchiolitis. Methods A total of 28 children with RSV bronchiolitis were selected as bronchiolitis group, among whom twelve cases were assigned into severe group and sixteen cases were assigned into mild group according to the severity of illness. Twelve cases with acute asthma were selected as asthma group. Ten children without recent infection waiting for surgery were chosen as controls. The percentage of Th17 cells in peripheral blood was measured by lfow cytometry. The serum level of IL-17 was detected by ELISA. The association of severity of illness with the percentage of Th17 cells and the level of IL-17 was studied in children with acute RSV bronchiolitis. Results The serum level of IL-17 and the percentage of Th17 cells were signiifcantly higher in the severe bronchiolitis group than those in the control group and mild bronchiolitis group (P<0.05). However, there was no signiifcant difference between the severe bronchiolitis group and the asthma group (P>0.05). Conclusions The percentage of Th17 cells and serum level of IL-17 are increased in children with acute RSV bronchiolitis, and may be involved in the pathogenesis of RSV bronchiolitis. (J Clin Pediatr,2013,31(9):850-853)

Objective To discuss the relationship between repetitive variable deceleration with a short interval (RDSI) in labor and neonatal acidosis.Methods One hundred and seventy-seven electronic fetal heart monitoring (EFM) patterns within one hour preceding delivery in term singleton pregnancies were collected in Peking University Third Hospital between February 2011 to October 2013.Continued EFM were recorded before delivery.Analysis was conducted on general information of both mothers and babies,including pregnant complications,duration of labor,cord and placental factors,nature of amniotic fluid,Apgar score and neonatal cord blood gas.RDSI was defined as that over 50％ intervals between two decelerations (the end of the last deceleration to the beginning of the next one) ≤ 60 s which appeared repetitevly in a period of 20 minutes.Independent sample t test,rank sum test,Chi-square test and Fisher's exact test were applied for statistics and receiver operating characteristic curve was obtained from the information of those with RDSI.Results Twenty-four of the 177 women with RDSI were assigned to the study group (24 cases,13.6％) and the rest 153 cases without RDSI to the control group.Background information of women in the two groups was comparable according to the maternal age,gestational weeks at delivery and duration of labor (all P ＞ 0.05).The occurrence of meconium stained amniotic fluid in the study group was higher than that of the control group [16.7％ (4/24) vs 5.2％ (7/153),x2=5.204,P=0.045],while the pH and base excess value of the neonatal blood gas in the study group were lower [7.20 (7.13-7.28) vs 7.29 (7.25-7.33),Z=-4.490;-6.10 (-4.67 to-9.62) mmol/L vs-3.20 (-4.90 to-1.55) mmol/L,Z=-5.044;P ≤ 0.01] resulting a higher rate of neonatal acidosis [50.0％(12/24) vs 7.8％ (12/153),x2=31.456,P ＜ 0.01].No significant difference was found in the incidence of neonatal asphyxia between the two groups.The area under the curve was 0.774 (95％CI:0.579-0.969).Conclusion RDSI in labor might indicate a high risk of neonatal acidosis.

Objective? To explore the effects of interpregancy interval (IPI) on pregnancy outcomes in multiparas with vaginal delivery and to provide a scientific reference for preconception counseling and clinical guidance for women who planned to bear another child. Methods? All the multiparas who labored via vaginal delivery in Peking University Third Hospital between January and December 2016 were selected in this retrospective analysis. The multiparas were divided into three groups based on their IPI. The IPI of the first group was 0-35 months (n=134); The IPI of the second group was 36-71 months (n=274); and the IPI of the third group was≥72 months(n=256). The relationship between IPI and pregnancy complications, comorbidities, labor time, hemorrhage and perinatal outcome was analyzed. SPSS 22.0 was used for statistical analysis. Results? Premature rupture of membranes (PROM) was found in 18 multiparas in the first group, 37 in the second group and 58 in the third group; uterine fibroid was found in 7 multiparas in the first group, 17 in the second group and 31 in the third group; there was statistically significant difference in PROM and the incidence rate of uterine fibroid between the groups with different IPI (χ2=9.379,8.143;P＜0.05); when confounding factors such as the mothers' age were adjusted, the risk of PROM and uterine fibroid continued to rise since the 72nd month of IPI (OR=1.888,2.519;P＜0.05). Conclusions? Longer IPI is associated with the increase in the risk of PROM and uterine fibroid. Pre-pregnancy and pregnancy education should be enhanced to ensure maternal and child health according to the characteristics of multiparas with longer IPI.

Objective:To investigate the factors affecting willingness of pregnant and parturient women for epidural labor analgesia and to provide the basis for further promoting epidural labor analgesia.Methods:Using the convenient sampling method, a total of 225 parturient women who underwent vaginal delivery in Department of Obstetrics in Peking University Third Hospital from March to May 2019 as the research objects. General information questionnaire, Questionnaires on Information Sources of Epidural Labor Analgesia and Suggestions of Medical Staff, Relatives and Friends for Epidural Labor Analgesia and Epidural Labor Analgesia Brief Scale were used to investigate them. A total of 225 questionnaires were distributed and 214 valid questionnaires were returned.Results:Among the 214 parturient women, 106 pregnant women (49.53%) had willingness for epidural labor analgesia. The results of binary Logistic regression analysis showed that gravidity, whether or not epidural labor analgesia was used and belief of epidural labor analgesia were the influencing factors of willingness of pregnant and parturient women for epidural labor analgesia ( P<0.05) . Conclusions:In the future, it is necessary to strengthen the education of medical staff on the professional knowledge of epidural labor analgesia for pregnant women and improve the belief of epidural labor analgesia for pregnant women, so as to further promote epidural labor analgesia.

Objective:To explore the risk factors of postpartum hemorrhage in parturients undergoing vaginal delivery with a second child and establish a risk prediction model.Methods:Using the convenient sampling method, a total of 2 500 parturients undergoing vaginal delivery with a second child who underwent regular prenatal examinations at Peking University Third Hospital from July 2019 to March 2023 were selected as the research objects. According to the amount of blood loss, parturients with blood loss greater than or equal to 500 ml within 24 hours after delivery were selected as the case group ( n=278), while parturients with blood loss less than 500 ml within 24 hours after delivery in the same period were selected as the control group ( n=2 222). Univariate analysis and binomial Logistic regression were used to analyze the influencing factors of postpartum hemorrhage in parturients with vaginal delivery with a second child. Based on the selected risk factors, a nomogram prediction model was established using R software, and the consistency of the model was tested. Results:The incidence of postpartum hemorrhage in 2 500 parturients undergoing vaginal delivery with a second child was 11.12% (278/2 500). Binomial Logistic regression analysis showed that in in vitro fertilization-embryo transfer, pre-delivery body mass index, lateral perineal incision, neonatal weight, placenta previa, placenta implantation and manual extraction of placenta were the influencing factors for postpartum hemorrhage in parturients undergoing vaginal delivery with a second child ( P<0.05). According to the influencing factors, a nomogram model was established to predict the probability of postpartum hemorrhage in women who gave birth to a second child. The C- index of the prediction model was 0.706, the area under the receiver operating characteristic curve was 0.706, and the χ 2 value of the Hosmer-Lemeshow goodness-of-fit test was 7.720 ( P=0.461) . Conclusions:In vitro fertilization embryo transfer, pre-delivery body mass index, perineal lateral resection, neonatal weight, placenta previa, placental implantation and manual extraction of placenta are risk factors for postpartum hemorrhage in parturients undergoing vaginal delivery for a second child. The prediction model constructed based on risk factors has certain accuracy and clinical value for predicting postpartum hemorrhage in parturients with vaginal delivery of a second child.