Objective To explore the evidence of the hypophysis,pituitary gland danger advertises for the elephant and the reasonable treatment measure.Methods The clinical characteristics,misdiagnosis reason of the dangerous evidence in 35 hypophysis were retrospeceively analyzed.Results Only 11 cases were finally diagnosed in one year after onset of illness(31.8%).The misdiagnosis rate amounted to 68.2%.With the alimentary canal symptom the leader hair was 91.4%,32 cases.Do not adjust for the menses the next in order,anemia etc.3 cases had the central myelin sheath in the bridge of tapetum fuses,4 cases had organ dysfunction,4 cases dieds.Conclusion To sufferer who infurs big issue of blood in postpartum history on the appearence of the alimentary canal symptom,low serum natrium,hypoglycemia or hypotensions the evidence of the hypophysis,pituitary gland danger possibility should be watched out,on time proceed the relevant check,treatment as early as possible,can reduce the misdiagnosis rate and death rate.

Objective To observe the clinical efficacy of recombinant human endostatin (endostar)combined with intravenous chemotherapy and intraperitoneal hyperthermic perfusion chemotherapy for advanced ovarian cancer (AOC).Methods Sixty-one patients with AOC were divided into treatment group (31 cases) and control group (30 cases) by table of random digit.The treatment group was given endostar +TP project (paclitaxel intravenous chemotherapy + cisplatin intraperitoneal hyperthermic perfusion chemotherapy).The control group was given endostar + TP project (paclitaxel and cisplatin intravenous chemotherapy).The recurrence rate,survival rate,improvement of quality of life (QOL) and drug side effects were observed in two groups.Results The improvement rate of QOL in treatment group was significantly higher than that in control group [64.5％(20/31) vs.33.3％(10/30),x2 =5.931,P=0.015].The 1-year and 2-year recurrence rate in treatment group were significantly lower than those in control group [17.2％(5/29)vs.41.4％(12/29),34.5％(10/29) vs.62.1％(18/29),P=0.043 and 0.036].The 1-year and 2-year survival rate in treatment group were significantly higher than those in control group [93.1％(27/29) vs.72.4％(21/29),79.3％ (23/29) vs.51.7％ (15/29),P =0.037 and 0.027].The incidence of nausea and vomiting in treatment group was significantly lower than that in control group [67.7％ (21/31) vs.93.3％ (28/30),P =0.012],there was no significant differences in bone marrow suppression,hair loss and liver and renal injury incidence between two groups (P ＞0.05).Conclusion Endostar combined with intravenous chemotherapy and intraperitoneal hyperthermic perfusion chemotherapy for AOC is safe and effective,and can improve patients' QOL,reduce the rate of recurrence and prolong survival time.

Object:To understand the situation of postpartum abuse and postpartum depression Method:This was a community-based face-to-face survey of a representative group of women who had a child aged 6 to 18 months in 32 communities of Tianjin, Liaoning, Henan and Shaanxi provinces between Nov 1, 2001 and February28, 2002 Totally 12044 subjects were found by stratified cluster sampling Results:The incidence of postpartum depression (according to result of Zung's self-rate depression scale for one week assessment during the interview) was 20 9%, while the rate of postpartum abuse was 8 3% Women often suffered abuses with many forms (physical, sexual and emotional maltreatment), and recurrently for a long time Among them, sexual abuse was the most frequent one Multiple logistic regression showed association between abuse and depression Conclusion:The incidences of postpartum depression and postpartum abuse are high Being abused has influence on depression

Objective To investigate the occurrence of cesarean section (CS) among reproductive age women in last thirty years, and explore the factors related to high CS rate. Methods Population proportional to size sampling method was employed in sampling. The sampled women were interviewed face to face. Data were double entered by EPIDATA 2.1 and analyzed by SPSS 11.5. Results The CS rate continuously increase from 0.9% in 1971-1980 to 20.2% in 2001-2002 and the speed is more and more rapid. More and more CSs were required by the women themselves and the rate increased from 19.3% in 1971-1985 to 49.7% in 2001-2002. Logistic regression analysis showed that women who were less than 30, senior high education or above and white-collar or jobless women had more than 8 times of antenatal visits, lived in eastern region and had B-ultrasound exam, were more likely to have caesarean section. Conclusions The caesarean section rate was increasing rapidly in the last thirty years especially after 1990. There are two reasons for this increase, on one hand caesa- rean sections with medical indications increase because of the progress of perinatal care and related technology; on the other hand unnecessary caesarean sections increase because of some social and demographic factors, which result in more caesarean section required by the pregnant women.

Objective To investigate the influence of early rehabilitation and defibrase on the hemodynamic cerebral vascular dynamic index (CVDI) of hemiplegic patients with acute cerebral infarction. Methods Ninety hemiplegic patients with acute infarction were randomly divided into a rehabilitation and a control group. Both groups received defibrase routine treatment. The rehabilitation group received systematic rehabilitation training in addition. The Fugl-Meyer assessment ( FMA) , the Scandinavian Scoring Scale ( SSS) and Barthel's index ( MBI) were employed to evaluate the functioning of the two groups. The CVDIs of all patients were quantified before and after treatment. Results The FMA, MBI and SSS scores as well as the CVDIs of both groups had improved after 4 weeks of treatment, but all were more improved in the rehabilitation group than in the control group. Conclusions Early rehabilitation was effective for relieving neurological impairment and improving ability in the activities of daily living for patients with acute cerebral infarction.

objective To investigate the recurrence of stroke,clinical prognosis and vascular changes in patients with ischemic stroke due to middle cerebral artery stenosis. Methods The ischemic stroke patients with symptomatic middle cerebral artery stenosis were enrolled continuously and followed up prospectively for six months. The recurrence of ipsilateral stroke,clinical prognosis and dynamic changes of vessels were analyzed. Results Eighty patients were included,and 20.0% of the patients(16 cases)presented with recurrence of ipsilateral ischemic stroke and 56 cases (70.0%)with a good outcome(modified Rankin scale[mRS]≤1)during the 6 months follow-up;38.6% patients (27 cases) presented with significant vascular changes with progression in 12 cases (17.1%)and regression in 15 cases (21.4%). Conclusion The patients with simple symptomatic middle cerebral artery stenosis have an high rate recurrence of ipsilateral stroke but have good prognosis;Lesioned artery of the majority of patients in the short period after stroke was stable,but vascular stenosis in some patients could appear progression or remission.

Objective To explore the clinical significance of Downes score in predicting respiratory failure (RF) in term neonates.Methods From June 1, 2011 to December 31, 2013, 243 hospitalized term neonates with dyspnea, who were born at 37 to 42 gestational age and admitted to the hospital within 24 h after birth, were selected from Neonatal Medical Center of Huai'an Maternity and Child Healthcare.Downes scores were evaluated based on five indicators including respiratory rate, skin color, three depressions sign, moaning and lung breath sounds at the time of admission.RF was diagnosed based on clinical menifestations and radial arterial blood gas analysis.Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of Downes score on RF.Results The average Downes score of the 243 cases was 6.57±0.86 and the RF rate was 69.6％ (169/243).The RF rate was 93.4％ (169/181) when Downes score ≥ 4.5, with the sensitivity, specificity, misdiagnostic rate and missed diagnositic rate of 100.0％, 83.8％, 16.2％ and 0.0％, respectively.While, the RF rate was 80.7％ (130/161) when Downes score ≥ 5.5, with the sensitivity, specificity, misdiagnostic rate and missed diagnositic rate of 76.9％, 58.1％, 41.9％ and 23.1％, respectively.When Downes score ≥ 6.5, the incidence of RF was 97.6％ (123/126), with the sensitivity, specificity, misdiagnositic rate and missed diagnositic rate of 72.8％, 95.9％, 4.1％ and 27.2％, respectively.The cutoff value was 6.5 according to the Youden Index, which with lower rate of misdiagnosis and missed diagnosis.When Downes score ≥ 7.5, the incidence of RF was 100.0％(22/22), with the sensitivity, specificity, misdiagnositic rate and missed diagnosis rate of 13.1％, 100.0％, 0.0％ and 87.0％, respectively.The area under the ROC curve was 0.906 (95％CI: 0.866-0.955).The higher the Downes score, the greater the possibility of RF (P=0.000).Conclusions Dynamic Downes scores in term neonates with dyspnea could predict the risk of RF.The higher the Downes score, the greater the possibility of RF.

To predict and identify the dominant B‐cell epitopes of conserved region of Treponema pallidum repeat protein F (TprFN ) and provide the basis for development of polyvalent epitope‐based syphilis vaccine ,the amino acid sequence of TprFN was obtained from GenBank and analyzed with comprehensive meta‐analysis Mobyle ,ABCpred and IEDB online software .The peptides containing predicted epitopes were artificially synthesized . To obtain and measure the titers of antibodies against TprFN ,New Zealand rabbits were immunized with recombinant protein TprFN expressed in E .coli and identified by Western blot (WB) .Sera from TprFN‐immunized rabbits ,syphilis patients ,and normal human and normal rabbits were used to deter‐mine the immunoreactivity and specificity of 7 predicted peptides of TpFN by indirect ELISA .Comprehensive meta‐analysis of online software showed that P1 (43‐62AA) ,P2(57‐71AA) ,P3(81‐88AA) ,P4(89‐103AA) ,P5(125‐138AA) ,P6(231‐251AA) and P7(268‐279AA) might be the B‐cell epitopes .A protein was expressed in a soluble form and identified as TpFN by WB .The ELISA indicated that P1 and P3 were active with TprFN‐immunized rabbit sera and syphilis patient sera but not with negative control sera .These results indicate that P1 and P3 are the potential dominant B‐cell epitopes .

Objective To reduce the incidence of the hypocapnia,the cutoff value of the end-tidal carbon dioxide partial pressure[Pet(CO2)] for predicting the hypocapnia so as to understand the suitable adjustment target and target range of the Pet(CO2) in preterm infants under mechanical ventilation.Methods From Jan.2012 to Oct.2013,96 cases of the preterm infants with respiratory distress syndrome(RDS) who needed mechanical support were selected from the Huaian Maternity and Child Health Care Hospital.Pet(CO2) value of each time point(1 h,24 h,48 h and 72 h after mechanical ventilation) were recorded,while radial artery blood was collected for blood gas analysis.The level of pa (CO2) ＜ 35 mmHg(1 mmHg =0.133 kPa) diagnosed hypocapnia;while the level of Pa (CO2) ＞ 60 mmHg was for diagnosing hypercapnia.The diagnostic cutoff and the suitable adjustment target and adjustment target range of the Pet(CO2) were confirmed by receiver operating characteristic (ROC) curve.Results The data from 381 arterial blood gas analysis results were gained,of which 151 times belonged to hypocapnia,and the rate was 39.6％,the other 230 cases were normal,and no case was of hypercapnia.The area under the ROC curve was 0.895,and the area of the standard error was 0.016.There was a statistical significance in Pet(CO2) value for the diagnosis of hypocapnia(P =0.000).The lower the value of Pet (CO2),the greater the likelihood of hypocapnia,and 95 ％ confidence interval area was 0.864-0.926.The Pet (CO2) optimal diagnostic cutoff value determined in accordance with Youden index was 30.5 mmHg.When Pet (CO2) among 41.5 mmHg,sensitivity was 100％.Conclusions Diagnostic cutoff value for forecasting hypocapnia is 30.5 mmHg.The suitable adjustment target of mechanical ventilation parameter adjustment is 41.5 mmHg for the Pet(CO2).The target range of mechanical ventilation parameter adjustment is 30.6-41.5 mmHg for the Pet(CO2).