Objective To compare the clinical effects of different labor induction methods in the termination of intermediate pathological pregnancy. Methods From January 2015 to December 2016,ninety?two cases of intermediate ( 11-16 weeks ) pathological pregnancy were treated in Huangyan Hospital of Wenzhou Medical University. The patients were treated with different intermediate labor induction program to terminate their pregnancy. Among them,29 cases were treated with mifepristone combined with water bag abortion ( group A) ,47 patients with mifepristone and misoprostol induction( group B) ,16 cases with single rivanol ( group C) . The successful rate of labor induction and the labor induction related indexes ( the onset time of contraction,the total duration of labor,the total amount of bleeding in the hospital,the volume of bleeding in the perioperative period) , the rate of postpartum re?curettage and the adverse events after birth of the two groups were compared. Results The successful rates of labor induction in the three groups were 93. 10% (27/29),100%(47/47) and 87. 50% (14/16) respectively,the difference among the groups was statistically significant (χ2=8. 502,P<0. 05). The onset time in group A was (4. 61±2. 15) h,in group B it was (3. 68±2. 10) h,in group C it was (5. 85±2. 30) h,the difference among the 3 groups was statistically significant (F=6. 05,P =0. 025). The total duration of labor in group A was (10. 45±3. 21) h,in group B was (7. 50±3. 40) h,in group C was (14. 60±4. 89) h,the difference among the 3 groups was statistically significant (F=7. 48,P =0. 013). The total hospitalization time in group A was (4. 70 + 2. 33) d,in group B was (2. 80±1. 7) d,in group C was (6. 05±2. 50) d,the difference among the 3 groups was statistically significant (F=10. 23,P =0. 011). The perioperative bleeding volume in group A,B,C were (64. 88±20. 50) ml,(40. 10±15. 26) ml,(91. 50±31. 73) ml,respectively,the difference was statistically significant (F=8. 70,P=0. 020). The rate of postpartum re?curettage in group A was 7 cases (24. 10%),in group B was 6 cases (12. 80%),in the group C was 9 cases ( 56. 30%) ,the difference was statistically significant (χ2=20. 40,P=0. 003) . The incidence of adverse events in group A and group B were all 0,and in the group C,it was 3 cases ( 18. 75%) ,the difference was statistically significant (χ^2= 40. 00, P<0. 001 ) . Conclusion The pathological pregnancy should be terminated by induction of mifepristone combined with misoprostol, the operation is simple, safe and effective, and the implementation is feasible in the outpatient operation room of obstetrics and gynecology department.

Objective To analyze the epidemiological characteristics of measles in the floating population in Daxing District from 2002 to 2015 and to provide a specific guidance for the control and preven-tion of measles. Methods The epidemiological characteristics of measles in the floating population in Dax-ing District were analyzed based on the data collected from Diseases Reporting Information System and Ques-tionnaires for measles cases. Results A total of 1 263 measles cases were reported in the floating population in Daxing District from 2002 to 2015, accounting for 73. 09% of all reported cases in that area. Among the 1 263 measles cases, 1 027 cases (81. 31%) were reported from March to June. The top 5 towns with high incidence of measles were Huangcun, Jiugong, Xihongmen, Yizhuang and Yinghai, from which 80. 29% of measles cases were reported. Age distribution of the measles cases showed that 145 cases were children younger than 8 months, 412 cases were children aged 8 months to 14 years old and the rest 706 cases were a-bove 14 years old. And of all cases, only 224 cases had measles vaccine immunization history. Conclusion It is necessary to maintain the high vaccination rate of 3 doses of measles vaccine by multi-approaches and increase the immunization rate in migrant workers. Moreover, strengthen the surveillance for measles is also an effective way for measles control and elimination.

In this study, the formulation and preparation process of curcumin nanocrystalline injection were optimized to improve curcumin dissolution rate and bioavailability in vivo.Media grinding method was used to prepare curcumin nanocrystals, and the particle size was used as the evaluation index.The Box-Behnken experimental design was used to optimize its formulation and preparation process, and to characterize its physical and chemical properties.In addition, the dissolution of nanocrystal with different particle sizes was investigated by the paddle method, and the pharmacokinetics in rats were studied.The experimental results showed that the optimal formula and process were obtained through Box-Behnken experimental design, and that uniform curcumin nanocrystals with an average particle size of 223.1 nm were obtained.The results of X-ray diffraction and differential scanning calorimetry analysis showed that the crystal form was stable during the preparation of nanocrystals. In vitro dissolution experiments with different particle sizes showed that the dissolution rate and the degree of dissolution would increase if the particle size was smaller.Pharmacokinetic studies in rats showed that cmax and AUC0-∞ of curcumin nanocrystal injection were 4.9 and 4.1 times that of curcumin raw materials, respectively.In summary, the curcumin nanocrystal injection developed in this research have a stable preparation process and can significantly improve the dissolution rate and bioavailability of the drug, which provides some ideas for the research on curcumin preparation.

Objective To explore the effects of Shaoyao Gancao granule on hair growth,behavior,and the hypothalamic pituitary adrenal(HPA)axis in mice with alopecia areata(AA).Methods Forty-two C3H/HeJ mice were randomly divided into control,model,Shaoyao Gancao granule high-,middle-,low-dose,corticotropin-releasing hormone receptor 1(CRHR1)antagonist,and compound glycyrrhizin tablet(CGT)groups.Photography,dermoscopy,weight analysis,and behavioral measurement were performed.Corticotropin-releasing hormone(CRH),adrenocorticotropic hormone(ACTH),cortisol,glucocorticoid receptor(GR),and brain-derived neurotrophic factor(BDNF)were also assessed.Results Compared with the model group,high-dose Shaoyao Gancao granules improve hair regeneration and weight gain(P＜0.05),increased the percentage of total exercise distance and central area exercise distance in an open field test(P＜0.05),reduced the immobility time in the forced swimming and tail suspension experiments(P＜0.05),reduced peripheral blood levels of CRH,ACTH,and cortisol(P＜0.05),and increased expression of GR and BDNF in the hippocampus(P＜0.05).Conclusions Shaoyao Gancao granule promotes hair growth and improves behavioral performance in mice with AA.These effects may be related to downregulating CRH,ACTH,and cortisol expression,upregulating GR and BDNF expression,and inhibiting excessive activation of the HPA axis.

This study preliminarily discussed the TCM syndrome types of myasthenia gravis (or flaccidity) and its treatments and prescriptions through consensus method,providing evidence and level revision of the recommended expert consensus of myasthenia gravis in TCM clinical practice guideline.Literatures over TCM syndrome types,symptoms,therapeutic regime,medication and acupuncture were involved in the syndrome analysis of myasthenia gravis through literature retrieval.The common clinical syndromes were outputted by mentioned rate.Ten first-rate hospitals were finally included,such as The Affiliated Hospital of Changchun University of Traditional Chinese Medicine,Dongfang Hospital of Beijing University of Chinese Medicine,Guangdong Province Traditional Chinese Medical Hospital and Affiliated Hospital of Anhui University of Traditional Chinese Medicine.Twelve experts in aggregate were confirmed to participate in the discussion for the identification of the TCM syndrome types,treatments and prescriptions of myasthenia gravis.As a result,five TCM syndrome types,such as syndrome of spleen and stomach qi deficiency,syndrome of spleen-kidney deficiency,deficiency syndrome of both qi and yin,syndrome of deficiency and sinking of qi,were confirmed;while five therapeutic regimes were approved,including reinforcement of qi,tonification of spleen and stomach,tonification of spleen and kidney qi,tonification of qi and yin,the supplement of qi and restoration of yang for ascending qi collapse.In addition,five prescriptions were supported by the experts,such as Bu Zhong Yi Qi (BZYQ) decoction,BZYQ decoction combined with You Gui pills,BZYQ decoction combined with Sheng Mai powders and Sheng Xian decoction.In conclusion,the expert consensus method for the screen of TCM syndrome types of myasthenia gravis embodied the conception of literature research based on the clinical practice combined with the scientific methods in conformity with the current research approaches to TCM syndrome types.

Objective To study the nursing effect of temporary ballon occlusion of the abdominal aorta in the treatment of pernicious placenta previa and placenta accrete. Methods Nursing points and experience of 126 cases of pernicious placenta previa and placenta accreta using temporary ballon occlusion of the abdominal aorta to prevent intraoperative bleeding in caesarean section were retrospectively summarized. This paper introduced the method, safety and superiority of the way of temporary ballon occlusion of the abdominal aorta, and the method of nursing care of patients with temporary ballon occlusion of the abdominal aorta, and the methods of the observation and prevention of postoperative bleeding and the nursing of pain. Results Totally 126 patients successfully achieved hemostasis, no hysterectomy occurred. Conclusions Through effective nursing of temporary ballon occlusion of the abdominal aorta in the treatment of pernicious placenta previa and placenta accrete, the postpartum hemorrhage, blood transfusion and the risk of hysterectomy can be reduced.

OBJECTIVE: To explore the clinical and genetic characteristics of a child with MEGDEL syndrome. METHODS: Clinical data of the child was reviewed. Peripheral blood samples of the child and his parents were collected. Mitochondrial genome and the whole exome of the child were analyzed by next-generation sequencing. Candidate variants and its origin were verified by Sanger sequencing and fluorescence quantitative PCR. RESULTS: The patient, a 2-year-and-6-month-old male, has featured hypoglycemia, mental and motor retardation with regression. Cranial MRI showed bilateral putamen damage suggestive of Leigh syndrome. Testing of urine organic acid indicated that the level of 3-methylpentenoic acid was slightly increased. Whole exome sequencing revealed that the child has harbored heterozygous deletion of exons 6 to 17 and c.307A>T nonsense variant of the SERAC1 gene, which were respectively inherited from his parents who were asymptomatic. Treatment with Levocarnitine, vitamin B1, vitamin B2, coenzyme Q10, baclofen and glucuronolactone resulted in improvement of sleep and mental state. CONCLUSION A case of MEGDEL syndrome without deafness was diagnosed. Discovery of the nonsense mutation and large fragment deletion have enriched the spectrum of SERAC1 gene variants.
Child, Preschool ; Hearing Loss, Sensorineural/genetics* ; Humans ; Leigh Disease ; Male ; Metabolism, Inborn Errors/genetics* ; Molecular Biology ; Mutation

Objective To investigate the application effects of information primary care quality control in obstetric ward so as to improve the nursing quality and provide better service.Methods The content of the information nursing quality control was revised by nursing department. Management measures of information primary care quality control were established and implemented.Results Through practice, the rate of nursing quality indexes, satisfaction rate of nursing service and satisfaction rate of nurses to quality control of nursing were improved (P<0.05).Conclusions The establishment of information primary care quality control system ensures the real-time and objectivity of nursing quality control and improves satisfaction and enthusiasm of nurses, thus effectively improves nursing quality and satisfaction of patients.

Objective:To explore the effects of nurse as standardized patient (NSP) in clinical apprenticeship and objective structured clinical examination (OSCE) of psychiatric nursing.Methods:Totally 260 undergraduate nursing students admitted to the School of Nursing of a medical university in 2017 were selected into experimental group, who were taught in combination of real patients and NSP, and received assessment of clinical apprenticeship skills through OSCE involving NSP. Totally 286 undergraduate nursing students admitted in 2016 were selected into control group, who received conventional clinical apprenticeship teaching and assessment. The discrimination and difficulty of the assessment of the experimental group was considered, and the test scores, the degree of recognition of the assessment form by the nursing students, and the ability of critical thinking were compared between the two groups.Results:Totally 247 nursing students in the experimental group and 280 in the control group completed the study. The degree of difficulty and discrimination met the assessment requirements. There was a statistically significant difference in apprenticeship performance between the two groups ( P<0.01) . After OSCE, the recognition scores of the two groups for OSCE were (3.22±0.64) and (4.17±0.58) , respectively, and the difference was statistically significant ( P<0.01) . The total scores of Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) of the two groups were (278.29±25.66) and (289.53±35.43) , respectively, and the difference was statistically significant ( P<0.01) . There were statistically significant differences in the scores of CTDI-CV in 4 dimensions between the two groups, they are open-mindedness, analytical ability, systematic ability and self-confidence ( P<0.05) . Conclusions:The NSP-based clinical apprenticeship and OSCE for psychiatric nursing is feasible and practical, which can improve students' critical thinking ability, and is worth referencing and promoting.

Objective To investigate the clinical outcomes of hemiarthroplasty with Wagner SL prosthesis in treating failed internal fixation of intertrochanteric fractures of elderly patients.Methods Aretrospective case series study was conducted on the clinical data of 14 patients with failed internal fixation of intertrochanteric fractures admitted between March 2015 to April 2018.There were seven males and seven females with a mean age of 82.2 years (range,75-94 years).The primary internal fixators were proximal femoral nail anti rotation in nine patients,dynamic hip screw in three patients,and proximal femoral locking plate in two patients.The main causes of internal fixation failure were screw loosening in six patients,cutting out of screws in five patients,nonunion in two patients,and plate breakage with nonunion in one patient.Affected limb shortening and coxa varus deformity to various degrees were seen in all the patients before operation.The mean interval from internal fixation to hemiarthroplasty was 6.6 months (range,2-12 months).All patients received hemiarthroplasty using Wagner SL prosthesis,of which nine patients had additional trochanter claw plate with titanium cable fixation and two patients had tension band wire fixation.The operation time,intraoperative,and postoperative complications were recorded.Harris hip scores were measured before operation and at the last follow up to evaluate hip function.Radiographs were performed to assess the fracture healing,prosthesis position,and biological fixation.Results All patients were followed up for 6-30 months (mean,14.5 months).The mean operation time was (108.0 ± 12.4) minutes (range,88-130 minutes).No iatrogenic fracture occurred during the operation.One patient was seen contralateral intertrochanteric fracture during follow-up,and no complications such as periprosthetic fracture,prosthetic sinking,and infection occurred in the 13 patients.The Harris score increased from (26.1-±7.5)points before operation to (83.1 ±4.1)points after operation (P ＜ 0.01).All patients were able to stand and walk,of which four needed crutch assistance.At the last follow-up,X-ray film showed that the prosthesis was well positioned and that all of them reached bony fixation.Fourteen cases of greater trochanteric fracture were healed,with two cases of slight displacement.Conclusions Hemiarthroplasty is an effective remedial treatment for failed internal fixation of intertrochanteric fractures in the elderly,which can improve hip function and enhance the life quality of patients.Wagner SL prosthesis can obtain stable fixation.