Objective To learn the current obstetric beds allocation,obstetric service delivery and access in midwifery institutions at various levels in the localities and nationwide as well as the trends,and assess the equity of obstetric beds allocation,for the purpose of recommending on a reasonable adjustment of obstetric beds allocation in these institutions.Methods Random sampling made in 44 cities in China for questionnaire survey on obstetric beds allocation,service delivery and utilization in 2008～2010 at all midwifery institutions in these cities.Interview of health administrators and medical workers at obstetric of midwifery institutions in 6 counties.Results Every thousand square kilometers in China average 5.9 midwifery institutions,and every thousand people average 0.24 obstetric beds.During 2008 ～ 2010,the number of beds and midwifery service delivery kept a growing trend while in townships obstetric service deliveries maintain a falling trend.The fairness index of maternity beds layout nationwide is 0.021283.Obstetric beds supply and demand ratio in different regions ranges among 0.97～ 1.41.The number of deliveries made in county level hospitals is 54.1％,but the beds in such hospitals account for but 48.1％.Conclusion The equity of obstetric beds allocation is good in terms of population layout.The quantity of obstetric beds meets the current needs nationwide,while the allocation of obstetric beds is less than reasonable among obstetric institutions of various levels in the country.The authors recommend a better control and adjustment of midwifery institutions layout,especially more such hospitals at the township level to meet the need of women delivery in hospital in remote areas.

Objective To investigate the effects of compound bifonazole solution for the treatment of superficial mycosis.Methods The study groups were treated with compound bifonazole solution and the control group with clotrimazole solution in a double-blind controlled clinical trial.The solutions were applied to skin lesions once a day.The course of treatment was two weeks for tinea corporis and tinea cruris and four weeks for tinea manus and tinea pedis.The patients were followed up weekly for two weeks after cessation of treatment and evaluated with regard to erythema,papule,blister,scale,keratinization and pruritus.Mycologic examinations were performed before,during and right after treatment and two weeks after treatment.Results A total of434patients participated into the study.The clinical cure rates of study group were82.25%in tinea corporis and tinea cruris,and68.75%tinea manus and tinea pedis,with a total response rates of95.85%and92.5%in tinea corporis and tinea cruris,and92.5%in tinea manus and tinea pedis,respectively.The clinical cure rates of control group were58.6%in tinea corporis and tinea cruris,and44.7%in tinea manus and tinea pedis,with a total response rates of83.0%and87.2%in tinea corporis and tinea cruris,and in tinea manus and tinea pedis,respectively.The MICs to350clinical isolates of pathogenic fungi were1.6~2.5mg/L for compound bifonazole solution,and3.125~25mg/L for clotrimazole solution.Conclusions Compound bifonazole solution is a high-effective,broad-spectrum anti-fungal agent.It is keratolytic,well permeable and safe for relatively long term application.

ObjectiveTo investigate the role of active protein C (APC) in lipopolysaccharide (LPS) induced microglia activation.MethodsMicroglia from one day old Sprague-Dawley newborn rat was collected, purified and identified by primary culture and immunofluorescence staining, and then was randomly divided into four groups including LPS group (1.0μg/ml LPS plus 10μl phosphate buffered saline 12 h later), LPS+ APC group (1.0μg/ml LPS plus 0.1μg/ml APC 12 h later), APC group (10μl phosphate buffered saline plus 0.1μg/ml APC 12 h later) and control group (10μl phosphate buffered saline at each time point). The morphology of micaroglia in all groups was observed under microscope, and the expression of tumor necrosis factor-α (TNF-α) and protease-activated receptor-1 (PAR-1) were determined by immunofluorescence staining. One-way analysis of variance and LSD test were applied for statistical analysis.ResultsPrimary culture microglia was successful and the purity was no less than 99%. In LPS group, the microglia morphology was activated, and the expression of TNF-α was increased significantly than the control group (2.11±0.35 vs 1.38±0.28, LSD test,P=0.002). In LPS+APC group, the microglia morphological change was reversed, and the expression of TNF-α had no significant difference with the control group (1.35±0.36 vs 1.38±0.28, LSD test,P>0.05). The expression of PAR-1 in LPS+APC group was higher comparing with that in the control group (4.60±0.84 vs 2.64±0.41, LSD test,P=0.008) and the LPS group (2.44±0.86, LSD test,P=0.002). The expression of PAR-1 in APC group and LPS group had no obvious difference with control group (2.62±0.69, 2.44±0.86 vs 2.64±0.41, LSD test, bothP>0.05).ConclusionsBy increasing the level of PAR-1 in microglia, active protein C could inhibit the activation of miciroglia and the expression of TNF-α induced by lipopolysaccharide, therefore, protecting the brain tissues from inflammation-induced damage.

Objective To explore the clinical effects of aortic valvuloplasty in treatment of ventricular septal defect(VSD)with moderate or severe aortic valve insufficiency(AI)in children.Methods Thirteen children less than 14 years old underwent open heart surgery as well as aortic valvuloplasty for VSD with moderate or severe AI.There were 9 cases of subpulmonary VSD,perimenbranous VSD in 4 cases.AI was mo-derate in 4 cases,severe in 9 cases.Results There was no hospital death.Post-operative echocardiogram and X-ray revealed that both cardiothoracic ratio and left ventricular end diastolic diameter decreased markedly(P

Objective To establish an indicator system for performance assessment of women and children health care institutions,and provide basis for performance management of such institutions.Methods In this study,literature searching,expert discussion,Delphi method,coefficient of variation method,correlation analysis,principal components analysis,factor analysis and cluster analysis were used to establish the indicator system.In addition,expert scoring and CRITIC methods were called into play to calculate the weight coefficient of each index,and to test the validity and reliability of such an indicator system.Results Thanks to the framework of this indicator system,we set up six class 1 indicators,including heahhcare quality,healthcare efficiency,quality and efficiency of public health service,social efficiency,economic benefit,and development potential.Conclusions Scientific studies can help us build a scientific and practical general performance assessment indicator system applicable to women and children care hospitals at all levels.

Objective To investigate muscle MRI characteristics of lower limbs in Chinese patients with dysferlinopathy. Methods Detailed clinical information of 42 patients with dysferlinopathy confirmed by Western blot or DYSF genetic test were studied retrospectively, including age, course, serum creatinine kinase (CK) and modified Gardner?Medwin and Walto score, and T1WI, STIR image. Each muscle was scored according to its fatty degeneration evaluated on T1WI (fat replacement score). The patients were divided into 3 groups:Miyoshi myopathy (MM), limb girdle muscle dystrophy 2B (LGMD 2B) and preclinical stage (asymptomatic hyperCKemia or exercise intolerance). The data including the scores of each muscle between MM and LGMD 2B were compared by ANOVA analysis and Chi square test. The relationship of fatty replacement score with course and GM?W score was analyzed by Spearman rank correlation analysis. Results Thirty nine patients underwent thigh MR scanning and 36 patients underwent leg MR scanning. At the thigh level, there is no specificity that the fatty replacement was found in both the anterior and posterior parts while the rectus femoris, sartorius and gracilis were rarely involved. At the leg level, the most severely involved muscle was the soleus, followed by gastrocnemius. It formed a sandwich?like pattern that the anterior part (anterior and posterior tibial muscle and peroneus longus muscle) and the posterior part (medial and lateral gastrocnemius) were less involved than the middle part (soleus). Of 42 patients, 14 cases were MM, and 24 were LGMD 2B. The fat replacement score of each muscle between two groups showed no significant differences (F=0.066 to 3.907,P all>0.05) except for the adductor muscle (F=5.239, P=0.028), semimembranosus (F=6.703, P=0.014) and semitendinosus (F=7.689, P=0.009). Of 4 pre?symptomatic cases, 3 showed edema of posterior part of leg on STIR, especially soleus. In all patients, the fat replacement score correlated positively with course (rs=0.732, P=0.000) and GM-W score (rs=0.485, P=0.001). Conclusions The MRI of Chinese patient with dysferlinopathy was characterized by the milder involvement of rectus femoris, sartorius and gracilis muscle in the thigh and a sandwich?like pattern in the leg, which is helpful for differential diagnosis of inflammatory Myopathy versus other types of muscular dystrophy.

Human platelets have distinct characters when preserved by different methods. A efficient flow cytometric assay for different preserved platelets expression of CD62p and phosphatidylserine(PS) is in dire need. Efficient flow cytometric assay for CD62p and PS expressed by preserved platelets was established and the major conditions were optimized. The platelets need not to be washed to wipe off plasma and can be labelled diredtly during the sample preparation. It is efficient for flow cytometric analysis when fresh platelet riched plasma (FPRP) was set as negative control, thrombin actived FPRP, and liquid nitrogen treated FPRP were set as positive control respectively. Gly-Pro-Arg-Pro acetate salt (GPRP) was applied to prevent platelets aggregation and fibrin formation, stabilize platelets and minimize the artificial platelets activation. This is also the key to conquer difficulty of flow cytometric quantitive analysis when platelet, Ca(2+) and plasma coexist. This flow cytometric method is specially suitable for the multi-parameter assay including PS expression for cryopreserved platelets. Minimal sample manipulation, no fixation, and GPRP application resulted in minor artifacts and good sample stability. Results suggested, this flow cytometric assay for preserved platelets is simple and efficient. In addition, the author prepared four different methods treated platelets that can be easily distinguished through this flow cytometric assay. It not only makes sure the practicability of this flow cytometric assay, but also suggests the value of the treated platelets applied in preserved platelets flow cytometric ass
Blood Platelets ; metabolism ; Flow Cytometry ; methods ; Humans ; P-Selectin ; biosynthesis ; Phosphatidylserines ; analysis ; Reproducibility of Results ; Tissue Preservation

Objective: To assess the quality for meta-analysis on prevention and treatment of coronary artery disease (CAD) in China.
Methods: We systemically searched 4 Chinese databases of VIP, CNKI, CBM and Wan Fang for their meta-analysis on CAD prevention and treatment from 1987-01 to 2013-10. According to inclusion and exclusion criteria, 2 researchers independently screened and cross-checked all the literatures. The qualities of methodology and report were evaluated by R-AMSTAR and PRISMA scales.
Results: A total of 201 literatures were enrolled for our study. The average score of methodology quality was (24.65±3.97), no literature met all required items, and the major problems were as lack of“a priori design”, insufifcient and bias of data selection combining inappropriate data synthesis. The average score of report quality was (17.20 ± 2.90), no literature met all 27 required items, and the major problems were as incomplete report of abstract, objective, protocol and registration, incomplete data collection/analysis, using and publishing bias information, incomplete quality assessment.
Conclusion: Both of methodology and report of meta-analysis for CAD prevention and treatment have quality problems at different levels, further improvement should be expected.

Objective To investigate the dynamic change of nutritional risk and malnutrition before op-eration and chemotherapy beginning and at the chemotherapy end in the patients with gastrointestinal malig-nant tumors.Methods The patients receiving gastrointestinal malignant tumors operation in Zhejiang Provin-cial Tongde Hospital from January 2017 to December 2022 were selected as the study subjects.The anthropo-metric measurement data,Karnofsky functional status(KPS)score change were recorded before operation and chemotherapy beginning and at the chemotherapeutic end.The nutritional risk screening 2002(NRS2002)and Global Leadership Initiative Consensus on Diagnostic Criteria for Malnutrition(GLIM)were adopted to evalu-ate the nutritional status of the patients.Results A total of 239 patients were included,there were 221 cases(92.47％)of nutritional risk before the chemotherapeutic beginning,206 cases(86.19％)of GLIM standard malnutrition,71 cases(29.70％)of moderate malnutrition and 135 cases(56.49％)of severe malnutrition in GLIM classification evaluation.At the chemotherapeutic end,there were 182 cases(76.15％)of nutritional risk,181 cases(73.75％)of GLIM standard malnutrition,52 cases(21.76％)of moderate malnutrition and 129 cases(53.97％)of severe malnutrition in GLIM classification evaluation.The screening rate of nutritional risk and malnutrition at the chemotherapeutic end were significant higher than those before operation and the difference was statistically significant(P＜0.001).The levels of total protein,albumin,leukocyte count,neu-trophile granulocyte,hemoglobin and platelet count at the chemotherapeutic end were decreased compared with those before operation with statistical difference(P＜0.05).Conclusion The nutritional risk and malnu-trition incidence rate in the patients with gastrointestinal malignant tumors are high,moreover which at the chemotherapeutic end are higher than those before operation.

Objective To explore the value of preoperative nutritional risk screening and malnutrition on postoperative prediction in the patients with gastrointestinal tract malignant tumor.Methods A total of 428 patients with gastrointestinal tract malignant tumors receiving elective operation in the gastrointestinal surgery department and proctology department of this hospital from January 2017 to October 2023 were se-lected as the study subjects.The patients were classified by postoperative complications Clavien-Dindo classifi-cation and divided into non-complication group(n=288)and complication group(n=140)according to whether or not having complications.The Nutritional Risk Screening 2002(NRS2002)and Global Leadership Initiative on Malnutrition(GLIM)were adopted to evaluate the nutritional status of the patients.The postop-erative complications during the hospitalization period,hospitalization duration,hospitalization expenses,30 d and 60 d non-planed readmission were recorded.Results Compared with the non-complication group,the age,complications ≥2,NRS2002 score ≥3 points,severe malnutrition proportion,urea level,hospitalization dura-tion,hospitalization expenses,ICU admission ratio,30 d and 60 d non-planned readmission rate in the compli-cation group were higher,BMI,KPS score,albumin,total calcium,low density lipoprotein,RBC count,Hb and HCT level were lower,and the differences were statistically significant(P＜0.05).The logistic regression a-nalysis results showed that after adjusting the relevant confounding factors,nutritional risk in NRS2002 screening,malnutrition in GLIM assessment and moderate to severe malnutrition in GLIM classification were all risk factors for postoperative complications occurrence in the patients with gastrointestinal malignant tumors(P＜0.05).None of them were the risk factors for unplanned readmission on 30,60 d(P＞0.05).The receiver operating characteristic(ROC)curve analysis results showed that the arae under the curve(AUC)of NRS2002 was greater than that of GLIM(0.733 vs.0.704),and the difference was statistically significant(P＜0.05).There was no statistically significant difference in the comparison among the GLIM grading(0.710)in NRS2002 and GLIM(P＞0.05).Conclusion The predictive ability of NRS2002 for postoperative complications in the patients with gastrointestinal tract maliganat tumors is slightly superior to that of GLIM.