Objective To study the risk factors of obstetrical brachial plexus palsy (OBPP).Methods Forty-six newborn infants with OBPP were recruited between January 1997 and December 2009 from Technical Appraisement Center for Medical Malpractice of Shandong province as OBPP group.In the control group,138 newborn infants delivered in the same time,same hospital and same gender were collected,with a ratio of 1:3.All the cases were analyzed retrospectively.The newborn,maternal,childbirth data and working experience of midwives were analyzed by univariate and multivariate logistic regression analysis.Results ( 1 ) External pelvimetries of the two groups were normal.All were singleton newborns by vaginal deliveries with cephalic presentation.Twenty-two newborns had left unilateral palsies,and the other 24 had right unilateral palsies.The numbers of the whole,upper and fore arm type were 17,26 and 3,respectively.The maternal age,gravidity,parity and gestational weeks were higher in OBPP group than in the control group ( P ＜ 0.05 ).( 2 ) The maternal antepartum body mass index ( BMI ) [ ( 29.5 ± 2.4 ) kg/m2 ],height of the uterus [ (34.9 ± 2.4) cm ] and abdominal circumference [ ( 105 ± 6) cm ] in OBPP group were higher than those in the control group [ ( 26.1 ± 2.5 ) kg/m2,( 33.7 ± 2.2 ) cm and ( 99 ± 5 ) cm,respectively ] ( P ＜ 0.05 ).The newborn birth weight in OBPP group [ ( 4390 ± 489 ) g ] was significantly higher than the control group [ ( 3404 ± 360 ) g] ( P ＜ 0.01 ).The working experience of midwives in OBPP group [ ( 5.2 ± 2.3 ) years ] was less than the control group [ ( 8.9 ± 5.4) years ] ( P ＜ 0.01 ).(3) There was a higher proportion of instrumental delivery ( 28.3％ vs.3.6％ ),uterine atony (28.3％ vs.6.5％ ),prolonged second stage(8.7％ vs.0.7％ ) and fetal malposition( 10.9％ vs.2.9％ ) in the OBPP group than in the control group ( P ＜ 0.05 ).(4) Univariate logistic analysis showed that the P values of maternal age,antepartum BMI,height of uterus,abdominal circumference,newborn birth weight,gravidity,second stage duration,instrumental delivery,fetal malposition,uterine atony and working experience of midwives were all less than 0.10.And the working experience of midwives was a protective factor.(5)The factors listed above were taken as variables,selected stepwise regression for multivariate logistic regression analysis.Boundary value was 0.10.It showed that the antepartum BMI ( OR =1.733 ) and newborn birth weight ( OR =1.004 ) were related to OBPP ( P ＜ 0.10 ).The significance of maternal antepartum BMI was higher than birth weight.Conclusions The maternal antepartum BMI is the most important risk factor for OBPP,and the newborn birth weight is the other risk factor.The working experience of midwives is a protective factor.

Objective To analyze the risk factors of postmenopausal vaginal bleeding complicating cervical cancer .Methods Totally 43 cases of postmenopausal vaginal bleeding complicating cervical cancer were selected as the observation group ,while 52 cases of postmenopausal vaginal bleeding complicating non‐organic lesions and benign lesions were selected as the control group . Through the medical records and self‐developed questionnaire ,the risk factors of postmenopausal vaginal bleeding complicating cer‐vical cancer were investigated .Results There were no statistically significant differences in age of menopause ,age of IUD place‐ment ,usage of postmenopausal estrogen drugs ,smoking history ,complicating hypertension between the two groups (t= 0 .674 , 1 .156 ,χ2 =0 .283 ,0 .425 ,0 .281 ,P>0 .05);while the years of menopause to vaginal bleeding occurrence ,endometrial thickness and duration of vaginal bleeding in the observation group were more than those in the control group ,the differences were statistically significant (t=6 .717 ,5 .000 ,10 .754 ,P< 0 .05) .The univariate and multivariate Logistic regression analysis results showed that the risk factors of postmenopausal vaginal bleeding complicating cervical cancer were the years of menopause to bleeding ,endometri‐al thickness and duration of vaginal bleeding (P<0 .05) .Conclusion For the patients with postmenopausal bleeding ,the risk of complicating cervical cancer should be considered ,especially the years of menopause to bleeding ,endometrial thickness and duration of vaginal bleeding .

Objective To explore related influencing factors for postoperative delirium in elderly patients, to provide a reference for the prevention and treatment. Methods Fifty-four patients with delirium after surgery were used as observa?tion group, and a total of 150 subjects with no delirium after surgery during the same period were selected as the control group. Data of age, gender, malnutrition, disorders of water and electrolyte metabolism, postoperative mechanical ventilation, postoperative hypoxemia, severe infection and postoperative pain degree, and the combination of basic diseases were com?pared and analysed between two groups. The binary logistic regression analysis was used to analyse the influencing factors of postoperative delirium. The outcome and prognosis were observed and analyzed in observation group. Results The average age was significantly higher in observation group than that of control group (P<0.05). The percentages of postoperative hy?poxemia and severe infection were significantly higher in observation group than those of control group ( P<0.05). Patients with higher age, postoperative hypoxemia and severe infection were risk factors for postoperative delirium. In observation group,1 case died of lung infection, 1 case died of multiple organ failure, the remaining 52 patients were improved and dis?charged from hospital after three months. Conclusion For patients with higher age, postoperative hypoxemia and severe in?fection are the risk factors for occurrence of postoperative delirium. More attention should be paid to clinical preoperative and postoperative periods.

OBJECTIVE: To establish and improve the quality management system of drug dismounting and subpackage in hospital.METHODS: The status quo and problem of drug dismounting and subpackage were analyzed,and improvement approaches were put forward.RESULTS: The quality management system of drug dismounting and subpackage was established and improved by enhancing personnel quality,dismounting environment,material management as well as process control.CONCLUSION: The quality management system of drug dismounting and subpackage can effectively guarantee the quality of dismounted drug and is worthy of spreading.

s Objective To investigate the predictive value of maternal serum C reactive protein,IL 6 and glucose concentration for the early intrauterine infection in patients with preterm premature rupture of the membranes(PPROM).Methods Amniotic fluid(AF) was collected from patients with PPROM,IL 6,glucose concentration,anti Chlamycdia trachomatis, anti lytomegalovirus IgM and ureaplasma urealytiaum were detected and cultured.Results The most sensitive test was AF IL 6 determination(P

Objective To investigate the role of soluble intracellular adhesion molecule-1(sICAM-1), corticotropin-releasing hormone(CRH)and interleukin-6(IL-6) in the pathogenesis of pregnancy-induced hypertension (PIH). Methods Maternal plasma sICAM-1, CRH and IL-6 level were determined in 81women at 26~37 gestational weeks among which 23 were normal pregnant women and 58 with PIH. The later were grouped into 21 women with mild, 19 with moderate, 18 with severe PIH. sICAM-1 and IL-6 were measured by ELISA and CRH by RIA. Results The levels of plasma sICAM, CRH and IL-6 were significantly elevated in women with moderate and severe PIH compared with control subjects(P

Objective To investigate the serum asymmetric dimethylarginine (ADMA)expression in patients with acute cerebral infarction. Methods A total of 100 patients with acute cerebral infarction admitted to the Department of Neurology,the First Affiliated Hospital of Xi′an Medical College from March 2013 to August 2015 were enrolled retrospectively. According to the National Institutes of Health Stroke Scale (NIHSS)scores,they were divided into three groups:mild infarction (n =21;<4),moderate infarction (n =49;4 -15),and severe cerebral infarction (n = 30;> 15);100 healthy subjects without cerebrovascular disease in the same period were used as a control group. Enzyme linked immunosorbent assay was used to detect the plasma ADMA concentration,and the levels of plasma ADMA among the groups were compared. Results The concentrations of plasma ADMA of the mild,moderate,severe cerebral infarction,and the control groups were 0. 80 ± 0. 16,1. 14 ± 0. 28,1. 33 ± 0. 33,and 0. 52 ± 0. 16 μmol/ L,respectively. There were significant differences among the groups (F = 2. 32,P < 0. 05). Multivariate logistic regression analysis suggested that ADMA was an independent risk factor for cerebral infarction (OR,1. 140,95% CI 1. 078 -1. 212,P = 0. 045). Conclusions The expression levels of plasma ADMA increased gradually in patients with mild,moderate,and severe cerebral infarction. The higher the ADMA levels,the severe the neurological deficit would be. ADMA might be an independent risk factor for cerebral infarction.

BACKGROUND:In recent years, studies on the application of traditional Chinese medicine in bone tissue engineering are stil at the initial stage in China. Reports about psoralen antibiotic biphasic ceramic bone have not been seen in bone tissue engineering research. OBJECTIVE:To fabricate the psoralen antibiotic biphasic ceramic bone by vacuum evaporator and to observe the physicochemical properties, antibiotic activity and biocompatibility of the material. METHODS:Biphasic ceramic bone was prepared by twice low-temperature calcining pig vertebrae combined with sodium pyrophosphate, and then the ceramic bone was immersed in chitosan/psoralen compound solution to prepare psoralen antibiotic biphasic ceramic bone. The surface morphology was observed by scanning electron microscope, and the compressive strength was tested. Antibiotic activity of the psoralen antibiotic biphasic ceramic bone on Escherichia coli and Staphylococcus aureus was tested by microbiological methods. Mouse osteoblasts MC3T3-E1 were co-cultured with the psoralen antibiotic biphasic ceramic bone for 4 and 8 days, and the cel adhesion and proliferation on the scaffold surface were observed under the scanning electron microscope. RESULTS AND CONCLUSION:Psoralen antibiotic biphasic ceramic bone had natural pore structure with the trabecular bone, trabecular space and lumen system and exerted great antibiotic effect on Escherichia coli and Staphylococcus aureus. The compressive strength was (4.69±0.50) MPa. Mouse osteoblasts MC3T3-E1M could be adherent to the psoralen antibiotic biphasic ceramic bone and proliferate rapidly, suggesting the psoralen antibiotic biphasic ceramic bone has good cytocompatibility.

Purpose To explore the correlation between fetal cardiac function and interventricular septal thickness in fetuses of gestational diabetes mellitus (GDM) mothers. Materials and Methods Thirty-nine GDM mothers were involved in the study and divided into group MH (fetuses of GDM mothers with interventricular septal hypertrophy) and group NMH (fetuses of GDM mothers with normal interventricular septal thickness). Ultrasonic cardiogram was performed for both groups to assess such variables as interventricular septum thickness at end diastole (IVSd), left ventricular ejection fraction (LVEF), left ventricular fraction shortening (LVFS), right ventricular fraction shortening (RVFS), the ratio of E and A of mitral flow (E/AMV), the ratio of E and A of tricuspid flow (E/ATV), peak velocity of aortic valve (VPAO), peak velocity of pulmonary valve (VPPA) and myocardial performance index (MPI). The results were further compared with those of control group. Results The VPAO, VPPA, LVEF and LVFS in group NMH were significantly higher than those in control group (P<0.05). The VPAO, VPPA, LVEF, LVFS and RVFS in group MH were significantly higher than those in control group whilst the E/AMV and E/ATV significantly lower than those in control group (P<0.05). The LVEF, LVFS and RVFS in group MH were significantly higher than those in group NMH whilst the E/AMV and E/ATV significantly lower (P<0.05). MPI in group MH was significantly higher than that in group NMH (P<0.05), whilst both were significantly higher than that in control group (P<0.05). The LVEF, LVFS, RVFS, VPAO and VPPA were positively correlated with IVSd (r=0.48, 0.51, 0.45, 0.30, 0.30;P<0.05). Conclusion Cardiac function in fetuses of GDM mothers may be associated with interventricular septal thickness.

Objective To study the characteristic and manifestations in the middle aged and elderly peoplewith discoid meniscus injury and the outcome of the arthroscopic surgery. Methods Twenty-nine patients with discoid meniscus injury were treated by the arthroscopic surgery from January 2009 to May 2013. According to the injury of discoid meniscus in operation, 6 cases (6 knees , 20.69%) underwent meniscal plasty, 16 cases (16 knees, 55.17%) underwent subtotal meniscectomy, and 7 cases (7 knees, 24.14%) underwent meniscectomy. The Ikeuchi and Lysholm evaluation system was used to assess knee joint function and compared. Results All the postoperative patients were followed up for 12-18 months, and the average was 14 months. According to Ikeuchi knee rating, 5 cases were excellent, 17 cases were good, 4 cases were fair, 4 cases were poor and the rate of excellent and good was 75.86%. Lysholm scores 3, 6 and 12 months after operation were (65.76 ± 5.35), (70.27 ± 4.73) and (77.81 ± 6.24) scores, and before operation was (55.47 ± 3.63) scores. Three, 6 and 12 months after operation, Lysholm scores were significantly higher than those before operation (P<0.05). Conclusions The middle aged and elderly people discoid meniscus injury has its own characteristics compared with adolescent patients in symptoms, signs, and treatments. Arthroscopic surgery is an effective treatment for discoid meniscus with minimal.