Objective: To investigate the prevalence and types of maternal near miss in Hangzhou City from 2015 to 2020, so as to provide insights into early identification and interventions for maternal near miss. Methods: The data of maternal near miss in 5 hospitals of Hangzhou City from 2015 to 2020 were collected from China's National Maternal Near Miss Obstetrics Surveillance System, and the incidence and mortality of maternal near miss, types of pregnancy-related complications/comorbidities and types of critical illness were descriptively analyzed. Results: Totally 230 490 pregnant and lying-in women were recruited in 5 hospitals in Hangzhou City from 2015 to 2020, and there were 182 514 live births, 177 428 women with pregnancy-related complications/comorbidities, and 1 790 cases of maternal near miss with a 0.98% annual incidence rate. The incidence of maternal near miss was high in 2019 (1.18%). The hospital mortality and death index were respectively 3.29/105 and 0.33% among pregnant and lying-in women from 2015 to 2020, and there was no death found among pregnant and lying-in women from 2018 to 2020. The main pregnancy-related complications/comorbidities included anemia (79.33%), obstetric hemorrhagic disorders (69.83%), and gestational hypertension (16.65%). The main critical illness among maternal near miss included coagulation dysfunction (87.23/104), cardiovascular dysfunction (20.44/104), and respiratory dysfunction (9.70/104). Conclusions The incidence of maternal near miss was high and the hospital mortality appeared a reduction tendency among pregnant and lying-in women in Hangzhou City from 2015 to 2020. Coagulation dysfunction is the primary critical illness among maternal near miss, and the management of anemia and hemorrhagic diseases requires to be improved.

Objective To investigate the therapeutic value of embolization in severe hemorrhagic cystitis(HC) following allogeneic stem cell transplantation.Methods Six patients undergoing allogeneic stem cell transplantation developed severe HC with a median onset time of 33 days after transplantation.All these patients had been resistant to conservative managements and received the treatment of selective embolization of bilateral internal iliac arteries.Results Eight times of embolizations were performed for 6 patients.The HC was cured in 4 patients and the HC improved in 1 patient,yielding a response rate of 83 %.One patient didn't respond to this measure.For the patients with response,macroscopic hematuria disappeared 7 to 10 days after the treatments and microscopic hematuria vanished 20 to 30 days after the intervention therapy.Both procedures were tolerated well and no severe adverse effects were observed.Conclusions Selective embolization of internal iliac arteries seems to be a safe and effective treatment for severe HC.This measure can be proposed for patients undergoing refractory and persistent severe HC.

Background and purpose: L-asparaginase (L-Asp) is an important drug in the treatment of childhood lymphoid neoplasms at present, but a lot of adverse reactions of L-Asp were observed. Pegasparaginase (PEG-Asp) is available in China in recent years. This study aimed to explore efifcacy and side-effect of PEG-Asp as ifrst-line treatment in childhood acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL). Methods:A total number of 211 ALL or LBL patients were treated with CCLG 2008 or BFM-90 protocol with PEG-Asp or L-Asp between Apr. 2008 and Mar. 2013;42 patients, among whom, were 35 ALL patients and 7 LBL patients, were treated with PEG-Asp as ifrst-line treatment;169 patients were treated with L-Asp as ifrst-line treatment (including 53 patients treated with L-Asp during induction protocol; with PEG-Asp during consolidate protocol). The clinical outcome and adverse reaction of PEG-Asp with L-Asp were observe and compared. Results: There were 35 ALL patients in PEG-Asp ifrst-line treatment group and the complete remission rate after 1 course of PEG-Asp was 97.1%,however, which was 83.3%of high risk ALL patients. The complete remission rate of 7 LBL patients of PEG-Asp ifrst-line treatment group was 57.1%. There was no signiifcant difference between 2 groups (P>0.05). Thirty-four patients relapsed including 5 patients of PEG-Asp ifrst-line treatment group, 16 patients of L-Asp ifrst-line treatment group and 13 patients treated with L-Asp during induction protocol and with PEG-Asp during consolidate protocol. Thirty-one patients died including 3, 18, 10 patients in 3 groups respectively. Twenty-two patients died of relapse, 4 died without remission, 5 died of complications. There was also no signiifcant difference between 2 groups (P>0.05). The incidence rates of adverse reactions were 47.6% and 63.3% respectively. Anaphylaxis, liver functions abnormalities, blood coagulation abnormalities, gastrointestinal reaction, hyperglycemia and pancreatitis were common in our patients. The incidence rate of anaphylaxis in PEG-Asp as ifrst-line treatment group was lower than other groups (P=0.03). But there was no signiifcant difference been observed in the incidence of other adverse reaction. Conclusion: The short-term efifcacy of PEG-Asp as the ifrst-line treatment in childhood leukemia and lymphoma was satisfactory and the incidence rate of anaphylaxis was lower. However, we will still pay much attention to adverse reaction monitoring of PEG-Asp.

Objective To assess the clinical effect and safety of human blood albumin in treatment of acute cerebral hemorrhage.Methods 88 patients with acute cerebral hemorrhage were randomly divided into 2 groups. Both group were given routine therapy and 45 cases in the treating group were given additional 10% human blood albumin 100 ml ivgtt once a day for 7 days.14 days served as a treatment course.Neurofunction was compared before and after treatment.Results Both the effective rate (P<0.05) and the neurofunction in the treating group were better than that of the control group (P<0.05).No advert effect happened.Conclusion Human blood albumin is an efiective and safe medicine for treatment of acute cerebral infarction.

Objective To investigate the expression of peroxisome proliferator-activated receptors (PPARs) in epidermal keratinocytes of patients with psoriasis vulgaris and its significance.Methods Immunohistochemical method was used to examine the expression of PPARα,β/δand.γ in tissue specimens from the normal skin of 5 human controls,lesional and normal skin adjacent to the lesions of 17 patients with psoriasis vulgaris.A semi-quantitative analysis was carried out by image analyzer.Results Different levels of expression of the three PPAR isotypes were observed in the nuclei of epidermal keratinocytes of normal human controls.The expression intensity of PPAR α,β/δand γ was statistically higher in the epidermis of adjacent normal skin than that in psoriatic lesions(all P<0.01)and normal control skin(all P<0.01).Conclusions The decreased expression of PPARα may be associated with the overproliferation and parakeratosis of epidermal keratinocytes in psoriatic lesions,and PPAR β/δ and γ may display a synergistic effect on the maintenance of homeostatic proliferation and difierentiafion of epidermal cells.

Objective:To study the significance of CD55,CD59 and CD34 in the early diagnosis of aplastic anemia-paroxysmal nocturnal hemoglobi nuria(AA-PNH),and to search for a sensitive marker of the early diagnosis,so as to achieve the objective of early finding,early diagnosis and early treatment.Methods:CD55,CD59 and CD34 in AA-PNH patients were detected by Flow cytometry,the relationship among CD55,CD59 and CD34 in AA-PNH patients,PNH,AA patients and control group were studied to find out their statistic relevance.Results:The levels of CD55,CD59 and CD34 of PNH and AA-PNH were significantly lower than AA group and any other group and control group,the markers were positively correlated with hemolysis degree and were earlier than other markers of hemolysis.Conclusion:CD55,CD59 and CD34 antigens may act as the most sensitive marker of early diagnosis in PNH and AA-PNH syndrome,and have a close correlation with prognosis.

Objective : To explore the influencing factors for maternal anemia during the third trimester of pregnancy, so as to provide the evidence for the effective prevention of anemia. Methods : Data of parturients, who received prenatal care and delivered at Hangzhou Women＇s Hospital from October to December of 2019 were retrospectively collected and analyzed. The obstetric electronic medical record system of this hospital was used to collect general information of the subjects. Serum ferritin, serum vitamin B12, serum folic acid and hemoglobin were determined at the second and third trimester. A multivariate logistic regression model was used to analyze the influencing factors for anemia in the third trimester. Results : A total of 1 143 parturients were enrolled, with a median age of 29 ( interquartile range: 4 ) years. Among them, 1 050 cases had normal weight before pregnancy, accounting for 91.86%; 267 cases were multiparas, accounting for 23.36%; 74 cases of anemia occurred during the third trimester of pregnancy, accounting for 6.92%.Multivariate logistic regression analysis indicated that the multipara（OR=1.714,95%CI: 1.032-2.848）, iron deficiency duiring the second trimester（OR=3.301,95%CI: 1.401-7.781）, iron deficiency during the third trimester （OR=14.134,95%CI: 1.944-102.774）and folate deficiency during the third trimester（OR=2.960,95%CI: 1.295-6.766）were influencing factors for anemia during the third trimester. Conclusion Anemia during the third trimester of pregnancy is related to iron deficiency during the second and third trimesters, folic acid deficiency during the third trimester, and multipara.

Objective To investigate the needs of the main caregivers of children with cerebral palsy and probe into the nursing strategies. Method One hundred and fifteen main caregivers of children with cerebral palsy participated in the survey by a general state questionnaire and the family needs questionnaire. Results The score by the family needs questionnaire was (96.13 ± 19.47), with an average score of (3.00 ± 0.61). And the top needs of the main caregivers were information and econony need. Conclusions The needs of the main caregivers of children with cerebral palsy are high. More attention should be paid to community and family-based rehabilitation and supports to those care-givers.

Objective To observe the effect of Danshen in the treatment of severe hand-foot-and-mouth disease and investigate its mechanism.Methods One hundred and forty cases of children with severe hand foot and mouth diseases who hospitalized the intensive care unit were enrolled in the study from February 2012 to July 2014.The children were randomly divided into a control group and an observation group,with 70 cases in each group.The control group was given antiviral to reduce the intracranial pressure and intravenous immunoglobulin and the observation group was given Danshen in addition to the control group.The levels of neuron specific enolase (NSE)、S-100βprotein、TNF-α and IL-6 were detected at admission and checked again seven days after treatment.The changes of the above indicators and the clinical curative effect were compared before and after therapy.Results The total effective rate of the control group and the observation group was 80.0% and 92.9% respectively,showing statistical significance(P<0.05). After treatment, observation group of serum NSE (9.42 ± 2.56μg/Lvs. 11.71 ± 3.21μg/L,t=2.159), S-100β (177.34 ± 87.28 ng/Lvs. 286.14 ± 159.69 ng/L, t=2.315), TNF-α (15.98 ± 4.35 ng/Lvs. 23.17 ± 4.80 ng/L, t=4.297), IL-6 (41.72 ± 6.64 ng/Lvs. 52.05 ± 9.33 ng/L,t=3.492) , the level of were lower than those in the control group(P<0.05 orP<0.01). In the observation group, serum. The fever clearance time、the disappearance time of rash and the hospitalization time in the observation group (3.55 ± 1.02 d vs.4.55 ± 1.09 d, 7.14 ± 1.04 d) were shorter than those in the control group (4.46 ± 0.97 d vs.5.88 ± 1.44 d, 8.68 ± 1.06 d;t=5.409, 6.161, 8.677 respectively, P<0.01).Conclusions On the basis of conventional therapy,Danshen can effectively alleviate the systemic inflammatory response in children with severe hand foot and mouth diseases, reduce brain damage and improve the clinical efficacy.