Objective To investigate the value of emergency hysterectomy on arresting severe postpartum hemorrhage Methods A retrospective analysis was performed on 10 cases of hysterectomy by reason of postpartum hemorrhage between Jan 1990 and Dec 2000 Results All the patients were severe postpartum hemorrhage that couldn't be controlled by conservative treatment. Among them,there were 5 cases of DIC,2 cases of placental adherence,1 case each of uterine atony,uterine rupture and infection of uterine incision. Blood loss averaged 2 427 ml. All the 10 patients were recovered. Emergency hysterectomy was related to times of gestation and delivery and also to delivery pattern Conclusion Emergency hysterectomy is one of the effective methods on arresting severe postpartum hemorrhage.

This study was aimed to observe the effect ofZi-Bu Pi-Yin Recipe (ZBPYR) on the mRNA expressions of NMDA receptor subunits NR1, NR2A, NR2B in different brain regions of spleen-yin deficiency Alzheimer's Disease (AD) model rats. The levels of NR1, NR2A, NR2B mRNA expressions were detected by using RT-PCR method. The results showed that the levels of NR1, NR2A, NR2B mRNA expressions of AD group and spleen-yin deficiency AD group decreased significantly (P < 0.05). The levels of NR1, NR2A, NR2B mRNA expressions of ZBPYR treatment group increased significantly (P < 0.05). It was concluded that the expression levels of NMDAR mRNA in different brain regions of the ZBPYR treatment group increased significantly, which indicated that ZBPYR may up-regulate the protein expressions of NMDAR by increasing the expression levels of NMDAR mRNA, thereby to play the anti-dementia effect.

Objective To investigate the infection status of infectious diseases for 2 521 patients before blood transfusion in a Hospital in Changsha.Methods A total of 2 521 patients who would be transfused were selected,and six kind of serum hepatitis B virus indicators,hepatitis C virus antibody (antiHCV),human immunodeficiency virus antibody (anti-HIV/1 + 2),and treponema pallidum antibody (antiTP) of nine common infectious disease targets were detected with enzyme-linked immunosorbent assay (ELISA).Results Among 2 521 patients,HBsAg-positive cases were 8.33％,anti-HCV positive were 0.59％,anti-HIV positive [confirmed by the Provincial Center for Disease Control (CDC)] was 6 cases,and TP-positive were 2.301％.A total of 289 patients were tested positively,with a total positive rate of 11.46％.Conclusions Detection before transfusion may reduce infection risk and decrease the risk of occupational exposure,strengthen medical staff self-protection,and reduce medical malpractice caused by blood transfusion.

Objective To investigate the dementia caregivers' awareness of dementia diagnosis for patients aged≥80 years in veterans community in Beijing.Methods Patients aged 80 years and over who were diagnosed as dementia were selected from Dec.2009 to Jul.2011 in the veterans community in Beijing.A face-to-face interview and questionnaire survey were conducted in dementia caregivers individually,including basic social demographic data (gender,age,educational background),awareness rate of dementia,treatment and drug use situation and their attitude to dementia patients.Results A total of 118 caregivers were investigated individually.The caregivers in this study were mainly the spouse of the patients,and most of them were elderly people.46.6％ (55/118) of caregivers were the spouse of the patients,and 52.5％ (62/118) of caregivers were 65 years old and over.The caregivers' awareness rate of dementia was 32.3％ (38/118) when patients were diagnosed as dementia.There was no correlations of gender,age and educational background with the awareness rate of dementia diagnosis (all P＞0.05).50％ of dementia patients received the dementia treatment,and only 17.8％ (21/118) of patients got the first line drug treatment for dementia (acetylcholinesterase inhibitors and / or memantine).98.3 ％ (116 / 118) of caregivers agreed that the dementia patients should be treated kindly.Conclusions The dementia caregivers are mainly patients' spouse in veterans community and most of them are the elderly.The awareness rate of dementia diagnosis is low among the caregivers.Most patients do not take the formal treatment.The social support for the dementia caregivers should be strengthened.

Objective: To investigate the characteristics of acoustic impedance test and its diagnostic role for occupational noise induced deafness, in order to provide an objective basis for the differential diagnosis of occupational noise induced deafness. Methods: A retrospective study was conducted to investigate the cases on the diagnosis of occupational noise-induced deafness in Guangdong province hospital for occupational disease prevention and treatment from January 2016 to January 2017. A total of 198 cases (396 ears) were divided into occupation disease group and non occupation disease group based on the diagnostic criteria of occupational noise deafness in 2014 edition, acoustic conductivity test results of two groups were compared including tympanograms types, external auditory canal volume, tympanic pressure, static compliance and slope. Results: In the occupational disease group, 204 ears were found to have 187 ears (91.67%) of type A, which were significantly higher than those in the non occupational disease group 143/192 (74.48%) , the difference was statistically significant (χ²=21.038, P<0.01). Detection of Ad or As type, occupation disease group in other type were 16/204 (7.84%) , 3/204 (1.47%) , were lower than Ad or As type of occupation disease group (15.63%) , other type (9.38%) , the differences were statistically significant[ (χ²=5.834, P<0.05) , (χ²=12.306, P<0.01) ]. Occupation disease group canal volume average (1.68±0.39) ml higher than that of non occupation disease group (1.57±0.47) ml, the difference was statistically significant (t=2.756, P<0.01) ; occupation disease group mean static compliance (1.06±0.82) ml higher than that of non occupation disease group (0.89±0.64) ml. The difference was statistically singificant (t=2.59, P<0.01) . Conclusion We observed that acoustic impedance test had obvious auxiliary function in the differential diagnosis of occupational noise induced deafness, More than 90% of the confirmed cases showed an A-form tympanograms, it is one of the objective examination methods which can be used in the differential diagnosis of pseudo deafness.

Objective To explore the relationship between the objective indexes and TCM syndromes of occupational hand arm vibration disease ,and to provide clinical data for the objectification of TCM syndrome differentiation. Methods 101 patients with occupational hand arm vibration disease were collected ,including 24 patients with Xingbi,39 with Tongbi and 38 with Zhuobi,according to the theory of traditional Chinese medicine syndrome differentiation ,the relationship was observed between different TCM Syndrome types and various of parameters,such as 5-and 10-minute rewarming rates in cold water rewarming test,terminal latency,amplitude, conduction velocity ,average time ,average amplitude of abductor pollicis brevis and abductor digiti minimi in electromyography. Results 5-and 10-minute rewarming rate in cold water rewarming test did not differ significantly among the three groups(P > 0.05). Amplitude of median nerve motor conduction differed significantly among the three groups of Xingbi,Tongbi and Zhuobi(χ2 = 6.14,P < 0.05),Further comparison between the groups was made in Xingbi and Tongbi(χ2=0.132,P=0.895),Xingbi and Zhuobi(χ2=2.277,P=0.023),Tongbi and Xingbi (χ2 = 2.172 ,P = 0.030). There were no significant differences among the three groups in latency and conduction velocity of the median nerve motor conduction and latency ,amplitude and conduction velocity of ulnar nerve motor conduction(P>0.05). The differences of conduction velocity and amplitude of median nerve and ulnar nerve sensory conduction,average time and average amplitude of abductor pollicis brevis and abductor muscle among the three groups had no statistical differences(P>0.05). Conclusions The distribution is different in the amplitude of median nerve motor conduction among the three groups of Xingbi,Tongbi and Zhuobi,further analysis shows that the difference is mainly reflected in the Xingbi group. We conclude that the median nerve axonal injury is lighter in Xingbi group than in the other two groups.

Objective To investigate the effect evaluation of self-nursing on the stent-tract in the discharged patients with orthopedic external fixation support. Methods A total of 112 patients with orthopedic external fixation support were selected, and designed the self-nursing material. Before discharging guidance, make sure that the patient or patients′ family mastered the operation methods and nursing key points. After discharge, the continuing nursing support was provided. Results The incidence of infection was 4. 46%. All the 112 patients, the times of return visits were 432, and the times of changing the dressing were 3 940, with the mean times of 35. 2;The reducing the costs were 43 340, with the mean reducing of 387. Conclusions The self-nursing on the stent-tract in the discharged patients with orthopedic external fixation support can save the human resource, time and medical costs of the patients and patients′ family, it can also help the doctors with discharged treatment and reduce the work of nurses.

Objective:To investigate the characteristics of asymmetric hearing loss in left and right ears of patients with occupational noise-induced deafness and to explore the possible causes of asymmetric hearing loss.Methods:A total of 423 cases of occupational noise-induced deafness diagnosed in Guangdong Province Hospital for Occupational Disease Prevention and Treatment from May 2015 to May 2018 were investigated retrospectively. On the basis of three consecutive pure tone audiometry (PTA) with intervals of more than 3 d in hospital, the minimum of hearing threshold of each frequency and the frequency response threshold of auditory steady-state response (ASSR) , and based on the GBZ 49-2014 "Diagnosis of Occupational Noise-induced Deafness". The statistical analysis of Wilcoxon signed rank test and Spearman correlation analysis were carried out by nonparametric test. The hearing threshold weight of PTA and the response threshold of ASSR were tested and compared from different dimensions according to sex, age, length of service of exposure noise, diagnosis grade and so on.Results:There were 369 male (87.23%) and 54 female (12.77%) ; the age was (41.8±7.6) years; the length of service was (10.1±6.2) years. The weighted values of left ear PTA and ASSR were higher than those of right ear ( P<0.001) . The weighted values of left ear PTA and ASSR were higher than those of right ear ( P<0.05) in men, patients with age ≤ 40 and 41-60 years, 3-9 years of service, and patients with mild grade ( P<0.05) . After the equalization of characteristic variables, the weighted values of left ear PTA and ASSR were also higher than those of right ear ( P<0.05) . There was a positive correlation between the weighted value of PTA and the weighted value of ASSR ( P<0.001) . Conclusion:There is asymmetry in hearing loss of patients with occupational noise deafness, and hearing loss in the left ear is higher than that in the right ear.

Objective: Study of the results and the degree on occupational noise-induced deafness in-to the different high frequency hearing threshold weighted value, in order to provide theoretical basis for the re-vision of diagnostic criteria on occupational noise-induced deafness. Methods: A retrospective study was con-ducted to investigate the cases on the diagnosis of occupational noise-induced deafness in Guangdong province hospital for occupational disease prevention and treatment from January 2016 to January 2017. Based on the re-sults of the 3 hearing test for each test interval greater than 3 days in the hospital, the best threshold of each frequency was obtained, and based on the diagnostic criteria of occupational noise deafness in 2007 edition, Chi square test, t test and variance analysis were used to measure SPSS21.0 data, their differences are tested among the means of speech frequency and the high frequency weighted value into different age group, noise ex-posure group, and diagnostic classification between different dimensions. Results: 1. There were totally 168 cases in accordance with the study plan, male 154 cases, female 14 cases, the average age was 41.18 ±6.07 years old. 2. The diagnosis rate was increased into the weighted value of different high frequency than the mean value of pure speech frequency, the weighted 4 kHz frequency increased by 13.69% (χ²=9.880, P=0.002) , 6 kHz increased by 15.47% (χ²=9.985, P=0.002) and 4 kHz+6 kHz increased by15.47% (χ²=9.985, P=0.002) , the difference was statistically significant. The diagnostic rate of different high threshold had no obvious differ-ence between the genders. 3. The age groups were divided into less than or equal to 40years old group (A group) and 40-50 years old group (group B) , there were higher the diagnostic rate between high frequency weighted 4 kHz (A group χ²=3.380, P=0.050; B group χ²=4.054, P=0.032) , weighted 6 kHz (A group χ²=6.362, P=0.012; B group χ²=4.054, P=0.032) , high frequency weighted 4 kHz+6 kHz (A group χ²=6.362, P=0.012; B group χ²=4.054, P=0.032) than those of speech frequency average value in the same group on oc-cupational noise-induced deafness diagnosis rate, the difference was statistically significant. There was no sig-nificant difference between age groups (χ²=2.265, P=0.944) . 4. The better ear's mean value of pure speech fre-quency and the weighted values into different high frequency of working years on each group were compared, working years more than 10 years group was significantly higher than that of average thresholds of each frequen-cy band in 3-5 group (F=2.271, P=0.001) , 6-10 group (F=1.563, P=0.046) , the difference was statistically significant. The different high frequency weighted values were higher than those of the mean value of pure speech frequency, and the high frequency weighted 4 kHz+6 kHz had the highest frequency difference, with an average increase of 2.83 dB. 5. The diagnostic rate into weighted different high frequency was higher in the mild, moderate and severe grades than in the pure speech frequency. In the comparison of diagnosis for mild occupational noise-induced deafness, in addition to the weighted 3 kHz high frequency (χ²=3.117, P=0.077) had no significant difference, the weighted 4 kHz (χ²=10.835, P=0.001) , 6 kHz (χ²=9.985, P=0.002) , 3 kHz+4 kHz (χ²=6.315, P=0.012) , 3 kHz+6 kHz (χ²=6.315, P=0.012) , 4 kHz+6 kHz (χ²=9.985, P=0.002) , 3 kHz+4 kHz+6 kHz (χ²=7.667, P=0.002) were significantly higher than the diagnosis rate of the mean value of pure speech frequency. There was no significant difference between the two groups in the moderate and se-vere grades (P>0.05) . Conclusion Bring into different high frequency hearing threshold weighted value in-creases the diagnostic rate of occupational noise-induced deafness, the weighted 4 kHz, 6 kHz and 4 kHz+ 6 kHz high frequency value affects the result greatly, and the weighted 4 kHz+6 kHz high frequency hearing threshold value is maximum the effect on occupational noise-induced deafness diagnosis.

The general practitioners are facing a series of issues in aspect of medical humanities:incomprehensive humanity care,insufficient subjective components in medical records,low service efficiency particularly during heavy work load in outpatient service.To adapt the challenges,a general hospital in Shanxi province had explored a pathway to integrate the medical social work into patient care in general practice since 2017.The medical social workers jointed the general practice team,involved in outpatient service and patient education,generated humanity records to improve the humanistic care,and to promote doctor-patient communication.The general medical services were significantly improved after the program implementation in the hospital.