BACKGROUND: The postnatal sexual health of women is crucial in reproductive health, due to lack of sexual knowledge and sexual heath care service as well as conventional idea, the medical staff and postnatal women themselves pay little attention and discussion on the sexual health after childbirth.OBJECTIVE; To investigate the prevalence and types of women's sexual problems after childbirth, identify the factors associated with dyspareunia and investigate the status quo of postnatal sexual health care service. DESIGN: Cross-sectional study and follow-up survey within six months after delivery.SETTING: Department of Reproductive Medicine, Chongqing University of Medical Sciences. PARTICIPANTS: A total of 798 primiparous women delivering a live birth in Department of Obstetrics at the First Affiliated Hospital of Chongqing University of Medical Sciences between November 2000 and July 2001, and 79 husbands who accompanied their wives during the follow-ups were adopted in this study.METHODS: The primiparous women after 6 months of childbirth and husbands conducted routine postnatal follow-ups and were informed of the follow-up content. The interview was used in this cross-sectional study and the questionnaires were finished under the help of health professional. And some advice, consultations and treatments can be given in time. MAIN OUTCOME MEASURES; ①main change of postnatal sexual life;②postnatal sexual problems and related factors. RESULTS: Totally 460 out of 798 primiparous women in accordance with the inclusive and exclusive criterions received follow-up surveys after telephone or letter notification. ①Main change of postnatal sexual life: Of the 460 respondents, 94.74% had resumed sexual activity within six months after delivery. Compared with one year pre-pregnancy, the number of sexual activity decreased obviously within 3-6 months after delivery, and 66.0％ of postnatal women decreased the sexual desire.②Postnatal sexual problems and related factors: Sexual morbidity increased significantly after the childbirth: In the first three months after delivery, 70.6％ of women experienced sexual problem(s), declining to 55.6％ during the 4th-6th months, and reduced to 34.2％ at the 6th month, but not reaching pre-pregnancy levels of 7.17％. The sexual problems of women after delivery included dyspareunia, vaginal dryness, orgasm disorder and vaginal relaxation, etc.4. And dyspareunia was the most common type. Between the 4th and 6th month after delivery, dyspareunia was significantly associated with the effect of traditional sexual ideas, experience of dyspareunia before pregnancy and current breastfeeding (P ＜ 0.05), while the association of dyspareunia with delivery mode was not significant.③Sexual care service and sexual counseling after delivery: Only 20.8％ of women received information about sexual health from health care personnel within 42 days after delivery, and consultation rate of sexual intercourse problems was 8.0％.④Husbands' comprehension of postnatal problems in women: Only 59.2％ of partners whose wives had postnatal sexual problem(s) knew that their wives had ever experienced sexual problem(s) and 8.1％ of partners had sought medical help. CONCLUSION; Sexual health problems are very common in women after childbirth, taking up for 70.6％. And the quality of postnatal sexual health is unrelated with delivery mode, but postnatal health care service are often overlooked, additionally lack of professional counseling and treatment. The current practices of encouraging the husband's supports after the childbirth may well influence the prevention and treatment of postnatal sexual problems in women.

Objective To study the relationship between ischemic mitral regurgitation and geometric angles of the mitral valve leaflets in patients with coronary artery disease and papillary muscle dysfunction by transesophageal echocardiography(TEE) ,and to evaluate anatomy and pathophysiology mechanicm of the ischemic mitral regurgitation with left ventricular papillary muscle dysfunction .Methods A total of 84 subjects were enrolled in this study .All of the subjects were divided into group A (healthy volunteers constituted the control group ,n =40) ,group B (chronic inferior or posterior myocardial infarction patients with papillary muscle dysfunction group ,n =44) ,group C(patients from group B after mitral valvuloplasty surgery ,n = 20) .The relationship between mitral regurgitation and geometric angles of the mitral valve leaflets and mitral annulus were studied by TEE .Results Geometric angle between the mitral valve leaflets and mitral annulus were significantly larger in group B ,and geometric angles of the mitral valve leaflets and mitral annulus was positive correlated with degree of mitral regurgitation .Degree of mitral regurgitation significantly reduced in group C ,no significant difference was found at the geometric angles of the mitral valve leaflets and mitral valve annular compared with group A .Conclusions The degree of mitral regurgitation were highly correlated with geometric angles of the mitral valve leaflets and mitral valve annular in patients with left ventricular papillary muscle dysfunction caused by coronary heart disease .Repair of the mitral valve leaflets surgery can significantly reduce geometric angles of the mitral valve leaflets and mitral valve annular ,and reduce the degree of mitral regurgitation significantly .

Objective To evaluate the localization of mitral valvular(MV)prolapse by transthoracic echocardiography(TTE),transesophageal echocardiography(TEE)and explore the interrelationship between the different subregions of MV prolapse and mitral regurgitation(MR).Methods Total of thirtythree patients with MV prolapse and more than moderate MR were included.TEE was used to further judge the location of scallop lesions and the result of both TTE and TEE were compared with the surgical findings respectively.The relationship between the different subregions of MV prolapse and MR was analyzed.Results Compared with the surgery findings,the accuracy rate of TTE and TEE in diagnosis of MV prolapse was 100％ qualitatively,80％ for TTE and 94％ for TEE in localizing the diseased region with the anterior and posterior MV,the result of TEE was significantly different from TTE(P＜0.05).MR level was related to the location of MV prolapse.Conclusions Compared with the TTE,TEE had more advantages in localizing the position of the MV prolapse.Mitral regurgitation is related to the location of MV prolapse.

Objective To explore the prophylactic effect of methylprednisolone combined with granisetron on postoperative nausea and vomiting.Methods Two hundred patients scheduled for lumpectomy of breast were randomly divided into four groups with 50 cases each.The patients in group M1 received a pre-anesthesia intravenous doses of methylprednisolone 25 mg,the patients in group M2 were injected methylpredsisolone 25 mg repeatedly four hours later,in group D received a pre-anesthesia doses of dexamethasone 5 mg,in group N normal saline 2 ml.All the four groups of patients received granisetron 3 mg intravenously at the end of surgery.The incidence of nausea and vomiting in the 24 hours were observed.Results The PONV incidences of group M1,M2,D,N were 36%,18%,38% and 58%.Both group M1,M2 and D significantly decreased the total inci-dence of PONV (P <0.05)in the 24 h.The incidence of PONV was significantly lower in group M2, compared with group M1 and group D respectively (P <0.05).Conclusion Methylprednisolone-gran-isetron combination is as equally effective as dexamethasone-granisetron combination for preventing PONV in lumpectomy,but repeated methylprednisolone after 4 h is more effective than dexametha-sone and single-used methylprednisolone.

Starting from the practices of grade protection assessment on the information system of Peking Union Medical College Hos -pital, the paper introduces the information system grade and assessment contents and processes , discusses common problems found in specific work and risk analysis approaches so as to provide a reference for work related to information security .

Objective To investigate the changes of serum myelin basic protein (MBP) and S100B orotein (S100B) in premature infants with periventricular leukomalacia (PVL) and their outcomes.Methods Seventy-eight premature infants with PVL (PVL group)and 43 normal infants (control group)who were hospitalized in our hospital from Nov 2007 to Jul 2008 were enrolled in the study.The infants were sampled for MBP and S100B levels on 1st,3rd,7th and 14th d after birth.Thirty normal infants and 69 infants with PVL were followed up every three months as they discharged until they were one year corrected age and their development quotients(DQ) were measured using Gesell development schedules.Results ( 1 ) The serum MBP levels increased on day 1 [ (7.61 ± 1.78 ) μg/L ],peak on day 3 [ ( 14.53 ± 3.12 ) μg/L],and then decreased.The serum MBP levels in infants with PVL group were significantly higher than those of control group at 1st,3rd,7th and 14th d after birth ( P ＜ 0.05 ).(2) The serum S100B levels increased on day 1,day 3 and day 7 [ (3.82 ±0.68),(4.41 ±0.91,),(5.78 ± 1.54) μg/L],peaked on day 7,and then decreased.The S100B levels of infants in PVL group were significantly higher than those of control group at 1st,3rd and 7th d after birth (P ＜0.05) ;and decreased on day 14 (P＞0.05).(3) Infants whose MBP and S100B levels increased at 7th day after birth had significantly decreased DQ than those of normal infants ( P ＜0.05 ).Conclusion The serum MBP and S100B levels in infants with PVL are correlated with the severity of central nervous system injury.If the serum S100B and MBP levels of PVL infants continues to rise more than 7 d,the DQ are lower,and the outcomes are poor.

ObjectiveTo investigate the shoulder-hand syndrome complicated in stroke patients discharged from hospital and effects of intervention for it on motor function.Methods112 stroke patients discharged from hospital were divided into treatment group and control group. The treatment group received intervention to provent and treat the shoulder-hand syndrome. They were assessed with Fugl-Meyer assessment, Barthel index 15 d, 1 month, 3 month, and 6 month after discharged, and the incidence of shoulder-hand syndrome were recorded. ResultsThe scores of Fugl-Meyer Assessment and Barthel Index were significant difference between these 2 groups (P<0.01). The incidence of shoulder-hand syndrome increased with time. ConclusionShoulder-hand syndrome may occur within 6 months after stroke. It is important to develop an effective prevention, treatment and rehabilitation to deal with it.

Objective:To observe the clinical effect of children's massage combined with traditional Chinese medicine hot compress in the treatment of children with night crying heart and spleen fever syndrome.Methods:From April 2017 to January 2019, 90 children with nocturnal crying heart and spleen fever syndrome in the Department of Pediatrics, Shijiazhuang Traditional Chinese Medicine Hospital, who met the selection criteria were divided into 2 groups according to random numbers, with 45 cases in each group. The control group was given oral calcium and vitamin D, and the observation group was given children's massage combined with traditional Chinese medicine hot compress treatment. Both groups were treated for 7 days. The scores of TCM syndromes were performed before and after treatment, and the improved SPIEGEL sleep scale was used to evaluate the sleep quality of the children, and to evaluate the efficacy of crying and TCM syndromes.Results:After treatment, the scores of the primary and secondary symptoms in the observation group were significantly lower than those in the control group ( t values were 44.449, 46.204, 56.476, respectively, all Ps<0.001); SPIEGEL sleep scale score (4.7 ± 0.9 vs. 8.3 ± 1.4, t=14.715) was significantly lower than that of the control group ( P<0.01). While the tongue coating and fingerprint abnormalities did not change significantly after treatment in both groups ( χ2 values were 0.403, 0.401, respectively, all Ps>0.05). The total effective rate of crying in the observation group was 91.1% (41/45) and that in the control group was 62.2% (28/45). The difference between the two groups was statistically significant ( χ2=10.497, P<0.01). The total effective rate of TCM syndromes in the observation group was 97.8% (44/45) and the control group was 48.9% (22/45). The difference between the two groups was statistically significant ( χ2=27.500, P<0.01). Conclusions:Pediatric massage therapy combined with traditional Chinese medicine hot pack can improve the TCM syndromes and symptoms of children with night crying heart and spleen fever syndrome, relieve sleep dysfunction, and improve clinical efficacy.

The clinical and genetic data were retrospectively analyzed in a pedigree with pseudohypoparathyroidism type Ⅰ a.Clinically typical Albright hereditary osteodystrophy (AHO),hypocalcemia,hyperphosphatemia,and PTH- and TSH-resistance were manifested in the proband,but not in his brother and parents.The proband's symptom of epilepsy was alleviated by treatment with calcium and vitamin D,which was of no avail in regard to AHO.After GNAS1 genes were sequenced and compared with the GenBank data among the family members,a deletion of c.1107_1108 ( p.Glu370ArgfsX11 ) in exon l3 of GNAS1 gene leading to a frameshift mutation was found in the proband and his mother.It suggested that the GNAS1 gene mutation might be related to the pathogenesis of the disease.

Clinical post competence and medical ethics literacy are the key qualities that applied medical talents should have. The synergy of medical education is an effective way to deepen the reform of competence-oriented medical education. Under the background of synergy of medical education and considering the orientation of training applied medical talents in our college, we explore a progressive path of "three early education", which means early exposure to specialties, early exposure to practice, and early exposure to clinical practice. Meanwhile, we strengthen the cultivation of medical students' medical ethics literacy throughout the whole process of "three early education", laying a solid foundation for medical students before they enter the stage of clinical practice training. Practice shows that the progressive "three early education" mode and the cultivation of medical ethics literacy throughout the whole process can effectively improve medical students' clinical post competence.