Objective To determine the critical value of the Edinburgh postnatal depression scale (EPDS) in preliminary screening of postpaitum depression (PPD) in puerpera of Chengdu. Methods A prospective cohort of 732 women completed the Chinese version of EPDS and the Beck depression inventory (BDI) three to fourteen days after giving birth. Results The optimal critical value for EPDS to screen PPD was as follows: score no higher than 5 symboled no or slight PPD;score between 6 and 9 represented mild PPD, score equal to or higher than 10 showed moderate or severe PPD. Conclusions The EPDS is reliable in screening PPD in Chengdu, and it has optimal critical value at which it is sensitive to identify PPD in puerperas of Chengdu.

Objective To evaluate the utility of the Chinese version of the Edinburgh postnatal depression scale(EPDS)when being used in puerperas in Chengdu.Methods Following translation and back translation,the EPDS was commented by six experts,then a prospective cohort of 732 women completed the EPDS and the Beck depression inventory(BDI)three to fourteen days after siring birth.Rusuits The concordance rates of translation and back translation were all 100%;the content validity ratio of the EPDS was 0.9333;the Cronbaeh's alpha coefficient of the EPDS was 0.76,the cumulative variance contribution of the two factors was 44.979%,and the spearman correlation coefficient between the EPDS and BDI was 0.584,＜0.01.Conclusions The EPDS possesses good cknical pefformanee,is very concise,easy to read and understand and well accepted by mainland Chinese puerperas and researchers.It is a good instrument for screening for postnatal depression in puerperas of Chengdu.

Objective To explore the effect of Quyushengxin Method on transforming growth factor-β1/Smads in ventricular remodeling of rats after acute myocardial infarction. Methods 50 male Wistar rats were randomly divided into control group, sham operation group, myocardial infarction group, Chinese medicine group and western medicine group with 10 rats in each group. Chinese medicine group was administered 3 d before the operation once a day. The rats were sacrificed 7 d later. The peripheral blood bone marrow mesenchymal stem cells (BMSCs) was detected and the mRNA level of TGF-β1, Smad3 and Smad7 were observed with RT-PCR. Myocardial c-kit cell number and HE staining results were also observed. Results The expression of TGF-β1 mRNA and Smad3 mRNA were higher and the expression of Smad7 mRNA was lower in the model group than in the sham operation group (P<0.05). The expression of TGF-β1 mRNA and Smad3 mRNA were lower and the expression of Smad7 mRNA was higher in the Chinese medicine group than in the model group (P<0.05). And the c-kit cell number was more in both Chinese medicine group and western medicine group than in the model group. And there was no significant difference between Chinese medicine group and western medicine group (P>0.05). Conclusion Quyushengxin Method can inhibit ventricular remodeling after myocardial infarction in rats.

Objective To explore the cleaning effect of moisturizing through multiple enzymes cleaning fluid or alkaline cleaning fluid in the cleaning of medical equipment .Methods One thousand and two hundred surgical instruments used by cesarean delivery and recycled immediately from June 2013 to September 2013 were chosen and divided into the Ⅰ,Ⅱ,Ⅲ,Ⅳgroup according to the random number table , each with 300 .the ⅠandⅡgroup received the cleaning 2, 12 h after the moisturizing through the multiple enzymes cleaning fluid , respectively;and Ⅲ and Ⅳ group received the cleaning 2, 12 h after the moisturizing through the alkaline cleaning fluid , respectively .The qualification rates of cleaning were compared among the groups .Results No differences were found in the qualification rates of cleaning through the visual , microscopically and test paper detection between Ⅰ and Ⅲ groups ( P >0.05 ).The qualification rates of cleaning through the visual , microscopically and test paper detection were respectively 97.33% (292/300),96.33% (289/300) and 97.00%(291/300) in Ⅳ group, and were higher than 87.00% (261/300),86.33% (259/300) and 86.33%(259/300) in Ⅱ group, and the differences were statistically significant (χ2 =18.690,18.950, 14.592, respectively;P<0.01).The qualification rates of cleaning through the visual , microscopically and test paper detection were respectively 98.67% (296/300),98.00% (294/300) and 98.33% (295/300) in Ⅰgroup, and were higher than those of Ⅱgroup, and the differences were statistically significant (χ2 =30.688, 22.017,30.513, respectively;P <0.01).No differences were found in the qualification rates of cleaning betweenⅢandⅣgroups (P>0.05).Conclusions The surgical instruments after the normal use should be cleaned within 2 hours, and the moisturizing through multiple enzymes cleaning fluid or alkaline cleaning fluid can all ensure the cleaning quality .The surgical instruments after the use can not be cleaned within 2 hours, and should be firstly moisturized through the alkaline cleaning fluid and secondly cleaned through the machine so as to improve the cleaning quality of instruments .

Objective:To translate the English version of the Questionnaire Assessing the Childbirth Experience (QACE) into Chinese and test its reliability and validity, enriching the evaluation tools used for delivery experience in China, providing guidance for medical personnel to evaluate the delivery experience of mothers, and providing reference for improving the delivery experience of mothers in the future.Methods:Based on Beaton ′s cross-cultural debugging guide, the Chinese version of QACE was developed, including correct translation, comprehensive, back translation, expert consultation and pre-test. The reliability and validity of the questionnaire survey was carried out on 235 participants who visited the postpartum clinic in West China Second Hospital, Sichuan University and Mianyang Central Hospital. Results:In 235 participants, aged 20-29 years old with 79 cases, aged 30-39 years old with 152 years old, aged 40-43 years old with 4 cases. The Chinese version of QACE consisted of 4 dimensions (emotional state, relationship with medical staff, first time spent with newborns, and feelings after 1 month postpartum) and 13 items. The Cronbach α coefficient of the scale was 0.812, the Cronbach α coefficient of each dimension was 0.661-0.844, and the broken half reliability was 0.527. The scale level content validity index was 0.95. Four common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 67.682%. Conclusions:The Chinese version of QACE has significant reliability and validity, and can be used to evaluate maternal delivery experiences.

Objective To analyze the possible influencing factors of postoperative bleeding after endoscopic submucosal dissection and endoscopic mucosal resection ( ESD/EMR) for early gastric cancer. Methods Clinical data of patients receiving ESD/EMR for the diagnosis of early gastric cancer at the Endoscopy Center of Beijing Friendship Hospital from January 2013 to May 2018, including demographic information ( age, gender and history ) , endoscopic lesion characteristics ( tumor size, location and morphology) and postoperative pathological features ( differentiated types and invasive depth) were collected to analyze the effects of these factors on bleeding after ESD/EMR. Results A total of 195 patients with early gastric cancer were included in the study and 9 cases ( 4. 6％) had postoperative bleeding. The medication history of clopidogrel and main lesion sizes were statistically different between postoperative bleeding group and non-bleeding group ( P=0. 018 and P=0. 034 ) . Multivariate analysis showed a history of clopidogrel ( OR=10. 223, 95％CI:1. 143-91. 468, P= 0. 038 ) , multiple lesions ( OR= 6. 412, 95％CI:1. 123-36. 616, P=0. 037) and lesions sizes of larger than 2 cm ( OR=6. 718, 95％CI:1. 130-39. 935, P=0. 036) were possible risk factors for postoperative bleeding. Survival analysis showed of higher postoperative bleeding risks in patients with the history of clopidogrel ( P<0. 001) and lesions sizes of more than 2 cm ( P=0. 022) . Conclusion More attention should be paid to the risk of ESD/EMR postoperative bleeding in early gastric cancer patients with medication history of clopidogrel and multiple large lesions.

Objective:To explore the value of ex- vivo porcine stomach model for endoscopic submucosal dissection (ESD) training for international trainees. Methods:Fifteen international students received ESD training and learning for twenty days. Firstly, students learned basic theory of ESD and completed a questionnaire. Then they were randomized to receive endoscopic training either on the vitro animal (group A) or on training experience (group B) of the clinical observation. At last, one case was assessed by an experienced endoscopist. The total and step-by-step operating time, complete resection, size of specimen and complications were recorded. All students completed the questionnaire once again. SPSS 20.0 was used for t test and chi-square test. Results:There was significant difference in total ESD operation time between group A and group B ( P<0.05). There were significant differences between the two groups on cutting time and dissection time, but there was no difference on marking time, injection time and operating speed. There was only one case of block resection and perforation in each group. For group A, their mastery and clinic confidence of ESD had been obviously increased after the animal training course. Compared with the operation before the training in group A, it was found that the total time and cutting time of the ESD after the training were also significantly improved. Conclusion:Theory combined with endoscopic training on vitro animal model can make the trainees familiar with the basic theory and master the operational skills, which is helpful and valuable for them to perform ESD in further clinic practice.

Objective: To compare the efficacy and safety of endoscopic submucosal dissection(ESD) and surgery in the treatment of early gastric cancer. Methods: Clinical data of patients with early gastric cancer who received ESD or surgery in Beijing Friendship Hospital from June 2012 to May 2018 were collected. Complete resection rate, complication incidence, hospital stay and expenses between the two groups were compared. Results: There was no significant difference between two groups in complete resection rate[95.7%(245/256) VS 99.0%(97/98), P=0.191], or the complication incidence [5.9%(15/256) VS 8.2%(8/98), P=0.471]. Hospital stay was shorter in the ESD group than that in the surgery group(11.5±3.7 d VS 19.4±13.0 d, P=0.000). Expenses were less in the ESD group than those in the surgery group (27 383.1±10 143.0 yuan VS 78 004.3±79 027.8 yuan, P=0.000). Conclusion The efficacy and safety of ESD are comparable with surgery in the treatment of early gastric cancer, but ESD is superior to surgery in hospital stay and expenses.

Objective: To investigate the risk factors of operation time of endoscopic submucosal dissection (ESD) for superficial gastric lesions. Methods: Clinicopathologic data of 193 patients (195 lesions) diagnosed with early gastric cancer preoperatively who received ESD in Beijing Friendship Hospital from January 2015 to December 2017 were retrospectively collected, including basic information (age, gender, body mass index, comorbidities), lesion characteristics (size, location, morphology), the operators′ experience of ESD, operation time, and postoperative pathology, etc. Univariate analysis was performed to find the risk factors of ESD operation time, and logistic regression analysis was performed on the factors with statistical differences in univariate analysis to find the independent risk factors of ESD operation time over 120 min. Results: The mean age of the patients was 63.34±9.11 years. The median time of ESD operation was 120.00 (95.00, 165.00) min and the median size of the lesions was 1.50 (1.00, 2.38) cm. Early gastric cancer was diagnosed by postoperative pathology in 164 lesions (84.10%), among which 162 lesions (98.78%) achieved en bloc resection, and 148 lesions (90.24%) achieved curative resection. The gender (P=0.018), location(P<0.001) and size (r=0.209, P=0.007) were risk factors of the operation time by univariate analysis, while age, body mass index, American Society of Anesthesiologists (ASA) grade, roughness of lesion surface, presence or absence of white moss and ulcer, depth of lesion invasion, operative period, gross shape of lesion, degree of differentiation, and experience of operator were not associated with operation time (all P>0.05). Multivariate analysis showed that the lesion located in cardia/fundus of stomach (OR=5.656, 95%CI: 2.291-13.964, P<0.001), body of stomach (OR=2.667, 95%CI: 1.048-6.785, P=0.040) and >2 cm in size (OR=2.761, 95%CI: 1.229-6.205, P=0.014) were independent risk factors for the operation time longer than 120 min. Conclusion Lesions located in the cardia/fundus, body of stomach and >2 cm in size are independent risk factors for long operation time of ESD.