Objective To investigate the changes of cesarean section rate and indications in different level hospitals of different areas in China during 2000 to 2009. Methods Literatures published in Chinese journals on variation of cesarean section rate and indications from 2000 to 2009 were analyzed. Cochran-Armitage test was used to analyze the trend. The differences of cesarean section rate between different areas or different level hospitals were analyzed by chi-square test.Results Forty-nine papers were enrolled in this study.Cesarean section rate had risen from 2000 (32.1％,10 353/32 258) to 2009 (52.5％,3674/6992)(Z=-20.8267,P＜0.01).During 2000 to 2008,the average cesarean section rate of level one grade A hospital was 45.7％ (3754/8214),which was higher than 34.5％(25 015/72 507) in level three grade A hospital and 32.3％(28 140/87 121) in level two grade B hospital (P＜0.05,respectively).Except for level three grade A hospital,cesarean section rate had risen in the other two level hospitals during 2003 to 2008. The average cesarean section rate was 58.6％ (4982/8502) in northeast area during 2000 to 2007,which was higher than that of other areas (P＜0.01); and the average cesarean section rate was 27.5％ (12 264/44 595) in central China and 33.0％ (23 239/70 421) in southern China,which were lower than that of other areas (P＜ 0.01 ). Social factor,instead of dystocia,became the most important indication for cesarean section,and its proportion kept rising annually,from 11.3％ (1170/10 353) in 2000 to 27.1％(2094/7726) in 2008 and remained above 20.0％(5159/24 691) since 2004.The proportion of scar uterus rose from 6.7％(694/10 353) in 2000 to 12.5％ (459/3674) in 2009. Conclusions Cesarean section rate rises fast and its major indications had changed in China. It is suggested that special method should be taken to control the current situation.

Objective To explore the mediator effect of coping styles in relationship between hope level and subjective well-being of empty-nesters in urban community.Methods 208 empty-nesters were tested with Herth Hope Scale,Coping Style Questionnaire and Subjective Well-Being to investigate the influence and the pathways of hope and coping styles on subjective well-being with structural equation modeling.Results Influence of hope level on subjective well-being of empty-nesters in urban community accorded with completely-mediated model (x2/df =1.971,GFI =0.955,AGFI =0.911,RMSEA =0.068),and influence of hope level mediated by positive coping styles accounted for 41.76％(Z=3.692,P＜0.01).Conclusion The influence of hope level on subjective well-being is mediated mainly by positive coping styles for empty-nesters in urban community.

Objective:Clonidine,by activating peripheral α-sbrenoceptors, produces transient pressor response after i.v.injection in anesthetized animals.Moxonidine, with at least 40-fold higher affinity to I1-imidazoline receptors than to α2-adrenoceptors,produces also a transient pressor response. This work was designed to investigate whether I1-imidazoline receptors are involved in this pressor effect of moxonidine. Methods:Female spontaneously hypertensive rats(SHRs,aged 14-16 weeks)were anesthetized with urethane.To observe the transient pressor responses,moxonidine 0.1,0.3,1.0mg/kg(intravenous,i.v),2.0μg(intracerebroventricular,i.c.v.)and 1.0,10.0mg/kg(intragastric,i.g.)were administrated in different groups of rats.To evaluate the roles of α1-adrenoceptors,α2-adrenoceptors and I1-imidazoline receptors in the transient pressor responses to moxonidine, prazosin(10.0μg/kg),yohimbine(2.0mg/kg),phentolamine(0.2mg/kg),idazoxan(1.0mg/kg)or yohimbine+idazoxan(2.0mg/kg+1.0mg/kg)were intravenously given to the animals before moxonidine 0.3mg/kg (i.v.).Results:It was found that i.v.moxonidine produced a greater pressor response than clonidine when producing a similar reduction of blood pressure.This effect of moxonidine was not influenced by prazosin, but was partly inhibited by yohimbine, phentolamine or idazoxan,and completely blocked by the combination of yohimbine and idzaxon.Neither i.c.v.injection nor i.g. administration of moxonidine induced transient pressor responses.Conclusion:The transient pressor response of i.v. moxonidine is mediated by both peripheral I1-imidazoline receptors and α2-adrenoceptors.

Objective To study the regularity of compound herbal formulae for perimenopausal syndrome. Methods Compound herbal formulae published on journals for the treatment of perimenopausal syndrome was searched and collected. A database was established for data mining using frequency count, cluster analysis and association rule analysis. Regularity of key herbs and pair (group) of herbs was summarized. Results There were 49 prescriptions (totaling 100 herbs and 553 counts of frequency) in the compound herbal formulae for perimenopausal syndrome. The herbs which were used for more than 3 times included 57 herbs (totally 504 counts of frequency), and they were cluster analysed and classified into 8 clusters including drugs for invigoration, clearing heat, warming and nourishing, restoring vital energy, tranquilizing, calming the liver, soothing the liver, and promoting mentality. The rules in pair of herbs were 39, and rules in group of herbs were 17, by using association rule analysis. Conclusion It was feasible that study the regularity of Chinese compound prescription for the treatment of perimenopausal syndrome by using data mining.

Objective To investigate the relationship of serum adiponectin (APN) gene promoter region single nucleotide polymorphism (SNP) frequency and type 2 diabetes mellitus (T2DM).Methods 120 cases of T2DM were divided into Yin Deficiency Syndromes(n=42), Yin hot (n=38), yin and yang (n=40) and 50 cases of normal volunteers were select as the control group. The diponectin gene (aPM1) promoter polymorphisms of each group were detected with polymerase chain reaction amplification (PCR).Results Serum APN Yin hot levels in patients with T2DM (6.98 ± 1.23 μg/ml) were lower than Qi and yin (2.55 ± 0.78 μg/ml) and yang group (3.48 ± 0.22 μg/ml) (P<0.05), and TG, LDL-C, TC (4.48 ± 0.87 mmol/L, 4.98 ± 0.42 mmol/L, 5.36 ± 0.79 mmol/L) were higher than Qi and yin (3.25 ± 0.75 mmol/L, 4.02 ± 0.69 mmol/L, 3.12 ± 0.52 mmol/L) and yang group (3.18 ± 0.69 mmol/L, 4.09 ± 0.71 mmol/L, 3.22 ± 0.78 mmol/L)(P<0.05). Yin hot type aPM1-11377G/C genotype of the GG genotype was significantly higher than the proportion of Qi and yin and yang group (P<0.05), while the yin and yang and yin and yang group aPM1-11377G/C genotype the proportion was higher in GG genotype (P<0.05). GG genotype was significantly lower than serum APN type CG and CC genotype (P<0.05), whereas no significantdifference in other indexes (P>0.05).Conclusion T2DM patients Yin hot type inherent relationship with aPM1-11377G/C polymorphism, aPM1-11377G/C polymorphism may reflect R2DM Disease Syndromes typing a certain extent, and by influence insulin resistance in patients with arterial plaque and serum APN levels, thereby affecting T2DM disease occurrence and progression.

Objective To study the medication regularity of compound herbal formulae in treating patients with advanced non-small lung cancer (NSCLC). Methods Compound herbal formulae published on journals for the treatment of NSCLC were searched and collected from CBM, CNKI, and Wanfang Data for database establishment. Frequency analysis, cluster analysis, and association rule analysis were used for data mining, and regularity of main Chinese medicinal herbs and herbal pairs (combinations) were investigated. Results There were 107 compound herbal formulae (involving 193 Chinese medicinal herbs and 1298 frequency) for NSCLC. 42 Chinese medicinal herbs were used for more than 9 times. Cluster analysis on the tastes and properties of the 42 Chinese medicinal herbs found that, among the four qi, cold showed the highest frequency (409);among the five tastes, sweet showed the highest frequency (627);among the meridians, lung meridian showed the highest frequency (546). Cluster analysis divided main Chinese medicinal herbs into 9 types, including yin-nourishing herbs, heat-clearing herbs, qi-tonifying herbs, blood-enriching herbs, blood circulation activating herbs, hemostasis herbs, phlegm-reducing herbs, qi-descending herbs, lung-astringing herbs. Associate rule analysis obtained 26 rules for Chinese medicinal herbal pairs, 18 rules for Chinese medicinal herbal combination, most of which were combinations for tonifying qi, nourishing yin, and clearing heat. Conclusion Chinese compound herbal formulae for the treatment of NSCLC mainly use Chinese medicinal herbs with properties of cold and mildness, with the tastes of sweet and bitter, with meridians of lung, spleen, and stomach, with the treatment of tonifying qi, nourishing yin, and detoxication.

Importance of central laboratories in hospitals is rising sharply as they provide laboratory support to hospital development in its science researches. The paper introduced the mission and features of the central lab of the hospital, as well as its technical personnel makeup, instrumentation, and rules and regulations. Authors prove in the paper that central labs are playing a key role in hospital science research as its research base.

Objective To study the distribution characteristics of TCM basic syndromes in sub-healthy status. Methods Based on a clinical epidemiologic method, an epidemiological investigation in people working in the fields of education and health care in Jing’ an District of Shanghai from Oct. to Dec., 2009 was conducted in order to conclude the main symptoms and basic syndrome characteristics of sub-health. Results Totally 1152 cases out of 1502 were in sub-healthy status. The most common symptoms of sub-healthy status were fatigue, fatigue that is not improved by bed rest, dizziness, dryness of eye, waist acerbity of eye, dry pharynx, memory difficulty, decreased food appetite, hypoposia, sweating, pain, negative feeling, tantrum, difficulty in falling asleep, early awakening, low-quality sleep, aneuria, drop in energy, frequent colds, and cold-blooded feeling;the most common physical signs were low spirits and neurolysis, sallow complexion, low voice, big body of tongue, pale tongue, greasy fur, and pulse breakdown;the most common syndrome types were qi-stagnation in liver with deficiency of spleen (20.31%), deficiency of both heart and spleen (16.49%), spleen asthenic fluid-retention (14.76%), qi-depression in liver (11.98%), hepatic and renal yin-deficiency (11.63%), phlegm-heat attacking internally (8.07%), qi-deficiency in liver and spleen (7.99%), pathogenic fire derived from qi-stagnation in liver (3.13%). Conclusion Based on this cross-sectional study, clinical manifestation and symptom types of sub-healthy status could be identified preliminarily, and the basis of treating sub-health with traditional Chinese medicine could be provided.

In 1930s, Wolf created the first partogram. In 1950s, Friedman proposed the classical model of partogram that has been applied in clinical labor assessment ever since. Over the past ten years, Zhang has made great improvement in this field. Here, we reviewed the three different stages in partogram research (the first proposed stage, Friedman's classical stage and Zhang's stage) in terms of its background, demographic characteristics and clinical application. Moreover, this article also emphasized the necessity of partogram research and discussed the prospects for future research and clinical application based on the recent progress in China.

Objective To know the clinical nursing staff′s master degree in pain management knowledge, the status of pain management, and nursing staff′s training requirements for pain management, so as to provide scientific references for the improvement of clinical nursing staff′s pain management trainingand pain management system.Methods A total of 264 clinical nurses from northern of Jiangsu province were surveyed by Chinese version knowledge and attitudes survey regarding pain ( KASRP ) and the Carlson′s EBPMP prior conditions instruments (CPCIs).Results The master degree of pain management in clinical nurses was low, and the average rate of correct response on KASRP score was 49. 91%, and the mean score of KASRP was (19. 96± 3. 34). The differences in KASRP score among nursing staff with different master degree of pain management and different age were significant different ( F=3.966,3.592;P<0.05) . Among all the internal and external factors which may influence the evidence-based nursing practice and pain management that nursing staff take, the dimension of previous practice gained the highest score ( 4. 18 ± 0. 52 ) , while the innovativeness instrument gained the lowest score ( 3. 09 ± 0. 57 ) . Conclusions The clinical nurses′ knowledge of pain in northern of Jiangsu province is insufficient, and the level of pain management needs to be improved. Clinical nurses have urgent need in learning knowledge of pain, and further strengthen clinical training in pain management should be provided to increase their knowledge of pain and clinical nursing quality.