OBJECTIVE To investigate the perioperative use of antibacterials in patients with cesarean section(CS) so as to provide references for rational administration of drugs in the clinic.METHODS Case history of 305 CS cases was randomly retrieved,whose data concerning medication,drug categories,DDDs,duration of medication,drug combination,etc were analysed.RESULTS All of the total 305 CS cases were given antibacterials in perioperative period.6 categories antibiotics were used,which included:ceftriaxone,penicillin,lincomycin,cefoperazone/sulbactam,metronidazole and gentamicin.294 cases received only one kind of antibacterial,accounted for 96.39% of the total.CONCLUSIONS The perioperative use of antibacterials in the majority of CS patients is rational.Prophylactic use of antibacterials in perioperative period for CS should be regarded as the chief means,because it can effectively inhibit and kill bacteria,prevent endogenous or exogenous infection and lower the postnatal infection of CS patients.

ObjectiveTo explore the effect of psychological care and community revisit on preven-tion of postpartum depression. Methods300 cases of pregnant women were randomly divided into the intervention group and the control group with 150 cases in each group. The intervention group took psycho-logical care and community revisit, the control group received conventional care. The incidence of missing follow- up and depression in the two groups were compared using χ2 test. ResultsThe incidence of miss-ing follow-up and depression in the intervention group was significantly lower than those of the control group. ConclusionsPsychological care and community revisit can significantly reduce the occurrence of postpartum depression.

Objective: To investigate the action and mechanism of Bupleurum chinense SD and Schisandra chinensis Turcz extract on liver fibrosis in rat.Methods: The model was prepared by injection of 40% CCl 4 plant oil solution, then the enzyme active AST、AST、MAO、ALP、r-GT、TG in serum and MAO、ALP、GSH、TG in hemogeneous were measured by enzyme method, the level of Pc-Ⅰand PcⅢ were measured by radio-immunity. Results: Bupleurum chinense and Schisandia chinensis extract can reduce significantly enzyme active of ALT、AST、TG、MAO in serum of fibrosis rat, the GSH was elevated and the r-GT was not effect in serum, but it could reduce the level of MAO、ALP、Pc-Ⅰ、Pc-Ⅲ in the homogeneous, sometime the TG was increased and the GSH was not effect in homogeneous. The histopathology showed that Bupleurum chinense and Schisandia chineusis extract could get damaged liver cell back and reinforce the regeneration of hepatic cell. Conclusion:Bupleurum chinense and Schisandid chinensis extract the action of protective and restoration on injured liver cell, and its could eliminate the bile accumulation, to retard the fatty degeneration in fibrotie rat.

Objective To investigate the role of apoptosis and the regulating role of receptor interacting protein 1(RIP1) in acute pancreatitis .Methods Thirty C57 mice were divided into three groups :control group ,acute edematous pancreatitis (AEP) group and acute necrotizing pancreatitis (ANP) group .The AEP group was continuously injected by cerulein 50 μg/kg for 13 times ,the ANP group was continuously injected by cerulein 50μg/kg for 13 times and lipopolysaccharide 15 mg/kg once;the con‐trol group was injected by the same volume of normal saline for 7 times .The acinar cell apoptosis was observed by the terminal de‐oxynucleotidyl transferase‐mediated deoxyuridine triphosphate nick‐end labeling (TUNEL) assay .The RIP1 mRNA expression was measured by real time fluorescence PCR .The expression of RIP1 protein was detected by Western blotting .Results The mouse models of AEP and ANP were established successfully .Compared with the control group ,acinar cell apoptosis existed in both AEP and ANP model groups ,moreover compared with the AEP group ,apoptosis in the ANP group were decreased ,the differences were statistically significant(P<0 .05) .Compared with the control group ,the expression of RIP1 mRNA and protein in the AEP group was increased ,while which in the ANP group were decreased ,the differences were statistically significant(P<0 .05) .Conclusion RIP1 participate in the pathogenesis of acute pancreatitis ,which may associate with acinar cell apoptosis .

Objective:To explore the status of job burnout among clinical nursing teachers in different depart-ments, in order to provide reference for the nursing education management .Methods:The questionnaire of Maslach Burnout Inventory ( MBI) of revised Chinese Version was distributed to 535 clinical nursing teachers .Results:The incidence of job burnout was 48 .3%, while the incidences with mild , moderate and severe job burnout accounted for 18 .9%, 15 .7%, 9 .3%respectively .Clinical nursing teachers in different departments have diffrences on oc-cupation actions .Clinical nursing teachers in the operation room revealed a significant greater personal accomplish -ment, but the emergency department scored lower .The teachers in emergency department scored higher on emotion-al exhaustion than those in other departments , and the teachers in oncology department is the secondary in scores of emotional exhaustion .The scores of the teachers in oncology department were the highest on depersonalization among all the departments,while the teachers in infection department is at the secondary place .Conclusion:The clinical nursing teachers'job burnout should be paid attention to .Strategies including intervention by nursing education management and teachers'learning and training should be taken to reduce the damage of physical and mental health caused by burnout and increase the clinical care and teaching quality .

Objective To study the relationship between serum fibrinogen,uric acid and the severity of coronary heart disease(CHD).Methods 156 patients with or without coronary heart disease were divided into CHD group and control group.All subjects were examined by cronary artery angiography.The severity of coronary artery stenosis was evaluated and graded with Leaman coronary scoring system.With the multiple analysis method,the relationships were studied between serum fibrinogen,uric acid and the severity of coronary heart disease.Results With multiple logistic regression,smoking,age,fibrinogen,triglyceride and low-density lipoprotein were independently associated with the severity of coronary heart disease.Gender,uric acid and other variables did not have significant independently association with the severity of coronary heart disease.With stepwise multiple regression analysis,age,fibrinogen,total cholesterol,lipoprotein(a)and low density cholesterol showed significant independent association with the severity of coronary heart disease,but uric acid and other variables did not.Conclusion Fibrinogen was related to the severity of coronary heart disease independently,but uric acid was not independently associated with the severity of coronary heart disease.

Acute Disease ; Enterocolitis, Necrotizing ; complications ; diagnosis ; Hand, Foot and Mouth Disease ; complications ; diagnosis ; Humans ; Severity of Illness Index

Objective To compare the diagnostic value of MRS acquired by body coil(BODY)and endorectal Coil(ERC)in the detection of prostate cancer.Methods MRI and 3D MRS were performed in 12 patients with prostate disease,in which 6 of them were proved to have prostate cancer and the other 6 noncancerous disease.Both BODY and ERC MRS were performed in 7 patients,and only BODY MRS was performed in the other 5 patients.All MRS data were quantitatively assessed with a per-sextant method.The metabolic ratio of(Choline+Creatine)/Citrate[(Cho+Cre)/Cit]was measured in each ROI.ROC analysis was carried out to assess and to compare the diagnostic value of BODY and ERC MRS in patients with prostate cancer with Wilcoxon test.Results (1)The ratios of(Cho+Cre)/Cit in the prostate cancer group(median 1.744,0.295 to 7.998)was statistically higher than that in the non-prostate cancer group (median 0.412,0.112 to 2.113)acquired by using BODY MRS(Z=-9.159,P＜0.01).(2)The ratios of(Cho+Cre)/Cit in the prostate cancer group(median 1.975,0.479 to 7.998)was statistically higher than that in the lion-prostate cancer group(median 0.400,0.104 to 2.232)acquired by using ERC MRS(Z=-9.200,P＜0.01).(3)The mean ratios of(Cho+Cre)/Cit in the prostate cancer group and in the non-prostate cancer group acquired by using both coils were not of statistically significant difference(P＞0.05).(4)ROC analysis for diagnosing prostate cancer showed no significant difference(P=0.851)between the areas under the curve of BODY and that of ERC MRS(Az=0.93 1 and 0.935 respectively).Conclusion The BODY MRS could provide comparable diagnostic efficacy to ERC MRS in patients with prostate cancer.

Objective To primarily investigate the clinical value of analgesia/nociception index (ANI) in evaluating the analgesic effect during lobectomy performed via video-assisted thoracoscope.Methods Forty ASA physical status Ⅰ or Ⅱ patients,aged 25-64 yr,weighing 45-80 kg,undergoing elective lobectomy performed via video-assisted thoracoscope,were enrolled in this study.After induction of anesthesia with propofol,sufentanil and cisatracurium,patients received double lumen endotracheal intubation.Anesthesia was maintained with targetcontrolled infusion of propofol,and iv infusion of remifentanil and cisatracurium.The concentration of propofol was adjusted to maintain the bispectral index (BIS) value in the range of 40-60.ANI,HR,systolic blood pressure (SBP),diastolic blood pressure (DBP) and BIS value were recorded within 5 min before and after the predefined time points including posture change between lateral and supine position,ventilatory pattern change between onelung and double-lung ventilation,skin incision and trocars insertion,lymph node dissection and pleural lavage.At skin incision and during trocars insertion,lymph node dissection and pleural lavage,the development of hemodynamic responses (increase in HR and SBP ＞ 20％ of baseline value) were recorded.Results The incidence of hemodynamic responses was 100％ at skin incision and trocars insertion,and 84 ％ during No.4,7,10 groups of lymph node dissection and after pleural lavage and difference was found in ANI during these stimuli.ANI was significantly decreased within 5 min after skin incision,trocars insertion,No.4,7,10 groups of lymph node dissection and pleural lavage than that before the procedures (P ＜ 0.05).The BIS value was maintained at 40-60,and no significant changes were found between before and after the procedures (P ＞ 0.05).No significant changes were found in ANI,HR,SBP,and DBP between before and after the changes of posture and respiratory pattern (P ＞ 0.05).Conclusion ANI can be used to evaluate the analgesic effect during lobectomy performed via video-assisted thoracoscope in patients and is unaffected by the changes of posture and ventilatory pattern.

Objective To compare the clinical effects of dydrogesterone and gestrinone on postoperative endometriosis and the rate of pregnancy in patients with infertility. Methods One hundred and fifty patients with postoperative endometriosis were enrolled in the current study who were hospitalized in fuzhou General Hospital of Nanjing Command from Jan. 2009 to Aug. 2013. They were randomly divided into dydrogesternne group(76 cases)and gestrenone groups(54 cases)based on progestogent treatment. The situation of pain symptoms improvement,the recurrence rate of 1 year,side effects and postoperative pregnancy rate were observed in order to evaluate the drug efficacy. Results There were a high rate of postoperative pain remission rate and a low recurrence rate of the two groups,and the difference was not significant( P ﹥0. 05 ). The main adverse reaction of patients in dydrogesterone group was breast pain and the incidence rate was 3. 9%( 3/76 ),while there was no breast pain in gestrinone group,and the difference was not significant( P =0. 140 ). The main adverse reaction of patients in gestrinone group was liver function damage and the incidence rate was 25. 9%(7/54),while the dydrogesterone group hadn't liver function damage,and the difference between two groups was significant( P =0. 000 ). The abnormal uterus bleeding incidence rate in dydrogesterone group was 15. 8%(12/76),higher than that of gestrinone group(13. 0%(7/54)),and the difference was significant(P=0. 038) . The serum carbohydrate antigen-125(CA-125)level in two groups were down to normal after operation,and still declined after drug treatment for 3 months. But there was no obvious change after 6 months. One year pregnancy rate of dydrogesterone pregnancy was 80%(24/30),higher than that of gestrinone group(48%,12/25),and the difference was significant( P =0. 038 ). Conclusion There is no significant difference in therapeutic effect between two groups. However,dydrogesterone therapy have no significant liver damage,and a higher postoperation pregnancy rate.