Diabetic ketoacidosis is one of the most common causes of death in the pediatric diabetes,and it is also one of the most common endocrine emergencies in children.With the further studies of this disease,more attentions are paid to the central nervous damage about DKA.The mechanisms about DKA-related cognitive dysfunction from the macro to the micro are constantly updated.This article gives a review on the pathogenesis of the cognitive dysfunction due to DKA.

Objective To observe the influence of parturients hemodynamics and curative effect of preventing hypotension syndrome by using hypotension syndrome prevention bracket in cesarean section with spinal anesthesia.Methods One hundred parturients of cesarean section,ASA grade Ⅰ-Ⅱ,were divided into two groups according to whether the use of hypotension syndrome prevention bracket with 50 cases each:observation group and control group.Control group in anesthesia after the success of the surgery made bed left tilt 15°,and observation group in anesthesia after the success immediate used hypotension syndrome prevention bracket.In the two groups,the change of systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR),mean arterial pressure (MAP),the incidences of hypotension syndrome and nausea and vomiting during and after operation,and anesthesia to uterine incision time and anesthesia time were observed.Results There was no significant difference in anesthesia to uterine incision time,anesthesia time,intraoperative infusion quantity,amount of bleeding between the two groups (P ＞ 0.05).The incidences of hypotension syndrome and nausea and vomiting in observation group were 8.00％ (4/50) and 4.00％ (2/50),in control group were 42.00％ (21/50) and 24.00％ (12/50),there were significant differences between the two groups (P ＜ 0.05).The observation group at 5 min after anesthesia SBP,DBP,MAP were (106.12 ± 12.91),(57.26 ± 11.43),(73.57 ± 11.03) mm Hg (1 mm Hg =0.133 kPa),and the control group were (95.44 ± 19.53),(50.15 ± 15.53),(66.36 ± 15.64) mm Hg,there were significant differences between the two groups (P ＜ 0.05).The observation group at 10 min after anesthesia SBP,DBP,MAP were (104.35 ± 11.86),(55.92 ± 10.81),(72.54 ± 10.37) mm Hg,the control group were (102.31 ± 15.48),(55.12 ± 11.89),(70.72 ± 11.33) mm Hg,there were significant differences between the two groups (P＜ 0.05).The observation group at 3 min after the delivery of fetus and the end of operation DBP,MAP were (54.13 ± 9.14) and (62.63 ± 8.61) mm Hg,(68.13 ± 10.40) and (80.88 ± 9.05) mm Hg,the control group were (49.24 ± 11.55) and (58.04 ± 11.67) mm Hg,(70.57 ± 8.58) and (75.35 ± 10.41) mm Hg,there were significant differences between the two groups (P ＜ 0.05).Conclusion Cesarean section parturients using hypotension syndrome prevention bracket can reduce the occurrence of hypotension syndrome,which can help to maintain the stability of parturients hemodynamics,it is worth of clinical promotion.

Objective To investigate the incidence rate and risk factors of obstetric emergency hysterectomy.Methods The clinical data of childbirth puerpera in Shangqiu four municipal hospitals were retrospectively analyzed,80 patients underwent routine obstetric emergency hysterectomy were selected as hysterectomy group,56 postpartum hemorrhage patients without uterus excision were randomly selected as control group.The related risk factors of obstetric emergency were analyzed.Results (1) The total delivery number was 65 259 cases,cesarean rate was 47.46％ (30 972/65 259),postpartum hemorrhage rate was 4.61％ (1 429/30 972),and uterus removal rate of cesarean section was 0.18％ (56/30 972),vaginal delivery postpartum hemorrhage rate was 3.28％ (1 124/34 287),in the courtyard the vaginal delivery emergency uterus removal rate was 0.03％ (12/34 287).The postpartum hemorrhage rate and obstetrics emergency uterus removal rate were higher than vaginal delivery,the differences were statistically significant (x2 =77.22,33.24,all P ＜ 0.05).(2) The results of the single factor analysis showed that,placenta previa and implant,placental abruption,merge multiple or huge uterine fibroids,uterine rupture,blood coagnlation dysfunction,armount of bleeding ＞ 2 000ml,vanda operation with oxytocin rate between the two groups,there were significant differences(P ＜ 0.01).(3) The results of unconditional multi-factor Logistic regression analysis showed that,placental abruption,uterine rupture,merge multiple or huge uterine fibroids,blood coagulation dysfunction,amount of bleeding ＞ 2 000ml were independent risk factors which lead to obstetric emergency hysterectomy.Vanda operation with oxytocin and hysterectomy had negative correlation.Conclusions Obstetric emergency hysterectomy was related with a variety of factors.Strengthen the perinatal health care,and actively prevent emergency hysterectomy can reduce the dangerous factors of uterus removal rate and has important significance.

Objective To probe into patients' mental and physical requirements,strengthen medical ethics and serve patients with great humanity.Methods A survey with self-designed questionnaire was conducted to find out satisfaction rates and problems concerned with the relationship between nurses and patients and the percentage was dealt with statistics.Results In emotion,satisfaction rates(SR) of inpatients and the patients who had already left hospital were 96.47% and 96.86% respectively;in communication,their SR were 95.88% and 97.45%;in skill,SR were 95.44% and 97.06%;in basic nursing,SR were 94.41% and 95.07%;in patients' comprehensive evaluation of nurses,thier SR were 95.59% and 96.75%.Conclusion Improvement of the relationship between nurses and patietns depends on heightening ethical level of nursing workers,which is the key measure to effectively mobilize initiative and raise working efficiency and nursing quality.

Objective To investigate the clinical associated risk factors which affect the postpartum urinary incontinence ,providing theoretical basis for early prevention and treatment of this disease . Methods The clinical data of 60 cases who diagnosed postpartum urinary incontinence were collected ,and established database ,and apply regression analysis method were used to analyze the clinical associated risk factors .Results The results showed that BMI(OR=2.534,95%CI:0.975 ~6.489 ),fetal weight (OR =2.342,95%CI:0.723 ~6.575) second stage (OR=3.346,95%CI:0.635~6.673).Conclusion high BMI,fetal weight is heavy,prolonged second stage was re-lated risk factors with postpartum urinary incontinence .

Objective To describe the experience of nurses in combined care program of traditional Chinese medicine (TCM) and provide references for nursing managers. Methods The phenomenology research method was adopted in this study. Fourteen nurses who had achieved the combined care program of TCM participated in an in-depth interview. Data were analyzed by using phenomenological analysis. Results All nurses approved nursing program of TCM: finding sense of belonging in nursing work;demonstration of self-value;standardization of nursing tednnique;harmonious environmont of nursing work. But some defect still existed: too subjective evaluation item of nursing program of TCM;inappropriate evaluation table;lact of hospital characteristics of TCM nursing;deficiency of TCM knowledge. Conclusion Nursing managers should pay more attention to nurses' emotional experience, grasp the implementation of the problems during the program and improve the program, optimize the skills, provide trainings.

Cadmium targets on kidney and bone and results in many toxic effects. Disturbance of calcium metabolism is one of the important aspects of cadmium toxicity, which includes reduced intestinal calcium absorption, increased urinary calcium excretion, negative calcium balance, development of osteomalacia and osteoporosis. There exists two potential mechanism of influence of cadmium on calcium metabolism. One is the direct inhibition of cadmium on active transports of calcium. The other is the indirect influence on calcium metabolism due to reduced renal synthesis of 1,25-dihydroxycholesterol induced by cadmium. Further research should focus on revealing how cadmium directly inhibits calcium entering into cells and transporting by calcium binding protein, elucidating whether renal synthesis of 1,25-dihydroxycholesterol is reduced in low-level cadmium exposure population, and also on clarifying the molecular biological mechanism of effects of cadmium on calcium metabolism.

After the HRP solution was injected into gastric wall of the Beijing Duck, the afferent neurons of the stomach were retrogradely traced. The results arc as follows: 1.The afferent sympathetic neurons from the proventriculus distribute in T_1-L_1 spinal ganglia, concentrically in T_(1-6), the peak number is in T_3. 2.The afferent neurons of the vagus from the proventriculus arc present in the nodosal and jugular ganglia. After HRP was injected into the ventral muscle of the proventriculus, most of the labelled neurons were found in the jugular ganglia. 3.From the gizzard, the afferent sympathetic neurons localize in T_1-L_1 spinal ganglia. The muscle tenium craniodorsalis is concentrated in T,_6, the peak number in T_3. The remained parts of the gizzard are concentrated in T_(2-6), the peak number in T_4. 4.The afferent neurons were retrogradely traced in the nodosal ganglia after HRP was injected into each part of the ventricul. But in the jugular ganglia labelled cells were found only in the region of the muscle tenuim craniodorsalis of the gizzard.

Apoptosis is important to the development of diseases. Research recently indicates that c-Jun N-terminal kinase (JNK) and cysteinyl aspartate-specific protease (caspase) play key roles in apoptosis and affect the development of diseases. This article is to introduce the function and relationship between JNK and caspase in apoptosis during the process of diseases.

Objective To establish the method of extraction and separation of formononetin in Mucuna sempervirens Hemsl..Methods The extraction and separation conditions of formononetin was studied by orthogonal test.Results Solid-liquid ratio was 1:40(g:mL),with methanol refluxing and extracting for 3 times at 85 ℃,1.5 h once,the content of formononetin was 0.038 12%.Conclusion The optimal parameters for extraction and separation condition of formononetin in Mucuna sempervirens Hemsl.was established.