Objective:To choose a best method of estimating the amount of blood loss after cesarean deliveryby comparing of three methods,to analyze the related factors of the amount of the blood loss more than 500ml after cesarean section.Methods:We collected the clinical data of the patients who were accepted cesarean delivery and treated in our hospital between January 2014 and December 2014.We estimate the amount of blood loss by different methods(including visually estimated,hematocrit (HCT) change and formula).Based on the formula method as the gold standard,we analyze the risk factors of the patients whose blood loss were more than 500 ml.Results:Among the 583 patients,using the method of visually estimated,there were 23 cases whose blood loss were more than 500 ml(3.95％),using the method of formula,there were 133 cases whose blood loss were more than 500 ml (22.81％),using the method of HCT change,there were 116 cases whose blood loss were more than 500 ml(19.90％).The incidence of patients whose blood loss were more than 500 ml between HCT change and formula method showed no significant difference(P ＞ 0.05),but the incidence by visually estimated method was less than the two other methods (P ＜ 0.05).We found the value of HCT change was a statistically significant positive correlation with the amount of blood loss more than 500ml.When the blood loss was more than 500 ml,the accuracy and sensitiveness of HCT method were significantly higher than those of visually estimated method(76.69％,87.93％ vs 12.78％,73.91％,respectively).Abnormal labor,uterine leiomyoma,placental factors,and macrosomia were risk factors of cases whose blood loss more than 500ml.Conclusions:HCT method is similar in accessing the blood loss after cesarean section with formula method,especially in the cases whose blood loss was more than 500 ml;HCT method is more convenient than formula method,and more accurate than visually estimated method.HCT method can be used as the standard for estimating blood loss initially,and formula method should be used as the method for estimating the blood loss accurately.Patients with macrosomia and abnormal labor are more likely to occur massive hemorrhage after cesarean section.

?AlM: To discuss the differences in accommodative lag of different stimulation between the adolescent myopes who wore rigid gas permeable contact lens ( RGPCL ) and spectacles for one year.
?METHODS: Totally 85 myopes between 10-16y were enrolled in the study. Every subject was examined with the visual function test, medical optometry, corneal topography and ocular health check etc. of eyes. According to the above measurements and the compliance of children and their parents, 41 subjects were selected to wear RGPCL, 44 subjects were chosen to wear spectacles. Based on maximum plus to maximum visual acuity ( MPMVA) , accommodative lag was determined by dynamic retinoscopy method in two groups. The subjects were examined once every 3mo, accommodative lag was measured again using the same method for comparative analysis after one year. Wearing a year later, myopia progression of the two groups was measured and compared.
?RESULTS: There was no significant difference between two groups of initial accommodative lag (P>0. 05). After wearing one year, there was also no significant difference between the accommodative lag examined and the initial lag in RGPCL group (P>0. 05), the results demonstrate significant difference between the accommodative lag examined after wearing one year and the initial lag in spectacles group ( P < 0. 05 ). One year later, the differences were significant in accommodative lag between RGPCL and spectacles wearers stimulated by 2D, 3D and 4D ( P < 0. 05 ), and the accommodative lag increased with increasing stimulation in both groups. After wearing a year, the myopia progression of RGPCL group was less than spectacles wearers, and the differences were significant (P<0. 05).
?CONCLUSlON:After wearing RGPCL and spectacles one year in high accommodative stimulus, there is an obviously decreased in accommodative lag in RGPCL group, which suggests that RGPCL can control the progression of myopia in adolescents. The accommodative lag of the two groups increase obviously with increasing stimulation, which suggest that the adolescents need keeping good habits of reading.

Objective To establish a model in rats for studying the lung injury induced by powder combustion. Methods The explosion box and trauma chamber were constructed based on the fire simulation-platform. The smoke composition was analyzed on-line. The animal clinical manifestation was observed, and the lung water ratio, arterial blood gases, gross appearance and macropathology were analyzed to evaluate the injury level. Results The smoke contents included CO, SO 2, NO and NO 2. When the injury occurred, the CO concentration was 505 23 ppm, and SO 2 concentration was 67?4.8ppm. The time to cause injury was 4 minutes. The tachypnea immediately occurred for most of the rats, then bradypnea and dyspnea. The metabolic acidosis happened at the early stage of injury and the combined effects of metabolic acidosis and respiratory acidosis appeared at the late stage. Water ratio in the lung gradually increased and reached the peak at 6 hours later, and the normality was not recovered after 24 hours. The gross appearance and macropathology proved the lung injury. The obvious bleeding appeared at 4 hours, and the edema reached the most grievous level at 6 hours, and the normality was not recovered after 24 hours. Conclusion The model has been successfully established to study powder combustion-induced acute aspiration lung injury in rats .This model can keep the injury conditions stably and has the benefits of easy-making and repeatable.

Objective To explore the clinical significance and changes of tumor necrosis factor-?(TNF-?)and interleukin-6(IL-6)level in children with acute viral myocarditis(AVM).Methods TNF-? and IL-6 level in serum from 53 AVM children and 20 healthy children were measured by radio-immunoassay and enzyme-linked immunosorbent assay(ELISA).The relation between the levels of TNF-? and IL-6 in serum with the occurrence and development in acute viral myocarditis was analyzed.Results Thirty-two were males and 21 females in the 53 AVM children.The ages ranged from 3-11 years old.There were 12 males and 8 females in control group.The serum level of TNF-? and IL-6 were(526.7?32.9),(3.23?0.53)mg/L in AVM group and(383.1?27.5),(1.63?0.22)mg/L in control group.There were significant difference between the 2 groups(Pa

Objective To survey the distribution of TCM constitution of Guangxi adults.Methods Identification questionnaire of constitution in TCM was performed to identify the TCM constitution types of 3000 adults who were taken medical examination in the first affiliation hospital to GuangXi TCM university Health Administration Center or of permanent residence in Nanning,Wuming,Qinzhou,Hezhou.Results 612 cases (20.4％) had constitution of phlegm-dampness in 504 cases (16.8％) had constitution of phlegm-dampness,431 cases (14.3％) had constitution of yang asthenia,422 cases (14.1％) had constitution of qi asthenia,353 cases (11.8％) had constitution of damp-heat,348 cases (11.6％) had constitution of yin asthenia,159 cases (5.3％) had constitution of qi stagnation,100 cases (3.3％) had constitution of blood stasis,and 71 cases (2.4％) had allergic constitution.Conclusion There were 9 kinds constitutions in the adults of GuangXi province.The constitution of yin-yang harmony was the most among all.Most male had phlegm-dampness or damp-heat constitution.Most female had yang asthenia,qi asthenia,qi stagnation or yin asthenia constitution.

Questionnaire survey(n=147)and group interview(n=13)were used for this investigation.Our results showed that 66.7%of participants considered"heavy work burden and insufficient specialists"to be the main challenge.Half of comingnity healthcare providers were not satisfied with thepayment systerm.We suggest that the overall-consideration of community healthcare service development in urban and suburb areas and 4 kinds of performance pattems should be strengthened:the perfommnce appraisal and quality control schemes should be modified;and the employee headcount in community healthcare centers or transferred employees'salary should be moderately increased in the fumre.

Adult ; Aged ; Cross Infection ; microbiology ; Drug Resistance, Bacterial ; Drug Resistance, Fungal ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; complications

Objective To isolate bioactive compound of enhancing fibrinolysis from secondary metabolites of marine microorganism.Methods The separation of microorganism from seawater samples,screening of producing fibrinolytic compound's strain,selection of the active strain's optimum fermentation medium and refining of active compound were done by the method of selective cultivation,measuring of compound's fibrinolytic activity and semipreparative HPLC,respectively.Results Nine hundred and thirty-six single strains from 31 samples were collected 100 meters off the coast,and cultures of the fungus(FG216) contained enhancing fibrinolytic compound.Compounds from modified Czapek medium as the fermentation medium of FG216 showed significant fibrinolytic effect.Finally,active fraction were isolated and refined from cultures of FG216.Conclusion In this paper,active compound of enhancing fibrinolysis were gained from secondary metabolites of isolated single microorganism from seawater.

Objective:A study was conducted to observe and compare the efficacy and safety of endostar combined with peme-trexed in elderly patients with advanced lung adenocarcinoma. Methods:Sixty advanced lung adenocarcinoma (ⅢB-Ⅳ) patients who never received any therapy were included. The patients were divided into two groups. One group comprised endostar treatment com-bined with pemetrexed (26 cases of males, 15 cases of females, and 11 cases of individuals aged 65 years old to 78 years old), and the other group comprised pemetrexed only (34 cases of males, 20 cases of female, and 14 cases of individuals aged 65 years old to 78 years old). The two groups were treated for 4 to 6 cycles, and evaluation of treatments was performed every two cycles. Results:The endostar group was re-treated for 80 cycles, and the average cycle was 3.1. The group without endostar was re-treated for 115 cycles. The short-term effects are as follows. The total effective rates (RRs) in the experimental and control groups were 23.1%and 14.7%, re-spectively, and the difference was statistically significant (P<0.05). The disease control rate (DCR) was not significantly different (P>0.05). For pleural effusion, RR and DCR were significantly better in the experimental group than in the control group (P<0.05). In the experimental group, compared with PD, the microvessel density (MVD) in the DCR showed higher expression, and a statistically signif-icant difference (P=0.03) was observed. In the control group, compared with PD, the MVD in the DCR also showed higher expression, but no significant difference (P=0.73) was observed. The long-term effects were as follows: median progression-free survival (PFS), median survival, and side effects between the two groups were not significantly different (P>0.05). Conclusion: Endostar combined with pemetrexed showed increase in total efficiency in elderly patients with lung adenocarcinoma, and malignant pleural effusion was controlled without increasing the toxicity of chemotherapy. MVD can be used as a predictor of Endostar application.

Objective To investigate the clinical values and characteristics of whole body bone ima-ging (SPECT/CT)in detecting bone metastases in the preoperative patients with lung adenocarcinoma or squa-mous cell carcinoma for staging and determining the best treatment plan.Methods Eighty-two preoperative patients with primary pulmonary adenocarcinoma or squamous cell carcinoma performed 99 Tcm-MDP SPECT/CT whole-body bone imaging.One week before surgery,parts of positive lesions performed MRI scan.The differ-ence of the incidence of bone metastasis was analysed by χ2 test.Results In all 82 patients with lung cancer, there were 38 adenocarcinomas and 44 squamous cell carcinomas.Bone metastases were detected in 38 cases, the incidence rate was 46.3%.Of which,among lung adenocarcinoma,the incidence rate was 57.9% (22 /38),and the incidence rate was 36.4% (1 6 /44)in lung squamous cell carcinoma,and the difference was sta-tistically significant (χ2 =1 2.66,P =0.027).The most common area was bilateral ribs,followed by vertebra, pelvis,bones of the extremities and skull.Conclusion Lung adenocarcinoma compared with squamous cell carcinoma is prone to bone metastases,and bone metastases are more common in bilateral ribs.It has important value that whole body bone imaging in screening for bone metastases of pre-operative patients with lung cancer for staging and making the treatment plan.