Objective To explore the complications and the treatments of repeated cesarean delivery in scar uterus pregnancy accompanied by the placenta praevia. Methods We performed a retrospective study in 6832 cases underwent first cesarean delivery,within which 201 cases were accompanied by the placenta praevia;and 337 cases underwent repeated cesarean deliver, within which 26 cases were accompanied by the placenta praevia. All subjects accepted cesarean delivery from January2006 toApril 2010 in our hospital. Results The occurrence rate of placenta previa was significantly higher in the repeated cesarean delivery than first-ever cesarean delivery (7. 72% vs 2. 94%, x2 = 22. 33, P ＜ 0. 01 ) , especially the occurrence of complete placenta previa (42. 30% vs 0. 00%, x2 = 80. 43, P ＜ 0. 01 ). The rates of uterus rupture, placenta accreta, postpartum hemorrhage and hysterectomy (r = 26. 92% ,23.08% ,26. 92% and 7. 69%, respectively) in repeated cesarean delivery in scar uterus pregnancy accompanied by the placenta praevia were significantly higher than those of the cases ( r = 2. 57% ,0. 32%, 1.29% and 0. 00%, respectively ) had repeated cesarean delivery in scar uterus pregnancy but no placenta previa ( x2 = 27.97,50. 41,42. 16,12. 79, respectively, Ps ＜ 0. 01 ). Conclusion The incidence of placenta previa increased in scar uterus pregnancy, especially the complete placental previa.Scar uterus pregnancy accompanied by the placenta praevia are more likely to occur uterus rupture,placenta accreta,postpartum hemorrhage and had hysterectomy. Obstetricians should give more effort to reduce the cesarean section rate,improve the quality of medical care.

Objective To explore the effect of group psychological training on the mental health and self consistency of nurses from operating rooms.Methods 52 nurses of an operating room were randomized into the treatment group(n=25)and the control group(n=27): The latter received humane care and instructions for mental self care and the former received group psychological training for 8 weeks based on the same treatment as in the control group.Symptom checklist 90(SCL-90)and self consistency and congruence scale(SCCS)were used to assess and compare the difference of the two groups before and after training.Results The intra-and inter-group comparisons between pre-and post-intervention showed statistical differences in terms of the total score by SCL,interpersonal sensitivity,depression and hostility,total score by SCCS and the score on the subscale of inconsistency between themselves and their experience(all P<0.05 or P<0.01).Conclusion Group psychological training can effectively improve the level of mental health and self consistency of OR nurses and thus can improve the total psychological status of the OR nurses.

Objective: To study the basic information of life way disease and the corresponding risk factors of behavior in the community of Peking University Health Science Center, understand the background issue and social support system, and analyze the requirement for community health service so that the critical issue for health can be dealt with and the comprehensive program of prevention and treatment of the disease can be accordingly supplied. Methods: The random face to face questionnaire about life way disease and risk factors in 1 051 residents over 6 years of age in the community of Peking University Health Science Center was conducted according to the typical sampling principle in 1 primary school, 1 middle school, 1 university and its community, and the investigations of health data from the hospital and the police office in the community were also conducted through discussing about life ways risk factors. Accordingly , the data obtained by way of EXCEL were analyzed and processed using SPSS 11.5. Results: Diagnostic data of demography, epidemiology, behavior environment, education and organization were obtained concerning the public health of the Peking University Health Science Center community. Conclusion: The key health issue in the Peking University Health Science Center community is significantly influenced by the bad way of life. And some behavior risk factors, such as fatness, lack of outdoor exercise in the community members. Thus, the major necessary health service of Peking University Health Science Center residents is to carry out a comprehensive management program of life way disease for the whole people.

Objective To explore the significance of transvaginal color Doppler ultrasound in the diagnosis of cervical carcinoma. Methods 45 patients undergoing surgery for cervical carcinoma were enrolled. Transvaginal color Doppler flow imaging was performed preoperatively to detect the arterial blood flow signals within the tumors and the lowest resistance index (RI) value was recorded for analysis. Results Significant difference RI values were noted in cervical carcinoma group compared with contrast group (P <0.001). RI were associated with tumor diameter, stage status, pathologic grade and pelvic lymph node metastasis of cervical carcinoma(P < 0.05). There were no relations between RI and patients's age and pathologic type (P >0.05). Conclusion The angiogenesis character of cervical carcinoma can be showed by RI, and RI had some inherent connections with clinicopathologic parameters of cervical carcinoma. Transvaginal color doppler ultrasound could accurately predict angiogenesis of cervical carcinoma preoperatively and be of importance in the diagnosis of cervical carcinoma. It could provide standard in prognosis evaluation.

ObjectiveTo investigate the clinical effect of EaLeSu on cervical intraepithelial neoplasia(CIN Ⅱ~Ⅲ)patients with HPV infection treated with loop electrosurgical excision procedure(LEEP). Methods 165 cases of CIN Ⅱ~Ⅲpatients with HPV infection who underwent LEEP operation were randomly divided into observation group(n=83)and control group(n=82). In the observation group,patients were given a piece of EaLeSu in cervical wound at once in postoperative and two vaginal EaLeSu per day from the first postoperative day for eight consecutive days. The patients in the control group were treated with routine debridement and wound dressing with iodine. We observed the vaginal drainage times within 4 weeks after operative,bleeding rate,cervical wound repair,and cervical HPV DNA infection after 6 months. Results There were significant differences in the bleeding rate,vaginal drainage time,cervical wound repair and HPV DNA infection between the two groups(P < 0.05). Conclusion EaLeSu showed a definite effect on cervical intraepithelial neoplasia(CIN Ⅱ~Ⅲ)patients with HPV infection treated with LEEP.

Objective To compare the value of assessment with DWI and contrast-enhanced MRI (CE-MRI) in activity of sacroiliitis of patients with ankylosing spondylitis(AS).Methods Ninety-six patients conforming to modified New York criteria were prospectively collectedas the AS group, and twenty-one healthy volunteers were enrolled into the control group. According to the Bath AS disease activity index (BASDAI), erythrocyte sedimentation rate and C-reaction protein, AS patients were divided into the active AS group (n=60) and the chronic AS group (n=36) . All subjects were performed with conventional MRI, DWI and CE-MRI of bilateral sacroiliac joints. The MRI manifestations were reviewed and the ADC values and signal intensity enhancement rate (ΔSI) were measured.ANOVA was performed for the comparison ofΔSI and ADC values among active AS group, chronic AS group and control group with BASDAI and lab test results as the gold standards. ROC was analyzed with ΔSI and ADC values for activity of AS and paired
samples t test was obtained to comparethe areas under the ROC ofΔSI and ADC values.Results Among 96 cases of AS patients, MRI of sacroiliac jointsshowed that 62 cases had subchondral bone edema (57 cases of active group, 5 cases of chronic group), that 11 cases had bone surface erosion(4 cases of active group, 7 cases of chronic group), that 15 cases had bone sclerosis(6 cases of active group, 9 cases of chronic group) and that 58 cases had fat deposition on the sacroiliac joints (27 cases of active group, 31 cases of chronic group). The ΔSI values of the active group, the chronic group and control group were respectively (2.51 ± 1.69)%,(1.19 ± 0.67)%and(0.75 ± 0.21)%, and the ADCvalues were(1.33 ± 0.33)× 10-3,(1.00 ± 0.43)× 10-3 and(0.38±0.13)×10-3mm2/s. There were significant differences forΔSI and ADC values among three groups (F=18.375, 16.366. P<0.01), and statistical significance ofΔSI and ADC values were found between every two groups of three(P< 0.05).The area under the ROC between ΔSI and ADC to determine activity of AS patients were respectively 0.814 and 0.730, which had nostatistical significance(t=1.632, P=0.103). The sensitivity and specificity to determine activity of AS patients byΔSI=1.44%were 81.67%and 80.00%.The sensitivity and specificity to determine activity of AS patients by ADC=1.15 × 10-3/mm2 were 76.67% and 71.43%.Conclusion DWI and CE-MRI performed equally in detecting activity of AS patients.

Objective:To investigate the promotive effect of 4,5,6,7-tetrabromobenzotriazole (TBB) on the apoptosis of the human cervical cancer HeLa cells,and to clarify its effect mechanism in related signaling pathways.Methods:The human cervical cancer HeLa cells at logarithmic growth phase were divided into control group(without TBB) and experiment group(with TBB).MTT assay was used to detect the survival rate of the HeLa cells;the morphology of HeLa cells was observed under inverted microscope;Annexin Ⅴ-FITC/PI double staining and flow cytometry(FCM) were used to determine the apoptotic rates of the HeLa cells;the expression levels of apoptosis-related proteins p-Akt,Akt,Bcl-2,Bax,cleaved-caspase-3,and Pro-caspase-3 were detected by Western blotting method.Results:The MTT results showed that the survival rates of the HeLa cells in experiment group were significantly decreased(P<0.01) in a dose-dependent manner compared with control group.The apoptotic morphology of the HeLa cells in experiment group were found as cell shrinkage and karyopyknosis under inverted microscope.The Annexin Ⅴ-FITC/PI double staining and FCM results showed that the apoptotic rates of the HeLa cells in experiment group (3,6,12 and 24 h) were higher than that in control group (P<0.05 or P<0.01).The Western blotting results showed that compared with control group,the expression levels of the anti-apoptotic proteins p-Akt and Bcl-2 in HeLa cells in experiment group were decreased obviously,whereas the expression levels of the pro-apoptotic proteins Bax and cleaved-caspase-3 were increased and the expression levels of Pro-caspase-3 were decreased.Conclusion:TBB may promote the apoptosis of human cervical cancer HeLa cells by inhibiting the Akt signaling pathway.

Postoperative delirium involves attention and cognitive impairment and is a common, serious and often fatal condition in the elderly.This review summarizes the definition, diagnosis, pathogenesis, risk factors, prevention and treatment of postoperative delirium in elderly patients with hip fractures.

Objective: To understand the public health emergency response capacity in primary and secondary schools, and to explore the problems and challenges in the prevention and control of public health emergency in primary and secondary schools for specific strategies. Methods: By using the stratified group sampling method, a questionnaire survey on general situation, knowledge, attitude and training, as well as public health emergencies response capacity among 2 988 teachers or leaders responsible for school emergency response in primary and secondary schools from Beijing, Chongqing and Yunnan. Results: Participants varied on their positions, titles, educational background and knowledge accuracy. Higher knowledge accuracy was associated with higher educational background ( χ 2=50.73-203.36, P < 0.05 ). The implementation of regular public health emergency related programs was poorly conducted in high schools (50.0%). Urban schools (42.0%) had higher proportion of qualified health care professionals than rural schools (18.2%), and private schools (48.5%) was higher than public schools (24.7%). The primary challenges included the shortage of guidance from professionals and the lack of related testing equipment (84.91%, 74.03%). Conclusion Although the ability of emergency handling of public health emergencies in schools in the three regions is advancing with the times, there are still many deficiencies, some omissions in the mastery of knowledge. It is suggested to inerease pre service and special training of school health work CDC should strengthen technical guidance and work supervision of infectious disease management in schools.

Objective To investigate the correlation between the elastographic characteristics of liver and postoperative function of liver allografts.Methods Forty-eight cases of liver transplantation from The First Affiliated Hospital of Sun Yat-sen University were analyzed,Shear wave elastography (SWE) was performed before operation or at one week or one month post-operation.Liver function was evaluated by measuring alanine aminotransferase (ALT),aspartate transaminase (AST),total bilirubin (TBIL),γ-glutamine transferase (GGT),albumin (ALB),alkaline phosphatase (ALP),prothrombin time (PT),activated partial thromboplastin time (APTT),and international normalized ratio (INR).Early allograft dysfunction (EAD) was also analyzed with reference to SWE among liver transplant recipients.Results SWE at one week after transplantation was significantly correlated with TBIL (r=0.525 6,P<0.01),APTT (r=0.668 3,P<0.000 1),PT (r=0.593 7,P=0.000 1),INR (r=0.609 6,P<0.000 1) and prealbumin (r=-0.464 1,P<0.01).However,no significant correlation was observed between pre-operative SWE and parameters of post-operative liver function.SWE in EAD patients was higher than that of patients without EAD (17.60±1.09 kPa vs.13.38±0.99 kPa,P<0.01).The optimal cut-off value of SWE at one week post-operation was 14.85 kPa.Conclusion Postoperative SWE is significantly correlated with postoperative liver function tests and EAD,suggesting SWE is a potential test for evaluating the quality of liver allografts.