Objective To study the changes of intrapartum cesarean rate, cesarean indications and pregnancy outcomes after the new partogram applied. Methods Totally 3 290 pregnant women trying to vaginal delivery which were managed according to the new partogram in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from August to October in 2014 (new partogram group) were involved;2 987 pregnancy women trying to vaginal delivery from May to July in 2014 which were managed according to the old partogram (old partogram group) were involved as control. The intrapartum cesarean rate, cesarean indications and the pregnancy outcomes between the two groups were analyzed. Results The rate of intrapartum cesarean delivery was 8.50%(254/2 987) in old partogram group, and was significantly higher than that in new partogram group (6.2%, 204/3 290;P<0.01). Cesarean indications in old partogram group included 18 labor protraction (7.1%, 18/254), 82 labor arrest (32.3%, 82/254), 44 relative cephalopelvic disproportion (17.3%, 44/254), 80 fetal distress (31.5%, 80/254), 23 intrauterine infection (9.1%, 23/254) and 7 cesarean delivery on maternal request (CDMR;2.8%, 7/254) . Cesarean indications in new partogram group included 33 labor arrest (16.2%, 33/204), 71 relative cephalopelvic disproportion (34.8%, 71/204), 73 fetal distress (35.8%, 73/204) and 22 intrauterine infection (10.8%, 22/204), 5 CDMR (2.5%, 5/204). There were no significant differences in incidence of asphyxia neonatorum and puerperal morbidity (P>0.05), but the incidence of postpartum hemorrhage in new partogram group was higher than the old partogram group [6.9% (14/204) versus 1.6% (4/254), P<0.05]. Conclusion After the new partogram applied, the rate of intrapartum cesarean delivery is significantly decreased, but the incidence of postpartum hemorrhage is increased.

Objective To investigate the clinical curative effect of dorsal nerve fasciocutaneous flap in the treatment of children fingertip defect.Methods A total of 20 children (26 fingers)with fingertip defect were chosen as the research objects,and all of them were given the dorsal nerve fasciocutaneous flap surgery within the same finger.The sensory recovery,color,shape and function of the fingers were ob-served.Results All the 26 fingers were survived,and the survival rate was 100%.There were 8 cases of ambient blood circulation crisis 1 to 2 days after the surgery which were eliminated with corresponding treatment.Postoperative follow-up results showed that the sensory re-covery of the skin flap was S2 ~S3 6 months after surgery,and the two-point discrimination (2-PD)was 8 ~14 mm;the sensory recovery of the skin flap was S3 ~S3 +(19 fingers of S3 and 7 fingers of S3 +)12 months after surgery,and the two-point discrimination (2-PD)was 6 ~10 mm;the sensory recovery of the skin flap was S3 +~S4 (20 fingers of S3 +and 6 fingers of S4)12 months after surgery,and the two-point discrimination (2-PD)was 5 ~8 mm.Up to then,the finger shape and color of patients was similar with normal finger,the skin graft donor site was smooth without scar contracture,the finger joint function recovered well,and the distal interphalangeal joint function were normal.Conclusion Treatment of dorsal nerve fasciocutaneous flap repair for children fingertip defect has good clinical effect and it is wor-thy of clinical application.

Objective To study on the immunogenicity of SAK and its mutant using PAb.Methods 4 New Zealand white rabbits subcutaneously injected with corresponding antigens were grouped into group SAK involving 2 rabbits and group SAK2 involving 2 rabbits.The antiserums were collected 1 week after third injection.The rabbit IgG fraction was precipitated with saturated(NH4)2SO4 and purified by DEAE-Sepharose column chromatography,and then the antibody titer was determined by ELISA.The immunoreactivity of antigen to polyclonal antibody against SAK and SAK2 was tested using ELISA.Results The immunoreactivity of SAK2 to polyclonal antibody against SAK was sharply reduced to a very low level determined by ELISA,which indicated that some epitopes of SAK had been deleted.Conclusions The immunoreactivity of SAK to polyclonal antibody against SAK2 did not get a dramatically change compared with SAK2,which indicated that the reconstruction of epitope did not create new epitope.

Objective To compare the intelligence quotient (IQ) between children with Asperger syndrome (AS) and children with attention deficit hyperactivity disorder (ADHD) in order to provide reliable evidence for differential diagnosis.Methods The intelligence of 141 children with AS,154 children with ADHD and 102 normal control (NC) children aged 6-13 years old examined by the China-Wechsler Intelligence Scale for Children was analyzed,and the diagnoses of AS and ADHD was made according to the Fourth edition of the Diagnostic and Statistical Manual of Mental Disorder.Results The proportions of children at low level of IQ (borderline and mental retardation range) in children with AS and with ADHD group were both significantly higher than those of NC group.The proportions of children at top level of IQ (superior and very superior range) in ADHD group were significantly lower than those of AS and NC groups.In the AS group,higher proportions of verbal IQ (VIQ) at top level and performance IQ (PIQ) at low level were found.The average VIQ,PIQ and full IQ (FIQ) of the AS,ADHD and NC groups were (102.55 ± 17.27,91.31 ± 16.01,97.10 ± 15.88),(95.39 ±13.49,94.16 ± 12.92,94.40 ± 12.78) and (104.06 ± 13.66,103.05 ±11.80,103.91 ± 12.92),respectively.The VIQ,PIQ and FIQ in ADHD group were lower than those in NC group significantly(P ＜ 0.01);compared with NC group,the PIQ and FIQ in AS group were significantly lower (P ＜ 0.01),while the VIQ was not significantly different(P ＞0.05).The AS and ADHD group scored both lower than the NC groupin the subtests ofcomprehension, coding, picture completion andpicture arrangement (P ＜ 0.01).The difference values between VIQ and PIQ in the AS,ADHD and TD group were(11.23 ± 17.29),(1.23 ± 13.10) and (1.00 ± 10.91),respectively,among which only the value in AS group was statistically significant (P ＜ 0.01) but not in ADHD and NC group(P ＞0.05).The proportion of children having a VIQ-PIQ difference value more than 15 in AS group was 54.60％ (77/141 cases),which was significantly higher than that in ADHD [22.07％ (34/154 cases)] and NC groups [13.72％ (14/102 cases)] (P ＜ 0.01),while the latter 2 value had no statistical difference (P ＞ 0.05).The differences among scores on the three Kaufman factors were significant in AS group (P ＜ 0.01) but not in ADHD and NC groups(P ＞ 0.05).Conclusions Compared with ADHD and normal control children,there are some unique intelligence profiles in children with AS,which show VIQ and PIQ separation,imbalance intelligence structure as well as strengths and weaknesses coexisting.Furthermore,children with ADHD and AS children share common features in some subtests scores.

Objective To investigate the expression of suppressor of cytokine signaling-3 (SOCS-3) gene in placenta,its role in the pathogenesis of pre-eclampsia and its effect on proliferation and migration of HTR-8/SVneo cells.Methods Fifteen women with severe pre-eclampsia hospitalized in the First Affiliated Hospital of Nanjing Medical University from October 2010 to March 2011 and t 5 normal pregnant women during the same time period were investigated.Cultured HTR-8/SVneo cells were transfected with SOCS-3 specific small interfering RNA (siRNA) or negative siRNA as the controls.The expression of SOCS-3 mRNA and protein in placenta and these cells was detected by real-time quantitative reverse transcription-polymerase chain reaction and Western blot.Cell proliferation was detected by methyl thiazolyl tetrazolium,cell cycle by flow cytometry and migration by the Transwell test.Two independent t tests were used for statistical analysis.Results The SOCS-3 mRNA and protein levels in the severe pre-eclampsia group were lower than those in the normal group (0.25±0.03 vs 0.71±0.08 and 0.21±0.05 vs 0.75±0.12,t=15.94 and 14.29,respectively,both P＜0.05).SOCS-3 mRNA and protein levels in the transfection group at 24 hours were lower than those in the negative control group (0.39±0.02 vs 1.00±0.04 and 0.003 7±0.001 4 vs 1.514 9±0.035 7,t=27.58 and 73.35,respectively,both P＜0.05).The integral absorbance values of cell proliferation in the transfection group at 48,72 and 96 hours after transfection were 0.23 ± 0.01,0.32±0.02 and 0.37± 0.02,respectively,which were lower than those in the negative control group (0.39± 0.02,0.55 ± 0.04 and 0.86± 0.04,t=2.60,6.64 and 42.44,respectively,all P＜0.05).The cell clonal formation was lower in the transfection group compared with the negative group (116± 15 vs 312±24,t=9.96,P＜0.05).The ratios of G1/G0 and S phase cells in the transfection group were (55.75±2.21) ％ and (31.59±0.83) ％,respectively,and were significantly different from those in the negative control group [(47.88± 1.87) ％ and (37.38± 1.34) ％,t=45.43 and 20.06,respectively,P＜0.05].After 48 hours,cell migration in the transfection group was lower than that in the negative control group (93 ± 11 vs 167± 17,t=21.36,P＜O.05).Conclusion SOCS-3 expression is probably involved in the pathogenesis of pre-eclampsia by being down-regulated and therefore impeding proliferation and migration of the trophoblast.

Objective To explore the effects of teaching method of concept-map orientation on cultivating intern nursing students' autonomous learning competencies. Methods 120 volunteers were randomly divided into the experimental group and the control group with 60 students in each group. The students from the experimental group participated in the training activities, in which concept-map orientation and clinical case served as a vehicle. While the students from the control group attended lectures held by nursing department. All the students fulfilled the Measure Scale of Autonomous Learning Competencies of Nursing Undergraduates before and after this study. Results There was significant difference between before and after the study, and significant difference was also seen in total score and score of each dimension between the experimental group and the control one. Conclusions The teaching method of conceptmap orientation can cultivate nursing students' autonomous learning competencies.

Surgery is usually the first choice for patients with lung cancer,whereas the risk increases with age.A comprehensive evaluation of the patients should be applied in order to bring about the best outcome.By convention,the preoperative assessment includes neoplasm staging,cardio-respiratory function assessment, nutritional status assessment,and etc. The surgical planning includes limited resection,video-assisted thoracoscopic surgery and so on.

OBJECTIVETo observe the intervention effect of electroacupuncture (EA) at "Weizhong" (BL 40) on rats with bupivacaine-induced multifidus muscle injury, so as to explore the action mechanism.

METHODSA total of 72 rats were randomly divided into a control group, a model group, a Weizhong group and a Shenshu group, 18 rats in each group. Each group was again randomly divided into a 4-day subgroup, a 7-day subgroup and a 14-day subgroup, 6 rats in each subgroup. Rats in the model group, Weizhong group and Shenshu group were treated with intramuscular injection of 0.5% bupivacaine (BPVC) to establish the model of multifidus muscle injury. Rats in the Weizhong group and Shenshu group were treated with EA at "Weizhong" (BL 40) and "Shenshu" (BL 23), 20 min per treatment, once a day. Each subgroup was treated for 4 days, 7 days and 14 days respectively. Rats in the control group and model group were treated with immobilization. The morphology and cross sectional area (CSA) changes of multifidus with HE and Masson staining at different time points were observed; the expression of insulin like growth factor 1 (IGF-1) and myogenic differentiation antigen (MyoD) was measured by immunohistochemical method.

RESULTSAfter the modeling, there were significant morphology changes of multifidus at different time points, which was not fully recovered after 14 days. The morphological observation in the Weizhong group and Shenshu group was superior to that in the model group. At 7th day, the CSA in the Weizhong group was higher than that in the model group (P < 0.05); at 14th day, the CSA in the Weizhong group and Shenshu group was higher than that in the model group (P < 0.01, P < 0.05). At 4th day and 7th day, the expression of IGF-1 in the model group was higher than that in the control group (both P < 0.01); at 4th day, that in the Weizhong group was higher than that in the model group (P < 0.01), and that in the Weizhong group was higher than that in the Shenshu group (P < 0.05), and that in the Shenshu group was as higher than that in the model group (P < 0.05); at 14th day, that in the Shenshu group was higher than that in the model and Weizhong group (P < 0.01). At 4th day, the expression of MyoD in the Weizhong group and Shenshu group was higher than that in the model group (P < 0.01), which was more significant in the Weizhong group (P < 0.01).

CONCLUSIONElectroacupuncture at "Weizhong" (BL 40) and "Shenshu" (BL 23) can both promote the regeneration of multifidus muscle injury. EA at "Weizhong" (BL 40) has a better effect at early phase, which may be related to the up-regulation of IGF-1 and MyoD and the completion of the proliferation of myoblast in advance.

Acupuncture Points ; Anesthetics, Local ; adverse effects ; Animals ; Bupivacaine ; adverse effects ; Electroacupuncture ; Humans ; Male ; Muscles ; injuries ; physiopathology ; Muscular Diseases ; chemically induced ; physiopathology ; therapy ; Rats ; Rats, Sprague-Dawley ; Regeneration

Background Pregnancy-induced hypertension syndrome (PIHS) appears retinopathy.Optical coherence tomography (OCT) and contrast sensitivity (CS) has been widely used in ophthalmology, but the application of OCT and CS in PIHS fundus lesions is less reported.Objective This study was to assess fundus changes of PHIS by using OCT and CS.Methods Two hundred and thirty-three eyes of 116 PIHS patients with fundus diseases were enrolled from January 2011 to January 2014 in the Cangzhou Central Hospital.One hundred eyes of fifty normal pregnant women were collected at the same period.Best corrected visual acuity (BCVA), fundus examination, OCT, CS were performed on these subjects.The CS values and BCVA between normal pregnant woment and PIHS patients were compared by independent samples t test.The correlation between BCVA grade and CS grade, OCT grade and CS grade, OCT grade and BCVA grade was calculated by trend x2 test and Gamma rank correlation analysis.The study was approved by the Ethics Committee of Cangzhou Central Hospital, all the subjects signed informed consent.Results OCT results showed that 172 eyes were abnormal (65.15％) ,including 94 eyes with neurosensory serous retinal detachment (54.65％) ,40 eyes with pigment epithelium and the ellipsoid zone change (23.26％) and 38 eyes with optic disc edema,retinal hemorrhage and other changes (22.09％).The CS values in each spatial frequency and the BCVA in the PIHS group were significantly lower than those in the normal control group (all at P ＜ 0.05).The OCT examination result was positively correlated with BCVA in the PIHS group (G=0.807,x2=93.418,both at P =0.000).The CS value under the 6.0 c/d had the best correlation with BCVA (G=0.820,x2=97.397, both at P=0.000).The OCT examination result was positively correlated with CS under the 6.0 c/d(G=0.932,x2 =126.376,both at P=0.000).Conclusions Combination of fundus examination,OCT and CS can objectively and comprehensively assess the morphology and function of retinopathy in PIHS patients,which provide the basis for the clinical diagnosis and timely treatment.

Objective To observe the effect of scalp acupuncture combined with speech training on language development delay in mental retardation children. Methods 40 cases were divided into 2 groups, 20 cases in each group. The observation group was treated with scalp acupuncture combined with speech training. The control group was treated with speech training. They were assessed with the development quotient (DQ) of adaptability and language of Gesell Developmental Schedules before and 3 months after the treatment. Results DQ of adaptability and language improved after treatment in both groups (P<0.05), and improved more in the observation group than in the control group (P<0.05). Conclusion Scalp acupuncture combined with the speech training is more effective on language development delay in mental retardation children.