Objective To investigate the efficacy and safety of uterine brace suture technique in the treatment of postpartum hemorrhage caused by uterine inertia.Methods 63 cases of postpartum hemorrhage of cesarean section were divided into two groups.33 patients treated with uterine brace suture technique severd as the research group.30 patients treated with traditional technique for postpartum hemorrhage of cesarean section were recruited as the control group.Operation time,hemorrhage volume,puerperal morbidity and therapeutic efficacy between the two groups were compared.Results Operation time was(53.31 4±10.61)min in the research group,and(76.16±13.73)rain in the control group,respectively.There were(601.00±162.36)ml of hemorrhage volume in the research group,and(1 063.33±320.10)ml in the control group,respectively.No case with hysterectomy in the research group,however 5 cases were treated with hysterectomy in the control group.There were 2 cases of puerperal morbidity in the research group,and 9 cases in the control group,respectively.The differences were statistically significant in operation time,hemorrhage volume,puerperal morbidity and therapeutic efficacy between the research group and the control group(t=7.428,7.121,χ2=4.698,all P＜0.05).Conclusion Uterine brace suture technique is one of effective treatment for postmnurn hemorrhage caused by uterine inertia,particularly useful because of its simplicity of application and relative safety.It Was worthy to be popularized in primary hospitals.

Pancreatic cancer (PC) is one of the deadliest solid malignancies.Although surgery remains the only curative treatment,more than 80％ of patients suffer relapse after resection.More and more data evidence that PC is a systemic disease suggests systemic therapy plays crucial roles in the multidisciplinary treatment.Thus,new treatments are urgently needed for PC patients.Recently,a growing number of novel and promising drugs are being evaluated in preclinical and clinical settings.Herein,we reviewed the progress in the new cytotoxic and targeted therapy for metastatic PC.

Hemodynamics is monitoring a series of physiological and pathological parameter changes such as blood flow,the chamber pressure of the heart,pressure or resistance of cardiovascular and cardiopulmonary system.Traditional hemodynamic monitoring in septic shock manily includes central venous pressure,cardiac index,blood lactate and pH.In recent years,expanded non-invasive or invasive monitoring technologies include central venous or mixed venous oxygen saturation,continuous ultrasound associated with underlying cardiac output monitoring and pulse indicator continuous cardiac output.Macro-hemodynamic,metabolic and microcirculatory parameters constitute a new hemodynamics network.In order to properly assess the patient's blood volume and circulation function and to overcome the limitations of a single parameter,it is need to emphasize analysis and integration of the various parameters.

Objective: To exploration the self-efficacy, self-esteem, and positive/negative affect and the re-lationships among them in Chinese adolescents. Methods: The Rosenberg's Self-Esteem Scale, Generalized Self-Ef-ficacy Scale, and Adolescents Positive/Negative Affect Scale were administrated to 2247 middle school students sampled from 16 schools from 6 districts. Results: Self-esteem tended to increase as grade [(2.91±0.38), (2.93±0.41), (3.01±0.41), (2.98±0.44), (3.04±0.41), (3.17±0.42)]. Boys had higher self-efficacy [(2.74±0.39)vs.(2.68±0.40), P <0.001]. Two senior grades had higher self-efficacy than other 4 grades (P<0.05). Girls had higher positive and negative affect [(2.77±0.67)vs.(2.68±0.67), (2.22±0.70) vs.(2.13±0.68), Ps <0.05]. Junior grade one had the highest positive effect (2.85±0.62), grade one and two in high school had more negative effect than other 4 grades (2.26±0.71, 2.25±0.73).Self-efficacy and self-esteem were positively correlated with positive affect (r=0.24, 0.36), negatively correlated with negative af-fect (r=-0.17, -0.32) ; self-esteem significantly mediated the relationship between self-efficacy and positive/negative affect (Z=13.00, -13.07) . Conclusion: Self-esteem tends to increase as grade, boys have higher self-efficacy than girls, and girls have higher positive and negative affect than boys. Self-esteem mediates the rela-tionship between generalized self-efficacy and positive/negative affect in Chinese adolescents after controlling the effects of gender and grade.

Through the literature combing the interest groups of hospital information disclosure in the United States, the demand and practice of the main interest groups are analyzed. This paper uses policy maker4. 0 software to further analyze the interests of various interest groups, power and the degree of influence by the policy of hospital information disclosure. The results showed that interest groups involved in hospital information disclosure in the Unit-ed States can be mainly divided into five categories:consumers, employers, health insurance companies, hospitals, and decision makers ( government) . In order to balance the cost-effectiveness of various insurance schemes, health insurance companies choose high-quality service providers to restrict poor-service providers and insurers, and hospi-tals need to use public information to manage and improve health care. In order to monitor and improve the quality of medical services, employers need to weigh various insurance plans, health insurance companies have to measure the service quality of themselves and competitors, and hospitals need to manage and improve the medical quality and in-crease market share. As the largest stake in the hospital information disclosure, the results show that the consumer's position on the hospital information disclosure is low support. From the consumer as a main, although the hospital in-formation disclosure practices but the right to speak and other small powers have a limited participation. Analyzing the of the interest groups of hospital information disclosure in the United States, they all push forward the hospital infor-mation disclosure work to provide evidence to support.

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Objective To explore clinical features and misdiagnosis reasons in mitochondrial encephalomyopathy,lactic acidosis,and stroke-like episodes (MELAS) syndrome.Methods The results of clinical data,brain magnetic resonance imaging (MRI),and the course of diagnosis were analyzed in 6 patients with MELAS.Results (1) Clinical features:headache and vomiting were the starting symptoms in 4 of 6 cases,and developmental delay was initial symptoms in 2 of 6 cases.Marasmus occurred in 6 cases,seizure in 5 cases,fever in 3 cases,and hirsutism and visual impairment in 2 cases.(2) Experimental results:blood lactic acid was higher in 6 (4.28 ～ 10.3 mmol/L).(3) Brain MRI:6 patients had abnormal signals in parietal,occipital,temporal lobe,which were not in accordance with vascular distribution.(4) Molecular genetics:All the 6 patients had A3243G gene mutation.(5) Three patients were misdiagnosed for viral encephalitis,and 2 developmental retardation.Conclusions MELAS is characterized with developmental retardation,and repeated encephalitis attack.It is also misdiagnosed because of its variety of clinical features.If patients have high level of lactic acid and multiple MRI signal abnormalities of brain which are not in accordance with vascular distribution,MELAS should be suspected of.Genetic examination and muscle biopsy are especially important in the diagnosis of MELAS.

Objective To study the effect of Shenqiwan and vitamin E on mtDNA 4834 deletion in a mimetic aging rat model .Methods Forty rats three months old ,were randomly divided into four groups :group A ,which was treated with hypodermic 5 % D -galactose for 8 weeks ,and group B (shenqiwan group ,n=10) which was treated daily with Shenqiwan for 2 weeks after hypodermic 5 % D -galactose for 6 weeks ,group C (vitamin E group ,n = 10) which were treated daily with Vitamin E for 2 weeks after hypodermic 5 % D -galactose for 6 weeks ,group D were given saline only .Auditory brainstem response (ABR) was used to detect the hearing thresh-old of rats before and after the treatment .The inner ear tissue was harvested and mitochondrial DNA was amplified to identify the 4834 bp deletion mutation by nested primer polymerase chain reaction (nested PCR) technique .Re-sults The threshold of ABR in the group A ,B and C were significant higher than that in group D .However the difference in shift of ABR threshold between group A ,B ,C and group D was not significant .The mtDNA4834 de-letion rate in three modeled groups (group A ,B ,C) was significant high than that of in group D .There was statis-tically significant difference between the treated group (group B ,C) and the model group (group A) on mtDNA4834 deletion in cochlea ,but the difference between the treated groups on mtDNA 4834 deletion in cochlea was not statistically significant .Conclusion Shenqiwan and vitamin E can reduce the aging induced mtDNA 4834 deletion in aging rats inner ear .

Based on the health service delivery system and its performance, it shows the major issues faced by Indonesian health system, including heavy disease burden of NCD, imbalance allocation of medical care and resources, poor access to health service in rural area, low level of government health budget and so on. Presently, the reform in Indonesian health system is in the direction of equity and self-government, via participation of community, private sector or civil society, availability of comprehensive, equitable health care and health resource, to enhance health system and improve population health.

The aim of this study is to investigate the apoptotic inhibition and its molecular mechanism of dexamethasone (DEX) acting on cisplatin (CDDP)-induced apoptosis of human lung adenocarcinoma cell SPC-A1; SPC-A1 cells were pre-cultured in vitro for 24 hours with DEX in different concentrations and then CDDP was added in different concentrations for culturing for further 48 hours. The survival rates of the cells were determined by MTT. The expression of serum/glucocorticoid-induced kinase (SGK-1) and mitogen-activated protein kinase phosphatase-1 (MKP-1) in SPC-A1 cells after being cultured by 1 micromol/l DEX at different time was detected by semi-quantitative RT-PCR technology. The expression of glucocorticoid receptor (GR) in SPC-A1 cells was measured by immunohistochemistry (IHC) with biotin-labeled anti-GR. The results of MTT showed that SPC-A1 cells had resistance to CDDP-induced apoptosis with pre-cultured DEX and the resistance intensity presented DEX concentration-dependent. The expressing quantity of SGK-1 in SPC-A1 cells stimulated by DEX could be elevated and increased with intention of time, but the express of MKP-1 was not detected. Up-regulated expression of GR in SPC-A1 cells stimulated by DEX was detected by IHC. The number of cells expressing GR in SPC-A1 cells was significantly higher than that in the control group. The results showed that DEX inhibited apoptosis of SPC-A1 cells induced by CDDP. The possible molecular mechanism is that elevated expression of GR induced by DEX up-regulates the expression of SGK-1 which locates at the downstream of anti-apoptosis pathway. The apoptosis resistance of SPC-A1 cells may account for all above the factors.
Adenocarcinoma ; pathology ; Apoptosis ; drug effects ; Cell Line, Tumor ; Cisplatin ; pharmacology ; Dexamethasone ; pharmacology ; Dual Specificity Phosphatase 1 ; metabolism ; Humans ; Immediate-Early Proteins ; metabolism ; Lung Neoplasms ; pathology ; Protein-Serine-Threonine Kinases ; metabolism ; Receptors, Glucocorticoid ; metabolism ; Up-Regulation