Objective To study the influence of biofeedback combined electrical stimulation therapy in parturients occurred breast pain under the cooperation between doctors and nurses. Methods Method of randomized controlled study was adopted. 112 puerperants were randomized chosen to experimental group (56 cases) and control group (56 cases). Diagnosed by doctors and confirmed that was normal. One group received biofeedback combined electrical stimulation therapy, the other group received regular therapy. Results There were great differences in breast hardness and milk volume ,when 3 days after the intervention, Z=5.91, P<0.01 (the cases of one degree of swelling in the two groups was 19 and 1 respectively). There were great differences in breast swelling and the hardness and milk volume, when 7 days after therapy and postpartum 42 days. The score of cooperation between doctors and nurses were (98.66±2.96) points, the satisfaction to this therapy was 94%(47/50). Conclusions Biofeedback combined electrical stimulation therapy can reduce breast pain and hardness in puerperants, it has great difference in breastfeeding status under the cooperation between doctors and nurses.

Objective To evaluate effect of continuous pelvic floor muscle training(PFMT) during pregnancy on delivery outcome, and to provide reference for clinical nursing work. Methods By searching database, the literature about continuous PFMT during pregnancy on delivery outcome were included,then EndNote was used to check the literature and RevMan5.2 was applied for Meta-analysis of the literature which met the inclusion criteria. Results A total of 11 papers were included. Meta-analysis showed that continuous PFMT during pregnancy can reduce lateral perineal resection rate (OR=0.66, 95%CI 0.48-0.89), increase rate of natural childbirth (OR=1.70, 95%CI 1.32-2.19) and promote progress of the first (MD=-0.52, 95%CI-0.92--0.12) and second (MD=-0.18, 95%CI-0.30--0.06) stage of labor. The intervention group shortened the first and the second stage of labor for 0.18h and 0.52h compared with the control group respectively. Conclusions Continuous PFMT during pregnancy can improve natural delivery rate, reduce the incidence of perineal side incision and shorten the time of labor, it is worthy of being promoted in clinical practice.

Objective To establish diagnostic standards of colorectal tubular adenocarcinoma with confocal laser endomicroscopy(CLE), and to evaluate its diagnostic value in vivo.Methods The confocal images of 12 cases, which were pathologically confirmed colorectal tubular adenocarcinoma(4 well differentiated, 4 moderately differentiated and 4 poorly differentiated), were collected and analyzed to establish diagnostic standards of the disease with CLE.Then 49 lesions were prospectively evaluated based on CLE standards,which were compared to histopathology results.Results The sensitivity, specificity, accuracy, positive predictive value(PV +)and negative predictive value(PV -)of CLE in diagnosing tubular adenocarcinoma were 94.7%, 90.9%, 93.9%, 100% and 76.9%, respectively.The corresponding data of well differentiated adenocarcinoma were 100%, 83.3%, 88.9%, 85.7% and 87.0%, those of moderately differentiated adenocarcinoma were 86.7%, 90.5%, 86.1%, 86.7% and 90.5%, and those of poorly differentiated adenocarcinoma were 77.8%, 92.6%, 88.9%, 100% and 86.2%.Conclusion CLE is able to diagnose and grade colorectal tubular adenocarcinoma.

【Objective】To observe the effect of acupuncture mainly on cleft points on chemical radiculitis rats and to explore the therapeutic mechanism of acupuncture on lumbar disc prolapse.【Methods】Twenty-four rats with chemical radiculitis were equally randomized into acupuncture group and model group,and another 12 normal rats were in the blank control group.Acupuncture group received acupuncture on acupoints of Jiaji(EX-B2)and Weizhong(BL40)and cleft points of Foot-Shaoyang Meridian and Foot-Taiyang Meridian for 28 days.After treatment,rat behavioral changes and morphological features of nerve cells were observed,the weight of inflammation filter paper was detected,and hemorheologic parameters,nitric oxide (NO) and interleukin 6(IL-6) were assayed.【Results】Acupuncture improved the motor function of affected limb,recovered the senses of pain and tough,improved hemorheologic parameters,reduced the inflammatory reaction,relieved degeneration of nerve root,and decreased the contents of inflammatory factors(P

Objective To investigate the tendency of distribution and drug-resistance of the causative organisms of urinary tract infections(UTIs)in Wuhan,and provide reliable evidence for clinical treatment.Methods Analyzed the 5 378 stains of pathogen isolated from the urine of patients in hospital.The bacteria isolates were identified with BD Phoenix-100 while can-dida isolates were identified by color plate.Results A total of 5 378 stains of pathogen had been isolated.There were 2 945 stains (54.8%)of Gram-negative bacteria,1 657 stains (30.8%)of Gram-positive bacteria,776 stains (14.4%)of fungus. The rates of Escherichiacoli resistant to penicillin were highest (>83%),and there were no carbapenem-resistant strains. There were vancomycin and linezolid-resistant Enterococcispp strains,the lowest dection rates of which were 0.3%.The de-tection rate of MRCNS was over 83%.Conclusion Escherichiacoli was the most common pathogens of urinary tract infec-tion,and theβ-lactamase inhibitor complex can be used as empirical treatment of E.coli infections.Thedetection rate of MRCNS increased,which shoud be kept a watchful eye on.

Purpose: To study the function of surrounding acupuncture located by cranial MRI on apoplexy. Method: Forty cases of the patients diagnosed as cerebral infarction were divided into the group of surrounding acupuncture by MRI location and the group of traditional scalp acupuncture, 20 cases in each group,and were treated respectively with surrounding acupunc -ture by MRI location and traditional scalp acupuncture,to determine the indexes of blood rheology before and after treatments. Results: There was significant diffe -fence (P＜0.01) in comparison of various indexes in blood rheology between the apoplectic patients and healthy adults of same age. In comparison before and after the treatments in the group of surrounding acupunc -ture by MRI location there was significant difference (P＜0.01) in various indexes of blood rheology, except ESR and ESR equation K value. In comparison before and after the treatments in the group of traditional scalp acupuncture, there was significant difference (P＜0.05) in various indexes of blood rheology, except ESR, sclerosis index and ESR equation K value. Conclusion: The findings indicate that blood becomes thick and flows slowly and resistance increases in blood flow in the apoplectic patients. The two kinds of the needling techniques have an improving function in various indexes of blood rheology in the apoplectic patients and surrounding acupuncture by MRI location was better than traditional scalp acupuncture in improving blood rheology.

Objective:To survey the status quo of job burnout among rural general practitioners and to analyze its influencing factors.Methods:A total of 2 805 rural general practitioners in three counties in southwest Shandong province were enrolled in the study. The survey was conducted with a basic information questionnaire and the Maslach Burnout Inventory-Human Service Survey (MBI-HSS). The influencing factors of job burnout were analyzed by Pearson chi-square test (χ2) and binary logistic regression model.Results:A total of 2 272 rural general practitioners completed the survey with a completion rate of 81.0%. The rates of middle or high job burnout in the dimensions of emotional exhaustion, depersonalization and reduced personal sense of achievement were 55.1%(1 251/2 272), 34.0%(772/2 272) and 91.3%(2 075/2 272), respectively. Binary logistic regression model showed that working hours/week ≥ 60 h ( OR=1.341, 95 %CI:1.057-1.702, P<0.05), monthly shift times ≥20 ( OR=1.434, 95 %CI:1.182-1.739, P<0.05), daily consultation time≥13 h ( OR=1.294, 95 %CI:1.055-1.589, P<0.05), daily consultation of 11-20 patients ( OR=1.317, 95 %CI:1.075-1.614, P<0.05), no part-time job ( OR=1.583, 95 %CI:1.201-2.087, P<0.05), insomnia ( OR=2.638, 95 %CI:2.225-3.128, P<0.05), feeling depressed at work ( OR=3.170, 95 %CI:2.661-3.776, P<0.05) were risk factors for emotional exhaustion; participation in public health services ( OR=1.485, 95 %CI:1.155-1.910, P<0.05), being married ( OR=2.273, 95 %CI:1.198-4.313), no part-time jobs ( OR=1.677, 95 %CI:1.276-2.203, P<0.05), insomnia ( OR=1.487, 95 %CI:1.211-1.827, P<0.05), and feeling depressed at work ( OR=1.642, 95 %CI:1.339-2.015, P<0.05) were risk factors for depersonalization; working hours/week ≥ 60 h ( OR=2.089, 95 %CI:1.454-3.002, P<0.05), daily consultation time ≥ 9 h ( OR=2.495, 95 %CI:1.748-3.561, P<0.05), insomnia ( OR=2.061, 95 %CI:1.519-2.796, P<0.05), and feeling depressed at work ( OR=1.894, 95 %CI:1.383-2.593, P<0.05) were risk factors for reduced personal achievement. Protective factors included monthly income ≥3 000 Yuan ( OR=0.589, 95 %CI: 0.353-0.982, P<0.05) and monthly shift of 10-19 times ( OR=0.581, 95 %CI:0.411-0.820, P<0.05). Conclusion:The overall job burnout among rural general practitioners in southwest Shandong province is serious, especially the depersonalization and the reduction of personal sense of achievement. It is suggested to improve the salary, reduce the working intensity, optimize the working hours, and pay attention to their physical and mental health for rural general practitioners to alleviate the current situation of their occupational burnout.

Objective: To observe the effect of Tuina (Chinese therapeutic massage) on creatine kinase (CK), mitochondrial Ca2+ concentration, and ultrastructure of skeletal muscle in delayed onset muscle soreness (DOMS) model rats.Methods: A total of 130 healthy male Sprague-Dawley rats were randomly divided into a blank group, an exercise control group, a pre-exercise Tuina group, and a post-exercise Tuina group. According to the time points for sample collection, the exercise control group was divided into a 0 h exercise control group, a 24 h exercise control group, a 48 h exercise control group, and a 72 h exercise control group; the pre-exercise Tuina group was further divided into a 0 h pre-exercise Tuina group, a 24 h pre-exercise Tuina group, a 48 h pre-exercise Tuina group, and a 72 h pre-exercise Tuina group; and the post-exercise Tuina group was divided into a 0 h post-exercise Tuina group, a 24 h post-exercise Tuina group, a 48 h post-exercise Tuina group, and a 72 h post-exercise Tuina group. Rats in all groups except for the blank group received DOMS modeling. Professionals performed Nie-Pinching manipulation and finger Nian-Twisting manipulation on the lower limbs of the rats. The samples were collected at 0 h, 24 h, 48 h, or 72 h after exhaustive exercise for each pre-exercise Tuina group. The samples were collected at 0 h, 24 h, 48 h, or 72 h after Tuina for each post-exercise Tuina group. The changes in serum CK, skeletal muscle mitochondrial Ca2+ concentration, and Ca2+-adenosine triphosphatase (ATPase) were determined. The ultrastructure changes of skeletal muscles in each group were observed by a transmission electron microscope. Results: The electron microscope showed that compared with the exercise control group, the skeletal muscle structures of the pre-exercise Tuina group and the post-exercise Tuina group were significantly improved, and the overall performance of skeletal muscle in the pre-exercise Tuina group was more similar to that of the blank group. The level of serum CK in the pre-exercise Tuina group and the post-exercise Tuina group was significantly lower than that in the exercise control group (P<0.01). The Ca2+ concentration of skeletal muscle in the 24 h, 48 h, and 72 h pre-exercise Tuina groups was lower than that in the post-exercise Tuina group at the same time point (P<0.01). The Ca2+-ATPase concentration of skeletal muscle in the 24 h and 72 h pre-exercise Tuina groups was lower than that in the post-exercise Tuina group at the same time point (P<0.05).Conclusion: Tuina effectively prevents muscle damage caused by heavy exercise and long-term exercise, which may be related to the increase of skeletal muscle Ca2+-ATPase activity and mitochondrial Ca2+ transport.

This article was aimed to study the chemical constituents of the petroleum ether fraction of Liparis nervosa.Chemicalcompoundswereisolatedandpurifiedthroughvariouschromatographytechniques.The accurate structures of chemical compounds were confirmed with spectral data and literatures. The results showed that7chemicalconstituentswereisolatedfromthepetroleumetherfractionofLiparis nervosa,whichwere moscatin (1), batatasin Ⅲ (2), bergapten (3), isoimpinellin (4), xanthotoxin (5), imperatorin (6) and β-sitosterol (7). It was concluded that chemical constituents 3-7 were isolated from this genus for the first time. And chemical constituents 1-7 were isolated from this plant for the first time.

Objective: To analyze the impact of intergenerational care on child physical health, so as to provide references for promoting the overall development of children s health. Methods: Based on the 2016 national data of the Chinese Family Tracking Survey, descriptive statistics, Mann Whitney U test, Kruskal-Wallis H test and OLS regression analysis were used to explore the relationship between health status of 4 226 children aged 0-14 and intergenerational care. Results: OLS regression analysis showed that intergenerational care had a significant impact on physical health of preschool children (t=-2.11,P=0.04), but had no significant impact on the health of school-age children (t=-0.58,P=0.56). Annual family income, family population size, age and gender of caregivers had a significant impact on the health of preschool children (P<0.05).The self-rated health of caregivers and whether children participated in medical insurance had a significant impact on the health of all children (P<0.01). Conclusion Intergenerational care has a significant impact on the health status of preschool children, but has no impact on the health status of school age children. Attention should be paid to the health of caregivers, medical insurance condition and the impact of physical exercise on children’s health, as well as the health literacy improvement of child caregivers, and children’s medical insurance and welfare.