Objective To investigate the delivery mode of pregnant women with prior cesarean section in Northern China,and their clinical characteristics.Methods A multi-center observational study of 1 068 women who had prior cesarean delivery in 24 medical centers in Northern China was conducted between December 2013 and May 2014.The clinical data,including general condition,antenatal examination results,delivery mode,and maternal and fetal outcomes,were collected and compared between vaginal delivery and cesarean section.Mann-Whitney U test and Chi-square test were used for statistical analysis.Results The median age of the 1 068 women were 32 years (range,18-45 years).Thirty-seven (3.5％) had a history of prior vaginal delivery.There were seven twin pregnancies and all delivered by cesarean section.Thirty-five women had suspected uterine rupture and underwent cesarean section,but were confirmed without uterine rupture during the operation.There was no maternal and fetal/neonatal death.Of the 1 068 women,43(4.0％) had successful vaginal birth and 1 025 (96.0％) underwent repeat cesarean sections.Compared with cesarean section group,vaginal delivery group tended to have a greater thickness of the lower uterine segment in the third trimester as shown by ultrasound [(3.3 ± 0.9) vs (2.9± 1.1) mm,Z=-2.240,P=0.025],a higher percentage of prior vaginal delivery [16.2％(6/37) vs 4.6％(31/673),x2=9.570,P=0.009],a lower rate of regular antenatal examination [58A％(25/43) vs 73.2％(742/1 0t3),x2=4.737,P=0.026],a shorter hospital stay[(3.7±2.4) vs (5.9±3.8) d,Z=-6.043,P=0.000],and lower 1-min Apgar score (9.1 ±2.2 vs 9.9±3.9,Z=-2.410,P=0.016),but without difference in the 5-min Apgar score (9.9±0.4 vs 9.6± 1.3,Z=-0.947,P=0.344).Conclusions Rate of vaginal delivery for women with prior cesarean section in Northern China is low.Vaginal birth with prior cesarean section is relatively safe,especially for those with a previous history of vaginal delivery.

Objective: To investigate the clinical effect of Gynecologic Qianjin Tablets (Radix Codonopsis, Radix Angelicae sinensis, Folium Mahoniae, Caulis Millettiae Reliculatae, Herba Andrographis, etc.) for treating chronic pelvic inflammatory disease. Methods: 30 cases with chronic pelvic inflammatory disease in study group were treated by Gynecologic Qianjin Tablets, which has the effects of boosting Qi and blood and clearing away heat and wet in 2 weeks, 3 times per day and 6 tablets per time; and meanwhile, 30 cases treated by tablet of Jinji Tablets in control group were also observed. Results: The response rate in study group was 83.33% , while in control group was 63.33% ( P

OBJECTIVE To evaluate the diagnosis value of the procalcitonin(PCT) test in the lower respiratory tract infection(LRTI),and to provide the application of PCT in the bacterial infectious disease.METHODS Procalcitonin concentrations were measured using the quantitative immunofluorescence test in 93 patients and the results were compared with the levels of C-reactive protein(CRP) and white blood cell count(WBC).Samples were collected and divided into 2 groups,one including 63 cases(bacterial infected group) the other including 30 cases(non-bacterial infected group) corresponding to their clinical diagnosis(temperature,heart rate,bacteremia culture,CRP,WBC count).RESULTS The levels of PCT in bacterial infected group were significantly higher than in non-bacterial infected group(P

Objective To understand the level of resilience and quality of life of burn patients during convalescence,to provide theoretical guidance for burn patients' psychological crisis prevention and intervention.Methods 255 cases of burn patients during convalescence were interviewed with general status questionnaire,CD-RISC,and burn specific health scale(BSHS).Results The resilience score of burn patients was at the middle level,the level of quality of life was at the lower-middle-level,significant positive correlation was found between the level of resilience and quality of life.Resilience level had a greater impact on the level of mental health in burn patients.The factors of physical strength and tenacity of resilience scale were positively correlated with mental health.Conclusions Intervention should be given to help people improve resilience,in order to reach the effect of potential development and prevention of behavior dysfunction,so that help them engender positive psychological adjustment.

Objective To evaluate the status of self-efficacy and its influencing factors in adult patients with low vision,then explore an effective approach to improve their self-efficacy levels.Methods Seventy adult patients with low vision were sampled by random number table method.General social-demographic questionnaire and self-efficacy questionnaire were used to investigate these patients' general information and self-efficacy.Seventy pieces of questionnaires were issued and returned with the valid rate of 100％.Results The total score of self-efficacy in seventy adult patients with low vision was(16.25:±:1.93) points,92％ of patients had a low level of self-efficacy.The influencing factors of self-efficacy in adult patients with low vision were the attitude toward disease,mental status and gender.Conclusions The selfefficacy in patients with low vision was affected by many factors at different levels,so we should focus on main influencing factors to adopt corresponding nursing measures in order to improve self-efficacy of adult patients with low vision.

Objective: To study the effect of arginine (Arg) on serum NO, NOS activities and thymus T cells in mice under heat stress. Method: NIH-mice were randomly divided into 3 groups and given water L-Arg 1.5 mg/g bw and L-Arg 2.5 mg/g bw for 14 d respectively. There were 42 mice in each group and were under heat stress (41?0.5)℃ for 120 min except 6 mice not stressed as control. Blood was taken at 0, 2, 4, 8, 12, 24 h after heat stress from 6 mice each time. The quantity of NO, activities of NOS and the change of thymus T cells in serum were measured. Results: At normal temperature or under heat stress, the quantity of NO, activities of NOS, the concentration of CD3+, CD4+ cells and CD4+/CD8+ of the groups with L-Arg were higher than those of the groups without L-Arg, but the concentration of CD8+ was contrary. The difference between two groups with L-Arg was not significant . Conclusion: The immunity of mice was destroyed under heat stress for 4-8 h. The quantity of NO, activities of NOS, and the number of T cells and CD4+/CD8+in serum could be improved after given L-Arg.

Systems-based integrated course is the core and hot spot in current advanced medical education reform.An integrated organ-system oriented curriculum system of endocrinology and metabolism was applied in eight year clinical medicine and five year excellent doctor education.The teaching contents of endocrinology and metabolism from traditional Basic Medicine,Internal Medicine and Surgery were integrated and optimized to compile the integrated syllabus and teaching cases.Curriculum integration oriented PBL teaching and comprehensive morphology experimental teaching were implemented into the integrated endocrinology and metabolism system curriculum.This endocrinology and metabolism course integration based on organ-system based learning is conducive to establishing the organic connection between Basic Medicine and Clinical Medicine,and cultivating high-quality medical talents.

Flavonoids, which is composed of a C6-C3-C6 backbone, is a kind of secondary metabolites of Chinese materia medica (CMM). It has received extensive attention from all over the world and obtained a rapid develop-ment due to its widespread distribution, structural complexity and active diversity. This article has summarized the progress of flavonoids both in antioxidant activity and in mechanism, so as to provide some references for the re-search and development of new medicine of flavonoids with antioxidant activity.

OBJECTIVETo discuss the effect of surgical staging and using craft bone with vancomycin for the treatment of calcaneal fractures.

METHODSFrom January 2006 to December 2012,13 patients with open calcaneal fractures were treated including 9 males and 4 females with an average of 35.2 years old ranging from 23 to 66. All cases were emergency cases. According to Sanders classification of calcaneal fractures, 2 cases were type II, 7 cases were type III, 4 cases were type IV. According to Gustilo-Anderson soft tissue injury classification, 8 cases were type II, 2 cases were type III A, 2 cases were type III B, 1 case were type III C. Firstly a thorough debridement or VSD procedures were applied,secondly calcaneal fracture were treated with open reduction, plate fixation and bone graft complex with antibiotics. Based on clinical examination, radiographic evaluation, and American Foot and Ankle Surgery Society (AOFAS), ankle function were evaluated after operation.

RESULTSOpen wounds were headed after dressing and repairing,, lateral calcaneal wound were healed during the first period. All patients were followed up for 6 to 36 months (means 14.5 months). Fracture healing time was 14 to 20 weeks (means 16.2 weeks). Last follow-up AOFAS ankle-hindfoot score was (80.0 +/- 7.4) ranging from 55 to 95.

CONCLUSIONFor patients with open fractures, through reasonable clinical evaluation, staging operation, using bone graft with antibiotics can reduce the incidence of postoperative wound infection and promote fracture healing.

Adult ; Aged ; Anti-Bacterial Agents ; administration & dosage ; Bone Transplantation ; methods ; Calcaneus ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; Fracture Healing ; Fractures, Open ; surgery ; Humans ; Male ; Middle Aged

The methamphetamine(METH)addiction is a compensatory adaptation of the central nervous system after the long-term exposure to METH in the molecular,cellular,neuronal loop function and brain structure.As a new type of post transcriptional regulatory molecules and regulatory factors,miRNAs are a large number of regulatory factors in the central nervous system.Studies have shown that miRNAs play an important role in the regulation of METH addiction.This paper is to review and summarize the expression features and the regulatory role of miRNAs in METH addiction,as well as the different expression of miRNAs in different tissues and organs.The aim of this paper is to provide a reference for further study on the role of miRNAs molecules in METH addiction and the discovery of new drug targets.