Objective:To systematically evaluate and integrate the midwifery care needs of parturition, to provide reference for formulating effective measures to improve obstetric care.Methods:A computer search was conducted on Cochrane Library, PubMed, Web of Science, Embase, China National Knowledge Infrastructure, China Biomedical Literature Database and Wanfang Database for qualitative research on midwifery care needs of parturition. The search period was from the establishment of the database to April 2024. The quality of the included literature was evaluated using the qualitative research quality evaluation criteria of the Australian Joanna Briggs Institute Evidence based Health Care Center. A thematic synthesis was used for result integration.Results:A total of 16 articles were included, and 63 major research results were extracted and summarized into 9 new categories, forming 4 integrated results: physiological comfort needs, respect needs, professional nursing support needs and social network harmonious needs.Conclusions:The needs of midwifery care during childbirth are diverse and need help and support from various aspects. It is suggested that nursing staff should pay attention to the experience and needs of childbirth, improve the management plan of nursing during childbirth, improve the cognitive experience of childbirth and promote natural childbirth.

Objective To investigate the association between asthma and IL-9 level,to provide reference for early prevention of asthma occurrence and improvement of asthma condition.Methods The data of single nucleotide polymorphism (SNP) were collected from two genome-wide association studies (GWAS) related to asthma and IL-9.Forty-three SNP instrumental variables associated with IL-9 were screened to conduct the forward direction Mendelian randomization (MR) analysis with asthma as the outcome.The three SNP associ-ated with asthma served as the instrumental variables,the IL-9 level change served as the study outcome to conduct the reverse MR analysis.Heterogeneity was detected by using Cochran's Q test,and the pleiotropy was detected by using the MR-Egger regression method.The robustness of the results was tested by the a leave-one-out method.Results The Q-test showed that no heterogeneity existed (P=0.383,0.883),and the MR analysis of fixed-effects model was used.The IL-9 level increase led to that the asthma occurrence risk was increased by 17％ (OR=1.17,95％CI:1.02-1.34).The asthma occurrence led to the IL-9 level increase by 0.09 standard deviation (OR=1.09,95％CI:1.01-1.19).After removing SNP one by one,the MR analy-sis results were steady.The MR-Egger regression method did not find the pleiotropy of instrumental variables (P=0.995,0.129).Conclusion There are bidirectional gene association between the IL-9 level change and asthma occurrence risk.

Objective:To improve the Rapid Arterial Occlusion Evaluation (RACE) scale and to investigate its value in identifying large vessel occlusion (LVO) in patients with acute anterior circulation ischemic stroke (AIS).Methods:Consecutive patients with AIS treated in Liangxiang Hospital of Fangshan District, Beijing through stroke easy access from January 1, 2016 to December 31, 2018 were enrolled prospectively. The clinical data and multimodal CT examinations required to determine LVO were collected. The existing problems in the RACE score were modified. The patients were evaluated by the modified RACE score, RACE score, and National Institute of Health Stroke Scale (NIHSS). The receiver operator characteristic (ROC) curve was used to evaluate the predictive ability of the modified RACE score for LVO, and it was compared with the RACE score and NIHSS score. The ROC curves of LVO predicted by modified RACE score and NIHSS score in patients with left and right hemispheric lesions were compared.Results:A total of 184 patients were included, of which 66 (35.9%) had LVO. The age (64.8±11.7 vs. 60.5±10.8 years; t=2.483, P=0.014), baseline NIHSS score (13 [6.75-17] vs. 5 [2-9]; Z=-6.361, P<0.001) and the proportion of patients with gaze (37.9% vs. 17.4%; χ2=4.696, P=0.030) in the LVO group were significantly higher than those in the non-LVO group. ROC curve showed that the modified RACE score was more effective in identifying LVO than RACE score (area under the curve: 0.812 vs. 0.770; Z=4.654, P<0.001). The best cutoff value of the modified RACE score in predicting LVO was 5, and its predictive sensitivity and specificity were 75.8% and 75.4%, respectively, and the positive and negative predictive values were 63.3% and 84.8%, respectively. A comparison of patients with left hemispheric lesion and those with right hemispheric lesion showed that the ability of the modified RACE score in predicting LVO was more balanced (area under the curve: 0.826 vs. 0.796; Z=0.454, P=0.650), while there was a significant difference in NIHSS score (area under the curve: 0.856 vs. 0.703; Z=2.149, P=0.031). Conclusions:The modified RACE score is better than the original RACE score in the predictive value of LVO in patients with AIS, and its predictive power of LVO in patients with left and right hemisphere stroke is more balanced than the NIHSS score, which may help clinical discrimination and screening for patients suitable endovascular treatment.

Objective:To investigate the protective effect of REV-ERBα agonist SR9009 on hippocampal working memory in rats with acute rapid eye movement (REM) sleep deprivation after exploratory laparotomy and its possible mechanism.Methods:Ninety SD rats were randomly divided into control group, sleep deprivation group, exploratory laparotomy group, sleep deprivation+exploratory laparotomy group, and sleep deprivation+exploratory laparotomy+SR9009 group ( n=18). Rats in the sleep deprivation group, exploratory laparotomy group, and sleep deprivation+exploratory laparotomy group were given REM sleep deprivation for 96 h or (and) exploratory laparotomy, respectively. Rats in the sleep deprivation+exploratory laparotomy+SR9009 group accepted exploratory laparotomy after REM sleep deprivation for 96 h, and accepted intraperitoneal injection of 100 mg/kg SR9009 daily from the day after surgery to the 6 th d of surgery. The reversall escape latency of rats was recorded by contrapuntal space exploration training one-5 d after surgery. On the 5 th d of surgery, reversal space exploration experiment was conducted to record the number of times of rats crossing the original platform. Western blotting was used to detect the protein expressions of REV-ERBα and BMAL1 in the hippocampus of rats. The levels of interleukin (IL)-1β and IL-6 in the hippocampus of rats were detected by enzyme-linked immunosorbent assay. Immunofluorescent staining was used to detect the expressions of neuronal nucleoprotein (NeuN) and glial fibrillary acidic protein (GFAP). Results:(1) The escape latency in the sleep deprivation group, exploratory laparotomy group, and sleep deprivation+exploratory laparotomy group was significantly longer than that in the control group on the first, 2 nd, 3 rd, 4 th, 5 th d of surgery ( P<0.05); while the escape latency in the sleep deprivation group and sleep deprivation+exploratory laparotomy group was significantly longer than that in the exploratory laparotomy group ( P<0.05); on the 2 nd, 3 rd, 4 th, 5 th d of surgery, the reversal escape latency in the sleep deprivation+exploratory laparotomy+SR9009 group was statistically shorter than that in the sleep deprivation+exploratory laparotomy group ( P<0.05). The number of times of rats crossing the original platform in the sleep deprivation group, exploratory laparotomy group, and sleep deprivation+exploratory laparotomy group was significantly smaller than that of the control group ( P<0.05); that of rats in the sleep deprivation+exploratory laparotomy group was significantly smaller than that of the exploratory laparotomy group, and that of rats in the sleep deprivation+exploratory laparotomy+SR9009 group was significantly larger than that of the sleep deprivation+exploratory laparotomy group ( P<0.05). (2) As compared with the control group, the exploratory laparotomy group, sleep deprivation group and sleep deprivation+exploratory laparotomy group had significantly decreased expressions of REV-ERBα and BMAL1, and statistically increased IL-1β and IL-6 levels in the hippocampal tissues ( P<0.05); as compared with the sleep deprivation+exploratory laparotomy group, the sleep deprivation+exploratory laparotomy+SR9009 group had significantly increased expressions of REV-ERBα and BMAL1, and statistically decreased IL-1β and IL-6 levels ( P<0.05). (3) As compared with the control group, the exploratory laparotomy group, sleep deprivation group and sleep deprivation+exploratory laparotomy group had decreased amount of neurons in the hippocampal CA3 area and increased amount of activated astrocytes; as compared with the sleep deprivation+exploratory laparotomy group, the sleep deprivation+exploratory laparotomy+SR9009 group had increased amount of neurons in the hippocampal CA3 area and decreased amount of activated astrocytes. Conclusion:Acute REM sleep deprivation can lead to work memory impairment in rats accepted exploratory laparotomy, which might be associated with neuroinflammation and REV-ERBα/BMAL1 pathway, and SR9009 could alleviate the damage.

OBJECTIVE:To study the protective effects of Polygonum hydropiper extract on acute gastric mucosal lesion (AGML)in rats. METHODS:48 rats were randomly divided into normal group(normal saline),model group(normal saline), positive group(ranitidine hydrochloride,0.05 g/kg),P. hydropiper extract low-dose,medium-dose and high-dose groups(2.7, 8.1,24.3 g/kg by crude drug),i.g. for consecutive 7 d,once a day. Except for normal group,other groups were given absolute ethyl alcohol to induce AGMI model after 1 h of last administration. 1.5 h after modeling,gastric mucosal lesion index of rats was calculated;the pathological changes of gastric tissue in rats were observed;nuclear factor E2 related factor 2(Nrf2)content and SOD activity in gastric tissue of rats were determined by ELISA. RESULTS:Compared with normal group,the gastric mucosa of model group was damaged obviously,there was blood capillary rupture in submucosa,gastric mucosal lesion index was increased significantly(P<0.01);Nrf2 content and SOD activity were significantly decreased in gastric tissue of rats(P<0.05 or P<0.01). Compared with model group,gastric mucosal lesion of rats was relieved to different extent;in positive group,P. hydropiper extract medium-dose and high-dose groups,gastric mucosal lesion index was decreased significantly(P<0.05),and Nrf2 content and SOD activity were increased significantly(P<0.05 or P<0.01). CONCLUSIONS:P. hydropiper extract has good protective effect on absolute ethyl alcohol-induce AGMI,the mechanism of which may be associated with raising Nrf2 content and enhancing SOD activity in gastric mucosal tissue.

Objective To optimize the extraction technology of Taxus x media by using the contents of Paclitaxel and 10-deacetylbaccatin(10-DAB),two representative active diterpene alkaloids of taxane type from T.x media,as evaluation standard.Methods The smashing tissue extraction(STE)of Paclitaxel and 10-DAB from T.x media,was investigated by comparing with ultrasonic extraction(UE)which was one of the modern technologies of extraction.Results STE was more efficient than UE,and the contents of 10-DAI3 and Paclitaxel in the extracts obtained by STE were higher than those by UE.Conclusion STE is a fast,high-performance,and energy-saving technology for the extraction of diterpene alkaloids of taxane type.STE also provides a simple,component-safe,workable,and highly efficient method for the extraction of active natural product.

n occurring after the treatment of IVM in women with PCOS are not mounting. However, the relative high rates of multiple pregnancies, low birth weight and preterm labor were increased.

Objective To explore the prevalence of nonalcoholic fatty liver disease(NAFLD)in patients with polycystic ovary syndrome(PCOS).MethodsA case-control study employing 60 non pregnant patients with PCOS and 60 non-pregnant patients without PCOS as control was conducted to compare the prevalence of NAFLD.Resuits The aminotransferase(ALT),fasting insulin and homeostasis model assessment of insulin resistance(HOMA-IR)levels were(29±15)U/L,(19±12)mU/L and 0.47±0.29 in PCOS group,which were significantly higher(P＜0.05)than corresponding parameters in control group[(15±13)U/L,(11±8)mU/L and 0.31±0.21)].The occurrence of insulin resistance and NAFLD was 63％(38/60)and 42％(25/60),higher than those in control group[35％(21/60)and 20％(12/60),P＜0.05].The increment of ALT was 40％(24/60)in PCOS group,higher than that of 3％(2/60)in control group(P＜0.01).Compared with patients witIlout NAFLD,patients with NAFLD had significantly increased body mass index(P＜0.01),waist-hip ratio,AIJT,C-reaction protein,fasting insulin,insulin and HOMA-IR levels 2 hours after oral glucose tolerance test(P＜0.05).Conchsion The increased prevalence of NAFLD in PCOS patients suggests an association between these two conditions and the necessity of hepatic screening among PCOS patients for potential NAFLD.

BACKGROUND: Cell apoptosis is one of the important pathological changes in ischemic-reperfusion (IR) injury. As the key factor involved in cell apoptosis regulation, interleukin (IL)-iβ converting enzyme, when activated, leads to cell apoptosis via protein degradation.OBJECTIVE: To investigate the relationship between the expression of IL-1β converting enzyme and cell apoptosis in cerebral IR injury and explore the role of this enzyme in post-ischemia cell apoptosis.DESIGN: Randomized controlled experiment.MATERIALS: The experiment was performed at the Center of Neuroscience of the Third Military Medical University between March 1996 and December 2000. Totally 64 adult healthy Wistar rats were randomized into two groups, namely IR group (n=56) and sham operation group (n=8). In IR group, the rats were subjected to four vessel occlusion to mimic whole brain IR injury, and reperfusion was carried out after 30 minutes of ischemia for 3, 6, 12, 24, 48, 72 hours and 7 days, respectively (8 rats at each time point). Only separation but not occlusion of the bilateral common carotid artery was performed in sham operation group.METHODS: Four rats were randomly selected from IR group at each time point and 4 from the sham operation group for immunohistochemical study and in situ hybridization, with the other 4 rats for in situ end-labeling assay.MAIN OUTCOME MEASURES: Protein and mRNA expression of ILlβ converting enzyme and neural cell apoptosis in the brain.RESULTS: Totally 64 rats were used in this study and all data were statistically analyzed. In the sham operation group, IL-1β converting enzyme protein and mRNA were expressed in small amount in most of the normal brain tissues, and their expressions were also detected in the neurons and small glial cells in IR group localized mainly in the cerebral cortex, cerebellum Purkinje's cells, hippocampal and subcortical white matters. The expression of IL-lβ converting enzyme began to increase at IR 12 hours, reaching the peak level at 48-72 hours followed by declination since 7 days after the operation. Cell apoptosis occurred 12 hours after IR (49.4±6.8) /section and peaked at 72 hours (228.6±29.8)/section, showing significant correlation with the temporal expression of IL-1β converting enzyme protein and mRNA (r=0.89, 0.68, P ＜ 0.05).CONCLUSIONS: Expressions of IL-1β converting enzyme protein and mRNA increased after IR in close correlation with post-ischemia cell apoptosis, and their temporal expression pattern supports the presumption that IL-1β converting enzyme is an important factor in cell apoptosis.Apoptosis is mostly likely to occur in the cerebral cortex, hippocampus and basal ganglion in IR injury, where IL-1β converting enzyme is highly expressed, further demonstrating that post-ischemia expression of IL-1β converting enzyme might be involved in cell apoptosis regulation.