Objective:To explore the perinatal characteristics and early postnatal circulatory function of the larger fetus in monochorionic diamniotic twin pregnancy complicated with selective intrauterine growth restriction (sIUGR).Methods:From February 2018 to August 2022, a total of 91 larger fetuses of the sIUGR pregnancies who were hospitalized in the neonatal intensive care unit of Peking University Third Hospital were retrospectively included. The perinatal factors, clinical monitoring indicators, and echocardiographic data of the larger twins in pregnancies with three types of sIUGR were compared using one-way analysis of variance and LSD test, Kruskal-Wallis H test, Chi-square test, and Bonferroni correction. Results:The gestational age, birth weight, and placental weight were (30.6±1.5) weeks, (1 503.9±286.4) g, and (548±120) g in the type Ⅱ sIUGR larger twins and were (30.5±2.3) weeks, (1 523.5±424.4) g, and (560±109) g in type Ⅲ, which were all smaller, lower, and lighter than those in the type Ⅰ[(33.0±1.7) weeks, (2 022.1±372.3) g, and (630±131) g, respectively] (LSD test, all P<0.05). Compared with type Ⅰ sIUGR larger twins, type Ⅱ and Ⅲ sIUGR larger twins had longer hospital stay [36.0 d (27.0-43.0 d) and 32.0 d (15.0-47.0 d) vs. 17.0 d (9.5-22.0 d)], higher proportion of preterm births due to fetal distress [63.6% (21/33) and 75.0% (15/20) vs. 31.6% (12/38), χ2=7.30 and 9.93] (Bonferroni correction, all P<0.017); Compared with type Ⅰ sIUGR larger twins, type Ⅱ sIUGR larger twins had higher proportion of postnatal use of vasoactive drugs [45.5% (15/33) vs. 18.4% (7/38), χ2=6.04, P=0.014]. The interventricular septum thickness was larger in the type Ⅲ sIUGR larger twins than those in the type Ⅰ and Ⅱ twins [(4.4±1.4) vs. (3.8±0.9) and (3.3±0.9) mm]; the thickness of left ventricular free wall was the largest in the type Ⅲ larger twins, followed by those in the type Ⅰ and type Ⅱ [(4.6±1.3) vs. (3.1±0.7) vs. (2.7±0.6) mm]; the left ventricular end-diastolic diameter, right ventricular outflow tract diameter, right ventricular anteroposterior diameter, and pulmonary artery diameter in type Ⅰ larger twins were increased comparing with those in type Ⅱ and Ⅲ [left ventricular end-diastolic diameter: (15.0±2.1) vs. (13.4±2.3) and (12.3±3.2) mm; right ventricular outflow tract diameter: (8.7±1.4) vs. (7.3±1.4) and (7.1±0.8) mm; right ventricular anteroposterior diameter: (7.1±1.5) vs. (6.5±0.9) and (6.4±1.0) mm; pulmonary artery diameter: (6.8±1.1) vs. (6.3±0.9) and (6.3±0.8) mm] (LSD test, all P<0.05). Conclusion:The larger fetuses of type Ⅱ and Ⅲ sIUGR pregnancies had smaller gestational age and lighter birth weight who are more prone to have fetal distress, so it is necessary to strengthen dynamic monitoring and circulatory support for such neonates during the perinatal period and early postnatal period. The thickening of the left ventricular wall and interventricular septum in the early postnatal period of type Ⅲ larger fetuses may lead to the decrease of ventricular diastolic function reserve, thereby the evaluation and monitoring of the myocardial diastolic function of these neonates in the early postnatal period are critical.

Consensus and guidelines regarding point-of-care ultrasound (POCUS) carried out by neonatologists in neonatal intensive care unit (NICU) have been published in many countries. This review summarizes the development, advantages, limitations, and current issues of POCUS in NICU, aiming to promote the establishment of systematic training courses, accelerate the development of POCUS in NICU in China, and ensure the effectiveness and safety of POCUS implementation.

This is a case report of preterm female neonate with Raynaud's phenomenon, who was born at 30⁺³ weeks of gestation. Her right upper limb completely turned pale from wrist to fingers with undetermined cause five days after birth, with weakened radial artery pulsation and lower skin temperature than the other side. After several treatment steps including right upper limb massage, keeping warm, intravenous infusion of Alprostadil and application of tropical mucopolysaccharide polysulfate cream, the affected limb gradually turned to purple and then ruddy. No abnormality was detected in the examinations for secondary Raynaud's phenomenon, therefore a primary Raynaud's phenomenon was considered. No similar symptoms recurred during hospitalization or follow-ups. Though rare, Raynaud's phenomenon should be considered if patients' hands suddenly turn to pale and then purple. The main treatments involve removing the causative factors, keeping warm and massage of the affected limb. Medications can be used to improve peripheral circulation if necessary. Long-term follow-up is needed for neonates suffered from Raynaud's phenomenon.

Objective To investigate the relationships between low one-minute Apgar score and the prognosis of extremely preterm infants (EPI) and extremely low birth weight infants (ELBWI). Methods Altogether 50 EPI and ELBWI who had a low one-minute Apgar score ( ≤ 7) and were admitted to the Neonatal Intensive Care Unit (NICU) of Peking University Third Hospital from January 1,2010 to December 31, 2015 were enrolled in this study. All of them were divided into two groups according to their Apgar score: mild group (4-7) and severe group (0-3). Medical records of the subjects were reviewed and an at least 18 months follow up study was conducted. Conditions of all subjects during perinatal period and hospitalization were summarized. Outcomes and follow-up results were compared between the two groups by using Fisher exact test. Results (1) General information: Fifty infants were involved, among which 37 had a mild low Apgar score and 13 had a severe low Apgar score. The mean gestational age was (27.7±2.1) weeks and the mean birth weight was (884.4±174.3) grams. (2) Main complications (some infants with more than one complication): There were 42 cases of neonatal respiratory distress syndrome, 12 cases of pulmonary hemorrhage, 21 cases of bronchopulmonary dysplasia, 31 cases of patent ductus arteriosus, 36 cases of intraventricular hemorrhage, 22 cases of white matter damage and six cases of retinopathy of prematurity. (3) Outcomes: The survival rate was 48% (24/50) and the mortality rate was 52% (26/50). Among the 26 infants, five died despite treatment and 21 died within 72 hours after their parents giving up treatment. There were no significant differences in the survival rates, mortality rates and rates of abandon treatment between the two groups [43% (16/37) vs 8/13; 11%(4/37) vs 1/13; 46% (17/37) vs 4/13; Fisher exact test, all P>0.05]. (4) Follow-up results: Twenty-one infants were followed-up to at least 18 months of age, among which four were normal, 10 had growth retardation and recurrent respiratory tract infection and seven had motor development retardation. The incidence of motor development retardation in severe group was higher than that in mild group, and the difference between them was statistically significant (5/8 vs 2/13, Fisher exact test, P=0.046). Conclusions EPI or ELBWI with a low one-minute Apgar score have many nosocomial complications, resulting in high mortality and high incidence of motor development retardation.

Gynecological malignant tumors bring great pain and psychological pressure to patients and affect the quality of life of patients seriously. Their families are faced with serious mental burden during the caring of patients especially spouses. Their quality of life is also affected seriously. This article reviewed the research progress in the quality of life of caregivers including the impact of general quality of life of caregivers for patients with gynecological malignancies, the impact on sexual life between couples and the strategies to improve the quality of life of caregivers. It came to the conclusion that only scientific and effective nursing interventions could improve the quality of life of caregivers.

Objective To explore the influence of regular measurement of transcutaneous bilirubin (TcB) on clinical outcome of neonatal hyperbilirubinemia.Methods Healthy term and late-preterm newborns (gestational age ≥ 35 weeks) born between January 1 and December 31,2013 at Peking University Third Hospital were reviewed retrospectively.All neonates were divided into monitoring group (n=1 071)or control group (n=2 437) according to whether regular monitoring of TcB was performed.General clinical information and TcB levels on admission were recorded.The incidence of hyperbilirubinemia and readmission for hyperbilirubinemia,level of bilirubin and length of hospital stay were compared between the two groups.Chi-square test or independent sample t test were used for statistical analysis.Results (1) The incidence of hyperbilirubinemia and readmission rate for hyperbilirubinemia were lower in monitoring group when compared with control group [4.7％ (50/1 071) vs 7.1％ (172/2 437) and 1.3％ (14/1 071) vs 3.3％ (81/2 437) respectively,P＜0.05].There was no significant difference of bilirubin level and hospital stay between the two groups (P＞0.05).(2) Of all the 222 hyperbilirubinemia patients,the number of neonates with gestational age ＜37 weeks,37-38 weeks and ＞38 weeks was 26 (11.7％),33(14.9％) and 163(73.4％),respectively.There was no significant difference of gestational age,birth weight and gender proportion between the two groups.(3) The follow-up rate in January was 41.5％ (49/118),and the mean follow-up rate in February,April,July and October (with revised follow-up methods) was 83.1％ (345/415),higher than that in January (x2=82.505,P＜0.01).(4) The first three causes of hyperbilirubinemia in all 222 patients were early-onset breast milk jaundice (72 cases,32.4％),perinatal causes (60 cases,27.0％) and unknown reasons (50 cases,22.5％).The first three causes of hyperbilirubinemia in monitoring group (50 cases) were unknown reasons (24 cases,48.0％),early-onset breast milk jaundice (14 cases,28.0％) and hemolysis (9 cases,18.0％).Those in the control group (172 cases) were early-onset breast milk jaundice (58 cases,33.7％),perinatal causes (57 cases,33.1％) and unknown reasons (26 cases,15.1％).Conclusions Regular monitoring of TcB can reduce the incidence ofhyperbilirubinemia and the readmission for hyperbilirubinemia.

The article introduces the concept of stigma and the measurement tools of stigma in abortion women as well as research progress of sociological factors, quality of life and interventions of abortion women. This article points out that china is still lack of related research. Strengthening the care for artificial abortion women from people of all walks of life is called on.

Objective To Investigate the correlation between psychological elasticity and coping mode in patients with embryo transplantation failure in hospital, and provide scientific theoretical basis for targeted intervention measures. Methods Totally 225 patients with embryo transplantation failure were selected by random sampling as the research object, and cross-sectional study was used to collect their basic demographic information. Connor-Davidson resilience scale(CD-RISC) and medical coping modes questionnaire (MCMQ) were used to evaluate their psychological elasticity and medical coping mode. Results The average score of psychological elasticity of patients with embro transplantation failure was (66.79±14.27) points and the score of coping mode was (44.77±5.61) points. Psychological elasticity was compared among races, causes of infertility, education backgrounds, times of embryo transplantation failure, types of infertility, and the causes of hospitalization, the differences were statistically significant ( P<0.05) . The total score of psychological elasticity in an patient with embryo transplantation failure was significantly correlated to the total score of coping mode ( r=0.377,P<0. 01). All the dimentions were significantly related ( P<0. 01) except optimism and avoidance. Conclusions The psychological elasticity and coping are correlated in patients with embryo transfer failure. In order to increase the patients′ psychological elasticity and help them establish the effective coping, medical personnel should know the patients′psychological elasticity level clearly and intervene with targets measures.

Objective To systematically review the effects of Yoga on cancer related fatigue in breast cancer patients. Methods While foreign literatures searched from PubMed, EMBASE, CINAHL, ISI Web of Knowledge, EBSCO, MEDLINE, etc, Chinese literatures came from CNKI, CBM, VIP and Wanfang Data, besides Google scholar was assisted to collect all randomized control trails ( RCTs) about Yoga releasing breast cancer related fatigue. Retrieval started from creating database to1 July 2014 without language restriction. Cochrance evaluation manual was used to evaluate the RCTs, and RevMan 5. 1 software was used for Meta analysis. Results A total of 9 RCTs met the inclusion criteria, with a total of 623 breast cancer patients, including 342 patients in the yoga group ( intervention group) and 281 patients in the usual care group ( control group) . The Meta-analysis results revealed that Yoga played certain effects to release breast cancer related fatigue. Conclusions Whether Yoga, as a effective method to release breast cancer related fatigue, can be generally promoted in clinical required clinical high quality, large sampling and multicenter RCTs to support.

BACKGROUND:Hepatoblasts are one of high-grade cell sources for severe liver disease treatment.Efficient separation and purification of hepatoblasts from fetal liver has important practical significances.OBJECTIVE:To introduce the preparation of hepatoblasts from fetal liver,conduct a transversal comparison of these preparation methods,and point out their advantages and shortcomings,so as to provide the evidences for the experimental and clinical choices of hepatoblasts.RETRIEVAL STRATEGY:Using the keywords of "fetal liver progenitor/hepatoblasts,isolation/purification",we searched the articles about fetal liver hepatoblasts separation and purification in PUBMED between January 1997 and August 2007 in English.At the same time,we searched the relative articles in CNKI using the keywords of "liver,embryo,endothelial progenitor/hepatoblasts" between January 1997 and August 2007 in Chinese.In addition,some related books and foreign articles were checked in the laboratory of Jilin University.After the first examination,the articles published in the authority magazines within five years were given prior consideration.Exclusive criteria were those repetitive researches or Meta-analysis.Totally 245 articles were collected,we selected 33 representative articles about hepatoblasts separation and purification methods.LITERATURE EVALUATION:Among 31 included articles,10 ones introduced the study background,5 ones studied the fetal liver cell dissociation,9 ones referred to the hepatoblasts separation and purification,and 7 ones indicated the problems and prospect in this field.DATA SYNTHESIS:The hepatic epithelial cell precursor cells(also known as hepatoblasts) with hepatic and biliary epithelial cell differentiation potential isolated from fetal liver,could in vitro proliferate and differentiate,after transplantation in vivo they show a good homing,and the ability to integrate and regenerate.Hepatoblasts isolation technology is being improved daily,and the related researches on this field will boost cell-based liver therapy in clinical application.CONCLUSION:Improvements and combination of the various isolation methods,as well as new and high-specific antigen discovery will further improve the isolation efficiency of hepatoblasts from fetal liver.