Objective:To explore the status quo of postpartum hemorrhage assessment in obstetric doctors and nurses and provide a reference for developing a scientific, effective and practical early warning assessment tool for postpartum hemorrhage.Methods:The obstetric doctors and nurses were selected from 92 hospitals across China by convenient sampling from April 6th to 13th, 2019. The self-designed questionnaire was used to investigate their demographic information and status of postpartum hemorrhage assessment. Totally 4 490 questionnaires were distributed. The questionnaires were reviewed to ensure the integrity of information after collected. Totally 4 490 valid questionnaires were collected, with a recovery rate of 100%.Results:The hospitals where 4 406 out of the 4 490 obstetric doctors and nurses worked assessed high risk factors for postpartum hemorrhage, accounting for 98.1%. There was statistically significant difference in assessing high risk factors for postpartum hemorrhage or not between hospitals of different kinds ( P<0.05) . Among the hospitals which assessed high risk factors for postpartum hemorrhage, high risk factors for postpartum hemorrhage were assessed jointly by doctors and nurses or midwives in the hospitals where 77.6% of the obstetric doctors and nurses worked, and the postpartum hemorrhage high risk factor scale was used for postpartum hemorrhage assessment in hospitals where 62.1% of the obstetric doctors and nurses worked. The top 2 time of assessing high risk factors for postpartum hemorrhage was postpartum assessment and intrapartum assessment. The most frequently used method to measure amount of bleeding was weighing. According to the obstetric doctors and nurses, the biggest challenge when assessing high risk factors for postpartum hemorrhage was "no appropriate tool for assessing high risk factors for postpartum hemorrhage". Conclusions:Obstetric doctors and nurses pay attention to the assessment of high risk factors for postpartum hemorrhage, but there is no continuous and dynamic assessment for these high risk factors yet, and the measurement of amount of bleeding needs to be consistent. Hospital managers and obstetric doctors and nurses are in badly need of a postpartum hemorrhage assessment tool which is suitable for clinical use.

Objective:To explore the trend of postpartum hemorrhage after two-child policy and to analyze the high-risk risks of postpartum hemorrhage so as to put forward intervention measures to reduce the postpartum hemorrhage.Methods:We retrospectively selected 8 784 delivery women with routine production inspection and hospitalized at a ClassⅢ Grade A hospital from 2014 to 2018. We collected the general information, record of production inspection, delivery record and analyzed the trend of postpartum hemorrhage rate, blood loss and related high-risk factors.Results:From 2014 to 2018, there were statistical differences in the postpartum hemorrhage rate, serious postpartum hemorrhage rate and blood loss ( P<0.05) . The trend showed an increasing trend. In 2017, the postpartum hemorrhage rate, serious postpartum hemorrhage rate and blood loss were 16.9%, 6.1% and (540.1±758.2) ml respectively highest in those years. From 2014 to 2018, the percentage of delivery women with advanced ages, multiple pregnancy, pregnancy times≥2, history of cesarean section≥2 were increasing; delivery women with the prenatal hemoglobin≤110 g/L and percentage of natural labor were decreasing with a statistical difference ( P<0.05) ; the percentage of emergency cesarean section was on the rise; the percentage of placental expulsion time from 15 to 30 minutes declined with statistical differences ( P<0.05) ; the percentage of placental expulsion time≥30 minutes and above was no significant trend. Conclusions:From 2014 to 2018, the postpartum hemorrhage rate, serious postpartum hemorrhage rate and blood loss did not show an increasing trend. However, the percentage of high-risk pregnant and delivery women increased gradually. Therefore, we should carry out the pregnancy risk assessment rating for pregnant and delivery women and formulate a suitable high-risk assessment tool for postpartum hemorrhage so as to reduce the incidence of postpartum hemorrhage.

Objective:To explore the influencing factors of the failure of labor induction by oxytocin and delivery outcome, and provide a basis for standardizing pregnancy management and process management of labor induction by oxytocin.Methods:Using a self-designed data collection form, the data of 1 705 pregnant women who underwent labor induction by oxytocin in the Department of Obstetrics of China-Japan Friendship Hospital from 2014 to 2018 were retrospectively collected, and the influencing factors of the failure of labor induction by oxytocin and the outcome of delivery were analyzed.Results:A total of 1 705 primary mothers were included in the study. Multiple factor analysis show that, amniotic fluid pollution, macrosomia, and the duration of labor induction by oxytocin were independent influencing factors for the failure of labor induction by oxytocin. The duration of labor induction by oxytocin was related to the method of delivery, weight of the newborn, and amount of postpartum hemorrhage, and the difference was statistically significant ( P<0.01) . The outcome of delivery labor induction by oxytocin was the cause of cesarean delivery, and "intrauterine fetal distress" and "cephalopelvic disproportion" accounted for the highest proportion. Conclusions:The main influencing factors for the failure of labor induction by oxytocin are amniotic fluid pollution, macrosomia, etc., and the influencing factors will gradually increase with the process of labor induction, thereby reducing the natural delivery rate. Therefore, it is necessary to strengthen pregnancy management, control pregnancy weight and fetal weight, and reduce pregnancy complications. It is also necessary to strengthen clinical management of labor induction by oxytocin, provide sound education and guidance for labor induction by oxytocin, and increase the vaginal delivery rate after labor induction by oxytocin.

?? [Abstract]? Objective? To understand the knowledge level of part-time nurses on dynamic posts of obstetric nursing and their needs for dynamic post training of obstetric nursing,so as to provide basis for the formulation of staff management training programs for dynamic posts of obstetric nursing. Methods? By purposive sampling, 47 part-time nurses hired by the Department of Nursing in China-Japan Friendship Hospital from November to December of 2018 were selected for the study. Self-designed Obstetric Nursing Dynamic Post Perception and Training Implementation Questionnaire was used to investigate the participants' perception and training needs towards the dynamic posts of obstetric nursing. In the study, totally 47 questionnaires were distributed and 47 valid ones were collected, yielding an effective recovery rate of 100%. Results? In the 47 part-time nurses, 68.09%(32/47) of them understood the dynamic post of obstetric nursing, 87.23%(41/47) of them held the opinion that admission criteria was needed for the dynamic post, 100% of them expressed the needs for pre-service training. The contents of the top three training needs were: "emergency management of sudden changes of obstetric patients" "effects of commonly used drugs in Obstetric Department" "theoretical knowledge of Obstetrics specialty", and different training time was set according to the difficulty of posts. Conclusions? Part-time nurses have insufficient knowledge of dynamic posts in obstetric nursing, and need to acquire obstetric specialty knowledge urgently. At the same time, training programs and assessment criteria for dynamic posts of obstetric nursing should be formulated to ensure the safe and effective operation of nursing work.

Objective To investigate the anti-oxidative effects of alprostadil on contrast-induced nephropathy(CIN)after percuteous coronary intervention (PCI)in patients with chronic kidney disease(CKD).Methods A total of 200 patients with CKD were enrolled in our hospital.According to the random number table was divided into alprostadil 100 cases,100 cases of conventional treatment group.The levels of serum creatinine (Scr),creatinine clearance (eGFR),serum cystatin C (ScysC)and 8-hydroxy-deoxyguanine (8-OHdG)were observed before and after operation at 72 h and 7 d after operation.Results The incidence of CIN in the alprostadil group was significantly lower than that in the conventional treatment group (6% vs 12%,P<0.05).There was no significant difference in the level of Scr,eGFR,ScysC and 8-OHdG between the alprostadil group and the conventional treatment group (P>0.05).The level of Scr in the alprostadil group was significantly lower than that in the conventional treatment group at 72 h and 7 d after operation.The level of eGFR was significantly higher than that of the conventional treatment group (P<0.05).The levels of ScysC and 8-OHdG in the two groups were significantly higher than those before operation at 72 h and 7 d(P>0.05).The levels of ScysC and 8-OHdG in the alprostadil group were significantly lower than those in the conventional treatment group at 72 h and 7 d after PCI(P<0.05).Conclusion Alprostadil may improve the oxidative stress in patients with CKD and provide a preventive effect on CIN.

Objective To study the CYP2C19 genotype in patients with acute coronary syndrome(ACS) complicated with diabetes mellitus(DM)receiving percutaneous coronary intervension(PCI)by polymerase chain reaction(PCR),and to evaluate the efficacy of Ticagrelor in CYP2C19 gene polymorphism. Methods A total of 494 ACS patients with DM were enrolled. The patients were divided into routine treatment group and individual treatment group. Routine treatment group received 0.1 g/d aspirin/d and 75 mg/d of Clopidogrel. CYP2C19 gene polymorphism was examined in individual treatment group.(*1/*1)was classified into fast metabolic type,mutant heterozygous type(*1/*2,*1/*3)into intermediate metabolic type and mutant pure type (*2/*2,*2/*3,*3/*3) into slow metabolic type. Fast metabolic type received aspirin 0.1 g/d and Clopidogrel 75 mg/d,and intermediate and slow metabolic type received aspirin 0.1 g/d and Ticagrelor 90 mg bid for 12 months or more to observe the inci-dence of adverse cardiovascular events ,bleeding and other adverse reactions in 2 groups. Results The incidence of cardiac death ,recurrent myocardial infarction and angina pectoris ,stroke ,stent thrombosis and target vessel revascularization in routine treatment group was significantly higher than that in individual treatment group(P <0.05). There was no significant difference between two groups in terms of major bleeding and secondary bleeding (P > 0.05). The minimum bleeding rate was slightly higher in intermediate metabolic type in individual treatment group but without significantly difference when compared with that in fast metabolic type and slow metabolic type (both P>0.05). Conclusion Without elevating the risk of bleeding within 12 months,the efficacy of Ticagrelor is not affected by CYP2C19 gene polymorphism in patients with ACS complicated with DM after PCI.

Objective To investigate the correlation between morning blood pressure surge and Coronary Microvascular Dysfunction.Methods 58 cases of patients with hypertension in our hospital were given 24 h ambu-latory blood pressure monitoring(ambulatory blood pressure monitoring,ABPM).The coronary microvascular dys-function was estimated by the index of microcirculatory resistance(IMR). All cases were given biochemical test-ing,included TCH,TG,HDL-c,LDL-c and SUA.Results According to whether ABMP was arise,the patient were divided into MBPS group(n=21)and the Non-MBPS group(n=37).24 h,day,night and morning peak of systolic blood pressure were significantly higher in the morning peak group than in the average morning peak group. Multiple linear regression analysis showed that,MBPS,24 h average systolic blood pressure,day average systolic blood pressure,night average systolic blood pressure,and age were independent risk factors for coronary artery disease.Conclusion Morning blood pressure surge is closely related to severity of coronary microcirculation dysfunction. It is an independent risk factor for coronary microcirculation dysfunction. To control the blood pres-sure in patients with hypertension effectively can reduce morning peak target organ damage.

Aim To study the molecular mechanism of Raptor in the migration and invasion of breast cancer cells and provide the clinical theory basis for prevention of breast cancer invasion and metastasis.Methods Western blot was used to detect the expression of Raptor protein in MCF-7 cells and MDA231 cells.The siRNA plasmids were used to transfect MDA231 cells.At the same time,the plasmid pcDNA3.1-Raptor was transfected into MCF-7 breast cancer cells.And Western blot was used to analyze the protein expression level of E-cadherin and Vimentin.Transwell was used to test the ability of invasion.Nucleus mass separation experiment was used to test the expression of Snail.Results The expression of Raptor protein in MDA231 cells was higher than in the MCF-7 cell.When the control group of Scr/MDA231 cells compared with siRaptor/MDA231,Raptor protein expression was decreased obviously after plasmid transfection interference,accompanied by reduction of Vimentin protein expression and increase of E-cadherin protein expression.Compared with MCF-7/Con,Raptor protein expression significantly increased in MCF-7/Raptor,accompanied by increase of Vimentin protein expression and reduction of E-cadherin protein expression.The number of cells through the artificial basilemma Transwell in siRaptor/MDA231 cells was significantly reduced(P<0.05),and the number of cells through the Transwell chambers artificial basilemma was significantly increased in MCF-7/Raptor(P<0.05).Nucleus mass separation experiment results showed that the expression of Snail decreased obviously in the siRaptor/MDA231 than in the Scr/MDA231,however,the expression of Snail was obviously higher in the MCF-7/Raptor.Conclusions Raptor can promote the occurrence of EMT in breast cancer,thus it promotes invasion and metastasis of breast cancer.

Objective To investigate the effect and mechanism of mitomycin C in reducing hypertrophic scar in rat traumatic osteomyelitis model.Methods A total of 120 Wistar rats were divided into control group (Group A,n =40),traumatic osteomyelitis group (Group B,n =40),traumatic osteomyelitis treated with Mitomycin C group (Group C,n =40),according to the random number table.The model of traumatic osteomyelitis was produced by Staphylococcus aureus.Muscle tissues around the focus were harvested at 15 d and 30 d postinjury.HE staining was used to observe the changes of muscle tissue structure.Immunohistochemistry was used to detect expression of transforming growth factor (TGF)-β1.Masson staining was used for collagen deposition evaluation.Western blot was used for detection of levels of TGF-β1 and collagen Ⅰ.Results HE staining revealed consistent alignment of fibers within the muscle in Group A.Fibrosis with the muscle was observed in both Group B and C,but the degree of muscle fiber disorder was decreased in Group C compared to Group B.Either 15 d or β0 d after injury,expressions intensity of TGF-β1,collagen fraction volume,and activation levels of TGF-β1 as well as collagen Ⅰ were higher in Group B and C than Group A,and all parameters were decreased in Group C compared to Group B (all P ＜ 0.05).Conclusion Mitomycin C can reduce hypertrophic scar formation in traumatic osteomyelitis model,and the potential mechanism relates to downregulated TGF-β1 and collagen Ⅰ.

Aim To study the effect of emodin in Po-lygonum multiflorum on the expression of CYP450 isoenzymes in L02 hepatocytes and explore its mecha-nism of cytotoxicity. Methods L02 cells were treated with different concentrations of emodin. Cell viability was examined by MTS assay kit, and cell membrane injury was examined by detecting the release rate of lactate dehydrogenase( LDH) . The expression of cyto-chrome P450 mRNA was detected by real time PCR. Results The result of MTS assay showed that L02 cells viability was significantly reduced following expo-sure to emodin in a concentration and time dependent manner. The LDH release rate of L02 cells significant-ly increased after exposure to emodin for 48 h com-pared with the control group. On the mRNA level, compared with the control group,emodin had inductive effects on mRNA of each CYP450 enzyme, while had significant inductive effects on mRNA of CYP1 A1 and CYP1 B1 in a concentration and time dependent man-ner. Conclusion Emodin in Polygonum multiflorum may generate significant liver injury in L02 cells and has inductive effects on CYP450 enzyme activity.