Objective To retrospectively analyze of factors influencing early preterm birth(EPB)and late preterm birth(LPB)in pregnancy women with placenta previa complicated by placenta accreta spectrum disorders(PAS),and assess maternal and infant outcomes.Methods We included 590 cases of pregnancy women with placenta previa complicated by PAS who underwent cesarean sections at five hospitals in Wuhan and Xianning cities between January 2018 and June 2021.These patients were divided into three groups based on delivery gesta-tional age:EPB,LPB,and term birth(TB).A multiple logistic regression model was employed to analyze the risk factors associated with EPB and LPB.Additionally,differences in early maternal and infant outcomes among these groups were examined.Results Among 590 pregnancy women with placenta previa complicated by PAS,the proportions of EPB and LPB were 9.7%and 54.4%.The use of uterine contraction inhibitors prior to cesarean section,vaginal bleeding,and previous cesarean sections history were identified as risk factors for both EPB and LPB.The proportion of severe postpartum hemorrhage was comparable between the EPB group and the LPB group;however,the incidence of neonatal asphyxia,low birth weight infants,and the rate of newborns transferred to the Neonatal Intensive Care Unit(NICU)within 24 hours after cesarean delivery were significantly higher in the EPB group compared to the LPB group.Conclusions Placenta previa complicated by PAS predominantly leads to LPB.The history of prior cesarean sections,uterine contractions,and vaginal bleeding prior to cesarean section,are sig-nificantly associated with both EPB and LPB.During the perinatal period,efforts should be made to extend gesta-tional weeks under close monitoring to minimize the incidence of premature births and thereby improve early mater-nal and infant outcomes.

Objective:To explore the nursing cooperation of gonioscope assisted transluminal trabeculectomy (GATT).Methods:From February 2019 to August 2020, preoperative visits, preoperative equipment debugging and surgical instrument preparation were conducted for 30 patients (30 eyes) undergoing GATT for open-angle glaucoma in Zhongshan Ophthalmic Center of Sun Yat-sen University. Nurses closely attended the patients and expertly cooperated with doctors in the intraoperative management of patients. The incidence of complications was observed. The intraocular pressure (IOP) and medication were compared before and after operation.Results:Totally 30 cases (30 eyes) completed the operation successfully without serious complications and nursing adverse events. Twenty-six patients (86.7%) completed 360° total incision, and four patients (13.3%) completed 270° total incision. The mean preoperative IOP was (27.43±6.46) mmHg (1 mmHg= 0.133 kPa), the mean postoperative IOP was (13.67±3.01)mmHg. The difference between preoperative and postoperative IOP and the use of anti-glaucoma drugs were of statistical significance ( t value was 10.67, Z value was 4.18, P<0.05). Conclusions:The implementation of fine nursing for patients with GATT can ensure the smooth operation, reduce the incidence of complications and improve the postoperative rehabilitation effect.

Objective To investigate the scientific and objective quality management methods of ophthalmic nursing to improve the quality of ophthalmic clinical nursing. Methods According to the implemention details of review standards of tertiary special eye hospital (2011) and the management specification of clinical nursing of Guangdong province, combining with the characteristics of ophthalmic nursing to formulate the 21 indicators. The indicators had been applied in 12 wards to evaluate the nursing quality since 2013 each quarter. Using the Plato analysis method to analyze the data dynamically since 2013, then controlling and improving the nursing quality in view of the analysis result. The clinical nursing quality in the first half of 2013 was compared with the second half of 2013. Results The ophthalmic nursing indicators of 12 wards in the second half of 2013 were higher than the first half of 2013. Significant statistical difference was found in the implementation rate of periocular clean, cut fingernails preoperative, infusion system, identification, send medicine to the mouth, patients at high risk of falling drop of bed evaluation, wrist band awareness, patients′ satisfaction between two groups (χ2=4.115-12.308, P < 0.05 or 0.01). Conclusions Establishing and implementing the nursing quality evaluation indicators system of ophthalmology can evaluate the clinical nursing quality objectively and promote the continuous improvement of clinical nursing quality.

Objective To investigate the prevention measure of infections from the large number of cataract surgery at the Life- line Express. Methods From September to November 2013, a total of 1 069 cases (1 070 eyes) completed cataract surgery in Songyuan City of Jilin Province. A series of peri- operative prevention measures for nosocomial infection were established and implemented according to the characteristics of cataract surgery carried out in Life- line Express and local environment. Results The measures to prevent the nosocomial infection were fulfilled quite well, 1 069 patients had received cataract surgery successfully, no case occurred entophthalmia. Conclusions Effective prevention of the nosocomial infection can be achieved through establishing a sound system and measures, which can ensure the effect of surgery.

Objective To study the effect of Jingyebaidu granules on treating cytomegalovirus ( CMV) infection during mid-pregnancy. Methods The sexually mature guinea pigs with no CMV infection history served as the subjects. Put the male and female ones in the same cages. Then the female ones were randomly divided into three groups during mid-pregnancy. Model control group:15 guinea pigs which were inoculated 1 mL suspension of GPCMV intraperitoneally. Jingyebaidu Medicine group:15 guinea pigs which were treated with Jingyebaidu(3. 09 mL·kg-1 ) through stomach perfusion after inoculation for 14 days. Normal control group:15 normal mid-pregnant guinea pigs. Viremia rates were examined 7 days after infection. All animals were sacrificed 20 days after infection. The placenta infection rate, pup infection rate, still-born rate were examined. Results Compared with the normal controls, the still-born rate was increased in model control group(8. 33% vs 34. 55%, P<0. 05). In comparison to the model control group, the GPCMV maternal infection rate(86. 67% vs 33. 33%), placenta infection rate (91. 67% vs 61. 22%), pup infection rate(90. 91% vs 48. 28%), still-born rate(34. 55% vs 15. 52%) were significantly decreased in the Jinyebaidu group (all P<0. 05). Conclusion Jinyebaidu granules could reduce maternal infection,pup loss, and placenta infection caused by CMV inoculation during mid-pregnancy.

Objective To explore the value of plasma procalcitonin (PCT)detection in dif-ferentiation and judgment of severe pyemia.Methods 70 patients with pyemia were divided into general pyemia group (n =23),severe pyemia group (n =28)and pyemia shock group (n =19), and plasma PCT,lactic acid,c-reactive protein,the acute physiology and chronic health evaluationⅡ 24 hours (APACHE Ⅱ)and 1,2,3 days in hospital as well as serum PCT,lactic acid,c-reac-tive protein were detected and compared.Results Plasma PCT,lactic acid,CRP and APACHE Ⅱscore of pyemia shock patients were significantly higher than the general pyemia group (P <0.05). Serum PCT,CRP and APACHE Ⅱ score of pyemia shock patients were significantly higher than that of severe pyemia group (P <0.05).15 patients with pyemia died,55 patients survived.72 hours plasma PCT,lactic acid,CRP and APACHE Ⅱ score in death group were significantly higher than the survival group (P < 0.01).When pyemia patients were admitted to hospital,PCT were positively correlated with APACHE Ⅱ scores (r =0.528,P <0.01).Conclusion PCT is superior to the current clinical application of CRP inflammatory response parameters,and it can be used as an early identification of systemic infection,judgment of pyemia severity and prognosis judgment in-dex.

Objective To explore the value of plasma procalcitonin (PCT)detection in dif-ferentiation and judgment of severe pyemia.Methods 70 patients with pyemia were divided into general pyemia group (n =23),severe pyemia group (n =28)and pyemia shock group (n =19), and plasma PCT,lactic acid,c-reactive protein,the acute physiology and chronic health evaluationⅡ 24 hours (APACHE Ⅱ)and 1,2,3 days in hospital as well as serum PCT,lactic acid,c-reac-tive protein were detected and compared.Results Plasma PCT,lactic acid,CRP and APACHE Ⅱscore of pyemia shock patients were significantly higher than the general pyemia group (P <0.05). Serum PCT,CRP and APACHE Ⅱ score of pyemia shock patients were significantly higher than that of severe pyemia group (P <0.05).15 patients with pyemia died,55 patients survived.72 hours plasma PCT,lactic acid,CRP and APACHE Ⅱ score in death group were significantly higher than the survival group (P < 0.01).When pyemia patients were admitted to hospital,PCT were positively correlated with APACHE Ⅱ scores (r =0.528,P <0.01).Conclusion PCT is superior to the current clinical application of CRP inflammatory response parameters,and it can be used as an early identification of systemic infection,judgment of pyemia severity and prognosis judgment in-dex.

Objective To investigate the value of prognosis of NT-proBNP in severe sepsis and septic shock patients .Methods 70 patients with sepsis admitted to our hospital were divided into general sepsis group (n=23) ,severe sepsis group(n=28) and sep-tic shock group(n=19) according to the severity of the disease ,the plasma NT-proBNP ,lactic acid ,C-reactive protein were meas-ured within 1 h after admission ,and calculated the 24 h acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) .Results (1) Plasma NT-proBNP concentration ,lactic acid ,CRP and APACHE Ⅱ score in severe sepsis group ,septic shock group was sig-nificantly higher than that of general sepsis group(P< 0 .05);Plasma NT-proBNP concentration ,CRP and APACHE Ⅱ score in septic shock group was significantly higher than severe sepsis group (P<0 .05) .(2)70 cases of patients with sepsis with 15 cases died and 55 cases survived .Plasma NT-proBNP concentration ,lactate ,CRP and APACHEⅡscore of death patients was significantly higher than the survival patients(P<0 .01) .(3) Plasma NT-proBNP concentration at the time of sepsis patients admitted to hospi-tal with positively correlated to APACHE Ⅱscores(r=0 .528 ,P<0 .01) .Conclusion The plasma NT-proBNP is closely related to the prognosis of patients with sepsis ,early detection of plasma concentration of NT-proBNP helps to evaluate the prognosis of pa-tients w ith sepsis .

Objective To evaluate the value of the TIMI risk index in predicting 30-day and one-yosr mortality and incidence of heart failure in patients with ST-elevation myocardial infarction (STEMI).Method Data of 229 patients with STEM1 from August 1999 to March 2006 in the First Affiliated Hospital,Sun Yat-sen University,were retrospeclively collected,analyzed and scored with TIMI risk index.When categorized into quintiles(≤12.5,12.5～17.5,17.5～22.5,22.5～30,>30) and modeled as a continuous variable,difference of prediction of 30day and one-year mortality and 30-day incidence of heart failure of patients were compared respectively.Results When categorized into quintilos and modeled as a continuous variable,30-day and one-year mortality and 30-day incidence of heart failure were increasing with increasing score of risk index (P<0.05).The area under the recewer operating characteristic curve were 0.65,0.68,0.67 and 0.70,0.72,0.70,respectively.Conclusions The TIM1 risk index can be used as a simple,rapid and practical tool to risk-stratify patients with STEMI.

The value of ELISA, N-PCR and RT-PCR in clinical practice for pregnant women with HCMV infection was investigated. 5581 pregnant women were screened by ELISA. Among them, 100 cases were positive for IgM (group 1), 69 for both IgM and serous DNA (group 2) and 69 for both IgM and mRNA (group 3). The infectious status, maternal-fetal transmission and pregnancy outcome were monitored. It was demonstrated that the accordance rate of group 3 and group 2 with group 1 was 56.25% and 43.75%, respectively. The maternal-fetal transmission rate in the group 1, 2 and 3 was 19.00%, 40.58% and 46.15%, respectively, with a significant difference found between group 2, 3 and group 1 (P < 0.01). Incidence of spontaneous abortion, fetal death, fetal abnormality and neonatal death in group 1, 2 and 3 was 10.00%, 15.94% and 30.77%, respectively, and that of group 3, 2 was 4 and 2 times as much as that of group 1, respectively (OR = 4.00, P < 0.001; OR = 2.343, P < 005, respectively). It was concluded that HCMV-IgM(+) can only be considered as an screening indicator for pregnant women with HCMV infection, while IgM(+) combined with serous DNA(+) or mRNA(+) indicates active infection and has a high incidence of maternal-fetal transmission and abnormal pregnancy outcome.
Adult ; Antibodies, Viral ; blood ; Cytomegalovirus ; immunology ; isolation & purification ; Cytomegalovirus Infections ; diagnosis ; transmission ; virology ; DNA, Viral ; blood ; Enzyme-Linked Immunosorbent Assay ; Evaluation Studies as Topic ; Female ; Humans ; Immunoglobulin M ; blood ; Infectious Disease Transmission, Vertical ; Polymerase Chain Reaction ; methods ; Pregnancy ; Pregnancy Complications, Infectious ; virology ; Pregnancy Outcome ; Prenatal Diagnosis ; Reverse Transcriptase Polymerase Chain Reaction