Objective:To compare oxytocin combined with ergometrine with oxytocin alone in terms of primary prophylaxis for postpartum hemorrhage (PPH) at the time of cesarean section (CS).Methods:This was a multicenter double-blind randomized controlled interventional study comparing ergometrine combined with oxytocin and oxytocin alone administered at CS. From December 2018 to November 2019, a total of 298 parturients were enrolled in 16 hospitals nationwide. They were randomly divided into experimental group (ergometrine intra-myometrial injection following oxytocin intravenously; 148 cases) and control group (oxytocin intra-myometrial injection following oxytocin intravenously; 150 cases) according to 1∶1 random allocation. The following indexes were compared between the two groups: (1) main index: blood loss 2 hours (h) after delivery; (2) secondary indicators: postpartum blood loss at 6 h and 24 h, placental retention time, incidence of PPH, the proportion of additional use of uterine contraction drugs, hemostatic drugs or other hemostatic measures at 2 h and 24 h after delivery, the proportion requiring blood transfusion, and the proportion of prolonged hospital stay due to poor uterine involution; (3) safety indicators: nausea, vomiting, dizziness and other adverse reactions, and blood pressure at each time point of administration.Results:(1) The blood loss at 2 h after delivery in the experimental group [(402±18) ml] was less than that in the control group [(505±18) ml], and the difference was statistically significant ( P<0.05). (2) The blood loss at 6 h and 24 h after delivery in the experimental group were less than those in the control group, and the differences were statistically significant (all P<0.05). There were no significant differences between the two groups in the incidence of PPH, the proportion of additional use of uterine contraction drugs, hemostatic drugs or other hemostatic measures at 2 h and 24 h after delivery, the proportion requiring blood transfusion, and the proportion of prolonged hospital stay due to poor uterine involution (all P>0.05). (3) Adverse reactions occurred in 2 cases (1.4%, 2/148) in the experimental group and 1 case (0.7%, 1/150) in the control group. There was no significant difference between the two groups ( P>0.05). The systolic blood pressure within 2.0 h and diastolic blood pressure within 1.5 h of drug administration in the experimental group were higher than those in the control group, and the differences were statistically significant ( P<0.05), but the blood pressure of the two groups were in the normal range. Conclusion:The use of ergometrine injection in CS could reduce the amount of PPH, which is safe and feasible.

Objective To evaluate the value of endorectal ultrasonography (ERUS) in assessment of mesorectal fascia (MRF) invasion in rectal cancer.Methods Data of 44 patients who accepted preoperative ERUS and total mesorectal excision surgery within a week were retrospective analyzed.There were 18 patients who accepted preoperative neoadjuvant chemotherapy and 26 patients didn't acceped.Taking the pathological diagnosis of circumferential resection margin (CRM) as the gold standard,the diagnostic efficiency of ERUS for the MRF invasion in rectal cancer was evaluated.Results The final pathological T staging was T1 in 2 cases,T2 in 17 cases and T3 in 25 cases.There were 2 cases of CRM positive results,and 42 cases of CRM negative results.With regard to the location of tumor,there were 16 cases located in low,and 28 cases in mid rectum.There were 26 cases located in anterior or antero-lateral wall of rectum,13 cases in posterior or postero-lateral wall,and 5 cases with a circle of rectum.The diagnostic accuracy were 83.33 ％ (15/18) and 92.31％ (24/26) for cases of accepting and not accepting the preoperative neoadjuvant chemotherapy;80.77％ (21/26) for cases located in anterior or antero-lateral wall,and 100％ (13/13) for cases located in posterior or postero-lateral wall;75.00％ (12/16)and 96.43 ％ (27/28) for low position and mid position tumors.The total diagnostic accuracy was 88.64％ (39/44).Conclusion ERUS can be an effective method in preoperative assessment of the MRF invasion in rectal cancer.

Objective To explore the relationship between ileocolonic lesions and perianal fistulas of Crohn's disease as sessed by CT enterography (CTE).Methods Totally 28 patients with initial diagnosis of active ileocolonic lesions of Crohn 's disease were collected,16 with perianal fistula and 11 without perianal fistulas.All patients underwent CTE and pelvic MRI.Total number of lesions,minimum length between every two lesions in colon wall and maximum length of colonic le sions were calculated.The rank sum test was performed respectively.Results Lesions of 14 patients (14/16,87.50％) in perianal fistulas group located in left colon or rectum,while lesions of 6 patients (6/12,50.00 ％) in non-perianal fistulas group located in left colon or rectum,the difference was statistically significant (Z=-2.135,P＜0.05).The mean number of lesions in patients with perianal fistulas was 3.06,while in patients without perianal fistulas was 2.91,there was no statistical difference (P＞0.05).The maximum length of colonic lesions in patients with perianal fistulas was (12.79± 8.30)cm,while in patients without perianal fistulas was (7.04± 3.09)cm,and there was no statistical difference(P＞ 0.05).The minimum length hetween every two lesions in patients with perianal fistulas was (5.23±2.98)cm,while in pa tients without perianal fistulas was (8.44 ± 2.87) cm,the difference was statistically significant (Z =-2.095,P＜ 0.05).Conclusion Crohn's disease complicated with perianal fistulas has relationship with lesion location and smaller length intervals between two lesions in colon wall,and has no relationship with total number of lesions and maximum length of colon lesions.

Liver Imaging Reporting and Data System was released online in 2011 by America College of Radiology (ACR) for standardizing the performance,interpretation and reporting of CT and MR imaging examinations of the liver in patients at risk for hepatocellular carcinoma.This article overviewed the profile of this system,its updated version and recent progress on its clinical application.

Objective To investigate the possible effect of ginsenoside Rg1 and oligo Aβ1-42 on PKA/CREB pathway.Methods The damage was induced by oligomeric Aβ1-42 in primary cortical neuron.Neurons were incubated with or without glutamate,or incubated in Aβ,or pre-incubated in Rg1 and then co-incubated in Aβ.The proteins of p-CREB,t-CREB,PKA Ⅱ α and BDNF were detected by Western blot.Results After the treatment with Oligo Aβ1-42 for 2 h,the p-CREB/t-CREB level induced by glutamate was obviously lower (P＜ 0.001).However,in neurons pre incubatedwith 2.5,5.0,10.0 μmol/L of ginsenoside Rg1 and then co-incubated with 5μmol/L of oligo Aβ1-42,the p-CREB/t-CREB induced by glutamate was significantly increased as compared with that of Aβ1-42 group (P＜0.05).Upon Aβ1-42 exposure for 2 h,cortical neurons showed a statistically significant increase in PKA Ⅱ α as compared to the control group (P ＜ 0.001).Pre-treatmentwith varying doses of ginsenoside Rg1 (2.5,5,10μmol/L) showed a decrease in PKA Ⅱ α as compared to neurons treated with Aβ1-42 alone for 2 h (P＜0.001).Furthermore,BDNF level significantly increased in Rgl-pretreated cells as compared to cells treated with Aβ1-42 alone for 24h (P＜0.05).Conclusions Ginsenoside Rg1 attenuates the oligo Aβ142 inhibition of PKA/CREB pathway.

Aim To explore the possible protective effect of ginsenoside Rg1 on oligomeric Aβ1-42 induced apoptosis and its possible mechanism. Methods The damage was induced by oligomeric Aβ1-42 in primary cortical neurons. Cells were incubated in the absence or presence of Aβ, or co-incubated in sp600125 with Aβ, or pre-incubated in ginsenoside Rg1 then co-incu-bated in Aβ. The p-JNK, JNK, caspase-3 activity and TUNEL-positive cells were detected. Results In Aβ1-42 treated group, the ratio of p-JNK/JNK level was increased more than that in non-treated group for 15 min. However, in neurons preincubated with (2. 5, 5, 10 μmol·L-1 ) ginsenoside Rg1 and then co-incuba-ted with 5 μmol·L-1 oligomeric Aβ1-42 , the p-JNK/JNK ratio, caspase-3 activity and TUNEL positive neu-rons were significantly decreased compared with those of Aβ1-42 treated group. Conclusion Ginsenoside Rg1 can attenuate the oligomeric Aβ1-42-induced apop-tosis by JNK pathway.

Objective To investigate the effects of goal setting nursing strategy on behavior of patients with metabolic syndrome. Methods A total of 100 patients with the metabolic syndrome in our hospital for treatment from May to September in 2012, as research object, and all patients were divided into control group and observation group on average according to random number table. The patients of control group were given routine care, while the observation group underwent goal setting nursing. The self-efficacy and health behavior of patients with metabolic syndrome were evaluated by Exercise of Self-Care Agency Scale ( ESCA ) and the“whirlpool” way of life assessment questionnaire. Results After nursing care, the health knowledge score of observation group (47. 45 ± 6. 23) was significantly higher and that of the control group (42. 26 ± 5. 65);the sense of self responsibility score of observation group (25. 17 ± 5. 26) was significantly higher than that of the control group (18. 95 ± 4. 38);self care skill score the observation group (27. 49 ± 4. 63) was beyond (22. 76 ± 4. 26) in the control group;self concept scores in observation group (27. 02 ± 4. 51) was significantly higher than that of control group (23. 83 ± 4. 47);self-efficacy in observation group (127. 13 ± 10. 42) was significantly higher than that of the control group (107. 80 ± 9. 74). The score between the observation group and the control group with total score of self-efficacy and the 4 dimensions of the score and self-care behaviors were statistically significant ( t=3. 927, 7. 025, 4. 251, 5. 462, 8. 731;P <0. 05 ); patients in the two groups were compared after nursing care. The difference of the proportional distribution of dietary structure, movement and stay up index in two groups of healthy behavior was statistically significant (Z =4. 290,10. 097, 4. 702;P <0. 05). Conclusions Goal setting nursing strategy can effectively improve the metabolic syndrome patients′ self-care behavior and self-efficacy, and is worthy to promote in the clinical.

Objective To investigate the imaging findings of rare tumors or tumor-like lesions in liver grafts after liver transplantation.Methods Imaging data of 4 patients with rare tumors or tumor-like lesions in the liver grafts of patients after liver transplantation from December 2006 to August 2013 in the Third Affiliated Hospital of Sun Yat-sen University were reviewed.Findings of computerized tomography ( CT ) and ( or ) magnetic resonance imaging ( MRI) plain scan and dynamic enhanced MRI of liver lesions in these patients were analyzed specially.Results In the 4 patients, 3 cases were misdiagnosed , including undifferentiated liver sarcoma , secondary lymphoma and eosinophilic granuloma.One case was diagnosed correctly with hepatic metastases of gallbladder carcinoma.The undifferentiated liver sarcomas appeared as cystic and solid space occupying masses with significant and persistent enhancement in the surrounding solid and separating parts .No enhancement was observed in the cystic parts , which increased rapidly in a short term.No edema area around the lesions was observed , but many calcifications were detected.The secondary hepatic lymphoma appeared as intrahepatic multiple nodules , most of which presented uniform signal intensity with moderate enhancement in every phase.No intrahepatic vascular invasion was observed but extrahepatic lymphadenectasis was detected .Bleeding was observed in a few lesions.The liver eosinophilic granuloma appeared as multiple liver lesions with variable signal intensity and enhancement modes , which suggested that the lesions were consisted of variety of elements and in the different disease stages.Most of the lesions were observed with progressive circled enhancement.The recurrence of gallbladder carcinoma and hepatic metastasis after liver transplantation appeared as a intrahepatic hypodensity lesion with slight enhancement in arterial phase and slight hypodensity in portal phase.Retroperitoneal lymph nodes were observed swelled and fused.Conclusions Rare tumors or tumor-like lesions in liver grafts have distinctive imaging features.Imaging examinations are useful for the early detection of these rare tumors or tumor-like lesions in liver grafts.Imaging findings combining with disease history and clinical manifestations can help to make correct diagnosis.

Objective To explore the correlation between sense of life and the negative emotions in clinic nurses to provide reference frame for maintaining their mental health .Methods One hundred clinic nurses were included randomly.Purpose in Life Test (PIL), Self-Rating Depression Scale (SDS), and Self-Rating Anxiety Scale ( SAS) were used to analyze the negative emotions and sense of life .Results There were thirty-three clinic nurses PIL score below 92 points, accounted for 33.0%, forty-one clinic nurses between 92-112, accounted for 41.0%, twenty-six clinic nurses more than 112 points, accounted for 26.0%.The average PIL score was (96.19 ±14.33), which was lower than normal model , and the difference was statistically significant (t=4.453,P<0.05).The light, moderate SDS score was 20.0%, 10.0%, respectively.The average SDS score was (56.19 ±7.33).The light, moderate SAS score was 23.0%, 14.0%, respectively. The average SAS score was (55.47 ±6.86).There was negative correlation between PIL score and SDS score , and between PIL score and SAS score (r=-0.444, -0.453,respectively;P<0.05).Conclusions There is a negative correlation between negative emotions and sense of life .The stronger sense of life the nurses have , the better mental health they will have , which is conductive to nurse more efforts to study and work , and improve the nursing quality and hospital service levels .

Objective To evaluate the effects of limb ischemic preconditioning (LIP) on the intestinal injury during release of hepatic portal occlusion (RHPO) in rats.Methods Thirty-six male Sprague-Dawley rats,aged 6-7 weeks,weighing 200-250 g,were randomly divided into 3 groups using a random number table:sham operation group (group S,n =12),RHPO group (n =39) and LIP+ RHPO group (n =20).Hepatic ischemia/ reperfusion was produced by occluding portal vein and hepatic artery for 30 min followed by 6 h reperfusion according to Pringle's method.LIP was produced by tourniquet occlusion of the right femoral artery and vein for 10 min followed by 24 h reperfusion before hepatic ischemia.The animals were sacrificed at 6 h after hepatic portal occlusion was released and the mucous membrane of small intestine was obtained for microscopic examination and for determination of malondialdehyde (MDA) content,superoxide dismutase (SOD) activity,myeloperoxidase (MPO)activity,total antioxidant capacity (T-AOC) and intercellular adhesion molecule-1 (ICAM-1) mRNA and protein expression.The degree of damage to intestinal mucous membrane was scored according to Chiu.Results Compared with group S,Chiu's score and levels of MDA and MPO were significantly increased,SOD activity and TAOC were decreased,and ICAM-1 mRNA and protein expression was up-regulated in group RHPO (P ＜ 0.05 or 0.01).Compared with group RHPO,Chiu's score and levels of MDA and MPO were significantly decreased,SOD activity and T-AOC were increased,and ICAM-1 mRNA expression was down-regulated in group LIP + RHPO (P ＜ 0.05).Conclusion LIP can alleviate the intestinal injury during RHPO in rats by enhancing the antioxidant function and down-regulating the expression of ICAM-1.