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Objective To analyze the trend in caesarean section rate and puerpera characteristics in hospital,and provide valuable information for maternal and child health policy making and clinical practice.Methods A total of 12 041 women who delivered in the affiliated Chaohu Hospital of Anhui Medical University from October 1,2010 to September 30,2016 were selected.Based on Robson classification system,changes in the rate of caesarean delivery as well as its relationship with two-child policy and infant sex ratio were analyzed.Results The overall caesarean section rate gradually decreased from 66.9％ to 44.2％ during the past six years.Respectively,the caesarean section rate in primiparae with singleton term babies decreased to 32.1％ and the rate in multiparas without uterine scar decreased to 14.2％,and the rate in premature delivery decreased to 22.9％,the differences were significant (P＜0.01).The proportion of vaginal delivery (R1,R3),multiparas with uterine scar (R5) and twins pregnancy (R8) increased,the differences were significant (P＜0.01).The annual overall newly-born sex ratio ranged from 110:100 to 128:100.In group R1,more babies were girls,the proportion was stable,more women with premature delivery and multiparas had boy babies,but the boy babies by multiparas without uterine scar obviously decreased in the last 2 years.Conclusions Primiparae with singleton head birth,multipara without uterine scar and women with premature deliveries are the key population in the effort of reduction of caesarean section rate.The caesarean section rate and proportion were unstable in multiparas with uterine scar,breech deliveries and twin deliveries.The application of Robson classification system can improve the comparability of the surveillance data.
ABSTRACT
Objective To analyze the trend in caesarean section rate and puerpera characteristics in hospital,and provide valuable information for maternal and child health policy making and clinical practice.Methods A total of 12 041 women who delivered in the affiliated Chaohu Hospital of Anhui Medical University from October 1,2010 to September 30,2016 were selected.Based on Robson classification system,changes in the rate of caesarean delivery as well as its relationship with two-child policy and infant sex ratio were analyzed.Results The overall caesarean section rate gradually decreased from 66.9％ to 44.2％ during the past six years.Respectively,the caesarean section rate in primiparae with singleton term babies decreased to 32.1％ and the rate in multiparas without uterine scar decreased to 14.2％,and the rate in premature delivery decreased to 22.9％,the differences were significant (P＜0.01).The proportion of vaginal delivery (R1,R3),multiparas with uterine scar (R5) and twins pregnancy (R8) increased,the differences were significant (P＜0.01).The annual overall newly-born sex ratio ranged from 110:100 to 128:100.In group R1,more babies were girls,the proportion was stable,more women with premature delivery and multiparas had boy babies,but the boy babies by multiparas without uterine scar obviously decreased in the last 2 years.Conclusions Primiparae with singleton head birth,multipara without uterine scar and women with premature deliveries are the key population in the effort of reduction of caesarean section rate.The caesarean section rate and proportion were unstable in multiparas with uterine scar,breech deliveries and twin deliveries.The application of Robson classification system can improve the comparability of the surveillance data.
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<p><b>OBJECTIVE</b>To investigate the effects of prednisone on the expressions of FAK and Pyk2 in the kidneys of rats with adriamycin-induced nephritis.</p><p><b>METHODS</b>Thirty SD rats were randomized into normal control group, adriamycin-induced nephritic model group, and prednisone treatment group (n=10). Prednisone was administered at 10 mg/kg once daily in nephritic rats starting since the 7th day after adriamycin injection. Twenty-four-hour proteinuria was measured in the rats at different time points, and renal tissue histology was examined using transmission electron microscope. The expression levels of Pyk2, FAK and nephrin mRNA in the renal tissue were detected tested by RT-PCR, and the protein expressions of FAK, Pyk2, phosphorylated Pyk2 and phosphorylated FAK-Tyr397 were detected by Western blotting; immunohistochemistry was used for detecting nephrin protein expression in the kidney.</p><p><b>RESULTS</b>Compared with the normal control group, the rats with adriamycin-induced nephritis showed significantly increased proteinuria (P<0.01), which was obviously lowered by prednisone treatment (P<0.01). Transmission electron microscopy revealed extensive fusion of the foot processes of the podocytes in the model group. Prednisone treatment promoted nephrin expression in the kidney (P<0.05). Compared with the control group, the model and prednisone treated groups showed significantly lowered nephrin mRNA expression (P<0.01) but increased FAK mRNA expression (P<0.01), but prednisone-treated group had a higher nephrin mRNA expression than the model group (P<0.05). The model group exhibited significantly increased expressions of FAK total and phosphorylated proteins, P-FAK/FAK, and P-Pyk2/Pyk2 (P<0.01), which were all lowered in the treatment group (P<0.01). Correlation analysis suggested that the expressions of FAK mRNA, FAK, pFAK, Pyk2 mRNA and pPyk2/Pyk2 were positively correlated with proteinuria (r=0.819, 0.750, 0.838, 0.762, 0.934, respectively, P<0.01).</p><p><b>CONCLUSIONS</b>Adriamycin increases phosphorylated FAK and Pyk2 expressions to mediate kidney injury in rats. Prednisone inhibits Pyk2 and FAK activation, decreases proteinuria, and alleviates podocyte lesions to protect the glomerular filtration barrier.</p>
Subject(s)
Animals , Rats , Doxorubicin , Focal Adhesion Kinase 2 , Metabolism , Kidney , Metabolism , Pathology , Kidney Glomerulus , Membrane Proteins , Metabolism , Nephritis , Drug Therapy , Podocytes , Pathology , Prednisone , Pharmacology , Proteinuria , Drug Therapy , RNA, Messenger , Rats, Sprague-DawleyABSTRACT
Objective To explore the clinical practice and patient experience of perioperative therapeutic communication in rectal cancer patients, in order to provide theoretical basis for the further clinical application of therapeutic communication. Methods To adopt phenomenology method of qualitative research, collecting data by the direct participation, observation, half structural formula thorough interview and other methods. To establish coding and refine theme. Results Four themes of the rectal cancer patients experience of perioperative therapeutic communication were generalized: emotional adaptation, actively coping with surgery, intraoperative cooperation, postoperative rehabilitation and self-care. Conclusions Application of therapeutic communication system can effectively interfere with patients cognitive behavior, improve communication ability of nurses and extended the nursing service connotation.
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Objective To explore the role of CD4~+CD25~+CD127~(lo) regulatory T cells (Tregs) and inter-leukin (IL)-6, transforming growth factor beta (TGF-β), IL-17 in the pathogenesis of lupus nephritis (LN) by detecting the levels of IL-10, IL-6, TGF-β, IL-17, CD4~+CD25~+CD127~(lo) Tregs in the peripheral blood of patients with active and inactive LN. Methods Three-colour flow cytometry was used to quantitatively measure proportions of Treg cells, the levels of TGF-β, IL-17 were detected by ELISA, and the levels of IL-10, IL-6 in the peripheral blood were detected by Cytometric Bead Array System. Results ① Compared with the inactive LN and the normal controls (P<0.01), the level of CD4~+CD25~+CD127~(lo) Tregs from patients with active LN was lower(P<0.01). When compared with the normal controls, the level of CD4~+CD25~+CD127~(lo) Tregs from LN inactive patients had no significant difference (P>0.05). ② Compared with patients with inactive LN, the levels of IL-10, IL-6 was higher (P<0.01) in patients with active LN. ③ Compared with the patients with inactive LN and the normal controls, the levels of TGF-β, IL-17 was not significantly different (P>0.05). ④ The level of CD4~+CD25~+CD127~(lo) T cell was correlated negatively with the levels of IL-10, IL-6 and SLEDAI (P<0.05), and was not correlated with C3 and C4. ⑤ SLEDAI was correlated positively with the levels of IL-10 and IL-6 (P<0.01). SLEDAI and the level of IL-10 were correlated negatively with C3 and C4 (P<0.01 for both). ⑥ The level of CD4~+CD25~+CD127~(lo) Tregs from LN was not correlated with TGF-β and IL-17. ⑦ TGF-β was correlated positively with the level of IL-17. Conclusion ① The level changes of Tregs and IL-10, IL-6, TGF-β in the peripheral blood of LN can be used as the indicators for the activity status of lupus nephritis. ② Tregs and IL-10, IL-6 in the peripheral blood of LN patients is negatively correlated. ③ The glucocorticoid hormone is helpful to elevate the level of Tregs but decrease IL-17. T cell level can vary in different body status, different microenvironmental and immune status.