ABSTRACT
BACKGROUNDS@#At present, there is no consensus on the induction methods in term pregnancy with borderline oligohydramnios. This study aimed to compare the effectiveness and pregnancy outcomes of labor induction with dinoprostone or single-balloon catheter (SBC) in term nulliparous women with borderline oligohydramnios.@*METHODS@#We conducted a retrospective cohort study from January 2016 to November 2018. During the study period, a total of 244 cases were enrolled. Of these, 103 cases were selected for induction using dinoprostone and 141 cases were selected for induction with SBC. The pregnancy outcomes between the two groups were compared. Primary outcomes were successful vaginal delivery rates. Secondary outcomes were maternal and neonatal adverse events. Multivariate logistic regression was used to assess the risk factors for vaginal delivery failure in the two groups.@*RESULTS@#The successful vaginal delivery rates were similar between the dinoprostone group and the SBC group (64.1% [66/103] vs. 59.6%, [84/141] P = 0.475), even after adjustment for potential confounding factors (adjusted odds ratio [aOR]: 1.07, 95% confidence interval [CI]: 0.57-2.00, P = 0.835). The incidence of intra-amniotic infection was lower in the dinoprostone group than in the SBC group (1.9% [2/103] vs. 7.8%, [11/141] P < 0.001), but the presence of non-reassuring fetal heart rate was higher in the dinoprostone group than in the SBC group (12.6% [13/103] vs. 0.7%, [1/141] P < 0.001). Multivariate logistic regression showed that nuchal cord was a risk factor for vaginal delivery failure after induction with dinoprostone (aOR: 6.71, 95% CI: 1.96-22.95). There were three factors related to vaginal delivery failure after induction with SBC, namely gestational age (aOR: 1.51, 95% CI: 1.07-2.14), body mass index (BMI) >30 kg/m2 (aOR: 2.98, 95% CI: 1.10-8.02), and fetal weight >3500 g (aOR: 2.49, 95% CI: 1.12-5.50).@*CONCLUSIONS@#Term nulliparous women with borderline oligohydramnios have similar successful vaginal delivery rates after induction with dinoprostone or SBC, with their advantages and disadvantages. In women with nuchal cord, the risk of vaginal delivery failure is increased if dinoprostone is used in the induction of labor. BMI >30 kg/m2, large gestational age, and estimated fetal weight >3500 g are risk factors for vaginal delivery failure after induction with SBC.
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Administration, Intravaginal , Catheters , Dinoprostone/therapeutic use , Fetal Weight , Labor, Induced/methods , Nuchal Cord , Oligohydramnios , Oxytocics , Pregnancy Outcome , Retrospective StudiesABSTRACT
Objective@#To establish the loop-mediated isothermal amplification (LAMP) method for detection of variola virus.@*Methods@#One set of primers were designed for recognizing 5 distinct sequences on variola virus-specific gene HA. To optimize the reaction temperature and primers screening, and the sensitivity and specificity of this method for variola virus (VARV) detection were evaluated.@*Results@#Rapid detection of variola virus by LAMP assay was completed within 60 min at 63 ℃. The sensitivity of LAMP with detection limits of 1 pg/μl was 10 times higher than that of PCR, that is, the LAMP sensitivity was 3.37×105 copies/μl, and the PCR sensitivity was 3.37×106 copies/μl. and the result of 2 kinds of other virus were negative, showing that it had a good specificity.@*Conclusions@#The method reported here demonstrates a potential and valuable means for detection of VARV. The LAMP assay is suitable for wide-area sample screening and on-site detection of variola virus in grassroots units, for on-site and primary quarantine, medical units for rapid diagnosis.
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Objective To develop a method of simultaneous detection and Gram classification for pathogens causing sepsis with gram-specific probes based real-time PCR. Methods A pair of universal primers and a set of probes including Gram-positive probe and Gram-negative probe were designed based on the bacterial highly conserved region of 16SrRNA gene. With the gram-specific probes based real-time PCR, 35 clinical frequently-isolated strains including 17 gram-positive and 18 gram-negative bacteria were identified correctly with the corresponding gram probe. The blood samples from 512 cases of suspected septicemia, who were hospitalized in our neonatal ward and the NICU and developed clinical signs suggestive of infection, were tested with routine culture and bacterial gram-specific probes based real-time PCR separately. Results The detection limit of the gram-specific probes based real-time PCR assay was 10 CFU of the bacteria. The 35 isolates could be detected and classified correctly by gram-specific probes based real-time PCR. The PCR results were all negative for Cytomegalo virus, EB virus, hepatitis B virus, Cryptococcns neoformans, candida albican, human genomic DNA and negative control. The gram-specific probes based real-time PCR appeared to be quite specific. For 512 blood specimens from the patients with suspicious neonatal sepsis, the positive rate of the gram-specific probes based real-time PCR array was 8.20% (42/512,), which is significantly higher than that of blood culture (32/512, 6.25%) (χ2=8.10, P<0.01). When blood culture was used as a standard, the sensitivity of the gram-specific probes based real-time PCR was 100%. The specificity was 97.92% and the accuracy was 98.05%. Canclusions Cram-specific probes based real-time PCR with universal primers and gram-specific probes are developed. This study suggests that the bacterial gram-specific probes based real-time PCR are very useful for the rapid and accurate diagnosis of bacterial infection.
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Objective Summarize the clinical experience on the improved intramedullary nail therapy for the fraction of femurand tibia,to improve the skill. Methods The modified intramedullary nail has been used for frac-tion-cure on 64 cases of which 29 are femur fraction and 35 tibin fraction through the period. Results All the pa-tients were recovered within 4 months without any joint malfunction or syndromes. Conclusion The far-end aiming of the modified intrameduUary nail could maintain a 100 % precision, which out down the surgery operation time and reduce bleeding. Remain the advantage of previous intrarnedullary nail is beneficial to bone fraction concrescence and function recovery.
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Objective To investigate the operative indications and the therapeutic effect of the pedide screw fixation used for treating multiple fractures of the thoracolumbar spine. Methods 16 cases of multiple fractures of the thoracolumbar spine were chosen to be treated by open reduction through posterior approach and pedicle screw fixation. 10 cases were the fractures involved adjacent segments,4 cases were the fractures with one intact vertebral segment between them,2 cases were the fractures with two intact vertebral segments between them. Results The patients were followed up for 12～36 months,with an average of 21.5 months. After the operations,function of moat of the injured nerves had beeu improved or restored. The vertebral height of the fractured segment showed no signifi-cant loss. The materials of internal fixation found no loosening or fracturing at the end of follow-up. Conclusion Fractures of multi-segment of thoraeolumhar vertebrae can cause serious instability and are required for timely treat- ment. The method of the internal fixation with pedicle screw-rod fixation system through posterior approach, fol- lowed by limited decompression, can reconstruct the stability of the vertebrae and promote the recovery of the im- paired neurological functions.
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Objective To summarize the clinical effects of retrograde intramedullary nail in treating distal femora| fracture. Methods Retrospectively analysed 52 cases of intereondyiar and supracondylar fracture of femur treated with retrograde intrameduUary nail. Results All cases were followed up for 6 to 24 months. All fracture were union except 2 reoperations cases had delay union. Conclusion Retrograde intrameduUary nail has supreme biological stability and allowed early exercise. It also can shorten operation time, reduce damage of periosteum and reduce delay union rate.
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Objective To study the characteristics of two operation methods and to choose a better one for repairing the sunken upper eyelid deformity by comparing with the traditional operation methods. Methods Two kinds of operation method were used, in which the brow fat pad flap and free fascia fat tissue graft were transfered for repairing the sunken upper eyelid deformity. Results Four cases of sunken upper eyelid were repaired successfully using the transferring of brow fat pad flap. The operative results were satisfactory with less complications. The fat did not absorb after a year follow-up. Other 5 cases of sunken upper eyelid were repaired successfully using free fascia fat tissue graft. The fat absorbed a little after a year follow-up and the shape of the upper eyelid was satisfactory. Conclusion The inversion of brow fat pad flap is a new method to repair the sunken upper eyelid deformity and has the following advantages: ⑴the fat tissue transferred to the recipient site has good blood supply with no absorption, and the long term result is permanent; ⑵the construction of brow fat pad is similar to the orbital septum fat, and the result is better and more natural; ⑶the donor site is adjacent to the recipient site, and the brow fat pad can be transferred easily, and ⑷there is no apparent postoperative scar in the donor site. The fascia-fat composite is expected to have a better survival rate than free fat alone and to be lighter than a dermis-fat, and is much similar to the anatomical structure of the repair site. Therefore, the method of fascia fat graft is one of good methods to be selected to repair the sunken upper eyelid.