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Objective:To explore whether the inequality of economic development in different provinces in China leads to differences in pediatric nurses ′ health education literacy and to analyze related factors affecting pediatric nurses ′ health education literacy. Methods:Self-designed and tested online questionnaire of competencies in health education (scoring scale 10-50) were distributed to pediatric nurses in China in October 2018. We examined the influencing factors of competencies in health education and its relationship with the province-level data on gross domestic product (GDP) per capita.Results:A total of 15 443 pediatric nurses from 31 provinces were eligible for the analysis. At the regional of GDP per capital over than 20 000 US dollars, 15 000 to 20 000 US dollars, 10 000 to 14 900 US dollars and less than 10 000 US dollars, the health education literacy scores were 40.76±4.52, 40.66±4.08, 40.50± 4.02 and 39.69±4.32 respectively. Significant difference was found between the competencies in health education of pediatric nurses and provinces with different GDP per capita ( F value was 9.21, P<0.001). Regression and hierarchical analysis models based on GDP per capita showed that: nurses with senior professional titles, bachelor degrees or above, aged over 40, and those working in emergency rooms have higher competencies in health education ( OR value was 0.296-4.766, P<0.05) . Lower competencies in health education were demonstrated on nurses who have been working less than 5 years ( OR value was 0.319, P<0.05). Conclusions:Economic development is one of the main factors that affect the competencies in health education of pediatric nurses in China. Pediatric nurses who were young, had limited working experience, with low office titles, with low education background, and who working at non-emergency rooms require more training.
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Objective:To investigate the effect of preventive use of antiemetic drugs on postoperative nausea and vomiting (PONV) in patients with cesarean section(CS) under multi-mode analgesia.Methods:The clinical data of 5530 patients with cesarean section in the University of Hong Kong-Shenzhen Hospital (HKU-SZH) from February 1, 2016 to January 31, 2020 were retrospectively collected and divided into four groups: Ondansetron 4 mg group (group A, n=2 712), Dexamethasone 5 mg group (group B, n=39), Ondansetron 4 mg combined with Dexamethasone 5 mg group (Group C, n=413), and blank group (Group D, n=2 366). All drugs were given before the end of theoperation. The prophylactic effectiveness with different antiemetic prescription has been compared in this study. Results:There were no significant differences in height, weight, age, the ratio of NRs≥6 at 24 h and oxycodone usage among the four groups ( P>0.05). The incidence of postoperative nausea and vomiting was 2.29%(62/2 712), 0(0/39), 1.45%(6/413) and 1.90%(45/2 366), respectively. There was no significant difference between the four groups ( P=0.463). Conclusions:Prophylaxis antiemetic administration seems do not reduce the incidence of PONV after CS under this strategy of multi-mode analgesia.
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Major obstetric hemorrhage (MOH) may endanger the life of maternal during the perioperative period. Its highly efficient management involves multidisciplinary co-operation and is a complex clinical emergency situation which needs teamwork to complete. Anesthesiologist, as the key member of the obstetric MOH management team, should actively cooperate with the obstetricians once they decide to perform an emergency procedure for the parturient. They should possess perfect skill in resuscitation and rich experiences for assessment of MOH. They also should be professional in monitoring and caring for the critically ill patient. Constantly simulation training also should be actively carried out for MOH. In this review, the definition and etiology of MOH, drug and surgical treatment, anesthesia management (including preparation before anesthesia, hemorrhagic shock assessment, choice of anesthesia methods, blood transfusion, blood cell salvage, coagulation function and hemodynamic monitoring) were reviewed, and the conclusions were just for references.
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Objective To investigate the correlation between peroxisome proliferator-activated re-ceptor-gamma ( PPAR-γ) gene polymorphism and preeclampsia ( PE) . Methods 110 PE patients and 110 normal pregnants who delivered in our hospital from May 2016 to October 2018 were selected as the study subjects. Detection of two loci of PPAR-γ gene by SNaPshot technique: rs10865710 and rs4684847. Re-sults ⑴ rs10865710:The genotype frequencies of CC, CG and GG in the control group were 44. 55％, 42. 73％ and 12. 73％, respectively, and those in the PE group were 31. 82％, 44. 55％ and 23. 64％, re-spectively. There was a critical difference in the distribution of genotype frequencies between the two groups (x2 =5. 975, P=0. 050); The frequencies of C and G alleles were 65. 91％ and 34. 09％ in the control group, 54. 09％ and 45. 91％ in the PE group, respectively. There was significant difference in the fre-quency distribution of C and G alleles between the two groups (x2 =6. 402, P=0. 015). ⑵ rs4684847:the genotype frequencies of CC, CT and TT in control group were 94. 55％, 5. 45％, 0, and those in PE group were 84. 55％, 15. 45％ and 0, respectively,with significant difference in the distribution of genotype frequencies between the two groups (x2 =5. 875, P =0. 015). The frequencies of C and T alleles in control group were 97. 27%, 2. 73% and those in PE group were 92. 27% and 7. 73%, respectively,with significant difference in allele frequency distribution between the two groups (x2 = 5. 551, P = 0. 030). ⑶ The frequency of GG genotype and G allele at rs10865710 locus in PE group was significantly higher than that in control group [OR (95% CI) =2. 600 (1. 190 - 5. 679), P = 0. 021; OR (95% CI) = 1. 64 (1. 117 -2. 411), P =0. 015]. The frequencies of CT genotype and T allele at rs4684847 locus in PE group were significantly higher than those in control group [OR (95% CI) =3. 168 (1. 199 -8. 374), P =0. 026; OR (95% CI) =2. 987 (1. 155 -7. 726), P =0. 030]. Conclusions The single nucleotide polymorphisms of PPAR-γ gene rs10865710 and rs4684847 may be related to the susceptibility to preeclampsia in Chinese population.
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Hepatic disease is one of the high-prevalence diseases in China, of which gastrointestinal bleeding is a common complication treated by proton pump inhibitors. Vonoprazan is a novel proton pump inhibitor which acts better than lansoprazole in pharmacokinetics and pharmacodynamics. In this study, the pharmacokinetics of vonoprazan was compared between acute hepatic injury and normal condition in rats. Results showed that the exposure (AUC) of vonoprazan was significantly higher in rats with acute hepatic injury than in normal rats, and the metabolites formation rates of vonoprazan also slowed down, which might be due to the change of activity of enzymes and transporters. This find may provide a theoretical basis for the dose regulation of vonoprazan in patients with hepatic injury.
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Cardiac arrest in pregnancy is the emergency sereve case in clinic,which can threaten life and health of the fetus and pregnant women.Pregnancy cardiac arrest once happened,providing health care providers should start high quality chest compressions immediately,open the airway and commence ventilation,activate an emergency call system in which all providers in the maternal/neonatal resuscitation teams.We read from several aspects of 2014 the United States society for Obstetric Anesthesia and Perinatology consensus statement on the management of cardiac arrest in pregnancy in order to improve the cardiopulmonary resuscitation quality of pregnant women after cardiac arrest and optimize maternal and neonatal outcomes.
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Cardiac arrest in pregnancy is the emergency sereve case in clinic,which can threaten life and health of the fetus and pregnant women.Pregnancy cardiac arrest once happened,providing health care providers should start high quality chest compressions immediately,open the airway and commence ventilation,activate an emergency call system in which all providers in the maternal/neonatal resuscitation teams.We read from several aspects of 2014 the United States society for Obstetric Anesthesia and Perinatology consensus statement on the management of cardiac arrest in pregnancy in order to improve the cardiopulmonary resuscitation quality of pregnant women after cardiac arrest and optimize maternal and neonatal outcomes.
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AIM:To investigate the clinical significance of microRNA-26a-5p (miR-26a-5p)-regulated mye-loid cell leukemia-1 (MCL-1) expression in the development of maternal preeclampsia.METHODS:Plasma and placen-tal tissues were collected from 21 cases of normal pregnancy, 13 cases of maternal gestational hypertension, 15 cases of mild preeclampsia and 26 cases of severe preeclampsia.The levels of plasma and placental miR-26a-5p and placental MCL-1 mRNA were detected by real-time PCR.Western blotting analysis was used to determine the protein expression of placen-tal MCL-1.The clinical significance of the above parameters was also analyzed.RESULTS:miR-26a-5p expression gradu-ally increased(P<0.01) in the 4 groups of maternal plasma and placentas with the disease development, and the mRNA expression of MCL-1 was significantly reduced in the placentas (P<0.01), both showing a significant negative correlation (P<0.01).Meanwhile, the expression of miR-26a-5p and MCL-1 protein in the placental tissues was negatively correla-ted (P<0.01).The miR-26a-5p up-regulation in maternal plasma and placental tissues was negatively correlated with ges-tational age, maternal plasma albumin levels and fetal weight, while it was positively correlated with maternal blood pres-sure and urinary protein level (P<0.01), which was in contrary to the down-regulation of placental MCL-1.CONCLU-SION:Up-regulation of miR-26a-5p is involved in the occurrence and development of preeclampsia by down-regulation of MCL-1.
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Objective To analyze monitoring data on congenital heart disease (CHD) in Shenzhen city from 2009 to 2013.Methods This study described epidemiological characteristics of perinatal CHD.Patients with CHD were divided into isolated CHD group and complex CHD group (the patients were found with malformations of other systems).The prognosis,social and demographic characteristics,and complications of pregnancy were analyzed.Results The average incidence rate of CHD was 7.25‰,of which 94.36％ were diagnosed by ultrasound,of which 33.20％ were diagnosed before delivery.The top three cardiovascular abnormalities were patent ductus arteriosus,patent foramen ovale,and ventricular septal defect.There were about 14.11％ of CHD with other system malformations,mainly including musculoskeletal system,facial features,and nervous system.Compared isolated cardiac malformations and complex cardiacmalformations,significant differences were found in the age stratification,culture degree,prognosis,diagnosis time,incidence rate of complication of pregnancy,and childbirth complications rate (P ＜0.01).Conclusions Most CHDs were diagnosed by ultrasound.Simple cardiovascular malformation was common,especially CHD with two or more types of cardiovascular malformations.The incidence rate of CHD in 30 to 40-year-old women,stillbirth rate,incidence of prenatal diagnostic rate were significantly higher than the simple CHD group.