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Objective:To explore the effects of high-efficiency centering pregnancy care (CPC) combined with information-knowledge-attitude-practice (IKAP) health education on cesarean delivery on maternal request (CDMR) rate, maternal and neonatal health status so as to provide referential significance for reducing CDMR rate and improving postpartum maternal and neonatal health status and breastfeeding rate.Methods:In the prospective, single-center and controlled study, a total of 82 primiparas undergoing antenatal examination and delivery in South Binhu Hospital of Hefei First People′s Hospital were enrolled as the research objects between January 2020 and December 2021 by convenience sampling method, including 41 cases given routine health care in routine group between January and December 2020 and 41 cases given high-efficiency CPC combined with IKAP health education on basis of routine group in combination group between January and December 2021. The cognition of cesarean section, delivery modes, incidence of postpartum complications, neonatal complications and breastfeeding between the two groups were compared.Results:The age of the routine group was (26.71 ± 2.18) years old, and the age of the combination group was (27.16 ± 1.79) years old. The proportions of correct cognition, partially correct cognition and incorrect cognition to cesarean section in combination group were 73.17% (30/41), 21.95% (9/41), 4.88% (2/41), and 53.66% (22/41), 26.83% (11/41), 19.51% (8/41) in routine group, and the difference between the two groups was statistically significant ( Z = 4.22, P<0.05). The incidence of cesarean section and CDMR in combination group was 24.39% (10/41) and 1/10, lower than that in routine group [46.34% (19/41), 10/19], and the difference between the two groups was statistically significant ( χ2 = 4.32, P<0.05; Fisher′s exact test, P = 0.049 ). The total incidence rates of postpartum complications of primiparas and neonatal complications in the combination group were 4.88%(2/41) and 7.32%(3/41), lower than 12.20%(5/41) and 12.20%(5/41) in the routine group, and the differences between the two groups were not statistically significant (Fisher′s exact test, P = 0.432, 0.712). The scores of functional health literacy, communicative health literacy and critical health literacy in combination group were (85.73 ± 4.09), (51.93 ± 4.72) and (58.63 ± 4.32) points, higher than those in routine group [(80.17 ± 5.26), (46.37 ± 5.11) , (52.71 ± 5.07) points], and the difference between the two groups was statistically significant ( t = 5.34, 5.12, 5.69, all P<0.01). At 3 months after delivery, exclusive breastfeeding rate, milk powder feeding rate and mixed feeding rate in combination group were 58.54% (24/41), 7.32%(3/41), 34.15(14/41), higher than 26.83% (11/41), 29.27(12/41), 43.90%(18/41) in routine group, and the difference between the two groups was statistically significant ( χ2 = 10.73, P<0.05). Conclusions:High-efficiency CPC combined with IKAP health education can reduce incidence of CDMR, decrease maternal and neonatal complications, enhance maternal postpartum health literacy and improve breastfeeding rate in primiparas by improving correct cognition to cesarean section. It is worthy of clinical application.
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Objective:To observe and analyze the effect of double and single bridge exercise on the electromyographic activities of related core muscle groups in stroke patients, and to explore its rules and characteristics.Methods:A prospective cohort study was conducted on 40 stroke patients hospitalized in the Department of rehabilitation medicine, Hefei second people's Hospital, Anhui Province from March 2020 to May 2021.The surface electromyography (sEMG) instrument was used to collect the surface electromyographic signals of erector spinalis, rectus abdominis, gluteus maximus and biceps femoris during double and single bridge exercise, and the root mean square (RMS) and integrated electromyography (iEMG) of the time domain indexes were analyzed. The measurement data conforming to normal distribution was expressed in xˉ± s.The non normal distribution data was expressed in M (Q1, Q3). Wilcoxon rank sum test was used to compare the difference between the two groups. Results:There was significant difference between RMS (30.0 (21.3, 45.5) μV vs. 24.0 (14.0, 35.8) μV) and IEMG (15.5. (10.0, 23.0) μV?s vs. 9.0 (5.0, 13.0) μV?s s) values of gluteus maximus on the healthy side and the affected side during double bridge exercise ( Z values were 2.07, 4.19; P values were 0.039, <0.001, respectively). There was significant difference in RMS (31.0 (15.3, 70.0) μV ratio of the healthy and affected biceps femoris 17.0 (11.0, 28.8) μV) and IEMG (14.5 (8.0, 26.5) μV?s vs. 7.0 (5.0, 10.8) μV?s) values of biceps femoris on the healthy side during double bridge exercise ( Z values were 3.44, 3.64; P values were 0.001 and <0.001, respectively ). There was significant difference between RMS(38.5(32.3, 46.0) μV vs. 35.0(22.3, 43.0) μV) and IEMG (16.5(12.0, 22.8) μV?s vs. 12.0(7.0, 21.0) μV?s) values of the gluteus maximus on the healthy side during single bridge exercise ( Z values were 2.24, 2.45; P values were 0.025, 0.014, respectively). There was significant difference between RMS (38.0 (15.3, 70.0) μV vs. 19.0 (12.0, 35.5) μV) and IEMG (16.0 (10.0, 27.0) μV?s vs. 6.5 (5.0, 12.5) μV?s s) values of biceps femoris on the healthy side during single bridge exercise ( Z values were 2.98,4.34; P values were 0.003 and <0.001, respectively). There was significant difference between RMS (24.0 (14.0, 35.8) μV vs. 35.0 (22.3, 43.0) μV) and IEMG (9.0 (5.0, 13.0) μV?s vs. 12.0 (7.0, 21.0) μV?s) values of double and single gluteus maximus on the affected side ( Z values were 2.24, 1.99; P values were 0.025,0.047, respectively). Conclusion:Double bridge and single bridge exercise could improve the related core muscle groups of stroke patients with hemiplegia, and single bridge was better than double bridge for the activation of gluteus maximus
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Objective:To observe the clearance strategies of hemiplegic stroke survivors with foot drop.Methods:Thirty hemiplegic stroke survivors with foot drop formed the observation group and 30 healthy counterparts constituted the control group. A three-dimensional motion capture system was used to observe and compare the minimum toe clearance (MTC) and its variability between the two groups to draw the motion trajectory of the toe in the swing phase of their gaits. The gait parameters were correlated with the toe clearance.Results:The average MTC of the observation group subjects on both the hemiplegic and non-hemiplegic side (12.01±3.36 and 22.38±5.51mm) was significantly smaller than the control group′s averages. The variability of their MTCs on both sides was also significantly greater. Clearance on the hemiplegic side was significantly less and its variability was significantly greater. Among the observation group, MTC on the hemiplegic side was positively correlated with walking speed, step length, swing phase percentage, maximum angle of hip extension, maximum angle of knee flexion, maximum angle of ankle dorsiflexion, and the range of motion of the knee and ankle joints.Conclusions:Hemiplegic stroke survivors with foot drop walk unstably with little toe clearance. It is necessary to intervene at the hip, knee and ankle to improve their obstacle clearance.
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Objective:To introduce a programmed death-1 (PD-1) inhibitor nivolumab used as a new antitumor agent. Methods:According to the literatures, the action mechanism of nivolumab and the clinical trial results on the main indications approved or being investigated in phase III trials were reviewed and evaluated. Results:Nivolumab could restore the antitumor activity of T cells through binding with PD-1 and consequently blocking its interaction with the key ligands of PD-L1 and PD-L2. Several completed and ongoing clinical trials showed that nivolumab used alone or combined with chemotherapy or CTLA-4 inhibitor ipilimumab exhibited better effica-cy when compared with current clinical used chemotherapy drugs in the treatment of melanoma, non-small cell lung cancer and renal cell carcinoma. Nivolumab was well tolerated during the treatment with such main grade 3-4 adverse events as immune-mediated pneu-monia, abnormal liver functions and fatigue. Conclusion:Through its anti-tumor immune response, nivolumab can improve the clinical efficacy in the treatment of various tumors including melanoma, non-small cell lung cancer and renal cell carcinoma.
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OBJECTIVE: To develop a RP-HPLC method for a simultaneously determination of the contents of sirolimus and probucol in the mixed-eluting stents. METHODS: Kromasil C18 column was used as an analytical column; the mobile phase consisted of acetonitrile and water which eluted by a gradient procedure at a flow rate of 1.0 mL?min-1. The detection wavelength was 277 nm; the column temperature was 55 ℃ and the sample size was 20 ?L. RESULTS: The calibration curves of sirolimus and probuol were linear in the range of 1.0～20.0 ?g?mL-1 (r=0.999 9). The average recoveries were 99.47%and 98.35%, respectively, with intra-day RSD and inter-day RSD all less than 5%. CONCLUSION: The method is simple, accurate and can be used to determine the contents of of sirolimus and probucol in the mixed-eluting stents.