Comparative study on the effect of different early warning systems on risk assessment of maternal disease / 中国实用护理杂志

Objective:To comprehensively evaluate and compare the early warning system's ability to predict the risk of maternal disease in China, such as the British National Intensive Care Audit and Research Center (ICNARC)-Obstetric Early Warning Score (OEWS) system, the National Maternal Safety Early Warning Standard (MEWC) recommended by the National Coalition for Maternal Safety, the Irish Maternity Early Warning System (IMEWS) proposed in the clinical practice guidelines issued by the head of health services at the Royal Medical College of Ireland.Methods:A total of 872 pregnant women who were admitted to the Women′s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital were prospectively observed from January 2019 to December 2019. The data during hospitalization were collected to calculate the scores of the three obstetric early warning scoring systems, to compare and evaluate the prediction and identification ability of three early warning systems for critically ill pregnant women.Results:A total of 872 cases were included in this study, of which 167 were critically ill, accounting for 19.2%, and 705 were non-critically ill, accounting for 80.8%. The three obstetric early warning systems (OEWS,MEWC,IMEWS) in critical group scored 4(2, 6),3(0, 6),5(3, 6), and non-critical group scored 1(0, 1), 0(0, 0), 2(0, 3), respectively. The critical group scored significantly higher than the non-critical group ( P<0.001). The AUC of OEWS was 0.961 (95% CI 0.948-0.975, P<0.001) and that of MEWC was 0.803 (95% CI 0.757 - 0.850, P<0.001). The AUC of IMEWS was 0.853 (95% CI 0.817-0.888, P<0.001). No obstetric critical illness occurred when OEWS was 0. The positive likelihood ratio was 8.208 6 when OEWS≥6. Conclusions:Three kinds of early warning systems have good predictive ability for the occurrence of critical obstetric diseases in China. Among the three warning systems, OEWS has better predictive ability than the other two, and has better hierarchical ability. However, due to the differences in population, environment and conditions in different regions, each obstetric medical unit can improve OEWS according to its own conditions and design an obstetric early warning system that meets its own clinical needs.

Brain Imaging Study on the Pathogenesis of Depression & Therapeutic Effect of Selective Serotonin Reuptake Inhibitors

Objective@#Predefining the most effective treatment for patients with depressive disorders remains a problem. We will examine the differential brain regions of gray matter (GM) in major depressive disorder (MDD) patients and the relationship between changes in their volume and the efficacy of early antidepressant treatment using magnetic resonance imaging (MRI). @*Methods@#159 never-medicated patients with first-episode MDD and 53 normal control subjects (NCs) were enrolled. The brains were scanned by MRI and measured with the 17-item Hamilton Depression Rating Scale (HAMD-17) at baseline and after 2 weeks of treatment with selective serotonin reuptake inhibitor (SSRI)s, and the non-responder group and responder group were obtained. The patients were analyzed by voxel-based morphological (VBM) and SPSS software. Receiver operator characteristics (ROC) analysis was performed for the difference between the responder group and the non-responder group in the differential brain regions, and Pearson correlations were computed between volume size and HAMD score reduction rate. @*Results@#Smaller GM volume of the right superior temporal gyrus (STG), and the orbital parts of the right medial frontal gyrus and right inferior frontal gyrus were observed in MDD versus the NCs. The non-responder group demonstrated a significant volume reduction at the right STG compared with the responders, but no corresponding change in orbital part of right medial frontal gyrus and right inferior frontal gyrus. ROC analysis showed that Accuracy=71.2%. There was a positive correlation between the STG gray matter volume and the HAMD-17 score reduction rate (r=0.347, p=0.002). @*Conclusion@#The study results confirmed the local changes in brain structure in MDD and may initially predict the early treatment response produced by SSRIs as antidepressants.

A case study of broad ligament haematoma following cesarean section / 中国实用护理杂志

Objective:To summarize up the care experience about a woman with broad ligament haematoma after cesarean section.Methods:The clinical data of 1 case of broad ligament haematoma of uterus after cesarean section and summarized the main points of clinical nursing was reviewed. The nurse found the signs of intraperitoneal bleeding through closely observation, and it was confirmed to be a hematoma of broad ligament of uterus by B ultrasound. After removal of hematoma, the nurse strengthened the abdominal drainage and circulation monitoring to prevent re-bleeding in the abdominal cavity, nursing the fever in the process of hematoma absorption. At last, it was important to pay attention to psychological nursing, helping the maternal to live through acute period.Results:The woman was discharged on the 8 thpost-operative day. Conclusions:The nurses of obstetric should have the ability of critical thinking in clinical work, carry out postoperative monitoring strictly after cesarean section and timely find signs of internal bleeding. Through multidisciplinary rescue, a serious adverse outcome of broad ligament haematoma can be prevented.

A new predictor of the efficacy of immunotherapy for non-small cell lung cancer—lung immune prognostic index (LIPI) / 国际肿瘤学杂志

Immune checkpoint inhibitors have demonstrated the ability to significantly improve survival across a range of cancers. So predictive markers are required to guide treatment decisions. The lung immune prognostic index (LIPI) is recently developed to predict immune checkpoint inhibitors (ICIs) treatment outcomes for non-small cell lung cancer. The pre-treatment LIPI is a convenient prognostic marker able to identify ICIs-treated patient groups with significantly different survival and response outcomes.

Efficacy of lobaplatin plus S-1 and the predictive value of circulating tumor cell in patients with advanced gastric cancer / 中华肿瘤杂志

Objective@#To investigate the efficacy and safety of lobaplatin (LBP) plus S-1 for advanced gastric cancer (AGC) and determine the potential role of circulating tumor cells (CTC) for predicting the therapeutic response and prognosis.@*Methods@#From January 2014 to February 2015, 64 consecutive patients with AGC received lobaplatin plus S-1 chemotherapy in Liaocheng People′s Hospital. The clinical features, clinical response, adverse effects, prognosis and CTC pre- and post-treatment were retrospectively analyzed. The correlation between CTC and patients′ disease control rate (DCR), objective response rate (ORR), progression free survival (PFS) as well as overall survival (OS) were investigated.@*Results@#All 64 patients completed 2 cycles of chemotherapy.The number of patients who achieved complete regression, partial regression, stable and progression were 0, 24 (37.5%), 18 (28.1%) and 22 (34.4%), respectively. ORR was 37.5% and DCR was 65.6%. The median PFS was 10.8 months(95%CI 7.1-12.0) and the median OS was 16.1 months(95%CI 12.4-18.8). The ORR and PFS were not significantly different between patients with baseline CTC≥2 and CTC<2 (25.0% vs 53.6%, P=0.150; 6.2 months vs 7.5 months, P=0.780), while the DCR and OS were significantly different (45.9% vs 90.0%, P=0.008; 10.5 months vs 17.2 months, P<0.001). After 2 cycles of chemotherapy, the ORR and DCR in patients with CTC≥2 were 16.7% and 45.9%, respectively, which were significantly lower than those observed in patients with CTC<2 (50.0% and 90.0%, respectively). The former also had shorter median PFS and OS (6.6 months vs 8.9 months, 8.4 months vs 15.0 months, respectively). Patients with persistently CTC<2 or those exhibiting an conversion to CTC<2 following chemotherapy had an improved PFS and OS, while patients with persistently CTC≥2 or those exhibiting an conversion to CTC≥2 following therapy had shorter PFS and OS.The most frequent adverse effects were grade 1 or 2 gastrointestinal discomfort and myelosuppression. No patients discontinued chemotherapy because of adverse events.@*Conclusions@#Lobaplatin plus S-1 had manageable safety profile and promising antitumor activity in patients with AGC. CTC could be used as a biomarker in evaluating therapeutic response and predicting their prognosis.

Effects of different umbilical cord ligation methods on anemia and jaundice in preterm infants with a gestational age less than 32 weeks / 中华护理杂志

Objective To investigate the effects of different umbilical cord ligation methods on anemia and jaundice in preterm infants with a gestational age less than 32 weeks.Methods A total of 135 preterm infants with a gestational age less than 32 weeks were recruited and randomly divided into the umbilical cord milking group,the delayed cord clamping group and the immediate cord clamping group,with 45 cases in each group.Comparisons among three groups were performed on hemoglobin,hematocrit at 1 h and 1 week after birth,and bilirubin peak,total time of phototherapy,the incidence of anemia,pathologic jaundice as well as polycythemia before discharge.Results Finally 40 cases in the umbilical cord milking group,42 cases in the delayed cord clamping group and 38 cases in the immediate cord clamping group were recruited.Compared with the immediate cord clamping group,Hb(g/L)and hematocrit(％) levels were significantly higher in the umbilical cord milking group and the delayed cord clamping group(P＜0.05),the anemia rate was significantly lower in umbilical cord milking group and the delayed cord clamping group(P＜0.05).However,there were no statistical differences in Hb(g/L) and hematocrit(％) levels as well as ane mia rate between the umbilical cord milking group and the delayed cord clamping group (P＞0.05).There were no significant differences among three groups in bilirubin peak,total time of phototherapy and the incidence of pathologic jaundice as well as polycythemia.Conclusion Umbilical cord milking and delayed cord clamping can both reduce the anemia rate,but not increase the risk of pathological jaundice.Umbilical cord milking can be preferred method for preterm infants with a gestational age less than 32 weeks and asphyxia.

Regional homogeneity in depression:a meta-analysis of resting-state functional-MRI studies / 中华行为医学与脑科学杂志

Objective To effectively combine the results of resting state regional homogeneity(ReHo) fMRI studies in depression.Methods Literatures between 2003-2016 on fMRI of depression in PubMed,Web of Knowledge,EBSCO host medline,CNKI,CQVIP and Wanfang Med Online were taken as research objects.Screening the relevant data according to the included and excluded standard,then,software of AES-SDM was employed to do Meta analysis,in addition,the age,gender,duration of disease,the year of education and treatment were also analyzed.Results 23 articles met the standard,including 1 036 cases,of which 507 for the depression group,529 for the control group.Meta analysis showed the significant ReHo abnormalities of Default Mode Network(DMN) which centers on left precuneus,left superior frontal gyrus and right cingulate gyrus,in addition,left lenticular nucleus,left postcentral gyrus,left cerebellum and left fusiform gyrus had significant ReHo differences.In the regression analysis,gender,age,duration of disease,years of education,disease severity were all affected factors.The difference of cingulate gyrus was the most stable,and the duration of the disease significantly affected cingulate gyrus (SDM =2.777).Conclusion The abnormalities of DMN which centers on left precuneus,left,medial superior frontal gyrus and right cingulate gyrus are the most consistent in depression,the DMN is closely related to depression.

Uncertainty in illness and influencing factors of the patients with pregnancy-induced hypertension / 中国实用护理杂志

Objective To research the illness uncertainty in people with pregnancy-induced hypertension and explore its influencing factors. Methods We investigated 150 cases of pregnancy-induced hypertension patients with Adaption of the General Information Questionaire, Mishel′ s Uncertainty in illness Scale, Social Support Rating Scale. Results The score of illness uncertainty was (66.79 ± 11.02) points. The illness uncertainty states for 76% of the patients was higher than normal. Multiple linear regression analysis showed that the severity of disease,degree of education,the number of pregnancy, subject support were major influencing factors. Conclusions There are higher level of illness uncertainty in the patients with pregnancy-induced hypertension.Medical workers should pay attention to the influencing factors of the illness uncertainty,and take action to lower the level of the illness uncertainty.

Differences and influencing factors of Wechsler's cognitive test in first-episode depressive patients with or without sleep disorder / 中华行为医学与脑科学杂志

Objective To investigate the difference of Wechsler's cognitive test and its influencing factors in first-episode depression patients with and without sleep disorder.Methods 156 patients with de-pression were divided into two groups according to their sleep conditions,including sleep disorder group(n=77)and non-sleep disorder group(n=79).Wechsler Intelligence Scale(WAIS)and Wechsler Memory Scale(WMS)were used to assess the cognitive function,while Hamilton Depression Scale(HAMD-17) were used to assess depressive symptoms.Results (1)Sleep disorders group had lower scores on verbal IQ (95.51±16.45),performance IQ(90.94±13.87),FIQ scores(92.48±15.49)than those in the non-sleep disorder group((105.59±15.20),(96.19±13.62),(101.20±14.70)respectively),the differences were statistically significant(P<0.05).Sleep disorder group had lower scores in immediate memory(10.47 ± 3.88),short-term memory(49.87±14.35)and memory quotient(87.90±18.25)than those in the non-sleep disorder group((11.86±3.47),(56.52±13.03),(97.27±18.76)respectively),the differences were statisti-cally significant(all P<0.05).(2)Multivariate linear regression analysis showed that education and age ex-plained 24% of variance in verbal IQ(F=21.258,P<0.01).Education,sleep disorder factors explained 12.9% of variation in performance IQ(F=9.825,P<0.01).Education,sleep disorder factors explained 22.3% of variance in total IQ(F=22.847,P<0.01).Education,age,sleep disorder factors explained 28.4%of variation in short-term memory(F=23.850,P<0.01).Education and age explained 20.4% of variation in immediate memory(F=18.10,P<0.01).Education and sleep disorder factors explained 21.9% of variation in memory quotient(F=26.162,P<0.01).Conclusion The intelligence and memory impairment in first-epi-sode depression patients with sleep disorders is more serious,and the education,sleep disorder and age are the most important factors.

Study of 4C characteristic home care on obstetric department / 中国实用护理杂志

Objective To construct and evaluate the effects of 4C characteristic home health care services model on the health of puerperas and fetuses.Methods A total of 162 puerperas and neonates were recruited,assigned by random nember table to routine community care condition and 4C characteristic home health care condition matched on the type and degree of health condition as well as the puerperas' culture background.The health condition of puerperas and neonates were investigated and compared between the two groups 42 days after delivery.Results The incidence of breast bilges,cracked nipple,re-visit the doctor,re-admission,anxiety and depression were significantly lower in the home health care group than routine community care group [3.7％ (3/81) vs.23.5％ (19/81),2.4％ (2/81) vs.17.3％ (14/81),2.5％ (2/81) vs.16.0％ (13/81),1.2％ (1/81) vs.16.0％ (13/81),(37.35±10.72) scores vs.(41.73±10.55) scores,(39.53±13.19) scores vs.(43.94±13.44) scores,x2=21.753,18.378,8.890,11.259,t=2.621,2.108,P ＜ 0.05 or 0.01].The success breastfeeding rates,correct rate of related knowledge and master degree of newborn,self-nursing newborn skills and puerperas and relatives' satisfaction scores were significantly higher in the home health care group than routine community care group [71.6％ (58/81) vs.37.0％ (30/81),95.1％ (77/81) vs.59.3％ (48/81),91.4％ (74/81) vs.53.1％ (43/81),（92.31±3.61) scores vs.(89.83±5.43) scores,x2=21.202,29.506,29.569,t=3.423,P＜ 0.01].In additon,the rate of re-visit the doctor,re-admission and omphalitis were significantly lower in home health care group than the routine community care group [2.5％ (2/81) vs.13.6％ (11/81),6.2％ (5/81) vs.23.5％ (19/81),4.9％ (4/81) vs.22.2％ (18/81),x2=6.774,9.172,9.288,P＜0.01 or 0.05].Conclusions 4C characteristic home health care reduced the probability of breast problems and unhealthy emotions for the puerperas,reducing the severity of jaundice as well as omphalitis for fetuses,reducing the probability of re-visit the doctor and re-admission for the puerperas and neonates,which can increase patients' satisfactory and promoting the mothers and their families to master self-nursing and newborn nursing skills and the other related knowledge.

Analysis of encephaloflucgram in survivors of the coal mine flooding accident / 中华行为医学与脑科学杂志

Objective To investigate the change characteristics of the brain neurotransmitters of human with stress events by the Encephaloflucgram technology (ET) at the noninvasive condition. Methods Extract shocking informations with neurotransmitter requlation systems in EEG ( S spectral line) by ET and analyze thechange characteristics of the brain neurotransmitters of human with stress events, the clincial symptons of the patients were evaluated by the post-traumatic stress disorder-check scale (PCL-C). Results ①Compared with expected number,the activity of neurotransmitters such as γ-aminobutyric acid (GABA) were significantly decreased (4.64 ±2.88,8.45 ±0.42, P＜0. 01 ) and the activity of neurotransmitters such as dopamine( DA ) ( 17.01 ±7.41,7.59±0.55, P＜0. 01),acetylcholine(Ach) (17.01 ±7.41,14.95 ±0.65, P＜0.05) ,norepinephrine (NE ) ( 13.07 ± 4.33,11.82 ± 0.84, P ＜ 0. 05 ) were increased. ②There was a significant difference on GABA ( t =6.902, P ＜ 0. 01 ) between suspect of post-traumatic stress disorder and non-post-traumatic stress disorder. ③In PCL-C scale score, intrusion factor had negative correlation to the activity of GABA ( r = - 0.777, P ＜ 0.01 ), and positive correlation to the activity of DA ( r = 0.360, P ＜ 0.01 ), hyper-arousal factor was positive correlated with the activity of NE ( r=0.221, P＜0.05) ,escaping/numbness factor was negative correlated with the activity ofGlu( r= -0.274, P＜0.05). Conclusion In traumatic stress events GABA,Ach,DA,NE neurotransmitters aresignificantly changed ,and meybe participat stress responses.

Study of IL-18 and ICE expression in human ovarian cancer tissue / 中国免疫学杂志

0.05).Conclusion:The decreased expressions of IL-18 and ICE in local ovarian cancer Tissues should have certain relation to the occurrence and development of ovarian cancer.

nNOS specific inhibitor 7-nitrioindazole up-regulates the neurogenesis after focal cerebral ischemia in the adult mice / 中国药理学通报

Aim To explore the effect of nNOS specific inhibitor 7-nitrioindazole(7-NI) on the neurogenesis after focal cerebral ischemia in the adult mice dentate gyrus.Methods Focal cerebral ischemia was induced by middle cerebral artery occlusion(MCAO).A bromodeoxyuridine(BrdU) method was used to identify the proliferated cells in hippocampal dentate gyrus.Step-down test was performed to assay the learning and memory function.Results The number of BrdU~+ cells was increased in the ipsilateral but not contralateral dentate gyrus after focal cerebral ischemia.7-NI promoted the increment in the ipsilateral dentate gyrus significantly.7-NI also improved the survival of the new-born cells,as well as the learning and memory function of ischemic mice.Conclusion Our results indicate that nNOS down-regulates the neurogenesis after focal cerebral ischemia.