RESUMO
Objective To investigate effect of the application of misoprostol and oxytocin in full-term pregnancy induced labor with premature rupture of membranes.Methods From March 2016 to June 2017,95 pregnant women in term pregnancy induced labor with premature rupture of membranes in General Hospital of Taiyuan Iron&Steel (Group) CO.LTD were selected as the research objects,and they were randomly divided into study group and control group,the control group was given oxytocin,the study group was given misoprostol for induction of labor,then the effect,the total production process,delivery time,labor time,maternal and infant outcomes,the occurrence of adverse reactions of the two groups were observed.Results The total effective rate of pregnant women of the study group and the control group were 95.83％,78.72％,respectively,the difference was statistically significant (x2=7.136,P ＜ 0.05);The total production process,delivery time and labor time in the study group were (5.76 ±1.38)h,(9.39 ±3.44)h,(5.53 ± 1.51) h,respectively,which in the control group were (7.89 ± 1.67)h,(12.83 ±3.76)h,(7.56 ± 1.9 2)h,respectively,the research group's total stage of labor,delivery time,delivery time were shortened significantly compared with those of the control group (t =5.829,7.331,4.276,all P ＜ 0.05);The cesarean delivery,fetal distress and amniotic fluid contamination rates of the study group were 6.25％,8.33％,8.33％,respectively,which of the control group were 21.28％,31.91％,27.65％,respectively,the study group's cesarean section rate,fetal distress and amniotic fluid were significantly lower compared with those of the control group (x2 =6.936,10.185,7.429,all P ＜ 0.05).The incidence of abnormal uterine contraction,gastrointestinal reaction and tachycardia had not statistically significantly difference between the two groups (P ＞ 0.05).Conclusion Compared with oxytocin,misoprostol for full-term pregnancy with fetal membranes induction effect is more significant,which can shorten the birth process,improve maternal and child outcomes.So it is worthy of clinical promotion.
RESUMO
<p><b>OBJECTIVE</b>To investigate the epidemiological characteristics of respiratory syncytial virus (RSV) subtypes and genotypes in southern Zhejiang province, and to determine whether RSV genotypes are correlated with the disease severity of lower respiratory tract infection (LRTI).</p><p><b>METHOD</b>Nasopharyngeal secretions (NPS) from children under 5 years of age who were hospitalized with LRTI during 5 consecutive seasons from July 1, 2009 to June 30, 2014 were collected. RSV antigen was determined using direct immunofluorescence (DIF). Two hundred strains of RSV were randomly selected from each epidemic season. RNA was extracted and identified as subtype A or B by using reverse transcription-polymerase chain reaction (RT-PCR), and randomly selected strains of the full length attachment (G) genes of both subtype A and subtype B were amplified by PCR and sequencing. Clinical data were collected, and the disease severity between different genotypes were compared simultaneously.</p><p><b>RESULT</b>Of the total 1 000 randomly selected RSV positive samples, 462 (46.2%) and 538 (53.8%) samples were identified as subtype A and B, respectively. It was found that subtype B predominated in the 2009-2010 and 2012-2014 epidemic seasons and subtype A in 2010-2012 epidemic seasons. A total of 112 strains of complete sequences of G genes were obtained, including four subtype A genotypes NA1, NA4, GA2 and ON1, and six subtype B genotypes BA8-10, BA-C, CB1, and GB2. Phylogenetic analysis revealed that 39/52 (75.0%) subtype A strains were classified as NA1 genotype, followed by ON1 genotype (10/52,19.2%) and 44/60 (73.3%) subtype B strains were classified as BA9 genotype, followed by BA8 genotype (6/60,10.0%). BA9 was the predominant genotype among subtype B except 2010-2011 epidemic season, while NA1 was the predominant genotype among subtype A except 2013-2014 epidemic season. Only ON1 and BA9 genotypes were checked out during 2013-2014 epidemic season. There was statistically significant difference in the average severity score of illness in 39 cases infected with NA1 genotype (4.154) and 44 cases of BA9 genotype (3.341) (U=642.500, P<0.05). Furthermore, in the rate of oxygen uptake, the percentage of those infected with NA1 genotype (33.3%) was higher than those infected with BA9 genotype (13.6%) (χ2=4.544, P<0.05). However, there were no significant difference in the age, clinical symptoms, the percentage of intensive care unit admission, length of hospitalization and the outcome of the disease between NA1 and BA9 infection.</p><p><b>CONCLUSION</b>The shift of predominant RSV subtype from 2009 to 2014 were B-A-A-B-B in the southern areas of Zhejiang province. Multiple genotypes co-circulated during five RSV epidemic seasons. NA1 and BA9 genotypes were the predominant genotypes of subtype A and B, respectively. Compared with infection with BA9 genotype, NA1 genotype infection was associated with more severe disease and proportion of patients needed oxygen therapy was higher.</p>