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Objective:To investigate the efficacy of Doula delivery combined with painless delivery and its effects on pregnancy outcome.Methods:A total of 150 parturient women who underwent delivery in the First People's Hospital of Yongkang from June 2019 to June 2020 were included in this study. They were randomly assigned to undergo either conventional delivery (control group, n = 75) or Doula delivery combined with painless delivery (observation group, n = 75). Analgesic effect, mode of delivery, duration of labor and pregnancy outcome as well as mood score before and after intervention were compared between the two groups. Results:Total analgesia-effective rate in the observation group was significantly higher than that in the control group [100.00% (75/75) vs. 65.33% (49/75), χ2 = 31.45, P < 0.05]. Vaginal delivery rate in the observation group was significantly higher than that in the control group [84.00% (63/75) vs. 66.67% (50/75), χ2 = 6.60, P < 0.05]. The length of the first stage of labor, the second stage of labor, the third stage of labor and total labor length in the observation group were (398.42 ± 35.41) minutes, (43.65 ± 5.78) minutes, (8.36 ± 1.08) minutes and (450.87 ± 37.98) minutes, which were significantly shorter than those in the control group [(543.21 ± 47.87) minutes, (76.73 ± 16.56) minutes, (9.76 ± 1.23) minutes, (629.34 ± 45.26) minutes, t = 21.05, 16.33, 7.40, 26.15, all P < 0.05]. The incidence of neonatal asphyxia, fetal distress and postpartum hemorrhage in the observation group were [1.33% (1/75), 2.67% (2/75) and 2.67% (2/75), respectively, which were significantly lower than those in the control group [13.33% (10/75), 17.33% (13/75), 18.67% (14/75), χ2 = 7.94, 8.96, 10.07, all P < 0.05]. Self-rating Anxiety Scale score and Self-Rating Depression Scale score in the observation group were (43.25 ± 4.28) points and (40.28 ± 3.45) points, which were significantly lower than those in the control group [(52.12 ± 3.95) points, (47.79 ± 3.72) points, t = 13.18, 12.81, both P < 0.05). Conclusion:Doula delivery combined with painless delivery can relieve women's emotional changes, alleviate pain, shorten labor duration, and improve pregnancy outcomes.
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Objective:To investigate the clinical efficacy and possible mechanism of bifidobacterium tetralogy combined with escitalopram oxalate in the treatment of patients with depression and to provide evidence for further clinical research.Methods:A total of 100 patients with depression who received treatment in Taizhou Second People's Hospital from September 2019 to March 2021 were included in this study. They were randomly assigned to receive either escitalopram oxalate and placebo (control group, n = 50) or escitalopram oxalate and bifidobacterium tetralogy (observation group, n = 50). All patients received 9 weeks of treatment. Psychological status pre- and post-treatment was evaluated using the Hamilton Rating Scale for Depression and the Hamilton Rating Scale for Anxiety. Serum cortisol, inflammatory factors interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) levels were detected using the enzyme-linked immunosorbent assay. Results:Physiological status scores in each group were significantly lower after treatment compared with before treatment. Scores of the Hamilton Rating Scale for Depression and the Hamilton Rating Scale for Anxiety scores post-treatment in the observation group were (10.78 ± 2.03) points and (6.37 ± 2.58) points, which were significantly lower than those in the control group [(16.78 ± 2.85) points, (13.23 ± 2.95) points, t = 11.40, 13.38, both P < 0.001]. Serum levels of cortisol, inflammatory factors IL-1β and TNF-α in each group were significantly decreased after treatment compared with before treatment. Serum levels of cortisol, inflammatory factors IL-1β and TNF-α post-treatment in the observation group were (137.34 ± 63.29) μg/L, (14.38 ± 6.08)ng/L, (13.95 ± 6.46) ng/L, which were significantly lower than those in the control group [(181.22 ± 59.27) μg/L, (25.94 ± 6.92) ng/L, (20.44 ± 6.24) ng/L, t = 15.29, 6.16, 9.24, all P < 0.001). Conclusion:Bifidobacterium tetralogy combined with escitalopram oxalate is highly effective on depression. The combined therapy can remarkably reduce depression and anxiety symptoms and greatly decrease serum cortisol, IL-1β, and TNF-α levels.
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Objective To introduce a method of distal digital replantation with a venous drainage through medullary cavity.Methods Normal saline mixed with methylene b lue were perfused into digital arteries in 5fresh finger specimens and medullary cavities in 10fresh finger specimens.Then microanatomic al observation of vessels was performe d in the specimens.From April 1999to June 2000,15severed fingers in14cases were replanted with a venous drainage through medullary cavity.Medullary cavities of the distal and middle phalanx were drilled and made unobstructed after the distal joint of the finger was removed.The bones were fixed using only a single straig ht Kirschner wire in each finger.One or two digital arteries or the branch es of the terminal arteries were anasto mosed and two digital nerves sutured in each finger.Results Mi-croanatomical observation showed t hat a venous drainage through medullary cavity was dominating without su-perficial venous drainage and the di gital medullary cavity closely connected with the profunda digital vein s and the superficial digital veins by the venous system of the bone.All replan ted fingers survived in 14cases.The average postoperative follow-up wa s 7.8months,ranging from 6to 10mont hs.Nearly normal appearance and satisfactory sensation of the dista l phalanx were obtained with 2-PD of 5-9mm.Conclusion Distal digital replantation with a venous d rainage through medullary cavity is a new method.It has following advan-tages:simple and reliable operatio n,high survival rate and enlarged in dication of distal digital replanta tion.[