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Objective To survey the contraceptive knowledge and service ability of postpartum visitors in Shanghai Minhang district.Methods A questionnaire survey on the contraceptive knowledge and contraceptive services was conducted in May 2018 among postpartum visitors from 13 community health service centers in Shanghai Minhang district.Results One hundred and forty-eight valid questionnaires were collected.All the participants were women,among whom 6.8％ (10/148) were obstetricians and gynecologists,8.1％ (12/148) were general practitioners and public health doctors,52.7％ (78/148) were nurses and 32.4％ (48/148) were village doctors.One hundred and ten participants were married women of childbearing age,among whom 18.2％(20/110) did not take contraceptive measures,43.6％(48/110) used condom,10.9％ (12/110) used in vitro ejaculation or safe period or combination of two methods,and only 27.3％(30/1 10) used IUD or tubal ligation.The overall correct rate of contraceptive knowledge was 65.9％ (1 755/2 664).The correct rates of knowledge about postpartum intrauterine device,the placement time of subcutaneous implantation of contraceptives,the correct use of condoms were particularly low.During the visits,postpartum lactating mothers,condom and safe period were recommended for contraception;and condom was recommended most (93.2％,138/148),however,only 24.3％(36/148) of them carried free contraceptive condom when visiting home.Conclusions The general levels of contraception-related knowledge and ability of community postpartum visitors are less satisfactory.It is necessary to strengthen the training and assessment of contraceptive knowledge for them.
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Objective We aimed to assess systematically the effect of evidence-based nursing in the prevention of postpartum hemorrhage in puerpera of our country.Methods Relative literature was searched by computer at home according to the inclusion and the exclusion criteria,which was analyzed by RevManS.2 software,and literature selection and repetition was used according to the Note Express software.Results A total of 22 studies were brought into the study,the statistical result was analyzed by fixed effect model and the result was OR=0.29,95％CI (0.22,0.39),P ＜ 0.01.The sensitive analysis was carried out by replacement of statistical models,the result was OR=0.31,95％CI (0.24,0.42),P ＜ 0.01,which indicated that the result was stable and reliable.Conclusions The results of this study show that the application of evidence-based nursing can significantly reduce the postpartum hemorrhage rate in China,which is worthy of application in clinic.
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Objective We aimed to assess systematically the effect of pressure treatment instrument on pre-venting deep venous thrombosis of lower extremity for hospitalized patients.Methods Relative literature was searched by computer at home according to the inclusion and the exclusion criteria,which were ana-lyzed by RevMan5.2 software and literature selection and repetition were used according to the Note Ex-press software.Results A total of 13 studies of randomized controlled or not randomized controlled trials were brought into the study by fixed effects model.A total of 1 194 were included into the study,599 in the experimental group and 595 in the control group.Literature analysis showed that pressure treatment in-strument can decrease the incidence rate of deep venous thrombosis of lower extremity (OR=0.24,OR95％ CI:0.15～0.37,P＜0.01) and increase venous blood flow velocity (OR=0.52,OR95％CI:0.25～0.80,P＜0.01).By replacing the statistical effect model,the sensitivity analysis showed a stable and reliable result conclusion.Conclusions Pressure treatment device can reduce the incidence rate of lower extremity deep venous thrombosis in hospitalized patients,prolong the survival time and improve the quality of life,and can also reduce the complications caused by anti-thromboembolic drugs.It is favored by clinical workers more and more,and it is worthy of further promotion and application.
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Objective To systematically review the effect of cluster-based nursing for prevention of deep venous catheter-related bloodstream infection.Methods We searched the domestic literature,using RevMan5.2 software for statistical processing.Results A total of 13 qualified literature was included.Its combined OR=0.33,95％CI=(0.26,0.43),indicating that the cluster-based nursing could significantly reduce deep venous catheter-related bloodstream infection rate.Conclusions Cluster-based nursing is a practical nursing intervention,which should be promoted in clinical practice.
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Objective To assess systematically the effect of (cognitive behavior therapy,CBT) on PANSS of schizophrenia.Methods Relative literature was searched by computer at home according to the inclusion and the exclusion criteria,which were analyzed by RevMan5.2 software,and literature selection and repetition were used according to the Note Express software.Results A total of 11 studies were brought into the study.According to the different time of intervention,the results showed that,the cognitive behavior therapy intervention continued for 2 months,I2 was 80％,the statistical result of random effects model analysis was [SMD=-0.64,95％CI (-1.14～-1.13),P＜0.05]; the cognitive behavior therapy intervention continued for 6 months,I2 was 64％,the statistical result of random effects model analysis was [SMD=-0.40,95％CI (-0.71,-0.08),P＜0.05]; the cognitive behavior therapy intervention continued for 12 months,the statistical result of fixed effects model analysis was[MD=-5.65,95％CI(-6.20,-5.09),P＜0.01].The replacement of statistical models for the sensitive analysis showed that the result was stabile and reliable.Conclusions The cognitive behavior therapy may reduce PANSS of patients with schizophrenia,But because the influence of some factors,the time of intervention is limited,so the result of this research is that the best intervention time for clinical symptoms improvement is from 6 months to 1 year.
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Objective To evaluate the effect of Angio-Seal vascular closure device by the femoral artery hemostasis.Methods Relative literature was searched by computer,according to the inclusion and the exclusion criteria,which were analyzed by RevMan5.2 software.Results A total of four studies of randomized controlled trial were brought into this research,the total sample size was involved in 3 191 cases,the sample size of the intervention group and the control group respectively was 1 583 and 1 608.The analysis results showed,Angio-seal vascular closure device can significantly shorten the time of hemostasis after femoral artery interventional therapy in patients and the limb braking time.The sensitive analysis results showed that the results stability were high and the conclusions were reliable.Conclusions Application of Angio-seal vascular closure device can significantly shorten the interventional therapy in patients with bleeding time and braking time.
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Objective To assess systematically the effect of problem-based learning (PBL) versus traditional methods in nursing students.Methods Relative literature was searched by computer at home and abroad.according to the inclusion and the exclusion criteria,which were analyzed by RevMan5.2 software,and literature selection and repetition were used according to the Note Express software.Results A total of 9 studies of randomized controlled or not randomized controlled trial were brought into the study by random effects model.A total of 1 187 were collected into the study,574 in the experimental group and 613 in the control group.According to subgroup analysis showed by measurement scale,problem-based learning (PBL) can significantly improve the critical thinking ability of nursing students.The results had high stability and reliability.Conclusions PBL teaching method can significantly improve the critical thinking ability of nursing students,and provide a better learning method for clinical teachers and students,which is worthy of further promotion.
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Objective To evaluate the effect of early nursing interventions on the dysphagia of strok e patients.Methods The randomized controlled trials (RCT) on early nursing interventions were collected using the database such as Chinese Science and Technology Periodical Database (VIP),China national knowledge internet (CNKI) and Wanfang Database.The results were analyzed with RevMan5.2 Software.Resuits Six studies were included in the study.The dysphagia recovery rate was significandy increased in the intervention group.Conclusions Early nursing interventions can effectively promote the dysphagia function recovery of stroke patients.
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Objective To explore the effectiveness of dietary treatment in reducing macrosomia risks for pregnancies with borderline gestational glucose intolerance (BGGI).Methods From July 2009 to June 2011,a total of 1046 pregnant women with BGGI were randomized into group A (intervention,n =525) and group B (non-intervention,n =521).Another 521 pregnancies with normal glucose screening were assigned into group C (normal control).Randomization was applied following stratification according to age,body mass index (BMI),prior Cesarean section (C-section) and multiparity,etc.Women in group A underwent the examinations of fasting plasma glucose (FPG),2 h-post prandial glucose and HbA1c once every 2 weeks.Their newborn outcomes were collected for analysis.Results Women of three groups were similar in age,parity,initial BMI and initial FPG.Dietary treatment for group A improved glucose-related indices and women's pregnancy weight gain (P ＜0.0l).Also,in comparison with group B,the intervention of group A reduced risk of macrosomia (9.14％ vs.13.82％,P =0.02),prior C-section rate (43.87％ vs.56.07％,P ＜ 0.01) and postpartum hemorrhage (3.81％ vs.7.10％,P =0.02).However these indices were no better than group C.Dietary treatment did not increase the risk of fetal growth restriction,neonatal hypoglycemia and hyperbilirubinemia.Conclusion As a simple noninvasive therapeutic measure for improved glucose tolerance,BGGI may reduce the risk of risk of macrosomia and prior C-section rate.
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Objective To study the mechanism of hypoxia inducing factor-1α(HIF-1α)pathway in establishment of hypoxia inducing low endometrial receptivity.Methods RL95-2 cell lines.the ideal model of study ER,were cultured in hypoxia condition induced by CoCl2,and the expression of mRNA and protein of HIF-1α and tumor necrosis factor like weak inducer of apoptosis(TWEAK)were measured by reverse transcription-PCR and western blot. The apoptosis rate was analyzed by flow eytometry.Then the mechanism confirmed by comparing the two factors in endometrium and the ultra-appearance of inflammatory reaction and apoptosis between recurrent spontaneous abortion women and control women.Results (1)On difierent time point(0,12,24,48 hour),mRNA expression of HIF-1α were 0.272±0.010,0.354±0.020,0.591±0.020.0.890±0.020,while the expression of TWEAK were 0.104±0.010,0.510±0.020,1.021±0. 020, 1. 237 +0. 040, respectively, the expression level between 12, 24, 48 and 0 hour all showed significant differences (P＜0. 05 ). (2) Protein expression of HIF-1α were 0. 853 +0. 010, 0. 931 ±0. 030,1. 124±0.010, 1.317±0.0 20 respectively, while was 0.042±0.010, 0.091 ±0.010, 0. 131±0.020,0. 205 ±0. 030 in TWEAK expression, the different level were statistically significant ( P＜0. 05 ). ( 3 )With longer culture under hypoxia, the cell apoptosis rate increased obviously. The apoptosis rate of each time point were ( 3.2±1.4 ) %, ( 16. 2 ±3.2 ) %, ( 26. 3±3.5 ) %, ( 31.8±3.5 )%, the differences between 12, 24, 48 and 0 hour had significance (P ＜0. 05). (4) The positive rate of HIF-1α stained in epithelium cells and stroma cells of test group were 32. 3%, 8.4% and 16. 7%, 7. 3% in control group. The positive rate of TWEAK were 28. 3%, 3.9% in recurrent spontaneous abortion group and 11.6%, 2. 7% in control group ( P ＜0. 05 ). The ultra-appearance of inflammatory cell infiltrated and apoptosis were obvious in test group. Conclusions Cell inflammation reaction and apoptosis induced by HIF-1α pathway may participate the mechanism of hypoxia inducing low endometrial receptivity. HIF-1α might become a novel target for improving poor endometrial receptivity.
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Objective To investigate the possible role of nerve growth factors (NGF) and its receptors in ovarian follicle development,and detect the difference between polycystic ovarian symdrome (PCOS) and normal control.Methods Immunohistochemisty was applied to detect the expression of NGF,p75NTR,TrkA in ovarian follicle granulosa cells.Results In 54 cases (including 9 cases of IVM-PCOS,16 cases of IVF-PCOS and 29 cases of IVF-Normal),49 cases showed NGF protein positive in granulose cells with significance difference between groups (P＜0.05),and especially NGF was the strongest expressed factor in IVF-PCOS group but there was no remarkable difference between the other two groups in the expression of NGF.41 were TrkA protein positive,almost all IVF cases were TrkA protein positive while only 2 in IVM and there was no remarkable difference in expression of TrkA between IVF PCOS and IVF Normal(P＞0.05).The cases with stronger expression of NGF or TrkA had higher estradiol level than that of lower expression group (P＜0.05).51 cases had positive expression of p75 NTR protein but there was no significant difference between groups (P＞0.05).Conclusions TrkA is expressed in mature ovarian follicle,and the interaction of NGF-TrkA may be involved in ovarian follicle development,and overexpression of NGF may be associated with PCOS development.
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Objective To evaluate the contraception efficacy, mode of bleeding, side effects and other positive effects of drospirenone-ethinylestradiol (Yasmin) in healthy Chinese women. Methods This was a multicenter, randomized, control study of 768 healthy Chinese women who consulted about contraception. The subjects were randomized into Yasmin group (30 μg ethinylestradiol plus 3 mg drospirenone, 573 cases) or desogestrel group (30 μg ethinylestradiol plus 150 μg desogestrel, 195 cases) with the ratio of 3: 1. Each individual was treated for 13 cycles. Further visits were required at cycle 4, cycle 7, cycle 10 and cycle 13 of treatment. Weight, height, body mass index were evaluated at each visit. The menstrual distress questionnaire (MDQ) was given to the women at baseline, visit 3 (cycle 7) and visit 5 (after cycle 13). Results The values of basal features were similar between two groups (P> 0.05). The Pearl index (method failure) of Yasmin was 0. 208/hundred women year which was lower than that of desogestrel (0. 601/hundred women year). The mode of bleeding was similar between two groups after trial without showing any significant difference. According to MDQ subscale, the improvement of water retention and increasing appetite during inter-menstrual period and water retention and general well-being during menstrual period in the Yasmin group ( -0. 297, -0. 057, 0. 033, 0. 150 respectively) was more obvious than that in the desogestrel group ( - 0. 108, 0. 023, 0. 231, - 0. 023 respectively) with a significant difference (P < 0. 05 ). Some other values which improved in beth two groups, especially the improvement of breast tenderness and pain and skin abnormality in Yasmin group (18.0%, 89/494; 12. 6%, 62/494) was more distinct than that in desogestrel group (11.3%, 19/168; 5.4%, 9/168). The mean weight increased in desogestrel group (0. 57 kg) while it decreased in Yasmin group ( -0. 28 kg) with a significant difference (P < 0. 01 ). Conclusions Both Yasmin and desogestrel have good efficacy on contraception and similar modes of menstrual bleeding. Yasmin is better than desogestrel in terms of weight control and premenstrual syndrome of oral contraceptive.
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The present paper combines the estimates of efficacy and side effects of 10 mg mifepristone for emergency contraception obtained from randomized trials. A total of 6083 women participating in 12 randomized trials and receiving 10 mg mifepristone for emergency contraception up to 120 h after intercourse, were analyzed for efficacy. Between 4188 and 5833 women were analyzed for side effects and 3601 for delay of menses of more than 7 days. Prevented fractions, the effect of delay and of further acts of intercourse after treatment administration were analyzed in 3440 women, using individual data. The combined pregnancy rate from all the 12 trials was 1.7% [101/6083, 95% confidence interval (CI): 1.3-2.2]. From the three trials providing individual data, the combined pregnancy rate was 1.3% (45/3440, 95% CI: 0.9-1.7) and the estimate of pregnancies prevented was 83.4% (95% CI: 77.4-87.8). There was a sharp decline in efficacy when treatment was administered during the 5th day after intercourse compared to administration during the 1st day, the odds of pregnancy increasing by a factor of 5.3 (95% CI: 1.9-14.9). The relative risk of pregnancy was about 28 times higher among women with unprotected acts of coitus between treatment administration and the onset of next menses, compared with women reporting none [odds ratio (OR) = 27.6, 95% CI: 12.7-60.2]. The increase in risk for women reporting protected acts of intercourse during this interval was not statistically significant (OR = 1.8, 95% CI: 0.9-3.8). There was a large heterogeneity among trials in all side effects and delay of menses of more than 7 days (all had p < 0.0001 for the test of homogeneity). The percentage of women with nausea ranged from 0.0-19.4% (highest upper 95% confidence limit: 23.0%), that of vomiting from 0.0-4.3% (highest upper 95% confidence limit: 6.1%), that of lower abdominal pain from 4.3-19.1% (highest upper 95% confidence limit: 22.7%). The percentage of women with delay of menses of more than 7 days ranged from 4.3-25.8% (highest upper 95% confidence limit: 34.1%). We conclude that 10 mg mifepristone is an effective emergency contraception regimen, with an acceptable side-effects profile. Postponing treatment until the 5th day seriously decreases efficacy. The risk of pregnancy is dramatically increased among women having unprotected acts of intercourse between treatment administration and the onset of next menses. This risk may be enhanced for women whose ovulation is postponed by treatment.
