Comparison of Three Identification Tests of Vulvovaginal Candidiasis' Candida Strains / 昆明医科大学学报

Objective To compare the advantages and disadvantages of three methods of yeast-like fungi identification of vulvovaginal candidiasis (VVC).Methods The pathogenic candida strains were identified by CHROM agar chromogeinc culture medium,the chromogenic medium of Autobio and VITEK 2 system,and the result of VITEK 2 system was the gold standard.Results All candida strains were appraised.By VITEK2 system,217 candida isolates were identified as candida albicans,and 26 were detected as non-candida albicans.214 isolates were identified as candida albicans and 13 isolates were identified as non-candida albicans by Autobio.214 isolates were appraised as candida albicans,16 isolates were identified as non-candida albicans.The coincidence rate of identification of CHROMagar and the chromogenic medium of Autobio were 94.7％ and 95.06％.Compared with VITEK 2 system,there was no significant difference between these two chromogeinc culture medium identifying candida albicans and non-candida albicans.Conclusion The chromogenic medium of Autobio has higher cost-effectiveness,higher color discrimination and simpler technical operation,and is worthy of promotion in identifying candida species in clinic.

Species analysis of candida isolates came from recurrent vulvovaginal candidiasis patients / 安徽医科大学学报

Objective To identify the Candida species isolated from recurrent vulvovaginal candidiasis( RVVC) pa-tients, and provide etiologic datum of RVVC. Methods All Candida isolates, including those from vulvovaginal candidiasis ( VVC) and RVVC patients, were identified by using CHROMagar chromogenic medium and VITEK2 yeast identification kits. Results The proportions of nonalbicans species from nonpregnant RVVC relapse patients and pregnant VVC patients were both significantly higher than those from nonpregnant VVC patients ( P<0. 05 ) . Among pregnant patients, the percentage of C. albicans isolated from RVVC relapse was couer, but there was no significant difference of C. albicans species percentage between RVVC and VVC patients. Conclusion RVVC may be related to the recurrence of same Candia species and the reinfection of different Candia species. Pregnant women may be more inclinable to suffer from disorder caused by nonalbicans species.

Analysis of 124 cases of placental abruption and its early diagnosis / 重庆医学

Objective To analyze the clinical manifestations of placental abruption ,and try to provide evidence‐based data for early diagnosis .Methods Retrospective cases of placental abruption from January 2008 to March 2014 were analyzed ,the clinical characteristics ,etiological factor and outcomes were compared .Results There were 58 cases in Ⅰ degree ,45 cases in Ⅱ degree and 21 cases in Ⅲ degree .The incidence of PIH in Ⅰ degree group was significantly lower than that in Ⅱ degree group ,the incidence of PROM in Ⅰ degree group was significantly higher than that in Ⅱ and Ⅲ degree groups(P< 0 .05) .The main symptoms of Ⅰ degree group were vaginal bleeding .The main performances of Ⅱ and Ⅲ degree group were abdominal pain with or without vaginal bleed‐ing .The cesarean section rate of Ⅰ degree group was significantly lower than that of Ⅲ degree group ,and the rate of maternal‐fetal adverse outcomes was statistically lower than Ⅱ and Ⅲ degree groups (P< 0 .05) .Conclusion It is helpful for early diagnosis of placental abruption and improving prognosis by regular prenatal care ,analyzing and combining with history or risk factors ,ultra‐sound ,physical examination ,and paying attention to clinical performance like abdominal pain and vaginal bleeding ,as well as impro‐ving the ability to identify the abnormal FHR .

Etiological and Clinical Analysis of 45 Cases of Placental Abruption / 昆明医科大学学报

Objective To analyze the risk factors and clinical characteristic of placental abruption. Methods We retrospectively analyzed the medical documents of 45 patients treated in the first affiliated hospital of Kunming medical university during 2010 to 2012. All mild placental abruption patients and severe placental abruption patients were used to analyze the high risk factors and outcomes of pregnancy. Results The incidence of placental abruption was 0.41%. Seventeen severe placental abruption patients and 28 mild placental abruption cases were included in this study. The incidence of uteroplacental apoplexy and perinatal infant outcomes were significant diferenct between two groups (P≤0.023) .The high risk factors were hypertensive disorders in pregnancy, premature rupture of membranes,complicated with other diseases in pregnancy, and so on. About 22.2%placental abruption couldn't be explained by any reasons. Conclusions Severe placental abruption can occur in pregnant women with no high risk factors and cause bad pregnant outcomes. To improve the skills of medical personnel is the powerful measure in placental abruption treatment.

Practice audits to reduce caesareans in a tertiary referral hospital in south-western China.

OBJECTIVE: To assess the effectiveness of a three-stage intervention to reduce caesarean deliveries in a Chinese tertiary hospital. METHODS: A retrospective study was conducted to assess whether educating staff, educating patients and auditing surgeon practices (introduced in 2005) had reduced caesarean delivery rates. Multiple logistic regression was used to check for a potential association between caesarean rates and rates of admission to the neonatal intensive care unit (NICU). FINDINGS: The caesarean delivery rate ranged from 53.5% to 56.1% in 2001-2004 and from 43.9% to 36.1% in 2005-2011. When 2001-2004 and 2005-2011 were treated as "before" and "after" periods to evaluate the intervention's impact on the mean caesarean section rate, a significant reduction was noted: from 54.8% to 40.3% (odds ratio, OR: 0.56; 95% confidence interval, CI: 0.52-0.59; χ(2) test: P < 0.001). The overall drop in the caesarean section rate was significant (χ(2) test: P < 0.001) and inversely correlated with the years (Spearman's ρ: -0.096; P < 0.001). Although complicated pregnancies increased after 2004, the primary caesarean section rate decreased annually by 20% on average in 2005-2011, after practice audits were implemented. Multiple logistic regression showed a positive association between the caesarean delivery rate and the rate of admission to the NICU (adjusted OR: 1.26; 95% CI: 1.14-1.40). CONCLUSION: Patient and staff education and practice audits reduced the Caesarean section rate in a tertiary referral hospital without an increase in admissions to the NICU.

Epidemiological study on vaginal Candida glabrata isolated from pregnant women.

Candida glabrata was the second most frequently occurring fungus and the dominant non-albicans species caused candidal vulvovaginitis. We used a randomly amplified polymorphic DNA method to compare genotypes of vaginal C. glabrata from pregnant women with or without clinical symptoms. The aims of our study were to define the prevalence of C. glabrata during pregnancy and identify the relationship between genotypes of C. glabrata and the clinical symptoms. A total of 50 C. glabrata strains were isolated, identified, and genotyped from 628 pregnant women. The prevalence of C. glabrata during pregnancy was 7.96% (50/628). C. glabrata was detected in 25.12% (50/199) of all Candida isolates. 17 unique genotypes were generated by RAPD and the mean SAB value of all isolates was 0.891+/-0.002. All results show that the genotypes of vaginal C. glabrata isolated from pregnant women were highly similar but non-identical. Compared to those of symptomatic patients in the same trimester and asymptomatic patients in different trimesters, C. glabrata isolated from the asymptomatic patients in the first trimester had more genotypical similarities. Genotypical similarities of C. glabrata were related to clinical signs and symptoms, to some degree.