Objective To explore the effect of different pre-labor position for premature rupture of membrane (PROM) after 37 weeks with vertex and engaged presentation on the maternal and neonatal outcomes. Methods A total of 120 women over 37 weeks PROM with single fetus in vertex presentation and engaged head were randomly allocated into two groups. The trial group (60 women) received no limit of movement after hospitalization and before labor while the control group (60 women) adapted lateral and supine position alternatively with hip-up. Labor process and neonatal outcomes were observed and recorded. SPSS 13.0 software was adopted to analyze the data. Results Compared with the control group, the trial group had higher rate of normal birth (70% vs. 46.7%, χ2=6.72, P=0.01), shorter first and second stage of labor (t=2.11, P=0.039; t=2.75, P=0.007), fewer incidence of dysuria during labor (χ2=8.11, P=0.0041), and less amount of amniotic fluid (107±55 mL vs. 248±42 mL, t=4.188, P=0.000 1). Conclusion For PROM over 37 weeks pregnancy with single vertex presentation and engaged head, no limit on the position before labor is safe and feasible, and it can improvie spontaneous delivery rate, shorten labor process, decrease amount of amniotic fluid, and eliminate the incidence of dysuria. It is worth to be popularized in the clinic.
Objective To investigate the scientificity of patient-reported outcomes instrument for asthma ( Asthma-PRO) , which maybe used to evaluate the efficacy of anti-asthma drugs in clinical trials and clinical practice.Methods 366 asthma patients and 100 healthy subjects were face-to-face interviewed by well-trained investigators, and the data of Asthma-PRO instrument were collected. The psychometric performance such as reliability, validity, responsiveness and clinical feasibility in the Asthma-PRO instrument was evaluated. Results The split-half reliabilities of the Asthma-PRO instrument and each dimension were greater than 0.8. In the analysis of internal consistency of each dimension, the cronbach’s alpha coefficient was greater than 0.7. Factor analysis showed that the instrument has good construct validity. The scores of each of the facets and total scores between the asthma patients and the healthy subjects were different. The recovery rate and the efficient rate of the questionnaire were more than 95%, and the time required to complete a questionnaire was within 20 minutes, indicating that the scale had a high clinical feasibility. Conclusion The Asthma-PRO instrument has good reliability, validity, responsiveness and clinical feasibility.
ObjectiveTo investigate the MRI manifestations of internal carotid artery dissection (ICAD) before and after treatment. MethodsMRI materials of 20 patients with ICAD between November 2007 and February 2013 were collected for analysis. ResultsMRI manifestations of ICAD showed 17 cases of artery stenosis, 16 cases of mural hematoma or thrombus, 3 cases of aneurysmal dilatation, and 2 cases of lines of intimal flap. The treatment outcome MRI manifestations showed that 18 patients had effective response, including disappeared (n=9) and lessened (n=8) artery stenosis, disappeared (n=13) and diminished (n=3) hematoma and thrombus, and shrunken aneurysmal dilatation (n=1); and there were 2 cases of unchanged aneurysmal dilatation, and another 2 patients had aneurysmal dilatation while stenosis lessened. ConclusionMRI manifestations of internal carotid artery dissection mainly include stenosis, mural hematoma or thrombus, and aneurysmal dilatation. Stenosis, mural hematoma or thrombus usually disappear and lessen in the treatment, and all MRI findings may vary among each other.
ObjectiveTo explore the relationship between the diet during pregnancy and gestational diabetes mellitus (GDM), and analyze the effect of GDM on weight gain, outcome and complication of mother and infant. MethodsWe selected 128 GDM pregnant women and 267 non-GDM pregnant women who were investigated by semi-quantitative food frequency method during September 2009 to March 2011. Then, we collected relevant information and the data were analyzed by t-test and chi-square test. ResultsThere were statistically significant differences between the two groups in total calorie, carbohydrate, fat and protein intakes per day (P<0.05). In general, the rates of insufficient weight gain and excessive weight gain during pregnancy in the GDM group were significantly higher than the non-GDM group (P<0.05), while proper weight gain rate was significantly lower (P<0.01). The risk of hydramnion, intrahepatic cholestasis and pregnancy-induced hypertension in the GDM group was significantly higher than the non-GDM group (P<0.05), while there was no significant difference between the two groups in premature delivery, cesarean section or premature membrane ruptures (P>0.05). Apgar scores were significantly different at minute 1 and 5 between the infants in the two groups (P<0.05). The incidence of fetal death, malformation, mild neonatal asphyxia and fetal macrosomia in the GDM group was significantly higher than the non-GDM group (P<0.05). No significant differences between the two groups in low birth weight infant, cord entanglement and fetal distress were detected (P>0.05). ConclusionGDM can lead to high incidence of poor outcome and complication. It is vital to strengthen the examination and keep balanced dietary structure, in order to reduce the complication and improve the health of mother and child.
ObjectiveTo evaluate the reliability,validity and feasibility of a patient-reported outcomes (PRO) scale in the subjects with respiratory failure. Methods364 patients with chronic respiratory failure and 97 healthy subjects were face-to-face interviewed by well-trained investigators,and the data of respiratory failure -PRO instrument were collected. The psychometric performance such as reliability,validity,responsiveness and clinical feasibility in the respiratory failure -PRO instrument was evaluated. ResultsThe Cronbach's alpha coefficient of the respiratory failure -PRO instrument and each dimension were greater than 0.7. Factor analysis showed that the instrument had good construct validity. The scores of each of the facets and total scores between the patients and the healthy subjects were different. The recovery rate and the efficient rate of the questionnaire were more than 95%,and the time required to complete a questionnaire was within 15 minutes,indicating that the scale had a high clinical feasibility. ConclusionThe respiratory failure -PRO instrument has good reliability,validity,responsiveness and clinical feasibility.
Objective To developapatient-reported outcomes scale of chronic obstructive pulmonary disease used for Chinese, thus offering tools for clinical efficacy assessment. Methods According to the development standard of International Patient-Reported Outcomes, the item pool was established and the preliminary scale was prepared. Then, 100 patients with chronic obstructive pulmonary disease and 50 healthy subjects were face-to-face interviewed with preliminary scale by well-trained investigators.Those copies were collected, surveys were analyzed and items were selected with 5 methods including measure of discrete tendency method, factor analysis, correlation coefficient method, Cronbach’s alpha coefficient method and item response Theory. Finally, the final scale was gained. Results The eventual scale contains 4 areas(physiological dimain, psychological dimension, social dimension, treatment), 11 dimensions(specific symptoms, general symptoms, individual, anxiety, depression, disease cognization, disease influence on social pctivity, social support, compliance, drug adverse reaction, satisfactory), and 52 items. Conclusion The ultimate scale coincides with the theoretical framework and reflects the connotation of the quality of life of patients with chronic obstructive pulmonary disease.
Sample size, mean and standard deviation are necessary when conducting meta-analysis for continuous outcomes. Advanced methods of data extraction were needed if the mean and the standard deviation couldn’t be obtained from a literature directly. Eight methods were introduced and two examples were given to illustrate how to apply the methods.
Objective To review recent advancement of the relationship between obesity and gastric cancer. Method We searched PubMed, Medline, EMBASE, Cochrane Library databases, CNKI, and WanFang database for recent clinical trials about the impact of obesity on occurrence, surgery outcomes, and prognosis of gastric cancer. Results Obesity significantly increased the risk of adenocarcinoma of esophagogastric junction (AEG), increased difficulty in radical operation of gastric cancer and complications of perioperative period, but it had no effect on the long-term operative outcomes. The association between obesity and the survival of gastric cancer was not clear. However, the better survival was observed in most researches of gastric cancer patients with excess body weight. Conclusions The relationship between obesity and gastric cancer is very complex, and there is no consistent conclusion. A reasonable body weight by a healthy lifestyle is expected to decline the incidence of AEG.
Objective To guide blood glucose management during pregnancy and reduce the incidence of long-term complications of the fetus by exploring the long-term growth condition of offspring of pregnant women with gestational diabetes mellitus. Methods A total of 180 cases full-term newborns of pregnant women with gestational diabetes mellitus from December 25th, 2011 to December 25th, 2012 were selected as the diabetes group. Another 200 newborns of pregnant women without any complications were randomly collected as the control group. Birth weight, gestational age, sex, blood glucose, and 24-, 48-, 72- and 120-hour transcutaneous bilirubin value after the birth of the newborns were recorded; weight, height, body mass index (BMI), triglycerides, total cholesterol, high density lipoprotein (HDL), low density lipoprotein, blood pressure and fasting plasma glucose quota between the two groups were contrasted when the children were three years old. Results There were no significant difference in the birth weight, gestational age and sex between the diabetic and the control group. The blood glucose levels of the newborns in the diabetic group was significantly lower than that in the control group (P<0.05). The 24-, 48-, 72- and 120-hour transcutaneous bilirubin values of the newborns in the diabetic group were significantly higher than those of the control group (P<0.05). The weight, height and BMI of the three years old offspring in the diabetic group were significantly higher than those in the control group (P<0.05). There were no significant difference in triglycerides, total cholesterol, HDL, Low density lipoprotein, fasting plasma glucose quota, and systolic blood pressure between the diabetic group and the control group (P>0.05), but the diastolic blood pressure in the diabetic group was much higher than that in the control group (P<0.05). Conclusion The impact of gestational diabetes mellitus on offspring of pregnant women was not only in the fetus and newborn period, but also in the future, which should be timely intervened.
Objective To evaluate long-term outcomes of surgical closure of atrial septal defect (ASD) and combined surgical radiofrequency ablation for atrial fibrillation (AF). Methods A total of consecutive 15 patients with ASD undergoing surgical closure of ASD and combined surgical radiofrequency ablation in our department between March 2003 and April 2015. There were 7 males and 8 females at an average age of 47.1±10.8 years ranging from 16 to 62 years. Retrospective analysis and follow-up were performed to evaluate long-term success rate freedom from AF after surgery. Results All patients recovered and discharged, and no patient suffered death or stroke. The duration of follow-up was from 3 to 136 months for all patients. Success rate freedom from AF at 1, 3, 5 and 10 years was 81.3%, 75.0%, 68.8% and 61.1%, respectively. During follow-up, there was no death or stroke. One patient required permanent pacemaker implantation. Conclusion Concomitant surgical closure of ASD and biatrial radiofrequency ablation is safe and effetive with better long-term outcomes. It is necessary to perform the two procedures together for ASD patients.