Design and application of intelligent surgical operation scheduling system / 中华护理杂志

Objective To develop an intelligent scheduling system for surgery by setting up constraints in an intelligent working environment to achieve automatic scheduling of surgery and personnel,and to precisely match the sub-professional nurses for surgeries.Methods Scheduling constraints were set up,and finally efficient scheduling was developed.Results During the process of clinical application,the rates of error and omission for surgical schedule fell to 4.78％,the rate of surgery re-adjustment fell to 17.74％,the number of average daily operation increased,the matching degree of sub-professional surgery nurse post reached 94.71％.Conclusion The intelligent surgical scheduling system can improve the scheduling efficiency and quality,improve the utilization of the operation rooms,and improve the collaboration quality and efficiency of the sub-professional nurses.

The effect of syphilis treatment during pregnancy on serological test results in infants born to syphilis mothers / 中华传染病杂志

Objective To discuss the effect of syphilis treatment during pregnancy on serological test results in infants born to syphilis mothers.Methods Data of pregnant women with syphilis and their infants in Zhejiang Province between January 2013 and December 2014 were retrospectively analyzed and the effect of syphilis treatment during pregnancy on non-treponemal antigen serological test results in infants were compared.x2 test was used for positive rate of serological tests,incidence of congenital syphilis,and neonatal mortality in infants with syphilis,and rank sum test was used to compare the titers of rapid plasma reagin (RPR) test and tolulized red unheated serum teat (TRUST).Results A total of 3 953 infants were born to 3 901 mothers with syphilis.Of which 3 262 were tested,including 2 226 by RPR and 1 036 by TRUST.The rate of infants with positive RPR was significant lower in treated mothers (45.02％)compared with untreated mothers (55.04％;x2 =12.88,P＜0.01).The significant differences of titers of RPR or TRUST were observed among mothers with or without treatment (RPR:Z=-2.45,P=0.01;TRUST:Z=-2.65,P=0.01),different course of treatment (RPR:Z=-2.33,P=0.02;TRUST:Z=-2.60,P=0.01).Fifty-seven infants were diagnosed with congenital syphilis.The rate of congenital syphilis was 3.50％(27/772) born to untreated mothers,which was dramatically higher than treated mothers (0.96 ％,30/3 129,x2 =27.72,P＜ 0.01).Forty-two infants died.Neonatal mortality was also higher in the untreated group (2.59 ％,20/772) than the treated group (0.70％,22/3 129,x2 =20.72,P＜ 0.01).Conclusion Adequate treatment for women with syphilis during pregnancy could decrease serological tests of RPR and TRUST among new infants and improve the infants their outcomes.

[Clinical study on 67 cases with uterine rupture].

OBJECTIVE: To investigate the incidence, etiology, diagnosis, treatment and outcome of uterus rupture. METHODS: From January 1999 to May 2013, clinical data of 67 cases with uterine rupture in Woman's Hospital, School of Medicine, Zhejiang University were studied retrospectively. RESULTS: A total of 67 cases of uterine rupture with 21(+2)-39(+2) gestational weeks out of 128 599 deliveries were recorded giving an incidence of uterine rupture was 0.052 1% (67/128 599) . Cesarean scar rupture were found in 59 cases (88%, 59/67) and noncesarean scar rupture were found in 8 cases (12%, 8/67). The causes of uterine rupture include 60 cases of scar uterus (59 cesarean scar cases and 1 myomyectomy scar case), 2 cases of assisted delivery operation trauma, 2 cases of malformed uterus, 3 cases of unknown causes (all with artificial abortion history).Non obstructive dystocia and improper oxytocin use were found to be related with uterine rupture.Fifty-two cases of cesarean scar spontaneous incomplete rupture were found and repaired during repeated cesarean delivery without maternal and fetal complications. The remaining 15 cases need emergency rescue operation for fetal distress or dead fetus, severe acute abdomen, prepartum or postpartum vaginal bleeding even maternal hypovolemia; 6/15 uterine rupture cases were diagnosed with the history, clinical symptoms and signs, 3/15 cases with ultrasonic found dead fetus in the peritoneal cavity before exploratory laparotomy and 6 cases were diagnosed just during laparotomy.Hysterectomy was done in 10/15 cases and uterine repair in 5/15 cases; there was no maternal death and 12 perinatal fetal death (5 cases of mid-late pregnancy termination for deformed fetus) of the 15 uterine rupture cases.One case with hysterectomy was complicated with stress pancreatitis and dysfunction of liver and kidney and discharged 20 days after operation, the remaining 14 cases were discharged 5-7 days postpartum.One case with repaired malformed uterus got pregnancy 4 years later and delivered a 2 000 g healthy baby by cesarean section at gestational age of 33(+4) weeks. CONCLUSION: Uterine scar caused by caesarean section or other operations became the leading cause of uterine rupture, assisted delivery operations, history of intrauterine manipulation and uterine malformations were the predisposing risk factors of uterine rupture.

Clinical study on 67 cases with uterine rupture / 中华妇产科杂志

Objective To investigate the incidence,etiology,diagnosis,treatment and outcome of uterus rupture.Methods From January 1999 to May 2013,clinical data of 67 cases with uterine rupture in Woman's Hospital,School of Medicine,Zhejiang University were studied retrospectively.Results A total of 67 cases of uterine rupture with 21 +2--39 +2 gestational weeks out of 128 599 deliveries were recorded giving an incidence of uterine rupture was 0.052 1 ％ (67/128 599).Cesarean scar rupture were found in 59 cases (88％,59/67) and noncesarean scar rupture were found in 8 cases (12％,8/67).The causes of uterine rupture include 60 cases of scar uterus (59 cesarean scar cases and 1 myomyectomy scar case),2 cases of assisted delivery operation trauma,2 cases of malformed uterus,3 cases of unknown causes (all with artificial abortion history).Non obstructive dystocia and improper oxytocin use were found to be related with uterine rupture.Fifty-two cases of cesarean scar spontaneous incomplete rupture were found and repaired during repeated cesarean delivery without maternal and fetal complications.The remaining 15 cases need emergency rescue operation for fetal distress or dead fetus,severe acute abdomen,prepartum or postpartum vaginal bleeding even maternal hypovolemia; 6/15 uterine rupture cases were diagnosed with the history,clinical symptoms and signs,3/15 cases with ultrasonic found dead fetus in the peritoneal cavity before exploratory laparotomy and 6 cases were diagnosed just during laparotomy.Hysterectomy was done in 10/15 cases and uterine repair in 5/15 cases; there was no maternal death and 12 perinatal fetal death (5 cases of mid-late pregnancy termination for deformed fetus) of the 15 uterine rupture cases.One case with hysterectomy was complicated with stress pancreatitis and dysfunction of liver and kidney and discharged 20 days after operation,the remaining 14 cases were discharged 5-7 days postpartum.One case with repaired malformed uterus got pregnancy 4 years later and delivered a 2 000 g healthy baby by cesarean section at gestational age of 33 +4 weeks.Conclusion Uterine scar caused by caesarean section or other operations became the leading cause of uterine rupture,assisted delivery operations,history of intrauterine manipulation and uterine malformations were the predisposing risk factors of uterine rupture.

Expression and significance of chemokine CXC receptor 3, 4 and their ligands at the early pregnancy decidua and villi / 中华妇产科杂志

Objective To explore the expression and significance of chemokine CXC reeeptor (CXCR)3 and CXCR4 and their ligands(CXCL)at the early pregnancy decidua and villi.Methods Decidual mononuclear cells were isolated from the normal decidua of 5-8 weeks pregnant women by lymphocyte separation medium in vitro.CD56+natural killer(NK)cells were purified by dynabeads cell sorter kiL Purity and phenotype of CD56+decidua NK cells were analyzed by fluorescence-activated eell sorter (FACS).Gene expression of CXCR3 and CXCR4 in decidua NK cells and CXCL9,CXCL10 and CXCL12 in early pregnancy decidua and villi was assessed bv RT.PCIZ Protein expression of CXCL9,CXCL10 in normal endometrium and early pregnancy decidua was characterized and quantified by streptavidin-biotin pemxidase chain reaction(SP)immunohistochemistry and computered image analysis system.Correlations between the gray degree of CXCL9 and CXCL10 and the number of CD56+NK cells in upper tissue were analyzed by Spearman's correlation ceefficient rank tesL Results The phenotype of 98.7%decidua NK cells was CD56bright.The genes of CXCR3 and CXCR4 were expressed in decidua NK cells and that of CXCL9 and CXCL1O were expressed in early pregnancy decidua and CXCLI2 in early pregnancy villi.CXCL9 and CXCL10 were expressed in the cytoplasm of surface epithelia,glandular epithelia and stromal cells of early pregnancy deeidua and were not expressed in villi by immunohistochemistry.The gray degree of CXCL9 and CXCL10 in the secretory phase endometrium(56±43,59±47)was stronger than that in the proliferative phase(16±18,8±14,P<0.05)and reached the highest(143±35,158±29,P<0.05)in the early pregnancy decidua.The number of cD+56 NK cell in the secretory phase endometrium(60±20)was more than that in the proliferative phase endometrium(23±4,P<0.05)and was the most in the early pregnancy decidua(114±15,P<0.05).The gray degree of CXCL9 in upper tissue had a positive correlation with the number of CD+56 cells(r=0.88,P<0.05)and that of CXCL10 had a similar pattern to CXCL9(r=0.86,P<0.05).Condusion The interactions between CXCL9,CXCL10 and CXCL12 expressed in decidua and villi and CXCR3,CXCR4 expressed in CD+56 decidua NK cells may influence the CD+56 NK cell recruitment at the maternal-fetal interface.

Effect of estradiol benzoate on the heat shock protein 70, 90 expressions in endometrial glandular epithelial cell / 中华妇产科杂志

Objective To explore the effect of estradiol benzoate on the expressions of heat shock protein (HSP)70, 90 in endometrial glandular epithelial cell. Methods Normal endometrial glandular epithelial cells were isolated, and cultured by enzymolysis method and identified by electron microscopy and immunohistochemical analysis. The normal endometrial glandular epithelial cells were treated with culture medium only, estradiol benzoate (10 -9 , 10 -8 , 10 -7 or 10 -6 mol/L), estradiol benzoate(10 -9 , 10 -8 , 10 -7 or 10 -6 mol/L) and antiestrogen ICI 182780(fulvestrant,faslodex, 1?mol/L)and ICI 182780 only for 6, 12, 18, 24 hours respectively. The dose-and time-related effect of estradiol benzoate and ICI 182780 on the cell growth was measured by mononuclear cell direct cytotoxicity assay (methyl thiazolyl tetrazolium assay), and that on the expression of HSP70 and HSP90 in normal endometrial glandular epithelial cell in vitro was measured by immunohistochemical analysis and computerized image analysis system. Results Estradiol benzoate stimulated cell growth in a time-and dose-dependent manner and the effect was attenuated by the antiestrogen ICI 182780. The average cell growth rates of 10 -9 , 10 -8 , 10 -7 , 10 -6 mol/L estradiol benzoate for 24 hours were(170?9)%,(207?11)%,(231?12)%,(257?10)%, which were significantly higher than those of 6 hours (117?13)%, (129?10)%, (146?10)%, (176?6)%, P