Background: Aortic dissection (AD) is a relatively rare but dreadful illness, often accompanied by severe, sharp (or tearing) back pain or anterior chest pain, as well as acute hemodynamic compromise. Painless dissect...Background: Aortic dissection (AD) is a relatively rare but dreadful illness, often accompanied by severe, sharp (or tearing) back pain or anterior chest pain, as well as acute hemodynamic compromise. Painless dissection has also been reported in rare cases and might be misdiagnosed due to its atypical symptoms leading to catastrophic outcomes. Case presentation: The patient was admitted to the hospital due to right limb weakness with speech inability for more than 10 hours. In the routine cardiac ultrasound examination, the avulsion intimal echo was found in the initial segment of the descending aorta. The rupture range was about 11 mm, and the lumen was separated into real and false lumen. Further computed tomography angiography (CTA) examination confirmed the major arterial dissection (De Bakey Type I). Conclusion: We report a case of painless aortic dissection with active carotid artery thrombosis diagnosed by ultrasound and CTA, and to improve the understanding of painless aortic dissection by reviewing relevant domestic and foreign literature.展开更多
Objective:To observe the effects of remimazolam benzenesulfonate combined with alfentanil during painless gastroenteroscopy in elderly patients.Methods:This study analyzes patients aged 60–85 years old undergoing pai...Objective:To observe the effects of remimazolam benzenesulfonate combined with alfentanil during painless gastroenteroscopy in elderly patients.Methods:This study analyzes patients aged 60–85 years old undergoing painless gastroenteroscopy.A total of 140 patients,examined between February 2023 and February 2024,voluntarily participated and were randomly divided into an experimental group and a control group.The control group received alfentanil combined with propofol for anesthesia,while the experimental group received alfentanil combined with remimazolam benzenesulfonate.The relevant indices of both groups were separately analyzed.Results:Patients in the experimental group had a shorter awakening time,a faster discharge rate(P<0.05),and a shorter examination duration;however,the difference in examination time between the two groups was not statistically significant(P>0.05).Before anesthesia,there was no significant difference in the basic information and vital signs of the two groups(P>0.05).Two minutes after anesthesia,both groups showed a decline in vital signs,but the vital signs of the experimental group remained more stable after the procedure,with the group’s indices showing improvement over the control group(P<0.05).Additionally,the incidence of adverse reactions in the experimental group was lower than in the control group(P<0.05).Conclusion:In painless gastroenteroscopy for elderly patients,anesthesia using a combination of remimazolam benzenesulfonate and alfentanil improves anesthesia effectiveness,hastens patient recovery,enhances the stability of vital signs,and effectively controls adverse reactions,thereby improving patient comfort.展开更多
This article reports two cases of painless thyroiditis with special manifestations. Patient 1 was a 76-year-old female patient who presented with palpitations and chest tightness and was diagnosed with hyperthyroidism...This article reports two cases of painless thyroiditis with special manifestations. Patient 1 was a 76-year-old female patient who presented with palpitations and chest tightness and was diagnosed with hyperthyroidism by thyroid ultrasound and electrocardiogram, which is a painless thyroiditis with atrial fibrillation as the first symptom. Patient 2 is a 44-year-old male patient, with only palpitations, diagnosed as T3 thyroiditis by liver function and thyroid function tests, and accompanied by abnormal liver function, belonging to the painless thyroiditis with elevated FT3 only. This article points out that painless thyroiditis has multiple manifestations and is easily misdiagnosed as other diseases. Therefore, patients with symptoms such as palpitations and chest tightness should undergo cytologic or pathologic examination in time to avoid missed diagnosis and misdiagnosis.展开更多
Caesarean section is dramatically increased throughout the world in recent years. Rupture of the uterus is a devastating complication in trial of labour following previous Caesarean section. Evidence suggests that the...Caesarean section is dramatically increased throughout the world in recent years. Rupture of the uterus is a devastating complication in trial of labour following previous Caesarean section. Evidence suggests that the size of the uterine scar and the residual myometrial thickness (RMT) are associated directly with the risk of uterine rupture and risk of dehiscence in subsequent deliveries. Impact of the prelabour and labour Cesarean section on the RMT has not been studied in detail. Objectives: To compare RMT, Caesarean scar defects and to evaluate the elasticity of the Caesarean scar between women who underwent prelabour and labour Caesarean sections. Methods: This was a Cross sectional analytical study. Women who underwent Caesarean section in their first pregnancy were recruited. Sample was stratified to prelabour and labour Caesarean section groups. Transvaginal ultrasound scan was performed six months following the Caesarean section. Dimensions of the uterus, uterine scar defect, RMT and elastosonography of the uterine scar were assessed. Results: A total of 240 postpartum women were analyzed. Uterine niche was detectable in 194 subjects. Prelabour CS group had demonstrated 91.7% (n = 110) scar defects (uterine niche) out of 120 cases and the rate among labour CS group was 70% (n = 84). There was a significant difference in the presence of uterine niche among 2 groups as Prelabour group was found to have more scar defects (p mm (SD 1.2) and 4.99 mm (SD 1.3) respectively and there was no significant difference (t = 0.38, p = 0.71). There was no significant difference between the dimensions of the uterine CS defects of the studied groups. Prelabour CS group had significantly higher Target strain [0.28 vs. 0.24 (t = 2.12, p = 0.04)] and significantly less strain ratio [1.45 vs. 1.55 (t -2.42, p = 0.04)] than labour CS group indicating a better scar in prelabour group. Conclusion: There was no significant difference in RMT and uterine scar defects between prelabour and labour Caesarean section groups. But prelabour Caesarean section scars were less stiff than labour Caesarean section scars. Further studies are warranted to elaborate on the association.展开更多
This article analyses the determinants of young women’s participation in the labour market. For this purpose, the Employment Policy Enhancement Survey (EAPE), conducted by the Laboratoire de Recherches et d’Etudes E...This article analyses the determinants of young women’s participation in the labour market. For this purpose, the Employment Policy Enhancement Survey (EAPE), conducted by the Laboratoire de Recherches et d’Etudes Economiques et Sociales (LARES) in collaboration with CERDI in 2018 was used as the database. The results of Gallant and Nychka’s (1987) semi-nonparametric procedure show that health status, household size, marital status, and educational attainment are explanatory factors of young women’s labour market participation in Congo.展开更多
BACKGROUND Painless gastroscopy is a widely used diagnostic and therapeutic technology in clinical practice.Propofol combined with opioids is a common drug for painless endoscopic sedation and anaesthesia.In clinical ...BACKGROUND Painless gastroscopy is a widely used diagnostic and therapeutic technology in clinical practice.Propofol combined with opioids is a common drug for painless endoscopic sedation and anaesthesia.In clinical work,adverse drug reactions of anaesthesia schemes are often one of the important areas of concern for doctors and patients.With the increase in propofol dosage,the risk of serious adverse drug reactions,such as respiratory depression and hypotension,increases significantly;the use of opioids often causes gastrointestinal reactions in patients after examination,such as nausea,vomiting,delayed recovery of gastrointestinal function and other complications,which seriously affect their quality of life.AIM To observe the effect of wrist-ankle acupuncture therapy on the anaesthesia regimen and anaesthesia-related complications during and after painless gastroscopy examination.METHODS Two hundred patients were selected and randomly divided into a treatment group(n=100)and a control group(n=100).Both groups were routinely anaesthetized with the nalbuphine and propofol regimen,gastroscopy began after the patient lost consciousness,and given supportive treatment and vital sign monitoring.If the patient interrupted the surgery due to intraoperative torsion,intravenous propofol was used to relieve his or her discomfort.The treatment group received wrist-ankle acupuncture on this basis.RESULTS The general data before treatment,American Society of Anesthesiologist(ASA)grade and operation time between the two groups was no significant difference.The Wakeup time,and the Selfambulation time in the treatment group was significantly faster than that in the control group(P<0.05).The total dose of propofol in the treatment group was 109±8.17 mg,significantly lower than that in the control group(P<0.05).The incidence of respiratory depression and hypotension was not significantly different,but the incidence of hiccups was significantly lower than that in the control group(P<0.05).After the examination,the incidence of nausea,vomiting,abdominal distension,and abdominal pain was 11%,8%,6%,and 5%,respectively,which was significantly lower than that in the control group(P<0.05).In addition,both the operators and the patients were more satisfied with this examination,with no significant difference between the groups(P>0.05).CONCLUSION Wrist-ankle acupuncture treatment can optimize the painless gastroscopy and anaesthesia scheme,reduces propofol total dose;shortens patient Wakeup time and Self-ambulation time,improves patient compliance and tolerance,is beneficial to clinical application.展开更多
BACKGROUND Painless gastroenteroscopy is a widely developed diagnostic and treatment technology in clinical practice.It is of great significance in the clinical diagnosis,treatment,follow-up review and other aspects o...BACKGROUND Painless gastroenteroscopy is a widely developed diagnostic and treatment technology in clinical practice.It is of great significance in the clinical diagnosis,treatment,follow-up review and other aspects of gastric cancer patients.The application of anesthesia techniques during manipulation can be effective in reducing patient fear and discomfort.In clinical work,the adverse drug reactions of anesthesia regimens and the risk of serious adverse drug reactions are increased with the increase in propofol application dose application dose;the application of opioid drugs often causes gastrointestinal reactions,such as nausea,vomiting and delayed gastrointestinal function recovery,after examination.These adverse effects can seriously affect the quality of life of patients.AIM To observe the effect of modified ShengYangYiwei decoction on gastrointestinal function,related complications and immune function in patients with gastric cancer during and after painless gastroscopy.METHODS A total of 106 patients with gastric cancer,who were selected from January 2022 to September 2022 in Xiamen Traditional Chinese Medicine Hospital for painless gastroscopy,were randomly divided into a treatment group(n=56)and a control group(n=50).Before the examination,all patients fasted for 8 h,provided their health education,and confirmed if there were contraindications to anesthesia and gastroscopy.During the examination,the patients were placed in the left decubitus position,the patients were given oxygen through a nasal catheter(6 L/min),the welling needle was opened for the venous channel,and a multifunction detector was connected for monitoring electrocardiogram,oxygen saturation,blood pressure,etc.Naporphl and propofol propofol protocols were used for routine anesthesia.Before anesthesia administration,the patients underwent several deep breathing exercises,received intravenous nalbuphine[0.nalbuphine(0.025 mg/kg)],followed by intravenous propofol[1.propofol(1.5 mg/kg)]until the palpebral reflex disappeared,and after no response,gastroscopy was performed.If palpebral reflex disappeared,and after no response,gastroscopy was performed.If any patient developed movement,frowning,or hemodynamic changes during the operation(heart rate changes during the operation(heart rate increased to>20 beats/min,systolic blood pressure increased to>20%of the base value),additional propofol[0.propofol(0.5 mg/kg)]was added until the patient was sedated again.The patients in the treatment group began to take the preventive intervention of Modified ShengYangYiwei decoction one week before the examination,while the patients in the control group received routine gastrointestinal endoscopy.The patients in the two groups were examined by conventional painless gastroscopy,and the characteristics of the painless gastroscopies of the patients in the two groups were recorded and compared.These characteristics included the total dosage of propofol during the examination,the incidence of complications during the operation,the time of patients'awakening,the time of independent activities,and the gastrointestinal function of the patients after examination,such as the incidence of reactions such as malignant vomiting,abdominal distension and abdominal pain,as well as the differences in the levels of various immunological indicators and inflammatory factors before anesthesia induction(T0),after conscious extubation(T1)and 24 h after surgery(T2).RESULTS There was no difference in the patients’general information,American Society of Anesthesiologist classification or operation time between the two groups before treatment.In terms of painless gastroscopy,the total dosage of propofol in the treatment group was lower than that in the control group(P<0.05),and the time of awakening and autonomous activity was significantly faster than that in the control group(P<0.05).During the examination,the incidence of hypoxemia,hypotension and hiccups in the treatment group was significantly lower than that in the control group(P<0.01).In terms of gastrointestinal function,the incidences of nausea,vomiting,abdominal distension and abdominal pain in the treatment group after examination were significantly lower than those in the control group(P<0.01).In terms of immune function,in both groups,the number of CD4+and CD8+cells decreased significantly(P<0.05),and the number of natural killer cells increased significantly(P<0.05)at T1 and T2,compared with T0.The number of CD4+and CD8+cells in the treatment group at the T1 and T2 time points was higher than that in the control group(P<0.05),while the number of natural killer cells was lower than that in the control group(P<0.05).In terms of inflammatory factors,compared with T0,the levels of interleukin(IL)-6 and tumor necrosis factor-alpha in patients in the two groups at T1 and T2 increased significantly and then decreased(P<0.05).The level of IL-6 at T1 and T2 in the treatment group was lower than that in the control group(P<0.05).CONCLUSION The preoperative use of modified ShengYangYiwei decoction can optimize the anesthesia program during painless gastroscopy,improve the gastrointestinal function of patients after the operation,reduce the occurrence of examination-related complications.展开更多
BACKGROUND Breast abscess during lactation is a severe complication of acute mastitis,which can lead to discomfort,high fever,breast fistula,sepsis,septic shock,breast damage,disease persistence and frequent hospitali...BACKGROUND Breast abscess during lactation is a severe complication of acute mastitis,which can lead to discomfort,high fever,breast fistula,sepsis,septic shock,breast damage,disease persistence and frequent hospitalization.Breast abscesses may also lead the mother to discontinue breastfeeding,thereby harming the infant’s health.The predominant pathogenic bacteria are Staphylococcus aureus,Staphylococcus epidermidis and Streptococcus.The incidence of breastfeeding abscesses in breastfeeding women ranges between 4.0%and 11.0%.In cases of breast abscess,the rate of cessation of lactation is 41.0%.In instances of breast fistula,the rate of cessation of lactation is very high(66.7%).Furthermore,50.0%of women with breast abscesses must be hospitalized and treated with intravenous antibiotics.Treatment includes antibiotics,abscess puncture and surgical incision and drainage.The patients suffer from stress,pain and easily induced breast scarring;the disease’s progression is prolonged and recurrent,interfering with infant feeding.Consequently,it is crucial to discover an adequate cure.CASE SUMMARY A 28-year-old woman with a breast abscess was treated with Gualou Xiaoyong decoction and painless breast opening manipulation 24 d after cesarean delivery.On the 2nd d of treatment,the patient’s breast mass was significantly reduced,the pain was significantly reduced,and the general asthenia was improved.All conscious symptoms disappeared after 3 d,breast abscesses faded after 12 d of treatment,inflammation images disappeared after 27 d,and normal lactation images were restored.CONCLUSION In treating breast abscesses during breastfeeding,the combination of Gualou Xiaoyong decoction and painless lactation provides a positive therapeutic impact.This disease’s treatment offers the advantages of a short course of treatment,no need to discontinue breastfeeding and the ability to rapidly mitigate symptoms,which can be used as a reference in clinical practice.展开更多
Objective:To observe the Effective dose and safety of different doses of alfentanil combined with propofol in painless gastroscopy.Method:240 patients who underwent painless gastric examination from January 2021 to De...Objective:To observe the Effective dose and safety of different doses of alfentanil combined with propofol in painless gastroscopy.Method:240 patients who underwent painless gastric examination from January 2021 to December 2021 were randomly divided into a control group and a different dose group of alfentanil(N1 group,N2 group,N3 group,N4 group,and N5 group,with injection doses of 5,6,7,8,and 10ug/kg,respectively)using a number table method,with 40 patients in each group.The control group was anesthetized with propofol injection,while different dosage groups of alfentanil were anesthetized with different doses of alfentanil combined with propofol.Evaluate the anesthesia effect after the examination is completed.Compare the heart rate(HR),systolic blood pressure(SBP),apnea time,incidence of intolerance to gastroscopy insertion,and adverse reactions in each group.Result:Compared with before administration,SBP and HR in all groups decreased before gastroscopy placement(P<0.01);At 1 minute after gastroscopy insertion,both SBP and HR in the control group increased(P<0.01),while SBP in the N3 and N4 groups decreased(P<0.01),while HR remained unchanged(P>0.05).Both SBP and HR in the N5 group decreased(P<0.01).Compared with before gastroscopy insertion,SBP and HR in the control group,N1,N2,and N3 groups increased 1 minute after gastroscopy insertion(P<0.01),while there was no significant change in SBP and HR in the N4 and N5 groups(P>0.05).The apnea time of different dosage groups of alfentanil was lower than that of the control group(P<0.01),and the apnea time of N5 group was higher than that of N1 group,N2 group,N3 group,and N4 group(P<0.01).There was no significant difference in the Incidence of intolerant reactions during gastroscopy insertion,cough reaction,retching reflex,swallowing reflex and limb movement reaction rate between the six groups(P>0.05);There was no statistically significant difference in the incidence of itching,nausea,vomiting,anxiety,dizziness,drowsiness,diarrhea,and constipation after painless gastroscopy examination among the six groups(P>0.05).Conclusion:The combination of 8ug/kg alfentanil and propofol has a definite anesthesia effect,stable respiratory and circulatory system,and low incidence of adverse reactions when used for painless gastroscopy.展开更多
Objectives: The Foley balloon catheter (FC) is a viable method for cervical ripening, but concerns about infection risk restrict its use in cases of prolonged prelabour rupture of membranes (PROM). This study aims to ...Objectives: The Foley balloon catheter (FC) is a viable method for cervical ripening, but concerns about infection risk restrict its use in cases of prolonged prelabour rupture of membranes (PROM). This study aims to evaluate the efficacy and safety of the FC compared to oral misoprostol for cervical ripening after PROM. Study Design: A retrospective data-analysis of 128 pregnant women was conducted. Of these, 49 underwent cervical ripening with an FC and 79 with oral misoprostol. We included all women with a vital singleton pregnancy at 37 - 42 weeks of gestation who underwent cervical ripening after ≥ 24 hours of PROM in specific time frames in two Dutchsecondary care and teaching hospitals. The primary outcome was the incidence of intrapartum infection, a composite of maternal and neonatal infection. In addition, we evaluated the mode of delivery, duration of priming and priming-to-delivery interval. Secondary endpoints included uterine hyperstimulation, umbilical cord prolapse, birth weight, Apgar scores, length of admission to the neonatal low dependency unit, admission to the (neonatal) Intensive Care Unit (ICU) and mortality. Statistical analyses included bivariate and multivariate techniques. Results: Cervical ripening with FC, compared with oral misoprostol, showed a higher incidence of intrapartum infection, respectively 32.7% (n = 16) vs. 12.7% (n = 10) (p = 0.006). However, after adjusting for epidural anaesthesia and pregestational BMI, the association was no longer significant. No difference was found in mode of delivery and total priming-to-delivery interval (median 21.3 hours vs. 22.0, p = 0.897). Furthermore, FC, compared with oral misoprostol, showed a longer duration of cervical ripening and hence a shorter duration of active labour (p 0.001). Apart from the 1-min Apgar score, secondary maternal and neonatal outcomes did not differ between the groups. Conclusion: In women who require cervical ripening after prolonged PROM at term, the FC and oral misoprostol are similar in terms of efficacy and safety. Advantages associated with the FC are its safe application in women with a history of caesarean section, although we did not study these women, and an implied shorter duration of active labour. Our study adds to the limited available data on the use of the FC after the rupture of membranes and a large randomized controlled trial is needed to strengthen our findings.展开更多
The personal rights are the institute of civil law. They are the subject of legal regulation in Provisions § 11 and follows of Slovak Civil Code. Current legal regulation does not offer their definition, only enu...The personal rights are the institute of civil law. They are the subject of legal regulation in Provisions § 11 and follows of Slovak Civil Code. Current legal regulation does not offer their definition, only enumeration. Therefore, this situation makes good area for discovering if there are the next personal rights which have characteristic nature of this institute. It is important to analyze in which private relationships the personal right has the conditions for its full realization. It is important to discover in which kind of private relationships exist the personal rights which is typical for these relationships. This paper deals with the value of human personality--labour force. In the first part, the paper analyzes the nature of labour force and tries to show that labour force is the next personal right, using the method of analysis, induction, deduction, and synthesis. In the second part of the paper, it is labour force analyzed through its realization in labour relationships. This part of the paper tries to show that labour force is personal right typical for labour relationships, using the methods of analysis, synthesis, and generalization. The third part of the paper tries to evoke the discussion if the labour force is right or value.展开更多
This Paper, taking Nanhai City of Guangdong Province as an example, focuses on five interrelated aspects of the migrant labour force of China in recent year’s. Attention is initially paid to the background of the lab...This Paper, taking Nanhai City of Guangdong Province as an example, focuses on five interrelated aspects of the migrant labour force of China in recent year’s. Attention is initially paid to the background of the labour migration from inland towards coastal area. Then, the demographic characteristics of the migrant labour force are analysed before turning to the analysis on the rare for the migration. Fourthly, the impacts of the migrant workers on the socio-economic development of Nanhai City and the problems are examined. Finally, the prospects and some suggestions for the labour migration are put forward.展开更多
Foetal well-being during labour is of utmost importance. One of the ways to attempt to assess foetal well-being is by recording foetal heart rate (FHR). Loss of variability and deceleration patterns are known to be as...Foetal well-being during labour is of utmost importance. One of the ways to attempt to assess foetal well-being is by recording foetal heart rate (FHR). Loss of variability and deceleration patterns are known to be associated with foetal distress. Decelerations and foetal bradycardia have been described after any type of effective labour analgesia. This review addresses the questions if certain analgesic techniques and/or analgesics lead to clinically relevant FHR changes, what is their aetiology, and how we should manage these FHR changes.展开更多
On the basis of the analytical frame of discrimination, the thesis establishes a model of transfer of rural labour forces into city, and researches the impact of rural labour forces transfer on urban-rural income. The...On the basis of the analytical frame of discrimination, the thesis establishes a model of transfer of rural labour forces into city, and researches the impact of rural labour forces transfer on urban-rural income. The results show that the transfer of rural labour forces into city can increase urban-rural income and bridge the income gap between city and village to a certain extent. However, the capital stock of city in China is greatly more than that of the village, so the rural labour forces transfer cannot eliminate the urban-rural income gap completely. In order to elevate the rural income level in China and narrow urban-rural income gap, the government should paint a picture with two brushes at the same time: on one hand, the government should promote the transfer of rural labour forces into city, and change the status quo of dual urban-rural labour forces market structure; on the other hand, the government should increase the input in rural areas and promote the increase of rural capital stock so as to further increase rural residents' income in the process of labour forces transfer.展开更多
Aim: To evaluate an innovative sonopelvimetry method for early prediction of obstructed labour. Methods: A prospective study was conducted in two centers.GPS-based sonopelvimetry, laborProTM?(Trig Medical Inc., Yoqnea...Aim: To evaluate an innovative sonopelvimetry method for early prediction of obstructed labour. Methods: A prospective study was conducted in two centers.GPS-based sonopelvimetry, laborProTM?(Trig Medical Inc., Yoqneam Ilit, Israel) devise, was used prior to labour in nulliparous women at 39 - 42 weeks gestation remote from labor. Maternal pelvic parameters, including inter-iliac transverse diameter, obstetric conjugate and interspinous diameter were evaluated. Fetal parameters included head station, biparietal diameter and occipitofrontal diameter. Data on delivery and outcome were collected from the electronic files. Results: The innovative use of sonopelvimetry was applied to 154 consecutive women, none of the participants complained of discomfort or complications observed. The mean time of examination was 15 + 2 minutes. Mean time of examination to delivery interval was 4.8 days (range 0 - 16 days). Small interspinous diameter and high head station were the best predictors for obstructed labour. Analysis indicated 87% sensitivity and 61% specificity for birth weight fetal head station and ISD combined in predicting obstructed labour with an area under the curve of 0.77. Conclusions: Our results indicate that GPS-based?sonopelvimetry combined with fetal estimated weight is a valuable tool in the risk assessment of obstructed labour. Parameters obtained by sonopelvimetry combined with birth weight may be useful.展开更多
A study was conducted to describe the experiences of primiparous women with the support they received from their birth companions during labour and delivery in Malawi. The study design was descriptive and utilized qua...A study was conducted to describe the experiences of primiparous women with the support they received from their birth companions during labour and delivery in Malawi. The study design was descriptive and utilized qualitative data collection and analysis method on a sample of 20 primiparous women. The women were recruited from the postnatal ward of Bwaila hospital and were interviewed regarding their experiences on the support they received from their birth companions during labour and delivery using an open ended interview guide. Data was manually analyzed using content analysis. Primiparous women described the support they received from their birth companions as useful and beneficial. Birth companions provided advice, physical, emotional and spiritual support to the women during their labour and delivery. In addition, the birth companions were viewed as guardians of the women during labour and delivery. Results however, show that some women were not properly assisted by their companions because both the mothers and companions lacked knowledge on birth companionship. The results further show that birth companions play important roles during the birth and delivery of primiparous women and thereby improving birth outcomes. Therefore, there is a need to train the companions regarding support to a woman during labour and delivery. Primiparous women also need to be trained during antenatal care education so that they properly understand the roles of a birth companion as opposed to those of the midwives.展开更多
BACKGROUND Laparoscopic cervical cerclage is performed for patients with abnormal cervical anatomy and/or transvaginal cervical cerclage failure.However,the method of removing the stitches to allow labour induction re...BACKGROUND Laparoscopic cervical cerclage is performed for patients with abnormal cervical anatomy and/or transvaginal cervical cerclage failure.However,the method of removing the stitches to allow labour induction remains controversial.According to published literature,stitches are removed through laparoscopic or transvaginal methods.Herein,we report,for the first time,a case of a patient who had undergone laparoscopic cerclage,and then underwent removal of stitches by laparotomy and labour induction in the third trimester of pregnancy.CASE SUMMARY A patient who underwent laparoscopic cervical cerclage due to cervical insufficiency became pregnant naturally following the operation.At 31 wk of pregnancy,severe foetal malformations were found.To successfully induce labour,cerclage stitches were removed via laparotomy,and rivanol was injected directly into the uterus.Following successful induction of labour,the patient delivered a dead foetus.CONCLUSION This report provides a reliable scheme of removing cerclage stitches for patients who have undergone laparoscopic cerclage but experience severe foetal malformations.展开更多
Increasing the labour force participation rates of older workers is a fundamental component of most OECD (Organization for Economic Cooperation and Development) countries' response to the fiscal pressures associate...Increasing the labour force participation rates of older workers is a fundamental component of most OECD (Organization for Economic Cooperation and Development) countries' response to the fiscal pressures associated with ageing populations. Both pension reform and employment policies are key elements to achieving such increases in participation and reversing the early retirement trends of recent decades. Econometric modeling results from a panel of 12 OECD countries indicate that labour market variables have a greater influence than social security pension value or the standard age of retirement on the labour force participation rates of males aged 55-64 years. Further results from modeling the potential asymmetric response of participation rates to unemployment rates indicate that a decrease in unemployment rates has a greater impact upon increasing the labour force participation rates of older workers compared to the effect of an increase on unemployment rates has on discouraging participation. We found mixed results for the asymmetric response of participation to an increase or decrease in pension value. Findings thus emphasize the importance of labour market oriented policies to reduce unemployment rates in the developed economies in coming years to address ageing population concerns.展开更多
The economic reform launched in the People's Republic of China(China) led to a rapid growth in non-state sectors.Various forms of corporate governances and ownerships emerged during the last two decades,especially...The economic reform launched in the People's Republic of China(China) led to a rapid growth in non-state sectors.Various forms of corporate governances and ownerships emerged during the last two decades,especially the Township and Village Enterprises owned by local residents.This article is conducted on the changing labour relations in Chinese Township and Village Enterprises(TVEs) despite their increasing contributions to China's transition from planned economy to market economy,and studies the labour market and the Labour Law to understand the unique labour mobility and to test the relationship between Human Resource Management(HRM) practice and the performance among TVEs.展开更多
Epidural catheterization is routinely used by anaesthesiologists to provide labour and post-operative analgesia. In most cases, catheter placement is without serious side effects and uneventful. However, epidural absc...Epidural catheterization is routinely used by anaesthesiologists to provide labour and post-operative analgesia. In most cases, catheter placement is without serious side effects and uneventful. However, epidural abscess is a rare complication that may result in severe morbidity. We present a case of epidural abscess after labour epidural catheter placement in a healthy 36-year-old female who presented on post-partum d 10 with complaints of fever and back pain. She was treated with intravenous antibiotics and fully recovered.展开更多
文摘Background: Aortic dissection (AD) is a relatively rare but dreadful illness, often accompanied by severe, sharp (or tearing) back pain or anterior chest pain, as well as acute hemodynamic compromise. Painless dissection has also been reported in rare cases and might be misdiagnosed due to its atypical symptoms leading to catastrophic outcomes. Case presentation: The patient was admitted to the hospital due to right limb weakness with speech inability for more than 10 hours. In the routine cardiac ultrasound examination, the avulsion intimal echo was found in the initial segment of the descending aorta. The rupture range was about 11 mm, and the lumen was separated into real and false lumen. Further computed tomography angiography (CTA) examination confirmed the major arterial dissection (De Bakey Type I). Conclusion: We report a case of painless aortic dissection with active carotid artery thrombosis diagnosed by ultrasound and CTA, and to improve the understanding of painless aortic dissection by reviewing relevant domestic and foreign literature.
文摘Objective:To observe the effects of remimazolam benzenesulfonate combined with alfentanil during painless gastroenteroscopy in elderly patients.Methods:This study analyzes patients aged 60–85 years old undergoing painless gastroenteroscopy.A total of 140 patients,examined between February 2023 and February 2024,voluntarily participated and were randomly divided into an experimental group and a control group.The control group received alfentanil combined with propofol for anesthesia,while the experimental group received alfentanil combined with remimazolam benzenesulfonate.The relevant indices of both groups were separately analyzed.Results:Patients in the experimental group had a shorter awakening time,a faster discharge rate(P<0.05),and a shorter examination duration;however,the difference in examination time between the two groups was not statistically significant(P>0.05).Before anesthesia,there was no significant difference in the basic information and vital signs of the two groups(P>0.05).Two minutes after anesthesia,both groups showed a decline in vital signs,but the vital signs of the experimental group remained more stable after the procedure,with the group’s indices showing improvement over the control group(P<0.05).Additionally,the incidence of adverse reactions in the experimental group was lower than in the control group(P<0.05).Conclusion:In painless gastroenteroscopy for elderly patients,anesthesia using a combination of remimazolam benzenesulfonate and alfentanil improves anesthesia effectiveness,hastens patient recovery,enhances the stability of vital signs,and effectively controls adverse reactions,thereby improving patient comfort.
文摘This article reports two cases of painless thyroiditis with special manifestations. Patient 1 was a 76-year-old female patient who presented with palpitations and chest tightness and was diagnosed with hyperthyroidism by thyroid ultrasound and electrocardiogram, which is a painless thyroiditis with atrial fibrillation as the first symptom. Patient 2 is a 44-year-old male patient, with only palpitations, diagnosed as T3 thyroiditis by liver function and thyroid function tests, and accompanied by abnormal liver function, belonging to the painless thyroiditis with elevated FT3 only. This article points out that painless thyroiditis has multiple manifestations and is easily misdiagnosed as other diseases. Therefore, patients with symptoms such as palpitations and chest tightness should undergo cytologic or pathologic examination in time to avoid missed diagnosis and misdiagnosis.
文摘Caesarean section is dramatically increased throughout the world in recent years. Rupture of the uterus is a devastating complication in trial of labour following previous Caesarean section. Evidence suggests that the size of the uterine scar and the residual myometrial thickness (RMT) are associated directly with the risk of uterine rupture and risk of dehiscence in subsequent deliveries. Impact of the prelabour and labour Cesarean section on the RMT has not been studied in detail. Objectives: To compare RMT, Caesarean scar defects and to evaluate the elasticity of the Caesarean scar between women who underwent prelabour and labour Caesarean sections. Methods: This was a Cross sectional analytical study. Women who underwent Caesarean section in their first pregnancy were recruited. Sample was stratified to prelabour and labour Caesarean section groups. Transvaginal ultrasound scan was performed six months following the Caesarean section. Dimensions of the uterus, uterine scar defect, RMT and elastosonography of the uterine scar were assessed. Results: A total of 240 postpartum women were analyzed. Uterine niche was detectable in 194 subjects. Prelabour CS group had demonstrated 91.7% (n = 110) scar defects (uterine niche) out of 120 cases and the rate among labour CS group was 70% (n = 84). There was a significant difference in the presence of uterine niche among 2 groups as Prelabour group was found to have more scar defects (p mm (SD 1.2) and 4.99 mm (SD 1.3) respectively and there was no significant difference (t = 0.38, p = 0.71). There was no significant difference between the dimensions of the uterine CS defects of the studied groups. Prelabour CS group had significantly higher Target strain [0.28 vs. 0.24 (t = 2.12, p = 0.04)] and significantly less strain ratio [1.45 vs. 1.55 (t -2.42, p = 0.04)] than labour CS group indicating a better scar in prelabour group. Conclusion: There was no significant difference in RMT and uterine scar defects between prelabour and labour Caesarean section groups. But prelabour Caesarean section scars were less stiff than labour Caesarean section scars. Further studies are warranted to elaborate on the association.
文摘This article analyses the determinants of young women’s participation in the labour market. For this purpose, the Employment Policy Enhancement Survey (EAPE), conducted by the Laboratoire de Recherches et d’Etudes Economiques et Sociales (LARES) in collaboration with CERDI in 2018 was used as the database. The results of Gallant and Nychka’s (1987) semi-nonparametric procedure show that health status, household size, marital status, and educational attainment are explanatory factors of young women’s labour market participation in Congo.
基金Supported by Xiamen Medical and Health Guidance Project Section,No.3502Z20224ZD1169Xiamen sixth batch of TCM Reserve Talent Training Project,No.136,2022.
文摘BACKGROUND Painless gastroscopy is a widely used diagnostic and therapeutic technology in clinical practice.Propofol combined with opioids is a common drug for painless endoscopic sedation and anaesthesia.In clinical work,adverse drug reactions of anaesthesia schemes are often one of the important areas of concern for doctors and patients.With the increase in propofol dosage,the risk of serious adverse drug reactions,such as respiratory depression and hypotension,increases significantly;the use of opioids often causes gastrointestinal reactions in patients after examination,such as nausea,vomiting,delayed recovery of gastrointestinal function and other complications,which seriously affect their quality of life.AIM To observe the effect of wrist-ankle acupuncture therapy on the anaesthesia regimen and anaesthesia-related complications during and after painless gastroscopy examination.METHODS Two hundred patients were selected and randomly divided into a treatment group(n=100)and a control group(n=100).Both groups were routinely anaesthetized with the nalbuphine and propofol regimen,gastroscopy began after the patient lost consciousness,and given supportive treatment and vital sign monitoring.If the patient interrupted the surgery due to intraoperative torsion,intravenous propofol was used to relieve his or her discomfort.The treatment group received wrist-ankle acupuncture on this basis.RESULTS The general data before treatment,American Society of Anesthesiologist(ASA)grade and operation time between the two groups was no significant difference.The Wakeup time,and the Selfambulation time in the treatment group was significantly faster than that in the control group(P<0.05).The total dose of propofol in the treatment group was 109±8.17 mg,significantly lower than that in the control group(P<0.05).The incidence of respiratory depression and hypotension was not significantly different,but the incidence of hiccups was significantly lower than that in the control group(P<0.05).After the examination,the incidence of nausea,vomiting,abdominal distension,and abdominal pain was 11%,8%,6%,and 5%,respectively,which was significantly lower than that in the control group(P<0.05).In addition,both the operators and the patients were more satisfied with this examination,with no significant difference between the groups(P>0.05).CONCLUSION Wrist-ankle acupuncture treatment can optimize the painless gastroscopy and anaesthesia scheme,reduces propofol total dose;shortens patient Wakeup time and Self-ambulation time,improves patient compliance and tolerance,is beneficial to clinical application.
基金Supported by Xiamen Municipal Science and Technology Bureau Municipal Medical and Health Guidance Project,No.3502Z20224ZD1169Joint project of Natural Science Foundation of Xiamen Municipal Bureau of Science and Technology,No.3502Z20227368The Sixth Batch of Chinese Medicine Reserve Talent Training Project in Xiamen(Xiamen Municipal Health Commission Traditional Chinese Medicine),No.[2022]No.136.
文摘BACKGROUND Painless gastroenteroscopy is a widely developed diagnostic and treatment technology in clinical practice.It is of great significance in the clinical diagnosis,treatment,follow-up review and other aspects of gastric cancer patients.The application of anesthesia techniques during manipulation can be effective in reducing patient fear and discomfort.In clinical work,the adverse drug reactions of anesthesia regimens and the risk of serious adverse drug reactions are increased with the increase in propofol application dose application dose;the application of opioid drugs often causes gastrointestinal reactions,such as nausea,vomiting and delayed gastrointestinal function recovery,after examination.These adverse effects can seriously affect the quality of life of patients.AIM To observe the effect of modified ShengYangYiwei decoction on gastrointestinal function,related complications and immune function in patients with gastric cancer during and after painless gastroscopy.METHODS A total of 106 patients with gastric cancer,who were selected from January 2022 to September 2022 in Xiamen Traditional Chinese Medicine Hospital for painless gastroscopy,were randomly divided into a treatment group(n=56)and a control group(n=50).Before the examination,all patients fasted for 8 h,provided their health education,and confirmed if there were contraindications to anesthesia and gastroscopy.During the examination,the patients were placed in the left decubitus position,the patients were given oxygen through a nasal catheter(6 L/min),the welling needle was opened for the venous channel,and a multifunction detector was connected for monitoring electrocardiogram,oxygen saturation,blood pressure,etc.Naporphl and propofol propofol protocols were used for routine anesthesia.Before anesthesia administration,the patients underwent several deep breathing exercises,received intravenous nalbuphine[0.nalbuphine(0.025 mg/kg)],followed by intravenous propofol[1.propofol(1.5 mg/kg)]until the palpebral reflex disappeared,and after no response,gastroscopy was performed.If palpebral reflex disappeared,and after no response,gastroscopy was performed.If any patient developed movement,frowning,or hemodynamic changes during the operation(heart rate changes during the operation(heart rate increased to>20 beats/min,systolic blood pressure increased to>20%of the base value),additional propofol[0.propofol(0.5 mg/kg)]was added until the patient was sedated again.The patients in the treatment group began to take the preventive intervention of Modified ShengYangYiwei decoction one week before the examination,while the patients in the control group received routine gastrointestinal endoscopy.The patients in the two groups were examined by conventional painless gastroscopy,and the characteristics of the painless gastroscopies of the patients in the two groups were recorded and compared.These characteristics included the total dosage of propofol during the examination,the incidence of complications during the operation,the time of patients'awakening,the time of independent activities,and the gastrointestinal function of the patients after examination,such as the incidence of reactions such as malignant vomiting,abdominal distension and abdominal pain,as well as the differences in the levels of various immunological indicators and inflammatory factors before anesthesia induction(T0),after conscious extubation(T1)and 24 h after surgery(T2).RESULTS There was no difference in the patients’general information,American Society of Anesthesiologist classification or operation time between the two groups before treatment.In terms of painless gastroscopy,the total dosage of propofol in the treatment group was lower than that in the control group(P<0.05),and the time of awakening and autonomous activity was significantly faster than that in the control group(P<0.05).During the examination,the incidence of hypoxemia,hypotension and hiccups in the treatment group was significantly lower than that in the control group(P<0.01).In terms of gastrointestinal function,the incidences of nausea,vomiting,abdominal distension and abdominal pain in the treatment group after examination were significantly lower than those in the control group(P<0.01).In terms of immune function,in both groups,the number of CD4+and CD8+cells decreased significantly(P<0.05),and the number of natural killer cells increased significantly(P<0.05)at T1 and T2,compared with T0.The number of CD4+and CD8+cells in the treatment group at the T1 and T2 time points was higher than that in the control group(P<0.05),while the number of natural killer cells was lower than that in the control group(P<0.05).In terms of inflammatory factors,compared with T0,the levels of interleukin(IL)-6 and tumor necrosis factor-alpha in patients in the two groups at T1 and T2 increased significantly and then decreased(P<0.05).The level of IL-6 at T1 and T2 in the treatment group was lower than that in the control group(P<0.05).CONCLUSION The preoperative use of modified ShengYangYiwei decoction can optimize the anesthesia program during painless gastroscopy,improve the gastrointestinal function of patients after the operation,reduce the occurrence of examination-related complications.
基金Supported by Zhejiang Traditional Chinese Medicine Science and Technology Plan,No.2023ZL449.
文摘BACKGROUND Breast abscess during lactation is a severe complication of acute mastitis,which can lead to discomfort,high fever,breast fistula,sepsis,septic shock,breast damage,disease persistence and frequent hospitalization.Breast abscesses may also lead the mother to discontinue breastfeeding,thereby harming the infant’s health.The predominant pathogenic bacteria are Staphylococcus aureus,Staphylococcus epidermidis and Streptococcus.The incidence of breastfeeding abscesses in breastfeeding women ranges between 4.0%and 11.0%.In cases of breast abscess,the rate of cessation of lactation is 41.0%.In instances of breast fistula,the rate of cessation of lactation is very high(66.7%).Furthermore,50.0%of women with breast abscesses must be hospitalized and treated with intravenous antibiotics.Treatment includes antibiotics,abscess puncture and surgical incision and drainage.The patients suffer from stress,pain and easily induced breast scarring;the disease’s progression is prolonged and recurrent,interfering with infant feeding.Consequently,it is crucial to discover an adequate cure.CASE SUMMARY A 28-year-old woman with a breast abscess was treated with Gualou Xiaoyong decoction and painless breast opening manipulation 24 d after cesarean delivery.On the 2nd d of treatment,the patient’s breast mass was significantly reduced,the pain was significantly reduced,and the general asthenia was improved.All conscious symptoms disappeared after 3 d,breast abscesses faded after 12 d of treatment,inflammation images disappeared after 27 d,and normal lactation images were restored.CONCLUSION In treating breast abscesses during breastfeeding,the combination of Gualou Xiaoyong decoction and painless lactation provides a positive therapeutic impact.This disease’s treatment offers the advantages of a short course of treatment,no need to discontinue breastfeeding and the ability to rapidly mitigate symptoms,which can be used as a reference in clinical practice.
基金Hubei Chen Xiaoping Science and Technology Development Foundation for Perioperative analgesic Afentanil Special Fund(No.CXPJJH12000010)Health Industry Research Project of Hainan Province(No.20A200263)。
文摘Objective:To observe the Effective dose and safety of different doses of alfentanil combined with propofol in painless gastroscopy.Method:240 patients who underwent painless gastric examination from January 2021 to December 2021 were randomly divided into a control group and a different dose group of alfentanil(N1 group,N2 group,N3 group,N4 group,and N5 group,with injection doses of 5,6,7,8,and 10ug/kg,respectively)using a number table method,with 40 patients in each group.The control group was anesthetized with propofol injection,while different dosage groups of alfentanil were anesthetized with different doses of alfentanil combined with propofol.Evaluate the anesthesia effect after the examination is completed.Compare the heart rate(HR),systolic blood pressure(SBP),apnea time,incidence of intolerance to gastroscopy insertion,and adverse reactions in each group.Result:Compared with before administration,SBP and HR in all groups decreased before gastroscopy placement(P<0.01);At 1 minute after gastroscopy insertion,both SBP and HR in the control group increased(P<0.01),while SBP in the N3 and N4 groups decreased(P<0.01),while HR remained unchanged(P>0.05).Both SBP and HR in the N5 group decreased(P<0.01).Compared with before gastroscopy insertion,SBP and HR in the control group,N1,N2,and N3 groups increased 1 minute after gastroscopy insertion(P<0.01),while there was no significant change in SBP and HR in the N4 and N5 groups(P>0.05).The apnea time of different dosage groups of alfentanil was lower than that of the control group(P<0.01),and the apnea time of N5 group was higher than that of N1 group,N2 group,N3 group,and N4 group(P<0.01).There was no significant difference in the Incidence of intolerant reactions during gastroscopy insertion,cough reaction,retching reflex,swallowing reflex and limb movement reaction rate between the six groups(P>0.05);There was no statistically significant difference in the incidence of itching,nausea,vomiting,anxiety,dizziness,drowsiness,diarrhea,and constipation after painless gastroscopy examination among the six groups(P>0.05).Conclusion:The combination of 8ug/kg alfentanil and propofol has a definite anesthesia effect,stable respiratory and circulatory system,and low incidence of adverse reactions when used for painless gastroscopy.
文摘Objectives: The Foley balloon catheter (FC) is a viable method for cervical ripening, but concerns about infection risk restrict its use in cases of prolonged prelabour rupture of membranes (PROM). This study aims to evaluate the efficacy and safety of the FC compared to oral misoprostol for cervical ripening after PROM. Study Design: A retrospective data-analysis of 128 pregnant women was conducted. Of these, 49 underwent cervical ripening with an FC and 79 with oral misoprostol. We included all women with a vital singleton pregnancy at 37 - 42 weeks of gestation who underwent cervical ripening after ≥ 24 hours of PROM in specific time frames in two Dutchsecondary care and teaching hospitals. The primary outcome was the incidence of intrapartum infection, a composite of maternal and neonatal infection. In addition, we evaluated the mode of delivery, duration of priming and priming-to-delivery interval. Secondary endpoints included uterine hyperstimulation, umbilical cord prolapse, birth weight, Apgar scores, length of admission to the neonatal low dependency unit, admission to the (neonatal) Intensive Care Unit (ICU) and mortality. Statistical analyses included bivariate and multivariate techniques. Results: Cervical ripening with FC, compared with oral misoprostol, showed a higher incidence of intrapartum infection, respectively 32.7% (n = 16) vs. 12.7% (n = 10) (p = 0.006). However, after adjusting for epidural anaesthesia and pregestational BMI, the association was no longer significant. No difference was found in mode of delivery and total priming-to-delivery interval (median 21.3 hours vs. 22.0, p = 0.897). Furthermore, FC, compared with oral misoprostol, showed a longer duration of cervical ripening and hence a shorter duration of active labour (p 0.001). Apart from the 1-min Apgar score, secondary maternal and neonatal outcomes did not differ between the groups. Conclusion: In women who require cervical ripening after prolonged PROM at term, the FC and oral misoprostol are similar in terms of efficacy and safety. Advantages associated with the FC are its safe application in women with a history of caesarean section, although we did not study these women, and an implied shorter duration of active labour. Our study adds to the limited available data on the use of the FC after the rupture of membranes and a large randomized controlled trial is needed to strengthen our findings.
文摘The personal rights are the institute of civil law. They are the subject of legal regulation in Provisions § 11 and follows of Slovak Civil Code. Current legal regulation does not offer their definition, only enumeration. Therefore, this situation makes good area for discovering if there are the next personal rights which have characteristic nature of this institute. It is important to analyze in which private relationships the personal right has the conditions for its full realization. It is important to discover in which kind of private relationships exist the personal rights which is typical for these relationships. This paper deals with the value of human personality--labour force. In the first part, the paper analyzes the nature of labour force and tries to show that labour force is the next personal right, using the method of analysis, induction, deduction, and synthesis. In the second part of the paper, it is labour force analyzed through its realization in labour relationships. This part of the paper tries to show that labour force is personal right typical for labour relationships, using the methods of analysis, synthesis, and generalization. The third part of the paper tries to evoke the discussion if the labour force is right or value.
文摘This Paper, taking Nanhai City of Guangdong Province as an example, focuses on five interrelated aspects of the migrant labour force of China in recent year’s. Attention is initially paid to the background of the labour migration from inland towards coastal area. Then, the demographic characteristics of the migrant labour force are analysed before turning to the analysis on the rare for the migration. Fourthly, the impacts of the migrant workers on the socio-economic development of Nanhai City and the problems are examined. Finally, the prospects and some suggestions for the labour migration are put forward.
文摘Foetal well-being during labour is of utmost importance. One of the ways to attempt to assess foetal well-being is by recording foetal heart rate (FHR). Loss of variability and deceleration patterns are known to be associated with foetal distress. Decelerations and foetal bradycardia have been described after any type of effective labour analgesia. This review addresses the questions if certain analgesic techniques and/or analgesics lead to clinically relevant FHR changes, what is their aetiology, and how we should manage these FHR changes.
基金Supported by the Start-up Projects of Scientific Research of China West Normal University
文摘On the basis of the analytical frame of discrimination, the thesis establishes a model of transfer of rural labour forces into city, and researches the impact of rural labour forces transfer on urban-rural income. The results show that the transfer of rural labour forces into city can increase urban-rural income and bridge the income gap between city and village to a certain extent. However, the capital stock of city in China is greatly more than that of the village, so the rural labour forces transfer cannot eliminate the urban-rural income gap completely. In order to elevate the rural income level in China and narrow urban-rural income gap, the government should paint a picture with two brushes at the same time: on one hand, the government should promote the transfer of rural labour forces into city, and change the status quo of dual urban-rural labour forces market structure; on the other hand, the government should increase the input in rural areas and promote the increase of rural capital stock so as to further increase rural residents' income in the process of labour forces transfer.
文摘Aim: To evaluate an innovative sonopelvimetry method for early prediction of obstructed labour. Methods: A prospective study was conducted in two centers.GPS-based sonopelvimetry, laborProTM?(Trig Medical Inc., Yoqneam Ilit, Israel) devise, was used prior to labour in nulliparous women at 39 - 42 weeks gestation remote from labor. Maternal pelvic parameters, including inter-iliac transverse diameter, obstetric conjugate and interspinous diameter were evaluated. Fetal parameters included head station, biparietal diameter and occipitofrontal diameter. Data on delivery and outcome were collected from the electronic files. Results: The innovative use of sonopelvimetry was applied to 154 consecutive women, none of the participants complained of discomfort or complications observed. The mean time of examination was 15 + 2 minutes. Mean time of examination to delivery interval was 4.8 days (range 0 - 16 days). Small interspinous diameter and high head station were the best predictors for obstructed labour. Analysis indicated 87% sensitivity and 61% specificity for birth weight fetal head station and ISD combined in predicting obstructed labour with an area under the curve of 0.77. Conclusions: Our results indicate that GPS-based?sonopelvimetry combined with fetal estimated weight is a valuable tool in the risk assessment of obstructed labour. Parameters obtained by sonopelvimetry combined with birth weight may be useful.
文摘A study was conducted to describe the experiences of primiparous women with the support they received from their birth companions during labour and delivery in Malawi. The study design was descriptive and utilized qualitative data collection and analysis method on a sample of 20 primiparous women. The women were recruited from the postnatal ward of Bwaila hospital and were interviewed regarding their experiences on the support they received from their birth companions during labour and delivery using an open ended interview guide. Data was manually analyzed using content analysis. Primiparous women described the support they received from their birth companions as useful and beneficial. Birth companions provided advice, physical, emotional and spiritual support to the women during their labour and delivery. In addition, the birth companions were viewed as guardians of the women during labour and delivery. Results however, show that some women were not properly assisted by their companions because both the mothers and companions lacked knowledge on birth companionship. The results further show that birth companions play important roles during the birth and delivery of primiparous women and thereby improving birth outcomes. Therefore, there is a need to train the companions regarding support to a woman during labour and delivery. Primiparous women also need to be trained during antenatal care education so that they properly understand the roles of a birth companion as opposed to those of the midwives.
文摘BACKGROUND Laparoscopic cervical cerclage is performed for patients with abnormal cervical anatomy and/or transvaginal cervical cerclage failure.However,the method of removing the stitches to allow labour induction remains controversial.According to published literature,stitches are removed through laparoscopic or transvaginal methods.Herein,we report,for the first time,a case of a patient who had undergone laparoscopic cerclage,and then underwent removal of stitches by laparotomy and labour induction in the third trimester of pregnancy.CASE SUMMARY A patient who underwent laparoscopic cervical cerclage due to cervical insufficiency became pregnant naturally following the operation.At 31 wk of pregnancy,severe foetal malformations were found.To successfully induce labour,cerclage stitches were removed via laparotomy,and rivanol was injected directly into the uterus.Following successful induction of labour,the patient delivered a dead foetus.CONCLUSION This report provides a reliable scheme of removing cerclage stitches for patients who have undergone laparoscopic cerclage but experience severe foetal malformations.
文摘Increasing the labour force participation rates of older workers is a fundamental component of most OECD (Organization for Economic Cooperation and Development) countries' response to the fiscal pressures associated with ageing populations. Both pension reform and employment policies are key elements to achieving such increases in participation and reversing the early retirement trends of recent decades. Econometric modeling results from a panel of 12 OECD countries indicate that labour market variables have a greater influence than social security pension value or the standard age of retirement on the labour force participation rates of males aged 55-64 years. Further results from modeling the potential asymmetric response of participation rates to unemployment rates indicate that a decrease in unemployment rates has a greater impact upon increasing the labour force participation rates of older workers compared to the effect of an increase on unemployment rates has on discouraging participation. We found mixed results for the asymmetric response of participation to an increase or decrease in pension value. Findings thus emphasize the importance of labour market oriented policies to reduce unemployment rates in the developed economies in coming years to address ageing population concerns.
文摘The economic reform launched in the People's Republic of China(China) led to a rapid growth in non-state sectors.Various forms of corporate governances and ownerships emerged during the last two decades,especially the Township and Village Enterprises owned by local residents.This article is conducted on the changing labour relations in Chinese Township and Village Enterprises(TVEs) despite their increasing contributions to China's transition from planned economy to market economy,and studies the labour market and the Labour Law to understand the unique labour mobility and to test the relationship between Human Resource Management(HRM) practice and the performance among TVEs.
文摘Epidural catheterization is routinely used by anaesthesiologists to provide labour and post-operative analgesia. In most cases, catheter placement is without serious side effects and uneventful. However, epidural abscess is a rare complication that may result in severe morbidity. We present a case of epidural abscess after labour epidural catheter placement in a healthy 36-year-old female who presented on post-partum d 10 with complaints of fever and back pain. She was treated with intravenous antibiotics and fully recovered.