简介：AbstractThe obstetric issues and management styles in China are different from that in Western countries. Chinese medical education, residency training, obstetric care structure, and management of common obstetric complications are briefly reviewed and compared to the United States. Maternal-fetal medicine (MFM) is rapidly developing in China, but the development of MFM may not follow the same trajectory as in the West. Understanding the difference between China and the West may facilitate communication and foster mutual development.

简介：AbstractSince the 1970s, electronic fetal monitoring (EFM) also known as cardiotocography (CTG) has been used extensively in labor around the world, despite its known failure to help prevent many babies from developing neonatal encephalopathy and cerebral palsy. Part of EFM’s poor performance with respect to these outcomes arises from a fundamental misunderstanding of the differences between screening and diagnostic tests, subjective classifications of fetal heart rate (FHR) patterns that lead to large inter-observer variability in its interpretation, failure to appreciate early stages of fetal compromise, and poor statistical modeling for its use as a screening test. We have developed a new approach to the practice and interpretation of EFM called the fetal reserve index (FRI) which does the following: (1) breaking FHR components down into 4 components, (heart rate, variability, accelerations, and decelerations); (2) contextualizing the metrics by adding increased uterine activity; (3) adding specific maternal, fetal, and obstetric risk factors. The result is an eight-point scoring metric that, when directly compared with current American College of Obstetricians and Gynecologists EFM categories, even in version 1.0 with equal weighting of variables, shows that the FRI has performed much better for identifying cases at risk before damage had occurred, reducing the need for emergency deliveries, and lowering overall Cesarean delivery rates. With increased data, we expect further refinements in the specifics of scoring that will allow even earlier detection of compromise in labor.

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简介：<正>产科超声检查高度依赖操作者技术水平,胎儿异常的发现取决于操作者的受训程度和操作技巧。英国胎儿医学基金会(FetalMedicineFoundation),即FMF,是由Nicolaides教授于1996年创建,致力于促进胎儿医学研究和培训的非赢利性慈善机构。

简介：AbstractVenous thromboembolism (VTE) is a leading cause of maternal morbidity and mortality though with low rates. Compared to non-pregnant women of comparable age, women during pregnancy have five- to ten-fold increased risk of VTE, additional risk factors for VTE during pregnancy include a personal history of thrombosis, the presence of a thrombophilia, cesarean delivery, obesity, hypertension, preeclampsia, autoimmune disease, heart disease, sickle cell disease and multiple gestation. Thus, early clinical evaluation, preferably in peri-conceptional period, is crucial for VTE risk detection and, thus, for prophylaxis decision making. VTE thromboprophylaxis brought significant advantages in pregnancy outcomes and maternal deaths. Common pharmacological and mechanical forms of thromboprophylaxis includes heparin compounds, anti-embolic stockings and intermittent pneumatic compression devices. Low-molecular-weight heparin as first line strategy. Current guidelines or expert opinions on VTE treatment or prophylaxis during pregnancy diverge significantly. High quality research in this area is still needed, and China needs to develop its own VTE guidelines. Importantly, absolute risks and potential benefits of VTE thromboprophylaxis should be evaluated to make the best decisions on VTE screening, prevention, and treatment.

简介：ＴＨＥ“ＣＡＴＥＲＰＩＬＬＡＲＡＮＤＨＥＲＢ”ＩＮＣＨＩＮＥＳＥＭＥＤＩＣＩＮＥＡＮＤＩＮＭＥＳＯＰＯＴＡＭＩＡＮＭＥＤＩＣＩＮＥＷｕＹｕｈｏｎｇ，ＩＨＡＣＳｃｕｒｌｏｃｋｉｎＮＡＢＵ９５／１１０ｄｉｓｃｕｓｅｓａｎｉｎｔｅｒｅｓｔｉｎｇＭｅｓｏ...

简介：AbstractObjective:To build a reference fetal growth chart for the Chinese population based on fetal ultrasound measurements.Methods:This was a multicenter, population-based retrospective cohort study. Longitudinal ultrasound measurement data were collected from 24 hospitals in 18 provinces of China from 1st September through 31st October of 2019. The estimated fetal weight (EFW) was calculated based on head circumference, abdominal circumference, and femur length using Hadlock formula 3. Fetal growth curves were estimated using a two-level linear regression model with cubic splines. All participants were divided into two groups: the northern group (n = 5829) and the southern group (n = 3246) based on the geographical division of China and male fetus group (n = 4775) and female fetus group (n = 4300) based on fetal gender. The EFW was compared by fetal gender and geographical group. All statistical models were adjusted for maternal sociodemographic characteristics.Results:A total of 9075 participants with 31,700 ultrasound measurement records were included in this study. Male fetuses demonstrated significantly larger EFW compared to female ones starting at 16 weeks of gestation and extending to delivery (global test P < 0.01). The overall geographic difference in EFW was significant (global test P = 0.03), and week-specific comparisons showed that the northern group had a greater EFW starting at 15 weeks of gestation and extending to 29 weeks of gestation, although this difference did not extend to the time of delivery. The Z-score of EFW confirmed that our Chinese fetal growth charts differed from previously published standards.Conclusion:This study provides EFW and ultrasound biometric reference measurements for Chinese fetuses and reveals differences from other fetal growth charts. The chart is worth promoting in more regions of China but should be tested prudently before use.

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简介：Weexperimentallydemonstratetwokindsofallfew-modefiber(FMF)ringlaserswithhigh-ordermode(HOM)oscillationinthelasercavity.Onekindisaswitchable-wavelengthall-FMFHOMlaserwithanoutputoftunableopticalvortexbeams(OVBs);theotherisaQ-switchedall-FMFHOMlaserwithanoutputofpulsedcylindricalvectorbeams(CVBs).Thelasersarecomposedofall-FMFcomponentsandfew-modeerbium-dopedfiber.ASagnacinterferometermadeofa3dBFMFcouplerfunctionsasthewavelengthselector,andswitchablemultiwavelengthtunableOVBsareexperimentallyrealized.Carbonnanotube-basedsaturableabsorbersandthenonlinearpolarizationrotationtechniqueareusedtoachieveQ-switchedCVBlasers.Thisisthefirstreport,toourknowledge,onthegenerationofswitchable-wavelengthandQ-switchedHOMbeamsinall-FMFlasercavities.

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简介：我们有句俗话说：笑一笑，十年少!笑使人年轻，使人开朗，使人豁达。在医学界，笑已经作为一种治疗的手段……LaughterIstheBestMedicine.不再仅仅是西方的一句谚语。

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简介：你是不是对弥漫在中医馆里那股清香中带点微苦的气味印象深刻呢？当你走进兰溪市实验小学的校园，也能闻到这种独特的味道。

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简介：TibetanmedicinecompaniesinT.A.Rcanmanufacturemorethan360Tibetanpatentmedicines.Thereare18TibetanmedicinefactoriesinTibet,andtotaloutvalueexceeds3billionyuan.24kindsofTibetanpatentmedicineshavebeenincorporatedintoStateFundamentalMedicineList,inwhich14Tibetanpatentmedicinesarelistedinnationalprotectedtraditionalmedicinecategory.

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