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2018 Vol. 48, No. 6 Published: 2018-06-25   391 The effects of Cas9 knockout YAP1 gene on proliferation and migration capacity of pancreatic carcinoma cell L3.6 CHEN Qianjie, ZHANG Jinsan, GUO Qiang, DONG Jinglai, GUO Lisha, LI Xiaokun Objective: To investigate the effects of YAP1 on proliferation and migration in pancreatic cancer cells. Methods: CRISPR-Cas9 technique was used to knockout the YAP1 gene in human pancreatic cancer L3.6 cells, and Western blot was used to verify it. The proliferation ability of L3.6 cells before and after YAP1 knockout was detected by MTT colorimetry and EdU flow cytometry. The migration ability was measured by cells scratch and Transwell assay. Results: The L3.6 stable cell lines of YAP1 knockout (YAP1-KO) were successfully obtained. Compared with wild type L3.6 cell lines, the proliferation and growth abilities of YAP1-KO cells were significantly decreased, and the invasion ability of cells was also decreased. Conclusion: Knockout of YAP1 gene can significantly reduce the proliferation and migration abilities of pancreatic cancer L3.6 cells, which might provide a new potential target for targeted therapy of pancreatic cancer. 2018 Vol. 48 (6): 391-395，400 [Abstract] ( 911 ) HTML (1 KB)  PDF (1868 KB)  ( 795 ) 396 Prognostic information extract from CT images of patients with liver cancer using two-dimensional lattice complexity WU Ruixia, ZHANG Zirui, CHEN Yubin, YE Suzhe, Zheng Minghua, KE Daguan Objective: To verify whether the two-dimensional (2-D) lattice complexity algorithm can effectively extract hidden prognostic information in some medical images. Methods: The preoperative abdominal CT images of 92 patients with hepatocellular carcinoma (HCC) were converted into binary images with a size of 32×32 pixels and then into one-dimensional binary symbolic sequence by using two-dimensional Hilbert curves for calculating lattice complexity. All cases were scanned by support vector machine (SVM) for 10-fold cross-validation to select the best characteristics. And then, based on the characteristics of 46 patients, a classification model was established to identify the pattern recognition of other 46 patients’ survival period. Results: When using 28 images for each patient, the best average accuracy of classification in 10-fold cross-validation was 75.0% with the lattice complexity under the control parameter 19. For the 46 patients, the test accuracy was 69.6%. Conclusion: With 2-D lattice complexity, we could extract from CT images some prognostic information not previously captured. 2018 Vol. 48 (6): 396-400 [Abstract] ( 720 ) HTML (1 KB)  PDF (1427 KB)  ( 815 ) 401 Prokaryotic expression of murine PD-1 and its ligand PD-L1 extracellular domain gene and their affinity LYU Kaiji, CHEN Xudong, CHENG Kai, WANG Lude, ZHU Jinshun, KAMARA Saidu, ZHANG Lifang, ZHU Guanbao Objective: To prepare mouse PD-1 (mPD-1) and its ligand PD-L1 (mPD-L1) protein by prokaryotic expression system and mPD-L1 rabbit polyclonal antibody to verify in vitro the binding affinity of mPD-L1 and mPD-1. Methods: The recombinant plasmids pET21a/mPD-L1 and pGEX 4T-1/mPD-1 were constructed respectively by molecular cloning. Then the recombinant protein of PD-L1 and PD-1 was purified by Ni-NTA affinity chromatography and GST Agarose beads before it was confirmed by SDS-PAGE and Western blot. The purified mPD-L1 extracellular domain protein was immunized with healthy Japanese white rabbits to prepare rabbit polyclonal serum antibody. The titer and specificity of the obtained polyclonal antibody were analyzed by ELISA and Western blot, and the polyclonal antibody was used as positive control in immunofluorescence. Results: SDS-PAGE and Western blot results showed the expected size of the prokaryotic expression of the recombinant protein and mPD-L1 and mPD-1 were 25 kDa and 40 kDa respectively Japanese white rabbits immunized with mPD-L1 protein could produce specific antibodies with its titer peaked at 6 weeks after immunization. Western blot also showed that polyclonal serum could specifically recognize mPD-1. ELISA results showed that prokaryotic mPD-L1 protein could bind mPD-1 protein, with the experimental group OD450 reading significantly higher than the control group. Immunofluorescence results showed that green fluorescent mass seen in the membrane area of B16 cell (mouse melanoma cell) line which expressed PD-L1. Conclusion: mPD-L1 and mPD-1 proteins obtained after prokaryotic expression and then purified, and successfully verified the binding characteristics between mPD-L1 and mPD-1 in vitro, which provided the basis for the later study of the biological characteristics of mPD-1 and PD-L1. 2018 Vol. 48 (6): 401-407，412 [Abstract] ( 815 ) HTML (1 KB)  PDF (2121 KB)  ( 715 ) 408 Embryonic stem cell secreted cytokines in the enhancement of AML-12 cells anti-apoptotic ability LIN Wu, HUANG Zhaoshuai, BAO Miao, CHEN Xiaoming. Objective: To investigate whether the embryonic stem cell secreted cytokines can enhance AML-12 cell anti-apoptotic ability in extreme cell culture conditions. Methods: AML-12 cells were respectively treated with embryonic stem cells complete media (CON-M) or embryonic stem cells conditioned media (ESC-M) and cultured in extreme cell culture conditions. Cells viability was detected by MTT assay. Mitochondrial energy metabolism including oxygen consumption rate and extracellular acidification rate were measured using a Seahorse metabolic flux analyzer. Results: MTT assay indicated that AML-12 cells treated with ESC-M had stronger anti-apoptotic abilities in extreme cell culture conditions. Results from the Seahorse metabolic flux analyzer showed that ESC-M could increase AML-12 cells maximal respiration capacity, spare respiration capacity as well as glycolytic capacity. Conclusion: The embryonic stem cells secreted cytokines enhance AML-12 cells anti-apoptotic abilities in extreme cell culture conditions. 2018 Vol. 48 (6): 408-412 [Abstract] ( 793 ) HTML (1 KB)  PDF (1844 KB)  ( 743 ) 413 Analysis of the relative factors and model validation of intraocular pressure changes measured by noncontact tonometry after small incision lenticule extraction CUI Lele, ZHOU Weihe, LI Ming, YU Ye. Objective: To analyze the relative factors of changes of intraocular pressure (IOP) measured by noncontact tonometer (NCT) before and after small incision lenticule extraction (SMILE) and evaluate regression equations for predicting ΔNCT. The efficacy of regression equations was validated. Methods: This study included 154 patients (304 eyes) with myopia and myopic astigmatism receiving SMILE in Eye Hospital Wenzhou Medical University from June 2016 to August 2017. These eyes were randomly divided into group 1 (150 eyes) and group 2 (154 eyes). The spherical equivalent (SE), central corneal thickness (CCT), ablation depth (AD), ablation rate (AR), residual stromal bed thickness (RSBT), preoperative NCT (NCTpre), NCT at 3 months after operation (NCT3mo), average keratometry (Ave K), steep keratometry (Steep K) and flat keratometry (Flat K) were obtained. Two multivariate linear regression equations were established by analyzing ΔNCT and relative factors for group 1 after Spearman correlation analysis. Data of group 2 were used for validation. Results: There was significant difference in NCT before (15.72±2.86) mmHg and after SMILE (9.94±2.32) mmHg (P<0.05). The NCT had a decline of (5.78±2.59) mmHg. SE was highly correlated with AD and AR (r=-0.956, -0.949, P<0.001). NCTpre was moderately correlated with NCT3mo (r=0.559, P<0.01). The Spearman correlation analysis was performed to evaluate the relationship between relative factors and ΔNCT and the following multivariate linear regression equations were established: Equation A: ΔNCT=NCTpre×0.502–SE×0.385–3.951 (Adjusted R2=0.489, F=72.329, P<0.001); Equation B: ΔNCT=NCTpre×0.509+AR×0.179–5.545 (Adjusted R2=0.489, F=72.423, P<0.001). There was no significant difference between the predicted ΔNCT and measured values through equations A, B and equation Schallhorn (Simplified) for group 2 (P>0.05). A higher correlation was shown between the predicted ΔNCT and measured values obtained by equations B (r=0.650, P<0.001) and A (r=0.638, P<0.001) than equation Schallhorn (Simplified) (r=0.637, P<0.001). Conclusion:  NCTpre and AR were closely correlated with changes of NCT before and after SMILE. The regression equation of ΔNCT might be clinically applied to acquire the real postoperative NCT. 2018 Vol. 48 (6): 413-417 [Abstract] ( 727 ) HTML (1 KB)  PDF (1366 KB)  ( 831 ) 418 Lipoxin A4 regulation of LPS induced pro-inflammatory responses through inhibiting activation of p38 MAPK and activating Nrf2 pathway ZHUO Leying, WU Zhenjie, YU Xiang, ZHOU Meixi, LI Chengye, OUYANG Jinsheng, LIN Qibin, CAI Chang. Conclusion: LXA4 may attenuate Objective: To investigate the effect and mechanism of Lipoxin A4 (LXA4) on inflammatory response induced by lipopolysaccharide (LPS) in BEAS-2B cells. Methods: Cultured BEAS-2B cells in logarithmic growth phase were divided into 3 groups: control group (group A, non-treatment), LPS group (group B, incubated with 100 ng/mL LPS for 24 h), LPS+LXA4 treatment group (group C, pretreated with 100 nmol/L LXA4 for 30 min and incubated with 100 ng/mL LPS for 24 h). The mRNA levels of IL-6, IL-1β, heme oxygenase (HO-1) and NAD (P) H: quinone oxidoreductase (NQO-1) were detected by qPCR. The expression of reactive oxygen species (ROS) was detected by flow cytometric analysis. Glutathione (GSH) was measured by a GSH assay kit. Moreover, we investigated the effects of LXA4 on LPS-induced phosphorylation of p38 mitogen-activated protein kinases (MAPK) as well as nuclear translocation and phosphorylation of Nrf2. Results: Compared with group A, the mRNA expressions of IL-6, IL-1β and the level of ROS in group B were significantly increased (P<0.05), while the mRNA level of HO-1 in cells was significantly decreased (P<0.01). Nuclear translocation and phosphorylation of Nrf2 were reduced (P<0.05) and phosphorylation of p38 MAPK was significantly increased (P<0.01) after LPS stimulation. In contrast, in LXA4 treatment group, the above changes were reversed (P<0.05); besides, GSH activity and the mRNA level of NQO-1 were elevated (P<0.05). Conclusion: LXA4 may attenuate Objective: To investigate the effect and mechanism of Lipoxin A4 (LXA4) on inflammatory response induced by lipopolysaccharide (LPS) in BEAS-2B cells. Methods: Cultured BEAS-2B cells in logarithmic growth phase were divided into 3 groups: control group (group A, non-treatment), LPS group (group B, incubated with 100 ng/mL LPS for 24 h), LPS+LXA4 treatment group 2018 Vol. 48 (6): 418-423 [Abstract] ( 1105 ) HTML (1 KB)  PDF (1974 KB)  ( 2390 ) 424 The use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers in patients with acute myocardial infarction in Zhejiang Province from 2001 to 2011 and the identification of its associated factors GE Weili, MI Yafei, JIANG Jianjun, XUE Yingsheng, WANG Bin, LI Tao. Objective: To evaluate patterns of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) therapy in patients with acute myocardial infarction (AMI) in Zhejiang Province from 2001 to 2011, and to identify factors affecting the use of ACEI/ARB. Methods: Clinical information of AMI patients from 8 hospitals in Zhejiang Province were collected in 2001, 2006 and 2011, and patterns of ACEI/ARB therapy by year were analyzed. Binary logistic regression analysis was used to identify factors related to the use of ACEI/ARB. Results: A total of 604 patients were included, of whom 590 were eligible for Class I indication by Chinese guidelines and 14 were eligible for Class IIa indication. From 2001 to 2011, the use of ACEI/ARB in patients with Class I indication and Class IIa indication were 73.26%, 72.16%, 60.65% (P=0.005) and 0, 50.00%, 45.45% (P=0.513) respectively. In the three specific years to be studied, the use rate of ACEIs in patients with Class I indication was noticeably higher than that of ARBs. Binary logistic regression analysis showed that patients with Class I indication complicated with hypertension (OR=3.8, 95%CI=2.5-5.9), eGFR unmeasure (OR=15.7, 95%CI=6.9-35.6) were more likely to be treated with ACEI/ARB, and patients with LVEF value unmeasured (OR=0.3, 95%CI=0.2-0.5), eGFR< 60 mL/(min·1.73 m2) (OR=0.3, 95%CI=0.2-0.5) were less likely to be treated with ACEI/ARB. Conclusion: There’s little improvement in the use rate of ACEI/ARB therapy during hospitalization in AMI patients with Class I indication in Zhejiang Province from 2001 to 2011. Further efforts should be devoted to enhancing the compliance of therapy with current practice guidelines to improve the medical care. 2018 Vol. 48 (6): 424-428 [Abstract] ( 811 ) HTML (1 KB)  PDF (1406 KB)  ( 801 ) 429 Individual titanium meshes fabricated by 3D models combined with buccal-fat-pad flaps and free forearm flaps to reconstruct maxillary defects LIN Chongxiang, TU Chengwei, ZHENG Shunyou Objective: To evaluate the clinical efficacy of maxillary reconstruction by individual titanium meshes based on 3D printed maxilla models, buccal-fat-pad flaps and free forearm flaps. Methods: Retrospective analysis of 7 cases with maxillary defects from January 2016 to December 2017 was made. A three-dimensional individual maxilla model based on mirror images of the unaffected maxilla was obtained to fabricate an anatomicallyadapted titanium mesh before operation. The individual titanium mesh was implanted after maxillectomy, together with the buccal-fat-pad flap and free forearm flap to reconstruct the maxilla. Results: All patients were satisfied with their postoperative facial symmetry. All flaps were alive, and closure of oral and nasal cavities as well as maxillary sinus was complete. All cases were able to eat through oral cavities, and their postoperative vocalization was clear. Conclusion: Individualized titanium meshes combined with buccal-fat-pad flaps and free forearm flaps to reconstruct maxillary defects can obtain satisfactory functional and aesthetic outcomes forpatients. 2018 Vol. 48 (6): 429-432 [Abstract] ( 837 ) HTML (1 KB)  PDF (1673 KB)  ( 939 ) 433 Effect of smear layer thickness on bonding strength of two-step self-etching dentin bonding system ZHENG Tieli, ZHANG Jiahui, MAO Jiajie, GU qin. Objective: To compare the influence of the smear layer generated by the high-speed diamond bur or 600 grit silicon carbide paper on the microtensile bond strength (uTBS) of a two-step self-etching adhesive to human dentin. Methods: Flat medium occlusal dentin surfaces of 28 premolars were exposed and divided into 2 groups for further grinding with either a high-speed diamond or 600 grit silicon carbide paper. Two prepared dentin surfaces treated by each method were evaluated for the characteristics of smear layer using a scanning electron microscope (SEM). Twelve specimens from each grinded group were applied with a 2-step self-etching adhesive (OptiBond XTR), then built up with a resin composite. Each bonded specimen was sectioned into 1 mm-thick slab perpendicular to bonded interface.Six slabs from each group were randomly selected for observation of the bonded interface using SEM. Other slabs were cut into 1 mm×1 mm specimens. Fifteen specimens were randomly selected to be tested for microtensile bond strength. Results: The high-speed diamond bur created a significantly thicker and more rough smear layer than the silican carbide paper. There was no statistically significant difference (P>0.05) in microtensile bond strength between the groups. The 2-step self-etching adhesive (OptiBond XTR) could infiltrate well into the peritubular and intratubular dentin, then hybrid layer and resin tags were formed. Conclusion: Different smear layers had no significant influence on the uTBS of Optibond XTR bond to dentin. 2018 Vol. 48 (6): 433-436 [Abstract] ( 784 ) HTML (1 KB)  PDF (1855 KB)  ( 821 ) 437 Clinical analysis of hollow pull screw plus mental cable in the treatment of patellar fracture ZHANG Wei, ZHENG Junju, CHEN Mangmang. Objective: To study the clinical effects of hollow tension screw plus metal cable on large patellar fracture and explore biomechanical features. Methods: From January 2012 to January 2016, a total of 53 patients admitted to Wenzhou Central Hospital for closed patellar fracture were divided into the observation group and the control group. In the observation group, 26 cases were performed with open reduction hollow tension screw and metal wire internal fixation. In the control group, 27 cases were treated by open reduction and reduction of AO Kirschner wire tension band internal fixation. The two groups of patients were compared in terms of operation time, bone healing time, knee joint function and complications as well as biomechanical fixation firmness. Results: There was no statistical difference between the two groups in operation time and bone healing time (P>0.05). In comparison of knee joint scoring, the optimal rate was 100% in the observation group and 96.3% in the control group, with no statistical difference (P>0.05). The incidence rate of complications was 0% in the observation group and 25.9% in the control group, showing significant difference (P<0.05). In the aspect of biomechanics, patellar forces in the observation group was greater than the control group in the entity experiment of patella fracture end fracture under the shift distance of 1 mm, showing statistical difference between the two groups (P<0.05). Conclusion: Both hollow pulling screw plus metal wire internal fixation and AO steel wire tension band internal fixation have good healing effect in the clinical treatment of patella large fractures, however, the former has the advantages of better overall curative effect, fewer complications and stronger biomechanics fixation 2018 Vol. 48 (6): 437-440，445 [Abstract] ( 695 ) HTML (1 KB)  PDF (1518 KB)  ( 943 ) 441 The regulation of urotensin-II on the expressions of TGF-β1 in rat model of high pulmonary blood flow pulmonary arterial hypertension ZHANG Songyue, REN Yue, HE Yuee, LI Hao, WU Rongzhou Objective: To explore the impact of urotensin-II (UII) on the expressions of transforming growth factor β1 (TGF-β1) in rat model of pulmonary arterial hypertension triggered by high pulmonary blood flow. Methods: Sixty male SD rats were included and randomly divided into pulmonary hypertension model group (Group S, n=20), sham group (Group C, n=20), urotensin II inhibitor group (Group M, n=20). The pulmonary hypertension model was established after surgical connection of the common carotid artery and jugular vein in rats. Four weeks, eight weeks and twelve weeks later, 5 rats were selected from each group to measure the right ventricular pressure. Twelve weeks later, 5 rats from each group were sacrificed to obtain specimens of lung tissue. Western blot was used to detect the expression of UII and TGF-β1 protein in lung tissue. The content of TGF-β1 mRNA was detected via RT-PCR. One-way analysis of variance and Pearson correlation analysis were used to analyze the data. Results: For the pulmonary artery pressure, Group S reached a higher level compared with Group C (P<0.05), and the level of Group M was significantly decreased when compared with Group S (P<0.05). Twelve weeks later, the content of UII protein in Group S was remarkably increased (P<0.05) while in Group M was relatively decreased (P<0.05) compared with Group C. Twelve weeks later, the expression of both TGF-β1 mRNA and protein in Group S was higher than Group C (P<0.05), but in Group M it were significantly decreased (P<0.05). The expression of UII protein was positively associated with pulmonary artery pressure and TGF-β1 mRNA and protein expression. Conclusion: The down-regulation of UII reduces the expression of TGF-β1, which may ultimately alleviate the pulmonary hypertension in the rat model. 2018 Vol. 48 (6): 441-445 [Abstract] ( 768 ) HTML (1 KB)  PDF (1581 KB)  ( 796 ) 446 The value of CT diagnosis in three kinds of pleural thickening lesions LI Wenbin, JI Xiaowei, Cai Mengting, Chen Cong, WU Enfu. Objective: To explore the value of CT in the diagnosis and differential diagnosis of tuberculous pleurisy (TP), metastatic pleural disease (MPD) and malignant pleural mesothelioma (MPM). Methods: The CT images of 143 patients with pleural thickening (TP 95, MPD 31, MPM 17) proved pathologically were reviewed retrospectively in the First Affiliated Hospital of Wenzhou Medical University from January 2008 to April 2017. Combined with CT imaging data, imaging features of each disease were analyzed, and the significance of differential diagnosis was discussed. Results: In patients with TP, the most common features were male, local, smooth and non-circumferential pleural thickening, homogenous enhancement, no mediastinal pleural involvement with lymph node enlargement. Female, diffuse, irregular, nodular, non-circumferential pleural thickening, homogenous enhancement and mediastinal pleural involvement without lymph node enlargement were more frequently seen in MPD group. Female, diffuse, nodular non-circumferential pleural thickening, pleural based mass, inhomogeneous enhancement, no mediastinal pleural involvement and lymph node enlargement were more frequently seen in MPM group. TP group was younger than MPD group and MPM group. The maximal pleura thickness of TP group was shorter than that of MPD group, which was even shorter than that of MPM group. Conclusion: Age, sex, maximum pleural thickness, lesion range, shape, style, enhancement pattern, mediastinal pleural involvement and lymph node enlargement were factors of significance in differentiating tuberculous pleurisy, pleural metastases and malignant pleural mesothelioma. 2018 Vol. 48 (6): 446-449 [Abstract] ( 921 ) HTML (1 KB)  PDF (1465 KB)  ( 968 ) 450 Effects of prone position ventilation on lung function in neurointensive care patients CHEN Jie, JIN Shengwei, JIANG Xiaofen, YE Bingbing, CHEN Rui, HAO Yu. Objective: To investigate the effects of prone position ventilation on lung function and prognosis in neurointensive care patients. Methods: A total number of 32 neurointensive care patients with Motor Score (4-5) and Lung Injury Scores (LIS)>1 on the 7th day after surgery were enrolled in this study. They were randomly divided into two groups, the research group (n=15) (daily prone position 2 times/day, 2 hours/time) and the control group (n=17), treated with supine bed elevation of 30°-45°. We assessed LIS again on the 10th day and continued to observe if LIS fell by≥0.5. Otherwise, tracheotomy was performed on the 10th-14th day. Tracheotomy was also performed on those patients who had remained to be observed if they failed to pass spontaneous breathing trial within 14 days. Results: Compared with the control group, the oxygenation index and extubation success rate in the research group increased after treatment and meanwhile LIS and use of antibiotics in general ward dropped (P<0.05). There was no difference in mechanical ventilation time, the length of ICU stay, total hospital stay, and Glasgow Outcome Scale after 3 months. No significant changes took place in heart rate and mean arterial pressure after turning to prone position (P>0.05). Conclusion: Prone position ventilation improves lung function in postoperative neurological intensive patients and reduces the rate of tracheotomy and hospital-acquired pneumonia in general ward. It can be safely applied to postoperative patients after one week. However, there was no obvious improvement in the prognosis of the disease. 2018 Vol. 48 (6): 450-453，457 [Abstract] ( 678 ) HTML (1 KB)  PDF (1422 KB)  ( 708 ) 454 The application value of susceptibility weighted imaging in the diagnosis of cerebral calcification and cerebral microbleeds JIN Meiyu, JIN Hongguo, FAN Yanfen, YANG Rong, KOU Xuelian Objective: To evaluate the clinical value of susceptibility weighted imaging (SWI) in the detection and differentiation of intracranial calcifications and chronic microbleeds. Methods: The clinical data of 100 patients with cerebral calcification or microhemorrhage in Wenzhou Medical University Affiliated Zhoushan Hospital from October 2013 to October 2016 were retrospectively analyzed. MRI scans were performed on SWI sequences. These lesions were centering and quantitatively analyzed by two observers. Results: There were 76 calcifications in 50 patients, and other 50 patients had 245 microbleeds. The SWI sequence found that calcification had good observation ability (k=0.7). All the chronic microbleeds were seen on SWI but there was only moderate inter observer agreeability in evaluation of signal on phase component (k=0.5). Average pixel values of calcifications and chronic microbleeds were (-312.5±187.5) SD and (541.9±301.7) SD on phase SWI, respectively (P<0.001). Conclusion: Phase SWI can play an important role in the detection of intracranial calcifications and chronic microbleeds. 2018 Vol. 48 (6): 454-457 [Abstract] ( 840 ) HTML (1 KB)  PDF (1488 KB)  ( 940 ) 459 The clinical effect of free body position on promoting natural delivery JIANG Qingzhi, ZHENG Xiaohua, JU Meiyuan Objective: To study the effects of free position during the first and second stages of labor on natural delivery. Methods: A total 240 of pregnant women who delivered in our hospital were enrolled into this study from June 2013 to February 2014. They were randomly divided into observation and control group, with 120 cases in each. Women in the control group took lithotomy position the whole process, held breath and gave birth hard. For observation group, women could freely chose any comfortable body position such as lying, walking,standing, sitting, kneeling, creeping or squatting on delivery during the first and second stage of labor, and used lithotomy position when delivering. The effects between two groups were observed and compared in terms of uterine cervix dilatation, time of the labor duration, maternal postpartum hemorrhage rate, neonatal Apgar score and postpartum discomfort rate. Results: The natural delivery rate of the observation group was significantly higher than the control group (P<0.05). The time of total labor and the maternal postpartum hemorrhage rate of the observation group was less than the control group (P<0.05). The neonatal Apgar score≥8 of the observation group was obviously better than that of control group (P<0.05). Satisfaction rate of pregnant women in the observation group was higher than that of the control group. There’s statistical difference (P<0.05) between the two groups. Conclusion: Freely chosen body positions during the first and second stages of labor process can promote natural delivery, shorten the time of labor, reduce maternal and neonatal complications and secure the health of mothers and babies. Besides, it improves satisfaction degree of pregnant women and the skills and competency of health care workers. 2018 Vol. 48 (6): 459-462 [Abstract] ( 706 ) HTML (1 KB)  PDF (1400 KB)  ( 715 )

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