Objective To investigate the clinical value of the expert type terminal of long distance electronic fetal heart rate home monitoring system in the application to self monitoring of pregnant woman at home in peripartum Methods All the pregnant women ( n =284) were divided into two groups Research group ( n = 134) contained 73 high risk gravida There were 78 high risk gravida in control group ( n =150) In the research group, self monitoring at home in 134 women was taken by the expert type terminal of long distance electronic fetal heart rate monitoring system through telephone and fetal movement counting The women were requested to auscultate and transfer fetal heart rate (FHR) to electronic FHR monitoring center in hospital Non stress test(NST) was made 1～2 times every week when fetal movement was active When women felt any abnormality of baby, she should immediately test NST and then the photograph of NST was send to FHR monitoring center by telephone Doctor would make a diagnosis and management in time according to the photograph of NST In the control group, the way of fetal monitoring was fetal movement counting and regular NST test in the outpatient clinic Results The incidence of abnormal NST was significantly higher in the research group than that in the control group (respectively 22 0% vs 13 5%, P 0 05) Conclusions The expert type terminal of long distance electronic FHR monitoring system through telephone is a new way of the FHR self monitoring at home The application of this method could ease mental press of the women, decrease significantly perinatal mortality, decrease incidence of neonatal asphyxia, and improve quality of obstetrics Whatever there are high risk factors in any pregnant women, the system should be appied to all late pregnant women

Objective To observe the effects of misoprostol on the reduction of postpartum bleeding in cesarean section.Methods With oxytocin as control,the amount of bleeding during and two hours after cesarean section was observed.Results The mean amount of bleeding was (232.0±46.6) ml in misoprostol group and (385.0±74.7) ml in oxytocin group respectively.The difference between the two groups was significant (P＜0.01).Conclusion Misoprostol is more effective to improve uterin contraction than oxytocin and is better in the reduction of postpartum bleeding with safety and convenience.

ObjectiveTo investigate the clinical value of continuous electronic fetal heart rate (FHR) monitoring for preterm small for gestational age (PSGA) during labor. MethodsThree hundred and three pregnant women who had inevitable preterm labor at 32-36 weeks′ gestation because of premature rupture of membrane or unknown cause underwent continuous electronic FHR monitoring during labor from Jan 2002 to May 2004. In total, 78 newborns were preterm small for gestational age (PSGA ,PSGA group) and 225 newborns were preterm appropriate for gestational age (PAGA, PAGA group). The cardiotocography (CTG), outcome of labor, and cases with combined umbilical cord abnormality of both groups were analysed retrospectively. ResultsThe number of cases with pure U type variable deceleration of PSGA group and PAGA group was respectively 24 (30.8%) and 10 (4.4%) (P

0.05),the specificity of transthoracic echocardiography in diagnosing the atrial situs,ventricular structure,the connection of the ventricle and arteries or auricle,arterial situs was more than 90%.In mirror-image dextrocardia,majority had concordant segmental connection and could present anomalies with simple anomalies(42.9%) including atrial septal defect and ventricular septal defect,in addition,the major complex anomalies such as pulmonary stenosis were tetralogy of Fallot,double outlet of right ventricle(50%);In dextroversion,majority had discordant segmental connection and mostly presented anomalies with pulmonary stenosis or pulmonary atresia,including single ventricle,double outlet of right ventricle,transpo sition of great arteries,pulmonary atresia and so on(88.6%).Conclusion Echoca rdiography can exactly diagnose the most congenital dextrocardia with complex cardiovascular anomalies,and can be the first or alternative screening choice for diagnosing dextrocardia.

Objective To explore the relationship between the tiny enhanced foci in hematoma and hematoma expansion at the acute stage of intracerebral hemorrhage (ICH).Methods CT routine and enhanced scan were applied in 36 ICH patients which onset ≤5 h,and CT examined again follow-up 1 or 2 d.The neurological function was evaluated by European Stroke Scale(ESS)at the 1st d and 21st d after onset.Results The tiny enhanced foci in hematoma were found in 11 csaes by the first CT scane.Follow up CT scane,the hematoma expansion was occurred in 10 cases,including 8 cases with tiny enhancing foci in hematoma.The incidence of hematoma expansion in ICH patients with tiny enhancing foci in hematoma(8 cases,72.7%) was significantly higher than in ICH patients without tiny enhancing foci in hematoma(2 cases,8.0%)(P

Objective To study the right ventricular function of patients with pulmonary thromboembolism by using color Doppler ultrasound.Methods 31 patients with acute pulmonary thromboembolism,compared with 31 vohnteers,were enrolled in this study.The right ventricular anterior wall movement,right ventricular end diastolic volume,right ventricular ejection fraction,and myocardial performance index were observed by echocardiography.Resuits The right atrium diameter,right ventricles diameter,right ventrieular end diastolic volume and pulmonary artery inner diameter in study group were much larger than that in control group (P<0.01),and the right ventricular anterior wall movement and right ventrieular ejection fraction decreased in study group (P<0.01).Tricuspidal annular E peak velocity tended to be decreased,isovolumie relaxation time and isovolumic contraction time were prolonged and myocardial performance index was increased (P<0.01).Right ventricular myocardial performance index showed significant correlation with right ventrieular ejection fraction (r=0.78,P<0.01),isovolumic relaxation time and isovolumic contraction time(rl=0.88,r2=0.57,P<0.01).Conclusion The right ventricular function in patients with pulmonary thromboembelism is decreased and myocardial performance index is a sensitive index which can be used to reflect right ventricular function in pulmonary thromboembolism.

Objective To investigate the left atrium (LA) function and structure changes in the paroxysmal atrial fibrillation (AF) patients after catheter ablation using tissue Doppler imaging. Methods After complete pul-monary vein, radiofrequency ablation guided by Ensite NavX System, LA systolic function and LA diameter, volume, mean mitral gradient and mitral annulus early and advanced diastolic peak velocity were assessed in 32 cases of par-oxysmal AF patients,which were compared with age-matched controls before and after 24 hours, 1 week, 1 month) AF ablation. Results AF did not occur again in 32 AF paroxysmal patients after isolation. LA diameter and volume in AF groups before ablation were larger than controls(P<0.01), which were also larger 24 hours after ablation than before (P>0.05 ), but LA volume was larger than before (P<0.05), and decreased in I week after ablation (P< 0.05), but had no significant difference compared with controls in 1 month(P>0.05 ) ;mitral annulus advanced di-astolic peak velocity decreased in AF groups before ablation (P<0.01 )and was lower than that 24 hours after cathe-ter ablation (P<0.05 ), but increased after 1 week (P<0.05 or P <0.01 ), and had no significance after 1 month. Conclusion Catheter ablation is the effective way to manage AF because LA is distended and atrial systolic func-tion is reduced within 24 hours after procedure, then gradually increased in a week and will nearly recover to that be-fore procedure in a month, which may be correlated with LA repair, implicating that postprocedural thromboembollc risk and procedure injury should be taken into consideration.

Background and Objective Large randomized controlled trials have demonstrated that percutaneous coronary intervention (PCI) with the routine use ofdrug-eluting stents is safe and effective, however, the patients older than 75 years undergoing PCI are at increased risk for major adverse cardiac events, so that the patients are usually excluded from this trial. The aim of the present study was to assess the early clinical outcome and risk factors in old patients with acute ST elevation myocardial infarction (STEMI) following primary PCI. Methods We analyzed the outcome after stenting in 136 patients older than 60 years in our coronary care unit with acute STEMI, and the patients were further classified in 2 age groups: patients≥75 years and <75 years. Results Though the older group had a higher prevalence of adverse baseline characteristics and lower final TIMI flow than those of the younger, the procedural success had no difference between two groups. The main adverse clinical events (MACE) for the old group was a little higher comparing with the younger in 12-month following up. Conclusions Our study suggest that drug-eluting stent implantation in elderly patients with acute ST elevation myocardial infarction has high initial procedural success rates despite having more severe baseline risk characteristics, and to shorten the time form symptom onset to PC1 and improve final TIMI flow strategy may decrease MACE among old patients following PCI.

Objective To investigate the correlation between the serum ferritin levels and the post-stroke depression (PSD). Methods From July 2014 to October 2015, the inpatients with the first-ever acute ischemic stroke were colected consecutively. Chemiluminescence microparticle immune assay was used to measure the serum ferritin levels within 24 h after admission. Depressive symptoms were screened by using the 17-item Hamilton depression scale (HAMD-17) at 3 months after onset. In patients with a HAMD-17 score ≥7, the depression was further diagnosed according to The Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Results A total of 200 patients with the first-ever acute ischemic stroke were enroled, 55 (27. 5% ) of them were diagnosed as PSD. There were significant differences in the body mass index (BMI), years of education, waist circumference, high sensitive-C-reactive protein, homocysteine, National Institutes of Health Stroke Scale score (at baseline, discharge, and day 90), mRs score (at discharge and day 90), BI (at discharge and day 90), and the proportions of widowed or solitary patients between the PSD group and the non-PSD group (al P < 0. 05 ). The serum ferritin level in the PSD group was significantly higher than that in the non-PSD group ( median [ interquartile range], 261. 90[142. 10-364. 90] μg/L vs. 164. 40[132. 50- 195. 10] μg/L; Z = - 4. 814, P < 0. 001 ). Multivariate logistic regression analysis adjusted for confounding factors showed that the baseline serum ferritin level >136. 375 μg/L was an independent risk factor for PSD (odds ratio 1. 041 per 1-quartile increase, 95%confidence interval 1. 009-1. 239; P = 0. 045). Conclusions The elevated baseline serum ferritin level is associated with PSD.

Objective To express the anti-IL-1βscfv and soluble TNF receptor 1 (sTNFR1),and analyze their bio-activities.Methods sTNFR1 was obtained by RT-PCR from the total RNA of HeLa cells,and fused with IL-1βscfv by the hinge fragment of IgG molecule.The fusion gene IL-1scfv:TNFR1 was cloned into the expression vector pET27b(+).The fusion protein was expressed and purified from inclusion bodies.Results The ELISA analysis showed that the fusion protein could bind hIL-1β and hTNF-α respectively in a dose-dependent manner,indicating that scfv and sTNFR in the fusion protein can form the correct spatial configuration.The dolt-blot analysis showed that the fusion protein could concurrently bind with hIL-1β and hTNF-α,indicating that the combination of the two parts of the fusion protein does not influence each other for binding to their target molecules.The bioactivity assay showed that the fusion protein could inhibit both the cytotoxicity of hTNF-α on L929 cells and hIL-1β-induced proliferation of L929 cells,indicating that the fusion protein has the ability to neutralize hTNF-α and hIL-1β.Conclusion A bispecific fusion protein IL-1scfv:TNFR1 was successfully constructed.The fusion protein has the ability to inhibit the biological activity of hTNF-α and hIL-1β,and provides a drug candidate for the treatment of rheumatoid arthritis.