Objective To investigate the risk of heart failure to the mother and the neonate.Methods The clinical data of 30 pregnant womem with heart failure from January 1993 to December 2010 from Capital Medical University Tongren Hospital was retrospectively analyzed.Results Of the 30 patients,there were 12 affected with congenital heart disease (40％) ; 9 with rheumatic heart disease 30％,7 with heart failure in pregnancy-induced hypertension 23％.Heart failure appeared at the average of (34.20 ± 4.25) weeks in pregnancy.The average terminal time of pregnancy was (34.84 ± 2.17) weeks.The rate of early birth was 73.33％.The average birth weight was (2011 ±568) g,with 7 babies less than 2000 g.No death occurred in both new the mother and the neonate.Condusion The main causes of heart failure in pregnancy are congenital and rheumatic heart disease and pregnancy-induced hypertension.For those heart failure occurs before 30 weeks,it is the first selection that pregnancy shoud be terminated; For those occur after 30 weeks,active treatment should be performed to improve maternal heart function and promote fetal maturity.Apropriate threatment during per-cesarean section may decrease the case fatality of the mother and neonate.

Objective To observe the effects of restrain stress on the phosphorylation of p38 mitogen-activated protein kinase ~MAPK) in rat hypothalamus and the regulation effects of electroacupuncture on the phosphorylated-p38 MAPK. Methods Twenty-eight rats were randomly divided into a control group, a restrain stress group and a restrain stress plus electroacupuncture group. The Western blot was employed to observe the changes of phosphorylated-p38MAPK in the three groups. Results Western blot analysis demonstrated a higher level of phosphorylation of p38 MAPK in the hypothalamus from restrain stress group than that from control. The higher level of phosphorylated-p38 MAPK could last for 3 hours after stress was relieved. The level of phosphorylated-p38MAPK could be decreased to some extent when the Zusanli acupoint of the restrained rat was acupunctured. The effects of electroacupuncture of Zusanli on phosphorylated-p38MAPK in hypothalamus could still be retained although the electroacupuncture was ended for 3 hours. Conclusion The results suggested that restrain stress can lead to a higher level of phosphorylation of p38 MAPK in hypothalamus, which might be an important event in the response of hypothalamic-pitutary-adrenal ~HPA) axis. The mechanism underlying the regulation of HPA by electroacupuncture might be (related) to the regulation of phosphorylated-p38 MAPK in hypothalamus.

Objective:To assess the nursing care experiences and curative effects of the application of wound care technologies combined with other multiple treatments in the hepatolithiasis patient who suffered from postoperative severe intestinal fistula.Methods:The wound care difficult points were analyzed,the wound care technologies combined with other multiple treatments including multiple debridement methods were applied according to the severity of the intestinal fistula:multiple debridement, new skin protection, continuous flushing and drainage with double cannula, improved negative pressure closure drainage and wound pull-in technology, combined with systemic treatment and nursing intervention.Results:The intestinal fistula was treated for 12 days, and the wound infection was controlled for 24 days. Finally the wound was healed after 43 days and patient was discharged from hospital.Conclusions:In the case of severe intestinal fistula after hepatolithiasis operation, the application of wound nursing technology combined with treatment scheme provides a new treatment idea and scheme for intestinal fistula and wound healing.

Objective: To study the value of speckle tracking echocardiography (STE) for assessing left ventricular remodeling (LVR) in patients of acute ST-elevation myocardial infarction (STEMI) with late percutaneous coronary intervention (PCI). Methods: A total of 127 STEMI patients with elective PCI were enrolled. Echocardiography was conducted within 48 hours of admission and the patients were followed-up for 6-9 (median 7.8) months after discharge. LVR was deifned by left ventricular end-systolic volume (LVESV) elevation >15% than the ifrst echocardiography. The patients were divided into 2 groups: LVR group,n=41 and Non-LVR group,n=84. Results: There were significant differences between 2 groups in left ventricular global longitudinal strain (GLS), longitudinal Ts-SD, radial strain (RS) and longitudinal postsystolic index. Further Logistic regression analysis indicated that GLS (OR=0.39, 95% CI 0.26-0.57,P<0.01) and RS (OR=1.07, 95% CI 1.02-1.13,P=0.01) were the independent predictors for LVR occurrence; ROC presented that the optimal cut-off value for GLS was -10.85% (sensitivity 89.7%, specificity 91.7%) and for RS was 28.46% (sensitivity 82.1%, speciifcity 66.7%). Conclusion: STE measured GLS and RS were the independent predictors for LVR occurrence in STEMI patients with late PCI.

Objective To explore the reproductive outcomes of different management strategies of ectopic pregnancy .Methods A retrospective cohort study was performed for 648 consecutive patients with a diagnosis of ectopic pregnaney between June 2011 and september 2013.The follow-ups were conducted telephone interviews of pregnancy outcomes after various treatments .Results The subsequent intrauterine pregnancy rates after surgical , medical and expectant managements were 89(65.0%), 35(79.6%) and 6 (54.5%) the intrauterine pregnancy was higher for medical treatment than that for surgical treatment (P<0.05).The subsequent infertility rate after surgical , medical and expectant management were 4.5%, 36.4%, 19.0%.The subsequent infertility rate after medical treatment was lower than that for surgical and expectant managament ( P<0.05) .The re-ectopic pregnancy rates of laproscopic versus abdominal operation were [11 (11.7%), 13(30.2%)] with significant difference (P<0.05).And abdominal operation was higher than laproscopic operation .Conclusion For younger ectopic pregnancy patients , medical treatment shold be as possible as we can .If operation is necessary , laproscopic operation is preferred .

Objective Given the significant differences of ischemia-time tolerance observed in clinical heart transplantation between heart and other solid organs,it is important to make a clinical assessment of the correlation between the cold ischemic time of the donor heart and the survival rate after heart transplantation.With these results,we may standardize the management of clinical heart transplantation by providing a proper heart cold ischemic time frame for reference.Method The clinical data of 131 orthotopic heart transplantation patients in our hospital,from September 2008 to March 2014,were collected and analyzed retrospectively.All donor hearts were preserved in histidinetryptophan-ketoglutarate solution (HTK solution) during cold ischemic time.The cold ischemia time was 103-485 min,with an average of 245.2 ± 120.4 min.According to the cold ischemic time,all patients were divided into three groups:＜ 3 h (n =62); 3-6 h (n =41); ＞6 h (n =28).Result (1) Prolonged cold ischemia time could result in high IABP usage perioperatively (postoperative IABP support rate for the three groups was 3.2％,9.8％ and 14.3％ respectively,P =0.155) and high rejection rate (incidence of rejection was 6.4％,9.8％ and 17.9％ respectively,P =0.245),but there was no statistically significant difference.(2) Three weeks after the transplantation,all EF values of the three groups were reduced within the normal range,with no significant difference.Perioperative overall survival rate was 97.7％ (128/131),while survival rate of the three groups was 97.29％ (72/74),100％ (30/30) and 96.29％ (26/27),respectively (P =0.61).(3) One-year overall survival rate was 89.87％ (71/79),and the one-year survival rate of three groups was 92.2％ (47/51),90.9％ (10/11) and 82.4％ (14/17) respectively (P=0.51).Fifty-two patients were still under 1 year follow-up period.This study aimed to illustrate the effect of different cold ischemic time on perioperative cardiac function,rejection rate,IABP usage postoperatively (intra-aortic balloon pump or intra-aortic balloon counterppulsation) and early/mid-term efficacy after transplantation.Conclusion Cold ischemic time within 6-8 h is clinically safe for heart transplantation,and can provide satisfactory early and medium-term effect.Donor heart with cold ischemia time longer than 6 h may extend the recipient inclusion criteria.But considering the safety of transplantation,these donor hearts may be more applicable for the marginal recipients.This study describes the relationship between cold ischemic time and early and medium-term effect of heart transplantation.However,its long-term effects still require further investigation.

Objective To study the protection effect of acupuncture at acupoint ST 36 in rat with cold-restrainted stress-induced ulcer,and to observe the expression of NOS in hypothalamus and adrenal. Methods Ulcer Index in rats was used to study the protection effect of acupuncture, and and RT-PCR was employed to study the expression of NOS in hypothalamus and adrenal. Images were analyzed with semi-quantitative method. Results The ulcer Index was significantly decreased in rats with stress-induced ulcer by acupuncture as indicated by a comparison with those without acupuncture. The expression of NOS1 in hypothalamus was increased by acupuncture protect stress-induced ulcer. The increased expression of NOS2 was involved in stress-induced ulcer, and acupuncture decreased its expression. The expression of NOS3 in hypothalamus had the similar reaction to NOS2, but the decreased effect of acupuncture was limited. The expression of NOS1 and NOS3 in adrenal were increased by cold stress, only the expression of NOS1 could be repressed with acupuncture. There was no NOS2 expression in adrenal in stress-induced ulcer rats. Conclusion The protection effect in stress-induced ulcer exerted by acupuncture at acupoint ST 36 were mediated by increase of the physiological expression of NOS1 in hypothalamus as well as decrease of the expression of NOS2,NOS3 in hypothalamus and repress of the expression of NOS1 in adsenal.