Objective To analyze the factors related to the fetal death and to find the effective interventions. Methods 84 women with fetal death were recruited.Clinical data were collected and analyzed based on the retro-spective method.Results Among the 84 women,21 women with pregnancy complications,2 women delivered fetal macrosomia,2 women with oligohydramnios,4 women with polyhydramnios,50 women with abnormal umbilical cord, 1 woman with fetal growth restriction,1 woman with racket -shaped placenta,2 women with unknown causes,and 1 woman with placental calcification.Conclusion The main cause of fetal death was pregnancy complications and umbilical cord abnormalities.The early diagnosis,promptly correct,and timely termination of pregnancy will be the effective interventions to prevent the development of the fetal death.

Objective To investigate the clinical effect and nursing methods of bilevel positive air-way pressure(BiPAP)ventilation in patients with neurogenic pulmonary edema(NPE).Methods Totally 11 NPE patients from January 2004 to December 2007 were enrolled.Ventilation support adopted specific invasive BiPAP mode of Puritan-Bennett840.Aiway pressure release ventilation(APRV)tactics was ap- plied in this mode.The blood oxygen saturation rote(SpO2),acidity-alkalinity(pH),arterial oxygen pres-sure(PaO2),arterial carbon dioxide pressure(PaCO2)were analyzed and compared between synchronized intemittent mandatory ventilation(SIMV)mede2 h and 24 h after BiPAP ventilation.Results Among,arterial blood gas analysis of 11 patients,SpO2 and PaO2 were obviously ameliorated after BiPAP ventilation compared with SIMV ventilation.No side-effect occurred.Conclusions The application of invasive Bi- PAP ventilation support in NPE patients proved to be a fast and effective method.

Objective:To analyze the current status of medical students′ humanity education satisfaction rate and present situation of humanity quality and thus provide evidence to better practice of humanity education. Meth-ods:According to the random stratified cluster sampling method, the researchers selected 1146 medical students from Harbin Medical University and then investigated the objects′ humanity education satisfaction rate and general humanity situation. The data was analyzed using χ2 test in SPSS 17. 0. Results:①Satisfaction status of humanity education:the students′satisfaction to teachers′humanity quality, effect of course and library resources were low.② The present situation of humanity quality:80 . 2% of the medical students thought it was necessary to strengthen the medical students′humanity education;18. 1% of the medical students remembered the medical student oath, and there existed significant differences between different specialties;11 . 9% of the medical students could clear connotation of the humanistic concept, and there were significant differences between various grades;24. 4% and 14 . 5% of the medical students couldn′t clear the humanistic attribute of Marxist political theory course and moral course respectively; rural students′ humanity quality was statistically lower than the urban ones. Conclusion:Through optimizing the structure of humanity courses, strengthening the construction of teaching staff and attaching great importance of the library to humanity education effect, so as to improve medical students′ satisfaction of hu-manity education. The government should increase investment in rural education to narrow the gap of basic humani-ty quality education between urban and rural.

OBJECTIVE To improve the knowledge of pulmonary aspergillosis. METHODS We analyzed the clinical features of 17 cases of pulmonary aspergillosis inpatients from May 1994 to Apr 2006 in our hospital retrospectively. RESULTS Sixteen cases were infected out of hospital,1 case was infected in hospital.The correct diagnostic rate of pulmonary aspergillosis was only 21.4% in the patients infected out of hospital,70.6% cases infected out of hospital were misdiagnosed to as tuberculosis or lung cancer. CONCLUSIONS The misdiagnosed reasons are that the some doctors are short of perceptual knowledge of aspergillosis and pulmonary aspergillosis confuses easily with TB and cancer and other underlying diseases.

Objective To elucidate the role of insulin receptor and its ?-subunit autophosphorylation in evoking insulin resistance in non-obese type 2 diabetes. Methods 14 patients with non-obese type 2 diabetes and 12 healthy subjects were enrolled in this study. Insulin receptor numbers and its insulin affinity in erythrocytes were measured using radio-labelled ligand binding assay described by Comi et al. Insulin receptor autophosphorylation in erythrocytes membrane was initiated by adding insulin and ?- 32 P ATP. Then the membrane proteins were resolved on 7 5% SDS-PAGE and subjected to autoradiography. Results The numbers of high and low affinity receptors in erythrocytes of type 2 diabetes were 21?13 and 955?427 per cell respectively, and they showed no significant difference as compared with control. The high affinity constant(K 1) and low affinity constant(K 2) of insulin receptors in erythrocytes of type 2 diabetes were (1 70?0 93)?10 -9 LM -1 and (1 44?0 86)?10 -7 LM -1 respectively, also displaying no significant difference in comparison with the control. Insulin-induced receptor ? subunit autophosphorylation was 8 02?5 6△A/mg protein in type 2 diabetes, which was lower than that (28 38?15 24)△A/mg protein) in control(P

On the basis of understanding acupuncture method of inducing resuscitation (xing nao kai qiao) and training methods of modern rehabilitation medicine, new training methods were developed and could be used at different stages of stroke patients with upper-limb motor dysfunction, including acupuncture method of Jiquan acupoint (HT01) and rehabilitation training.

ObjectiveTo investigate the effect of therapeutic hypercapnia on hepatic ischemia-reperfusion (I/R) injury in rat liver transplantation.MethodsMale specific pathogen-free adult Wistar rats aged 6 weeks weighing 220-280 g were used in this study.Sixteen rats in which liver transplantation was successfully performed were randomly divided into 2 groups ( n =8 each): liver transplantation group (group LT) and therapeutic hypercapnia group (group TH).In group TH,PaCO2 was maintained at 80-100 mm Hg by inhalation of CO2 for 1 h at the begining of reperfusion.MAP,PaO2 and PaCO2 was recorded during reperfusion.Blood samples were obtained at 2 h of reperfusion for determination of serum ALT,AST,TNF-α,IL-1 and IL-6 levels,and then the rats were sacrificed and transplanted liver was immediately removed for determination of NF-κB activity and apoptosis and microscopic examination.The apoptotic index was calculated.ResultsMAP,PaO2 and PaCO2 were higher,and serum ALT,AST,TNF-α,IL-1 and IL-6 levels,NF-κB activity and apoptotic index lower in group TH than in group LT ( P ＜ 0.05).The histopathologic damage was ameliorated in group TH as compared with group LT.Conclusion Therapeutic hypercapnia can attenuate hepatic I/R injury in rat liver transplantation by inhibiting inflammatory response and apoptosis.

Objective To evaluate whether second-look endoscopy could prevent endoscopic submucosal dissection complicated with delayed bleeding and to clarify what kind of lesions that need second-look endoscopy. Methods 98 patients with early gastric cancer by histological diagnosis from Oct. 2014 to Sep. 2016 were included in this study. Mucosal damage related bleeding within 24 h after ESD was considered delayed bleeding. Clinical data of patients, lesions, surgical factors, and the incidences of bleeding before and after the second endoscopy examination were retrospectively studied. Results The en bloc resection rate of 98 patients was 100.0%, and all incisal margins were negative. No gastrointestinal perforation, death or severe complications occurred. 5.1%of the patients (5/98) occurred delayed bleeding after ESD and had been successfully stopped in a second-look endoscopy, and none received operations. No delayed bleeding occurred in follow-ups of patients with negative delayed bleeding. 40.0 % of the patients (2/5) with delayed bleeding received blood transfusion. The median time of second-look endoscopy after ESD was the second day after operation (1 ~ 3 d). The median bleeding time of 5 patients with delayed bleeding after ESD was the first day after operation (1 ~ 10 d). The median duration of surgery was 75 min (60~150 min), and the prediction success rate was 94.9 %. The results of univariate analysis showed that age [(69.6 ± 7.9) vs (60.9 ± 10.1) years old, P = 0.003] and operation time [(90.0 ± 41.0) vs (66.0 ± 42.0) min, P = 0.000] were both the risk factors in delayed bleeding and non-bleeding group. Binary Logistic regression analysis showed that operation time (OR^ =1.07; 95%CI:0.73 ~ 14.63, P = 0.010) was the only predictor of delayed bleeding after ESD. Conclusions Second-look endoscopy might be effective in preventing delayed bleeding after gastric ESD, especially within 48 hours after ESD. The operation time was an independent risk factor for delayed bleeding after gastric ESD.

Objective To investigate the relative activity of multidrug resistance P-glycoprotein in the plasma of breast cancer patients, analyze the expression of P-glycoprotein before and after chemotherapy and evaluate its clinical value. Methods The plasma of patients and chemical reagents were mixed and distributed into the 96-well plate. The plate was read at 340 nm absorbaace before and after reaction. The variation of absorbance for each well was calculated, and then relative activity of each sample was compared to the referent compound activity. The relative activity of over 30 % was taken as positive expression of the P-gp for each sample. Results The frequency of P-glycoprotein expression was significantly increased from 16.2 % before chemotherapy to 43.2 % after chemotherapy (P<0.05). The positive expression of P-glycoprotein before and after chemotherapy were 5/6 and 9/16, respectively, in patients with positive lymph node metastasis, and 1/6 and 7/16, respectively, in patients with negative lymph node metastasis. Conclusion The results of this preliminary study suggest in P-glycoprotein expression in plasma of patients play an important role in the selection of drugs, which may be useful to evaluate the prognosis for treatment of breast cancer patients.

Objective To investigate the expression of NKG2D peripheral blood of patients with esophageal carcinoma and expression of the soluble form of major histocompatibility complex class Ⅰ-related chain A (MICA). To analyze and discuss the function of NKG2D in anti-esophageal carcinoma mechanism and its relation with escape of immunosurveillance of cancer. Methods Flow cytometry analysis was used to detect NKG2D in the peripheral blood of 50 patients with esophageal carcinoma and 25 normal control individuals. Enzyme-linked immunoabsorbent assay was used to measure serum levels of soluble MICA. Results The expression of NKG2D were(87.25±3.06), (88.38±4.24), (92.46±1.46) respectively. Compared with the normal control individual, the expression of NKG2D in esophageal carcinoma group was significantly low; Among patients categorized according to most disease parameters tested (tumor size, grade of differentiation, regional lymph node status, disease stage), soluble MICA levels in sera did not statistically differ from those in normal control individuals. Patients with stage Ⅳ disease and/or regional lymph node metastasis, exhibited significantly higher serum levels of soluble MICA than control individuals. Conclusion The activity of NK cell and the anti-cancer cellular immunity level reduce in patients with esophageal carcinoma. The decrease of the receptor NKG2D is a reason for the descend of the the activity of NK cells. The escape of immunosurveiilance with esophagal carcinoma may correlate with down-regulate of NKG2D expression and up-regulate of sMICA.