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 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

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.

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.

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 effect of costimulatory molecules 4-1BB/4-1BBL on T cell activation with systemic lupus erythematosus(SLE)patients.Methods The expression of NF-kB mRNA and p38 MAPK mRNA of T cells with 20 SLE patients and 20 normal controls before activation,after activation and blocked bv 4-1BB/4-1BBL were detected bv RT-PCR.The protein levels of p-p38 MAPK and NF-kB were detected by Western blot.Results The expression of NF-kB mRNA and p38 MAPK mRNA and the protein expression of NF-kB and p-p38 MAPK of T cell with SLE patients were higher than that of normal controls(P＜0.01).There were more expression of NF-kB mRNA,p38 MAPK mRNA,NF-kB protein and p-p38 MAPK protein of T cell with SLE patients stimulated by anti-CD3 monoantibody(P＜0.01).In anti-4-1BB monoantibody blockage group,there were decreased expression of p38 MAPK mRNA and p-p38 MAPK protein(P＜0.01).but not the decreased NF-kB mRNA and protein expression.Conclusion Costimulatory molecule 4-1BB plays a critical role in T cell activation of SLE by p38 MAPK signal pathway.

OBJECTIVE To develop technique of central vein catheterization by external jugular vein puncture under ultrasound guidance.METHODS A total of 224 patients with central vein catheterization by external jugular vein puncture were randomized into two groups: the control group was treated by routine manipulation and observed blood vessels by macroscopic observation;the patients from the observation group were placed catheters with the assist of ultrasound techniques.To record the one time achievement ratio of catheterization and incidence of phlebitis and thrombus.RESULTS Comparing the two groups,we found the observation group had higher one time achievement ratio of catheterization and lower incidence of phlebitis and thrombus than that of the control group.And there were statistical significances between the two groups(P

OBJECTIVE Researching the dynamic changes of air bacteria content in the process of spine operating.METHODS Adopt settling process to monitor the bacterium content of the air in the process of surgery operating at the point of pre-operating,cut skin,surgical sutures,suturescontent.RESULTS There are two obvious peak values of bacteria content in the process of spinal surgery operating,at beginning of operating and operating finished.CONCLUSIONS There are two obvious peak values of bacteria total amount changes in the process of operating in operating room,the main factor of the bacteria total amount changes in the air is the personal activities in operating room during operatings.