Objective To summarize the common causes of fetal arrhythmia and explore its clinical significance and correlation with fetal prognosis. Methods The clinical situation and diagnostic procedure as well as the results of long-term follow-up of 26 cases of fetal arrthythmias were analyzed retrospectively. Results The incidence of fetal arrhythmias is 0.2%. 11.5%(3/26) of them were diagnosed fetal tachycardia, 15.4% (4/26) of them were diagnosed fetal bradycardia and 73.1% (19/26)were diagnosed irregular fetal cardiac rhythm . The average gestational age they were diagnosed was 35 +2 weeks (15 weeks to 41 +1weeks). Twenty-two cases were diagnosed by antenatal auscultation, 1 case was diagnosed by ultrasonography at 15 weeks' gestation, 3 cases were diagnosed by fetal heart monitoring. We performed fetal echocardiograms on 17 fetuses, 6 cases (35.3%)showed that premature atrial contraction with normal structure of fetal heart. All of the neonates survived postnatally and 24 of them (92.3%) accepted follow-up. Echocardiograms for16 neonates were performed and 2 of them were identified as atrial septal defects with normal heart rhythms. The incidence of structure heart disease in fetal arrhythmia is 7.7%. Conclusion The prognosis is well for most of the fetuses with arrhythmias, the incidence of heart structure disease is very low among them. We should pay attention to diagnose the fetus of heart structure disease with persistant bradycardia. Temporization for the management of arrhythmiatic fetuses should be accepted and the decision for termination of pregnancy should be made according to obstetric indication.

Published reports of benign nerve sheath tumors of the oropharynx especially at tongue base are extremely rare. They may slowly growing but represent a potential threat to the airway, prompt diagnosis and treatment are vital. To our knowledge, this case presents the rare clinical condition and the first giant one. Due to the rarity, awareness of the possibility of a schwannoma in various otolaryngological conditions is an important step in making a correct clinical diagnosis. Here we represent a rare case of a giant schwannoma that arose from valleculae projecting to supraglottis to cause swallowing difficult but no breathing problem. The mass was completely removed, and no recurrence during next 2 years follow-up.
Humans ; Male ; Middle Aged ; Neurilemmoma ; Tongue Neoplasms

With high incident of cancer and chronic disease, it is more and more important to develop palliative care; as developing later, there is neither unified palliative care mode and related policy, nor mature assessment collaboration in China. It pointed out that Australia as an advanced country with stable development of palliative care and assessment collaboration, called palliative care outcomes collaboration (PCOC). It expatiated the PCOC on structure,function and operation. China should learn from the mode of Australia palliative care assessment and management collaboration, find references to improve and further develop Chinese palliative care assessment collaboration.

Objective To investigate the current status of health education among nursing undergraduates,to analyze the existing problems and to bring up corresponding strategies for improving the health education ability for nursing undergraduates.Methods Totally 381 nursing undergraduates were recruited and investigated with a self-designed questionnaire.Aspects of students' cognition of health education,influencing factors of health education and the implementation of health education in clinic were investigated.Data were processed using SPSS 12.0 and percentages were calculated.Resuits 98.75％ students understood the importance of heath education in nursing work.However,systemic training courses of health education for nursing undergraduates were insufficient in both colleges and hospitals.Meanwhile,clinical teachers' ability of health education was limited.Only 15.59％students provided health education for patients independently.Conclusions Nursing colleges and practicing hospitals should strengthen health education consciousness of nursing undergraduates,enhance faculty construction and should set up related courses to train the health education skills.

Objective To assess the value of diffusion tensor imaging(DTI)and susceptibility weighted imaging(SWI)in diagno-sis of acute diffuse axonal injury.Methods The imaging data of 45 cases with acute DAI diagnosed by clinical symptoms were ana-lyzed retrospectively.In all the images of T2 WI,FLAIR ,DTI and SWI we analyzed the characteristic of signal and distribution of all the lesions.The numbers of lesions found in each sequence group were statistically analyzed by chi-square test.Results 497 lesions of DAI we all found.265 lesions were found in FLAIR,the detection rate was 53.3%.313 lesions in DTI,the rate was 62.9%.448 lesions in SWI,the rate was 90.1%.The detection rate of DTI and SWI were significantly higher than FLAIR,they had significant difference(P <0.05).Conclusion DTI combined with SWI,we can find DAI lesions in acute phase more comprehensively.DTI di-mensional diffusion tensor imaging technique can help us visualize discontinuous fibers intuitively in DAI and confirm objectively the existence of DAI lesions.

The blood concentrations of the pharmacodynamic substances of traditional Chinese medicines (TCMs) are usually very low. How can they exert pharmacological actions, in which forms (original form, metabolite or the both) do they exert the actions. To answer these questions, we proposed a new concept ofEffective Formsof pharmacodynamic substances of TCMs and a hypothesis of additive effect of multiple constituents of TCMs. The hypothesis includes that the aggregate or summation of Effective Forms of pharmacodynamic substances of TCMs is the core material base of the effi-cacy of TCMs, and the additive effect of the blood concentrations of different Effective Forms is one part of the action mechanism. The additive effect of the different Effective Forms of a TCMs means an additive effect of numerous con-stituents or/and metabolites on a same target, and therefore the efficacy brought by the addition of the concentrations of all these compounds, which different from the synergy effect of multi-constituents on multi-targets. Studies on the disposition of TCMs showed that a constituent can be biotransformed to many metabolites (up to more than 50 metabolites);different constituents can produce the same metabolites;many metabolites (up to 10 compounds for each metabolite) are isomers or homologues; some constituents can be converted to each other in vivo; and some metabolites are bioactive. These com-pounds having the similar structure are likely to have the same pharmacological effects on the same target, which could provide experimental evidences for the concept ofEffective Formsand the hypothesis ofAdditive Effect. We suggest that the Effective Forms and Additive Effects of the pharmacodynamic substances of TCMs should be extensively investi-gated in the future, and the results of such researches will help us further understand the pharmacodynamic substances and action mechanism of TCMs, and give a new explanation 'Toxicities Scattering Effect' for 'Why the toxicities of TCMs are low', and propose a new strategy for quality control of TCMs.

Airway Obstruction ; diagnosis ; etiology ; Aspergillosis ; complications ; diagnosis ; Humans ; Laryngeal Diseases ; complications ; diagnosis ; microbiology ; Larynx

Objective: To investigate effect of exogenous wild-type p53 gene on the cell growth and tumorigenicity of human gallbladder cancer cell lines. Methods: After identification of the genetic status of p53 gene of GBC-SD cell lines with the immunocytochemistry staining and the direct sequencing technique of PCR products, eukaryotic expressing plasmid pCMV-p53 was introduced by lipofectamine-mediated into GBC-SD cell lines. Growing transfected cells were selected by G418. The presence and expression of exogenous p53 gene was detected by PCR, RT-PCR and Western blot. The cellular proliferating ability was assessed using the cell growth curve and cloning assay. The xenograft in nude mice was performed to examine the effect of tumorigenicity. Results: P53 protein overexpression was showed in GBC-SD cell lines. A transversion of TAC→AAC at codon 126 of exon 5 was confirmed. PCR, RT-PCR and Western blot showed exogenous p53 gene had successfully transfected into GBC-SD cells and obtained high expression. The growth and proliferation of the cells were greatly decreased, and the tumorigenicity was significantly inhibited after transfection wtp53. Conclusion: The expression of exogenous wild-type p53 gene could effectively inhibit the growth of gallbladder cancer GBC-SD cells in vitro and in vivo.

Objective To assess the length of stay,early complication and cost of treatment in radical cystectomy (RC) patients with different Charlson Comorbidity Index Score (CCI).Methods A prospective study of a total of 102 patients who underwent RC between March 2012 and August 2014 in Center for Research of Urology in Yunnan Province,China.They were divided into three groups:69 cases in CCI=0 or 1group,19 cases in CCI=2 group,14 cases in CCI≥3 group.Comorbidities were graded according to CCI,and each patient was followed-up for 3 months after RC.Length of stay,early complications and treatment cost were analyzed by statistics.Results A total of 102 patients were analyzed.There were obvious differences with respect to length of stay,early complication and cost of treatment comparing patients in each CCI group,H=20.722,6.025,and 7.047,P＜0.05.The incidence of diversion-related early complications in patients with different CCI showed significant difference,H=7.100,P＜0.05,however,the non diversionrelated early complications did not show significant difference between patients with different CCI,H=2.590,P＞0.05.Conclusions Patients with different CCI showed difference in the length of stay,early complication and cost of treatment in RC patients with different CCI.CCI≥3 might help to identify patients at risk for early complications after RC,especially in the orthotopic urinary diversion operation.Patients' complication should be evaluated standardized before operation and these should be included in patients' consideration.

OBJECTIVE:To establish the HPLC characteristic chromatogram of pheretima,and compare the differences of the main ingredient contents of Guangdong pheretima and Shanghai pheretima and the chromatogram differences among pheretima and 3 other animal drugs. METHODS:Pheretima HPLC characteristic chromatogram method was adopted to determine the characteris-tic chromatograms of 16 Guangdong pheretima,8 Shanghai pheretima,3 eupolyphaga,3 hirudo and 3 catharsius. Similarity evalua-tion and t test were used to analyze the differences of chromatogram data of 5 animal drugs. RESULTS:The established HPLC char-acteristic chromatogram method firstly identified 11 common characteristic peaks,including 6 nucleosides,4 nucleobase and 1 ami-no acid;and it could be used for the identification of pheretima from eupolyphaga,hirudo and catharsius;the differences of main ingredient contents in the characteristic chromatogram of Guangdong pheretima and Shanghai pheretima were firstly studied. The contents of xanthine and adenosine in Guangdong pheretima were higher than Shanghai pheretima,while the contents of uridine, guanosine and 2′-deoxy guanosine in Shanghai pheretima were higher than Guangdong pheretima. A new index S,calculated by these 5 constituents,was successfully applied to distinguish the 2 kinds of pheretima. CONCLUSIONS:The characteristic chro-matogram can be used for the identification of pheretima,and can provide reference for the pharmacodynamic differences study of Guangdong pheretima and Shanghai pheretima.