Objective: To observe the effect of tolvaptan on treating the patients with intractable heart failure (HF) combining hyponatremia for their clinical conditions and improvements. Methods: A total of 100 relevant patients treated in our hospital from 2014-01 to 2015-01 were studied. Based on conventional treatment as cardiac stimulant, dieresis and correction of electrolyte disturbance, the patients were randomly divided into 2 groups: Tolvaptan group, the patients received tolvaptan15 mg/d for 5 days and Control group, the patients had no tolvaptan administration.n=50 in each group. The improvement of clinical symptoms, changes of cardiac, renal functions and blood levels of electrolyte were compared between 2 groups after treatment. Results:① Compared with Control group, Tolvaptan group had significantly improved dyspnea, reduced lung moist rale and low limb edemaP<0.01; Tolvaptan group showed increased 24 h urine volume (2416.0±771.6 vs 1124.6±215.7) ml,P<0.01, decreased plasma levels of NT-proBNP (2678.04 ± 537.09) pg/ml vs (4051.34 ± 306.07) pg/ml,P<0.01 and increased blood levels of sodium (139.08 ± 6.18) mmol/L vs (129.44 ± 2.20) mmol/L,P<0.01. ②In Tolvaptan group, the above improvements were found in 38 patients, and with 1 day tolvaptan therapy, their blood nitrogen dropped from (10.39 ± 1.23) mmol/L to (7.28 ± 1.53) mmol/L,P<0.01; the other 12 patients had no such effect, and with 1 day tolvaptan therapy, their blood nitrogen elevated from (10.39±1.23) mmol/L to (13.38 ± 0.66) mmol/L,P<0.01. Conclusion: Tolvaptan could effectively improve clinical symptom and cardiac function in patients with intractable HF, it is helpful to increase blood sodium level; the efifcacy of tolvaptan might be evaluated by the changes of blood nitrogen at the early stage of treatment.

Objective To explore the relationship between embryo damage and anxiety,depression and life events during pregnancy. Methods A case control study was carried out. 192 women diagnosed with embryo damage were selected as the case group,and 192 normal pregnant women or normal parturition within 7 days were selected as the control group from March to June,2014.All cases were from two 3-A-grade general hospitals of Jining. Self-rating anxiety scale ( SAS ) , center for epidemiological survey, depression scale( CES-D) and life events scale for pregnant women( LESPW) were used to evaluate the anxiety,depres-sion and life events of the two groups,so as to analyze the association between these factors and embryo dam-age. Results Multiple non-conditional logistic regression analysis showed that anxiety ( β=0. 409, OR=1.050,95%CI =1.003-1.009) ,depression( β=0.085, OR=1.088,95%CI =1.035-1.145) ,life events dur-ing pregnancy( β=0.003, OR=1.003,95%CI =1.001-1.005) were the risk factors of embryo damage,while education ( β=-0.749, OR=0.452,95%CI=0.298-0.685) ,pre pregnancy health status ( β=-1.366, OR=0.255,95%CI =0.098-0.655) and taking the initiative to acquire knowledge of eugenics ( β=-0.884, OR=0.413,95%CI =0.203-0.840) were the protective factors of embryo damage. Conclusion Anxiety,depres-sion and life events during pregnancy are related to the occurrence of embryo damage. High degree of educa-tion,pre pregnancy in good health and taking the initiative to acquire eugenics knowledge can reduce the oc-currence of embryo damage.

Objective To study and the succession of sarcosaphagous insects and their regular activity on carcass in Xinxiang area. Methods Six rats and five rabbits were sacrificed and placed at the remote grassland of Xinxiang Medical University in July 2015. The main insect species and the decomposition process were observed. The different decomposition stages and the community succession of insects were recorded. Results Seven main species could be identified belonging to 3 families from Diptera, main including Musca domestica, Chrysomya megacephala, Lucilia sericata, Boettcherisca peregrina, Helicophagella melanura. Muscina stabulans and Fannia prisca. And showed regulations of the succession of sarcosaphagous flies community. Conclusion It may be used for estimating postmortem interval in Xinxiang area.

Objective:To analyze and compare the dosimetric differences based on volumetric-modulated arc therapy (VMAT), fixed field intensity-modulated radiotherapy (F_IMRT), and electron irradiation combined with VMAT (E&VMAT) in radiotherapy for breast cancer after modified mastectomy, aiming to provide reference for clinical selection of treatment plan.Methods:Ten patients with the left breast cancer who received radiotherapy after modified mastectomy were randomly selected. The target areas included chest wall and supraclavicular region, and the prescribed dose was 43.5 Gy in 15 fractions (2.9 Gy/F). Based on the Pinnacle 3 planning system, the VMAT, F_IMRT and E&VMAT plans (electron beam for chest wall, VMAT for supraclavicular area) were designed for each patient. The conformity and homogeneity of the target areas, the dose of organs at risk and treatment time were compared. Results:The VMAT plan could improve the dose distribution of the target areas. The conformity index and homogeneity index of the target dose were significantly better than those of the F_IMRT and E&VMAT plans (all P<0.05). The average dose, V 30Gy, V 20Gy, V 10Gy of the left lung in the VMAT plan were significantly better than those in the F_IMRT and E&VMAT plans (all P<0.05). The V 5Gy of the left lung in the VMAT plan was significantly better than that in the F_IMRT plan ( P<0.05). There was no statistical difference in the V 5Gy of the left lung between the VMAT and E&VMAT plans ( P>0.05). The heart, right breast and right lung of the VMAT plan could meet the clinical dose limit requirements. The treatment time of the VMAT, F_IMRT and E&VMAT plans was (326±27) s, (1 082±169) s, and (562±48) s, respectively. Conclusions:Compared with the F_IMRT and E&VMAT plans, the VMAT plan has better quality and shorter treatment time. VMAT plan has higher value in clinical application compared with the F_IMRT and E&VMAT plans.