Objective: To investigate the factors that affect the outcome of pregnancies complicated with critically heart disease admitted to obstetric Intensive Care Unit (ICU). Methods: A retrospective study was conducted for 188 pregnant and postpartum patientscomplicated with heart disease who were admitted to the ICU in West China Second University Hospital from July 2009 to March 2013. Results: During the 4 years, there were 619 cases of pregnancy complicated with heart disease hospitalization. Among them, 188 (30.37%) patients complicated with severe heart disease were admitted to the ICU, accounting for 39.17% of the total ICU admission (480); the mean maternal age was (28.45±6.08) years old and the mean gestational time was (36.03±4.19) weeks. 23 (12.23%) patients received regular antenatal care in our hospital. 61 (32.45%) patients never received antenatal care before hospitalization. Among them, 5 patients were dead. hTe ratio for diagnosis of heart disease before pregnancy, during pregnancy and atfer admission were 39.89%, 25.54% and 34.57%, respectively; the most common heart diseases during pregnancy were congenital cardiac disease (80, 42.55%) and rheumatic heart disease (45, 23.94%) followed by arrhythmias (20, 10.64%). The most common complication were pulmonary arterial hypertension (51, 27.13%), arrhythmias (47, 25.00%) and severe heart failure (30, 15.96%); the cardiac function of 164 (87.23%) patients was at stage I–II and 5 (2.66% ) patients died when discharged from hospital. 151 (80.32%) patients received multidisciplinary consultation and 34 (18.09%) used central venous catheterization to control central venous pressure (CVP). 21 (11.17%) patients required mechanical ventilation. 11 (5.85%) patients required emergency life support (cardiopulmonary resuscitation 9 + electric deifbrillation 3). Conclusion: Pregnancy complicated with heart disease is the leading reason for admission to ICU. hTe congenital cardiac disease, rheumatic heart disease and arrhythmias are the main heart diseases during pregnancy. Multidisciplinary cooperation and intensive care are the key measures to improve the outcomes of patients with critically illness. It is very important for reduction of the maternal mortality rate through strengthening preconception care and antenatal care.

To observe clinical therapeutic effect of Ren Zhu Jian Wei Granules on precancerous lesion of stomach. Methods: 130 cases of precancerous lesion of stomach were randomly divided into tow groups, the treatment group (88 cases) treated with Ren Zhu Jian Wei capsules and the control group (42 cases) treated with Wei Fu Chun Tablets, and clinical data were analyzed. Results: The comprehensive therapeutic effect was 92. 0% in the treatment group and 73. 8% in the control group; and the clinical therapeutic effect was 94. 3% in the treatment group and 78. 6% in the control group with a significant difference (P

〔Abstract〕 Based on the retrieval sources of the official website of Inforway in Canada , Tongfang Knowledge Network and Internet re-sources, by investigating the conformance test of health informatization and health standards conducted by Inforway in Canada , the paper makes a comprehensive analysis of the conformance test of health information standards in Canada from 4 aspects, namely the certification subject, certification object , certification standard , certification process .It aims to provide references for the conformance test of health information standards in China .

Objective To evaluate the effect of treating malignant biliary obstruction by expandable metallic biliary endoprosthesis(EMBE) via percutaneous transhepatic approach companied with stereotactic radiotherapy(SRT). Methods We implanted total 19 stents via percutaneous transhepatic in 15 patients with malignant biliary obstuction, then the patients received stereotactic radiotherapy.Results The stent implanting in 15 cases was successful,and followed-up for 12 months .3 cases died in the third,fourth and eleventh month respectively without jaundice,others survied formore than one year.The survival rate for one year was 80%.Conclusion Implanting stent in bile ducts companied with stereotactic radiotherapy is an effective way in treating malignant biliary obstruction.

Objective To explore the effects of brain-derived neurotrophic factor (BDNF) on expression of apoptotic regulated genes (bcl-2 and c-jun) in hippocampus after status convulsivus (SC). Methods Seizures were induced in 32 adult Wistar rats with lithium-pilocarpine intraperitoneal injection (SC), the other 32 rats were as the normal controls (NC). The rats were sacrificed 6 h after injection of normal saline (NS), BDNF, or anti-BDNF in left lateral ventricle (or no injection). The expression of Bcl-2 and c-Jun protein and bcl-2 and c-jun mRNA were investigated with immunocytochemistry, RT-PCR and in situ hybridization. Results The expression of bcl-2 and c-jun (both protein and mRNA) was not significantly different in the hippocampus of both side in NC. In SC, the expression of bcl-2 ranged from more to less as BDNF>NS and non-injection>anti-BDNF in the hippocampus of non-injected side, while the expression of c-jun reversed. However,there was not significant difference in the expression of bcl-2 or c-jun in the hippocampus of non-injected side. Conclusion Exogenous BDNF can up-regulate the expression of bcl-2 and down-regulate the expression of c-jun in hippocampal cells, which may protect brain from apoptosis after after SC. The intraventricular injection of BDNF diffuses limited, which works less for clinical treatment.

ObjectiveTo explore the influences of age and duration of status convulsivus （SC） on mitochondrial membrane potential (△Ψm） in hippocampus. MethodsConvulsive seizures for 30 min or 3 h (30 min SC or 3 h SC) were induced in 80 infant (20 d after birth) and 80 adult Wistar rats (IRs ＆ ARs respectively) with lithium-pilocarpine ip. The rats were sacrificed at 6 different time points from the 3rd hour to 7th day after SC termination. The mitochondrial △Ψm in hippocampal cells was determined with flow cytometry. ResultsThe mitochondrial △Ψm in hippocampal cells started to decrease at the 3th hour after SC in both IRs and ARs. The bottom level was reached at the 6th hour after SC ［(6.08±0.43) in IRs and (5.70±0.63) in ARs ) ］. Both of them were significantly lower than that of control group (P<0.01） and began to increase at 12th hour after SC. On the 7th day after 30 minutes SC, the level of mitochondrial △Ψm in IRs increased to the level of control, while the level in ARs was still lower than that of control (P<0.05）. At the 3rd hour, the 3rd and the 7th day after SC, the levels of mitochondrial △Ψm in IRs were obviously higher than those in ARs. Compared with the same time point after 30 min SC, the levels of mitochondrial △Ψm at the 3rd and the 6th hour after 3 h SC were much lower in different age groups (P<0.05）. Except the effect of the age-related difference, there was a positive correlation between the duration of SC and the changes of mitochondrial △Ψm in partial correlation analysis （r=0.71，P<0.05）. ConclusionSevere seizure could induce the mitochondrial △Ψm decreased in hippocampus. Age and duration of SC were important factors associated with the mitochondrial △Ψm decrease. There may be an internal protective response against brain damage in premature brain.

Objective To explore the effects of environmental enrichment (EE) on learning and memory ability and the expression of brain-derived neurotrophic factor (BDNF) and synaptophysin in hippocampus of neonatal rats with hypoxic-ischemic brain damage(HIBD).Methods Forty Wistar neonatal male rats aged 7 days were randomly divided into EE intervention for 6 hours(6 h EE) group (n =10),EE intervention for 12 hours (12 h EE) group (n =10),model group (n =10) and sham group (n =10).The first 3 groups were performed with HIBD.The 6 h EE and 12 h EE group received EE stimuli for 6 h and 12 h respectively,once a day for 14 days.Learning and memory of the rats were tested by using Morris water maze.The expression levels of BDNF and synaptophysin in hippocampus were determined with Western blot.Results The escape latency of all groups gradually reduced with the increase of training days,but there was no significant difference in the escape latency among the 4 groups (F =0.237,P ＞ 0.05).The rats in the 6 h EE group,12 h EE group and model group spent less time in the target quadrant and showed a significant reduction of BDNF and synaptophysin(6 h EE group:0.529 ± 0.038,0.889 ± 0.027;12 h EE group:0.660 ± 0.034,1.114 ± 0.037;model group:0.225 ± 0.015,0.672 ± 0.057) in the hippocampus compared with the sham group (0.803 ± 0.026,1.347 ± 0.092) (all P ＜ 0.01).In the 6 h EE group and 12 h EE group,the rats significantly increased the time spent in target quadrant and aggrandized the expression of BDNF and synaptophysin in hippocampus compared with the model group.Moreover,the 12 h EE group had a better performance than the 6 h EE group in the space exploration and the expression of BDNF and synaptophysin.Conclusion EE is helpful for improving learning and memory ability in neonatal rats with HIBD,which may be associated with up-regulating the expression of BDNF and synaptophysin in hippocampus.

Objective To investigate the clinical characteristics of speech disorders in children with cerebral palsy (CP) and any relationship between those characteristics and cranial magnetic resonance images.Methods A sample of 138 children with CP were given the ＜ s-s ＞ language development test,a Chinese-language articulation test and oral motor scores to quantify their functional speech and articulation.The characteristics of their speech disorders,articulation and oral motor dysfunction were then related with abnormalities in their cranial magnetic resonance images (MRIs).Results Of the 138 MRIs,only 9 were normal.Three showed non-specific abnormalities (delayed myelination and/or broadening of the space outside the brain) and 122 (91％) showed specific abnormalities.Among the children with specific abnormalities,51.6％ had speech reception delay and 74.6％ had speech expression delays.The dysarthria rate was 71.3％,including 8.7％ with no speech ability at all.The main MRI abnormalities were lesions of the basal ganglia (23％),lesions of the cerebellum (11.5％),periventricular leukomalacia (PVL) (47.5％),extensive cortical or subcortical lesions (6.6％) and focal cerebral injury (11.5 ％).The corresponding oral motor scores increased successively.The children with lesions of the basal ganglia or cerebellum were most likely to manifest speech expression delay and dysarthria.The children with cortical or subcortical lesions or PVL also showed speech expression delay and dysarthria.However,the children who had a focal cerebral injury generally performed well on the speech ability assessment.Twelve children had no speaking ability at all,and in 7 of them the lesions were of the basal ganglia.Conclusions The probability and severity of speech disorders in children with cerebral palsy relate with specific abnormalities detectable with cranial MRI.Those with lesions of the basal ganglia or cerebellum will be more likely to show more severe speech disorders.

Objective To analyze the hepatitis E virus (HEV) infection status and the molecular characteristics of HEV isolated from pregnant women in Zhejiang Province.Methods Totally 98 236 serum samples collected from pregnant women during the year 2013 to 2015 were tested for HEV IgM by enzyme-linked immunosorbent assay (ELISA) and samples positive for IgM were detected for nucleic acid of HEV by nested polymerase chain reaction (PCR).The whole gene of HEV open reading frame 2 (ORF2) was further amplified and the prevalence was analyzed in nucleic acid-positive samples.Results Three hundred and fifty-two out of 98 236 serum samples were tested positive for HEV IgM,with positive rate of 0.36％.All the samples were simple positive of HEV IgM except for two samples co-infected with hepatitis B virus.HEV specific nucleic acid fragments were detected positive from three serum samples.Further phylogenetic analysis revealed that all the three HEV isolates in this study belonged to HEV genotype 4.Three isolates did not cluster in one branch,although they shared high nucleic acid homology and more than 97 ％ of amino acid homology.Variations were found significantly between sample sequence and other published HEV 4 isolates,including two variable regions found in the ORF2 gene (1-460 nucleotide and 620-870 nucleotide).However,the synonymous and non-synonymous substitutions rates in the two regions were similar,and neutral selection was the main evolutionary pressure.Conclusions HEV infection rate in pregnant women of Zhejiang Province is similar with the published data.The HEV isolates obtained in this study belong to genotype 4 with high variation rate.

Objective To observe the effects of early exercise on the expression of synaptophysin pro-tein and Nissl bodies in the hippocampus after hypoxic-ischemic brain damage( HIBD) , and to investigate possi-ble mechanisms. Methods A total of 35 neonatal Wistar rats aged 7 days were randomly divided into a train-ing group of 13, a control group of 11 and a sham-operation group of 11. HIBD was induced in the rats of the training and control groups, while those in the sham-operation group had the left common carotid artery separa-ted, but without ligation. Seven days after successful modeling, the training group began swimming training for 10 min every day lasting for 14 days, while the other groups were not trained. Western blotting was used to detect the expression of synaptophysin in the affected hippocampus of the brain based on the ratio of the gray band val-ues for synaptophysin and beta. Nissl staining was applied to observe the number of Nissl bodies and the morphol-ogy of the neurons in the hippocampus. Results The average expression of synaptophysin in the sinistrocere-bral hippocampus of the rats in the control group was significantly lower than that in the sham-operation group, but significantly higher than that of the training group. The control group had significantly fewer Nissl bodies than the sham-operation group, but significantly more than the training group. Conclusion Early training can in-crease the expression of synaptophysin and the number of Nissl body in the hippocampus after hypoxic-ischemic brain damage.