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 effects of safflor yellow ( SY) on body fat, fatty liver and insulin resistance in diet-in-duced obese mice. Methods:Male C57BL/6 mice at the age of 4 weeks were fed with high fat diet ( HF) for 8 weeks to make the obese model. The mice were intraperitoneally injected SY (100 mg·kg-1 ·d-1 ) for 6 weeks. At the end of experiment, the introper-itoneal glucose tolerance test ( IPGTT) and insulin tolerance test ( ITT) were performed, and the body fat, blood lipid profile and the other metabolic parameters were detected. Meanwhile, the epididymis fat and liver tissue were withdrawn for HE staining, the adipo-cyte area was quantified and the morphology of liver was observed. Results:SY significantly reduced the body weight, body fat mass, adipocyte area, liver weight and blood lipid levels of the obese mice (P<0. 05), and fatty liver was obviously alleviated after the ad-ministration of SY. Meanwhile, IPITT and ITT tests showed that SY significantly improved the glucose intolerance and insulin resist-ance of the obese mice(P<0. 05). Conclusion:SY has significant weight-loss effects and it can alleviate fatty liver, and improve glu-cose intolerance and insulin resistance in diet-induced obese mice.

Objective To compare the costs of laparoscopy and laparotomy in the operative treatment of ovarian cysts. Methods Patients with ovarian cysts who were operated on by laparoscopy (83) or by laparotomy (65) in the Peking University Third Hospital from June 2000 to August 2001 were retrospectively analyed.Patients' hospital stay,time taken for the patients to return to work,hospital charges,costs because of inability to work and total costs (including the direct medical costs,direct non-medical costs and indirect costs) were compared between the two groups. Results The mean hospital stay and the mean time taken for the patients to return to work were statistically shorter in the laparoscopy group than those in the laparotomy group.The mean hospital charges were significantly higher and the mean costs of without work were significantly lower in the laparoscopy group.The total costs in the two groups were similar (no significant difference). Conclusions According to the mean income of the people in Beijing,the costs of laparoscopy in the operative of the ovarian cysts are not higher than that of lapatomy.

This paper deals with the problems existing in the making of textbooks in our universities in our country,and proposes the solutions and feasible measures to the problems

Chronic obstructive pulmonary disease (COPD) is the leading death cause of pulmonary diseases, ranking the fourth of global death causes. Self-management program is able to gradually improve the Airways of COPD patients with ventilation, reduce the degree of lung failure, elevate the health status as well as promoting self-efficacy, which is the key process to effectively control COPD relapse. In recent years, more and more domestic and foreign academic employ the widely-used network technology and carry out a large number of information study on COPD self-management intervention. This article reviewed literatures about the intervention methods on self-management of patients suffered from COPD, aimed at providing a better basis for exploring more effective self-management.

Objective To investigate the effects of N-acetylcysteine (NAC) on the expression of cardiac adiponectin and its receptors in streptozotocin-induced diabetic rats. Methods Thirty-two male Wistar rats were randomly divided into four groups, with 8 in each: untreated control group (C group), NAC-treatment group (CT group), diabetic untreated group (D group) and diabetic NAC-treatment group (DT group). After 8 weeks, plasma glucose and insulin, and cardiomyocyte cross sectional area were measured. Cardiac protein expression of adiponectin receptor 1 and 2 (adipoR1 and adipoR2), AMP-activated protein kinase ? (AMPK?), phosphorylation of AMP-activated protein kinase ?-subunits and glucose transporter 4 (GluT4) were determined by Western blotting. Plasma and myocardial adiponectin levels were measured by radioimmunoassay. Plasma and myocardial free 15-F2t-isoprostane levels were assayed by enzyme immunoassay. Results Compared with C group, the ratio of ventricular weight to body weight and cardiomyocyte cross-sectional area, plasma and levels of free 15-F2t-isoprostane in myocardium and the protein expression of myocardial adipoR1 increased significantly in diabetic rats (D group) (P

Objective:To assess the safety and efficacy of riboflavin/ultraviolet-A-induced accelerated epithelium-off corneal collagen cross-linking (CXL) for teenagers with keratoconus.Methods:In this case series study, 25 eyes of 18 patients with primary keratoconus who underwent riboflavin/ultraviolet-A-induced accelerated epithelium-off CXL in Zhengzhou Second People's Hospital from January 2017 to February 2018 were included, and the average age of patients was (14.4±1.3) years.The uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), spherical equivalent (SE), maximum keratometry reading (K max), thinnest corneal thickness (TCT), posterior corneal elevation (PCE) and endothelial cell density (ECD) were measured before and after CXL.The patients were followed up for one year.The complications and adverse reactions were recorded.The study adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Zhengzhou Second People's Hospital (No.KY2017002). Written informed consent was obtained from each patient and their guardian prior to the surgery. Results:The mean UCVA (LogMAR) was 0.96±0.35 at baseline, which was significantly improved to 0.84±0.33 at 1 year postoperatively ( t=-5.765, P<0.01). The mean BCVA (LogMAR) was 0.45±0.22 preoperatively, which was significantly improved to 0.34±0.26 at 1 year postoperatively ( t=-4.843, P<0.01). The mean SE was (8.66±5.11)D at baseline, which was significantly higher than (8.07±5.21)D at 1 year postoperatively ( t=-3.253, P=0.003). The K max was reduced from (58.58±9.07)D preoperatively to (56.25±9.98)D at 1 year postoperatively, with significant difference between the two time points ( t=-4.357, P<0.01). The K max was reduced more than 1 D in 17 eyes (68%), was stable in 6 eyes(24%), and was increased more than 1 D in 2 eyes (8%). The TCT was reduced from (485.0±32.5)μm at baseline to (475.3±35.5)μm at 1 year postoperatively, with significant difference between the two time points ( t=-4.266, P<0.01). The differences of PCE and ECD between preoperative and postoperative 1 year were not statistically significant ( t=1.023, P=0.316; t=-1.424, P=0.167). There was one eye suffering peripheral sterile corneal infiltrate 2 days postoperatively, and favorable prognosis was achieved after the topical steroids application.No complication was encountered in other subjects. Conclusions:Riboflavin/ultraviolet-A-induced accelerated epithelium-off CXL is safe and effective in teenagers with keratoconus during the 1-year follow-up.The long-term effects need further observation.

2,4,6-Trinitrotoluene (TNT) and its by-products dinitrotoluene (DNT) pose a significant threat to human health and other living organisms.However, the conventional analytical methods involved in bulky and expensive instruments are complicated and time-consuming, impeding quick and on-line determination.In this work, a facile yet effective strategy of utilizing UV-vis spectroscopy coupled with partial least squares (PLS) was proposed, through which TNT and two isomers of DNT (2,4-DNT and 2,6-DNT) in nature water could be rapidly and simultaneously determined without any pre-separation.Variable combination population analysis (VCPA) was utilized to select important feather variables and significantly improved the predictive performance of the PLS model.The calibration set contained 25 samples constructed by orthogonal array design (OAD).The predictive ability of the models was validated by an independent prediction set including 15 samples, achieving up to 0.99 of the determination coefficients (R2) for each of the analytes.The optimized models were successfully applied to determine the 3 ingredients in 8 environmental samples involving in tap, lake and two kinds of river water with the recovery values of great than 97%.Finally, the proposed method was further validated by high performance liquid chromatography method.UV-vis spectroscopy coupled with chemometrics may be used as simple and effective strategy with high potential in environmental monitoring.

Objective To investigate the clinical features of divergence paralysis improve the diagnostic and therapeutic ability,and evaluate the effect of surgical and non-surgical treatment.Methods It was a retrospective case series study.11 cases with complete data,diagnosed and treated as divergence paralysis in Tianjin Eye Hospital from September 2014 to January 2016,were summarized.The observation items included general date,neurologica consultation,comprehensive eye examination,and the eye position and movement,deviation degree,binocular vision,AC / A,diplopia examination of pre-treatment and post-treatment.The patients were followed up from 3 months to 1.5 yeas,averaged 6.9 months.Results In our study,1 patient was MillerFisher syndrome,3 cases had a history of hypertension,and 1 case had the history of intaking sleeping pills for about 3 months.The rest of the patients denied the nervous system disease,cardiovascular disease and other medical history.All patients complained about uncrossed diplopia only at distance.All of the 11 patients had a sudden onset of their symptoms.Each patient was examined by same neurologist,meanwhile MRI or CT were performed.All the results showed normal.All patients had refractive error.The angle of esotropia for distance of 5 meters was from + 25 △ to + 55 △ and was from + 8 △ to + 40△ for near(33 cm)before treatment while changed into-4△ ～ + 12△ for distance (5m) and to-8△ ～ +8△ for near (33 cm) after treatment.The ratio of AC / A ranged from 1.3 to 4.0,with an average of 2.6.Conclusion The clinical characteristics of divergence paralysis are a greater angle of esotropia and ipsilateral diplopia.Lateral rectns resection and non-surgical treatment have better effects on the improvement of diplopia and esotropia.

AIM: To observe the expression of corticotropin releasing hormone (CRH) within the paraventricular nucleus of hypothalamus (PVN) and to explore the relationship between the activated CRH-containing neurons and sympathetic activity in rats with heart failure (HF).METHODS: Healthy male Sprague-Dawley (SD) rats were subjected to coronary artery ligation to induce HF, and chronic intracerebroventricular (ICV) infusion was performed by osmotic pump for 4 weeks.The rats in sham group and HF group were given vehicle (VEH;artificial cerebrospinal fluid 0.25 μL/h).The rats in HF plus treatment group were treated with CRH competitive inhibitor αh-CRH (15 mg/h).Meanwhile, the Lewis rats and Fischer 344 rats for control study also underwent coronary ligation to induce HF or sham surgery.After 4 weeks, left ventricular end-diastolic pressure (LVEDP) and maximum positive/negative change in pressure over time (±dp/dtmax) were determined.The right ventricular-to-body weight (RV/BW) and lung-to-body weight (lung/BW) ratios were calculated.The renal sympathetic nerve activity (RSNA) was recorded and the plasma norepinephrine (NE) level was measured.The expression of CRH in the PVN combined with the plasma adrenocorticotrophic hormone (ACTH) levels were measured.RESULTS: Compared with the sham-SD rats, the HF-SD rats had a greater number of CRH positive neurons in the PVN (accordingly the plasma ACTH levels were increased), accompanied by decreased ±dp/dtmax and increased RSNA, plasma NE, LVEDP, lung/BW and RV/BW.However, ICV treatment with αh-CRH attenuated these changes in the HF-SD rats (P<0.05).Compared with the sham-Fisher 344 rats, the HF-Fisher 344 rats also had a greater number of CRH positive neurons in the PVN (accordingly the plasma ACTH levels were increased).In addition, they had significantly increased RSNA and plasma NE level, higher LVEDP, RV/BW and lung/BW, and lower ±dp/dtmax (P<0.05).Compared with the SHAM-Lewis rats, the HF-Lewis rats had not significantly changed in the above parameters.CONCLUSION: In CHF, the CRH-containing neurons in PVN are activated, thus aggravating cardiac function by increasing sympathoexcitation.