0.05). Conclusion Tei index may be useful, convenient and reliable in fetal cardiac function assessment.

Hypoxic-ischemic encephalopathy (HIE) is the main reason of causing neonatal death and poor prognosis of the nervous system.The treatment of HIE has gone into the era of therapeutic hypothermia,the early,continuous,specification amplitude integrated electroencephalography(aEEG) monitoring for therapeutic hypothermia to screen appropriate cases,assess early the severity of HIE,provide early nerve protection treatment and evaluate the therapeutic efficiency,early intervention and improve the prognosis of the long-term HIE.This paper review the application of aEEG in the therapeutic hypothermia of HIE.

Aim To observe the effects of theaflavin on intracellular calcium concentration(i) level in rat ventricular myocytes and discuss the possible mechanisms.Methods The effects of theaflavin oni were investigated in rat ventricular myocytes.i was detected by laser confocal microscopy and represented by relative fluorescent intensity(FI-FI0)/FI0,%;FI0:control;FI:administration of drugs).Results ① Theaflavin(10,20,40 ?mol?L-1) had no effect on the i of ventricular myocytes in normal Tyrode′s solution.However,it reduced the i of ventricular myocytes in simulated ischemia solution in a concentration-dependent manner.② Pretreatment with Bay k8644(0.5 ?mol?L-1) mostly abolished the effects of theaflavin(20 ?mol?L-1) in simulated ischemia solution.③ Theaflavin(20 ?mol?L-1) markedly inhibited the low concentration of ryanodine-induced i increase in Ca2+-free Tyrode′s solution.④ When the propagating waves of elevated i(Ca2+ waves) were produced by increasing extracellular Ca2+ concentration from 1 mmol?L-1to 10 mmol?L-1,theaflavin(20 ?mol?L-1) could block the propagating waves of elevated i(Ca2+ waves),reduce the frequency and duration of propagating waves,and reduce i as well.Conclusion Theaflavin may reduce the i in isolated rat ventricular myocytes via inhibiting Ca2+ influx by voltage-dependent Ca2+ channel and alleviating Ca2+ release from sarcoplasmic reticulum(SR).

Objective To explore the association between the signal transducer and activator of transcription 4 (STAT4) gene polymorphism and Chinese Han systemic lupus erythematosus patients. Methods Pyrosequencing technique was used to genotype the 3 single nucleotide polymorphisms (SNP) in the samples of patients and normal individuals. Results Not only these 3 SNPs, but also the haplotypes composed by them showed significant difference between the SLE patients and normal individuals[rs11889341:P=0.012 02, OR (95%CI)=1.22( 1.044～1.424); rs7574865:P=0.003 454, 0R(95%CI)=1.25(1.076～1.451 ); rs8179673: P=0.004 275, OR (95%CI)=1.274 (1.079～1.505)]. Conclusion rs11889341, rs7574865 and rs8179673 of STAT4 are associated with the pathogenesis of Chinese Han SLE, and the STAT4 gene is a susceptibile gene for SLE in a few racial cohorts.

Objective To study the effects of rehabilitation training on the synaptic ultrastructure of the brain cortex after cerebral ischemia.Methods Sixty rats were randomly divided into a sham operation group,a cerebral ischemia group and a rehabilitation training group.A model of focal cerebral ischemia was created in the rats of the cerebral ischemia and rehabilitation training groups.The rehabilitation training group was given balancing,grasping,rotation and walking training every day.The sham operation group and cerebral ischemia group were kept in normal cages,taking food and moving freely.Electron microscopy was used to observe the density and ultrastructure of the cortical synapses at days 1,7,14 and 21 after the operation.Results In the sham operation group there were numerous synaptic terminals in the cortical neuropil.The majority of synapses were Gray type Ⅱ,containing spherical synaptic vesicles in presynaptic elements.After cerebral ischemia,the number of synaptic terminals had decreased and the synaptic structure was damaged.The synaptic vesicles lessened and dissolved.The presynaptic and postsynaptic membranes became unclear.At 21d after ischemia,the synaptic vesicles had disappeared and the presynaptic and postsynaptic membranes were damaged so seriously that the typical synaptic structure disappeared.After rehabilitation training,the damaged synaptic terminals recovered.Conclusions The synaptic structure was damaged after cerebral ischemia,and the damaged synaptic terminals recovered after rehabilitation training.Rehabilitation training can enhance synaptogenesis in the brain's cortex after cerebral ischemia and promote the recovery of motor function,at least in rats.

Objective To understand the effect of empowerment theory in wound care of patients with diabetic foot ulcer, to identify the problem, and to provide reference for the theory in clinical application. Methods Summarized the nursing interventions of 13 patients with diabetic foot of Strauss A classification using empowerment theory. Results All the wounds of 13 patients healed, the average total healing time were 70-273 (145.23 ± 68.87) days, and the median healing time were 111 days. The patients were followed up for 10-37 months without recurrence. Conclusions Using empowerment education in Strauss A classification diabetic foot patients Is feasible and worth promoting. However, to ensure patient safety, the process of application should be under close supervision.

Aim To observe the cardioprotection of chronic intermittent hypobaric hypoxia (CIHH) against ischemia/reperfusion injury in adult and young rats.Methods Adult and postnatal male Sprague-Dawley rats were divided randomly into four groups:control 28-day group (CON28),control 42-day group (CON42), CIHH 28-day treatment group (CIHH28), and CIHH 42-day treatment group (CIHH42). CIHH animals with maternal rats were put into a hypobaric chamber 2 days before birth to get 28 days and 42 days CIHH mimicking 3000 m altitude (P_B=525 mmHg,P_(O_2)=108.8 mmHg), 5 h daily, respectively.The control animals were kept in the same environment as CIHH rats with free access to water and food except hypoxic exposure. The isolated hearts were perfused in the Langendorff apparatus, undergoing 30 min global ischemia and 60 min reperfusion.Cardiac function was recorded continuously during the whole experiment. Parameters of left ventricular function included left ventricular developing pressure (LVDP), left ventricular end-diastolic pressure (LVEDP), maximal positive (+LVdp/dt) and negative (-LVdp/dt) velocity of left ventricular pressure, coronary flow (CF) and heart rate(HR).Results ① For adult rats, there was no significant difference in the parameters of left ventricular function between CIHH28 and CON28 groups. However, the recovery of cardiac function in CIHH42 rats was much better than that in CON42, including LVDP, LVEDP, ±LVdp/dt and CF (P<0.05). ② For young rats, the basic coronary flow (CF) in CIHH rats was significant higher than that in CON rats, while other parameters of cardiac function didn't change. The recovery of cardiac function in CIHH rats was much better than that in CON rats, including LVDP, LVEDP,±LVdp/dt and CF (P<0.05).Conclusion CIHH confers cardioprotection against ischemia/reperfusion injury in rat cardiomyocytes, which is predominant in CIHH42 group and significantly affected by the age of animals. Cardioprotective effects produce more easily in young rats by CIHH.

Objective To investigate the sequences of the 3' end of genomes from enterovirus 71 isolated from pediatric patients with different symptoms in Beijing during 2008-2009.Methods Clinical specimens were collected from pediatric patients suffering from hand,foot and mouth disease(HFMD)and/or with neurological complications who visited the affiliated Children's Hospital during the epidemic seasons of 2008 and 2009 in Beijing.The samples were inoculated into the Vero cell line,and the virus isolates were further identified by nested reverse transcription-nested PCR(RT-nPCR)assay using universal enterovirus primers,type specific primers for EV71 and CA16.The 3' end of genomes(including 3D and 3' UTR regions)from 10 EV71 strains derived from various clinical presentations were amplified and sequenced.Results Analysis of the nucleotide sequences of the amplified fragments showed that the 3' end of genomes of 10 EV71 isolates include the 3D region of 1386 nucleotides(nt)encoding the 3D polymerase(3Dpol,462 amino acids),the terminator codon TGA and 3' UTR of 81 nt.Nucleotide sequence identities among 3D regions from these 10 EV71 isolates were in the range of 95.8%-99.6%,while the nucleotide sequence identities for 3' UTR were 96.3%-100%.The majority of nucleotide changes were located at the third codon positions which caused silent mutations,thus the amino acid sequence changes of 3Dpol among those 10 EV71isolates were scanty.The residues 140 and 263 which were R and 1 were substituted by K and V,respectively in 3 of 4 neurovirulent strains,whereas only 1 of 6 strains from mild cases had these 2 amino acid changes.The sequences of the 3D and 3' UTR regions of 10 EV71 isolates were compared to the representative strains of known genotypes from the GenBank.The nucleotide and amino acid sequences of 10 EV71 isolates in the 3D region exhibited highest homology to the subgenotype C4 of EV71(92.7%-94.2%and 96.8%-97.6%.respectively).However,3' UTR of 10 EV71 isolates shared the highest nucleotide identity with CA16/G10(88.9%-91.4%).The phylogenetic analysis based on the 3D regions demonstrated that 10 EV71 isolates had the closest genetic relationship with the representative isolate of CA sub-genotype of EV71 and shared more homology with CA16/G10 than other known genotypes of EV71.Conclusion Genetic analysis of the 3' end of genomes from 10 EV71 strains indicated that the 3' end of genome may play a role in the evolution of EV71.

Objective To assess the impact of intervention with Insulin therapy management unit program in the poorly controlled type 2 diabetic patients in a community of Shanghai.Methods There were 55 patients with type 2 diabetes with poorly controlled hyperglycemia (HbA1C ≥ 8％) enrolled in this study.They were divided at random into 2 groups:intensive care group and standard care group.The subjects in intensive care group were provided with a glucose meter and required to monitor their blood glucose levels at least 2 or 3 times per day.Community health provider acquired information of blood glucose level,episodes of hypoglycemia,and dosage of insulin every week by cell phone.Standard care patients received diabetes care from the same provider in outpatient clinic every month.Results By the end of 6 months of intervention,the intensive care group showed a significant difference in HbA1C as compared to the standard care group (7.40％ ±0.91％ vs 8.65 ％ ± 1.28％,P＜0.01).The frequency of self-monitoring of blood glucose (SMBG) was 4 times per month in both groups at baseline.After intervention,the frequency of SMBG in intensive care group was greatly increased compared to standard care group (50times per month vs 5 times per month,P＜0.01).The frequency of self-reported hypoglycemia in intensive care group was increased compared to standard care group (3 times per month vs once per month,P＜0.01).The average daily dose of insulin in intensive care group was increased 6 units by the end of the present study(P＞0.05).Conclusion After 6 months of intervention,the glycemic control was obviously improved in type 2 diabetic patients treated with insulin and the daily dose of insulin was not increased significantly.TheInsulin therapy management unit is effective and safe.

Objective To investigate the cognitive dificiency characteristics and the neuro electrophysiological mechanism of sleep disordered breathing(SDB) in school-age children.Methods20 cases of SDB children and 20 cases of normal group at 6-8 years old participated in the continue performance test(CPT-AX).The amplitude and latency of N2,P3 of event related potentials(ERPs) were measured and analysed at Fz leads,and the behavioral results were recorded at the same time.ResultsThere were no significant differences between SDB group and normal group in behavioral correct number (36.10±4.69 vs 35.05±3.49),the reaction time ((523.77±68.73)ms vs (496.59±78.65)ms) and false alarm number (1.0 (0.25,3.75) vs 0.5 (0.00,3.00))(all P>0.05).The SDB group showed significant increase in Go-P3 amplitudes compared with the normal group((10.25±6.46)μV vs (6.56±4.63)μV,P<0.05).The Go-P3 latency in SDB group was significantly prolonged than that in the normal group((438.80±59.72)ms vs (406±36.30)ms,P<0.05),and the Nogo-N2 amplitude in SDB group significantly decreased compared with the normal group ((-12.46±4.75)μV vs (-15.50±3.82)μV,P<0.05).ConclusionThe children aged 6 to 8 years old with sleep disordered breathing consume more resources and time to complete the attention process,like a compensatory response.And during the monitoring process there is a resource shortage that results in obvious defect in process of inhibition.