Objective To investigate the risk of heart failure to the mother and the neonate.Methods The clinical data of 30 pregnant womem with heart failure from January 1993 to December 2010 from Capital Medical University Tongren Hospital was retrospectively analyzed.Results Of the 30 patients,there were 12 affected with congenital heart disease (40％) ; 9 with rheumatic heart disease 30％,7 with heart failure in pregnancy-induced hypertension 23％.Heart failure appeared at the average of (34.20 ± 4.25) weeks in pregnancy.The average terminal time of pregnancy was (34.84 ± 2.17) weeks.The rate of early birth was 73.33％.The average birth weight was (2011 ±568) g,with 7 babies less than 2000 g.No death occurred in both new the mother and the neonate.Condusion The main causes of heart failure in pregnancy are congenital and rheumatic heart disease and pregnancy-induced hypertension.For those heart failure occurs before 30 weeks,it is the first selection that pregnancy shoud be terminated; For those occur after 30 weeks,active treatment should be performed to improve maternal heart function and promote fetal maturity.Apropriate threatment during per-cesarean section may decrease the case fatality of the mother and neonate.

Objective To explore the value of hysteroscopy in diagnostic curettage, the incidence of complications and preventive measures in senile women. Methods One hundred and thirteen senile patients who underwent hysteroscopy from January 2002 to December 2007 were recruited in the study, and one hundred and fifty-seven non senile patients were selected as control group. All the patients were operated with diagnostic curettage and hysteroseopy. The success rate of hysteroscopy operation, the incidence of complications and control effect were recorded and compared between two groups. Results The success rate of hysteroscopy operation was 88. 5% (100/113) in the senile group and 100% (157/157) in the non senile group, and there was significant differenee(P <0. 01). The incidence of complications was higher in the senile women group than that in the non senile women group (P< 0. 01). In senile group, the accuracy of diagnostic curettage and hysteroscopy was higher than diagnostic curettage alone, and the success rate was 95.5% (64/67)in estrogen group and 69.6%(32/46) in blank control group (P<0. 01) ,which indicated that estrogen was positively related with the success rate of operation. Compared with misoprostol, estradiol-pretreatment operation was safer and had higher success rate. Conclusions It is safe and feasible to perform hysteroscopy and diagnostic curettage for older women, though it has higher incidence of complications and lower success rate compared with non senile women. Hysteroscopy and diagnostic curettage are more accurate than diagnostic curettage alone, and it is a good choice to apply estradiol before operation.

Objective To investigate the effect of perfusion and preservation with intragraft dipeptidyl peptidase Ⅳ (DPP Ⅳ) catalytic inhibitor on pulmonary function after lung transplantation in rats. Methods Pure SD rats were divided into six groups. Syngeneic rats (SD to SD) served as donors and recipients. Orthotopic lung transplantation model was used. Grafts of control groups (CONI and CON2) were flushed and preserved in LPD-glucoae exposed to 18 h of cold ischemia before transplantation. Peak airway pressure (PIP), blood gas (PO2), wet/dry weight ratio (W/D), the activity of myeloperoxidase (MPO) and the content of malonyldialdehyde (MDA) of CON1 group were analyzed at first day after transplantation. In CON2 group, the 7-day survival rate post-transplantation was observed. Experimental groups were divided into four sub-groups (EXP1-EXP4), and grafts were perfused and stored for 18 h with LPD-glueose plus DPPⅣ catalytic inhibitor. The pulmonary function was detected at 1st (EXP1), 3rd (EXP2), 5th (EXP3), and 7th day (EXP4) posttransplantation, respectively. Results The rats in CON2 were died at 7th day post-transplantation,and all rats in EXP4 group survived to the 7th day post-transplantation. As compared with CON1 group, PIP, W/D, MPO activity and MDA content were reduced (P<0. 01 or 0. 05), and PO2 increased (P<0. 05) in EXP4 group. The pulmonary function of DPPⅣ catalytic inhibitor-perfused grafts from 1 to 7 days was improved and all tested parameters were close to normal at 7th day.Conclusion Perfusion and preservation with an inhibitor of CD26/DPP Ⅳ enzymatic activity obviously reduced severity of ischemia-reperfusion injury and was beneficial to the rehabilitation of grafts'pulmonary function.

Objective To investigate the indication, feasibility and technique of minimally invasive nuss procedure with thoracoscope by using double braces in the treatment of wide-scope pectus excavatum repairing in adolescence. Methods 31 patients including 24 boys and 7 girls, suffered from pectus excavtum were corrected by nuss procedure under thoracoscope.The average age was (15.32 ± 3.89)years (ranged, 14 years and 18 years). All cases were moderate to severe degree according to Hallar index with depression scope of 4 ribs or more. A couple of braces of two-point or multipoint fixation for thoracoscopic-assisted nuss procedure were used. Results The procedure was successfully completed under thoracoscopy in all patients. Double braces were utilized in 27 cases, double are bars were required in 4 cases, and multipoint fixations were in 6 patients. The postoperative hospital stay was 5-11 days [average, ( 7.48 ± 1.95 ) days]. The duration of following up was one month to three years. The perioperative complications included intraoperative hemorrhage in 2 patients, bar invertion with displacement in 1, and interrupted pain for two months in 1. All patients recovered after expectant treatment. Conclusion Nuss procedure with double braces for the correction of a large area of asymmetric pectus excavatum under thoracoscopy is safe and effective technique for adolescence.

Objective To study laparoscopic pelvic lymphyectomy combined with vaginal hystectomy in the treatment of patients with stage Ⅰ endometrial carcinoma.Methods The data of 77 patients with stage Ⅰ endometrial carcinoma were reviewed retrospectively. These patients divided into the laparoscopic group and abdominal group according to the operation style. The operation time, blood loss, postoperation complication, rehabilition of the digestion tract, satisfaction degree to the operation of two groups were compared.Results There was no serious complications in the both groups. In the laparoscopic group, the operation time was longer than the abdominal group ( P<0.01), but so far as to the blood loss, the time of rehabilition of the digestion tract, the number of lymphyectomy, the postoperation pain alleviation and the degree of postoperation depression were superior to the abdominal group ( P<0.01).Conclusion Though the Laparoscopic operation takes longer time than the abdominal operation, it has much more advantage: mimimal blood loss, minimal abdominal scar, rapid postoperation rehabilition, much better pain alleviate, less urine retention.

120 age- and body mass-matched Lewis rats underwent anastomosis of vessels and bronchus using cuff technique and 60 rats received orthotopic left lung transplantation. All procedures were done by one operator. The feasibility and reliability of this technique was determined by examining graft patency usng X-ray, gross and histological examinations. The successful rate of the surgery was 96.7%, mean warm ischemic time was (14.5±3.2)min. On gross examination, grafts were well perfused and ventilated.Recipients of 14d after transplantation showed excellent chest X-ray signs and perfect graft function. The animal model established in this study has been verified to be a safe, simple and reproducible model.

Objective To analyze the clinical value of gastric bacterial cultivation in the early diagnosis of bacterial infection in preterm infants.Methods 174 preterm with risk perinatal factors of infection in NICU of Chang’an Hospital from January 2013 to December 2014 were collected,they were given the gastric juice cultivation checking in 1 hour after birth before eat-ing,watering and giving medicine.According to the clinical symptoms and laboratory test results,they were divided into the infected group and non-infected group.Their Gastric cultivation inspection was compared and analyzed in two groups.Results The positive rate of bacterial culture of gastric fluid was 40.8% (71/174),and located in the top four is Escherichia coli 30.99% (22/71),coagulase-negative staphylococci 21.13%(15/71),Staphylococcus aureus 14.08%(10/71)and group B streptococcus 8.45% (6/71).There was relation between premature infants with bacterial culture positive and meconium stained amniotic fluid,maternal infection during pregnancy,premature rupture of membranes,but not with gestational hyper-tension,fever unrelated to the mother giving birth.Conclusion There was high positive rate of gastric juice bacterial culture with a significant correlation of early onset infection.

Objective To explore the reproductive outcomes of different management strategies of ectopic pregnancy .Methods A retrospective cohort study was performed for 648 consecutive patients with a diagnosis of ectopic pregnaney between June 2011 and september 2013.The follow-ups were conducted telephone interviews of pregnancy outcomes after various treatments .Results The subsequent intrauterine pregnancy rates after surgical , medical and expectant managements were 89(65.0%), 35(79.6%) and 6 (54.5%) the intrauterine pregnancy was higher for medical treatment than that for surgical treatment (P<0.05).The subsequent infertility rate after surgical , medical and expectant management were 4.5%, 36.4%, 19.0%.The subsequent infertility rate after medical treatment was lower than that for surgical and expectant managament ( P<0.05) .The re-ectopic pregnancy rates of laproscopic versus abdominal operation were [11 (11.7%), 13(30.2%)] with significant difference (P<0.05).And abdominal operation was higher than laproscopic operation .Conclusion For younger ectopic pregnancy patients , medical treatment shold be as possible as we can .If operation is necessary , laproscopic operation is preferred .

Objective To investigate the clinical effect of maternal pat with Chinese medicine in episiotomy wound care. Methods One thousand one hundred cases of maternal with full-term,vaginal delivery, episiotomy in the Beijing Tongren Hospital Affiliated to Capital Medical University from Jun. 2013 to Jun. 2014 were randomly divided into test group and control group. Patients in test group were given routine nursing care combined with Chinese medicine maternal pat to nurse perineal wound,while in the control group were given routine nursing combined with common maternal pat. The data of perineal wound swelling,pain and healing were recorded and compared in two groups. Results The incidences of mild,moderated swelling within 24 h,48 h in test group were 35. 5%( 195/550 )and 6. 0%( 33/550 ),13. 4%( 74/550 )and 1. 6%( 9/550 ),significantly lower than that of the control group( 24 h:51. 5%( 283/550 ),24. 5%( 135/550 );48 h:34. 2%( 188/550 ), 2. 7%(15/550);Z=12. 555,8. 144;P﹤0. 01). The incidences of moderate,severe pain within 24 h,48 h in test group were 12. 5%(69/550)and 2. 9%(16/550),8. 4%(46/550)and 1. 3%(7/550),significantly lower than that of the control group( 24 h:37. 3%( 205/550 ),7. 5%( 41/550 );48 h:20. 6%( 113/550 ),3. 5%(19/550);Z=10. 429,11. 886;P ﹤0. 01). The wound healing rate in test group was 92. 36%,significantly higher than that of control group( 80. 73%,P ﹤0. 01 ). The wound infection rate in test group was 1. 82%, significant lower than that of control group(3. 82%,P﹤0. 01). The incidence of comfort and satisfaction in test group was 90. 18%,significantly higher than that of control group(73. 09%;Z= -5. 614,-7. 345;P ﹤0. 05). Conclusion Nursing lateral episiotomy wound using Chinese medicine maternal pat can reduce the swelling, pain and promote wound healing with convenient and comfortable. Therefore,it is worth of the clinical popularization and application.

Objective To investigate the expression of bradykinin as a substrate of CD26/DPP Ⅳ in rats with ischemia/reperfusion injury following lung transplantation (LTx). Methods Thirty-six syngeneic male SD rats were randomly allocated into control group and experimental group (n= 18each), and 36 rats served as donors. In control group and experimental group, the lungs were flushperfused and preserved with LPD and LPD+ CD26/DPP TV catalytic inhibitor (AB192) respectively,and LTx was performed 18 h after cold ischemia Histopathological studies were also done on the same locus of lung specimens and staining for bradykinin. The different proteins were separated by means of immobilized PH gradient-based two-dimensional gel electrophoresis. The differential expression of bradykinin was compared by Western blotting. Results The expression of bradykinin in control group was significantly higher than in experimental group. As compared with experimental group,bradykinin expression was significantly up-regulated in control group (P <0 . 05 ). Conclusion Inhibitor of CD26/DDP Ⅳ enzymatic activity significantly ameliorated ischemia/reperfusion injury in the early stage after LTx, which is probably associated with inhibition of the protein expression of bradykinin.