Objective To discuss the prognostic impact of atrial fibrillation (AF) in patients with chronic heart failure(CHF).Methods From January,2005 through December,2006 we studied 461 patients with a discharge diagnosis of CHF.Patients were divided by baseline rhythm in sinus rhythm(SR) or AF groups.The main endpoints were all cause death within 3 years and readmission to the hospital for heart failure.Results AF group were more likely to be older and female and to have a history of valvular disease and have a higher left ventricular ejection fraction (LVEF).However,SR group were more likely to have a history of ischemic heart disease.During 3 year follow-up,the main endpoints was higher in AF group than in those with SR group (P ＜0.01).After adjusting for other covariables,AF and age were related to increased the risk of main endpoints during 3 years follow-up (RR =1.311,95％ CI:1.002-1.715,P ＜0.05 ; RR =1.014,95％ CI:1.004-1.024,P ＜ 0.01).Conclusion AF and age were the main risk factors of increased adverse forward prognosis in patients with CHF.

Objective To improve the antenatal diagnosis of placental abruption by ultrasound. Methods A retrospective analysis was conducted on 33 placental abruption cases in our hospital between Jan. 1988 and Apr.2003. Results Among 33 cases, 28(84 8%) were found by ultrasound. There were more cases with anterior placental and severe abruption than posterior placenta and mild abruption without symptoms. The sonographic characteristics of placental abruption was dark and low echo area between placenta and uterine wall. Among these cases, mild and mixed echos were detected in 15 cases, partial thickened placenta 6 cases, protruding masses at the edge of placenta or under chorionic plate 8 cases(one case was misdiagnosed as chorioangioma). No signals of blood flow was shown the abruption area of placenta by color Doppler flow image. Conclusion Antenatal sonography has an important role in diagnosing placental abruption.

Objective To investigate the significance of sequential continuous sonography approach (SCSA) in diagnosing fetal deformity during prenatal stage. Methods Compared with postpartum data, the sequential continuous sonography of 16685 fetuses during gestational age 14 to 40~(+3) weeks. 1 were ana-lyzed retrospectively. Results 498 abnormal cases in 514 abnormal fetuses were scanned out with sequen-tial continuous sonography approach, and 16 cases were not successfully diagnosed by SCSA during prenatal stage. The rate of final diagnosis on deformity fetuses by SCSA was 96. 89%, the rate of misdiagnosis was 3. 1%. Conclusion Sequential continuous sonngraphy approach is a useful tool for diagnosing fetal de-formity during prenatal stage, h should be widely applied into the clinical inspection for prenatal diagnosis.

Objective To explore the safety and efficacy of Kushen Gel and amphotericin B vaginal effervescent tablets in the treatment of postpartum vulvovaginal candidiasis.Methods A total of 186 postpartum vulvovaginal candidiasis patients in postpartum lactation in our hospital were randomly divided into monotherapy group(n =90) and combination group(n =96),receiving amphotericin B vaginal effervescent tablets alone,and Kushen Gel combined with amphotericin B effervescent tablets treatment,respectively.And vaginal pH value before and after treatment,vaginal flora density,sexual pain after treatment and adverse reactions of two groups were compared.Results There was no significant difference in vaginal pH,vaginal flora density of the two groups before treatment (P ＜ 0.05).After treatment,the leucorrhea was decreased,improvement time of pruritus vulvae,mucosal hyperemia symptoms in the combination group were significantly shorter when compared to the monotherapy group (P ＜ 0.05);Vaginal pH value of the two groups was significantly improved,and showed a significant difference at 3 months of follow-up (P ＜ 0.05);After treatment and 3 months of follow-up,proportions of vaginal flora density for grade 1 of the combined group were significantly higher than that of the monotherapy group (P ＜ 0.05).After treatment,grade I sexual pain of the combination group was higher than that of the monotherapy group (63.54％ vs.42.22％,P ＜ 0.05).But there was no significant differences in adverse reactions in two groups (P ＞ 0.05).Conclusion Amphotericin B effervescent tablets for the treatment of patients with postpartum vulvovaginal candidiasis presents certain effect on improvement of symptoms and vaginal micro ecological environment,but has more adverse reactions,so Kushen Gel in combination can enhance the effect and safety.

Objective To explore the safety and efficacy of Kushen Gel and amphotericin B vaginal effervescent tablets in the treatment of postpartum vulvovaginal candidiasis.Methods A total of 186 postpartum vulvovaginal candidiasis patients in postpartum lactation in our hospital were randomly divided into monotherapy group(n =90) and combination group(n =96),receiving amphotericin B vaginal effervescent tablets alone,and Kushen Gel combined with amphotericin B effervescent tablets treatment,respectively.And vaginal pH value before and after treatment,vaginal flora density,sexual pain after treatment and adverse reactions of two groups were compared.Results There was no significant difference in vaginal pH,vaginal flora density of the two groups before treatment (P ＜ 0.05).After treatment,the leucorrhea was decreased,improvement time of pruritus vulvae,mucosal hyperemia symptoms in the combination group were significantly shorter when compared to the monotherapy group (P ＜ 0.05);Vaginal pH value of the two groups was significantly improved,and showed a significant difference at 3 months of follow-up (P ＜ 0.05);After treatment and 3 months of follow-up,proportions of vaginal flora density for grade 1 of the combined group were significantly higher than that of the monotherapy group (P ＜ 0.05).After treatment,grade I sexual pain of the combination group was higher than that of the monotherapy group (63.54％ vs.42.22％,P ＜ 0.05).But there was no significant differences in adverse reactions in two groups (P ＞ 0.05).Conclusion Amphotericin B effervescent tablets for the treatment of patients with postpartum vulvovaginal candidiasis presents certain effect on improvement of symptoms and vaginal micro ecological environment,but has more adverse reactions,so Kushen Gel in combination can enhance the effect and safety.