Objective To evaluate the pregnancy outcome of women with pulmonary arterial hypertension (PAH).Methods The medical records of 103 pregnant women with PAH admitted to Beijing Anzhen Hospital from January 2007 to March 2011 were studied retrospectively.Results (1) Degree of PAH and cardiac function.Among the 103 PAH,92 cases were patients with congenital heart disease and 13 cases were with rheumatic heart disease.They were divided by color doppler ultrasound into mild PAH group (34 cases),moderate PAH group (22 cases) and severe PAH group (47 cases).Per heart function classification,21 cases (20.4％,21/103) were class Ⅰ,44 cases (42.7％,44/103) were class Ⅱ,27 cases (26.2％,27/103) were class Ⅲ and 11 cases (10.7％,11/103) were class Ⅳ.More patients were class Ⅲ and Ⅳcardiac function in the severe PAH group than in the mild and moderate PAH groups,with statistically significant difference (P ＜ 0.05).(2) Delivery mode.There were 44 term delivery and 23 preterm birth in the 103 PAH patients.Sixty-three cases (94％,63/67) received cesarean section and 4 cases had vaginal delivery.There were 36 iatrogenic abortion (35.0％,36/103).The iatrogenic abortion rate in the severe PAH group was significantly higher than those in the mild and moderate PAH groups (P ＜ 0.05).(3) Perinatal outcomes.The full-term delivery rates in the mild and moderate PAH groups [80％ (20/25) and 14/17] were significantly higher than the severe PAH group (40％,10/25),respectively (P ＜ 0.05).And the premature birth rate of the severe PAH group(60％,15/25) was significantly higher than the mild and moderate PAH group [20％ (5/25)and 3/17,P ＜ 0.05].There were 4 neonatal asphyxia.The birth weight of mild,moderate and severe PAH groups were (3071 ± 443),(2910 ± 619) and (2381 ±589) g,respectively.The birth weight in the severe PAH group was significantly lower than the mild and moderate PAH groups (P ＜ 0.05).(4) Mortality.Nine cases naternal death happened,with a mortality of 8.7％ (9/103).All of them were severe pulmonary hypertension patients.Conclusions PAH is a serious complication during pregnancy.Women with mild PAH and normal cardiac function could continue pregnancy to full-term.Women with moderate PAH might continue pregnancy to 32 weeks under intensive care,cesarean delivery is preferable.Pregnant women with severe PAH should terminate pregnancy because of the high mortality.

Objective To investigate the distribution and antibiotic resistance of the K lebsiella pneumoniae strains isolated from clinical infections in terms of serotypes K1 ,K2 and virulence factor rmpA gene .Methods The hypermucoviscous phenotype of K .pneumoniae isolate was determined by string test .K1 and K2 serotypes and rmpA gene were detected using multiplex polymerase chain reaction .Results Of the 144 strains of K .pneumoniae ,the prevalence of hypermucoviscous phenotype ,K1 , K2 serotypes and rmpA gene was 62 .5% (90/144) ,52 .1% (75/144) and 65 .3% (94/144) ,respectively .The prevalence of K1 ,K2 and rmpA K .pneumoniae strains was 90 .7% (68/75) in K1 ,K2 serotypes .The prevalence of K1 ,K2 isolates and rmpA in hypermucoviscous or non‐hypermucoviscous phenoype was 63 .3% (57/90) ,85 .6% (77/90) and 33 .3% (18/54) , 31 .5% (17/54) ,respectively .The prevalence of serotype K1 ,K2 with or without rmpA gene was 72 .3% (68/94) and 14 .0% (7/50 ) respectively . Of the 42 K . pneumoniae strains isolated from liver abscess ,85 .7% (36/42) were hypermucoviscous phenotype and 88 .1% (37/42 ) were serotypes K1 , K2 . For the strains from other abscess , bacteremia ,community acquried pneumonia (CAP) ,urinary tract infection (UTI) and biliary tract infection ,the prevalence of hypermucoviscous phenotype was 81 .3% (13/16) ,40 .5%(15/37) ,85 .7% (12/14) ,52 .4% (11/21) and 21 .4% (3/14) ,respectively ,and the prevalence of serotypes K1 ,K2 was 56 .3% (9/16) ,29 .7% (11/37) ,64 .3% (9/14) ,38 .1% (8/21) and 7 .1% (1/14) ,respectively .K1 serotype isolate accounted for 61 .9% of the strains from liver abscess .The ratio between serotype K1 and K2 was similar in the isolates from other abscess ,CAP ,UTI or bacteremia .Non‐K1 ,K2 serotype isolates were common in biliary tract infection .The prevalence of extended‐spectrum beta‐lactamases (ESBLs ) was 5 .5% in hypermucoviscous phenotypes and 33 .3% in the non‐hypermucoviscous phenotypes .Conclusions rmpA gene is associated with the hypermucoviscous phenotype of K .pneumoniae strains and commonly identified in K1 ,K2 serotype isolates .Serotypes K1 ,K2 isolates are important pathogens in liver abscess and CAP ,and also common in other abscess ,UTI and bacteremia .K1 serotype isolate was most common in liver abscess .The prevalence of K1 or K2 serotype was similar in other infections . The prevalence of ESBLs is lower in hypermucoviscous strains than in non‐hypermucoviscous strains and is associated with lower resistance rate to most of the antibiotics tested .

Objective To explored the effect of sildenafil in treatment of pregnant women with pulmonary arterial hypertension.Methods From January 2012 to November 2013,64 pregnant women with pulmonary arterial hypertension (PAH) were randomly divided into group and control group.Control group:16 cases with mild and 16 cases with moderate PAH.To treatment with low-flow oxygen,low-salt diet therapy,cardiac,etc.sildenafil group:15 cases were mild pulmonary hypertension,and 17 cases moderate PAH.Treatment sildenafil 25 mg,rid in this study.Then the variation of the blood oxygen saturation,pulmonary artery systolic pressure,hemodynamic parameters and pregnancy outcome,including delivery modes,neonatal weight,morbidity of mother and fetus were compared.Results (1) Cardiac function and pulmonary hypertension:control group:the proportion of cardiac functional class Ⅰ-Ⅱ reduced from 81％ (26/32) to 56％ (18/32) significantly after treatment (P ＜ 0.05).Sildenafil group:the proportion of cardiac functional class Ⅰ-Ⅱ increased from 75％ (24/32) to 84％ (27/32) significantly after treatment (P ＜ 0.05).Between two groups,the proportion of mild and moderate turning to server PAH patients were significant differentce (P ＜ 0.05).(2) The pregnancy outcome of two group:the premature birth rate,low birth weight rate and cesarean section rate of 9％ (3/32),9％ (3/32)and 69％ (22/32)in sildenafil group were significantly lower than 16％ (5/32),19％ (6/32) and 81％ (26/32) in control group (P ＜0.05).The rate of vaginal delivery,term pregnancy and neonatal weight of 31％ (10/32),91％ (29/32) and (3 214 ±306) g in sildenafil group were different with 19％ (6/32),84％ (27/32) and (3 004 ±458) g in control group (P ＜ 0.05).(3) Hemodynamic parameters:in control group,arterial partial pressure of oxygen,oxygen saturation and left ventricular ejection fraction,pulmonary systolic pression were (80 ± 5) ％ to (72 ±8)％,(87 ±8) to(83±9) mmHg(1 mmHg=0.133 kPa),0.77 ±0.24 to 0.70 ±0.38 and (63 ±9) to (69 ± 12) mmHg before and after treatment,which showed remarkable decreased trends(P ＜ 0.05).The other parameter were not significantly different (P ＞ 0.05).In sildenafil group,arterial partial pressure of oxygen,oxygen saturation and left ventricular ejection fraction,pulmonary systolic pression showed increased trend before and after treatment,which were (80 ± 9) ％ to (88 ± 9) ％,(84 ± 3) to (89 ± 7) mmHg,0.70 ± 0.32 to 0.79 ± 0.27 (P ＜ 0.05),in the mean time,pulmonary systolic pression showed decreased trend from (65 ± 18) to (60 ± 13) mmHg (P ＜0.05).The other parameter did not show significant different (P ＞ 0.05).Conclusions Sildenafil treatment can significantly improve the clinical symptoms,cardiac function and hemodynamic parameters.It also could significantly improve pregnancy outcomes,reduce premature delivery,the incidence of low birth weight children,and cesarean section rate.

Objective To study the effect of authorization theory on patients with new-diagnosed type 2 diabetes with impaired glucose regulation.Methods Authorization education on diabetes were carried out in 54 new-dhgnosed type 2 diabetes patients with impaired glucose regulation for 1 year.The blood glucose,body weight,BML,systolic and diastolic blood pressure,waist circumference,waist-hip ratio and adiponectin were examined before and after authorization education.Courses of education were divided into five steps:identify the problem;express feelings;Set goals;make a plan;evaluate the result.Results All the above factors alleviated after authorization education,P＜0.05.Conclusions Authorization education for patients can make them change their living style actively and achieve the goal of behavior change.

Objective To explore the status of toileting behavior and its relationship to lower urinary tract symptoms (LUTS) in female nurses. Methods A total of 636 nurses were selected from three top three hospitals in Jinan by multi-stage sampling. The nurses′toileting behavior and LUTS were assessed by Women′s Toileting Behavior Scale and The International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms. Univariate analysis and hierarchical regression analysis were conducted to examine the factors associated with LUTS. Results The nurse groups were widespread adverse toileting behavior. Delayed voiding was the most severe problem in nurses. Among LUTS storage symptoms were the most severe,voiding symptoms followed and incontinence symptoms were mild. Hierarchical regression analysis exhibited that factors associated significantly with LUTS included age, body mass index, menstrual status, working experience, history of urinary tract infection and poor toileting behavior (mainly hard urination, delayed voiding, and anuria urination),which explained 9.1%,12.9% and 12.6% of the variance of storage symptoms, voiding symptoms and incontinence symptoms, respectively. Conclusions Poor toileting behaviors are highly prevalent in nurses and they are closely related to LUTS, leading to concerns about possible effects of working environment and poor bladder habits on LUTS. Cognitive-behavioral intervention for this group is essential for delivering information about correct toileting behavior and its association with LUTS. Hospital administrators are suggested to pay more attention to nurses′working environment and its impact on nurses′health in order to improve their quality of life and job satisfaction.

OBJECTIVE:To explore the effects of Cangfu daotan decoction on expression of organic anion transporting poly-peptide(oatp4a1)and level of sex hormone in the endometrium and ovary tissues of rats with obesity-type polycystic ovarian syn-drome(PCOS). METHODS:Obesity-type PCOS rat models were established. 50 rats were randomized into a normal control(iso-metric normal saline)group,a model(isometric normal saline)group,a metformin(0.043 g/kg)group and Cangfu daotan decoc-tion high-dose and low-dose [5.68 and 1.42 g(medicinal materials)/kg] groups. The rats were given drugs ig once a day for 14 con-secutive days. The expression of oatp4a1 protein in the endometrium and ovaries of the rats was determined by ECL and Western blot. The levels of luteinizing hormone(LH),follicle stimulating hormone(FSH),testosterone(T)and estradiol(E2)in rat’s se-rum were detected by ELISA. RESULTS:Compared to the normal control group,those in the model group had weaker expression of oatp4a1 protein in the endometrium and ovaries,higher levels of serum LH,LH/FSH and T,lower levels of serum FSH and E2. There were statistical significances(P<0.01). Compared to the model group,those in metformin group,Cangfu daotan decoction high-dose and low-dose group had higher expression of oatp4a1 protein in the endometrium and ovaries,lower levels of LH/FSH and T,higher levels of serum E2;those in metformin group and Cangfu daotan decoction high-dose group had lower levels of serum LH,higher levels of serum FSH. There were statistical significances(P<0.01 or P<0.05). CONCLUSIONS:Cangfu daotan decoc-tion can increase the expression of oatp4a1 in the endometrium and ovaries of obesity-type PCOS model rat,alleviate phlegmy dampness and regulate the level of sex hormone.

Objective To observe the effects of short hairpin RNA (shRNA) targeting Her2 on its gene expression when the shRNA was stably transfected into human ovarian cell lines, SKOV3 and SKOV3. ipl, which have different extent of malignancy and investigate the changes of the biological characters of the two cell lines after the stable transfection. Methods The plasmids expressing shRNA targeting Her2 gene were transfected into SKOV3 and SKOV3. ipl cells. The stably transfected cells were gained by antibiotic screening. The expression of Her2 before and after the transfection was detected by RT- PCR and western blot. The transwell experiment was used to observe the invasion ability of the cancer cells before and after the transfection, and the parent and the transfected cells were injected into nude mice to observe the tumor growth. Results After the stable transfection with Her2 shRNA, mRNA and protein levels of Her2 gene in SKOV3 and SKOV3. ipl cells were remarkably reduced. The expression of mRNA were (68.0±3. 1) %, (40. 8±2. 0) %, (99. 9±1.3) %, (42. 4±2. 5) %. The expression of protein were (72. 1±3.4) %, (36. 4±1.5) %, (98.2±1.7) %, (40. 7±2. 1) %. The invasion ability into basilar membrane of the transfected cells was greatly reduced compared with the parent cells. The invasion cell numbers were 7.6±1.1, 1.8±0. 8, 36. 2±9.7, 15.7±7. 2. The growth rate of the planted tumors was lower in transfected groups than that of the parent groups. Conclusions (1) The expression of Her2 gene in SKOV3 and SKOV3. ipl cells was remarkably reduced by RNA interference targeting Her2. (2) The biological characters of SKOV3 and SKOV3. ipl cells are changed when the expression of Her2 gene is reduced by RNA interference.

AIM: To explore the pathological features of airway inflammation in patients with eosinophilic bronchitis(EB) and compared to those with cough variant asthma(CVA).METHODS: Flexible fibre optic bronchoscopy was performed in 11 patients with EB,10 with CVA,14 with bronchial asthma and 10 normal controls.The mean thickness of the basement membrane was measured by light microscopy.Using immunohistochemical and special staining,the localization and density of inflammatory cells(eosinophils,mast cells,T lymphocytes) were detected in bronchial submucosa in EB and CVA patients.RESULTS: The mean thickness of the basement membrane was significantly increased in the subjects with EB [2.92 ?m(2.10-6.50 ?m)],CVA [5.64 ?m(3.23-8.48 ?m)] and bronchial asthma [9.08 ?m(6.61-11.99 ?m)] rather than that in the normal controls [2.08 ?m(1.62-3.40 ?m)].There were also significant differences among the three groups.The number of mast cells and eosinophils in the bronchial submucosal from subjects with EB [75 cells/mm~2(35-112 cells/mm~2),7 cells/mm~2(0-31(cells/mm~2))] was substantially decreased than those in subjects with CVA [148 cells/mm~2(34-200 cells/mm~2),114 cells/mm~2((1-768 cells/mm~2));P

Objective:To explore the status of nursing information ability and its relationships with information consciousness, information anxiety in intern nursing students, provide basis for the cultivation of nursing information ability of intern nursing students.Methods:From December 2019 to January 2020,185 nursing students working as interns in Jinan Central Hospital Affiliated to Shandong University were surveyed by general information questionnaire, information anxiety questionnaire, information consciousness questionnaire and nursing information ability assessment scale.Results:The total score of nursing information ability of nursing students in practice was 111.6±19.7; nursing information ability was positively correlated with information consciousness ( r=0.358, P<0.001), and not related to information anxiety ( r=0.136, P=0.065); information consciousness had a predictive effect on nursing information ability( β=0.287, P<0.001), and information anxiety could moderate the relationship between information consciousness and nursing information ability ( β=0.175, P=0.011). Conclusions:The score of nursing information ability is above the medium level, while improving the nursing information ability through the development of information consciousness, and the information anxiety level of nursing students should also be paid attention to.