Objective To evaluate the value of echocardiography in the evaluation of congestive heart failure (PHC) in peripartum cardiomyopathy patients.Methods 64 patients with congestive heart failure were randomly divided into two groups.The control group were treated with routine therapy.The study group were treated with levocarnitine in combination with routine therapy.Echocardiography was performed before and after treatment, and the changes of each index were compared.Results There was no significant difference in left ventricular end diastolic diameter, left ventricular ejection fraction and cardiac output between the two groups before treatment.After treatment, the left ventricular end diastolic diameter, left ventricular ejection fraction and cardiac output in study group after treatment were higher than those in control group(P<0.05).There was no significant difference in left ventricular short axis shortening, left ventricular end-systolic diameter and stroke volume between the two groups before treatment, but the left ventricular short axis shortening and stroke volume in study group after treatment were higher than those in control group (P<0.05), the left ventricular end-systolic diameter was lower ethan that in control group ( P<0.05 ) .The treatment effect of the study group was significantly higher than that in control group (P<0.05).The adverse reactions was significantly lower than that in the control group (P<0.05).Conclusion L-carnitine is effective in the treatment of heart failure in peripartum cardiomyopathy patients.It can be used to evaluate the therapeutic effect of cardiac ultrasound in order to provide guidance for clinical treatment.

Retinitis pigmentosa (RP) is a group of clinically and genetically heterogeneous retinal degenerative hereditary diseases that cause severe vision impairment and often blindness.They are characterized by dysfunction and loss of retinal pigment epithelial (RPE) cells and photoreceptor cells.Sodium iodate (NaIO3) is an antimetabolite known to selectively damage RPE.The RP induced by NaIO3 resemble patchy loss of RPE in human RP,and has been frequently used to establish a RP model.The RP models induced by NaIO3 can be established in a variety of experimental animals.Among those models,the RP model induced by one injection of NaIO3 is most commonly used.The NaIO3-induced RP animal models can be manipulated in terms of onset age and disease progression.Moreover,RPE cells in some animals have a self-regenerative potential under specific conditions.Therefore,this model is relevant in the study of RP pathogenesis,drug or stem/progenitor cell therapy and regenerative medicine.There have been many reports on researches and application of NaIO3-induced RP models,we summarized recent progress in this model.

Objective To investigate the effect of aspirin on the endometrium of patients with severe intrauterine adhesions after electrical resection.Methods 130 patients with severe intrauterine adhesions after electrical resection from August 2013 to August 2015 in our hospital were selected and randomly divided into the observation group and the control group ( 65 cases in each group ); The control group were given progestogen sequential therapy, while the observation group were given aspirin for treatment on basis of the control group; All the two groups were treated for three menstrual cycles; Before and after treatment indexes including uterine endometrial thickness, ovulation of the uterine artery blood flow index artery pulsatility index in ultrasound (PI), resistance index (RI), endometrial blood flow parameters[vascular index (VI), flow index (FI) and vascular blood flow index (VFI)] were recorded and compared, as well as menstruation and uterine cavity shape 3 menstrual cycles after treatment;All the two groups were followed up for one year, and one year pregnancy rates in the two groups were recorded.Results After treatment, the total efficiency in the observation group was 92.3% significantly higher than 69.2% in the control group ( P <0.05 ) .After treatment, in the two groups endometrial thickness, PI, RI, VI, FI and VFI were significantly improved compared with before treatment (P<0.05), but the observation group improved more obviously (P<0.05).Within one years in the observation group the pregnancy rate was 57.1%higher than that in the control group 26.5%(P<0.05) .Conlcusions Application of aspirin can significantly improve the endometrial thickness on the basis of estrogen and progesterone sequential therapy , increase the endometrial blood flow and improve the pregnancy rate, which mechanism may be related to promoting endometrial repair and improving blood perfusion of the uterus.

Object In order to identify the resources of official and unofficial plants in Rheum L.at molecular level, a random amplified polymorphic DNA (RAPD) analysis was performed. Methods The amplification program of polymerase chain reaction (PCR) was optimized. Arbitrary decamer primers of 121 based on the individual selecting method, and 64 based on the BSA method were screened. Results Four primers among all screened primers were found to be useful to amplify specific strips to the official plants of Rheum L. Conclusion This method is reliable, accurate, quick and reproducible for authenticating the official and unofficial plants of Rheum L. at molecular level. Moreover, the experiment results indicate that it is more effective to screen the primers using BSA method than using individual selecting method.

Objective To evaluate the safety and efficacy of a device that called bipolar RF (Aluma) for non-ablative treatment of facial laxity.Methods Thirty-nine Chinese volunteers of skin types Ⅲ-Ⅳ,with facial laxity and periorbital rhytides,received five times treatments at 10 days interval with Aluma RF energies (6-10 W).Standardized photographs were taken at baseline and serially for 3 months after the last treatment.The photographs were evaluated to assess the improvement in skin Iaxity by both doctors and patients.Results At 1-3 months after the last treatment,the results showed significantly subjective improvement in skin 1axity of cheek(P＜0.05),and mild to moderate Subiective improvement in skin laxity of periorbital area,nasolabial fold and upper neck.There was no serious complication.Conclusion The bipolar radiofrequency produces mild to moderate improvement of facial laxity in Chinese with no serious adverse sequelae.A high patients'satisfaction is achieved.However,further studies are necessary to demonstrate the long-term effects of the procedure and to optimize treatment parameters.

A 37-year-old female was admitted to the hospital for an itching and painful subcutaneous nodule with ulceration on the extensor aspect of her left forearm for more than 6 months.The pain was severe,continuous and localized.Systemic and local treatment with antibiotics resulted in no obvious improvement.The lesion had gradually increased in size over the past 6 months and the ulcer had enlarged for 1 month.On examination,a hard infiltrative plaque measuring about 5.5 cm × 4.0 cm with a well-defined margin was seen on the extensor aspect of her left forearm,along with ulceration and some dirty discharge on the surface.The diagnosis of fibrosarcoma,grade Ⅱ was eventually made by a biopsy of the lesion,which revealed increased pigmentation in the basal layer,and tumor tissue was tightly adherent to the epidermis.Dermis and subcutaneous fat layer were infiltrated with various sizes of spindle cells with fine collagen fiber bundles between the cells.Obvious atypia and mitotic figures were easily observed in some of the cells.Immunohistochemical analysis showed moderately positive staining for fibronectin,but negative staining for human melanoma black-45 (HMB45),S100,smooth muscle actin (SMA),Melan-a,high molecular weight cytokeratin (HCK),CD34,CD68 or cytokeratin.Some diseases should be differentiated from this case,including dermatofibrosarcoma protuberans,cutaneous spindle cell squamous carcinoma,atypical fibroxanthoma,malignant fibrous histiocytoma,and so on.

Objective To observe expression level of serum vascular endothelial growth factor-C (VEGF-C),VEGF-C receptor-2 and VEGF-C receptor-3 in patients with acute leukemia (AL) and to explore its clinical significance.Methods Enzyme-linked immuno sorbent assay (ELISA) was used to detect the serum expression levels of VEGF-C,VEGFR-2,and VEGFR-3 of 51 patients diagnosed with acute leukemia,43 patients under medical treatment and 16 healthy blood donors.Results (1) Serum VEGF-C,VEGFR-2,and VEGFR-3 expression levels in AL patients were significantly higher than those in normal control group.(2) Serum VEGF-C and VEGFR-2 expression levels in complete remission (CR) group significantly declined after treatment.Serum VEGF-C and VEGFR-2 expression levels in non-complete remission (NR) group slightly declined after treatment but no significant difference was found (P＞0.05).(3) No significant difference was found in serum VEGFR-3 expression levels both in CR group and NR group after treatment (P＞0.05).(4) Serum VEGF-C,VEGFR-2,and VEGFR-3 expression levels in NR group were significantly higher than those in CR group before treatment (P＜0.08).Conclusions Observing serum expression level of VEGF-C,VEGFR-2,and VEGFR-3 of AL patients may be helpful in monitoring curative effects and prognosis of acute leukemia.

Objective To observe the effect of the nutrition management according to the JCI(Joint Commission on Accreditation of Healthcare Organizations)management standard for critically ill pediatric patients with mechanical ventilation.Methods A total of 330 cases with mechanical ventilation were en-rolled in the control group from Hunan Province Children's Hospital PICU between Jan.2012 and Dec.2012, and these pediatric patients were managed with the conventional nutrient management.A total of 359 pediatric patients with mechanical ventilation were admitted to the experimental group from Jan.2013 to Dec.2013 and these patients were managed with nutrient management based on JCI standards.The length of mechanical venti-lation,stay in ICU,stay in hospital were compared between two groups,and the incidence of ventilator-associ-ated pneumonia,abandonment rate and mortality were also compared between experimental group and control group.Results The length of mechanical ventilation in control group[(8.39 ±1.34)days]was longer than that of experimental group[(5.69 ±1.12)days].The length of stay in PICU for control group[(12.32 ± 1.37)days]was more than that in experimental group[(9.42 ±1.53)days].The length of stay in hospital for control group [(15.37 ±2.16 )days]was higher than that of experimental group [(12.63 ±2.29 ) days].The incidence of ventilator-associated pneumonia(9.7%)in control group was higher than that of ex-perimental group,and the giving up or mortality rate in control group(8.48%)was higher than that of exper-imental group(4.35%).And there were significant differences by statistical analysis(P ﹤0.01 ,respective-ly).Conclusion According to the nutritional management in JCI standard,the length of mechanical ventila-tion,stay in PICU and stay in hospital time,the incidence of ventilator-associated pneumonia,and the aban-doned or mortality rate were reduced for critically ill pediatric patients with mechanical ventilation.

uate and should be standardized.

Objective To evaluate effectiveness of prevention and treatment for patients with chronic obstructive pulmonary disease (COPD) for one year at community health-care service (CHS)centers. Methods A quasi-experiment design was used to evaluate effectiveness of community management for patients with COPD who visited and registered at Xiaokunshan and Xinbang CHS centers in Songjiang district of Shanghai in 2008, with COPD patients from Xiaokunshan community CHS center as management group and those from Xinbang as control. Measures for community management included training for local general practitioners in essential knowledge of COPD prevention and treatment, allocation of necessary drugs for COPD treatment, and health education for COPD patients and their family members. No special measures were taken for control group except routine treatment. Results A total of 132 patients were diagnosed as COPD according to their pulmonary function on 2008, 61 at Xiaokunshan and 71 at Xinbang CHS canters.One hundred and two patients, 47 at Xiaokunshan and 55 at Xinbang, finished one-year follow-up. Five patients from Xiaokunshan who were smokers at their first visits and three of them quitted smoking after oneyear management. Meanwhile, none of nine smoked patients from Xinbang quitted smoking in the same period. There was no statistically significant difference in symptom scores, pulmonary function, and forced expiratory volume at the first second (FEV1) between patients in the two groups during one-year follow-up.Average score of quality of life in patients at Xiaokunshan dropped to 39. 12 after one-year management from 46. 96 at their first visits, and that in patients at Xinbang increased to 62. 11 from 56. 55 (P＜0.01).Average six-minute walking distance (6-MWD) in patients at Xiaokunshan reduced to 354. 26 meters after one-year management from 361.66 meters at their first visits, meanwhile that in patients at Xinbang reduced to 351.18 meters from 398.07 meters (P =0. 008). Scores of functional dyspnea in patients at Xiaokunshan fell to 0.34 from 0.40 at their first visit, meanwhile that in patients at Xinbang increased to 1.00 from 0.95(P =0.038). During the one-year follow-up, 13 patients at Xiaokunshan and 53 at Xinbang visited emergency departments for treatment, and four at Xiaokunshan were hospitalized and none died, and five at Xinbang were hospitalized due to acute exacerbation of COPD and four of them died. Conclusions The study suggests that strengthening prevention and treatment for COPD patients at community level by general practitioners, patients themselves and their family members can improve their quality of life, reduce emergency visits and hospitalization, alleviate dyspnea symptoms and delay the decline of 6MWD.