Objective To investigate the main pathogenic factors of fetal distress and its complications and to reduce perinatal mortality. Methods Two hundred and ten records and pathological slides in autopsy due to fetal distress were reviewed. Results Cord problem was the first cause of fetal distress followed by placental and maternal factors. Most fetal distress were caused by multi-factors. Among 210 cases,meconium aspirative syndrome was found in 170 cases (81%),amniotic fluid aspiration 36 cases (17.1%) and hypoxic syndrome 4 cases (1.9%). There were 59 cases complicated with aspirative pneumonia including 48 cases of meconium aspirative pneumonia and 11 with amniotic fluid aspirative pneumonia. The main complications were hypoxia-ischemic encephalopathy(HIE)(153 cases),diffused pulmonary hemorrhage(68 cases) and fatal malformations (27cases). Conclusion Fetal distress increases perinatal mortality when complicated with HIE,diffused pulmonary hemorrhage,pulmonary infection or fatal malformation

Objective:To improve the recognition of bleeding risk in the anticoagulant process by analyzing one case of senior patient with deep vein thrombosis occurred severe bleeding during the anticoagulant therapy.Methods:The possible causes of hemorrhage were analyzed after the brief introduction of medical history,lab test report and treatment process of the patient.Results:The reasons of hemorrhage might be as follows:① the combination of warfarin and dalteparin induced the adverse drug reaction;② albumin decreased during the treatment process resulting in the effect enhancement of warfarin;③ the clearance of warfarin decreased resulting from the low creatinine clearance of the elderly patient.Conclusion:Clinical anticoagulant practice should be more careful in senior patients.The frequency of related laboratory tests should be increased in order to find potential risks timely.

70%). Based on the degree of coarctation, they are divided into two groups, one is mild grade (the circumference of isthmus is 0.5～0.8 cm, the ratio of ascending aorta and the aortic isthmus is 30%～ 45%), another is severe grade (the circumference is less than 0.5 cm, the ratio

Objective To explore the significance of fatal malformations to the main causes of perinatal death. Methods Autopsy data from 515 perinatal death between 1981.11 to 1999.9 were obtained from the department of pathology, and the distribution of each category of birth defects was analysed. Results One hundred and forty four fatal malformations were collected. The rate of all birth defects among all autopsy was 50.1% in our hospital, and fatal birth defects was 55.8% out of all the malformations. The major birth defects were of heart and great vessal, digestive system, neural system, and respiratory system. Among which, multiple deformity was usually seen among the cases from the obstetric group,including defects of heart and great vessel, neural system, respiratory system and digestive system and the isolated malformations were mostly seen among cases from pediatric group. Conclusions Fatal malformations were still the leading cause of death during perinatal period . The detected rates of defects of the neural system and digestive system were different between autopsy cases from obstetric and pediatric.

Objective To investigate the expression of serum soluble cytotoxic T lymphocyte associated antigen 4 (sCTLA4), the association of sCTLA4 level with erythrocyte sedimentation rate (ESR) and C reactive protein (CRP), as well as its role in patients with Crohn's disease (CD). The relationship-1661A/G and -1722T/C polymorphisms of CTLA4 gene and between disease susceptibility and phenotype of CD was analyzed. Methods A total of 126 CD patients and 300 healthy controls were enrolled in the study. Serum sCTLA4 level was determined by enzyme-linked immunosorbent assay. The concentrations of ESR and CRP were analyzed by automatic ESR Analyzer SRS 100/Ⅱ and rate nephelometry, respectively. The polymorphisms of CTLA4-1661A/G and -1722 T/C were genotyped by DNA sequencing. Results Serum sCTLA4 level was higher in CD patients than in healthy controls [(18. 70±3. 72) ng/ml vs (1.72±0. 32) ng/ml, P＜0. 01)]. Among CD patients, sCTLA4 level was higher in patients with active disease when compared to those with inactive disease [(19.83±4.35) ng/ml vs (18. 02±3.14) ng/ml, P=0. 015)]. sCTLA4 level was positively correlated with ESR and CRP levels (r=0. 267, P=0. 003; r=0. 524 P ＜0.01, respectively). In CD patients, serum sCTLA4 level was significantly higher in those with stricturing disease behavior than that in those without stricturing and penetrating or with penetrating disease behavior (P= 0.021; P=0. 015, respectively). Detection of CTLA4 -1661A/G and -1722T/C polymorphisms showed no significant difference between CD patients and healthy controls. Conclusions The high level of serum sCTLA4 in CD patients is correlated with disease activity, CRP levels and disease behavior. It suggests that sCTLA4 may play an important role in pathogenesis of CD.

Objective To investigate CT findings,of the non-epithelial benign tumors of the larynx and their value in diagnosis and treatment.Methods Thirty-nine patients with non-epithelial benign tumors of larynx were examined with CT before treatment.Results Twenty-two cases with hemangioma displayed phebolithes in 9 cases,plain CT in 8 cases showed isodensity with respect to muscle near them and enhanced CT in 14 cases showed moderate to marked enhancement(9 cases)and no contrast enhancement(5 cases). Among 6 cases of neurogenic tumor,neurilemmoma(5 cases)presented as low to intermediate density on plain CT scan(1 case)and enhancement with homogeneous or inhomogeneous after enhanced CT,another case of neurofibroma presented as low density with homogeneous on plain CT imaging.Chondroma(3 cases) showed enhancement with inhomogeneous on enhanced CT scan.Pleomophic adenoma(3 cases)showed moderate to marked enhancement and one of the three cases presented as marked cystic degeneration. Lipoma(2 cases)demonstrated low density with no contrast enhancement.Lymphangioma,leiomyoma and fibroma(each has 1 case)displayed no contrast enhancement(lymphangioma)and moderate to marked enhancement(leiomyoma and fibroma)on enhanced CT scans.Conclusion CT can definitely display the shape,range and density of the tumors in larynx and provide information for diagnosis and treatment.

Objective Toevaluatea modified Ziehl-Neelsen(Z-N) stain in the diagnosis of tuberculous meningitis. Methods Cerebrospinal fluid specimens from 35 patients were stained by using the modified Ziehl-Neelsen staining. Re-sults The positive rate was 94.29% in 35 patients with tuberculous meningitisand the intracellular acid-fast bacilli was detected in 53.40%of all specimens. One case was stained positive in 15 patients with non-tuberculous meningitis. Con-clusion The modified Ziehl-Neelsen stain not only significantly improves the detection rates of tuberculous meningitisbut alsois able to identify intracellular M.tuberculosisin cerebrospinal fluidspecimen.Thus, the modified Z-N stain can be a convenient tool for diagnosing tuberculous meningitis.

To explore the status of the job satisfaction of the authorized and contract staff in a university affiliated hospital in the dilution situation of the hospital staffing management, and to discuss the key factors and reasons affecting the satisfaction difference. The questionnaire was developed based on Minnesota Satisfaction short form with extra items covering “the comprehensive satisfaction evaluation”. According to the hospital population of staff, the cluster random sampling method was used, and survey was conducted on the spot. Both authorized staff and the contract staff showed high degree of satisfaction. But the contract staff showed higher degree of satisfaction of leadership and their own responsibility sense than the authorized staff. The contract female staff showed higher degree of overall satisfaction than the authorized female staff. The discussion based on the results showed that new human resource management mode, new mechanism of flexible management of staff, targeted staff with targeted management.

AIM:To discuss the application value of retro-mode imaging by F-10 confocal scanning laser ophthalmoscope (cSLO) for detecting drusen in patients with age-related macular degeneration (AMD).METHODS:This was a retrospective case study.During the period of October 2015 to December 2016, 67 patients with unilateral AMD (67 affected eyes and 67 fellow eyes) were included in this study.All patients underwent color fundus photography, optical coherence tomography (OCT) and retro-mode imaging by F-10 cSLO.The features of drusen by color fundus photography, OCT and retro-mode imaging were comparatively observed in the affected eyes of patients with unilateral AMD.Positive numbers of drusen in the fellow eyes of patients with unilateral AMD detected by color fundus photography, OCT and retro-mode imaging were calculated and compared.RESULTS:Retro-mode imaging by F-10 cSLO gave easier to identify images of drusen than color fundus photography and OCT in the affected eyes of patients with unilateral AMD.In the fellow eyes of 67 patients with unilateral AMD, retro-mode imaging showed drusen in 56 cases(84%), color funds photography showed drusen in 36 cases(54%), OCT showed drusen in 48 cases(72%), the difference was statistically significant(χ2=14.31, P<0.05).The positive numbers of drusen detected by retro-mode imaging were significantly higher than color fundus photography, the difference was statistically significant(χ2=13.87, P′<0.0125).There was no statistically significant difference in the positive numbers of drusen detected by retro-mode imaging and OCT(χ2=2.75, P′>0.0125).CONCLUSION:Retro-mode imaging by F-10 cSLO provides a non-invasive technique and should be useful for detecting and monitoring drusen in AMD.

To explore the patterns and ideas of medical cooperation between Beijing and Hebei Chinese Medicine hospitals under the background of the integration of Beijing-Tianjin-Hebei regions. By searching the 2015 China statistical yearbook for health, a survey was conducted among doctors and patients in a Hebei hospital, which is cooperate with the Beijing hospital. We found that Beijing-Tianjin regional medical resources were imbalanced, and Hebei medical resources were insufficient, and patients and doctors were satisfied with the cooperation. There are still some difficulties in Chinese medicine hospital of Beijing and Tianjin cooperation, and many departments need to work together to promote Beijing-Tianjin-Hebei rational allocation of medical resources.