Cardiovascular dysfunction is common in severe sepsis.Although functional alteration is often described,the elevated serum levels of cardiac proteins and autopsy findings of myocardial immune cell infiltration,edema,and damaged mitochondria suggest that structural changes to the heart during severe sepsis may occur and may contribute to cardiac dysfunction.Myocardial functions may be improved by pretreatment with plateletactivating factor,cyclo-sporin A,glutamine,caffeine,simvastatin,or caspase inhibitors.We explored the advance on structural change of the heart during severe sepsis in order to deepen the understanding of these changes.

Objective To analyze the association between pre-pregnancy body mass index,pregnancy weight gain and gestational diabetes(GDM).Methods The pre-pregnancy body mass index,pregnancy weight gain and the incidence data of 345 gestational diabetes with full-term primiparae were analyzed.Results The GDM ratio of low-weight,ideal weight group,over-weight was 2.78％,2.96％,16.04％,respectively over-weight GDM pregnancy was significantly higher than the ideal weight group( x2 =4.269,P ＜0.05),and GDM over-weight before pregnancy was significantly higher than the low weight group the incidence of GDM,the difference was statistically significant( x2 =17.299,P ＜0.01 ) ;Pregnant women in different pregnancy weight gain A( ＜ 11.0kg),B( 11.0 ～ 17.9kg),C( 18.0～24.9kg),D(≥25.0kg) range,the GDM were 0％,1.75％,6.60％,11.02％,that GDM of A,B,C,D group were statistically different( P ＜ 0.05 ).Rate of weight gain during pregnancy on pregnancy size was proportional to the impact of diabetes.Conclusion Pre-pregnancy body mass index,pregnancy weight gain had clinical significance in evaluation of gestational diabetes.

Objective To explore the application of Orem self-care mode on hip function recovery of elderly patients with artificial hip replacement . Methods Fifty elderly patients with hip arthroplasty from 2014 January to December were set as control group and received routine nursing methods from 2015 January to December 50 elderly patients with hip arthroplasty , were set as observation group and received Orem self-care mode . The hip function of the two groups was evaluated by Harris scale. Result The hip joint function of observation group was higher than that of control group and the difference was statistically significant (P<0.05). Conclusion Orem self-care mode applied in nursing of elderly patients with hip arthroplasty can improve the recovery of elderly patients with hip function.

Objective To observe the effect of exercise on insulin resistance induced by a high fat diet and to explore the underlying mechanism.Methods Thirty healthy male Wistar rats were randomly divided into a normal control group (NC group) and a high-fat group (HF group),fed with normal chow and a high fat diet respectively.Eighteen weeks later,insulin resistance had appeared in the HF group.The HF group was then randomly subdivided into a high-fat diet control group (HC group,fed a high fat diet) and an exercise group (HE group,fed a high fat diet and subjected to swimming training for 6 weeks).After 24 weeks,an insulin sensitivity index was calculated.Serum free fatty acid (FFA) and skeletal muscle triglyceride (TG) were detected.Phosphorylation of adenosine monophosphate kinase-α (AMPKα) in skeletal muscle was detected by Western blotting.Results At twenty-four weeks the insulin sensitivity of the HC group had decreased significantly compared to the NC group.Serum FFA level and skeletal muscle TG content had both increased.Average phosphorylation of AMPKα in the HC group decreased to 48.7% of the NC group average.Compared to the HC group,insulin sensitivity and phosporylation of AMPK-α were elevated significantly in the HE group.Serum FFA level and skeletal muscle TG content were both lower.However,compared to the NC group,both serum FFA level and skeletal muscle TG content had increased in the HE group,while insulin sensitivity and phosphorylation of AMPKα had significantly decreased.Conclusions Exercise can significantly improve insulin resistance induced by a high-fat diet through decreasing serum FFA level and ectopic li-pid accumulation in skeletal muscle.

Objective To explore the best opportunity of termination of pregnancy and conservative therapy in the treatment of lata trimester of pregnancy combining hypertension or preeclampsia.Methods The clinical data of 198 patients with pregnancy combining hypertension or preeclampsia were studied retrospectively.Among the total patients,107 patients performed conservative therapy (conservative therapy group),91 patients performed termination of pregnancy (termination of pregnancy group).The prognosis of two groups was compared,including maternal and neonatal complications and morbidity and mortality.ResultsThe cesarean section rate of conservative therapy group was 54.2％ (58/107),termination of pregnancy group was 51.6％(47/91 ),there was no significant difference between two groups(P＞0.05 ).The perinatal complication rate of conservative therapy group and termination of pregnancy group was 15.9％(17/107) and 17.6％( 16/91 ),there was no significant difference between two groups(P＞0.05).The rate of placental abruption,low platelet disease,hypoproteinemia,postpartum hemorrhage between two groups had no significant difference (P＞0.05).Conservative therapy group had 3 cases neonatal asphyxia,1 case neonatal death.Termination of pregnancy group had 7 cases neonatal asphyxia,1 case neonatal death.The rate of adverse events of conservative therapy group had no significant difference compared with termination of pregnancy group (P＞0.05 ).The perinatal average weight of conservative therapy group was (2.635 ± 0.446)kg,termination of pregnancy group was (2.014 ±0.721) kg,there was significant difference (P＜0.05).Conclusion Under the premise of control blood pressure,spasmolysis,ensure maternal and neonatal safety,expectant monitoring can give more chances for fetuses to get more mature so decrease the complications.

Objective To compare the alaryngeal speakers'voice acoustic parameters and intra-tracheal pressure when they spoke different vowels.Methods 24 patients after tracheo-esophageal shunt phonation by the anastomosis of the membranous portion of the tracheal section with the anterior wall of esophagus after total laryngectomy and 16 esophageal speakers enrolled in this study. The voice acoustic parameters were measured when they spoke soft /a/ and soft /i/. The intra-tracheal pressure of 20 TE speakers was measured when spoke /a/ and /i/.Results There were no significant differences between vowel /a/ and /i/ in the two alaryngeal speaker group. The pressure of TE speakers after Shang's procedrue for comfortable /i/ was higher than that for /a/, and there was significant difference.Conclusion There were the same clinical meanings in evaluating alaryngeal voice acoustic aspect. when using vowel /a/ and /i/. However when using different vowel, the intrtracheal pressure was different in TE speakers.

Objective To investigate the role of cell apoptosis in the gut mucosal barrier dysfunction in rats undergoing cardiopulmonary bypass(CPB) . Methods The rat model of CPB was set up. The rats were divided into CPB group, sham operation(SO) group and normal control group. The morphological changes of ileum mucosal tissues were observed by microscope and electron microscope at 3h, 6h, 12h and 24h after operation, respectively. The apoptotic index of gut mucosal epithelial cells was measured with TUNEL method. Results Gut mucosal morphology was normal in CPB group at 3h, 6h and 12h after operation, but gut mucosal epithelial desquamation occurred at 24h after operation. Typical apoptotic cells could be seen with electron microscope in CPB group at every time point. Apoptotic index of gut mucosal epithelial cells significantly increased in CPB group at every time point compared with SO group, and peaked at 6h after operation. Apoptotic cells were mostly located in the gut crypt. Conclusion The data suggested that the apoptosis of intestinal epithelial cells significantly increased at early stage of post-CPB in rats, which might contribute to gut mucosal barrier dysfunction.

BACKGROUND:Superparamagnetic iron oxide has been widely used in biomedical applications, especialy in the field of targeted diagnosis and therapy. OBJECTIVE:To summarize the physicochemical property, preparation, surface modification, product testing and biomedical applications of superparamagnetic iron oxide. METHODS: In order to search relevant articles about the physicochemical property and biomedical applications of superparamagnetic iron oxide from PubMed, Sciencedirect, CNKI and Wanfang databases (from 2000 to 2014), a computer-based search was performed using the keywords of “superparamagnetic iron oxide, preparation, coprecipitation, surface modification, magnetic resonance imaging contrast agent, fluorescent tracing, targeted therapy” in English and Chinese, respectively. RESULTS AND CONCLUSION: The superparamagnetic iron oxide can be produced in the laboratory, and the preparation methods include hydrothermal method, vapor deposition method, mechanical miling method, liquid-phase microwave dielectric heating method, sol-gel method, emulsion method, co-precipitation method. Moreover, the superparamagnetic iron oxide can have different properties by surface modification and be applied in many biomedical fields, such as magnetic resonance contrast agent, fluorescent tracer, nanoparticle targeted therapy, hyperthermia and bioseparation.

Objective To explore the clinical function of biofeedback training in patients with high risks of postpartum depression,and to provide a new method to decrease the risk of postpartum depression.Methods From May 1,to December 31,2010,in Bayi Children's Hospital,General Hospital of Beijing Military Area Command of Chinese PLA,60 pregnant women with Edinburgh Postnatal Depression Scale (EPDS) evaluation score of 6 to 12 at 12～14 gestational weeks were randomly divided into the biofeedback training group (n=30) and the control group (n=30).The control group learned prenatal care knowledge in pregnant women's school.Moreover,the biofeedback training group received Self-generate Physiological Coherence System training till one week before delivery.Both groups were evaluated with the EPDS at baseline,and 3 days,6 weeks,3 months postpartum.Differences between the two groups were compared with mixed effect model.Results Totally,there were 51 pregnant women finished the study,including 25 women in the biofeedback training group and 26 in the control group.There were no statistical difference in EPDS score at 12～14 gestational weeks between the biofeedback training group and control group [8.5±2.0 vs 8.5±1.9,t=0.03,P=0.97].At 3 days,6 weeks and 3 months postpartum,the EPDS score of biofeedback training group was 4.1 ± 1.8,4.7 ± 2.0 and 4.6 ± 1.8 respectively,which was lower than those in the control group (6.5 ± 2.4,7.0 ± 2.5and 6.9±2.4) (interaction effect F=4.35,P=0.01).On each postpartum time-point,OR value and 95％CI was 0.12 (0.03-0.45),0.21 (0.06-0.68) and 0.23 (0.07-0.77),P＜0.05 respectively.Cohen's d value were 1.17,0.99 and 1.06 respectively.Compared with the baseline value,the total EPDS scores in each study stage declined with varied degrees in both groups,and the score-reducing level were obvious in the biofeedback training group than in the control group.Conclusion Biofeedback training could effectively relieve the depression symptoms in pregnant women with high risks of postpartum depression,and decrease the risk of postpartum depression.

Objective To investigate the change of intestine mucosal permeability during cardiopulmonary bypass (CPB) and its effect on gut barrier in rats model. Methods The rats model of CPB was established and samples of tissue and plasma were collected at different intervals. Plasma D-lactate and LPS concentrations were determined and gut tissue was examined microscopically. Results The plasma concentration of D-lactate and LPS increased gradually at 1h CPB, and increased markedly 1h after CPB. They recovered to normal 8h after CPB, respectively. In addition, it was noted that there was a significant positive correlation between the plasma concentrations of LPS and D-lactate (r = 0.8312, P