To explore the effects of two breathholding and exerting methods on the second labor course of primiparas.Methods Six hundred primiparas were divided according to the admission time into two groups: the control group and observation group. The former took conventional breathholding and exerting method and the latter breathholding and exerting method with breathing techniques. The two groups were compared in terms of outcome of delivery, rate of episiotomy, time for breathholding and exerting and the hemorrhage volume 2h after delivery, perineal laceration and neonate asphyxia.Results The rate of spontaneous delivery in the observation group was higher than that in the control group. The rate of episiotomy, bleeding volume 2h after delivery and perineal laceration were lower. The breathholding time was significantly shorter(P<0.05).Conclusion Breathholding and exerting at the second stage of labor can reduce energetic consumption and improve the outcome of delivery.

Objective To observe the analgesic effect of Qilong Toutong Granule and explore its underlying mechanisms of action. Methods Kunming mice were randomly divided into blank group, Zhengtian pill group, ibuprofen group, and high-, medium- and low-dose of Qilong Toutong Granule groups. After completing the prophylactic treatment for 3 days, hot-plate test and acetic acid-induced writhing test were used to observe the pain reaction of mice. SD rats were randomly divided into blank group, Zhengtian pill group, model group, rizatriptam group, and high-, medium- and low-dose of Qilong Toutong Granule groups. After gavaged for continuous 7 days, rats were intraperitoneally injected nitroglycerin (10 mg/kg), and 4 hours later, blood samples were collected from postcava for measuring the levels of plasma CGRP and β-EP by radioimmunoassay. Subsequently, rats were perfused transcardially and the brain tissues containing the trigeminal nucleus caudalis (Sp5C) were achieved for detecting the expression of Fos protein by immunohistochemical method. Results Qilong Toutong Granule significantly raised the pain threshold, reduced the number of writhing response of mice, remarkably down-regulated the levels of plasma CGRP, up-regulated the levels of plasmaβ-EP and inhibited the expression of Fos protein in Sp5C of rats compared with the model group. Conclusion Qilong Toutong Granule has good analgesic effect and its mechanisms on relieving migraine may be through regulating the levels of neurotransmitters or neuropeptides, and inhibiting the activation of Fos pathway.

Objective To compare the treatment effect of laparoscopic appendectomy(LA) and open appendectomy (OA). Methods One hundred and forty-five cases of LA performed from May 2003 to May 2005, and 142 cases of OA performed from June 2001 to March 2003 were studied retrospectively. Results There was no difference in operative time between group LA and group OA. In the procedure of LA, some occult disease could be discovered and treated, while OA was not. The administration of analgesic, activity time, incidence of incision infection and hospital stay in group LA were better than those of OA group. While the cost of hospitalization in LA was higher than that of OA. Conclusion LA has significant advantages in treating appendicitis and it should be promoted.

Objective To investigate the diagnosis and treatment value of laparoscopic surgery in tubal obstruction infertility patients with endometriosis.Methods Retrospective analysis was done in 381 cases underwent laparoscopic treatment for tubal obstruction from May 2005 to May 2010,,of which 119 cases were combined with endometriosis.The treatment results were analyzed,including the decomposition of the umbrella side tubal obstruction adhesions,lesions of endometriosis electrocoagulation,endometriosis cystectomy and pregnancy and so on.Results Hysterosalpingography(HSG)showed tubal occlusion in both side or one side in the distal end in 381 cases,and these patients were treated with laparoscopic surgery.There were 262 cases showed distal tubal occlusion not companied with endometriosis,of which 82 cases clinically pregnanced,accounting for 31.3％.Surgical treatment of endometriosis found in 119 cases,accounting for 31.2％ ; and 29 cases pregnaced,which accounted 24.4％.We found 42 cases of tubal adhesions grade Ⅰ-Ⅱ and endometriosis stage Ⅰ-Ⅱ,16 cases of clinical pregnancy,accounting for 38.1％ ;Twenty-six cases of tubal adhesions grade Ⅰ-Ⅱ and endometriosis stage Ⅰ-Ⅱ,7 cases of clinical pregnancy,accounting for 26.9％ ;Twenty-eitht cases of tubal adhesions grade Ⅲ-Ⅳ and endometriosis stage Ⅰ-Ⅱ,4 cases of clinical pregnancy,accounting for 14.3％ ;Twenty-three cases of tubal adhesions grade Ⅲ-Ⅳ and endometriosis stage Ⅲ-Ⅳ,2 cases of clinical pregnancy,accounting for 8.7％.The clinical pregnancy rate in the first group was significantly higher than the other groups,chnical pregnancy rate of the last group was the lowest.Conclusion Laparoscopic surgery is an effective treatment of tubal obstruction infertility combined with endometriosis.After laparoscopic surgery,the clinical pregnancy rate is significantly higher in Tubal obstruction without endometriosis than patients with endometriosis.After surgery,the clinical pregnancy rate in patients with the light stage tubal adhesions and endometriosis is better than those severely.

The principle on the pitting electrochemical noise detected by using wavelet transform was described briefly and the signal of pitting electrochemical noise was analyzed for commercial pure aluminum in 3.5 % NaCl solution. The result showed that wavelet transform could not only obtain the waveform characteristic of pitting signaland system noise in the multi-scale space, but also detect the waveform of pitting electrochemical noise according to the transmitting characteristic of the maximum module of wavelet coefficients, which represented the waveform characteristic.

Objective To evaluate left atrial function dynamic changes before and after radiofrequency catheter ablation (CA)with persistent atrial fibrillation (AF)and predict the maintain sinus rhythm of postoperative atrial fibrillation by speckle tracking imaging.Methods The study was including 45 cases underwent CA with persistent AF(preoperative 1 week,postoperative 24 hours,3 months,6 months)and 25 normal cases.Left atrial function and strain rate were analysed.These index were measured and calculated:the left atrial diameter index (LADI),left atrial area index (LAAI),left atrial maximum volume index (LAVImax)and left atrial ejection fraction(LAEF),left atrial wall strain rate of left ventricular systolie (SRs),left atrial wall strain rate of left ventricular early diastolie (SRe),left atrial systolic strain rate(SRa) and the average of left atrial wall each phase strain rate.Results ① LADI,LAAI,LAVImax were significantly increased;LAEF,SRs,SRe were decreased significantly;SRa were disappeared with AF compared with the control group.②LADI,LAAI,LAVImax decreased gradually,LAEF,SRs,SRe,SRa were gradually increased with the extension of the follow-up time.③Left atrial average SRs predicted maintenance of sinus rhythm with atrial fibrillation after operation of CA(odds ratio=0.607,95% CI=0.417-0.819,correction of P =0.017)was an independent predictor.Conclusions Speckle tracking imaging can quantitative evaluate left atrial function with persistent AF after CA.Left atrial global reservoir function predicts the efficacy of CA.

Objective To study the relationship between ischemic mitral regurgitation and geometric angles of the mitral valve leaflets in patients with coronary artery disease and papillary muscle dysfunction by transesophageal echocardiography(TEE) ,and to evaluate anatomy and pathophysiology mechanicm of the ischemic mitral regurgitation with left ventricular papillary muscle dysfunction .Methods A total of 84 subjects were enrolled in this study .All of the subjects were divided into group A (healthy volunteers constituted the control group ,n =40) ,group B (chronic inferior or posterior myocardial infarction patients with papillary muscle dysfunction group ,n =44) ,group C(patients from group B after mitral valvuloplasty surgery ,n = 20) .The relationship between mitral regurgitation and geometric angles of the mitral valve leaflets and mitral annulus were studied by TEE .Results Geometric angle between the mitral valve leaflets and mitral annulus were significantly larger in group B ,and geometric angles of the mitral valve leaflets and mitral annulus was positive correlated with degree of mitral regurgitation .Degree of mitral regurgitation significantly reduced in group C ,no significant difference was found at the geometric angles of the mitral valve leaflets and mitral valve annular compared with group A .Conclusions The degree of mitral regurgitation were highly correlated with geometric angles of the mitral valve leaflets and mitral valve annular in patients with left ventricular papillary muscle dysfunction caused by coronary heart disease .Repair of the mitral valve leaflets surgery can significantly reduce geometric angles of the mitral valve leaflets and mitral valve annular ,and reduce the degree of mitral regurgitation significantly .

Objective To investigate the relenvant factors of precocious puberty and provide the basis for precaution of high risk group of precocious puberty .Methods A 1:1 case-control study was performed on 50 healthy girls and 50 precocious puberty girls .Results Univariate analysis showed an significant differences in the exposure rates of following five factors between cases and controls:intake of nutritious and health products ,favoring meat and poultry,long time watching television,addiction to TV ads,family economic condition (The Chi-square values are 7.045,9.073,17.478,14.063,12.246 respectively,all P<0.05).The Logisitc regression showed that favoring meat and poultry,long time watching television and addiction to TV ads had significant differences among precocious puber -ty children(The Wald′s Value were 4.846,6.850,5.662 respectively,all P<0.05).Conclusion favoring meat and poultry,long time watching television and addiction to TV play an important roles in precocious puberty .

BACKGROUND:Induced pluripotent stem cel s have great prospects in tissue repair, due to the characteristic of self-renewal, multi-directional differentiation, no immunological rejection and ethics controversy.
OBJECTIVE:To summarize the differentiation of induced pluripotent stem cel s towards cardiomyocytes and endothelial cel s, and their applications in the cardiovascular diseases.
METHODS:The first author performed a data retrieval of PubMed and CNKI databases from 2000 to 2015 to search articles addressing the differentiation of induced pluripotent stem cel s towards cardiomyocytes and endothelial cel s, and reviewed the literatures systematical y. Final y, 78 articles were chosen for further analysis.
RESULTS AND CONCLUSION:Induced pluripotent stem cel s can differentiate into cardiovascular cel s through a variety of methods. Factors such as cyclosporin A and ascorbic acid C may improve myocardial differentiation of induced pluripotent stem cel s, while vascular endothelial growth factor and basic fibroblast growth factor may improve the endothelial differentiation of induced pluripotent stem cel s. Cardiovascular cel s derived from induced pluripotent stem cel s can be applied to build disease models in vitro, transplantation in vivo and drug screening.