Objective To develop Z-score reference ranges for tricuspid annular plane systolic excursion(TAPSE) in normal fetuses from the measurements of gestational age(GA),biparietal diameter (BPD) or femur length(FL) using fetal echocardiography.Methods A retrospective cross sectional study of 1012 singleton normal fetuses were performed.The gestation age ranged from 20 to 41 weeks.Non-cardiac fetal biometric parameters included GA and BPD and FL were measured and calculated GA based on menstrual age.TAPSE was measured in a standard apical four-chamber view by free angle M-mode echocardiography.Normal Z-score ranges were developed for TAPSE using GA,BPD and FL as independent variables.These were accomplished by using first standard regression analysis and then weighted regression of absolute residual values for each parameter in order to adjust for inconstant variance.Results Linear regression model was the best description of the data in each case and correlations between TASPE and independent variables (GA,BPD,FL) were excellent.Heteroscedasticity of standard deviation (SD) with increasing independent variables also could be modeled with a simple linear regression.According to these equations,TAPSE Z-score =(the actual measurement of TAPSE-predicted TAPSE)/prediction SD.Conclusions Normal reference ranges and Z-scores for TAPSE have been provided.These normative data may be useful tools for assessment of fetal TAPSE,to evaluate fetal right ventricular function more accurately and effectively.

Objective To obtain the annular plane systolic excursion difference (APSED)of fetuses in second and late trimester by free angle M-mode (FAM)and tissue motion of annular displacement (TMAD)in order to assess the fetal ventricular function.Methods The mitral annular plane systolic excursion(MAPSE)and tricuspid annular plane systolic excursion(TAPSE)of four hundred and fifty five normal fetuses from 20 to 41 weeks were measured by FAM echocardiography,and the difference between them were calculated.Early diastolic velocities (Em)of the mitral annular and early diastolic velocities (Em')of the tricuspid annular were estimated by pulsed-wave tissue Doppler imaging (TDI),meanwhile systolic velocities (Sm)of the mitral annular and systolic velocities (Sm')of the tricuspid annular were also estimated by TDI.Fifty normal fetuses in the second and late trimester were choosed randomly,two-dimension imaging was obtained at the apical four-chamber view,then mitral annular plane and tricuspid annular plane displacement curve were acquired at the same time by using off-line QLab 8.1 software,and the differences in the peak time between them were compared.The trace of annular displacement were recorded by color tissue tracking technology.Results There was a significant difference between FAM-TAPSE and FAM-MAPSE in different gestational weeks (P <0.05),FAM-TAPSE was growing with the increase of gestational weeks,FAM-APSED showed significant positive correlations with gestational week, Em,Sm,Em' and Sm'.Annular plane displacement curve showed that TMAD-TAPSE was higher than TMAD-MAPSE in the entire cardiac cycle,and there was no statistically significant difference in time to peak of the annular plane displacement curve between them(P >0.05).Conclusions The APSED existed in the second and late trimester continually.It was considering associated with fetal ventricular torsion.As the growth of gestational weeks,the increase of APSED reflected the enhanced reserve capacity of the fetal ventricular torsion.APSED can reflect the longitudinal motion and torsion movement of fetal ventricle quantitatively,and can be used as a new index to assess the fetal cardiac function.

Objective To establish z-score model for fetal tricuspid annular plane systolic excursion(FAM-TAPSE) and mitral annular plane systolic excursion(FAM-MAPSE) based on gestational age(GA),then to evaluate the ventricle systolic function of fetus with heart failure.Methods One thousand and twelve normal fetuses and 24 fetuses with heart failure were involved. FAM-TAPSE and FAM-MAPSE were measured by free angle M-mode echocardiography,and FAM-TAPSE and FAM-MAPSE z-score models of normal fetuses were constructed by using first standard regression analysis with GA as independent variable.The fetuses with heart failure were divided into left heart failure (LHF) group and right heart failure (RHF) group by Tei index.Subsequently,the two parameters between normal and fetuses with heart failure were compared. Results The models used to calculate z-score for FAM-TAPSE and FAM-MAPSE were constructed,and GA had close correlation with them. Compared with normal fetuses,the mean z-scores of FAM-TAPSE and FAM-MAPSE were statistically different in fetuses with heart failure(P<0.001). The FAM-MAPSE z-scores of LHF and the FAM-TAPSE z-scores of RHF were all less than-2 z-scores.Conclusions The FAM-TAPSE and FAM-MAPSE z-scores decline in fetuses with heart failure and they can provide quantitative evidence in evaluation of heart systolic function,FAM-TAPSE and FAM-MAPSE z-score would be markers for assessing heart systolic function in fetuses with heart failure.

BACKGROUND: Craniocerebral injury can cause a series of visceral complications, among which cardiovascular complication is paid special attention.OBJECTIVE: To investigate the effects of craniocerebral injury on changes of circulatory and local angiotensin Ⅱ (Ang Ⅱ ) and local angiotensin Ⅱ receptor 1 (AT1) in the heart.DESIGN: Randomized controlled experiment taking animals as subjects.SETTING: Beijing Tiantan Hospital, and the College of Basic Medicine,Capital University of Medical Sciences.MATERIALS: The experiment was conducted at the Central Laboratory of Capital University of Medical Sciences and the Central Laboratory of Beijing Tiantan Hospital from 2003 to 2004. Totally 40 healthy male Wistar rats were divided randomly into craniocerebral injury group and control group with 20 in each group.METHODS: Rats in craniocerebral injury group were treated with weightdrop method to establish the model of craniocerebral injury, while rats in control group received no impact. Twenty-four hours after hitting, 10 rats in each group were selected to assay their Ang Ⅱ and AT1; the other 10 in each group were selected to observe their myocardial forms.myocardium of rats assayed with light microscope after hematoxylin-eosin staining and transmission electron microscope.It was significantly higher in craniocerebral injury group than in control ity: It was obviously higher in craniocerebral injury group than in control Ⅱ and AT1: The area of positive reactant and gray value in craniocerebral toxylin-eosin staining: Strong acidophil staining was found on myocardial cellular plasma in craniocerebral injury group. The results showed that cytoplasm shrank obviously; muscle fiber broke, decreased or disappeared.Focal hydropic degeneration, lysis or necrosis was observed in myocardium.Ultrastructural pathological observation revealed pathological damage of myocardium.CONCLUSION: Craniocerebral injury in rats can cause myocardial damage, and changes of angiotensin system may be one of the factors.

Objective To investigate the changes of QT dispersion and heart rate variability in children with ventricular contraction. Methods 50 healthy children who came for medical examinations at Chengdu Women′s and Children′s Central Hospital from January 2012 to January 2014 were selected as control group. 147 children with ventricular contraction admitted in Pediatric Intracardiac Department of Chengdu Women′s and Children′s Central Hospital from January 2012 to January 2014 were divided them into Benign Group (LownⅠ&LownⅡ) and Malignant Group(LownⅢ, LownⅣA, LownⅣB&LownⅤ) according to the results of Lown classification. Benign Group contained 90 cases while Malignant Group contained 57 cases. Difference in QT dispersion and indices of heart rate variability of the three groups were compared. Results There were no statistically differences between control group and benign group in QT dispersion (P > 0.05). QT dispersion of malignant group was much longer than that of control group and the differences had statistically meaning(P<0.001). SDNN(standard deviation of NN intervals) , SDANN (standard deviation of the averages of RR intervals ), SDNN index (index of standard deviation of the averages of NN intervals), rMSSD(root mean square of successive differences) and PNN50(percentage of successive normal sinus RR intervals>50 ms) of malignant group was much shorter than that of control group and benign group and the differences had statistically meaning (P< 0.01). SDNN, SDANN and SDNN index of benign group was shorter than that of control group and the differences had statistically meaning (P<0.05). Conclusions Heart rate variability of children with malignant ventricular contraction becomes significantly shorter and QT dispersion becomes significantly longer. Detection of QT dispersion and heart rate variability can effectively predict the risky degree of ventricular contraction in children.

Objective To investigate the relationship between the composition of vaginal microbiota and the course of cervical precancerous lesion.Methods A total of 64 vaginal swabs were collected from 22 healthy women, 18 CINⅠ patients and 24 CINⅡ/Ⅲ patients who visited Obstetrics and Gynecology of the Second Xiangya Hospital of Central South University during July 2014 and July 2015.The Bacterial genomic DNA was extracted and the V3 and V4 hypervariable regions of 16S rRNA were amplified and high-throughput sequenced.The abundance and composition of vaginal microbiota were analyzed by Uparse, Mothur and LefSe statistical software.Results There was no significant difference in Alpha diversity index between CINⅡ/Ⅲ group(Chao:63±32;ACE:72±38;Simpson:0.70±0.27;Shannon:0.70±0.63) and control group ( Chao:48±24;ACE:54±25;Simpson:0.71±0.27;Shannon:0.65±0.58)(W=192,P=0.11;W=189,P=0.10;W=281,P=0.72;W=241,P=0.62).The ACE(85±37) and Chao(66±25) values of CINⅠgroup were significantly different from those of the control group (ACE:54±25;Chao:48±24)(W=99,P=0.006;W=113,P=0.02).At the phylum level, 78.69%(309 020/392 722) of the vaginal microbiota in the control group was Firmicutes, 16%(62 846/392 722) was Actinobacteria.Firmicutes was reduced to 64.86%(208 422/321 318) and Actinobacteria increased to 27.71%(89 040/321 318) in CINⅠgroup.The composition of vaginal microbiotain in CINⅡ/Ⅲ group was similar to those of control group.At the genus level, the composition of vaginal microbiota were similar between CINⅡ/Ⅲ group and control group, with Lactobacillus as predominant genus[71.81%(307 658/418 424)], Gardnerella[12.91%(55 299/428 424)], others such as Prevotella, atopobium were less.In the CINⅠ group, the abundance of Lactobacillus was decreased to 56.26%(180 787/321 318), Gardnerella was increased to 19.62%(63 057/321 318), and Listeria was increased to 7.7%(24 746/321 318).The composition of vaginal microbiota in the most samples was classified as CSTⅢ and CSTⅠ, with Lactobacillus inersand and Lactobacillus crispatus were dominant respectively.There was no significant difference in the composition of vaginal microbiota between the three groups(χ2=2.72, P=0.949).LEfSe analysis showed that the abundance of bacteria in CIN group and control group were varied.At the genus level, there were significant differences in the abundance of Geobacter, Atopobium and Ureaplasma (P<0.05, P<0.05, P<0.01, respectively).At the species level, there was significant difference in the abundance of Ureaplasma urealyticum serotype 9 (P<0.01).Conclusion The diversity and the composition of vaginal microbiota were similar between CIN patients and healthy women, but the abundances of some bacteria were varied, with Ureaplasma increased in patients with CIN.

OBJECTIVE To study the audiological and etiological characteristics of infants failed to pass hearing screening. METHODS 126 infants received audiological diagnostic tests,including auditory brainstem response(ABR),40 Hz auditory event related potential(40 Hz AERP),distortion product otoacoustic emissions(DPOAE),tympanometry and acoustic reflex. The degrees and types of the hearing loss,and etiological characteristics were analyzed. RESULTS Among 126 infants (252 ears),61 were diagnosed with sensorineural hearing loss(48.41%),48 were conductive hearing loss(38.09%),and 17 were found to have normal ABR thresholds(13.49%). The hearing loss was associated with various factors,including history of infection during pregnancy(21 cases),threatened abortion(9 cases),pregnancy with age at or over 35(6 cases),extension of pregnancy(7 cases),history of systematic diseases(10 cases),history of neonatal jaundice(13 cases),history of asphyxia and hypoxia(18 cases),premature and low birth weight neonates(8 cases),neonatal diseases (8 cases),family history of deafness(5 cases),craniofacial deformity(3 cases),central nervous system disorder(6 cases),and 9 cases were second child. CONCLUSION The infants who failed to pass hearing screening have various etiology characteristics in hearing loss. The infants associated with risk factors were mostly found to have sensorineural hearing loss.

Objective To analyze functioning and disability, unmet needs and the service for people with disabilities in Shenzhen, Guangdong, China. Methods Based on International Classification of Functioning, Disability and Health (ICF) and World Report on Disabil-ity, the theoretical framework had been constructed, and the unmet needs and service status for people with disabilities in Shenzhen in 2015 had been statistically analyzed. Results For the statistics of disability by categories, physical disability composed of 42.5%, speech disability composed of 1.5%;people with severe and extremely severe disabilities composed of 52.8%;Futian District composed of 19.7%, Yantian District composed of 2.2%;people aged 0 to 18 years composed of 17.4%, and people aged over 60 years (27.0%) were the larger group. For the unmet needs of people with disabilities, 25%needed rehabilitation therapy, 18.8%needed functional training, 23.2%needed assis-tive devices, and 32.9%had no need. For rehabilitation sevice in Shenzhen, 24.4%received rehabilitation therapy, 17.4%received function-al training, 20.4%received assistive devices, and 37.6%did not receive any service. For the barrier-free reconstruction, 4.6%needed bath-room reconstruction, and 0.7%needed internet access screen software. Conclusion The status of functioning and disability, unmet needs and service development of rehabilitation in Shenzhen had been analyzed. There was still a gap between unmet needs and services of rehabilita-tion. It recommended to construct precise services delivery based on unmet needs, improve the full coverage and quality of service of reha-bilitation.

Objective? To explore the effects of mother sound stimulation on nervous system development and brain function development among full-term newborns. Methods? From January to June 2017, we selected 60 newborns in Neonatology Department hospitalized for 1 to 7 days at Peking University First Hospital as subjects. All of the newborns were divided into intervention group and control group with the random number table, 30 cases in each group. Control group carried out routine nursing. On the basis of routine nursing, intervention group provided mother sound stimulation twice a day for 7 days. We observed the cerebral oxygen saturation and evaluated the nervous system development with the Neonatal Behavioral Neurological Assay (NBNA) among newborns between two groups. Results? Before intervention, there were no statistical differences in oxyhemoglobin, reduced hemoglobin, total hemoglobin and the NBNA score of newborns between two groups (P＞0.05). After intervention, the oxyhemoglobin, total hemoglobin and the NBNA score of intervention group were higher than those of control group with statistical difference (P＜ 0.05). There was no statistical difference in the reduced hemoglobin between two groups after intervention (P＞ 0.05), and no statistical difference in the reduced hemoglobin of intervention group before and after intervention (P＞0.05). Conclusions? Under the circumstance of maternal separation, the mother sound stimulation for newborns can increase brain tissue metabolism of newborn and promote their nervous development.

Objective To investigate the feasibility of using anti-sense RNA against classⅡmajor histocompatibility complex(MHCⅡ)transactivator(CⅡTA),which might regulate MHCⅡexpression,to suppress the relative immune response.Methods Stable transfectants of dermal fibroblasts with pDarⅡ(pDarⅡ-D)were tested for the expression of classic MHCⅡ(HLA-DR,-DP,-DQ)antigens induced with recombinant human interferon-gamma(IFN-?).mRNA abundance of CⅡTA,and classic MHCⅡwas mea-sured by RT-PCR.IL-2mRNA expressed in T cells,stimulated by transfected dermal fibroblasts,was de-termined by mixed lymphocyte reaction.Results When induced with IFN-?,the expression of HLA-DR and-DP antigens on pDarⅡ-D was reduced by95.63%and87.89%,respectively.Meanwhile,the mRNA contents of CⅡTA and classic MHCⅡwere decreased significantly(P