Purpose To explore the correlation between fetal cardiac function and interventricular septal thickness in fetuses of gestational diabetes mellitus (GDM) mothers. Materials and Methods Thirty-nine GDM mothers were involved in the study and divided into group MH (fetuses of GDM mothers with interventricular septal hypertrophy) and group NMH (fetuses of GDM mothers with normal interventricular septal thickness). Ultrasonic cardiogram was performed for both groups to assess such variables as interventricular septum thickness at end diastole (IVSd), left ventricular ejection fraction (LVEF), left ventricular fraction shortening (LVFS), right ventricular fraction shortening (RVFS), the ratio of E and A of mitral flow (E/AMV), the ratio of E and A of tricuspid flow (E/ATV), peak velocity of aortic valve (VPAO), peak velocity of pulmonary valve (VPPA) and myocardial performance index (MPI). The results were further compared with those of control group. Results The VPAO, VPPA, LVEF and LVFS in group NMH were significantly higher than those in control group (P<0.05). The VPAO, VPPA, LVEF, LVFS and RVFS in group MH were significantly higher than those in control group whilst the E/AMV and E/ATV significantly lower than those in control group (P<0.05). The LVEF, LVFS and RVFS in group MH were significantly higher than those in group NMH whilst the E/AMV and E/ATV significantly lower (P<0.05). MPI in group MH was significantly higher than that in group NMH (P<0.05), whilst both were significantly higher than that in control group (P<0.05). The LVEF, LVFS, RVFS, VPAO and VPPA were positively correlated with IVSd (r=0.48, 0.51, 0.45, 0.30, 0.30;P<0.05). Conclusion Cardiac function in fetuses of GDM mothers may be associated with interventricular septal thickness.

Objective Analyse the causes,diagnosis and treatment for delayed hemorrhage after distal radical gastrectomy.Methods Retrospective study on 45 patients combined with intro-abdominal hemorrhage after distal radical gastrectomy from January 2008 to June 2013.Results Thirteen patients combined with delayed hemorrhage in these 45 patients,all of 13 patients had intro-abdominal hemorrhage in 1week to 4 weeks after operation.And 5 of the 13 patiens were intermittent intro-abdominal hemorrhage 1 week after operation,these patients were demonstrated the blood come from gastroduodenal artery pseudoaneurysm fracture by CT and DSA examine,and they were cured by interventional embolization.Other 8 patients were marginal ulcer hemorrhage diagnosed by gastroscope,and they stoped bleeding with the help of gastroscope.Conclusions The causes of delayed hemorrhage after distal radical gastrectomy were complicated,and CT,DSA and endoscope can use for diagnosis.What was more,interventional embolization and endoscope were helpful for curing the intro-abdominal hemorrhage,avoiding re-operation.

Purpose To investigate the diagnostic value of fetal echocardiography in total anomalous pulmonary venous connection (TAPVC),and to analyze the reasons ofmisdiagnosis so as to improve accuracy of prenatal diagnosis.Materials and Methods The prenatal echocardiographic data of 24 cases of TAPVC confirmed by postnatal echocardiography and prenatal MRI from October 2001 to December 2015 in Children's Hospital Affiliated to Nanjing Medical University and Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine were retrospectively analyzed.Results In 24 cases,there were 14 fetuses of supracardiac type,7 cases of intracardiac type,2 cases of infracardiac type,and 1 case of mixed type.15 fetuses had TAPVC only,whereas 9 cases were associated with other cardiovascular anomalies,most commonly including bilateral right atria,single atrium,single ventricle,common atrioventricular valve and pulmonary stenosis.On 4-chamber views,the common sonographic sign was absent of pulmonary venous return to the left atrium in 24 cases (100.0％),and the presence of venous confluence between left atrium and descending aorta was observed in 22 cases (91.7％).In all 24 cases,1 case was missed diagnosis,and 3 cases were misdiagnosed as persistent left superior vena cava,common pulmonary vein atresia and patent left atrial cardinal vein.Conclusion TAPVC can be accurately diagnosed by fetal echocardiography,but it is prone to be misdiagnosed.

Objective To find out the risk factors of postoperative low cardiac output syndrome(LCOS) of patients undergoing cardiac valvular surgery in ICU in order to provide basic for prevention and control measures.Methods Ninety-six valve replacement patients with valvular heart disease were enrolled as our subjects and they were hospitalized in ICU of the First People's hospital of Yichang from Jan.2008 to May.2013.The patients postoperative LCOS (Dopamine ＞ 10 μg/(kg · min)) were served as observation group (n =41),and the other were control groups(n =55).All data of the patients were recorded.Non-conditions Logistic regressions analysis were adopted to analyze the independent risk factors which resulted in LCOS undergoing cardiac valvular surgery.Results Of 96 patients undergoing cardiac vavular surgery,41cases (42.7％) had postoperative LCOS.Single factor analysis showed that hepatomegaly (P =0.007),course of diseases ≥ 15 years (P =0.042),cardiopulmonary bypass ≥ 120 min (x2 =3.937,P =0.047),pre-operative cardiac function ≥ Ⅲ degree (P =0.003) were the independent risk factors of postoperative LCOS undergoing cardiac valvular surgery.The Logistic multi factor regression analysis showed that the independent risk factors of postoperative LCOS undergoing cardiac valvular surgery included course of diseases ≥ 15 years (OR =2.825,95％ CI =(1.015-7.861)),Pre-operative cardiac function ≥ Ⅲ degree (OR =7.306,95％ CI =(2.050-26.035),P=0.002).Conclusion Course of diseases ≥15 years and Pre-operative cardiac function≥ Ⅲ-Ⅳ degree are the independent risk factors of LCOS undergoing cardiac valvular surgery.

Objective To assess lipid status of pregnant women with GDM based on the lipid reference intervals for pregnant women .Methods Maternal blood and venous cord blood samples were collected in 81 well-controlled GDM mothers and 86 control subjects .The total cholesterol (CHOL) ,trigalloyl glycerol (TRIG) ,high-density lipoprotein cholesterol (HDL) ,low-density lipo-protein cholesterol (LDL) ,apolipoprotein A1 (ApoA) ,apolipoprotein B (ApoB) and lipoprotein (a) levels were measured by auto-matic biochemical analyzer .We used a normal pregnancy specific lipid reference interval (PSR) and normal non-pregnant reference intervals (NPR) respectively to assess the lipid status of pregnant women with GDM .Results Compared with normal control group ,the Apo A ,HDL and LDL levels in GDM group were significantly lower (P<0 .05) .The HDL ,LDL and Lp(a) levels of GDM cord blood were significantly lower (P<0 .05) .The weight of offspring birth of GDM pregnant women with low level HDL was significantly higher (P<0 .05) ,and that of GDM pregnant women with high level LDL offspring birth weight was significantly lower (P<0 .05) .Maternal HDL was not correlated with birth weight (r= -0 .190 ,P=0 .103) .Parent LDH and birth weight was negatively correlated (r= -0 .252 ,P=0 .029) .Conclusion The reference range of normal pregnancy-specific lipid we had estab-lished is more scientific for assessment of blood lipids .

Objective To study the distribution of Candida infection and drug tolerance in intensive care unit(ICU). Methods A retrospective study was conducted. The critical patients admitted from January 2011 to December 2013 in ICU of the First Hospital of Jiaxing in Zhejiang Province were enrolled,and their clinical data with positive Candida culture and drug susceptibility results in specimens of sputum,urine,blood,ascites,bile, etc were collected. In the study of these 3 years in ICU,the situation of Candida infection,the distribution of positive specimen,the condition of distribution of different strains of Candida,and the Candida tolerance to antifungal drugs were analyzed. Results From 2011 to 2013,2 412 times of patients(including one patient had admitted into ICU for more than one time)were admitted into ICU in which 407 cases were of Candida infection(16.9%),and the rate of Candida infection was rising gradually in the 3 years〔2011 to 2013 Candida positive rates were 13.4%(77/573), 16.1%(146/907),19.7%(184/932)〕,the difference being statistically significant(P<0.01). In the 407 strains of Candida,166 strains(40.8%)were isolated from sputum,157(38.6%)from urine,53 strains(13.0%)ascites, 13 strains(3.1%)blood,11 strains(2.7%)bile,7 strains(1.7%)from other specimens. The strain distribution of Candida was mainly as follows:Candida albicans(174 strains),Candida glabrata(131 strains),Candida tropicalis (83 strains),Candida parapailosis(5 strains),Candida krusei(12 strains),and 2 strains of rare Candida portugal and Lipolztica. From 2011 to 2013,the highest tolerance of Candida albicans,Candida glabrata,Candida tropicalis to fluconazole,itraconazole,Fushita Yasu and other antifungal drugs was in 2013,and the lowest was in 2012,the rates of tolerance of the above 3 strains of Candida to amphotericin B being 0,to itraconazole being the highest(10.9%, 27.8%,9.6%,respectively),to Fushita Yasu the secondary(6.6%,11.0%,0,respectively)and to fluconazole the last(4.7%,7.4%,1.9%,respectively),and the rates of tolerance of Candida parapsilosis,Candida krusei,Candida Portugal,Candida lipolztica to amphotericin B,fluconazole,itraconazole,Fushita Yasu were all 0. Conclusion In ICU,the Candida infection is mainly in the respiratory tract and urinary tract,its rate of infection has a tendency of rising,and the rate of Candida tolerance to itraconazole is the highest.

Objective To establisha high altitude military medicine digital library ( HAMMDL) in order to integrate high altitude military medicine ( HAMM ) digital resources and promote transformation of HAMM technology to health service application.Methods The solution of Web 3.0-basedHAMMDL was proposed.Ontology, the metadata and Wiki paradigm were used to manage and present resources , while the Model-View-Controller pattern was used in software design .Results Based on analysis of the functional requirements and key techniques of HAMMDL , design principles were proposed the hierarchical software architecture pattern was designed , the software supporting technology was provided and the construction method of HAMM ontologies was discussed .Conclusion With the synthesized application of relative technologies , smart utilization and socialized content management pattern of HAMM digital resources can be achieved .

Panax notoginseng (BurK.) F.H.Chen is a traditional Chinese medicinal material with a time-honored history of cultivation.There are a series of problems,such as high pesticide residues,serious disease and pest,and continuous cropping obstacles in the process of the cultivation of notoginseng.Pollution-free cultivation is an effective strategy for the sustainable development of notoginseng industry.We herein summarized three points of the pollution-free cultivation of notoginseng in this review.The standard of lands suitable for the cultivation of notoginseng was established on the basis of the analysis of medicinal plants around global producing areas.The integrated measures of soil improvement were put forward by cfficient rotation and soil disinfection with new varieties breeding combined with the management of water,light and fertilization,and the safe and low-toxic methods of disease and pest control.Additionally,the mode of wild tending should be carried out when the marker-assisted breeding of new varieties was developed,and the platform of comprehensive disease and pest control was founded.Above-mentioned points can effectively perfect and optimize the pollution-free cultivation of notoginseng and promote sustainable development of notoginseng industry.

Objective To analyze the process of triage in disaster rescue action performed by a mobile medical unit so that the rescue process can be improved , the efficiency of rescue enhanced , and the decision on health service in rescue action is supported.Methods The process of triage in disaster rescue action was modeled based on stochastic Petri net while the performance of the model was analyzed quantitatively .Results and Conclusion The critical factor which affects the efficiency of rescue work is obtained by analyzing the performance of the model .

Objective To construct an executable model of a hypoxia response network (HRN) and to analyze the dynamic evolution mechanism of an HRN including randomness as well as concurrency based on computer simulation. Methods Specific evolution rules and Gillespie algorithm were adoped to study the dynamic evolution of the structural model based on the construction of a structural model of an HRN using stochastic Petri net ( SPN ) .Results Dynamic evolution laws of an HRN were obtained and the simulation results were consistent with laboratory results in response to descript switch-like behavior of an HRN .Conclusion A visualization model of the HRN can be achieved using SPN method.Simulation results achieved by executing the model based on stochastic simulation using specific kinetic parameters can serve as a nice complement to traditional laboratory results , which can help shed light on the structure and function characteristics of an HRN.