The application of fetal echocardiography in clinical is increasing , more and more patients need de-tailed consulting services .The following suggestions are made:Echocardiographic doctors should set up the consulting service consciousness , provide consulting with patience , popularity and carefulness; the doctors should understand the patients and their family′s emotions and also pay attention to the psychological care;environmental requirements for patients′echocardiographic examination and counseling service;encouraging multidisciplinary join the participa-tion of consulting services .

Objective:To investigate the prevention and treatment status of venous thromboembolism (VTE) of pregnant women in general hospitals and specialized hospitals in China.Methods:This study was a cross-sectional survey about VTE prevention and treatment in 112 hospitals across China from January 1st to December 31st, 2019, including general information, resource accessibility, hospital system and strategy. According to the characteristics, the hospitals were divided into general hospital group (70 hospitals) and specialized hospital group (42 hospitals). The basic information, VTE diagnosis and treatment resources, prevention systems and the preference of the VTE risk assessment form of the two groups were compared. Logistic regression was used to analyze the proportion of VTE incidence and related factors in the two groups of hospitals.Results:(1) The median annual delivery volume of the general hospital group was significantly lower than that of the specialized hospital group (3 428 vs 9 969 cases, P<0.01), the diagnostic accessibility of CT pulmonary angiography (CTPA) was significantly higher than that of the specialized hospital [92.9% (65/70) vs 59.5% (25/42), P<0.01], and the proportion of obstetric VTE risk assessment was significantly higher than that of the specialized hospital group [85.7% (60/70) vs 66.7% (28/42), P=0.017]. (2) Among the 88 hospitals using the VTE risk assessment sheet, the utilization rate of the evaluation sheet recommended by the obstetric VTE guideline in specialized hospitals (78.6%, 22/28) was higher than that of general hospitals (48.3%, 29/60), and the difference was statistically significant ( P=0.007). (3) The proportion of VTE incidence in general hospital group was 0.126% (360/286 517), and the proportion of VTE incidence in specialized hospital group was 0.032% (154/484 111). Logistic regression analysis showed that the OR value of the specialized hospital group was 0.253 (95% CI: 0.209-0.305) and the difference was statistically significant ( P<0.01) compared with the general hospital group. After adjusting the hospital level, B-ultrasonography and CTPA accessibility, whether to establish a risk assessment and obstetric VTE system, the proportion of VTE incidence in specialized hospitals was still lower than that in general hospitals ( OR=0.307, 95% CI: 0.251-0.376, P<0.01). Conclusions:General hospitals have higher access to resources for diagnosing VTE than specialized hospitals, and the VTE evaluation system is better implemented. The utilization rate of the obstetric VTE guidelines in specialized hospitals is higher than that of general hospitals.

Objective In order to improve the surgical treatment for midpiece esophageal carcinoma, different surgical ways were com-pared. Methods From January 2010 to June 2012, 110 patients with midpiece esophageal cancer in our hospital were divided into the Ivor-Lewis group (55 cases) and the Sweet group (55 cases) according to different surgical ways, that is to say Ivor-Lewis surgery via right chest and Sweet surgery through left chest. Length of specimens, rang of tumor invasion, distance of removal, incidence of residual carcinoma in the esophageal edges, number of lymph nodes removed in chest and abdomen, and positive rate of carcinoma infiltrated lymph nodes were compared between the two groups. Questions of surgical anatomy were investigated through questionnaire among surgeons of the two groups, and the scores of both groups were analysed. Results The length of resected specimens and number of lymph nodes removed in Ivor-Lewis group was significantly lager than that of the Sweet group (P<0. 01). The positive rate of carcinoma infiltrated lymph nodes in Ivor-Lewis group was 1. 82%, which was significantly lower than 21. 82% in the Sweet group (P<0. 01). Results of questionnaire showed surgeons have gieven higher scores to Ivor-Lewis group. Conclusion Ivor-Lewis surgery is recommend for upper and midpiece esophageal carcinoma while Sweet surgery is more suitable for cardial and lower esophageal cancer.

【Objective】To study the chemical constituents of flavonoids from Hypericum perforatum L..【Methods】The chemical constituents of Hypericum perforatum L.were isolated and purified by chromatography,and their structures were identified on the basis of spectroscopic evidence.【Results】Five compounds from Hypericum perforatum L.were identified as quercetin,avicularin,quercitrin,isoquercitrin and hyperin.【Conclusion】Isoquercitrin is obtained from Hypericum perforatum L.for the first time.

Objective: To study the relationship between dilated cardiomyopathy and nuclear lamina protein (LMNA) gene mutation in Kazak ethnics at Xinjiang area.
Methods: A Kazak familial dilated cardiomyopathy (FDCM) with 31 members was studied. In addition, 160 patients with idiopathic dilated cardiomyopathy (IDCM) with 160 healthy controls were enrolled in our study, and they were divided into 4 groups: IDCM-Kazak, IDCM-Han and Control-Kazak, Control-Han.n=80 in each group. Peripheral blood DNA were extracted, 12 exons with nearby introns of LMNA gene were detected by PCR and the ampliifed products were sequenced and compared with the standard template of CHROMAS and BLAST software to identify mutation sites. LMNA mutation in both Kazak and Han IDCM patients were investigated.
Results: A novel LMNA mutation (insC, CGG→CCG) at exon 7 was identiifed in a FDCM proband, it caused an amino acid substitution as Arg to Pro, and a known LMNA polymorphism loci rs4641 (c.1362C>T His454His) was fund at exon 10. In addition, LMNA polymorphism loci rs4641 genotype distribution (χ2=5.16,P=0.036) and allele frequency (χ2=4.50,P=0.034) were statistically different between IDCM-Kazak group and Control-Kazak group; while such differences were no statistic meaning between IDCM-Han group and Control-Han group. Logistic regression analysis indicated that LMNA polymorphism loci rs4641 was related to IDCM occurrence in Kazak ethnics (P=0.025, OR=0.412, 95% CI 0.189-0.896).
Conclusion: LMNA polymorphism loci rs4641 was related to IDCM in Kazak ethnics at Xinjiang area, which might be susceptible loci for IDCM occurrence.

Objective To establish a capillary gas chromatography( GC)method for the determination of residual organic solvents in poly( lactic-co-glycolide)( PLGA),including methanol,acetone,dichloromethane,and toluene. Methods A capillary GC method was carried out. DB-624 capillary column(30 m× 0. 32 mm,1. 80 μm)with programmed temperature chromatography was employed. The initial temperature was kept at 40 ℃ for 8 min. Then the temperature was raised to 200 ℃ at a rate of 10 ℃·min-1 . The injection port temperature was 180 ℃,and the split ratio was 10:1. The carrier gas was nitrogen. The temperature of FID was set at 250 ℃,and the sample volume was set at 3 μL. Results Four residual organic solvents consisting of methanol,acetone,dichloromethane and toluene in PLGA were completely separated. The linear range of concentration of methanol,acetone,dichloromethane and toluene was within 10. 0-50. 0( r=0. 999 8 ),16. 7-83. 3( r=0.9998),2.0-10.0(r=0.9993),and3.0-14.8(r=0.9997)μg·mL-1,respectively.Therecoveryofmethanol,acetone, dichloromethane and toluene was 99. 9%( RSD=1. 5%),100. 8%( RSD=0. 9%),100. 1%( RSD=1. 1%),and 99. 5%(RSD=0. 6%),respectively. Six batches of samples met the requirements. Conclusion The method is proven to be sensitive and accurate after the validation. It is suitable for the determination of residual organic solvents in PLGA.

Objective To explore the feasibility of using irreversible electroporation (IRE)mediating HPV16 E6 shRNA into cervical cancer cell line SiHa,and to clarify the influence of their co-effect on the proliferation of SiHa cells and its mechanism.Methods A HPV16 E6 gene specific interference sequence was inserted in pGenesil-1 to build a interference vector.10 pulses of IRE with 800 V,100 μs,and 1 Hz were applied to the suspension of SiHa cells and vectors.According to the treatment factors,control group,IRE group,pGenesil-N group,pGenesil-N+IRE group,pGenesil-E6 group and pGenesil-E6 + IRE group were set up.The expression of green fluorescent protein (GFP)and transfection efficiency were confirmed by inverted fluorescence microscope 24 h after the vector was transfected by IRE,and the expression efficancy of GFP was calculated.The expression levels of E6 mRNA and protein were detected by RT-PCR and Western blotting method which was also applied to detect the expressions of P53 and PCNA.The proliferative activity of SiHa cells was determined by CCK-8 assay.Results Enzyme digestion and DNA sequencing verified that the vectors were correctly constructed.GFP was seen under inverted fluorescence microscope 24 h after IRE transfection.Compared with IRE group,the expression levels of E6 mRNA and protein were decreased detected by RT-PCR and Western blotting method after the vectors were treated with IRE,the P53 protein expression level was increased (P < 0.05),and the PCNA expression level was decreased (P <0.05).The CCK-8 assay results showed the proliferative activity of SiHa cells in pGenesil-E6+IRE group was decreased more obviously than that in pGenesil E6 group (P <0.05).Conclusion IRE can play the role of gene transfection of mediating HPV16 E6 shRNA into SiHa cells, and their co-effect can significantly inhibit the proliferation of SiHa cells.

To explore the effect of growth hormone releasing peptide (GHRP) on myocardial cell apoptosis in heart failure (HF) rats. Methods: Rat's HF model was established by the ligation of left anterior descending coronary artery induced ischemia. 40 male SD rats were randomly assigned into 4 groups: Normal control group, Sham operation group, HF group and GHRP treated HF group. n=10 in each group and the rats were fed for 4 weeks after the operation. Cardiac function was examined and myocardial cell morphology was observed; protein expressions of Smac/DIABL0 and Bcl-2 were measured by Western blot analysis; cell apoptosis was evaluated by FCM technique. The differences for above parameters were compared among groups to explore the effect of GHRP on myocardial cell apoptosis in HF rats. Results: Compared with HF group, GHRP treated HF group showed the less heart dilation, higher LVEF, lighter pathological changes in myocardial cells and decreased protein expression of Smac/DIABL0, all P<0.05. Bcl-2 level was lower in HF group than the other 3 groups, P<0.05. Compare with Normal control group, GHRP treated HF group had elevated Bcl-2 level, all P<0.05. Myocardial cell apoptosis index was different between HF group and GHRP treated HF group, P<0.05. Conclusion: The effect of GHRP on anti-HF should be via inhibiting myocardial cell apoptosis; the mechanism may partly be through promoting Bcl-2 protein expression and depressing Smac/DIABLO mediated mitochondrial pathway of apoptosis.

Objective To observe the effects of high fat diet on ulcerative colitis(UC)and atypical hyperplasia in different periods induced by azoxymethane(AOM)/dextran sodium sulfate(DSS)and the changes of interleukin-6(IL-6)level in blood. Methods The mice in DSS,DSS+AOM,DSS+high fat diet,and DSS+AOM+high fat diet groups were given DSS for 3 days and sterilization water for 4 days as one cycle for 9 cycles, and the mice in normal control group were given sterilization water(n=12 in each group). The mice in DSS+AOM and DSS+AOM+high fat diet groups received intraperitoneal injection of AOM(10 mg/kg)in the every first day of the first 3 cycles. The mice in each group were sacrificed at different time points,and the disease activity index and pathohistological index were used to determine the degree of inflammation. ELISA method was used for the detection of serum IL-6 level. Results Simple administration of DSS could induce UC in the mouse model. After 9 circles of treatment,atypical hyperplasia was not found in normal control and DSS groups,and the rate of atypical hyperplasia was 25%(1/4)in DSS+high fat diet group,50%(2/4)in DSS+AOM group,and 75%(3/4)in DSS+AOM+high fat diet group. However,there were no significant differences in the rate of atypical hyperplasia between DSS and DSS+AOM groups ,DSS+high fat diet and DSS+AOM+high fat diet groups ,DSS and DSS+high fat diet groups,and DSS+AOM and DSS+AOM+high fat diet groups(all P>0.05). The histopathological score and the disease activity index in DSS+high fat diet and DSS+AOM+high fat diet groups were higher than those in DSS and DSS+AOM groups(P<0.05). The IL-6 level in DSS+high fat diet and DSS+AOM+high fat diet groups was higher than that in DSS and DSS+AOM groups ,but the difference was not statistically signifi-cant(P>0.05). Conclusion High fat diet may be one of the stimulating factors of UC and atypical hyperplasia.

Objective? To explore the working characteristics and difficulties of hospice nurses and provide reference for improvement of palliative care practice. Methods? By purposive sampling, 10 nurses from a cancer specialist hospital and a community hospital in Beijing were selected and interviewed by semi-structured in-depth interviewing method and the interview data was analyzed by Colaizzi method. Results? The palliative nurses need patience and detailed mind, sympathy, compassion and empathy; the working characteristics of nursing included establishing trust, all the way accompany; palliative nursing and nurses have mutual influences: while getting the self-improved and sense of accomplishment, nurses' psychological burden was heavy and needed psychological adjustment; the palliative nurses faced difficulties such as unsuccessful communication with patients and their family members, lacking in relevant knowledge, misunderstanding from the colleagues and short of medical resources. Conclusions? Hospitals should strengthen the emotional adjustment support for the palliative nurses and to relieve the nurses from stress and negative affect; the government and hospitals should strengthen the propaganda of palliative care so that the citizens can better understand and accept palliative care.