It is still a controversy whether a patient with prosthetic heart valve can have a normal pregnancy. Here we report five cases of such patients, of which two with a tissue valve and one with a mechanical valve. Their heart functions were of grade I. They were carefully monitored by both the obstetrician and cardiologist till the term. The pregnancy periods were uneventful, but two babies were delivered by cesarean section and one was vaginal delivery. The patient with an artificial mechanical valve was given oral anticoagulant every day and vitamin K1 injected before the operation. Both the mothers and babies had no complications. Twenty-four hours later, the oral anticoagulant was resumed and puerperium was still normal. Two other patients with a mechanical heart valve were pregnant, their heart functions were of grade II and one of them suffered from complications. They were not in a condition for continuous pregnancy, and so, operations were performed. Therefore, women with a prosthetic heart valve can have children if their management is closely supervised and extreme care taken with the use of oral anticoagulant.

The relationship between immuno-suppression and poor prognosis of sepsis causes widely concern.Immuno-modulatory therapy is one of the research hotspots in critical medical care.Some studies have shown that to enhance the function of lymphocyte might improve the prognosis of septic patients.This paper will review the immune dysfunction and explore the value of immuno-modulatory therapy in process of sepsis.

Saireito, a 12-component Japanese herbal medicine, is used to treat immune-related diseases. We investigated the effects of oral administration of Saireito extract in a murine model of cardiac transplantation with fully mismatched allografts. Untreated recipients and those given water rejected their cardiac allografts acutely (median survival time [MST], 7 and 8 days, respectively), as did those treated with either 0.02 or 0.002 g/kg/day of Saireito extract (MST, 7 days in both groups). Recipients given 0.2 g/kg/day of Saireito extract had only moderate prolongation of allograft survival (MST, 41 days). However, all transplant recipients given 2 g/kg/day of Saireito extract had significant prolongation of allograft survival (MST>100 days). None of the single crude drug extracts of Saireito prolonged allograft survival, suggesting that its effects require administration of the combination agent. In mixed leukocyte cultures, proliferation of splenocytes from Saireito-treated CBA recipients was markedly suppressed compared with that of splenocytes from untreated mice, and interferon-γ production was significantly reduced. In flow cytometry experiment, the population of CD 4⁺CD 25⁺FOXP 3⁺cells was increased in the spleens of Saireito-treated CBA recipients compared with the spleens of naïve CBA mice or untreated CBA recipients. Thus, in our model, Saireito treatment induced hyporesponsiveness to cardiac allografts in a dose-dependent manner, and the combination of the components is essential for this effect.

Objective To explore the significance of procalcitonin(PCT)on locating the urinary tract infection(UTI)in children.Methods 38 patients were divided randomly into upper and lower urinary tract infection groups,detected the lever of PCT in serum with the double sandwich immunoflurosence assay,and made correlation with ?2-MG in urine.Results 1.The lever of PCT in serum in upper urinary tract infection group was significantly higher than that in lower urinary tract infection group(P0.05).Conclusion The PCT in serum can be used as a marker to differentiate the upper and lower urinary tract inf0ection.

Objective:To explore the effects of hypoxia on expression of Rho kinase and proliferation of rat pulmonary arterial smooth muscle cells(PASMC).Methods: Cultured PASMC were exposed to normoxia and hypoxia for 12、24 and 48 h.Viability of PASMC was examined by MTT assay.The cell cycle was analyzed by flow cytometry.Western blot was used to assess the levels of Rho kinase after primarily cultured rat PASMC were exposed to hypoxia for 12、24 and 48 h. Results: The result of MTT was increased in PASMC to hypoxia for 12 h compared with PASMC in normoxia.After exposure of PASMC to hypoxia for 24 h,the result of MTT peaked,then declined in 48 h,but still higher than that of PASMC when exposed to normoxia.Analysis of cell cycle indicated that the ability of cell proliferation increased significantly in PASMC exposed to hypoxia compared with normoxia.Rho kinase level was higher in PASMC exposed to hypoxia compared with normoxia.Conclusion: Hypoxia stimulates proliferation of PASMC and promotes PASMC into the phase of mitosis.Expression of Rho-kinase is increased in proliferated PASMC induced by hypoxia and the increased expression of Rho-kinase maybe one of important pathogenesis in hypoxia-induced proliferation of PASMC.

Bilingual teaching is a hot issue in the current medical education reform.This paper discussed the practice of bilingual teaching in ophthalmology education and explored the improvement of teaching materials,enhancement of teaching staff training and promotion of multimedia-based,web-based and PBL-based bilingual teaching in order to provide references for improving the quality of ophthalmology teaching.

Objective: To evaluate the microbial safety of human amniotic membrane(HAM) in preparation and preservation,and to establish effective methods of microbe control for HAM bank.Methods: Human amnions were collected from elective caesarean sections in 20 healthy women,and divided into groups based on different sterilization procedures and preservation methods.Bacteria,fungi and mycoplasmas were detected at 24h,1m,3m and 12m after preservation.Other amnions collected in eutocia from 5 healthy women were detected bacteria,fungi,lactobacilli and mycoplasmas.The series of serological determination for the parturients were followed up in 6 months.Results: Two HAM samples only soaked in NS were detected to be contaminated with E.coli and/or S.epidermidis,respectively from two caesarean sections.There is no microbe detected in all of the amnions from caesarean sections which were soaked in the antibiotics solution.One HAM sample from eutocia was yet detected to have lactobacilli after soak.The series of serological determination were all negative.Conclusion: During one year storage,HAM only from caesarean sections in healthy women,can successfully avoid contamination if soaked in the antibiotics solution then prepared and preserved with aseptic technique.

Acute respiratory distress syndrome is a serious disease and has a high mortality rate.Protective ventilation strategy and conservative fluid management is the mainstay of treatment and there is no effective pharmacological treatment yet.Recent studies found that beta-2 adrenergic receptor agonists in the treatment of acute respiratory distress syndrome could inhibit the inflammatory response,protect the functions of alveolar capillary barrier,improve pulmonary edema fluid removal,promote the secretion of surfactant and enhance the impaired lung repair,and so on.This review aimed for the pathogenesis,mechanism of action and treatment mechanism of the recent studies.

Early physical therapy intervention is important in improving the long-term outcome of the infants with high-risk of cerebral palsy. The early intervention programs that included child and parents were reported to affect the motor development of the high-risk infants.The approaches of early physical therapy included Vojta approach, Bobath approach and Doman-Delecato approach, etc. The Vojta approach has been regarded as advantages in early intervention. However, there are fewer studies on the effect of special motor training programs on motor development in high-risk infants

The maltracking of patella due to patellar malalignment and overuse are suggested to contribute the painful state in patients with patellofemoral pain syndrome.More and more attention was paid on the management of pain.This paper reviewed the most widely used assessment tool.The pain management strategies were summarized,and the efficacy of the different interventions was also discussed.