Objective To compare the effects of aspirin and warfarin in the elderly patients with chronic nonvalve atrial fibrillation.Methods 431 elderly patients with chronic non-valvalar atrial fibrillation were randomly divided into two groups: group A received aspirin; group B received warfarin.After patients were treated with aspirin or warfarin for two years,the incidence rate of stroke and hemorrhage rate were counted. Results Aspirin was as effective as warfarin in preventing stroke in patients age 65 to 75 years old without risk factor,and warfarin was more effective than aspirin in preventing stroke in patients (≥75) and all patients with risk factors. Warfarin and aspirin had low incidence rate of bleeding. Conclusion For the patients aged 65 to 75 years old have no risk factors, they should be treated with aspirin in preventing stroke .For the older patients older than 75 years old and patients have risk factors, they should be treated with warfarin,which is more efficient than asprin in preventing stroke.

Objective To assess the impacts of management of psychological health on metabolic indictors in community residents.Methods A total of 300 health check-up adults from one single community were randomly assigned to the control group (receiving routine health management,n =150) and the study group (receiving psychological health management,n =150).Blood pressure (BP),fasting plasma glucose (FPG),total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C) and life style were evaluated and compared at baseline and 1-year follow-up.Results No difference of clinical data was found between the two groups at baseline.After 1-year intervention,current sigarette smoking,BP,FPG,TC,TG and LDL-C of the study group were significantly decreased when compared with the control group (x2 =7.54,t =6.43,5.38,5.89,6.15,4.36,6.69,5.47 ; all P ＜ 0.05).Compliance to and satisfaction with health management were significantly improved in the study group (x2 =9.13,12.35,11.96,10.98,9.95 ; all P ＜ 0.05).Conclusion Management of psychological health may be effective in improving healthy life style,patients' satisfaction and cardiovascular metabolism in community residents.

Objective To explore the stress perception among acute myocardial infarction (AMI) patients during acute stage.Methods Phenomenological method of qualitative study was adopted.18 AMI patients during the acute stage of 3～4 days after the onset of the disease were interviewed.Results Stress made AMI patients hard to accept the fact of illness,worry about the treatment of illness and the impact on future life,be difficult to alter living habits,be hard to relieve negative emotion.Conclusions AMI patients during acute stage will experience different levels of psychological stress.Stress management should be fabricated and effective measures should be adopted to relieve their negative emotions in terms of inducing factors.

Objective] To observe the clinical effect of“eliminating the accumulative stagnation and heat with pressing and kneading manipulation”treatment efficacy of children with functional constipation. [Method] Randomly divide 60 cases into control group and treatment group, 30 cases in each;the control one took conventional pediatric tuina method; the treatment one took “eliminating the accumulative stagnation and heat with pressing and kneading manipulation”method. Compare their effects after three courses. [Result] After three courses treatment, in treatment group, 20 cases had marked effect, 8 effective, 2 void, total effective rate 93.33%;in control group, they were respectively 10,12,8 and 73.33%. The comparison of total effective rates had difference of statistical significance(P<0.05). [Conclusion] The method of “eliminating the accumulative stagnation and heat with pressing and kneading manipulation”has better curative effect than the conventional pediatric tuina method. And it is very simple to manipulate, and worthy of being popularized.

Objective To investigate the correlation between uric acid level and increase of carotid intima-media thickness (IMT) in the elderly.Methods Clinical data of elderly and middleaged people who took health physical examination from Jan.2013 to Dec.2014 in a 3A-level hospital in Beijing were collected.The elderly people were divided into IMT normal group and plaque group.Logistic regression and linear regression were used to analyze the related factors for IMT thickening and uric acid level.Results The occurrence rate of hyperuricemia had a significant difference between the elderly group and the middle-aged group (P＜0.01).There were significant differences in uric acid level [(350.6±89.6) μmol/L vs.(359.6±86.6) μmol/L, t=5.19, P＜0.05].Body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), blood urea,cholesterol, high density lipoprotein levels between the IMT normal group and plaque group were [(25.3±3.6)kg/m2 vs.(25.8±3.5) kg/m2, (115.9±13.8) mmHg vs.(126.8±16.9) mmHg, (74.6±11.3) mmHg vs.(77.8±12.1) mmHg, (4.9±0.9) mmol/L vs.(5.0±1.0) mmol/L,(1.2±0.3) mmol/L vs.(1.2±0.3) mmol/L, all P＜0.01].Multi factor correlation analysis showed that the IMT thickening was correlated with gender, SBP, low density lipoprotein, blood glucose,while had no correlation with uric acid level.Blood uric acid level was related with gender, smoking, BMI, triglycerides, blood glucose, C-reactive protein, high-density lipoprotein.Conclusions Blood uric acid level, BMI, blood pressure and lipids are increased in the plaque group as compared with the IMT normal group.However, blood uric acid level can not be used as an independent risk factor for IMT lesions.

Objective To investigate the effects of health management on risk factors of cardiovascular diseases in community residents.Methods A total of 208 adults from one single community who visited our health check-up center were randomly assigned to the control group(receiving routine consultation,n =104)and health management group(receiving health management intervention,n =104).At 1-year follow-up,fasting blood glucose(FBG),lipid profiles,and blood pressure(BP)were measured and risk factors of cardiovascular were surveyed.t or x2 test was used for data analysis.Results No difference of clinical data was found between the two groups at baseline.Follow-up results indicated that absolute risk of cardiovascular diseases,number of risk factors,health satisfaction,sick leave,daily vegetables intake and physical exercise,and BP were significantly improved in the health management group.Ten-year absolute risk of cardiovascular diseases(0.8 ± 0.4 vs 1.3 ± 0.5),number of risk factors(172 vs 283),and sick leave per year(118 d vs 264 d)were significantly decreased in the health management group when compared to the control group(all P ＜ 0.05).Furthermore,health satisfaction(83.7％(87/104)vs 52.9％(55/104)),and daily vegetables intake(520.5 g vs 348.3 g)and physical exercise(1.2 h vs 0.3h)were significantly improved in the health management group(all P ＜ 0.05).Conclusion Health management may be effective in decreasing risk factors of cardiovascular diseases in community residents.

Objective To search some references for estimating the time of death in some murder cases by observation the dynamic changes of organic amines derived from isolated human hepatic tissues. Method The contents of histamines, putrescines, cadaverines and undecomposed amino acids from the isolated human hepatic ussues were assayed dynamically by the method of high performance liquid chromatography (HPLC). Results The contents of the organic amines produced by the putrefaction under 8℃,15℃ , 23℃ and 32℃ were increased along with the time elapsed after death under four environmental temperatures before attaining to their peak value, While the contents of the undecomposed amino acids were decreased gradually after death. Conclusion The amount of organic amines produced by putrefaction of the isolated human hepatic tissues were directly related to the time of death. So do the environmental temperature.

Objective To explore the clinical effect and safety of high frequency oscillatory ventilation (HFOV) combined thoracic close drainage for the treatment of mechanical ventilated neonates with pneumothorax.Methods Twenty-two neonates were enrolled in this study,who needed mechanical ventilation diagnosed with neonatal pneumothorax and received treatment of HFOV combined thoracic close drainage from Jan.2012 and Jun.2014 in the People's Hospital of Dongguan.We recorded blood gas analysis and parameters of breathing machine before using HFOV and 2,12,24,48 hours after using HFOV respectively.Results There were significant differences between HFOV before use (0) and 2,12,24,48 hours after using HFOV in terms of blood pH value,arterial partial pressure of oxygen(PaO2),partial pressure of arterial carbon dioxide (PaCO2),oxygenation index (OI),the inspired oxygen concentration (FiO2),mean airway pressure (MAP) (F =6.606,17.760,8.387,17.242,25.185; P ＜ 0.05).Compared with before using HFOV combined thoracic close drainage,PaO2 was significantly increased from (51.25 ± 13.16) mmHg to (62.60 ± 15.95) mmHg.PaCO2 was significantly dropped from (63.57 ± 13.81) mmHg to (54.02 ± 11.58) mmHg and OI was dropped sharply from (16.57 ± 9.09) to (11.28 ± 4.67) at 2 hours after using HFOV combined thoracic close drainage (P ＜ 0.05).FiO2 significantly decreased from (0.76 ± 0.15) to (0.60 ± 0.13),as well as MAP from (9.91 ± 1.44) cm H2 Oto (8.50 ± 1.68) cm H2O.Furthermore,pH was significantly improved from (7.24 ± 0.15) to (7.34 ±0.10) at 12 hours later(P ＜0.05).PH,PaO2,PaCO2 were roughly back to normal at 48 hours after treatment.The main complications were intraventricular hemorrhage (2 cases),subarachnoid hemorrhage (2 cases),ventilator associated pneumonia (1 case) and pulmonary hemorrhage (1 case) (not during the time of HFOV treatment).Conclusion HFOV combined thoracic close drainage for the treatment of neonates with pneumothorax is safety and effective methods.

Objective To investigate the effect of the extent of postoperative prophylactic radiotherapy after radical surgery on the long-term survival in patients with thoracic esophageal carcinoma.Methods A retrospective analysis was performed on the clinical data of 201 patients with thoracic esophageal cancer who received postoperative prophylactic radiotherapy after radical surgery from 2000 to 2007.The effect of the extent of radiotherapy on survival was evaluated,and the possible prognostic factors were subjected to multivariate Cox regression analysis.The Kaplan-Meier method was used to calculate overall survival (OS) rates,and the log-rank test was used for survival difference analysis.Results The 5-year follow-up rate was 97.0％.The OS rates for patients who received radiotherapy to the whole mediastinum,whole mediastinum + lymph nodes along the left gastric artery,whole mediastinum + bilateral supraclavicular regions,upper and middle mediastinum + bilateral supraclavicular regions,and whole mediastinum + bilateral supraclavicular regions + lymph nodes along the left gastric artery were 21.7％,37.1％,38.7％,34.8％,and 19.8％,respectively (P =0.406).Multivariate analysis showed that postoperative N stage was the independent prognostic factor (P =0.009).After prophylactic irradiation,metastases to the supraclavicular lymph nodes,lymph nodes in the upper and middle mediastinum,and abdominal lymph nodes were observed in 11,34,and 10 patients,respectively.Conclusions The extent of postoperative prophylactic radiotherapy after radical surgery for thoracic esophageal carcinoma only includes upper and middle mediastinum and bilateral supraclavicular regions.

Objective To investigate the mechanism of the radiosensitivity effect of Cox-2 gene in esophageal cancer.Methods Cox-2 specific siRNA was constructed and transfected to EC9706 cells to downregulate intracellular Cox-2 expression.The expressions of MMP-2,Bcl-2 mRNA,AKT and phosphorylated AKT proteins were assayed after radiation.Colony formation,cell proliferation,apoptosis and cell invasion in vitro were examined as well.One-way ANOVA method was used to analyze the data.Results Affter 2 and 4 Gy irradiation,a significant increase in the mRNA expression of Bcl-2 was observed in the Cox-2 up-regulation group (F =3.36,4.32,P ＜ 0.05).In the group of Cox-2 downregulation,the expression of MMP-2 mRNA was significantly reduced(F =3.86,8.09,P ＜ 0.05).Affter irradiation,a significant decreaseof Bcl-2 mRNA (F =3.73,5.64,P ＜ 0.05) as well as an increase of Bax(F =7.03,7.42,P ＜ 0.05) was detected,and the levels of total and phosphorylated AKT proteins had the highest level in the Cox-2 upregulation group and had the lowest level in the Cox-2 downregulation group.In the Cox-2 downregulation group,the apoptosis induction obviously increased with dose (F =317.40,P ＜ 0.05),and the proportion of cells in Go-G1 phase gradually increased but the proportion of cells in S and G2-M phases decreased,concomitant with the obvious suppression of cell proliferation,in addition,cell invasion was decreased.Conclusions Downregulation of intracellular Cox-2 mRNA expression,concomitant with subsequent downregulation of MMP-2 and Bcl-2 and upregulation of Bax,resulted in reduction of the invasion and metastatic capabilities of tumor cells,and induction of Go-G1 phase arrest and apoptosis.Downregulation of AKT and phosphorylated AKT (pAKT) protein expression might also interfere with the capability of the PI3K/Akt signal transduction pathway to resist radiotherapy.