Objective:To explore dynamic change of heart rate variability (HRV) before and after circumferential pulmonary vein ablation (CPVA ) in patients with paroxysmal atrial fibrillation (PAF) and its relationship with postoperative recur‐rence .Methods:A total of 108 PAF patients undergoing left atrial circumferential pulmonary vein electrically isolated ra‐diofrequency ablation were selected .According to 12‐lead DCG on 3d and three months after operation ,patients were di‐vided into early recurrence group (n=10) ,late recurrence group (n=21) and no recurrence group (n=77) .HRV changes were followed up and compared among all groups .Results:Compared with before ablation ,on 3d after ablation ,there were significant reductions in standard deviation of normal to normal RR intervals calculated over the 24 h period (SDNN) , standard deviation of normal to normal RR intervals in all 5 min segments of the entire recording (SDANN) ,root‐mean square of differences betweensuccessive normal to normal intervals (rMSSD) ,low frequency (LF) ,high frequency (HF) in no recurrence group ;significant rise in mean heart rate ,and significant reductions in SDNN ,LF and LF/HF in early recur‐rence group ( P< 0.05 or <0.01);compared with no recurrence group ,there were significant rise in mean heart rate [(69.3 ± 11.2) beats/min vs .(75.4 ± 14.0) beats/min] ,SDANN[(66.9 ± 25.7)ms vs .(137.5 ± 92.3)ms] ,rMSSD [(22.1 ± 10.6)ms vs .(46.2 ± 19.2)ms] ,LF [(233.1 ± 31.4)ms vs .(251.7 ± 17.3)]and HF[(228.0 ± 82.4) ms2 vs . (508.0 ± 13.5) ms2 ] ,and significant reduction in LF/HF[(1.13 ± 0.53) ms2 vs .(0.41 ± 0.13) ms2 ]in early recurrence group (P<0.05 or < 0.01);significant rise in rMSSD [(23.9 ± 11.10) ms2 vs .(52.0 ± 28.7) ms2 ]and HF[(344.4 ± 103.2) ms2 vs .(482.1 ± 100.6) ms2 ] ,and significant reduction in LF/HF[(1.16 ± 0.41) vs .(0.85 ± 0.43)]in late recur‐rence group , P<0. 05 or <0. 01. Conclusion:Vagal tone reduction may reduce recurrence after CPVA in PAF patients .

To explore the possibility of bladder reinnervation and artificial triggering voiding established by Achilles tendon reflex after spinal cord injuries above cone. Bilateral anterior roots of S 1 and main bladder innervating roots (S 2 or S 3) in 8 patients were severed intradurally and then anastomosed to establish artificial reflex arc of "Achilles tendon spinal cord bladder". After followed up for an average of 2 8 years, it was found that the patients were free from nocturnal incontinence, with micturition frequency of 5～6/d, and the urinary volume varied from 250 to 500 ml each time. The results suggested that artificial reflex arc of "Achilles tendon spinal cord bladder" could restore bladder function in patients with spinal cord injuries above cone

Objective To investigate the approaches and clinical value of intra-abdominal fluid monitoring after laparoscopic splenectomy (LS). Methods We collected the data of 63 cases of LS performed in the West China Hospital from November 2005 to August 2008,and analyzed the level of amylase in intra-abdominal fluid,changes of color,volume,and characteristics of the drainage fluid,as well as the results of germiculture and ultrasonography. Results Among the cases,post-LS complications were detected by intra-abdominal fluid monitoring in 4 cases early after the surgery. In the four cases,2 patients showed hemorrhagic fluid (over 40 ml/h),and then was found having postoperative bleeding in the splenogastric ligament by abdominal exploration in 12 hours. In the other 2 patients,ravidous drainage fluid was detected in 6 days after the operation,and increased levels of amylase (15 189 and 9206 U/L,respectively) was revealed while germiculture was negative; pancreatic fistula (PF) was then diagnosed and somatostatin was administered. Of the 2 patients who developed PF,intra-abdominal drainage was patent in 1,and the drainage tube was withdrawn in 20 days; for the other cases who had non-patent drainage,ultrasonography-guided percutaneous puncture catheter drainage was performed,and the drainage tube was taken out in 2 months. Conclusions LS is safe,reliable,and minimally invasive. Postoperative monitoring of intra-abdominal fluid is valuable for early detection of post-LS complications.

Objective To assess the safety of emergent invasive treatment in severe postpartum hemorrhage. Methods Invasive treatment was performed in 18 patients with severe postpartum hemorrhage. The operation time, therapeutic effect, collateral circulation of uterus feeding arteries, pathological changes in uterine muscle after embolization and radiation dose received by the ovary during operation were investigated for safety assessment. Results (1) All eighteen patients who had been failed to conservative treatment were successfully cured with invasive treatment. The duration of hemostasis was 3 to 10 minutes, mean time (6?4) minutes. The operation time was 30 to 50 minutes, mean time (39?5) minutes. (2) Although both sides of internal iliac arteries or uterine arteries were embolized, a small amount of blood supply for uterus remains from ovary arteries, from branches external iliac arteries and from other arteries. (3) Uterine biopsies were performed in 3 patients 5 to 10 days after the invasive treatments for pathological examinations. Pathological findings showed that the necroses of uterine muscles were disconnected and the whole areas were blow 1/4. (4) The mean radiation dose received by the ovary in 5 cases was (17?7) cGy, which was within the safe limit. Conclusions The use of the emergency invasive treatment is safe in severe postpartum hemorrhage.

Objective To investigate the effect of endoscopic treatment of delayed hemorrhage after endoscopic sphincterotomy.Methods Retrospectively analyzed the data of 2 638 patients who underwent endoscopic sphincterotomy.There were 26 patients who delayed hemorrhage after endoscopic sphincterotomy.All the 26 patients underwent duodenoscopy,and endoscopic treatment was underwent for the patients who had active bleeding.Results There were 21 patients had active bleeding,and the other 5 cases had no bleeding.There were 12 patients with capillary hemorrhage and 9 cases with petechial hemorrhage.In the 12 patients with capillary hemorrhage,9 patients had been sprayed tissue glue,and 3 patients had been local injected with 1 10 000 noradrenalin.In the 9 patients with petechial hemorrhage,5 patients were treated with titanium clip,and 4 patients were treated with argon ion.All the 21 patients were crued,and no patient was operated and no patient died.Conclusion There are few patients who delayed hemorrhage after endoscopic sphincterotomy.Tissue glue sprayed,local injection,argon ion and titanium clip can cure the bleeding.

This study was aimed to investigate the effects of ursolic acid on human hepatic stellate cells (HSC-LX-2) proliferation and its mechanism.Different doses of ursolic acid were incubated with HSC-LX-2 cellin vitrof or 48 h.MTT was used for the detection of HSC-LX-2 cell proliferation.The expressions of PDGF-ERK signaling pathway associated proteins were measured by western blot.The results showed that the proliferation of HSC- LX-2 cells was inhibited by ursolic acid in a dose-dependent manner.The inhibition rate of 20,30 and 40μmol·L-1 of ursolic acid was 9.1%,42.3% and 62.6%,respectively.The IC50 was 35.2μmol·L-1.After incubated with ursolic acid for 48 h,protein levels of PDGF-R and p-ERK in 30 and 40μmol·L-1 group were significantly decreased when compared with the normal group (P<0.05 orP<0.01),except the ERK protein.It was concluded that ursolic acid can inhibit HSC-LX-2 cell proliferation.Its mechanism may be related to the blockage of PDGF-ERK signaling pathway.

Objective To observe and evaluate the expression and significance of Nogo-66 receptor (NgR) mRNA in adult rats′ optic nerve. Methods Optic and sciatic nerves of 8 adult rats were used to make the sections, which were divided into 3 groups: optic-nerve experimental group, sciatic-nerve control group, and optic-nerve negative control group. In situ hybridization was used to observe the expression of NgR mRNA in optic nerve and sciatic nerve. Results The expression of NgR mRNA in the 8 rats was positive in optic nerve and negative in sciatic nerve. The positive signals were arranged along the long axis of optic nerve. Conclusion The expression of NgR mRNA is positive in optic nerve while negative in sciatic nerve in adult rats, which suggests that the positive expression and distribution of NgR may be related to the poor regenerate ability of optic nerves.

The practical teaching system for information management and information system science in higher medical institutions was constructed with job skill training as its target by intruding the concept of competence-based education model into it in order to improve the practical performance of undergraduates majoring in informa-tion management and information system science. The system was designed by taking into consideration the teaching contents, teaching methods and teaching practice, and implemented in the undergraduates of Chengdu Medical College, and the implementation experiences were summarized.

We report a case of 46-year-old xanthoderm woman who was diagnosed as malignant peripheral nerve sheath tumors of right maxillary sinus, and have a literature review. Histology confirmed a diagnosis of malignant peripheral nerve sheath tumor. The woman had the right total maxillectomy and postoperative adjuvant radiotherapy. There is no local recurrence or metastasis of one year following up. Literature review revealed MPNST in the nasal cavity and para-nasal sinuses were not common with poor prognosis. The main cause of death is local recurrence and metastasis. Surgical resection showed more advantage than adjuvant radiotherapy and chemotherapy.
Female ; Humans ; Maxillary Sinus ; Middle Aged ; Neoplasm Recurrence, Local ; Nerve Sheath Neoplasms ; pathology ; therapy ; Neurilemmoma ; pathology ; therapy ; Paranasal Sinus Neoplasms ; pathology ; therapy ; Radiotherapy, Adjuvant

Objective To observe the curative effect of electro-acupuncture combined with rehabilitation training to shorten the period of flaccid paralysis after cerebral infarction.Methods 78 victims were divided into treatment group and control group at random. The treatment group received electro-acupuncture combined with rehabilitation training, and the control group received rehabilitation training only. Muscular tension was evaluated on the 15th day and 30th day after admission according to the modified Ashworth spasm rating scale.Results The number of flaccid paralysis victims in the treatment group is significantly less than that in the control group (P＜0.05) on the 15th day and 30th day after treatment.Conclusion Electro-acupuncture combined with rehabilitation training can shorten the period of flaccid paralysis after cerebral infarction significantly.