135 ms in selecting patients for cardiac resynchronization therapy(CRT).Methods Forty-five patients with SHF were randomly divided into two groups according to QRS width: Group 1(QRS width 135 ms could finely predict the presence of interventricular dyssynchrony,with a sensitivity of 80% and a specificity of 87.5%;while the same cutoff value to predict intraventricular dyssynchrony only yielded a sensitivity of 44.1% and specificity of 73.6%.Conclusion Intraventricular dyssynchrony and(or) interventricular dyssynchrony has a high prevalence in patients with SHF.A QRS duration cutoff value higher 135 ms can well evaluate the cardiac mechanical dyssynchrony in clinical practice,which may be of value for optimizing selection of CRT candidates and reducing the nonresponders.

Objective To investigate the result of RFCA and electrophysiologic characteristics in pediatric PSVT. Methods Electrophysiologic study and RFCA were performed in 25 patients(age

It is now clear that continued stimulation o f the neurohormonal system in heart failure (HF) has serious deleterious effects on the heart. The increase of circulating catecholamines exerts direct toxic ef fect on cardiac myocytes, increases membrane permeability and myocardial fibrosi s; lead to aggravation of HF. β-blockers are commonly used in the treatment of HF including propranolol, metoprolol, bisoprolol, bucindolol and carvedilol. These drugs are used in combination with ACEIs, digitalis and diuretics. Genera lly, the benefits of β-blockade therapy in HF include improving symptoms, decr easing morbidity, mortality, elevating need for hospitalization and quality of l ife. β- blockade therapy arrests and reverts LV remodeling and improves the ri sk of life threatening arrhythmias and sudden cardiac death. A few serious adver se effects include hypotension, heart blocks, bradycardia and fluid retention.

Objective: To observe the influence of sot alol on the QT dispersion in patients with atrioventricular accessory pathways u nderwent radiofrequency catheter ablation (RFCA). Methods: Thirt y-six patients were divided into 2 groups by random. One was the drug group(18 cases) treated by RFCA， and sotalol 160 mg was orally administered and intracar diac electrophysiological study was performed every 30 min for 5 times. Th e other group(control group, 18 cases) only treated by RFCA.QTd,QTcd and QTLcd w ere measured before and after RFCA. Results: There was no signif icant difference with QT dispersion before and after RFCA in control group. When compared with before RFCA, QTd in patients administered sotalol was (30.9 ±14.3) ms vs (24.7±9.6) ms; QTcd(33.7±17.1) ms vs (25.2±10.1) ms; QT Lcd(30.8±14.1)ms vs (25.6±19.4) ms (P<0.05). Conclusion: Sotalol can slightly lower QT dispersion, which is beneficial for preventing malignant ventricular arrthythmia. It is safe in RFCA in pateints with accessory pathway.

To improve the knowledge of students and strengthen the teaching effects of internal medicine teaching,the characters,teaching methods and notices of clinical guideline were analysed. Moreover,according to previous teaching experiences,a few unique opinions on it were put forward. The results showed that clinical guideline was one of the most important ways in internal medicine teaching.

0.05). The marks of the group of CBL in case analysis test and clinical skills test are significantly higher than that of the group of stepwise learning (P

Objective: To observe the influence of sotalol on the QT dispersion in patients with atrioventricular accessory pathways underwent radiofrequency catheter ablation (RFCA). Methods: Thirty six patients were divided into 2 groups by random. One was the drug group(18 cases) treated by RFCA, and sotalol 160 mg was orally administered and intracardiac electrophysiological study was performed every 30 min for 5 times. The other group(control group, 18 cases) only treated by RFCA.QTd,QTcd and QTLcd were measured before and after RFCA. Results: There was no significant difference with QT dispersion before and after RFCA in control group. When compared with before RFCA, QTd in patients administered sotalol was (30.9?14.3) ms vs (24.7?9.6) ms; QTcd(33.7?17.1) ms vs (25.2?10.1) ms; QTLcd(30.8?14.1)ms vs (25.6?19.4) ms ( P