Objective To develop a radiology algorithm and test its the accuracy in distinguish pacing in the septum from the other parts. Methods One hundred patients were implanted with double-chamber pacemakers. Sites of the leads were verified by two-dimensional echocardiography, and the patients were divided into 4 groups according to the echocar?diography:septal right ventricular outflow tract group(RVOT), RVOT anterior free wall group, mid septum group, and anteri?or septum group (near to the anterior free wall ). An algorithm was developed according to radiological characteristics in the 45° left anterior oblique (LAO45° ) view and the 30° right anterior oblique (RAO30° ) view. Then its sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were tested . Results The algorithm has high sensitivi?ty and specificity, which were 90%and 97%respectively. The positive predictive value and negative predictive value were 90% and 97% respectively. Conclusion The radiology algorithm we developed have a high sensitivity and specificity in identifying the site of the leads.

Objective: To study the action of acupuncture on the morbid psychology of the heroine addicts at late stage of detoxification. Methods: Four methods including acupuncture, combination of opium and acupuncture, combination of opium and buprenorphine, and combination of opium and Han's drug withdrawal instrument were adopted to study the effect of acupuncture on each factor in 90 listing symptoms of heroin addicts at late stage of detoxification by the self-evaluation scales. Result: Acupuncture had more advantages in improving obsessive symptoms, anxiety, psychogenic symptoms and No 10 factor (P＜ 0.01). Conclusion: Acupuncture can correct the morbid psychology of the addicts and help them enter the recovery stage smoothly.

OBJECTIVE: To compare the effects of de-addiction with the therapy of acupuncture, acupuncture plus opium, opium plus buprenorphine and opium plus Han's instrument for de-addiction and to study the effects of the four therapeutic methods on the protracted withdrawal syndrome and craving. METHODS: The effects of de-addiction were assessed with the opiate withdrawal scale and the craving degree with visual analogue scale (VAS). RESULTS: The dominance of acupuncture treatment for withdrawal syndrome appeared to be after the 6th day, and the dominance for controlling craving showed after the 8th day, moreover, there were little side effects. CONCLUSION: Acupuncture treatment had the potentiality of preventing relapse and could be used for treating the protracted withdrawal syndrome and psychic dependence during the period between the stages of abstinence and rehabilitation.

18F-FDG PET or PET/CT plays an important role in the differential diagnosis of rheumatic disease.By imaging evaluation of glucose metabolism,18F-FDG PET or PET/CT can identify disease activity and distribution.It can also evaluate treatment response of rheumatic disease based on the change of glucose metabolism between baseline and follow-up studies.This article reviews the clinical application of 18F-FDG PET or PET/CT in rheumatoid arthritis (RA),seronegative spondylarthropathy (SpA),large vessel vasculitis (LVV),polymyalgia rheumatica (PMR) and adult onset Still's disease (AOSD).

Objective To explore the expert survey of the weight and the current common weight of the similarities and differences in the quantitative analysis of the symptoms in syndrome evaluation. Methods Through the expert questionnaire survey, the data of the questionnaire were analyzed by SPSS11.5 software. For the question of whether the weight of each symptom was the same, the frequency of the experts who gave yes and no was calculated. For the weight of the specific number of such openness, the weight given by the experts was listed firstly, and then the weight of frequency of each expert was calculated, and the frequency of the largest weight was selected as the weight of the symptoms to determine the weight of the syndrome quantification assignment in the evaluation of the efficacy of the syndrome, and to compare the obtained weight with the current weight. Results The weight of the two methods is very close in the weight of the primary symptom and the weight of secondary symptom. But as for whether the weight of the primary symptom and secondary symptom is the same, the majority of the experts think that it should be different, and the current usual practice is to give the same weight. Conclusion During the weight determination, not every primary symptom or secondary symptom is the same important. Therefore, the practice of giving the same weight to evry primary symptom and secondary symptom is questionable.

Objective To explore the ultrasound imaging characteristics of thyroid papillary carcinoma complicated cervical lymph node tuberculosis, and to elucidate the key points of ultrasound diagnosis and to distinguish with cervical lymph node metastasis of papillary thyroid carcinoma.Methods In total, 1 5 well-documented cases of papillary thyroid carcinoma diagnosed definitely were selected, and there were 6 cases of concomitant lymph node metastasis. The ultrasonography of lymph node enlargement was analyzed, and the differences of the ultrasonographic characteristics between lymph node tuberculosis and metastatic lymph node including the location, swelling, calcification, blood flow and regional nodal liquefaction. Results Thyroid papillary carcinoma complicated with cervical lymph node tuberculosis was often found in the areas of Ⅲ,Ⅳ and Ⅴ, especially in the area of Ⅴ. Variety of echo was mixed in tuberculous of lymph node, and the echo was inhomogenous. The tuberculosis of lymph node calcification was patchy inhomogeneous distribution.The echo in part of liquefaction of lymph node tuberculosis was cottony weak. The flow signal of tuberculous lymph appeared the surrounding or internal punctate distribution,and the soft tissue was echogenic and disorder around the lymph node tuberculosis. Conclusion When ultrasonography examination is performed in the patients with the thyroid papillary carcinoma complicated with cervical lymph node enlargement, the history should be considered to analyze the ultrasound characteristics to dignose by observing the lesions of the surrounding soft tissues.

Objective To investigate the cause and countermeasures of frequent shocks in patients with implantable cardioverter defibrillators (ICD). Methods Eighty ICD patients with heart failure and malignant ventricular arrhythmias were followed up, including sixty-two male and eighteen female patients. There were 35 patients with single-chamber ICD, 23 with dual-chamber ICD and 22 with three-chamber ICD. Patients in this study were followed up for 1-6 years to analyze the reasons for ICD discharge. According to the specific circumstances, patients were treated. Results Twenty-three pa-tients in 80 patients suffered from shock treatment. Ten patients (12.5%) experienced frequent shocks. The causes of fre-quent shock included repeated episodes of ventricular tachycardia, invalid shock due to increased defibrillation threshold (DF) and false identification of the frequent episodes of paroxysmal ventricular tachycardia or arrhythmias. The management included the identification process adjustment of ventricular tachycardia and supraventricular tachycardia, increased num-bers of beats of ventricular tachycardia judgment and increase the basic pacing rate. The anti-arrhythmic drugs should be combinedly used, especially metoprolol and amiodarone. The ICD shock was significantly reduced after parameter optimiza-tion and anti-arrhythmic therapy. Conclusion The ICD shocks were effectively reduced with rational use of anti-arrhyth-mic drugs and valid ICD programming.

Objective To compare the efficacy of cardiac resynchronization therapy (CRT) on chronic heart failure (CHF) patients with different left bundle branch block (LBBB) morphologies. Methods Patients(n=45)who were treated with CRT were enrolled. According to the intrinsic ECG morphologies, patients were divided into 1)genuineLBBB group (n=32) who present negative dominant V1 and V2 lead wave (QS or rS);mid-QRS notching or slurring in at least 2 leads of Vl, V2, V5, V6, I and aVL as well as QRS duration≥140 ms in male or≥130 ms in female and 2)falseLBBB group (n=10) who meet traditional standards but fail to meet“genuine”LBBB diagnostic standard. The QRS duration, echocardiographic indi?ces and New York Heart Association (NYHA) Functional Classification were evaluated at the 12 months follow-up. CRT re?sponder was defined as patient with≥1 decrease in NYHA class and/or with≥15%reduction in left ventricular end-systolic volume (LVESV). CRT super-responder was defined as patient with≥30%reduction in LVESV. Results There was no dif?ference in basic characteristics of patients between groups. At the 12 months follow-up, 20 patients in genuine LBBB group and 6 patients infalseLBBB group were identified as responders (P>0.05). Compared with those infalseLBBB group, the responders ingenuineLBBB group showed better improvement in left ventricular ejection fraction and left ven?tricular end diastolic diameter (LVEDD) (both P<0.05). Conclusion Left bundle branch block morphology is less predic?tive for the efficacy of CRT. However, patients who show response to CRT withgenuineLBBB profile may get more bene?fits from CRT treatment than the patients withfalseLBBB profile.

OBJECTIVE To investigate the proliferation effect of di(2-ethylhexyl) phthalate (DEHP) on prostate in aged rats at the environmental exposure dose and the possible mechanism.METHODS Thirty-two male Sprague-Dawley rats,aged 1.5 years,were randomly divided into 4 groups (8 rats per group) and treated with DEHP (30,90 and 270 μg· kg-1,ig) and vehicle once daily respectively for 4 weeks.All the animals were anesthetized with pentobarbital sodium and sacrificed on the day subsequent to the last treatment.① Abdominal aortic blood samples were collected,and serum estradiol (E2),testosterone (T) and prolactin (PRL) levels were assayed by ELISA.② The prostate tissues were dissected and categorized into different lobes,weighed and measured.The prostate relative mass was calculated.③ The morphological changes were detected by HE staining and prostate epithelial height was analyzed with microscopic image analysis software.RESULTS Compared with vehicle control group,the prostate relative mass,dorsolateral prostate mass,and dorsolateral prostate index in DEHP 270 μg· kg-1 group were significantly higher (P＜0.05).The height of the ventral prostate epithelium in DEHP 30,90 and 270 μg· kg-1 groups was increased significantly (P＜0.01),so was the height of dorsal prostate epithelium in DEHP 270 μg· kg-1 group (P＜0.01).There were no significant changes in levels of E2,PRL or T in DEHP 30,90 and 270 μg· kg-1 groups,but the ratios of E2/T in DEHP 30 and 270 μμg· kg-1 groups were increased significantly (P＜0.05).CONCLUSION Low-dose DEHP could promote the proliferation of prostatic hyperplasia in the aged rats,which might be associated with the relative levels of endogenous hormone.

Objective To evaluate the prognosis and fertility outcomes of patients with early stage of cervical cancer treated by vaginal radical trachelectomy ( VRT ) in combination with laparoscopic pelvic lymphadenectomy.Methods The surgical data , disease recurrences and fertility outcomes were analyzed retrospectively for 51 patients who received VRT in Peking Union Medical College Hospital from Dec.2003 to Nov.2013.Results Forty-eight patients succeeded in preserving fertility.The median age was 29 years.International Federation of Gynecology and Obstetrics ( FIGO ) stage: 5 cases Ⅰa1 with lymph vascular space invasion (LVSI),4 cases Ⅰa2 and 39 cases in stage Ⅰb1.Tumor size: 20 cases with no visible lesion, 20 cases with tumor size ≤2 cm, 8 cases with tumor size >2 cm.Histological type:42 cases with squamous carcinoma , 6 cases with adenocarcinoma or adeno-squamous carcinoma.The mean excised cervical length and parametrial width was ( 2.6 ±0.6 ) cm and ( 1.9 ±0.5 ) cm, respectively.Six recurrences ( 12%) were observed after following up for a mean duration of ( 35 ±21 ) months.The recurrent rate in patients with tumor size >2 cm was 3/8, which was significantly higher than that of the
patients with tumor size ≤2 cm (8%, 3/40;P<0.01).Of the 35 patients who desired to conceive after the surgery, 13 women had 17 pregnancies and the pregnant rate was 37% (13/35).Nine women obtained 10 healthy live birth babies.The fertility rate was 26%( 9/35 ).Conclusions VRT in combination with laparoscopic pelvic lymphadenectomy could preserve the fertility of patients with early stage of cervical cancer with acceptable oncologic and fertility outcomes.Tumor size ≤2 cm should be emphasized as the indication of VRT in considering of the higher recurrent rate in patients with tumor size >2 cm.