Atrial fibrillation (AF) is one of the most common arrhythmias in clinical practice.It often causes serious thromboembolic complications,which brings great harm to human health.The incidence and morbidity rates of AF are increasing year by year.The research on the pathogenesis of AF has been focused on the aspects of electrical remodeling and structural remodeling.Atrial electrical remodeling and structural remodeling are the main mechanism of AF for the maintenance and recurrence.The intervention of atrial remodeling is helpful to the treatment of AF.It is found that the rennin-angiotensin aldosterone system (RAAS) plays an important role in atrial remodeling.RAAS blockers can significantly reduce the onset of AF by inhibiting the activation of the renin axis,which can block the activation of RAAS and improve the atrial remodeling.This may provide a new choice for the treatment of AF.This article reviews the research progress of RAAS blocking agent in the prevention and treatment of AF.

Objective:To explore the therapeutic effect of the use of budesonide for externally-used budesonide in the surgical cavities following endoscopic sinuous surgery(ESS).Method:122 cases with chronic sinusitis were randomly divided into two groups treated by the routine procedures after endoscopic sinuous surgery but the treatment group with 61 cases were treated by the addition of budesonide suspension for inhalation in the surgical cavities.The process of the epithelization in the surgical cavities by endoscopy was investigated.Result:The process of cleaning in 15 days in the surgical cavities was better in the budesonide-using group than in the controlled group.A significant difference was found(P

Objective To determine the association between serum potassium level and the severity of coronary artery atherosclerosis. Methods A total of 246 patients underwent coronary artery angiography were included into this study, and were divided into four groups according to the involved main coronary artery:control group (0 diseased vessel, n=81), one dis?eased vessel group (n=43), double diseased vessel group (n=46) and three diseased vessel group (n=76). Patients were also di?vided into low potassium group (K+<4.0 mmol/L, n=99) and high potassium group (K+≥4.0 mmol/L, n=147) according to the levels of serum potassium. The severity of coronary stenosis was quantitated by Gensini score system. The clinical data were compared between groups. The relationship between Gensini score system and clinical information was analyzed. The multi?ple regression method was used to analyse the risk factors of coronary heart disease (CHD). Results (1) There were higher percentages of elders, male, smoking, diabetes mellitus and hypertension patients in three diseased vessel group than those of control group. The serum potassium level was significantly lower in three diseased vessel group (3.97 mmol/L±0.37 mmol/L) than that of control group (4.11 mmol/L±0.33 mmol/L) and one diseased vessel group (4.13 mmol/L±0.41 mmol/L). There were higher percentages of elders, male and hypertension patients in double diseased vessel group than those of control group. The percentages of male and hypertension patients were higher in one diseased vessel group than those of control group. The Gensini scores were three diseased vessel group>double diseased vessel group>one diseased vessel group>control group (P<0.05). (2) There was a significantly higher Gensini score in low potassium group [36(8, 94)] than that of high potassium group [16(0,56)]. (3) There was significant negative correlation between serum potassium level and Gensini score (r=-0.206, P=0.001). (4) It was found that age, male, the low level of serum potassium, diabetes mellitus and hyperten?sion were independent risk factors of CHD. Conclusion The serum potassium level is negatively correlated with the severi?ty of CHD. The low level of serum potassium is an independent risk factor of CHD.

Cardiac conduction abnormalities and/or atrioventricular (AV) block have been reported as one of the most frequent complications of transcatheter aortic valve implantation (TAVI). The impairment of AV conduction was resulted from the balloon and valve-induced injury. Patients with right bundle branch block (RBBB) before TAVI operation, receiving the Medtronic CoreValve Revalving System (MCRS) implant and the implantation of valve prosthesis too deep in the left ven-tricular outflow tract have been reported to require permanent pacemaker implantation.

AIM: To evaluate the effects of simulated acute ischemia and reperfusion on L-type calcium current (ICa,L) in ventricular myocytes from diabetic and non-diabetic rabbits.METHODS: Using whole-cell patch clamp techniques, ICa,L was measured in left ventricular myocytes isolated from 6-week alloxan-induced diabetic rabbits and age-matched control ones at baseline, 5 min of simulated ischemia, and 5 min of reperfusion.RESULTS: There were no significant differences on baseline maximum ICa,L densities between diabetic and control ventricular myocytes. In control cells (n=11), maximal ICa,L densities of baseline, ischemia and reperfusion were (-8.36±1.63)pA/pF, (-5.90±1.75)pA/pF and (-4.22±1.02)pA/pF, respectively. The ICa,L of ischemia was less than that of baseline (P<0.01), while the ICa,L of reperfusion was less than those of baseline (P<0.01) and ischemia (P<0.05). In diabetic cells (n=9),the ICa,L of baseline, ischemia and reperfusion were (-7.55±1.62)pA/pF, (-6.05±1.58)pA/pF and (-5.12±1.13)pA/pF, respectively. Only ICa,L of reperfusion was less than that of baseline (P<0.01), while ICa,L of ischemia was not significantly different from that of baseline (P>0.05) or reperfusion (P>0.05).CONCLUSION: ICa,L in diabetic ventricular myocytes represents blunted response to acute ischemic injury, being decreased more slowly than that in control cells. Post-ischemic reperfusion is still a potent inhibitor against ICa,L in both diabetic and non-diabetic cells. This study may be indicative of the mechanism about ischemia-reperfusion injury to diabetic myocardium and the therapy for diabetic patients with ischemic heart disease.

Objective To study the expression and clinical significance of survivin in acute leukemia. Methods By using semi-quantitative RT-PCR technique, survivin gene expression was detected in 43 acute leukemia(AL). Results Survivin gene expression rate in the cells of AL patients at diagnosis was 69.77%(30/43). Survivin mRNA expression rate in both 18 acute lymphocytic leukemia (ALL) and 25 acute nonlymphocytic leukemia(ANLL) (72.22% and 68.0% respectively) was signficantly higher than that in control group (33.33%,P0.05). Conclusions Survivin gene was highly expressed in AL patients and could be a potential target for treatment of AL.

Objective To observe the effect of pure Chinese traditional medicine preparation Fuzheng Anti-poisonous capsule and Kang Aibao Lives capsule to treat HIV/AIDS. Methods 140 examples confirmed by the Yunnan Province Centres for Disease Control and Prevention were treated by Fuzheng anti-poisonous capsule and Kang Aibao Lives Capsule,according to the Chinese medicine syndrome differentiation. 83 cases taking the medicine for more than 6 months were collected. The changes of Chinese medicine clinical symptoms and signs,the clinical symptoms and signs,the integrals,body weights,cold-catching numbers and CD4 were observed. Results The effective rate,steady rate and ineffective rate of Chinese medicine clinical symptom were 79.52%,10.84% and 9.63%,respectively. Increase,stable and reduces of integral were 48.19%,45.78% and 6.02%,respectively. Weight gain,stable and reduce were 56.62%,19.28% and 24.10%,respectively. Reduce,stable and increase of cold-catching number were 46.99%,43.37% and 9.64%,respectively. Effective,stable and ineffective of CD4 was 56.00%,10.67% and 33.33%,respectively. Conclusion The Chinese medicine has the remarkable curative effect in treating AIDS,and also has the obvious superiority.

Objective To isolate and observe Pityrosporum yeasts from a patient with onychomycosis. Methods The involved nail specimens were investigated by means of culture, pathological and scanning electron microscopic examination and 20% KOH preparation. Results Physical examination showed that each finger and toe nail appeared brownish black, rough and thick, some of the fore part of the nail plate detached from the nail bed. Fingernail specimen's culture results showed that Trichophyton rubrum grew on Sabouraud's dextrose agar and Pityrosporum ovale grew on the medium containing rapeseed oil. The pathological examination revealed P.ovale yeast involvement in the fissure of the nail plate. Under the scanning electron microscopy, a lot of P.ovale yeasts with characteristic collarette structure inserted in the nail tissue was noticed. In the 20% KOH preparations of nail incubated at 56℃for 1h and stained with Quink Parker ink, spores and hyphae were identified morphologically with P.ovale and T.rubrum respectively. The patient received intermittent pulse therapy with itraconazole, the color of the nails became much brighter 1 to 2 months after the fourth cycle of therapy, but no further improvement was observed afterwards. P.ovale and T.rubrum grew again 6 months after treatment when the clippings of the fingernail were cultured. Conclusion This is the first document of onychomycosis related with P.ovale in China.

Objective To investigate clinical treatment status in early hospitalized patients with acute ST-segment elevated myocardial infarction(STEMI).Methods The data of hospitalized patients with STEMI admitted between January 2001 and June 2005 were retrospectively collected and studied from medical records of the 2nd Hospital of Tianjin Medical University.Results A total of 773 cases were investigated,71.80% of the patients were male,the median age was 66.0 years,and the hospitalization duration was 11.0 days.The median duration from the onset of STEMI to the arrival in the wards was 210 min.The median initiation time of door-to-needle or door-to-balloon treatment for reperfusion therapy was 60 and 100 minutes,respectively.As to the selection of the reperfusion strategies,patients who were male,younger(age

Objective:To investigate the root and canal morphology of mandibular first permanent molars in adolescents by cone-beam computered tomography (CBCT).Methods:366 mandibular first permanent molars in 1 83 adolescents aged 1 2 -1 6 years were examined by CBCT from July,201 2 to December,201 3.The age,sex,the number of roots and canals and canal morphology were re-corded.The data were statistically analyzed by software SPSS 1 9.0.Results:365 mandibular first permanent molars showed single mesial root except one with C-shaped root;282(77.05%)teeth had one distal root,83(22.68%)had two.356(97.27%)teeth had two mesial canals and 9(2.46%)had one.229(62.57%)teeth had one distal root with one canal,53(1 4.48%)had one distal root with two canals.83(22.68%)had two distal roots with one canal in each root,one (0.27%)had C-shaped root with three canals. There were no significant differences between males and females and between the two sides on the number of roots and number of ca-nals.Conclusion:Majority of mandibular first molars have two roots,the root change occurs in distal root.The prevalence of three-rooted mandibular first molars has no significant difference between genders and 2 sides.