Objective:To explore the influencing factors of recovering to normal atrioventricular nodal conduction (AVNC) in patients with acute myocardial infarction (AMI) complicated III atrioventricular block (AVB) .Meth‐ods:According to III AVB recovered to normal or not ,a total of 82 AMI complicated III AVB patients were divid‐ed into recovery group (n=51) and non- recovery group (n=31 ,including three cases undergoing permanent pace‐maker implantation and 28 dead cases) .The relationship among diabetes mellitus (DM) history ,ischemic precondi‐tioning (IP) ,levels of creatinine (Cr) and hemoglobin (Hb) at hospitalization ,systolic blood pressure (SBP) ,Killip class , cardiogenic shock and recovering to normal AVNC etc .were observed in two groups .Results:There were no significant difference in age ,sex proportion ,smoking history ,hypertension history ,DM history ,IP ,duration from onset to arriving at emergency room ,heart rate and SBP at hospitalization ,Hb level and early reperfusion treatment between two groups , P>0.05 all .Compared with recovery group ,there were significant rise in percentages of Kil‐lip ≥class II (39.2% vs .80.6% ) ,cardiogenic shock (21.6% vs .45.2% ) ,anterior wall infarction (7.8% vs . 32.3% ) ,Cr level [ (107.25 ± 6.69) μmol/L vs .(132.43 ± 11.52) μmol/L] and mortality (0% vs .90.3% ) ,and significant reduction in percentage of inferior wall infarction (92.2% vs .67.7% ) in non - recovery group , P<0.05 or < 0.01. Multifactor Logistic regression analysis indicated that Killip class was the independent predictor (OR=0.190 , P= 0.002 ) influencing recovering to normal AVNC in AMI + III°AVB patients .Conclusion:Killip class is an independent predictor influencing recovering to normal AVNC in AMI +III°AVB patients .

OBJECTIVE: To explore the antioxdant action of Xiangsha liujun pill in hyperlipidemia model rats. METHODS: Hyperlipidemia model was established by intragastric administrating emulsion in rats. The levels of blood lipids, serum SOD activity and MDA content in rats before and after intragastric administration of Xiangsha liujun pill were measured. RESULTS: Xiangsha liujun pill markedly inhibited the concentrations of serum total cholesterol (TC), trglyceride (TG), low-density lipoprotein (LDL) and high-density lipoprotein (HDL), promoted the activity of SOD and decreased the content of MDA (P

Objective To study the effect of action‐oriented health education in the patients with permanent urinary bladder fistula .Methods From January 2012 to March 2015 ,78 patients with permanent urinary bladder fistula were randomly divided into two groups ,39 cases in the control group were given routine health education ;39 cases in the in the study group were given action‐oriented health education ,at the 12‐month follow‐up ,the QOLI and self‐care ability of the patients were used to evaluate life self‐care abilityof patient quality .Results After 12 months ,the self‐care skills ,sense of responsibility ,health knowledge score and total score of the study group were higher than those of the control group (P< 0 .05) .The self‐care level of the study group was 94 .87% ,5 .13% and 0% respectively ,the control group were 23 .08% ,58 .97% ,17 .95% ,there was significant difference between the two groups(P< 0 .05) .The complication rate(17 .95% ) in the study group was significantly lower than that in the control group(61 .54% ) ,and the difference was statistically significant (P< 0 .05) .The psychological function ,physical function ,social function and total score of the study group were higher than those of the control group(P<0 .05) .There was no statistically signifi‐cant difference between the two groups in material life scoring (P>0 .05) .Conclusion Action‐oriented health education method has a positive effect on improving self‐care ability and quality of life ,and reducing the incidence of complications in patients with perma‐nent bladder stoma .

Objective To study the adsorbability of active carbon fiber(ACF) for gaseous benzene and to use ACF for the determination of benzene in the air in future.Methods The adsorbability of ACF was investigated and the results were compared with that of granular active carbon(GAC).Results The adsorption efficiency of ACF was 93%,the selective adsorbability was 94.28%,the saturation adsorption capacity of gaseous benzene was 25%,as for GAC,they were 88%,88.57% and 12% respectively.Conclusion ACF is better than GAC in the adsorption efficiency of benzene in the condition of low concentration and long time sampling.

OBJECTIVE To explore the relationship between the point mutations of gene CYP51 and the azole-resistance mechanism in clinical Candida albicans isolates.METHODS The paper diffusion test and NCCLS M-27 protocols were used to screen the fluconazole-resistant and itraconazole-resistant C.albicans clinical isolates.Gene CYP51 of two azole-resistant C.albicans clinical strains(2007H and 2007T strains) was amplified by three pairs of primers,respectively.The PCR products purified were sequenced,and compared with the nucleotide sequences of C.albicans(accession No.:X13296) to find out the mutation sites.RESULTS The nucleotide sequence analysis showed that there were both significant point mutations and silent mutations in gene CYP51 from two azole-resistant isolates of C.albicans.Seven mutations previously described,F105L,K128T,Y132H,T199I,R267H,G464S,and R467K,were identified in the two strains.The animo acid substitutions of Y132H and R467K,known to contribution to azole resistance,were detected in both 2007H strain and 2007T strain.Four novel mutations,including F71L,W244R,T311N and T352I,were simultanously identified.Nine silent mutations appeared in two isolates.CONCLUSIONS In this survey,the two azole-resistant C.albicans clinical isolates contained more than one mutation in gene CYP51 that is associated with azole resistance.Four novel mutations of CYP51 may be associated with the resistance of C.albicans to azoles.And the mechanisms need to be further studied in detail.

Objective 　To evaluate the clinical measurement of cerebral perfusion by dynamic CT. Methods　 Thirteen normal adults were examined by dynamic CT for the measurement of cerebral blood flow (CBF). Another dynamic CT scans with the measurement of CBF were performed separately to rule out cerebral ischemia in 5 cases and secondary Parkinson disease in 2. Results　 Normal cerebral cortical perfusion was measured at 59.3～96.8 ml*min-1*100g-1 with the　mean value 76.2 ml*min-1*100g-1. Normal white matter perfusion was measured at 27.1～43.1 ml*min-1*100g-1 with the mean value 33.9 ml*min-1*100g-1. In 5 cases of suspending cerebral ischemia, one showed increase of CBF and 4 presented decrease of CBF. In 2 cases of suspending secondary Parkinson disease, one appeared decrease of CBF and other one was normal. Conclusion　 Dynamic CT scan with the measurement of CBF can demonstrate the hemodynamic status of normal brain and pathological lesion. Combined with routine CT scan, measurement of cerebral perfusion by dynamic CT is an ideal method to show the morphological and functional changes of brain tissue simultaneously.

In order to meet the needs of training targets of medical higher occupational education.the construction and management of labs was explored.The lab construction developed rapidly,and lab management was further standardized to become more scientific.The whole benefits of labs were improved.These offered powerful support of quality to practical teaching and culture of skilled talents.

Functional experiment plays an important role in understanding the mechanisms of diseases and principles of diagnosis and treatment. It requires students to master basic skills of func-tional operation, and complicated disciplines of functional alteration as well. Thus functional experi-ment needs to be an open course. The use of the virtual reality (VR) and real-time recording tech-niques provides potential for this exploration. By the way of real-time recording system, HD video of experiment operation is played, which helps guiding students to learn basic experiment skills; while based on the development status of VR technology, it is more applicable for learning by oneself, such as preview before the class and review for the test, and furthermore, the advantage of VR technique will be more apparent, if the key development focuses on experiment extensions to disclose more compli-cated functional alterations. This new technique helps to improve teaching effects of functional experi-ment.

Objective To study the feasibility of the acute gastrointestinal injury (AGI) classification standard for evaluation of gastrointestinal function in intensive care unit (ICU) patients,and to discuss its value in administration of early enteral nutrition (EN).Methods A perspective study was conducted.85 patients with AGI admitted to ICU of Tianjin First Center Hospital from January 2013 to June 2013 were enrolled.EN was conducted after ICU admission or within 12-24 hours after high catabolic state.The patients were divided into four groups according to the AGI classification,i.e.grade Ⅰ,Ⅱ,Ⅲ,and Ⅳ,and they were treated according to the treatment procedure for AGI.The primary end points were 7-day rate of intake of standard EN,the degree of disease and nutrition,and their correlation with AGI classification.Secondary endpoint was rate of giving EN within 48 hours.Results Gastrointestinal dysfunction patients accounted for 49.42％ (85/172) of the ICU patients,and number of patients in grade Ⅰ,Ⅱ,Ⅲ,Ⅳ were 29,28,19,9 respectively.On the first day of ICU stay,there were no statistical differences in age,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,serum albumin (ALB) and prealbumin (PA) among four groups,and it was demonstrated that the baseline data were comparable.APACHE Ⅱ score on the seventh day of ICU stay was significantly lower than that on the first day in grade Ⅰ,Ⅱ and Ⅲ patients (grade Ⅰ:20.48 ± 2.45 vs.22.59 ± 2.06,t=-3.120,P=0.031 ; grade Ⅱ:19.34 ± 1.80 vs.21.65 ± 2.22,t=-4.316,P=0.012; grade Ⅲ:20.63 ± 1.34 vs.23.31 ± 1.70,t=-5.640,P=0.000),and serum PA (g/L) was significantly increased (grade Ⅰ:24.37 ± 6.54 vs.10.62 ± 7.24,t=-4.866,P=0.000; grade Ⅱ:19.79± 12.48 vs.11.57±8.94,t=-2.116,P=0.031; grade Ⅲ:19.15±8.43 vs.13.78 ± 6.59,t=-3.601,P=0.000).On the seventh day ofICU stay,the APACHE Ⅱ score was higher in grade Ⅳ than that in grade Ⅰ,Ⅱ and Ⅲ patients (22.87 ± 3.31 vs.20.48 ± 2.45,19.34 ± 1.80,20.63 ± 1.34,P＜0.05 or P＜0.01),and PA was obviously lower in grade Ⅳ than that in grade Ⅰ,Ⅱ and Ⅲ patients (g/L:14.02 ± 8.70 vs.24.37 ± 6.54,19.79 ±12.48,19.15 ± 8.43,P＜0.05 or P＜0.01).There was no statistically significant difference among four groups in respect of serum ALB (F=0.454,P=0.722).The rate of giving EN in 24 hours in grade Ⅰ,Ⅱ,Ⅲ,Ⅳ patients was 95.4％,72.1％,52.0％ and 0,respectively (x2=8.310,P=0.016),and in 48 hours it was 100.0％,83.0％,76.0％,and 0 (x2=5.470,P=0.025).7-day standard EN intake rate was 100.0％,88.7％,84.0％ and 34.0％ respectively in grade Ⅰ,Ⅱ,Ⅲ,Ⅳ patients (x2 =0.720,P=0.017).Correlation analysis showed that there was a negative correlation between AGI classification and rate of giving EN in 1 day (r=-0.62,P=0.04) and 7-day standard EN intake rate (r=-0.76,P=0.02).Conclusions AGI classification can be used to estimate the gastrointestinal function of patients with critical illness,and it has a significant correlation with early EN support.An early goal achieving intervention based on the AGI classification can improve the nutritional status and the general state of the patients.

Objective To search specific biomarkers of pathogenic bacteria in patients with sepsis so as to guide early using rationally antibiotic treatment.Methods Prospective survey of 147 patients with sepsis in ICU was carried out from Jan 2012 to Mar 2015.When patients blood culture was positive, clinical data including age, gender, vital signs, blood and, urine routine examination, DIC, blood biochemistry, c-reactive protein (CRP), procalcitonin (PCT), microbial detection, etc were recorded.Cultured blood samples were from central venous catheter and peripheral vessel.ELISA method was employed to detect soluble toll-like receptor 2 ( sTLR2 ) and interleukin-8 ( IL-8 ) , and the Acute Physiology and Chronic Health Evaluation Ⅱ( APACHEⅡ score ) was calculated.The chi-square test and analysis of variance were performed where necessary.Receiver operating characteristic ( ROC ) curves were used to calculate cut-points ( CP ) and area under the curve ( AUC) .Results According to the results of blood culture, patients were divided into three groups:GP group [ gram-positive bacteria ( G+) group];GN group [ gram-negative bacteria ( G-) group];FG group ( fungi group) .There were no significantly statistical differences in age, APACHEⅡ score, vital signs and markers of inflammation among three groups (P>0.05).Gram negative pathogenic bacterium was the most common microbe.Compared with GN group, the level of sTLR2 in the GP group was obviously higher ( P=0.000); but there was no significant difference in sTLR2 level between GP group and FG group (P=0.187). The amount of (1, 3) -beta glucan in the FG group was significantly higher than that in the GP group ( P=0.000).The sTLR2 level in FG group was obviously higher than that in the GN group (P=0.000).There were no significantly statistical differences in PCT, CRP and IL-8 among the three groups (P>0.05).For the diagnosis of gram negative bacteria infection, sTLR2 area under the curve was 0.768, and the sensitivity and specificity were 88.90%and 59.60%, respectively and the best cut-off point was 8.083 pg/mL.Namely, the diagnosis of gram negative bacteria infection was less likely, when level of sTLR2 was higher than 8.083 pg/mL.The markers of PCT, CRP, (1, 3) -beta glucan and IL-8 were less valuable for the diagnosis of Gram negative bacteria infection because the area under the curve was less than 0.5.Conclusions The combination of inflammatory indicators such as sTLR2 and (1, 3) -beta glucan etc, can imply the kind of pathogenic microorganisms partly.