Objective To investigate relation between atrial enlargement and pathogenesis of atrial tach yarrhythmia.Methods 786 patients were observed with atrial tachyarrhythmia through 24-hour electrocardiographic monitoring,echocardiographic was used to analysis atrial enlargement.Results The patient with left atrial enlargement in atrial tachyarrhythmia was more than those with right atrial enlargement(73.82%vs 21.25%,P＜0,01).Conclusions Atrial enlargement,especially left atrial enlargement,was the one of most important pathogeny in atrial tachyarrhythmia.The enhancement of pressure and muscle tension in atrial were the major factors of electronicphysiobgy disorganization,and the left atrial was the leading position in patients with electronicphysiology abnormity.

Objective To evaluate the clinical effect of Shuxuetong plus external application of deproteinised calf blood serum injection on diabetic ulcer foot.Methods 60 patients with diabetic foot ulcer were enrolled:30 cases (treatment group)were randomly assigned to receive deproteinised calf blood serum injection(external use)plus Shuxuetong(iv gtt),and the other 30 cases (control group)received routine western medicine therapy.One course of treatment lasted one month.In addition,both two groups received insulin to control blood sugar and antibiotics to control infection,with foot ulcer treated with debridement,drainage,and removal of necrotic tissue etc.Results Com-pared with the control group,the effective rate was higher in the treatment group(86.7% vs.60.0%,χ2 =5.455,P =0.020).The occurrence time of granulation tissue[(6.60 ±1.14)d vs.(10.80 ±2.17)d,t =-3.834,P =0.008] and wound healing time[(23.62 ±6.14)d vs.(35.65 ±4.45)d,t =-4.405,P =0.002]were shorter in the treat-ment group.The wound area in the two groups reduced after treatment,and the wound area in the treatment group reduced significantly[(3.48 ±1.16)cm2 vs.(8.60 ±2.51)cm2 ,t =-4.143,P =0.007].Conclusion As com-pared with the routine therapy with western medicine,the combination therapy of deproteinised calf blood serum injec-tion plus Shuxuetong has better efficacy for diabetic ulcer foot.

Objective To discuss the relationship between part of risk factors and the characters of coronary artery lesion of different gender patients with coronary heart disease(CHD). Methods Two hundred and eight patients who were diagnosed CHD by coronary angiography (CAG) were selected. All patients were divided into male group (122 cases) and female group (86 cases). The characters of CHD and part of clinical data in different gender CHD patients were compared and analyzed. The independent risk factors of different gender CHD patients were analyzed. Results The age of onset in female group was later than male group:(69.22±10.12) years vs.(62.80±11.34) years, P=0.000. The incidence rate of hypertension and diabetes in female group were significantly higher than those in male group: 83.7%(72/86) vs. 63.1%(77/122), 53.5%(46/86) vs. 32.8%(40/122);and the levels of total cholesterol(TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) in female group were significantly higher than those in male group:(5.16±1.26) mmol/L vs. (4.60±1.23) mmol/L,(1.16±0.27) mmol/L vs. (1.05±0.27) mmol/L, (3.17±1.16) mmol/L vs. (2.74±1.06) mmol/L;the level of uric acid (UA) in female group was significantly lower than that in male group: (319.83±90.05)μmol/L vs. (357.91±98.51)μmol/L, there were significantly differences(P<0.01). The level of trigalloyl glycerol (TG) in two groups had no significant difference: (1.91 ± 1.23) mmol/L vs. (1.75±0.97) mmol/L, P=0.298. Logistic regression analysis showed that age and diabetes were the risk factors of CHD in different gender (P<0.01 or <0.05). Conclusions There are different risk factors between different gender CHD patients, while the coronary artery lesion is similar. Diabetes is the most important independent risk factor of different gender CHD patients, which is more important for female patients with more risk factors.

Objective To assess the clinical effect of safflower yellow combined with kallidinogenase on ear-ly diabetic nephropathy.Methods 80 early diabetic nephropathy patients were all given diet control, appropriate exerciseand positive controlled blood sugar,blood fat,blood pressure.They were randomly divided into two groups,the control group was intramuscularly given kallidinogenase 40U dissolved in sodium chloride,once daily.Based on this, the treatment group added safflower yellow 100mg into 5%glucose injection 250mL and 3 unit insulin by intravenous drip.The period of treatment was three weeks.24h urinary micro-albumin(U-ALB) and urinary albumin excretion rate( UAER) before and after treatment between the two groups were surveyed.Results Before treatment,24 h U-ALB and UAER of the control group were (100.44 ±65.72) mg/L,(117.31 ±68.32)μg/min,which of the treatment group were (123.57 ±63.28) mg/L,(138.57 ±50.82)μg/min.There were no significant differences between the two groups(t=1.098,1.056,all P>0.05).After treatment,24h U -ALB and UAER of the control group were (79.39 ±65.33)mg/L,(92.68 ±67.95)μg/min,which in the treatment group were (71.87 ±60.03)mg/L,(62.52 ± 38.64)μg/min.Statistical differences of 24h U-ALB and UAER were observed in the two groups compared with before treatment(the control group:t=5.903,6.069,the treatment group:t=6.779,12.612,all P<0.05).After treatment, there was no significant difference in 24h U-ALB between the two groups(t=-0.386,P>0.05),while UAER in the treatment group was lower than the control group(t=-2.029,P<0.05).Conclusion Safflower yellow com-bined with kallidinogenase can reduce UAER in early diabetic nephropathy,and what's more,can put off its progress.

Objective To analyze the pathogenic characteristics of Chlamydia,Mycoplsma,Neisseria gonorrhoeae,Trichomonas,Candida and Herpes simplex virus in patients with urogenital infections and study the relevant influential factors.Methods Genital secretions of the patients who were suspicious of non gonococcal urethritis(NGU)were collected as samples to detect and cultivated Chlamydia trachomatis(Ct),Ureaplasma urealyticum(Uu),Mhominis(Mh),Neisseria gonorrhoeae(Ng),Candida(Cd),Trichomonies and the type 2 Herpes virus.At the same time,surveys with structured questionnaire were conducted.Results In the 977 detected patients,the rate of positive expression of Ct was 33.67%(329/977),Uu-16.1%(156/977),Mh-7.36%(72/977),N-2.56%(25/977),Cd-4.7%(46/977),Tv-2.87%(28/977),and HBS-2-0.72%(7/977).The rate of co-infections of two or more pathogens(mainly between Ct,Uu,Ng ang Cd)was 10.03(98/977).About 25.85% of the patients in the positive Ct and Uu group were infected without symptom.90% of NGU patients were sex active,aged 18～49 years and most of infections occurred in age group of 30～39 years.Positive rate of Ct,Uu and Cd was higher in females than in males.The infection rate due to ex-marital sexual contact was 65.30% among all the NGU patients.Conclusions(1)The Ct,Uu,Ng and Cd have a higher positive detection rate in the NGU patients in the STD clinic.(2)Co-infection with two or more pathogens are common in the NGU patients.(3)We should pay more attention to the patients with no symptoms.(4)Epidemics and transmission of NGU is largely related with a number of risk factors.

Objective To investigate the diagnostic value of treadmill exercise tests (TET), Hoher electro-cardiogram in coronary artery disease(CAD) patients. Methods 144 patients who clinically diagnosed as CAD,un-derwent TET and Hoher electrocardiogram. Then the patients with the positive results were examined by coronary arte-riography(CAG). According to the results of CAG the diagnostic value of TET and Hoher electrocardiogram was per-formed with comparative analysis. Results The sensitivity, specificity and evaluated accuracy rates of TET were 93.3% ,72. 2% and 73. 8% respectively. But the sensitivity,specificity and positive evaluated accuracy rates of Hol-ter electrocardiogram to examine myocardial iachemia were 76.7%, 88.4%, 57.1%. Conclusions The combined examination of TET and Holter electrocardiogram could preliminarily estimate the stenosis site of coronary artery. For the patients with unconditional GAG, those two examinations could increase the diagnostic reliability of positive rate of myocardial isehemia, and on this basis to enhance the diagnostic level of the stenosis site of coronary artery.

Objective Introducing the job embedded scale to explore the dropout intention of medical workers at tertiary hospitals.Methods Correlation analysis, analysis of variance and regression analysis were used to analyze with a job embedded scale, the dropout intention of medical workers of a Beijing hospital.Results There was a significant negative correlation between job embedding and dropout intention of such people(r=-0.223).The predictive ability of on-the-job embeddedness is better than off-the-job embeddedness.Fit-organizational, sacrifice-organizational, fit-community and sacrifice-community were significantly negatively correlated with dropout intention.There are differences in the relationship between job embedding and dropout intention of medical workers of different individual attributes.Conclusion Job embedded scale can effectively predict the dropout intention of medical workers, offering a usable tool to predict the dropout of these people.

Objective To analyze the risk factors and early prognosis factors of cerebral venous sinus thrombosis (CVST). Methods 68 patients with CVST were analyzed retrospectively. The patients were divided into early favorable prognosis group and early unfavorable prognosis group according to modified Rankin Scale (mRS). The clinical data and prognosis were analyzed by univariate analysis and multivariate logistic regression analysis. Results and Conclusion On discharge, there were 37(54.4%) cases and 31(45.6%) cases in the early favorable prognosis group and the early unfavorable prognosis group respectively. Univariate analysis showed that 8 factors, including pregnancy-associated factors, central nervous system infection, hyperhomocysteinemia, ocular symptoms, disturbance of consciousness, limb paralysis,secondary cerebral infarction and ventricular compression/midline shift/encephaledema were associated with the early prognosis.Multivariate logistic regression analysis showed that pregnancy-associated factors, central nervous system infection, hyperhomocysteinemia,disturbance of consciousness and ventricular compression/midline shift/encephaledema were the independent factors.

Background and purpose: Langerhans cell histiocytosis (LCH) is a rare complex reticulocndotheliai disease that often invades the head and neck. There in no consensus of treatment. Radiation is one of the treatment options for the localized lesions. Our aim in the study was to analyze the radiotherapeutic efficacy for LCH in the head and neck region. Methods: 8 patients with eosinophilic granuloma (EG) and 1 case with Hand-Schuller-Christian disease (HSC) were treated with radiotherapy in our hospital from July 2000 to May 2007. Their clinical data were retrospectively analyzed. Results: 5 cases of EG were treated with tumor partial excision and radiation, while the other 3 cases of EG were given radiation alone after biopsy. The HSC was administered with radiation and endocrine therapy. All the patients were followed up for 1.5-8 years. The response rate was 89%. Conclusion: Radiotherapy of LCH is an effective modality, but the optimal dose needs to be further studied.

Objective To study the feasibility of renal hypothermia achieved by retrograde icecold saline infusion with perfusion pump. Methods Twenty-one patients who received the open radical nephreetomy were divided into three groups,A group with ice-slush renal hypothermia,B group with gravitational retrograde ice-cold infusion,C group with retrograde ice-cold infusion by perfusion pump.After the kidney was dissected and the ureter was divided,the renal vasculars were clamped.The kidney was cooled by three methods respectively.The temperature of renal parenchyma was monitored for 15 min. Results Fifteen minutes later,the temperature of renal parenchyma of A group declined from 34.4℃ to 5.4℃,B group from 34.8℃ tO 23.8℃,C group from 35.1℃ to 22.3℃.Coneiusions Renal hypothermia can be achieved by retrograde cold saline infusion and the perfusion pump may accelerate the speed of cooling.