Beta blocker can be categorized by non-selective agents,selective agents and agents with vasodilatory effect.Beta blocker therapy represents a major advance in the treatment of heart failure patients.The mechanisms include up-regulation of beta receptor,reversing remodeling,improving contractile and diastolic function,antiarrhythmia and anti-ischemia.Evidences from randomized controlled clinical trials have supported its use in the treatment of patients with heart failure to decrease mortality and improve life quality.Guidelines with various versions recommend that ?-blockers are indicated for patients with symptomatic or asymptomatic heart failure and a depressed ejection fraction of lower than 40%.There is something to be noticed for rational use of ?-blockers such as timing,dosage,duration and contraindications.

Objective To explore the cognition processes of language in stroke patients by characterizing the differences between the event-related potentials (ERPs) N400 evoked bypicture-word andsentence-wordparadigms.Methods Twenty patients with a single brain lesion resulting from a first episode of stroke were tested along with 20 normal controls.Their N400 ERPs were tested using pictures and sentences as activating stimuli and phrases composed of nouns and verbs as the target stimuli.The N400 potentials were recorded from electrodes located at Fz,Pz,T3 and T4 positions of the International 10-20 system.The N400 latencies and amplitudes and the behavioral responses of the experimental and control groups were compared.Results The latencies were longer and the amplitudes were lower in response to sentence activation than to picture activation.The differences in terms of amplitude were the greatest with N400 recorded from Pz.The responses to the target stimuli were not significantly different with regard to the types of stimuli and recording location.The average response time was longer and the error rate was higher in response to sentence activation than to picture activation.Conclusion Multiple accesses,activating stimuli and integrating processes are involved in language cognition.The brain is more sensitive and accurate in response to picture stimuli in language cognition.The response to sentence stimuli is slower,and the error rate is higher.This suggests that it is better to usc varied prime stimuli in teaching children languages.

Adolescent ; Adult ; Female ; Hemorrhoids ; complications ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; physiopathology ; therapy ; Urinary Retention ; etiology ; physiopathology ; therapy ; Urination ; Young Adult

Adult ; Bone Neoplasms ; pathology ; surgery ; Femur Neck ; pathology ; Humans ; Male ; Osteochondroma ; pathology ; surgery

N400 as one of endogenic components in event-related potentials,which reflected the cognitive process of language in brain,has been more and more widely concerned.This article reviewed the discovery,the characteristics,the origins and the elicited methods of N400,summarized the investigations and point at issue on the cognitive process of language over the past several years,and explored the application foreground of N400 in the field of language cognition.

Objective:TO provide theoretic evidence for Chinese rehabilitation training to study the characteristics of right hemisphere in recognizing Chinese and association between left and right cerebral hemispheres.Methods:102 cases up to the qualification,including 41 patients with right-hemisphere-lesion(RHL)、 31 patients with left-hemisphere-lesion(LHL) and 30 healthy individuals as control,were collected and tested with The Standardized Aphasia Battery in Chinese(ABC)、Writing-scopy of Chinese Character and Visual Spatial Structure-scopy.Results:14 aphasic patients,including 1 RHL and 13 LHLs,were found 11 of 72 patients had apparent reading disorder,including 7 LHLs with language reading disorder and 4 RHLs with neglect reading disorder;and 29 of 72 patients had apparent writing disorder,including 13 LHLs with language writing disorder and 16 RHLs among whom 9 cases had visual space writing disorder and 7 cases had language writing disorder;RHLs showed lighter listenning comprehension disorder than that of LHLs in the test.Conclusion:Right hemisphere is mainly involved in Chinese written language recognition and processing,and one of the most important reasons of reading and writing disorder is left side neglect、visual consciousness and spatial analysis dysfunction due to RHL.

Objective To analyze the clinical characteristics of digestive system dysfunctions after cardiovascular surgery with cardiopulmonary bypass (CPB). Methods The clinical data of 2349 consecutive cases undergoing cardiovascular surgery with CPB from Jan 1996 to Dec 2002 were retrospectively reviewed. The risk factors, clinical features, diagnostic methods, treatment and prognosis of digestive system dysfuctions were summarized. Results The incidence of digestive system dysfunctions was 1.4% (n=33), and the most common events were paralytic ileus (33.3%, n=11) and gastrointestinal bleeding (27.3%, n=9). Liver function insufficiency and ischemic bowel disease were the most common causes of deaths. 26(78.8%) patients underwent medicine treatment, 7(21.2%) patients accepted surgical interventions, and 5 patients (15.2%) died. Conclusion Digestive system dysfunctions following cardiovascular surgery were uncommon but had a high mortality. Advanced ages, history of gastrointestinal disease and perioperative hemodynamic unstability may be the clinical risk factors of digestive system dysfuctions. Early diagnosis and prompt treatment are essential for the outcome of the patients.

Objective: To seek the direct evidence of myocardial inflammatory activation in a cohort of patient undergoing surgery on cardiopulmonary bypass (CPB). Methods: Twenty patients undergoing surgery on CPB had plasma samples obtained for tumor necrosis factor-? (TNF-?), perioperatively. Myocardial tissue samples were obtained intraoperatively, both pre-and post-CPB. Myocardial nuclear factor ?B (NF-?B) nuclear translocation and plasma TNF-? concentrations were analyzed by standard enzyme-linked immunosorbent assay (ELISA). Cross clamp times, CPB times and the time to extubation were recorded. The change of myocardial NF-?B nuclear translocation and plasma TNF-? concentrations was assessed by analysis of variance (ANOVA). The regression analysis was utilized to define the correlations among the optical densities of NF-?B, concentrations of plasma TNF-?, influencing factors and heart function. Results: (1) Seventeen patients had NF-?B nuclear translocation before initiation of CPB, the optical density (OD) of myocardial NF-?B was significantly increased at the end of CPB in nineteen patients. (2) The correlation between the activity of NF-?B and concentration of TNF-? was signi ficant. (3) The correlation between the activity of NF-?B and clinic outcomes and other influencing factors was not significant. Conclusion: Myocardial inflammatory activation may be present in the patients before CPB. CPB could increase the activity of myocardial NF-?B.

Objective To investigate the expression of CD14, the receptor of lipopolysaccharide (LPS) on Kupffer cell membrane during the course of CCl4-induced liver injury and its role in activation of Kupffer cells. Methods The experimental rats were hypodermically administered CCl4 twice weekly for up to 8 weeks. Kupffer cells were isolated from the liver of normal and CCl4-treated rats by the combined ‘collagenase-pronase’ perfusion method and discontinuous density gradient centrifugation. On the following day after isolation, the cells were incubated with RPMI-1640 containing various doses of LPS for 6 h. The tumor necrosis factor (TNF-?) in the supernatants was measured by ELISA. The expression of CD14 mRNA on Kupffer cells was determined by RT-PCR. The plasma levels of endotoxin were determined by chromogenic substrate limulus amebocyte lysate assay. Results Baseline TNF-? production of Kupffer cells isolated from CCl4-treated rats in 4 and 6 weeks was significantly higher than that of controls (P

Objective To study the diagnostic value of high-sensitivity C-reactive protein (hs-CRP) and C-reactive protein (CRP) in patients with SARS.Methods The level of hs-CRP and CRP in patients with SARS,general bacterial pneumonia and the control are quantitatively detceted by automatically partielc enhanced immunoturbidimetric assay.Results The quantification level of -hs-CRP and CRP are 0 69?0 62mg/L and 4 4?0 9 mg/L in healthy control respectively,10 79?1 36 mg/L and 98 0?28 9 mg/L in bacterial pneumonia,3 16?3 72 mg/L and 11 0?9 6 mg/L in SARS.Conclusion The serum level of hs-CRP and CRP rese in patients with both SARS and bacterial pneumonia,especially in the latter,which is 2 4 and 7 9 times more than the former.This suggests that hs-CRP and CRP may be goog indicators to differentiate SARS with general bacterial pneumonia.