Objective To evaluate the heart function of patients who had diastolic dysfunction.Using heart failure echocardiography index(HFEI),which synthesizes the multinomial parameter of echocardiography.The aim is to provide an impersonal,comprehensive and numerable criterion for appraising chronic congestive heart failure.Methods Totally 75 patients with diastolic dysfunction and 37 normal controls were involved in the study.All the subjects were graded by heart failure echocardiography index(HFEI)which was put forward by our hospital and the multinomial parameter of echocardiography was synthesized.At the same time,the scores of heart failure echocardiography index(HFEI)were compared with the outcomes of contemporaneous BNP and the NYHA class.Results The scores of heart failure echocardiography index(HFEI)in diastolic dysfunction group were higher than those in control group(P

Objective To evaluate the expression of Gankyrin in gastric carcinoma and preancerious lesions (including chronic atrophic gastritis and gastric epithelial dysplasia)and its clinicopathological significance.Methods Immunohistochemical assay was performed to de-tect the Gankyrin expression in 30 casess of normal gastric mucosa,60 cases of chronic atrophic gastritis,30 cases of gastric epithelial dyspla-sia,and 84 cases of gastric carcinoma.Moreover,the relationship between Gankyrin expression and clinicopathological features of gastric car-cionma was analyzed.Results Gankyrin expression was detected in normal gastric mucosa,chronic atrophic gastritis,gastric epithelial dys-plasia,and gastric carcinoma tissues in varying degrees,and the difference of Gankyrin positive rates was significant in different gastric leions mentioned above (P <0.05).The rate of Gankyrin expression in gastric carcinoma was significantly related with the clinical stage and metas-tasis.There’s no relationship between Gankyrin expression and the age,gender of patients,size,histologic grade of gastric carcinoma.Con-clusion Gankyrin participates in both the carcinogenesis and development of gastric carcinoma.Moreover,Gankyrin is a potential target for the diagnosis,prevention and treatment of gastric carcinoma.

Objective To explore the prenatal sonographic diagnosis of congenital vascular rings.Methods Eight fetuses with congenital vascular rings diagnosed in Affiliated Hospital of Weifang Medical College from January 9,2010 to November 25,2012 were retrospectively analyzed.All cases underwent threevessel trachea view to observe the position of aortic arch,its branches and the ductus arteriosus.The sonographic features were summarized.Results The eight cases were diagnosed at 22 to 28 gestional weeks,with an average of (25±2) weeks.They were 21 to 35 years old,with an average of (28±5) years.Seven cases were diagnosed by cardiac ultrasonography,and one induction case was diagnosed by autopsy.Among the eight cases,there were seven of right aortic arch with vagus left subclavian artery and left ductus arteriosus,and one case was complicated with double aortic arch.The former seven cases showed U-shape vascular ring surrounding the trachea composed of right aortic arch,vagus left subclavian artery and left ductus arteriosus.The other side of this U-shape was the heart structure,showing a complete vascular ring.In the latter one case,the O-shape vascular ring was composed of left and right sides of the aortic arch.Conclusion The U-shape,or O-shape vascular ring in three-vessel trachea view is the typical sonographic features of congenital vascular ring.Cardiac ultrasound examination should be performed on those suspected cases.

Objective To invesigate the reproducibility of automated breast volume scanner ( ABVS) in detection of breast lesions . Methods Thirty‐five patients with breast lesions diagnosed by conventional hand‐hold ultrasound were involved in the study . Every patient underwent ABVS twice by two different doctors . The number ,location and size of findings were documented and analyzed . Intra‐class correlation coefficients were used to evaluate the reproducibility . Results The number of findings was 67 and 68 respectively ,and the cronbach′s ɑwas 0 .997 . The ɑ of distance from nipple ,distance from skin ,and clock face location were 0 .343 ,0 .883 ,and 0 .949 . The ɑ of length superior‐inferior ,medial‐lateral ,and anterior‐posterior were 0 .938 ,0 .936 ,and 0 .948 . Conclusions The reproducibility of ABVS in detection of breast lesions is perfectly high . ABVS may be a good modality in monitoring benign lesions and evaluating neoadjuvant chemotherapy in the future .

Background Clinical study showed that FP-7/FP-8 Ahmed glaucoma valve implantation is effective and safe for the adult refractory glaucoma.However,it is welt-known that childhood glaucomatous eyes have different pathogenesis and protean clinical manifestations.So the efficacy of FP-7/FP-8 Ahmed glaucoma valve implantation in child deserves some attention.Objective This study was to retrospectively evaluate the efficacy and safety of FP-7/FP-8 Ahmed glaucoma valve implantation for refractory glaucoma in children.Methods The clinical data of 30 eyes of 26 children with refractory glaucoma who undergone FP-7/FP-8 Ahmed glaucoma valve implantation in the Center Hospital of Cangzhou from October 2008 to April 2011 were retrospectively analyzed.The age of patients was 4 months to 16.5 years.The patients included ocular hypertension after trabculectomy/goniotomy for cogenital glaucoma,later stage of cogenital glaucoma,aphakic or pseudophakic glaucoma,traumatic glaucoma and Sturge-Weber syndrome.The follow-up ranged from 1 week to 24 months to obverse the changes of intraocular pressure (IOP),postoperative complications and cumulative success rate.Results The mean IOP was significantly different among various time points (F=58.929,P＜0.05).The IOP was (36.93± 10.56) mmHg in preoperation and (13.13± 3.34),(14.13±3.15),(15.93±4.76),(17.96±5.37),(19.74±5.43) mmHg 1 week,1 month,6 months,12 months,24 months following surgery,showing significant reduce after operation.Compared with preoperative IOP,the IOP of 1 week,1 month,6,12,24 months after AGI was significant decreased,with significant differences between them (t =11.641,11.458,10.688,7.988,8.018,all at P ＜ 0.05).The total cumulative success rate after Ahmed glaucoma valve implant was 100％,96.67％,93.21％,85.76％ and 71.46％ 1 week,1 month,6 months,12 months,24 months after surgery.The postoperative complications occurred in 8 eyes,including shallow anterior chamber,drainage tube obstruction,hyphema of anterior chamber and valve exposure,and these were cured by medicine and surgery.No serious complication appeared in all patients after operation.Conclusions FP-7/FP-8 Ahmed glaucoma valve implantation is an effective and safe method for the treatment of refractory glaucoma,and it can be considered as one of the first choices for management of refractory glaucoma in childhood.

Objective: To study the mechanism of baicalin in inhibiting Mycobacterium tuberculosis（MTB）and to provide reference for drug-resistant tuberculosis treatment. Methods: Forty male Kunming mice were injected isoniazid-resistant MTB into their tail veins to build models of infection. They were evenly divided into MTB group,isophosiazone group,NF-κB inhibition group and baicalicin group according to treatment. The lung tissue and peripheral blood of the mice were collected on the 8th day after modeling. The morphological changes of the lungs were observed by HE staining. The number of MTB in lung tissue was detected by acid-fast staining and quantitative PCR. The number of macrophagein lung tissue was detected by immunohistochemistry. The expression of NF-κB and TLR4 in monocytes/macrophages were detected by flow cytometry. Results: The average weight of mice in the baicalicin group was significantly higher than that in the MTB group,the isophosiazone group and the NF-κBinhibition group（P<0.05）. The average fluorescence intensity of NF-κB and TLR4 in monocytes/macrophages in the baicalicin group were 448.21±30.61 and 401.01±34.58,which were significantly higher than those in the MTB group and the isophosiazone group（P<0.05）. Typical tuberculous chronic granulomatous lesions were observed in the MTB group,isophosiazone group and NF-κB inhibition group,except the baicalin group. The mean number of MTB and CD68+ macrophagesin lung tissue of mice in the baicalin group were significantly less than that in the MTB group,the isophosiazone group and the NF-κB inhibition group（P<0.05）. Conclusion Baicalin achieves an anti-tuberculosis effect by regulating the expression of NF-κB and TLR4 in macrophages,which can be weakened by adding NF-κB inhibitor.

Objective To investigate the molecular epidemiology and antimicrobial resistance status of uropathogenic Escherichia coli (UPEC) in senior population in Putuo District ,Shanghai .Methods A total of 72 UPEC strains were isolated from elderly inpatients with urinary tract infections in Putuo Hospital ,Shanghai University of Traditional Chinese Medicine from January 2013 to March 2015 .The strains were characterized by multi‐locus sequence typing (MLST ) .The β‐lactamase gene and the plasmid mediated quinolone resistance (PMQR) gene were detected ,and the mutations of quinolone resistance‐determining regions (QRDR) in gyrA and parC genes were demonstrated .In vitro drug susceptibility test was performed .Continuous variables were compared using t test and categorical variables were compared using chi‐squared test or Fisher exact test .Results The UPEC strains showed different resistance rates to ciprofloxacin ,cefotaxime and trimethoprim‐sulfamethoxazole ,which were 76 .4% ,73 .6% and 65 .3% , respectively .UPEC still remained highly sensitive to imipenem ,meropenem ,amikacin and piperacillin‐tazobactam .Among 72 isolates ,55 (76 .4% ) of 49 (68 .1% ) extended‐spectrum β‐lactamase (ESBL )‐positive strains harbored blaCTX‐M genes .Among the 55 ciprofloxacin resistant strains ,51 (92 .7% ) had three or four mutations in QRDR of gyrA and parC genes .The “hot‐spot” mutations of QRDR were located at amino acid position 83 and 87 in gyrA gene and at positions 80 and 84 in parC gene .Forward analysis by MLST showed that the most frequent sequence types (ST ) were ST131 (18/72 ,25 .0% ) , ST1193(7/72 ,9 .7% ) ,ST405 (7/72 ,9 .7% ) ,ST38 (5/72 ,6 .9% ) and ST648 (3/72 ,4 .2% ) .ST131 isolates were predominant in ST which caused community‐onset urinary tract infections .Multiple drug‐resistance were detected in ST 131 ,ST405 ,ST38 and ST648 which were mainly producing blaCTX‐M ESBL .Conclusions Community‐acquired multiple drug‐resistant UPEC strains such as ST131 clone are prevalent in elderly patients .Thus ,monitoring of molecular epidemiology would be beneficial to prevent the prevalence of multiple drug‐resistant UPEC .

Abstract: Large-scale clinical trial is an important measure of clinical evaluation on drugs. This paper introduces the concept and features of large-scale clinical trial, the possibility and necessity of large-scale clinical trial of traditional Chinese medicine, as well as its administration and quality control, with Myocardial Infarction Secondary Prevention Study in Traditional Chinese Medicine (MISPS-TCM), a National Program Subject, as an example.

Case recruitment of large-scale clinical trials should be strictly checked in quality and quantity for it is the key to clinical trial. This study discusses the main difficulties and countermeasures in the case recruitment of large sample, multi-center clinical trials according to the national research project "Myocardial Infarction Secondary Prevention Study in Traditional Chinese Medicine".

Background Traditional Chinese medicine (TCM), especially herbal medicine, has been widely used in China and now is also being increasingly used in other countries for the treatment of cardiovascular diseases. Although many studies have demonstrated that certain Chinese herbal products are effective and safe for the treatment of cardiovascular diseases, most of these lack sufficient quality. Therefore, large randomized clinical trials and further scientific research to determine its safety, effectiveness are necessary.QiShen YiQi Dripping Pills (QSYQDP) is a herbal preparation clinically used in the treatment and prevention of coronary artery disease. Preliminary observations have shown its safety and effectiveness. Methods/Design This randomized, controlled trial will recruit 3600 patients with a history of myocardial infarction. Patients will be randomized into two groups by a Centr-Randomized System. One group receives QSYQDP, the other group receive aspirin. This trial protocol will describe eligibility criteria, detailed information on the treatment definition, blinding, endpoints, statistical methods, sample size determination, data management, legal aspects, and the current status of the trial. Discussion This trial is one of the first randomized, controlled clinical trial to evaluate the efficacy and safety of traditional Chinese herbal medicine in the treatment and secondary prevention of coronary artery disease. The results of this study should help to define the role of TCM in modern medical care, as well as to provide the management strategy for CAD patients in China and other countries.