Objective To investigate the efficiency and safety of stent implantation for severe pulmonary vein stenosis after radiofrequency ablation (RFA)of atrial fibrillation.Methods The clinical date of 231 cases with atrial fibrillation received RFA treatment were analyzed retrospectively.Eight cases were confirmed with severe pulmonary vein stenosis after RFA by CTA.The stents were implanted after angiography.Results All the 1 9 serious pulmonary vein stenosis from the 8 patients were treated stent implantation.The degree of pulmonary vein stenosis,trans-stenotic gradient,mean pulmonary pressure and the level of BNP were significantly decreased after treatment (P <0.01).The minimal diameter of the stenosis was significantly increased compared with preoperative (P <0.01).Six months after stenting,2 patients in 4 pulmonary veins were stenosis.The stenosis was successfully di-lated by repeated interventions with balloon dilation.There was no stenosis appeared in the patients after the repeated interventions with balloon dilation for 3 months.Conclusion Stenting implantation was a feasible and safety method for severe pulmonary vein stenosis after RFA.

Objective To Study on regularity of iron deficient anemia(IDA) in gravida, provide preventive methods and improve hygienic quality.Methods IDA incidence rate of 12W～19W, 20W～27W, 28W～35W, 36W～pregnant duration were anlyzed in 521 gravida.Results The incidence of IDA in gravida was 16 87% and increased with the development of pregnancy.After 20 weeks of pregnancy,the incidence of IDA markedly increased accompanied with by the decreased Fe, SF and TS, especially during the 28～35 weeks of pregnancy, which reached the peak with the anenia incidence of 26 37%,and 80 50% of cases was irom deficient symptom,it suggesting iron deficiency in this stage and Fe, SF, TS decreased to the lowest level and the stored iron was almost exhausted and ZPP increased.Conclusions After 12 weeks of pregnancy,gravida should be supplemented with iron agent. It's also suggested that those gravida with gestational age older than 28 weeks with the Hb levels of less than 105g/L should be considered as IDA and should be treated with iron supplement. [

Verification of scientific literature novelty assessment is the final step in writing the literature novelty assessment report and is closely related with its academic level.The key points in verifying novelty assessment of medical literature were thus analyzed with examples in this paper, including the scientific and technical points, literature novelty assessment points, retrieval terms, retrieval strategies, and conclusion of literature novelty assessment.

Objective To analyse effects of high dietary fiber intervention on gestational diabetes mellitus(GDM ) .Methods 148 GDM hospitalized patients were selected as the research objects and they were divided into two groups randomly .72 patients in the control group controlled their diets by themselves ,while the 76 patients in the treatment group accepted the high dietary fiber inter-vention from the nutritionists based on their different conditions .The fasting plasma glucose(FPG) ,2-hour postprandial blood glu-cose(2hPG) ,hemoglobin A1c(HbA1c) ,triglyceride(TG)and total cholesterol(TC)were recorded in dietary therapy and the out-comes of pregnancy were followed up .Results Under diet control for 12 weeks ,The levels of FPG ,2hPG ,HbA1c ,TG and TC of twe groups reduced obviously(P<0 .05) .The effects of the treatment group was better than the control group(P<0 .05) .The av-erage weight of the patients′infants in the control group was(3 .82 ± 0 .72)kg ,while that in the treatment group was(3 .22 ± 0 .63) kg ,and the difference had statistical significance(P<0 .01) .Also ,the probability of the infant and mom complications in treatment group was obviously lower than that in the control group(P<0 .01) .Conclusion High dietary fiber intervention has great curative effects on patients with GDM ,and the reasonable dietary therapy can reduce the probability of complications .

Objective To report two cases of Candida parapsilosis-caused candidiasis characterized by verrucous nodules and masses,and to assess their clinical features,diagnosis and treatment.Methods A medical history including medication history and therapeutic response was carefully collected from two male patients.Physical examination was carried out with a focus on skin lesions.Diagnosis was made according to medical history as well as physical,mycological and histopathological examination findings.Antifungal agents were given at a high enough dose in time.After lesions improved,the doses of antifungal agents were tapered gradually,and drugs were withdrawn until patients completely healed.Compound preparations containing both antifungal agents and glucocorticoids were also topically applied in the early period of treatment.Results Both patients were diagnosed as Candida parapsilosis-caused candidiasis characterized by verrucous nodules and masses,and cured after 100-day supporting treatment and antifungal treatment with oral itraconazole,etc.Conclusions Candida parapsilosis-caused candidiasis should be managed with combination therapy mainly including antifungal agents.To achieve a satisfying efficacy,antifungal agents should be given early at a high enough dose for a long enough period.

Objective To compare cost-effectiveness between endoscopical esophageal variceal ligation (EVL) combined non-selective beta-receptor blocker strategies and covered-stents transjugular intrahepatic portosystemic shunt (cTIPS) in preventing esophageal variceal rebleeding in liver cirrhosis with portal hypertension.And to explore the threshold of cost-effectiveness in stents in China.Methods According to clinical practice and associated guidelines,a six state Markov-based decision analytic model was established with TreeAge Pro Suite 2014 to compare the cost-effectiveness between two interfering strategies after followed up for seven years.The parameters such as costs,life years (LY),quality-adjusted life-years (QALY) and incremental costeffectiveness ratio (ICER) were directed.Results The results of baseline research in the seven-year follow-up period indicated that the cost of endoscopical EVL combined non-selective beta-receptor blocker B was 7 444.25 United States dollar (USD)/each,and yielded 1.98 QALY.The expected cost of cTIPS was 13 151.69 USD/ each and could have 2.34 QALY.In the 7th year,ICER was 16 001.74 USD.Based on willingness-to-pay (WTP) threshold of China (19 887.00 USD),cTIPS had better cost-effectiveness than endoscopical EVL combined non-selective beta-receptor blocker B.The price of covered stents less than 5 401.52 USD had cost-effectiveness.The results of single factor sensitivity analysis indicated that rebleeding probability of endoscopical EVL combined non-selective beta-receptor blocker B group was the most influential factor in the result of model.The second important factor was the cost of cTIPS.The probabilistic sensitivity analysis reported cTIPS to be the optimal strategy at WTP of 19 887.00 USD in 83％ of the iterations.Conclusions Seven-year follow-up indicates that cTIPS may be a more cost-effective strategy than endoscopical EVL combined non-selective beta-receptor blocker B in preventing esophageal variceal rebleeding.The price of covered stents less than 5 401.52 USD which have cost-effectiveness in China.

Objective Discussing the correlation between joint detection of procalcitonin(PCT) ,hypersensitive c‐reactive protein (hs‐CRP) ,WBC and bronchopneumonia in children .Methods Choosing 89 bacterial infection bronchopneumonia children ,92 virus infection bronchopneumonia children ,90 mycoplasma infection bronchopneumonia children and 100 normal children ,detecting their PCT ,hs‐CRP ,WBC and statistical analysis of the level of parallelism .Results There is a positive correlation between bacterial in‐fection group′s PCT and hs‐CRP ,WBC(r=0 .807 ,0 .764 ,P<0 .05) .The joint detection of PCT ,hs‐CRP ,WBC positive rate in bac‐terial infection group is significantly higher than the rest group(P<0 .05) .Conclusion PCT ,hs‐CRP and WBC is a sensitive indica‐tor of bacterial infection .There is important clinical reference value in joint detection to the diagnosis of bacterial infection broncho‐pneumonia in children ,in dynamic monitoring the disease progression ,and in prognosis judgement .

Objective To observe the changes of serum lipids ,hs‐CRP ,MFG‐E8 and Klotho gene levels after rosuvatatin treatment in elderly patients with coronary heart disease complicating hyperlipidemia for investigating the action mechanisms of ro‐suvatatin and its application value .Methods Totally 129 elderly patients with coronary artery disease complicating hyperlipidemia in our hospital were randomly divided into two groups .The control group received only conventional treatment ,while on this basis the rosuvatatin group was given rosuvastatin 10 mg everyday ,with 2 months as a treatment cycle .Blood lipids ,hs‐CRP ,MFG‐E8 and Klotho gene levels before and after treatment were compared between the two groups .The regulation effect of rosuvatatin was investigated Results The blood lipod ,hs‐CRP ,MFG‐E8 and Klotho before treatment had no obvious difference between the two groups .The levels of TC ,LDL‐C and TG after treatment in the rosuvatatin group were significantly decreased compared with the control group ,while the HDL‐C level was significantly increased ,the differences were statistically significant (P<0 .05) .In addi‐tion ,the hs‐CRP level after treatment in the rosuvatatin group was significantly lower than that in the control group (P<0 .05) . Compared with the control group ,the levels of MFG‐E8 and Klotho after treatment in the rosuvatatin group were increased ,the difference was statistically significant (P<0 .05) .Conclusion Rosuvastatin could decrease the blood lipid and hs‐CRP levels ,up‐regulates the MFG‐E8 and Klotho levels ,alleviates the inflammatory reaction and has the anti‐vascular aging effect ,thus effectively treats the patients with coronary heart disease complicating hyperlipidemia .

Objective To investigate the efficacy and safety of recombinant human Pro urokinase ( rhPro-uk) in treatment of patients with acute ST segment elevation myocardial infarction.Methods 90 cases from 2014 to 2015 selected in three hospital diagnosed with STEMI were randomly assigned into experimental group and control group, 45 cases in each test group.Experimental group received rhPro-uk thrombolytic therapy, control group received urokinase thrombolytic therapy, thrombolytic efficacy and incidence of adverse events were observed and compared between two goups.Results After thrombolysis 2 h, ST segment decline ≥50% of patients in experimental group was 80.00%, ST segment completely fall rate was 55.56%, coronary recanalization rate was 77.78%, all significantly higher than that in control group(60.00%, 33.33%, 55.56 %,separately.P<0.05).After thrombolysis 2h, the difference of TIMI grade between two group was significant (Z=-3.198, P<0.05).After thrombolytic therapy, CTn-I, CK-MB peak levels between two groups were not significantly different.The peak time and average time of experimental group were significantly lower than that in control group (P<0.05).The incidence of adverse events of experimental group 13.33%, significantly lower than 33.33% in control group(P <0.05).Conclusion Therapeutic effect of rhPro-uk on acute ST-segment elevation myocardial infarction is better than urokinase, and has higher safety.

Objective To investigate the distribution characteristic and drug resistance of respiratory tract pathogens in ICU eld‐erly patients to provide the basis for clinical medication and control of nosocomial infection .Methods The isolation situation and drug resistance of pathogens in ICU elderly patients with respiratory tract infection from January 2012 to December 2014 were ret‐rospectively analyzed .Results Among 501 cases of respiratory tract infection ,350 cases were Gram‐negative bacilli infection ,which were mainly P .aeruginosa and A .baumannii;50 cases were Gram‐positive coccus infection ,which was mainly S .aureus ;101 cases were complicating fungal infection ,which was mainly C .albicans .The resistance of P .aeruginosa to imipenem showed upward trend (P<0 .05) ,A .baumannii had higher resistance to commonly used antimicrobial drugs ,but the drug resistance trend had no obvious change(P>0 .05) .Imipenem‐resistant A .bauman(IRAB) ,ESBLs‐producing E .coli and methicillin‐resistant S .aureus (MRSA) in the elderly patients with respiratory tract infection all exceeded 50% of each constitution ratio .Conclusion Multi‐drug resistant bacteria are usually isolated from ICU elderly patients ,their drug resistance rates maintain a higher level .Therefore clinicians should rationally select antibacterial drugs by combining with the laboratory reports ,increase the prevention and management of multi‐drug resistant bacteria and reduce the nosocomial infection occurrence .