Objective:To explore a method for pericardiocentesis and drainage,the duration,posture of drainage and the fluid volume by drainage.Methods:Forty patients half lying on the bed,the puncture was performed via the subxiphoid route after the site,depth and direction of needle entry were confirmed by echocardiography.Using seldinger method,we put the central venous indwelling catheter into pericardial sac and connect it with an aseptic bag for drainage.Results:Catheter pericardiocentesis in 40 patients was successful without complications.Duration of use of the indwelling pericardial catheter ranged from one day to seven days,the average is 1.5?2 days.The fluid volume removed was one hundred and eighty to two thousands milliliters,mean volume is 750?600ml.After drainage,chest discomfort and short breath were alleviated obviously.Prominent jugular veins disappeared.Reductions of heart rate were significant.Cardiac function improved.Conclusion:Seldinger technique is a safe method for pericardiocentesis and drainage with the assistance of echocardiographic diagnosis and guidance.It can avoid myocardial trauma and drain the pericardial effusions effectively.

Objective:To compare the effects of simvastatin,xuezhikang and pravastatin in patients with primary hyperlipidemia.Methods:Sixty patients were randomly divided into three groups,simvastatin 20mg were taken once a day at night;provastatin 10mg were taken once a day at night;xuezhikang 0.6g were taken twice a day in the morning and at night.Blood samples were taken before and 4 weeks,8 weeks,12 weeks after the treatment.Results:In simvastatin group:the serum levels of total cholesterol(TC),low-density lipoprotein cholesterol(LDL C) decreased markedly at the end of 4 weeks compared with those of the baseline ( P 0.05).In xuezhikang group:after 4 weeks of treatment,TC,TG,LDL C reduced markedly( P 0.05).From the change rates,we can see after 8 weeks,12 weeks of treatment the level of LDL C drcreased more significantly in simvastatin group (40%,45%) than in xuezhikang (31%,36%) and provastatin (31%,35%) ( P 0.05).Conclusion:The clinical effects of simvastatin,xunzhikang,provastatin on primary hyperlipidemia were equal among the three groups,but the time is different about when they take great effects respectively.Next,LDL C lowering effect of simvastatin was significant.Finally,xuezhikang was the best in reducing TG among the three groups and it has a relatively good economic effectiveness.

Objective:To investigate the risk of heparin leading to upper gastrointestinal bleeding in elderly patients undergoing percutaneous coronary intervention(PCI).Methods:To compare characteristics of unfractionated heparin and low molecular weight heparin,the dosage and lab indexes.Results:The upper gastrointestinal bleeding is easy to happen in elderly patients with disease of digestive tract when using heparin in PCI.Conclusion:The patients before undergoing PCI,especially the elderly,need to have a general examination,make an overall assessment with care to digestive disease.Doctors should pay more attention to the heparin dosage and lab indexes in order to avoid serious complications.

Objective:To identify the influence of personality characteristics on adult patients' satisfaction after initial orthodontic treatment and offer references to rise quality of orthodontic treatment.Methods:85 patients(34 males and 51 females;average age 23.3years?4.4years who treated their teeth by fixed orthodontics were included in the study.Satisfaction questionnaire was used to assess the satisfaction with the dentition in the study sample.The NEO Five Factor inventory was used to assess personality profiles and traits in the study samples.Comparisons between groups were made by using Logarithm of likelihood ratio test.Results:This test provides a comprehensive assessment of personality according to the five major domains namely Neuroticism,Extroversion,Openness,Agreeableness and Conscientiousness.Satisfaction of higher neuroticism scores is relative low(P0.05).Conclusion:Different personality traits were found to be correlated with adult patients' satisfaction with their dentition during initial orthodontic treatment.The orthodontists should pay more attention to higher neuroticism scores adult patients during treatment.In according to strengthen the communication between the orthodontists and outpatients,the therapeutic effect of adult orthodontic treatment could be increased.

In the past 10 years, 118 cases with primary congestive cardiomyopathy of first admittance to this institution were treated.12 cases died in the course of hospitalization. Out of the 106 cases discharged after clinical recovery, 91 cases were followed up. In the follow-up period, 1 year survival rate was 85.25%, 2 year survival rate 67%, 5 year survival rate 43.7%, and 10 yaar survival rate 25.5%, as calculated with the life-span table method. The results suggest that the remote prognosis of this disease is poor. The factors influencing the prognosis of this disease were the age of the patient, the heart size, and the status of heart functions. Severe and complicated cardiac arrhythmias could worssen the outlook of the patient even though no heart failure occurred. Early and long term administration of vessel-dilatating agent such isoscorbide dinitrate can improve the prognosis but steroid therapy has no effect.

Objective:To study the optimal intensity of warfarin therapy for prevention of thromboembolism in elderly patients with nonvalvular atrial fibrillation and to determine the safe range of INR.Methods:Warfarin was used for anticoagulant therapy for thirty-seven patients with nonvalvular atrial fibrillation.The patients were followed up and INRs were measured regularly.Results:When the dosage of warfarin changed from 2.11 milligram to 2.41 milligram,the range of INR was between two and two point five (2.0～2.5).When the dosage changed from 2.41 milligram to 2.70 milligram,the INR was between two point five and three (2.5～3.0).No atrial fibrillation related thromboembolism and major hemorrhage occurred in all patients.It required different number of days to reach the safe INR limits by raising or lowering the dosage of warfarin in the patients.Conclusion:Warfarin is effective in preventing stroke in elderly patients with nonvalvular atrial fibrillation.The optimal intensity of warfarin ranges from 2.11 milligram to 2.41 milligram and the safe range of INR is between two and two point five (2.0～2.5).

0.05).But the incidence of the coronary artery pressure decreasing and ventricular fibrillation,the time to stop bleeding,the bedrest time and vessel complication in 5F group were less than those in 6F group(P

MicroRNAs (miRNAs or miRs) are a class of small non-protein-coding RNAs, approximately 18 to 25 nt long. MicroRNAs can act as endogenous RNA interference. MicroRNAs can posttranscriptionally regulate the expression of hundreds of their target genes, controlling a wide range of biological functions such as cellular proliferation, differentiation, and apoptosis. MicroRNAs can posttranscdptionally regulate the expression of genes by hybridizing to complementary sequences in 3' UTR (3' untranslated region) of target messenger RNA (mRNA), repressing the translation of mRNA or increasing the instability of mRNA. A number of miRNAs are mapped to cancer-associated fragile regions (FRAs) as well as in minimal regions of loss of heterozygosity, minimal regions of amplification, or common breakpoint regions in the genome, suggesting that miRNAs might be involved in tumorigenesis. Many miRNAs are up or down-regulated in cancers as potential oncogene or tumor suppressors. It has been considered that the mutation of a series of oncogene or anti-oncogene gradually causes tumorigenesis. The conventional points of view were changed with the finding of non-protein-coding RNAs. MiRNA as members of non-protein-coding RNAs may play an important role in regulating tumor formation. Recent studies have in-vestigated the relationship of miRNAs with neoplasia, development, treatment and prognosis. Lung cancer is the leading cause of cancer-related deaths all over the world. Its etiology is primarily genetic and epigenetic damage caused by tobacco smoke. Systematic analysis of RNA and protein expression levels of thousands of genes has also contributed to defining the molecular net work of lung carcinogenesis. MiRNAs are closely related to lung cancer and play an important part in the diagnosis, therapy, surveillance and prognosis of lung cancer. We reviewed some miRNAs closely associated with lung cancer such as miRNA-126, miRNA-221, miRNA-222, has-mir-221, a polycistronic microRNA cluster miR-17-92, miRNA-128b, has-mir-137, has-mir-182, has-mir-372 and miRNA let-7. We summarized the roles of miRNAs in the genetic susceptibility, invasion or metastasis, diagnosis, therapy and prognosis of lung cancer.

Objective To assess the serum level of stromal-cell-derived factor 1 (SDF-1) in patients with congenital heart disease (CHD) and pulmonary arterial hypertension. Methods The heart color Doppler ultrasound was conducted to measure the tricuspid regurgitation velocity, in order to estimate pulmonary artery systolic pressure. According to the existing standards, a total of 86 patients were divided into CHD without pulmonary hypertension group (n=16), mild pulmonary hypertension group (n=18), moderate pulmonary hypertension group (n=17), severe pulmonary hypertension group (n=15). Another 20 healthy chil-dren were recruited as control group (n=20), The serum level of SDF-1 was detected by the ELISA method. Results The serum SDF-1 levels were signiifcantly lower in CHD groups than in control group (F=27.793, P<0.001). In CHD groups, CHD with se-vere pulmonary hypertension group had the lowest SDF-1 level, and CHD without pulmonary hypertension group had the highest SDF-1 level. There were signiifcant differences between CHD groups (P<0.05). The pulmonary artery systolic pressure was cor-related with serum SDF-1 levels (r=-0.737, P<0.001). Conclusions The serum level of SDF-1 is decreased in patients with CHD, and is negatively correlated with the severity of pulmonary arterial hypertension.

Objective:To discuss the experience accumulation and thinking tralning of clinical pharmacist in the pharmaceutical consultation with SOAP model. Methods:Clinical pharmacist performed the condition evaluation for one patient with Acinetobacter bau-rnannii infection after esophagus cancer surgery and was invited to the consultation for three times. Clinical pharmacist also provided the references for the drug treatment and monitored the whole process. Clinical pharmacist actively followed and pald return visits for the prognosis of the patient for one month. Results: After identifying the pathogen, the experiential therapy was given and the condi-tions of the patient were improved. According to the changes of the conditions, the treatment was adjusted in time with the most suitable drugs for the conditions and infection degree. Finally, the infection was controlled effectively, and the patient was discharged after the 35-day postoperative treatment. Conclusion:During the consultation, clinical pharmacist should correctly judge the conditions of pa-tients, summarize and evaluate the earlier therapy results, and then choose suitable drugs according to the property of PK/PD. Clinical pharmacist also should track the therapy results to assess the conditions of patients and individualize the treatment.