Objective To investigate the clinical effect of amiodarone combined with psychological intervention in the treatment of senile rapid arrhythmia.Methods 120 cases of elderly patients with rapid arrhythmia diagnosed and treated in our hospital from January 2015 to January 2017 were divided into two groups: the control group was treated with the system, the observation group was treated with the system combined with amiodarone+The clinical data of amiodarone combined with psychological intervention in the treatment of senile rapid arrhythmia were discussed and compared with the data obtained from the two groups.Results The clinical effect of the observation group (system synthesis+amiodarone+psychological intervention) in the treatment of elderly patients with tachyarrhythmia was better than that of the control group (systematic synthesis).The clinical symptoms improved significantly and the adverse reactions were few Statistically significant (P<0.05).Conclusion The clinical effect of prescription system combined with amiodarone+psychological intervention in patients with rapid arrhythmia is significant, which can effectively improve the clinical symptoms and less adverse reactions.It is widely used in the treatment of elderly patients with rapid arrhythmia.

Objective To study the clincial effectiveness and safety of endoscopic sphincteropapillotomy combined with balloon dilation for decompensated cirrhosis accompanied with choledocholithiasis.Methods Data of 79 cases of decompensated cirrhosis patients with choledocholithiasis who underwent limited endoscopic sphincterotomy plus endoscopic papillary balloon dilation (ESBD,the ESBD group) and 42 cases who underwent endoscopic papillary balloon dilation(EPBD,the EPBD group)were retrospectively analysed and compared for complete stone clearance rate,one-time stone clearance rate and complications.Results The rate of complete stone clearance and one-time stone clearance were 94.9％ (75/79) and 77.2％ (61/79)in ESBD group,and those were 88.1％ (37/42) and 59.5％ (25/42) in EPBD group respectively.The rate of complete stone clearance was a little higher in ESBD group than that in EPBD group.In ESBD group,ERCP-related bleeding occurred in 3 patients (3.8％),post-ERCP hyperamylasemia in 3 (3.8％)and post-ERCP pancreatitis in 2 (2.5％) ; while in EPBD group,post-ERCP hyperamylasemia occurred in 8 patients(19.0％),post-ERCP pancreatitis in 6(14.3％) and ERCP-related bleeding did not occur.There were no significant difference in ERCP-related bleeding between ESBD group and EPBD group (P =0.551).However,the rates of post-ERCP pancreatitis and hyperamylasemia in ESBD group were significantly lower than those in EPBD group(P ＜ 0.05).Conclusion ESBD is a safe and effective procedure for choledocholithiasis accompanied by decompensated cirrhosis,with several advantages over EPBD in terms of higher one-time stone clearance rate,reduced risk of post-ERCP pancreatitis and hyperamylasemia,and without noticeable increase in the risk of bleeding related to ERCP.

Objective To extract,isolate and identify the polysaccharide from ginseng,and to investigate its anti-tumor activity in vitro. Methods The ginseng polysaccharide was obtained through water extraction and ethyl alcohol deposition method. Use the Sevage method to remove the protein in the crude polysaccharide. The structural characteristics of the polysaccharide were determined by FT-IR spectra.The RM-1 and HeLa cells were divided into control group and different concentrations (0,50,100,200,300,400 and 500 mg·L-1 )of ginseng polysaccharide groups. The survival rates of the cells in various groups were detected by MTT method. The indirect killing effects of ginseng polysaccharide with different concentrations (0,50,100,200,300,400 and 500 mg·L-1 )on the cancer cells were determined by CTL test. Results The extraction rate of ginseng polysaccharide was 8.7 6% and the structural characteristics demonstrated that the main component of the extract was polysaccharide.The result of MTT showed that there were no significant differences of the survival rates of RM-1 and HeLa cells between different concentrations of ginseng polysaccharide groups after treated for 24 h compared with control group (P>0.05).The result of CTL test showed that the cytototic LHD release rates in different concentrations of ginseng polysaccharide groups were increased significantly (P<0.05)compared with control group;with the increase of ginseng polysaccharide concentration, the cytotoxic LDH release rates were increased firstly and then were decreased.When the concentration of ginseng polysaccharide was 100 mg·L-1 ,the cytotoxic LDH release rate was the biggest.Conclusion Ginseng polysaccharide can indirectly inhibit the growth of the tumor cells by activating T cells and play an anti-tumor effect.

Objective To extract the Ginseng polysaccharide (GPS), polysaccharides of Tricholoma matsutake (PTM)and polysaccharide of Lentinus edodes (PLE)from gingeng, tricholoma matsutake and lentinus edodes respectively,and to analyze and identify their structures,and to prepare their complex,and to study the indirect antitumor activity invitro of polysaccharide complex.Methods The polysaccharides were extracted with hot water and precipitated by ethanol.The carbohydrate levels were determined by the method of phenol-sulfuric acid.The m-hydroxyphenyl method was used to determine the levels of uronic acid, and the national standard method was used to determine the levels of starch.Infrared spectroscope and chemical methods were performed to analyze their structures. Orthogonal experiment was used to study mixing methods. Cytotoxic T lymphocyte experiment and LDH release assay were performed to detect the influence of polysaccharide complex of GPS,PTM,and PLE in the CTL killing activity,and its indirect killing effect on the P815 cells.Results The extraction rates of GPS,PTM, and PLE were 8.85%,9.40%,and 10.50%;the levels of total polysaccharides were 62.96%,59.13%,and 33.86%;the levels of uronic acid were 16.44%,9.37%,and 16.44%;the starch levels were 7.26%,2.80%,and 3.77%,respectively.The identification results showed that the polysaccharides were obstrained.When the quality ratio of the three kinds of polysaccharides was 1∶1∶1 and the concentration was 600 mg·L-1 ,the CTL cytotoxicity was the highest.Conclusion The polysaccharide complex is obtained,identified and characterized. Polysaccharide complex can enhance the cytotoxicity of CTL and has the indirectly inhibitory effect on the proliferation of P815 cells.

Objective To investigate the clinical features, therapeutic approaches, outcomes and alterations of peripheral lymphecytos subsets in cytomegalovirus (CMV) infections in patients with AIDS.Methods Ninety-six cases of AIDS were treated in Peking Union Medical College Hospital and 23 of them had CMV infection. We analyzed the clinical features, peripheral lymphocytes subsets, outcomes, CMV pp65 antigen and/or specific anti-CMV lgM. Results In the 23 CMV patients, nonspacific symptoms including fever,cough,chest distress and diarrhea occurred in 18, 11,9 and 8 patients, respectively. Thirteen patients had retinitis identified by ophthalmofundoscepy, 7 of them had blurred vision or floating as primary symptoms. Pneumocystis pneumonia, tuberculosis infection and other infection appeared in 18 patients.Fifteen(65. 2% )of the patients had positive serum tests. The positive rates for CMV pp65 and specific anti-CMV-IgM were 43.5% and 30. 4%, respectively. CD4+T cell count in CMV patients was remarkably decreased than that in non-CMV patients [14 (4,39) cells/μl vs (48 ( 12,128 ) cells/p J, P = 0. 005] and the proportion of CD8+ CD38+ T cells in CMV patients was higher than that in non-CMV patients,whereas the difference of CD8+T cell was not statistically different between the 2 groups. Conclusions CMV infection often occurrs in advanced AIDS patients. In HIV/AIDS patients with CD4+ T cell count ≤ 100 cells/μl,routine check for CMV pp65 antigen, specific anti-CMV IgM and ophthalmofundoscopy are recommended.Whenever encountering a young patient presenting with fever, blurred vision or floating, CMV complicating AIDS should be considered.

Objective To assess the predictive value for survival of BioCliM index in liver cirrhosis caused esophageal and gastric varices bleeding(EGVB)treated by endoscopic variceal ligation(EVL),endoscopic injection sclerotherapy(EIS)and endoscopic tissue adhesives(ETA).Methods From December 2006 to December 2011, the clinical data of 166 hospitalized patients with first occurrence of EGVB caused by liver cirrhosis and received endoscopic therapies were retrospectively analyzed.The scores of model for end-stage liver disease(MELD),model for end-stage liver disease-Na(MELD-Na),BioCliM index and Child-Turcotte-Pugh(CTP)were calculated. Receiver operating characteristic(ROC)curve and area under the curve(AUC)were applied to assess the accuracy of the four models in one-year and two-year prognosis evaluation,and to obtain the best critical value,and the mortality rates were compared among groups.Chi-square test,t test and rank-sum test were performed for statistical analysis.Results Among 166 patients,the levels of creatinine,bilirubin,albumin,sodium,international normalized ratio and prothrombin time were(0.10 ± 0.06)mmol/L,(0.02 ± 0.01)mmol/L,(30.13 ± 5.06)g/L, (139.13 ± 4.27)mmol/L,1.50 ± 0.32 and(17.83 ± 2.88)s,respectively.During the one-year and two-year follow-up,there were 14 patients and 23 patients dead,respectively.During the one-year and two-year follow-up, the incidences of portal thrombosis of death group were lower than those of survival group(10/14 vs 93.4%,142/152;73.9%,17/23 vs 94.4%,135/143);and the differences were statistically significant(χ2=8.029 and 10.774, both P<0.01).During the one-year and two-year follow-up,BioCliM indexes of death group were 0.12(-0.82, 1.44)and -0.81(-0.87,0.92),respectively,which were both higher than those of survival group(-0.84,-0.94 to -0.73;and -0.84,-0.94 to -0.72),and the differences were statistically significant(Z= -3.074 and -2.260,both P<0.05).During the one-year follow-up,the AUC values of MELD,MELD-Na,BioCliM index and CTP score were 0.698,0.691,0.749 and 0.723,respectively.During the two-year follow-up,the AUC values of MELD,MELD-Na,BioCliM index and CTP score were 0.587,0.582,0.647 and 0.633,respectively. But there was no statistically significant difference in AUC between BioCliM index and MELD,MELD-Na,and CTP score in one-year and two-year follow-up for prognosis evaluation(Z=0.509,0.566,0.271,0.687,0.731 and 0.162,respectively;all P>0.05).The best critical value of BioCliM index was -0.234.Followed up for one year and two years,the mortality rates of patients with BioCliM index over -0.230 were higher than that of patients with BioCliM index less than -0.234(31.0%,9/29 vs 3.6%,5/137;34.5%,10/29 vs 9.5%,13/137);and the differences were statistically significant(χ2=23.242 and 12.526,both P<0.01).Conclusions BioCliM index has a high accuracy in one-year and two-year mortality rate evaluation in liver cirrhosis patients with EGVB and received endoscopical therapies.We should pay attention to the prognosis evaluation before the endoscopical therapy.

2,3,5,4'-tetra-hydroxystilbene-2-O-glucoside (THSG), the water-soluble active components extracted from dried tuber root of Polygonum multiflorum (Polygonaceae), can promote the release of nitric oxide (NO) from vascular endothelial cells and has strong antioxidation. The postconditioning's protection of THSG on cardiac ischemia-reperfusion injury and the mechanism were investigated. After reperfusion for 3 h following occlusion of rat left anterior descending coronary artery (LAD) for 30 min, SαT recovery speed, arrhythmia and cardiac infarct size were observed.The ischemic size and infarct size was identified by using Evans blue and TTC staining methods respectively. The results showed that the infarct size in THSG 7. 5 mg/kg postconditioning group was significantly decreased from 43.6 %±9.1 % in mode group to 16.5 %±6.5 % (P＜0.01).SαT recovery was quicker and the incidence of arrhythmia (55.6 % vs 100 %, P＜0.05) was significantly lower than in control group. The infarct size in THSG+glybenclamide group was greater than in THSG group, but equivalent to that in control group (46.8 %±9.8 % vs 43.6 %±9. 1 %, P ＞0. 05), SαT recovery speed slower and the incidence of arrhythmia also lower (33. 3 % vs 100 %, P＜0. 01), suggesting that glybenclamide could abolish the effects of THSG postconditioning reducing the cardiac infart size. It was concluded that THSG administration before reperfusion could effectively alleviate the cardiac reperfusion injury and possessed the postconditioning effects of reducing cardiac infarct size, which might be related with the KATP channel opening.

Objective To evaluate the curative effects of vacuum sealing drainage equipment on prevention and treatment of subcutaneous effusion after breast cancer radical correction. Methods A total of 122 cases of breast cancer patients from June 2006 to June 2012 were randomly divided into control group ( n=62) and intervention group (n=60). The patients of control group underwent the conventional drainage while the patients of intervention group received the vacuum sealing drainage. The situation of subcutaneous effusion, infection, skin flap necrosis, decannulation time as well as day flow conditions in two groups were observed and compared. Results The incidence of subcutaneous effusion, infection and skin flap necrosis in control group were 12. 9%, 6. 4%, 8. 1% respectively. In intervention group, the incidence rate of subcutaneous effusion was 1. 7%, and no infection, and skin flap necrosis had been observed (χ2 =7. 90,8. 31,9. 12;P<0. 01). The extubation time and day flow conditions in control group was(6. 8 ± 2. 3) d and (70 ± 38) ml, while the interventiongroupwere(10.5±3.1)dand(105±28)mlwithstatisticalsignificance(t =2.10,3.95;P <0. 05). Conclusions Simple vacuum sealing drainage device can not only prevent the subcutaneous effusion, infection and skin flap necrosis after breast cancer radical correction, but also can realize the early extubation, therefore it is worthy of promotion in clinical.

Objective:To evaluate the effect of free interosseous posterior artery perforator flap in small hand defects.Methods:We retrospectively analyzed the case data of small hand skin and soft tissue defects treated with free interosseous posterior arterial perforator flaps from March 2019 to August 2020 in the Department of Burn Plastic Surgery, the Second Affiliated Hospital of Zunyi Medical University. According to the size of the defect during the operation, we designed free interosseous posterior artery perforator flap transplantation to repair wounds, and the perforating branch of the posterior interosseous artery is anastomosed with the proper digital artery and the common digital artery. The donor valve area is sutured directly. After the operation, the survival of the flaps was observed, and the repair effect of the flaps, hand function and complications were followed up.Results:Twenty-one cases were included, among whom there were 15 males and 6 females with a median age of 46 years (range, 23-61years). There were several causes of injury: 7 cases of heavy object injuries, 11 of machine strangulation, 3 of burns and scalds. For 8 cases, the defect sites were on the palms and 13 on the dorsal sites. The defect size ranged from 1.5 cm×2.0 cm to 3.0 cm×9.0 cm with exposed tendons and bones. The flap size ranged from 2.0 cm×2.0 cm to 3.5 cm×9.0 cm. Among them, compound tissue transplantation with tendon was used to reconstruct finger extension function in 1 case while tissue transplantation with nerve was used to repair the palmar wounds in 2 cases. The bilobed flaps were used in 4 cases, and the remaining 14 cases were single leaf free skin flaps. No arteriovenous crisis occurred in the flaps after the operation. All flaps of 21 patients survived, and there was no blood supply disorder in the flaps. After 6-12 months of follow-up, the texture and color of the flap were similar to adjacent skin, and unrestricted hand function was unrestricted. The two-point discernibility of the skin flap for patients with nerve grafts was 10-12 mm, serious complication in the donor sites, but the forearm donor area with linear scars.Conclusions:The application of interosseous posterior artery perforator flap is flexible. It can repair two adjacent small wounds at the same time with free bilobed transplantation, and can carry free cutaneous nerve transplantation to repair the palm side wound. This flap is one of the ideal flaps for repairing small defects on the hand.

Objective:To evaluate the effect of free interosseous posterior artery perforator flap in small hand defects.Methods:We retrospectively analyzed the case data of small hand skin and soft tissue defects treated with free interosseous posterior arterial perforator flaps from March 2019 to August 2020 in the Department of Burn Plastic Surgery, the Second Affiliated Hospital of Zunyi Medical University. According to the size of the defect during the operation, we designed free interosseous posterior artery perforator flap transplantation to repair wounds, and the perforating branch of the posterior interosseous artery is anastomosed with the proper digital artery and the common digital artery. The donor valve area is sutured directly. After the operation, the survival of the flaps was observed, and the repair effect of the flaps, hand function and complications were followed up.Results:Twenty-one cases were included, among whom there were 15 males and 6 females with a median age of 46 years (range, 23-61years). There were several causes of injury: 7 cases of heavy object injuries, 11 of machine strangulation, 3 of burns and scalds. For 8 cases, the defect sites were on the palms and 13 on the dorsal sites. The defect size ranged from 1.5 cm×2.0 cm to 3.0 cm×9.0 cm with exposed tendons and bones. The flap size ranged from 2.0 cm×2.0 cm to 3.5 cm×9.0 cm. Among them, compound tissue transplantation with tendon was used to reconstruct finger extension function in 1 case while tissue transplantation with nerve was used to repair the palmar wounds in 2 cases. The bilobed flaps were used in 4 cases, and the remaining 14 cases were single leaf free skin flaps. No arteriovenous crisis occurred in the flaps after the operation. All flaps of 21 patients survived, and there was no blood supply disorder in the flaps. After 6-12 months of follow-up, the texture and color of the flap were similar to adjacent skin, and unrestricted hand function was unrestricted. The two-point discernibility of the skin flap for patients with nerve grafts was 10-12 mm, serious complication in the donor sites, but the forearm donor area with linear scars.Conclusions:The application of interosseous posterior artery perforator flap is flexible. It can repair two adjacent small wounds at the same time with free bilobed transplantation, and can carry free cutaneous nerve transplantation to repair the palm side wound. This flap is one of the ideal flaps for repairing small defects on the hand.