Objective:To observe the feature of Lorenz plots of dual parasystole ,and explore its differential diagnosis significance .Methods :Lorenz plot data of seven patients diagnosed as dual parasystole was retrospectively analyzed . They were compared with those of single source premature beat ,dual premature beat and single source parasystole . Results :All case data were divided into six groups (seven cases in each group) ,its features were :group 1 [ (single source atrial premature beat (APB)] ,plots were characterized with three distribution and sinus rhythm located on 45° line ;group 2 (dual source APB) were five distribution with the same sinus rhythm location ,the points set before and after premature were located on its two sides ,the plot was symmetry ,slopes of line B were within 0~1 in group 1 and 2 and its slopes were no significant difference (P>0.05);group 3 was single source ventricular premature beat (VPB) ,show four distribution pattern ,sinus rhythm was located on 45° line ,the points set before and after prema-ture were almost parallel to X and Y axis ;group 4 ( dual source VPB) were in six distribution with the same sinus rhythm location ,its difference with single source VPB was the points set before and after premature were symme-try;slopes of line B all trends to 0 in group 3 and 4 ,their slope also no significant difference (P>0.05);Group 5 (single source parasystole ) was characterized as four distribution vertical to 45° line ,premature point set was vertical to 45° line ,point set before and after premature were vertical to axis X and Y respectively ;group 6 (dual parasysto-le) were seven distribution vertical to 45° line ,were similar to that of single source parasystole ,the difference was figure of group 6 was dual distribution ;slopes of line B were close to ∞ in group 5 and 6 ,and its difference were no significant (P>0.05) .The line B slopes in group 5 and 6 were significantly higher than those of group 1&2 [ (∞ ) vs .(4.78 ± 0.19)] ,and those of group 1&2 were significantly higher than those of group 3&4 (0.36 ± 0.06) ,P<0.01 all .Conclusion:There are significant difference in Lorenz plot features among single (dual) source atrial/ven-tricular premature beats ,single source parasystole and dual parasystole .Lorenz plot is helpful to differential diagno-sis of parasystole .

Objective:To analyze deceleration capacity of heart rate (DC) in patients with ventricular arrhythmia , and explore its predictive value for ventricular arrhythmia .Methods :Dynamic electrocardiogram (DCG) data of outpatients and inpatients ,who were treated in our hospital from Jan 2012 to Jul 2015 ,were retrospectively ana‐lyzed .A total of 41 rehabilitation patients with ventricular tachycardia (VT) directly detected by DCG were treated as VT group ,another 37 cases with similar general data and non‐tachycardia were enrolled as non‐tachycardia group in the same period .DCG was used to measure and calculate DC in all subjects , DC indexes were compared between two groups .Results:DC<4.5 ms was regarded as abnormal and DC<2.5 ms was regarded as significantly abnor‐mal .Compared with non-tachycardia group ,DC significantly reduced [ (8.72 ± 1.78) ms vs .(4.01 ± 1.90) ms] , P<0.01 ;there were significant rise in abnormal DC rate (5.41% vs .51.22% ) and significant abnormal DC rate (0 vs .29.27% ) in VT group , P<0.01 both .Conclusion:Detection rate of abnormal DC is high in VT patients .DC measurement is helpful for predicting ventricular arrhythmia and sudden cardiac death .

ObjectiveTo observe the variation in content of vascular endothelial growth factor （VEGF） in patients with Alzheimer's disease （AD） and to investigate efficacy of Yangxue Qingnao granule on AD and the effect on VEGF. MethodA total of 60 patients with cognitive impairment ［30 of AD and 30 of amnestic mild cognitive impairment （aMCI）］ were selected， and another 30 healthy people with Montreal Cognitive Assessment （MoCA）≥26 and age， gender， and complications insignificantly different from the patients were included as healthy control. The venous blood of aMCI group， AD group， and the healthy control group was collected at the enrollment to measure the level of serum VEGF. Then， the aMCI and AD patients were randomized into the observation group and the control group， with 30 patients in each group. The control group was given Donepezil Hydrochloride （5 mg·d^-1）， while the observation group received Donepezil Hydrochloride （5 mg·d^-1） and Yangxue Qingnao granule. MoCA was used to evaluate the severity of cognitive impairment. After the treatment for 6 months， the clinical efficacy and adverse reactions of the two groups were compared， and the serum VEGF levels were detected again by enzyme-linked immunosorbent assay （ELISA）. ResultThe serum content of VEGF in AD patients was significantly lower than that in aMCI patients and healthy people （P<0.05）. Serum VEGF levels in aMCI patients were significantly decreased compared with those in healthy people （P<0.05）. After treatment for 6 months， the serum VEGF level in the observation group was significantly higher than that before treatment， and was higher than that in the control group （P<0.05）. MoCA scores in the observation group were higher than those in control group （P<0.05）. The incidence of adverse reactions was insignificantly different between both groups. ConclusionThe serum levels of VEGF significantly decreased in aMCI and AD patients， suggesting that angiogenesis might be involved in the pathophysiological process of AD and correlated with the early stage of AD. Yangxue Qingnao granule， as a safe adjuvant therapy， showed ideal effect on aMCI and AD， as manifested by the improvement of cognitive function. The mechanism is the likelihood that it can elevate the expression of angiogenic factors such as VEGF， promote angiogenesis， and then improve the microcirculation of cortex.

Objective:To explore any effect of intermittent theta burst stimulation (iTBS) and of different sequencing of rehabilitation training on upper limb dysfunction after a stroke.Methods:Thirty-six patients with upper limb motor dysfunction after subacute subcortical cerebral infarction were divided at random into a control group, an experimental group 1, and an experimental group 2, each of 12. The control group was given prosthetic stimulation and upper limb function rehabilitation training. Experimental group l received focal iTBS stimulation on M1 immediately followed by upper limb rehabilitation training. Experimental group 2 received the same treatment but in reverse order. The experiment lasted four weeks. Upper limb functioning and ability in the activities of daily living (ADL) were quantified before and after the interventions using the Fugl-Meyer upper extremity assessment (FMA-UE) and the modified Barthel index (MBI). Cortical latency (CL) was also recorded.Results:Before the treatment there were no significant differences among the three groups, but afterward a significant increase was observed in the average FMA-UE and MBI scores of both experimental groups accompanied by a significant decrease in CL. There was no significant difference between the two experimental groups′ results, on average.Conclusion:Supplementing upper limb rehabilitation training with iTBS can significantly improve the upper limb functioning of ischemic stroke survivors, and the sequencing of the training has no effect on the therapeutic results.