Objective To evaluate left ventricular function in the way of intracavitary flow dynamics by vector flow mapping (VFM) with echocardiography, and to discuss its clinical usefulness. Methods Twenty-six patients with dilated cardiomyopathy(DCM) and 44 healthy controls were involved. The velocity distribution imagings on the section plane of the flow in the left ventricle were obtained by VFM,and series parameters of velocity and distance were measured with DSA-RS1 software,including systolic parameters,such as velocity gradient from cardiac apex to the aortic valve(△Vs) ,distance from cardiac apex to the aortic valve(Ds), velocity according to half distance (Vs1/2), and diastolic parameters, such as velocity gradient from the mitral orifice to the apex(△Vd), distance from mitral orifice to cardiac apex(Dd),velocity according to half distance(Vd1/2). Results Compared with the values in the control group, parameters of systolic velocity(△Vs, Vs1/2 ) and parameters of diastolic velocity ( △Vd, Vd1/2 ) were significantly lower, parameter of systolic distance (Ds) and parameter of diastolic distance (Dd) were significantly longer( P ＜0.05). Ds,Dd were positive correlated with left ventricular(LV) end-diastolic volume(EDV), end-systolic volume (ESV) ,LV diameter ( r ＞0.4, P ＜0.01 ), and negtively correlated with LV ejection fraction(EF) ( r ＞0.3, P ＜0.01 ). Vs1/2, Vd1/2 were negtively correlated with EDV, ESV, LV diameter ( r ＞0.3, P ＜0.01 ),and positive correlated with EF( r ＞0.3, P ＜0.01 ). Conclusions The velocity of DCM group was lower than that of control group, VFM is a new noninvasive and clinically useful parameter for the evaluation of intracavitary flow dynamics.

AIM:To observe the effect of Rheum emodi Wall on expess level of TNF-?、IL-1? and IL-6 on acute ischemic stroke(ACI)at high altitude. METHODS: 65 patients aith ACI at high altitude(2 260 m)were randomly divided into treatment group(34) and control groups(31).both groups received danshen-safflower injection.Meanwhile treatment group took Rheum emodi decoction orally for 4 weeks,while control group doesn't.Serum levels of TNF-?、IL-1? and IL-6 were measured by radioimmumoassay. RESULTS: The treatment group showed much higher rates of improvement than control group(88.24%;70.97%)after weeks.Serum levels of TNF-?、IL-1? and IL-6 decreased significantly in patients with ACI at treatment group as compared with those of control group. CONCLUSION: Rheum emodi Wall can improve the nervous function of ACI by reducing TNF-?、IL-1? and IL-6 content in serun.

Objective To investigate the relation between symptoms/pulmonary function and airway inflammation of asthmatic children through follow-up investigation on the pulmonary function and airway inflammatory,in order to provide basis for regular asthmatic therapy.Methods The pulmonary function and histamine challenge test of 32 cases of 7～14 years old asthmatic children under regular inhalation corticosteroid(ICS) therapy were carried out and the relation between the symptoms/pulmonary function and airway reactivity were evaluated.Results During the remission period after regular ICS therapy,the mean of one second force expiratory volume(FEV_1),25% and 50% of vital capacity of force expiratory flow(FEF_ 25 and FEF_ 50 ) predicted improved significantly when comparing with those prior to the therapy(P

Objective To investigate problem-based learning(PBL)in clinical teaching of pediatric interns.Methods To compare and analyze the grades of pediatric interns’case writing before and after PBL.Results There was significant difference between the two groups and the grades of interns by PBL were notably higher.Conclusion PBL can improve the interns’ability of case writing,clinical thoughts,operation ability,and enhance their enthusiasm in learning.

Objective: To investigate the prevalence and influencing factors of comorbidity of chronic diseases among hypertensive patients with uncontrolled blood pressure in Huzhou City, so as to provide insights into community hypertension control. Methods: Hypertensive patients with uncontrolled blood pressure at ages of 35 to 74 years were sampled using a cluster random sampling method from 5 districts (counties) of Huzhou City. Participants' demographics, living behaviors, and development of chronic diseases were collected using questionnaires, and the height, body weight, waist circumference and blood pressure were measured. Blood glucose, blood lipid and other biochemical parameters were detected, and the number and combination of comorbidity of chronic diseases were descriptively analyzed. Factors affecting the comorbidity of chronic diseases were identified using a multivariable ordinal logistic regression model. Results: A total of 1 215 respondents were included, with a mean age of (60.83±7.76) years, and including 652 men (53.66%) and 563 women (46.34%). The prevalence of dyslipidemia, diabetes, hyperuricemia and cardiac encephalopathy was 45.10%, 30.95%, 23.05% and 5.10%, respectively. The prevalence of comorbidity of chronic diseases was 69.22% among respondents, and there were 497 respondents with one comorbidity (40.91%), 272 with two comorbidities (22.39%) and 72 with three and more comorbidities (5.93%). Hypertension+dyslipidemia (20.74%), hypertension+diabetes+dyslipidemia (9.96%) and hypertension+diabetes+dyslipidemia+hyperuricemia (4.36%) were predominant comorbid combinations. Multivariable ordinal logistic regression analysis showed that participants with overweight (OR=1.782, 95%CI: 1.390-2.286), obesity (OR=2.411, 95%CI: 1.802-3.222), grade 2 hypertension (OR=1.438, 95%CI: 1.077-1.919) had a higher risk of multiple comorbidities than those with normal body mass index and controlled blood pressure, and women (OR=0.563, 95%CI: 0.456-0.696) had a lower risk of multiple comorbidities than men. Conclusions The prevalence of comorbidity of chronic diseases was 69.22% among community hypertensive patients with uncontrolled blood pressure in Huzhou City, and the comorbidity of chronic diseases mainly included dyslipidemia and diabetes. Men, overweight, obesity and hypertension resulted in a high risk of comorbidity of chronic diseases.

Objective To explore the predictive value for coronary heart disease by epicardial adipose tissue(EAT) thickness and carotid intima-media thickness(IMT) measured with high-frequency ultrasound.Methods According to the results of coronary angiography, the cases were divided into the normal control group (29 patients),coronary artery disease group with single-vessel lesion (43 patients),coronary artery disease group with multi-vessels lesion (28 patients), respectively. EAT and IMT were measured by high-frequency ultrasound. Results The EAT in the three groups were (4.8 ± 1.3) mm, (7.6 ± 1.8) mm,(10.1±2.6) mm respectively, and the IMT were (0.8±0.1)mm,(1.0±0.2)mm,(1.1 ± 0.2)mmrespectively. In either coronary artery disease group with single-vessel lesion or multi-vessels lesion, the EAT and IMT were significantly higher than those in the normal control group ( P＜ 0.01 ). And the difference between groups of single-vessel lesion and multi-vessels lesion was also statistically significant (P＜ 0.01). The areas under receive operating characteristic(ROC) curve to predict coronary heart disease by EAT and IMT was 0.947 and 0.917, respectively, there was no significant difference between the two areas. For patient with coronary artery stenosis＞50%, the sensitivity and specificity of EAT＞6 mm were 90.1% and 86.2% ,respectively,the sensitivity and specificity of IMT＞0.85 mm were 87.3% and 82.8%,respectively. Conclusions EAT and IMT measured by high-frequency ultrasound can precisely predictcoronary heart disease. EAT can be a new predictor to diagnose coronary heart disease.

Objective To study the expressions of Hsp70,P27,Bcl-2 in mucoepidermoid carcinoma of salivary glands and clinical significances.Methods Forty cases of mucoepidermoid carcinoma of salivary glands were chosen and the expressions of Hsp70,P27,Bcl-2 were detected by the method of immunohistochemistry,10 cases of polymorphic adenoma were chosen as control group.Results Both Hsp70 and P27 were stained with aliomycin in nucleus and cytoplasm,the positive rates of them were 75% and 27.5%,respectively,there were significant differences compared with control group(P0.05).The expressions of Hsp70 and P27 had significant differences in different clinical stages,different histological grades and lymph node metastasis(P0.05).Conclusion The expressions of Hsp70 and P27 can be used to estimate prognosis of patients with mucoepidermoid carcinoma.Hsp70 and Bcl-2 can inhibit apoptosis by different ways.

Objective A computerized clinical scenario imitating patients and clinical course variation for situation simulating teaching were established due to lack of typical patients,inadequacy of resourees in pediatric teaching probation and simplification in traditional teaching pattern.Methods Data of clinical typical patients were collected and recorded into video,and then these data were synthesized and put into computer,designing a computerized clinical setting imitating patients' set.216 uodergraduate students from grade 2008 were randomly divided into 2 groups.The patients in experimenial group were taught with computerized clinical scenario imitating patients,while traditional clinical probation in the hospital ward was carried out for those in the control group.Examination and questionnaire survey were performed at the end of the study.t test was used in statistical analysis.Results Comparison between the two groups using questionnaire survey showed that the learning motivation encouragement,active participation in teaching,guidance of clinical logical thinking and judgment,improvement of clinical thinking capacity,acceptance rate in classroom,preference rate were better in the experimental group than those in the control group (P ＜0.05).Student's performance in examination in the experimental group was higher than those in the control group ( P ＜ 0.05).Conclusion Teaching with computerized clinical scenario imitating patients is a teaching method closely related to clinical situation.It can significantly activate student's learning enthusiasm,improve clinical thinking and judgment capability,avoid risk of medical care and establish a new teaching setting for clinical pediatric teaching.

OBJECTIVE To evaluate bacterial drug resistance detection value in lower respiratory tract infection treatment.METHODS The data of distribution and antimicrobial resistance of clinical strains in sputum samples in patients with lower respiratory tract infection within some periods were collected and analyzed by WHONET software.Meanwhile,the delivery rates and detection positive rates of clinical species and antibiotics application status in clinic were retrospectively analyzed.RESULTS The delivery rates and detection positive rates of clinical species in patients with lower respiratory tract infection within some periods were 67.8% and 55.9%,respectively.The proportion of Gram-negative bacilli and Gram-positive cocci was 82.39% and 14.18%,respectively.Different drug resistance was displayed in different pathogenic bacteria.Resistant rate of Enterobacteriaceae bacteria and non-ferment bacteria against ciprofloxacin and piperacillin/tazobactam was 47.8%,34.8%and 31.5%,44.7%,respectively and resistant rate of S.aureus against levofloxacin was 63.9%.CONCLUSIONS Although the pathogenic bacteria in patients with lower respiratory tract infection show higher drug resistance to general antibiotics,most of patients with lower respiratory tract infection are treated according to clinical experience of doctors,not based on the results of bacterial culture and antimicrobial susceptibility test.Therefore,the results of bacterial culture and antimicrobial susceptibility test do not play a proper role to direct anti-infective therapy in clinic.