Objective To investigate the electrophysiology mechanism of the P wave dispersion (Pd) and the maximum P wave duration (Pmax) in patients with paroxysmal atrial fibrillation (PAF),and evaluate the effect of the Pd and Pmax in the prediction of PAF. Methods Forty-eight patients with PAF (group PAF) were slected and divided into 2 sub-groups according to the organic heart disease,group PAF1 (20 cases, without organic heart disease) and group PAF2 ( 28 cases, with organic heart disease). Forty-six patients without PAF were selected as control group. The Pd and Pmax were measured from the 12-lead surface electrocardiogram (ECG). Results The Pd and Pmax in group PAF was higher than that in control group [(41.11 ± 4.97 ) ms vs. (27.77 ± 4.72) ms, ( 111.43 ± 8.01 ) ms vs. (95.57 ± 9.01 ) ms] (P ＜ 0.05 ). The Pmaxin group PAF2 was significantly higher than that in group PAF1 (P ＜ 0.05),and there was no significant difference in the Pd between group PAF2 and group PAF1 (P＞ 0.05 ). The specificity, sensitivity and positive predictive value of Pd ≥40 ms combined with Pmax ≥ 110 ms was 95.65%, 81.25% and 95.12%. Conclusion The Pd and Pmax in the patients with PAF are significantly higher than those in the patients without PAF, and Pd≥40 ms combined with Pmax≥ 110 ms can be used to predict the PAF more reliably and accurately.

Objective To explore the clinical significance of heart rate turbulence (HRT) in patients with chronic heart failure(CHF).Methods Thirty CHF patients(CHF group) and 28 non-organic heart disease persons (control group) were examined by 24 hours dynamic electrocardiogram (DCG).According to the NYHA grading of the cardiac function,CHF group were divided into low-degree heart failure (LdHF) sub-group (NYHA Ⅰ -Ⅱ,16 cases) and high-degree heart failure (HdHF) sub-group (NYHA Ⅲ-Ⅳ,14 cases).In CHF group,ischemic heart disease (IHD) patients were 18 cases and non-ischemic heart disease (NIHD) patients were 12 cases.Two indexes of HRT including turbulence onset (TO) and turbulence slope (TS) were measured and analyzed.Results The TO value in CHF group [(0.43 ±0.83)%] was significantly higher than that in control group [( - 1.49 ± 1.00)%] (P ＜0.05),and the TS value in CHF group[( 2.67 ± 0.66) ms/RRI] was significantly lower than that in control group [( 8.52 ± 2.09)ms/RRI] (P ＜0.05).The TO value in the HdHF sub-group [(0.79 ± 0.67)%] was significantly higher than that in LdHF sub-group[(0.12 ± 0.86)%] (P = 0.026),and the TS value in the HdHF sub-group [(2.88 ±0.79) ms/RRI] was significantly higher than that in LdHF sub-group [(2.40 ± 0.35) ms/RRI] (P= 0.045).The TO and TS values had no significant difference between the IHD and the NIHD patients (P＞0.05).In CHF group,53.3%(16/30) patients' TO and TS values were both abnormal (TO ≥ 0,TS ≤ 2.5 ms/RRI),and 40.0% (12/30) patients had only TO or TS value abnormal,93.3% (28/30) patients had abnormal HRT.Conclusion The phenomenon of HRT in the patients with CHF obviously decrease,and the HRT can be used to evaluate the severity of heart failure and predict the prognosis of the heart failure.

Objective To observe the effect of maxillary sinus floor augmentation with transalveolar tech-nique and simultaneous implant.Methods 50 cases of patients with missing tooth in maxillary posterior region with insufficient vertical bone treated by author were selected.Maxillary sinus floor augmentation with transalveolar tech-nique and simultaneous implantation were given after local anesthesia.X -ray was given on the right day,2 weeks, 3 months and 9 months after operation.And the situation of osseointegration was observed.Results There were 2 cases of injuries of maxillary sinus mucoperiosteum in the 50 cases (4%),and no obvious complication was found for timely treatment.There were 5 cases of gingiva with obviously swollen around implant and BOP(+),and the symptoms were obliterated one week after paradental basic therapy and oral health guidance were given.All the situations of the osseointegration of implants were good,and no loosening or dropping case was found in follow up.One year after operation,the mean obsorbation of bone around the neck of implant was (0.9 ±0.3)mm.There was no obvious absorption of bone around implant,and obvious continuous image of maxillary sinus floor could be observed by imaging examination.The satisfaction of chew,pronounce,aesthetics,maintenance and comfort was all 100%,and 49 cases were satisfied with operation tolerance,and satisfaction rate was 98%.Conclusion Ther effect is desired to apply maxillary sinus floor augmentation with transalveolar technique and simultaneous implant under strict indication.And the satisfaction degree is high.

Objective To investigate the status and capacity of eye care services in Yunnan Province in 2007. Design Cross-sectional questionnaire survey. Participants 165 medical institutions in Yunnan Province. Methods Using a standardized questionnaire designed by Ministry of Health,the all hospitals of county or above and eye hospitals in Yunnan Province were investigated during October to December 2007. Main Outcome Measures Number of ophthalmologists and ophthalmic nurses,surgical volume per year,out-patient volume per year and number of ophthalmologists who can operate cataract independently. Results Totally 165 hospitals covered Yunnan Province participated in this study (response rate was 100%). In all these institutions,there were 735 ophthalmologists and 771 nurses. 392 ophthalmologists could perform cataract surgery independently. Within 16 prefectures of Yunnan,Zhaotong prefecture had the least resources of ophthalmology (7 ophthalmologists per million population) while Kunming had 32 ophthalmologists per million populations. In 2006,58346 eye surgeries were performed in all these institutions,including 23833 cases of cataract surgeries. 27 hospitals were not able to provide cataract surgical services. Out 165 institutions,only 29 hospitals (17.6%) had advanced ophthalmic equipments and 6 hospitals (3.6%) did not have any ophthalmic equipment. Conclusion There are big differences of eye care services among different level and different location of medical institutions in Yunnan Province of China. Inappropriate distribution of human resources and low productivity are main issues. Further resources allocation and optimized use of resources in eye care services are needed to meet the needs of patients.

Objective To investigate the medium and long-term influence of silicon oil versus heavy silicone oil on rabbit retinas.Methods 28 health standard rabbits were randomly divided into A,B and C groups,with 12,12 and 4 rabbits respectively.All rabbits received routine vitrectomy and tamponade with silicone oil (group A),or heavy silicone oil (group B) or balanced salt solution (group C).After 4,8,12 and 24 weeks,the retinal b-wave amplitude was measured by ERG,posterior retinal thickness was measured by optical coherence tomography (OCT).Retinal ultrastructure and tissue morphology were observed by transmission electron microscopy and optical microscopy.Results Compare to group C,the b-wave amplitude decreased at 4 weeks after surgery,and decreased at 8 weeks after surgery for group B,and decreased at 8 weeks after surgery,and decreased at 24 weeks after surgery for group A.The decreases were greater in group B than group A at 8,12,24 weeks after surgery,the difference was statistically significant (P＜0.05).The posterior retinal thickness of group A and B was thinner than group C at 24 weeks after surgery (P＜0.05).The decreases were greater in group B than group A,the difference was statistically significant (P＜0.05).Transmission electron microscopy and optical microscopy revealed severe pathological changes of retinal ultrastructure and morphology in group A and B rabbit eyes,at 12 weeks and 8 weeks after surgery respectively.The changes were more severe in group B and group A,including edema and necrosis in cone/rod cells,in disk membranes,mitochondria,cytoplasm,nucleus and other organelles.The morphological changes were also more severe in group B and group A,including degenerations of ganglion cell layer,inner nuclear layer changes.Those changes became more severe when the tamponade time extended.Conclusion The heavy silicone influence on visual function,ultrastructures,histomorphology of rabbit retinas is much worse than the silicon oil,and the effect is more significant with its time prolong.

The authors through the analysis on the state food and drug administration for clinical drug agency qualification , the ethics committee to run the problem:ethics committee incomplete management system and SOP;Familiar with work system and review process to be;Track review is not standard;Pilot project information manage-ment confusion;Ethics committee hardware substandard housing .And puts forward the following measures to solve these problems , reasonable adjustment of organization structure , strengthen the system construction , standard re-view process , establish 3 levels training model and improve office conditions .

Objective] To analyse the course of treatment based on differentiation of signs of Hashimoto thyroiditis combined with many diseases, offering treating thought and medication experiences. [Method] Trace back and state the relative documents about the general conditions, diagnosis and therapy, symptoms-pointed treatment of 1 case of Hashimoto thyroiditis combined with many diseases, introducing Pro. Wumin's clinical experience in treating the patient. [Result] The patient was early or late diagnosed as fatness, hyperlipemia, hyperinsulinemia, sub-clinical Hypothyrea, thyroid nodule and type-2 diabetes, Pro. Wumin combined TCM with WM, the patient was control ed the diseases and kept stable. [Conclusion] Combination of TCM and WM treating Hashimoto thyroiditis accompanied with diseases above has good cure effect, the patient is satisfied with the improvement and result.

Objective To investigate the effect of T149-C and A163-G polymorphism of osteoprotegerin promoter region combined with low-body weight on bone mineral density (BMD) of postmenopausal osteoporosis women and postmenopausal healthy women. Methods Seventy-three postmenopausal osteoporosis women and 61 postmenopausal healthy women were enrolled. The shifted patterns were searched from randomly selected 25 samples by SSCP-PCR and their sequences were determined by cycle sequencing. The T149-C and A163-G polymorphisms were determined by PCR-RFLP. BMD of lumbar spines and femoral neck, Ward and trochanteric areas were measured by dual energy X-ray absorptiometry. Results T149-C and A163-G polymorphisms in the postmenopausal osteoporosis women and the postmenopausal healthy women were through Hardy Weinberg equilibrium. Both single and combined genotype frequencies of the T149-C and A163-G polymorphism did not show any difference between postmenopausal osteoporosis women and postmenopausal healthy women. The BMD levels of the postmenopausal osteoporosis women were significantly lower than those of the postmenopausal healthy women in lumbar spines and femoral neck, and BMI levels of the postmenopausal osteoporosis women was significantly lower than those of the postmenopausal healthy women. Conclusions The T149-C and A163-G polymorphism has no synergistic effect on bone mass in both the postmenopausal osteoporosis women and the postmenopausal healthy women. The single and combined genotypes of the T149-C and A163-G polymorphism may not be used as genetic markers in predicting their risk of developing osteoporosis in Chinese women of the Han nationality, but may be susceptible gene of osteoporosis.

OBJECTIVE:To investigate the utilization of antibiotics in urinary surgery patients in our hospital.METHODS:The problems lie in the perioperative use of antibiotics in a total of 600 patients with ureter stones,kidney stones,bladder stones and(or)benign prostatic hyperplasia(BPH)undergoing urinary surgery from Jan.to June in 2006 and from Jan.to June in 2007 were analyzed in accordance with the Guiding Principles of Clinical Application of Antibacterials and the related regulations of antibiotics in our hospital.RESULTS:The rate of rational use of antibiotics rose from 12.5% before intervention to 88.2% after intervention.The problems of improper selection of antibiotics,irrational timing and too long duration of drug use were improved to a great extent.CONCLUSION:The intervention on the rational perioperative use of antibiotics is effective and it greatly enhanced the rationality in the perioperative use of antibiotics in urinary surgery patients.

OBJECTIVE:To prepare Stemoninine orally disintegrating tablets,and to optimize its formulation and preparation technology. METHODS:Direct powder compression method was used to prepare Stemoninine orally disintegrating tablets. Using material angle of repose,disintegration time and taste evaluation as index,single factor test was used to screen several factors as bulking agent,disintegrating agent,glidant and flavoring agent;using disintegration time as index,L9(34) orthogonal test was used to optimize the formulation with ratio of MCC+mannitol,PVPP,silica powder and aspartame+stevia as factors. Validation test was also conducted. RESULTS:Optimized formulation was that MCC+mannitol(1∶1)was 50%,PVPP was 20%,silica powder was 2% and aspartame+stevia(10∶1)was 7%. 3 batches of prepared Stemoninine orally disintegrating tablets were smooth in sur-face and good in taste;their disintegrating time was(22.6±2.1)s,and weight variation,hardness,contents were within the speci-fied range (all RSD≤0.97%,n=3). CONCLUSIONS:The formulation and technology of Stemoninine orally disintegrating tab-lets are reasonable,and the quality indexes are all in line with the requirements of orally disintegrating tablets.