Objective To compare the prevention effect of atrial fibrillation recurrence in hypertensive patients by telmisartan versus nifedipine.Methods Ninety-eight cases of hypertensive with paroxysmal atrial fibrillation patients were enrolled and divided into telmisartan group and nifedipine group with 49 cases each by random digits table method.Telmisartan group was given telmisartan 80 mg/d,nifedipine group was given nifedipine 30 mg/d.Dose of the drug needed to be adjusted according to individual condition until achieving the target.Followed-up for 18 months.Observed two groups of recurrence of atrial fibrillation and the recurrence time for the first time,recorded before and after the treatment of cardiac parameters:including left atrial diameter (LAD),left ventricular end diastolic diameter(LVDD),left ventricular posterior wall thickness (LVPWT),interventricular septum thickness (IVST),left atrial volume index(LAVI) and left ventricular mass index(LVMI).Results The blood pressure after treatment in two groups was lower than that before treatment,there was statistically significant difference (P＜ 0.05),but there was no statistically significant difference between two groups (P ＞ 0.05).After treatment,the recurrence of atrial fibrillation,atrial fibrillation recurrence time for the first time in two groups had no statistical significance (P ＞ 0.05).But the incidence of persistent atrial fibrillation in telmisartan group was significantly lower than that in nifedipine group [4.1％ (2/49) vs.16.3％ (8/49)],there was statistically significant difference (P =0.045).The cardiac parameters between two groups before treatment had no significant difference (P ＞ 0.05).After treatment,the cardiac parameters in two groups were signifcantly reduced,there were statistically significant differences (P ＜ 0.05).Moreover,the LAD,LVPWT,LAVI and LVMI in telmisartan group after treatment were significantly lower than those in nifedipine group [(37.6 ± 2.9) mm vs.(38.9 ± 2.4) mm,(11.6 ± 1.0) mm vs.(12.0 ± 0.9) mm,(22.0 ± 3.6) ml/m2 vs.(23.9 ± 4.2)ml/m2,(120.4 ± 18.2) g/m2 vs.(129.5 ± 19.2) g/m2],there were statistically significant differences (P ＜ 0.05).Conclusions Nifedipine and telmisartan can effectively lower the blood pressure.But telmisartan is superior to preventing atrial fibrillation recurrences and developing in hypertensive with paroxysmal atrial fibrillation patients,promoting cardiac parameters and postponing myocardial remodeling.

Objective To explore the relationships between antithrombinⅢ(AT-Ⅲ) and D-dimer (DD) level with pediat-ric critical illness score (PCIS) in children with sepsis, and to evaluate the values in assessing the severity of illness. Methods Sixty-one children with sepsis were included in this study. Within 24 hours after admission, blood samples were tested for the ac-tivity of AT-Ⅲ and DD level. The PCIS was calculated. According to PCIS, the patients were divided into extremely critical group (<70), critical group (71-80) and non-critical group (80-100). According to the prognosis, the patients were divided into survival and death groups. The differences of the activity of AT-Ⅲand DD were compared and the relationship with PCIS were analyzed. Results The activity of AT-Ⅲ was lower and DD level was higher in critical group than in non-critical group (P<0.01) and the changes in extremely critical group were more evident than those in critical group. The activity of AT-Ⅲand PCIS were positively correlated (r=0.548, P<0.01).The DD level and PCIS was negatively correlated (r=-0.657, P<0.01). Compared with survival group, the level of DD was significantly higher in death group (P<0.01), and PCIS and the activity of AT-Ⅲwere significantly lower in death group (P<0.05). Conclusions The patients with sepsis have dysfunctions of coagulation. The activity of AT-Ⅲ, DD level are correlated with illness severity, and can be useful for assessing the severity of sepsis.

Objective To study the relation of the variations of serum neuron-specific enolase (NSE) level and brain damage in asphyxia neonatorum.Methods The serum NSE level were detected in 75 asphyxia neonatorum(asphyxia group) and 20 normal neonatorum(control group) by the method of ELISA after parturition 1,3 and 7 d.The relation of serum NSE level and brain damage was analyzed.Results After parturition 1,3 and 7 d,the serum NSE level in mild asphyxia group and severe asphyxia group was higher than that in control group [(29.85 ±8.53),(59.26 ± 15.75) μg/L vs.(15.59 ±6.25) μg/L; (23.69 ± 6.54),(47.28 ±12.46) μg/L vs.(15.38 ±5.84) μg/L; (18.95 ±5.37),(62.57 ±19.62) μg/L vs.(13.92 ±5.37) μg/L],and the serum NSE level in sever asphyxia group was higher than that in mild asphyxia group,there had significantly difference (P＜ 0.05).After parturition 1,3 and 7 d,the serum NSE level in brain damage neonatorum (25 cases) was increased and in CT normal neonatorum (50 cases) was decreased,the serum NSE level in brain damage neonatorum was higher than that in CT normal neonatorum [(37.48 ± 12.09) μg/L vs.(30.95 ± 11.86) μg/L,(51.84 ± 14.21) μg/L vs.(21.73 ±6.15) μg/L,(68.25 ± 18.69) μ g/L vs.(15.62 ± 5.94) μ g/L],there had significantly difference (P ＜ 0.05).Conclusion The variations of serum NSE level can be the important indicator to monitor brain damage in asphyxia neonatorum.

Objective To study effects of high dosage of atorvastatin in acute coronary syndrome(ACS)patients on high sensitive creactive protein(hsCRP)and atherosclerosis.Methods 126 cases with ACS were divided into A,B and C group.30 patients in A group were given atorvastatin 20mg per night,41 cases in B group were given atorvastatin 40mg per night,while the other 55 patients in C group were taken atorvastatin 40mg per night and tirofiban in the first 24 to 48 hours.The patients were followed 6 months by evaluating serum hsCRP concentration,measuring the intimal thickness in the carotid artery with color Doppler.Results After treatment for 6 months,the patients in the three groups showed significant decrease in hsCRP,however,the therapeutic group showed significant difference amony the three groups.Additionally,the B and C groups further showed significant decrease in intimal thickness.Conclusion Using high-dose atorvastatin and tirofiban not only lowers hsCRP significantly,but also benefit stability of atherosclerotic plaque in carotid artery,and to reduce cardiovascular events.

Bilingual teaching is a hot issue in the current medical education reform.This paper discussed the practice of bilingual teaching in ophthalmology education and explored the improvement of teaching materials,enhancement of teaching staff training and promotion of multimedia-based,web-based and PBL-based bilingual teaching in order to provide references for improving the quality of ophthalmology teaching.

The value and detection of right ventricular in circulation have been paid more attention,.Because of the defects in traditional method,Tei index is the method in right ventricular measurement.The Tei index is sensitive in assessing RV function of patients with congenital heart disease.It is not affected by valve regurgitation and RV geometry.The Tei index is accurate and simple in estimating right ventricular function in congenital heart disease and is valuable and invasive index in estimating right ventricular functions.

Objective To investigate the CR low dose radiography to COPD in patients with pseudo normal phenomenon.Methods 160 cases of COPD diagnosed,stratified random dividing method according to the pulmonary function test values were divided into A,B,C and D group.Each group had 32 cases,at the same time,the increase in lung function in patients with mild to moderate pulmonary emphysema in 32 cases was E group,wich was treated with normal dose as a control group,in the normal dose and low dose CR photography failed to clear the diagnosis of emphysema,causing false normalization,statistical the case number,and verify the pulmonary function classification criteria,identify false normalization of lesions in such a case,the general rule to judge the feasibility analysis and prevention.Results There was no significant chifference among 5 groups of pseudo normal comparison (x2 =4.56,P ＞0.05).Conclusion Chronic obstructive pulmonary disease with low dose CR photography on severe and extremely severe patients is deteded by emphysema detection with rate high.Moderate,mild COPD detection rate is extremely low.

Objective To analyze the effect of a new model in the nursing care ward round in the hand surgery department.Methods The implementation of nursing care ward round in the hand surgery department was retrospectively analyzed.Results The comprehensive quality of nurses were increased obviously when the new model ward round was implemented.Patients were more satisfied with the work of nursing care.The evaluation of new model ward round by nurses was higher than before.Conclusions The new model of nursing ward round showed a great help for increasing the comprehensive quality of nurses,the responsibility awareness of nurses and the nursing quality.It presented an significant application value by developing new nursing care technique and helping establish harmonious relationship between the nursing staff and patients.

Execution is one of the key factors which influence the management level of hospital libraries. The paper introduces the concept, performance and synthesis patterns of execution, and points out that execution is the main means to enhance performance of li-brary, then puts forward concrete strategies to enhance execution of library from two levels: individuals and libraries.

Neonatal infection is one of the important reasons for newborns mortality.The current diagnosis indicators of neonatal infection have differences in the sensitivity and specificity,respectively.In recent years,procalcitonin (PCT) is widely used in the diagnosis of various infectious diseases.Studies showed that the PCT had higher sensitivity and specificity in the early diagnosis of neonatal infection.Serum PCT level is associated with the severity of neonatal infection,the development and the prognosis of the disease.It can be used to evaluate the effect of treatment and the prognosis.During the period of neonatal,the serum PCT is not affected by the level of maternal and the acute inflammatory response which caused by injuries and asphyxia,and it is associated with the severity of newborn bacterial infection.PCT has special significance to the diagnosis of neonatal infection.