Objective: To investigate the short-term effects of ischemic preconditioning (IP) on left ventricular diastolic function in diabetic patients with acute myocardial infarction(AMI). Methods: Totally 188 patients with first AMI were studied. Eighty-one patients without diabetes were divided into group A (with IP) and group B (without IP). The other 107 patients with diabetes were divided into group C (with IP) and group D (without IP).The effect of IP on peak creatine kinase value and left ventricular diastolic function were analyzed separately. Results: The peak creatine kinase value, the peak creatine kinase MB fractions and the incidence of E/A

Objective To observe the clinical effect of acupuncture combined with traditional Chinese medicine Tongluo huayu decoction on white matter damage in patients with occlusive cerebral infarction.MethodsA total of 76 patients with cerebral infarction with cerebral hemorrhage were enrolled in this study from April 2013 to January 2015.The random number table was divided into observation group and control group (38 cases).The control group was given routine western medicine treatment, the observation group on the basis of the control group plus traditional Chinese medicine tongluo huayu decoction, and with acupuncture treatment, the two groups were treated for 2 months, compare the effectiveness of treatment, analysis of the two groups before and after treatment platelet aggregation rate MAR (CDCA) and platelet-activated granule membrane glycoprotein 62P (CD62P), and the prognosis was analyzed by NIHSS, Montreal Metabolic Assessment Scale (MoCA) and Barthel Index (BI) Observe adverse reactions.ResultsThe effective rate of the observation group was 94.74% higher than that of the control group (78.95%, P< 0.05).After treatment, the expression of CD62P (21.87±1.55)%, MAR (35.23±1.62)% and NIHSS score (10.27±0.78) (P< 0.05).The incidence of adverse events was 13.16% in the observation group (25.04±1.11) and the BI index (88.15±1.20) were significantly higher than those in the control group (P< 0.05);There was no significant difference in the prevalence of adverse effects between 13.16% and 7.89%.ConclusionAcupuncture combined with traditional Chinese medicine Tongluo huayu decoction can effectively protect the white matter of patients with massive arterial occlusive cerebral infarction, improve its platelet CD62P, MAR and neurological function, cognitive function, improve the quality of life, and mild adverse reactions, it is worth in the clinical promotion application.

OBJECTIVE:To establish a HPLC method for determination of the plasma concentrations of isoniazid(INH)and its metabolite acetyl-isoniazid(AcINH).METHODS:Trichloroacetic acid was added to plasma to precipitate protein,then the supernatant was divided into 2 parts,distilled water was added to the first part;while HCl was added to the second one,after incubated at 80℃for 1 hour,1%cinnamaldehyde was added to perform precolumn derivatization.The column was Hypersil BDS C 18 ,the mobil phase was eluted with0.02mol/L NaH 2 PO 4 (pH=4.0)-acetontrile(69∶31)and detected wave-length was 340nm,the flow fate was1ml/min.RESULTS:INH detectable concentration showed a good linear correlation in the range of 0.57～145.88?mol/L,the average recoveries of INH and AcINH were 101.1% and 101.5% respectively,the average RSD within or between day was less than 10%.CONCLUSION:The present method is applicable to monitoring of INH plasma concentration and the study of metabolism capacity of N-acetyltransferase.

Objective:To help hospitals at different levels develop and provide patients with high-quality medical services.Methods: Primary data were gathered through face-to-face surveys with questionnaires employed.Totally 195 questionnaires and 134 valid questionnaires were collected.Analysis of variance,independent-sample test,and cross-table combining z-test were used to complete data analysis.Results: Research outcome indicates there is no significant difference in outpatients' satisfaction level among hospitals at different levels,similar to outpatients' loyalty level.There are different affecting factors on outpatients' recommendation and satisfaction.Conclusion: Hospitals should be clear of patients' satisfaction level,evaluate patients' loyalty objectively,and make great effort on patients' concerning aspects.

Objective:To explore the influencing factors on outpatients′ satisfaction of medical service.Methods: 195 samples coming from 5 provinces: Shandong,Hebei,Liaoning,Heilongjiang and Jilin province,and Tianjin City were all from the outpatients′ pupulation within a year,and were investigated with questionnaires.The data were collected by face-to-face survey,and totally 134 valid questionnaires were gathered.We use the following methods to complete data analysis: independent sample t-test,and analysis of variance,analysis of correlation,expecting to find the personal factors to affect outpatient satisfaction.Results: research outcome indicates that gender has no effect on outpatient′s satisfaction;while indexes as age and education level have significant influence.

Objective To evaluate the effect of different tube voltages on the radiation dose and image quality of a full field digital mammography system.Methods Both experiments were performed under manual exposure mode.In one experiment,the tube voltages were kept constant at 25,28 and 31 kVp,and the CIRS 015 phantom was exposed at three target/filter combinations molybdenum/molybdenum (Mo/Mo),molybdenum/rhodium (Mo/Rh),and rhodium/rhodium (Rh/Rh) and at tube current-exposure time products of 32-140mAs.The entrance skin exposure (ESE) and average glandular dose (AGD) were recorded,the signal-to-noise ratio(SNR) and contrast-to-noise ratio (CNR) and figure of merit (FOM) were measured to evaluate the influences of different tube voltages on dose and image quality at same target/filter combination.The univariate of randomized completed block-design was used for statistics.In second experiment,the phantom were exposed using Mo/Rh combination when the tube current-exposure time product was kept constant at 56 mAs,and the tube voltage varied between 23 and 33 kVp in 1-kVp increments.The ESE and AGD were recorded,the SNR,CNR and FOM were measured for plotting the curves against tube voltages.Results At Mo/Mo combination,the AGD,ESE,SNR,CNR and FOM of 25,28 and31 kVp were(1.25 ±0.56) mGy,(6.46±2.86) mGy,71.52±8.37,1.91 ±0.26,3.21 ± 0.68; (1.94 ±0.85) mGy,(9.18±4.07) mGy,144.46 ± 11.31,2.41 ±0.28,3.37 ±0.96 and (3.01 ±1.38) mGy,(12.60±5.59) mGy,128.89 ±15.29,2.47 ±0.31,2.31 ±0.76 respectively; at Mo/Rh combination were (1.23 ±0.55) mGy,(5.26 ±2.33) mGy,67.31 ±4.11,1.82 ±0.19,3.01 ± 0.82; (1.86 ±0.84) mGy,(7.57 ±3.34) mGy,139.54 ± 12.16,2.30 ±0.25,3.23 ±0.92 and (2.81 ±1.24) mGy,(10.48 ±4.62) mGy,127.77 ±15.14,2.59 ±0.31,2.67 ±0.68; and at Rh/Rh were(1.09 ±0.48) mGy,(4.89 ±2.16) mGy,67.46 ±2.23,1.48 ±0.72,3.08 ± 1.69; (1.75 ± 0.78) mGy,(6.88 ±3.03) mGy,137.74 ± 14.65,2.37 ±0.26,3.62 ± 1.07 and (2.59 ± 1.13) mGy,(9.32 ± 4.12) mGy,117.91 ± 19.05,2.51 ± 0.31,2.74 ± 0.84.Both experiments indicated that,for a given target/filter combination,the AGD,ESE and CNR increased,but the ESE/AGD decreased with the tube voltage increasing; The first experiment indicated both SNR and FOM of 28 kVp were higher than that of 25 kVp and 31 kVp; the second experiment showed both SNR and FOM decreased with tube voltages increasing.The differences of AGD、ESE、ESE/AGD、SNR、CNR and FOM among the three tube voltages were significant (F =4.391-528.848,P ＜ 0.05) ; but the difference of CNR between 28 and 31 kVp at Mo/Mo and Rh/Rh had no statistical significance (P ＞ 0.05) ; and the differences of FOM between 25 and 28 kVp at the three target/filter combinations were not statistically significant (P ＞ 0.05).Conclusion For a breast with 4.2 cm thickness and 50％ adipose 50％ glandular composition,different tube voltages have significant effects on the radiation dose and image quality.

[ABSTRACT]OBJECTIVETo estimate different dimensions of maxillary sinus measured on cone-beam computerized tomography (cone-beam CT), and determine the differences in side and gender.METHODScone-beam CT image data from 200 normal adults was selected and analyzed by Invivo Dental software. The craniocaudal diameter, anteroposterior diameter, width and volume of maxillary sinus were measured as well as the thickness of the orbital floor. Statistical analysis was performed with SPSS 11.5.RESULTSThere were no statistically significant differences in the craniocaudal diameter, anteroposterior diameter, width and volume of maxillary sinus between sides (P>0.05, respectively). Significant differences were noted in the craniocaudal diameter and volume of bilateral maxillary sinus and the width of right maxillary sinus based on gender (P<0.05, respectively). There were no significant differences in the width of left maxillary sinus, the anteroposterior diameter of bilateral maxillary sinus and the osseous thickness of the orbital floor (P>0.05, respectively).CONCLUSIONOur findings indicate that cone-beam CT can be used to measure different dimensions of maxillary sinus and provide imaging anatomical data for clinical treatment.

Objective To explore the correlation between the total burden of cerebral small vessel disease and poor prognosis of branch atheromatous disease(BAD)in elderly patients.Methods A total of 114 BAD patients admitted to Shanghai Eighth People's Hospital between January 2021 and March 2023 were enrolled,and according to mRS score at 90 d after onset,they were divided into a good prognosis group(mRS score ≤2,67 cases)and a poor prognosis group(mRS score＞2,47 cases).The clinical and imaging characteristics were analyzed,and the relationship between total cerebral small vessel disease burden and clinical prognosis of BAD was investigated using lo-gistic regression analysis.ROC curve analysis was used to determine the threshold of the total cere-bral small vessel disease burden for predicting adverse outcomes and to evaluate its sensitivity and specificity.Results The good prognosis group had younger age,smaller proportion of diabetes,lower SBP,NIHSS score at admission and white matter hyperintensities,and reduced ratio of cerebral microbleeds than the poor prognosis group(P＜0.05,P＜0.01).Statistical difference was observed in the total cerebral small vessel disease burden between the two groups(P＜0.01).Binary logistic regression analysis showed that the total cerebral small vessel disease burden score and NIHSS score at admission were independent predicators of poor prognosis in BAD patients(OR=3.350,95％CI:1.439-7.798,P=0.005;OR=2.814,95％CI:1.586-4.993,P=0.001).ROC curve analysis indicated that the total cerebral small vessel disease burden had a cut-off val-ue of 1.5,and the sensitivity and specificity for predicting poor prognosis was 63.8％and 86.6％,respectively,for BAD patients.Conclusion The total cerebral small vessel disease burden is an in-dependent predictor for poor prognosis of BAD patients.

Objective:To study the influence of different feeding patterns on mother-to-child transmission (MTCT) of hepatitis B virus (HBV) in pregnant women with high viral loads who received antiviral medication during pregnancy to the day of delivery.Methods:This prospective cohort study was conducted in Beijing You'an Hospital. From January 1, 2019, to March 31, 2020, and 574 pregnant women with positive hepatitis B surface antigen (HBsAg) and HBV DNA>2×10 5 IU/ml were enrolled. All participants received tenofovir, telbivudine, lamivudine, or propofol tenofovir from 24-28 weeks of gestation and discontinued on the day of delivery, and their neonates were postnatally given routine passive-active immunoprophylaxis. Based on the feeding patterns, the subjects were divided into three groups: breastfeeding ( n=257), bottle-feeding ( n=241) and mixed feeding groups ( n=76). The follow-up data were obtained from liver functions and HBV DNA level of the mothers at 6-8 weeks postpartum and HBV serological markers of infants at 7-12 months. One-way ANOVA, Student-Newman-Keuls, Chi-square test or Fisher exact test, and repeated measures ANOVA were used to analyze the data. Results:The average maternal HBV DNA levels before antiviral treatment did not differ significantly between the three groups [(7.90±0.67), (7.82±0.70), (7.83±0.70) log 10 IU/ml, F=0.912, P>0.05]. HBV DNA level before delivery in the mixed feeding group was slightly lower than that in the breastfeeding and bottle-feeding group [(3.87 ±1.08) vs (4.21±1.17) and (4.30±1.28) log 10 IU/ml, q= 3.052 and 3.831, both P<0.05], while the comparison between the latter two groups showed no significant differences ( P>0.05). After delivery, HBV DNA level in the bottle-feeding group was slightly lower than that in the breastfeeding group [(7.42±0.93) vs (7.69±0.90) log 10 IU/ml, q=4.583, P<0.05]. Among 580 infants (including six pairs of twins), only one bottle-fed infant (0.4%, 1/243) was infected with HBV through MTCT, and none in the breastfeeding or mixed feeding group ( P=0.553). Conclusions:For pregnant women with high viral loads of HBV who have received antiviral medication during pregnancy, although HBV DNA level will rebound after discontinuation upon delivery, breastfeeding is recommended considering it does not increase the risk of MTCT.

Objective: To investigate the feasibility of multiplex real-time RT-PCR with fluorescent probes in early screening of Ph-like acute lymphoblastic leukemia (ALL) and analyze the clinical feature and prognos. Method: A total of 118 adult B-ALL patients diagnosed between October 2010 and March 2016 were enrolled in this study. Multiplex RT-PCR was used to detect the Ph-like ALL related fusion gene and CRLF2 expression in 58 BCR-ABL and MLL rearrangement negative patients. The clinical features, treatment response and prognosis were analyzed in Ph-like fusion gene positive and/or CRLF2 over-expression patients. Result: Among 58 patients, 9 patients (9/58, 15.5%) showed Ph-like ALL related fusion genes positive and 10 patients (10/58, 17.2%) showed CRLF2 over-expression. There were statistical differences in age, WBC count, immunophenotypes, cytogenetics and risk stratification among Ph-like fusion gene positive or CRLF2 over-expression patients, Ph⁺ patients, MLL⁺ patients and B-other patients. The 2-year overall survival rates were 65%, 47%, 64% and 74% respectively among these four groups (P=0.043) . The 2-year relapse free survival rates were 51%, 39%, 62% and 70% respectively among these four groups (P=0.010) . Conclusion Routine screening of Ph-like ALL by multiplex RTPCR is feasible.