Objective To understand the related analysis of the cause of atrial fibrillation and atrial size.Methods Among 133 cases of inpatients suffened atrial fibrillation,the 12 lead electrocardiogram(ECG) was recorded to analyze atrial fibrillation,and the echocardiography was used to measure the atrium size.Results The diameter of left atrium was obviously enlarged along with the age,but the variety of right atrium was unobvious.The left atrium enlargement was present in 68% with atrial fibrillation,among which the left atrium enlargement were present in 40.46% with hypertension heart disease(54 cases),in 35.33% with coronary heart disease(47 cases),and in 14.28% with valve disease(19 cases).Conclusion The left atrium enlargement is related to atrial fibrillation.We infer that atrial fibrillation could enlarge the left atrium,rather than that is induced by the left atrium enlargement.

Based on the discussion of the present English teaching in medical colleges and universities in China,this paper clarifies the mission and task of English teaching in medical colleges and universities and proposes that medical colleges and universities should attach importance to the education goals and needs of the department,major and students in the information age.It is believed that a scientific,reasonable and perfect English curriculum can be achieved by integrating IT into English curriculum,applying individualized teaching mode and expanding course connotation.

This paper first explains the contextual theory,then it analyses the contextual characteristics under network environment with multimedia.At last,according to systematic functional linguistics,it discusses the implications of how to take advantage of the contextual characteristics in College English teaching and learning.

Objective to investigate the efficacy of functional electrical stimulation(FES)on the postoperative treatment of lumbar disc hernia-tion. Methods Informed consents were obtained from all the subjects before the study. totally 60 patients who had remnant nervous lesion after sur-gery of lumbar disc herniation were divided into two groups:FES group and Control group. FES group received treatment since the first day after sur-gery. the parameters of therapeutic apparatus were as follows:35 Hz,0.28 ms,1 time daily and 30 min each time. the intensity of the treatment was the maximum tolerated that the patients can take. the course was 4 weeks. the control group during the study did not receive any stimulation. the myodynamia of hallux dorsiflexion and JOA score of patients were recorded and analyzed. Results After 2 weeks treatment,the myodynamia of FES group was 15.10±5.03,which was significantly larger than that of the control group at 12.03±6.30(P < 0.05). After 4 weeks treatment,the myody-namia of FES group was 20.43±5.73,which was significantly larger than that of the control group at 14.57±7.17(P < 0.05). After 4 weeks of treat-ment,the JOA score of FES group was 24.63±1.91,which was significantly higher than that of the control group at 19.87±2.33(P < 0.05). Conclu-sion After 2-4 weeks of functional electrical stimulation therapy,myodynamia of hallux dorsiflexion in FES group was significantly improved. And at the 4th week after operation,JOA score was more higher than that of the control group. Functional electrical stimulation in the treatment of remnant nervous lesion after postoperative of lumbar disc herniation has exact curative effect,which is worthy of popularization.

Objective:To investigate the effect of gegenqinlian on serum TNF-αlevel in rats with chronic periodontitis and athero-sclerotic.Methods:40 healthy male Wistar rats were randomly divided into control group(N,n =10)and model group(D,n =30).After model establishment and identfication the rats in model group were divided into D1,D2,D3,D4 and D5 groups(n =5) and were administered with saline,metronidazole,atorvastatin,metronidazole combined with atorvastatin and gegenqinlian respec-tively for 4 weeks.Periodontal indexes(PD and AL)were measured,the maximum intima-media thickness of abdominal aorta(IMT) was pathologically examined,TNF-αlevel was detected by ELISA.Results:After treatment PD,AL and serum TNF-αlevels in D2,D3,D4 and D5 groups were significantly lower than those in D1 group(P <0.05),There was no difference of lipid and TNF-αlevels between D4 and D5 groups(P >0.05).Conclusion:Gegenqinlian can reduce serum level of TNF-αin rats,suggesting that the drug is effective in the treatment of periodontitis with atherosclerosis.

Objective To study the curative efficacy of different doses of atorvastatin combined with fenofibrate in treatment of mixed type hyperlipidemia and its effects on blood lipid and prognosis.Methods 120 patients of mixed type hyperlipidemia who received therapy were selected as research subjects.According to random number table,the patients were divided into A group (n=60) and B group (n=60).The two groups were treated with atorvastatin and fenofibrate,the dose of atorvastatin in A group was 10mg,which in B group was 20mg,fenofibrate dose was 200mg.After 4 weeks of treatment,the therapeutic effect was compared.Results After treatment,the blood lipids of the two groups were improved(P<0.05),but total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C) in A group were better than those in B group[(5.20±0.31)mmol/L vs.(5.87±0.46)mmol/L,(2.61±0.29)mmol/L vs.(3.85±0.34)mmol/L,(1.12±0.17)mmol/L vs.(0.93±0.13)mmol/L,(3.03±0.32)mmol/L vs.(3.48±0.41)mmol/L](t=9.355,21.493,6.877,6.702,all P<0.05).There was no significant difference in the total effective rate between the two groups[96.67%(58/60) vs.91.67%(55/60)](x2=1.365,P>0.05).The incidence rate of adverse reactions in A group was lower than that in B group[96.67%(58/60) vs.76.67%(46/60)](x2=6.171,P<0.05).Conclusion Low dose (10 mg) of atorvastatin combined with fenofibrate for mixed type hyperlipidemia has good lipid regulating effect,and adverse reaction is low,has little effect on the liver function of patients,which can effectively improve the prognosis,it is worthy of application and promotion.

Objective To investigate the comparison of clinical curative effect and inflammation factors between irbesartan hydrochlorothiazide and candesartan cilexetil in the treatment of patients with hypertension.Methods A total of 86 patients with hypertension in our hospital from June 2014 to October 2015 were collected and randomly divided into two groups, 43 cases in the control group were treated by candesartan cilexetil,43 cases in the experimental group were treated by irbesartan hydrochlorothiazide.The blood pressure, CRP, IL-6 and NO indexes were detected in the two groups and the clinical curative effect of the two groups was compared.Results The systolic pressure and diastolic pressure levels in the experimental group were significantly lower than the control group ( P <0.05 ); the serum CRP, IL -6 levels in experimental group were significantly lower than the control group, the NO level was significantly higher than the control group (P<0.05).Conclusion Irbesartan hydrochlorothiazide in the treatment of patients with hypertension has a better clinical curative effect, and higher security.

Objective To investigate the differences of clinical features,pulmonary function tests,chest imaging and prognosis between patients with idiopathic pulmonary fibrosis (IPF) combined with emphysema and without emphysema.Methods A total of 43 patients with IPF and with pulmonary fibrosis and emphysema (CPFE) were selected as observation group,and 40 patients with IPF and without emphysema were selected as control group.The clinical data of two groups of patients,including pulmonary function,partial pressure of oxygen,cellular components of bronchoalveolar lavage fluid (BALF),survival time were retrospectively analyzed and compared between two groups.Results The smoking index was (29 ± 17) pack years in observation group,much higher than that in control group (17 ± 15) pack years,the difference was statistically significant (P ＜ 0.05).The percentage of forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) was (70 ± 6)％ in observation group,significantly lower than that in control group (84 ± 9)％,the difference was statistically significant (P ＜ 0.05).The percentage of diffusion capacity of carbon monoxide (DLCO) in observation group was (43 ± 11)％,significantly lower than that in control group (55 ± 17)％,the difference was statistically significant (P ＜ 0.05).The percentage of lung volume in observation group was (78 ± 12)％,significantly higher than that in control group (63 ± 11)％,the difference was statistically significant (P ＜0.05).The vital capacity was expected to account for partial pressure had no significant difference in percentage and resting arterial oxygen value between two groups (P ＞ 0.05).The total number of BALF cells,macrophages,neutrophils,lymphoeytes and eosinophils ratio had no significant difference between two groups (P ＞ 0.05).Conclusion Smoking is an important risk factor of IPF with emphysema,emphysema does not affect the prognosis of patients with IPF.

Objective To observe the anesthesia and analgesia effect of ultrasound guided inter-scalene brachial plexus block (ISPSP)on upper extremity surgery.Methods Fifty-four patients (male 34 cases,female 20 cases,aged 37-73 years,ASA grade Ⅰ or Ⅱ)scheduled for elective upper limb surgery under ISPBP combined with general anesthesia were randomly assigned into two groups:magnesium sulfate group (group M,n =27)and control group (group N,n =27).0.5% ropivacaine 8ml (40 mg)+10% magnesium sulfate 2 ml (0.5 g)were used in group M ,0.5% ropivacaine 8 ml+ normal saline 2ml (40 mg)were used in group N.After the effects of ISBPB were confirmed,pa-tients were inserted laryngeal mask under intravenous induction.Anesthesia was maintained by inha-ling sevoflurane(MAC 0.8)during the operation.The onset time of sensory and motor block,duration of sensory and motor block,duration of analgesia,pain visual analogue digital score (VAS)4,8,12, 24 hours after operationand complications were recorded.Results Duration of sensory block and du-ration of analgesia of group M was significantly longer than those of group N (P <0.05).The patient`s VAS score of 8,12,24 hours after surgery in group M was significantly lower than that on group N (P <0.05).Onset time of sensory and motory block of both groups was similar.Conclusion 0.5%ropivacaine combined with magnesium sulfate in ultrasound-guided ISPBP can extend the duration of sensory block,reduce postoperative pain,as well as prolong analgesia time.

[Summary] A total of 352 pregnant women were selected in Affiliated Hospital of Qingdao University. Serum levels of TSH and FT4 were determined and pregnancy outcome were observed in all subjects. According to the standard of American Thyroid Association(ATA) published in 2011 and the Chinese Guideline of Gestation Thyroid Disease published in 2012, the subjects were grouped into control(0. 1≤TSH≤2. 5 mIU/ L), observation(2. 55. 17 mIU/ L)during first-trimester(T1)and control(0. 2≤TSH≤3. 0 mIU/ L), observation(3. 05. 22 mIU/ L) during second-trimester(T2). The results showed that the rupture of membranes, preterm labor, and total obstetrical adverse events in the observation group were significantly higher than those in control group during T1(all P<0. 05), no statistical significance between control group and treatment group. The rupture of membrances in the observation group was significantly higher compared with control group during T2 ( P < 0. 05), no significant difference in other adverse pregnancy outcomes between these two groups. Compared with control group during T1, the proportion of adverse pregnancy outcomes in observation group during T1 was significantly increased(P<0. 05). The elevated TSH is one of the risk factors for the increased incidence of adverse pregnancy outcomes at the first half of pregnancy, especially during T1. L-T4 treatment reduces the incidence of adverse pregnancy outcomes.