Objective Anovel index based on frequency-domain analysis of heart rate variability (HRV) was tested on patients with reduced left ventricular systolic function.This index,namely VHFI,was defined as the very high frequency (VHF) component of the power spectrum normalized to represent its relative value in proportion to the total power minus the very low frequency component.Methods Patients (n=130) were divided into a study group,consisting 66 patients with decreased left ventricular systolic function,and a control group,consisting 64 patients with normal heart structure and function and without severe coronary artery stenosis (＜50%).Results VHFI in the study group was significantly higher than that in the control group (19.17±13.35 vs 11.37±10.77,P＜0.001).Cardiac events occurred in 18 patients during follow-up (33.34±3.26 months).Defining the positive test as VHFI =15 and negative test as VHFI ＜15,achieved a sensitivity of 57.58% and a specificity of 78.13% for predicting decreased left ventricular systolic function,and achieved a sensitivity of 66.67% and a specificity of 64.29% for predicting cardiac events.Univariate Cox regression analysis showed that positive VHFI test was an independent variable in predictive cardiac events.Conclusions The results suggest that VHFI is a useful tool for quick evaluation of left ventricular systolic function and prediction of prognosis.

Objective To investigate the effects of self-made Yishen Antai Decoction combined with progesterone in the treatment of recurrent spontaneous abortion (RSA) and the effect on pregnancy outcomes and blocking antibodies (BA). Methods 100 cases of patients with RSA were randomly divided into the observation group and the control group, 50 cases in each group. The control group was treated with progesterone and on the basis, the observation group was additionally treated with self-made Yishen Antai Decoction. Both groups were intervened till 12 weeks of gestation, and the clinical curative effect was evaluated. Results The total effective rate of treatment, the success rate of pregnancy and the positive rate of blocking antibody (BA) showed significant differences between the observation group and the control group (P< 0.05). After treatment, the total TCM symptom score and serum levels of interleukin-2 (IL-2) and interferon-γ (IFN-γ) were significantly lower while interleukin-10 (IL-10) level was significantly higher in the observation group than the control group (P< 0.05). There were no serious adverse reactions in the two groups. Conclusion Self-made Yishen Antai Decoction is effective and safe in the treatment of RSA. It can significantly improve the success rate of pregnancy and the positive rate of BA, which may be associated with the regulation of IL-2, IL-10 and IFN-γ levels.

Objective To make an evidence-based rehabilitation plan for a patient with osteogenesis imperfecta after external fixation. Methods Based on a comprehensive assessment for the patient's condition, the clinical problems were listed. Related articles were searched from National Guideline Clearinghouse (NGC), The Cochrane Library, PubMed, CBM, CNKI and Wanfang databases. And the reference list of each eligible article was also included. Finally the optimum rehabilitation program was designed with optimal clinical evidence, patient's conditions and relatives' willingness. Results 1 randomized controlled trial and 4 case reports were included. A progressive exercise program was developed and implemented. No new fractures occurred during the intervention. Muscle strength, gait, activities of daily living had been greatly improved. 20 weeks later, the Berg score was 43 and the Barthel index was 80. Conclusion The progressive rehabilitation exercise program developed from evidence-based practice is safe, effective and feasible.

Compared with hip replacement, internal fixation in the treatment of the elderly femoral neck fracture, especially the application of cannulated screws, is minimally invasive, easy to operate and economical. In recent years, it becomes the research focus in the field of orthopedic clinical research. However, configuration of cannulated screws is still controversial. Most clinicians believe that three cannulated screws being placed in parallel in an inverted triangle configuration is better than that in a triangular configuration in biomechanics and clinical effect. Nonparallel strong oblique nailing technique allows the screws to share more weight to reduce postoperative complications, so that it is more suitable for elderly patients with osteoporosis. However, the related complications of internal fixation such as nonunion, femoral neck shortening and other problems are still the focus of domestic and foreign scholars. Issues about how to control the indication of internal fixation surgery, understand related factors of the complications, and prevent complications are required to be further explored.
Aged ; Bone Nails ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Internal ; adverse effects ; methods ; Humans ; Internal Fixators

Adult ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurotoxicity Syndromes ; diagnosis ; Retrospective Studies ; Tomography, X-Ray Computed

Objective To evaluate the clinical significance of laparoscopic operations in the treatment of ovarian endometriosis cysts. Methods We compared clinical data between 52 cases of laparoscopic operation for ovarian endometriosis cysts (Laparoscopy Group) and 75 cases of open operation for ovarian endometriosis cysts (Open Group) in the same period. Results The operation time was significantly shorter in the Laparoscopy Group (61 4?9 3) than in the Open Group (72 6?7 1) ( t =7 692, P =0 000). The time to first flatus was significantly earlier in the Laparoscopy Group (25 3?4 1 h) than in the Open Group (49 8?6 9 h) ( t =22 935, P =0 000). The postoperative pyrexia rate in the Laparoscopy Group (9/52) was significantly lower than that in the Open Group (31/75) ( ? 2 =8 216, P =0 004). There were no significant differences on the remission rate of dysmenorrhea between the Laparoscopy Group (26/37) and the Open Group (34/51) ( ? 2=0 128,P =0 818) and on the postoperative pregnancy rate between the Laparoscopy Group (5/22) and the Open Group (7/25) ( ? 2 =0 171, P =0 747). Conclusions Laparoscopic operation for ovarian endometriosis cysts is as effective as open operation, being an ideal alternative.

Objective To investigate the effect of specific small interfering RNA (siRNA) targeting receptor of advanced glycation end products (RAGE) on the production of fibrosis markers (laminin,hyaluronic acid (HA) and N-terminal procollagen Ⅲ propeptide (PⅢ NP) in hepatic fibrosis (HF).Methods The expression vectors of specific siRNA targeting RAGE were constructed.Primary rat hepatic stellar cells (HSC) were isolated and cultured.The primary rat HSC were transfected with the recombinant vector.The blank control group and unspecific siRNA vector pAKD-NC-transfected group were as controls.The expressions of RAGE,laminin,HA and PⅢ NP at mRNA and protein levels were detected by real-time polymerase chain reaction and Western blot,respectively.Least-significant difference (LSD) and Student-Newman-Keuls (SNK) were performed to analyze standard normal distribution or homogeneous variance.Non-normal distribution and heterogeneity of variance data were analyzed by non-parametric Wilcoxon test.Results The expressions of RAGE at mRNA and protein levels in pAKD-GR126-transfected primary HSC were (42.32 ± 6.16)％,(43.24±7.50)％,(51.06±13.79)％ and (47.94±5.36)％ in blank control group and pAKDNC group (F=7.791 and 36.513,all P＜0.05).The expressions of laminin at mRNA and protein levels were (41.07±3.13)％,(40.59±5.87)％,(53.89±2.25)％ and (52.46±4.68)％ in blank control group andpAKD-NC group (F=225.111 and 88.039,all P＜0.05).The expressions of HA at mRNA and protein levels were (45.69 ± 0.87) ％,(46.08 ± 2.36) ％,(54.20 ± 0.56) ％ and (52.30±3.42)％ in blank control group and pAKD-NC group (F=178.317 and 180.646,all P＜ 0.05).The expressions of PⅢ NP mRNA at mRNA and protein levels were (56.10±4.18)％,(55.15±2.39)％,(54.40±2.79)％ and (53.58±6.18)％ in blank control group and pAKD-NC group (F=141.633 and 49.670,all P＜0.05).Conclusion RAGE specific siRNA could inhibit the expression of RAGE in primary rat HSC and could significantly lower the expression of fibrosis markers laminin,HA and PⅢ NP at mRNA and protein level.

Objective To investigate vascular endothelial growth factor(VEGF) and TNF-α levels in the serum of patients with primary hepatocellur carcinoma(HCC),and to evaluate their relevance with the development and metastasis of HCC.Methods VEGF and TNF-α levels in serum were examined by enzyme linked immunosorbent assay(ELISA) technology in 87 patients with HCC and 10 healthy individuals.Results Serum VEGF and TNF-α,levels in HCC patients were significantly higher than that in the contorl group.In addition,HCC patients infected with hepatitis virus(including HBV and HCV) showed a remarkable elevation in serum VEGF and TNF-α levels.The VEGF and TNF-α levels in HCC with metastasis were also higher than those without metastasis.Conclusion The serum VEGF and TNF-α levels in HCC patients might serve as the pivotal biological indices that could reflect HCC progressien and metastasis.

Objective To investigate the preventive and therapeutic effects of nonsteroidal anti-inflammatory drugs ( NSAIDs) via rectum for hyperamylasemia and pancreatitis after ERCP (endoscopic retrograde cholangiopancreatography).Methods Sixty patients who underwent ERCP for various reasons were randomly divided into preventive and control groups.In addition to routine diazepam (10 mg) and anisodamine (10 mg) given intramuscularly in both groups before ERCP, 100 mg of indometacin suppositories was administered by rectum in preventive group.Serum amylase level was measured before and 6 hours and 24 hours after the procedure.Results Serum amylase levels at 6 hours after ERCP in preventive and control groups were (367.5 ± 268.7 ) U/L and (1034.2 ± 713.5 ) U/L, respectively ( P < 0.05 ), which were (324.9±142.3)U/L and (826.8 ±395.7)U/L, respectively, at 24 hours after ERCP (P<0.05).Conclusion Rectal use of NSAIDs can prevent hyperamylasemia and acute pancreatitis induced by ERCP.

Vascular prosthesis can absorb y-globulin or fibrinogen when they are transplanted in vivo, accordingly the cellular components in blood, such as platelet, are easy to attach on surface and become fiat shape to be activated, which then result in an inreversible aggregation and thrombus formation. During the process of transplanting vascular prosthesis at a diameter of more than 6 mm, a high vascular patency rate can be observed, while small-diameter (< 6 mm) vascular prosthesis transplantation is under low blood flow, therefore it produces the thrombosis. It is necessary to conduct surface modification of small-diameter vascular prosthesis and to enhance hemocompatibility. The main methods of modification include the alter of surface structure of vascular prosthesis, the augmentation of endothelial cells attachment on surface of vascular prosthesis, and grafting modification of vascular prosthesis surface.