Objective To research the risk factors of new-onset atrial fibrillation (AF) during hospitalization in patients with acute myocardial infarction.Methods Five hundred and one patients first diagnosed with acute ST-segment elevation myocardial infarction who accepted primary coronary intervention from January 2012 to May 2014 in the Second Hospital of Tianjin Medical University were selected.These patients were divided into non-AF group and new-onset AF group depending on whether happened new-onset AF during hospitalization.Data of the patients in acute myocardial infarction complicated with new-onset atrial fibrillation were collected.Univariate and multivariate logistic regression analysis were used to determine the predictors of new-onset AF.Results AF occurred in 49 cases of the 501 (9.8％) patients diagnosed as acute myocardial infarction.Logistic regression analysis showed that admission heart rate(OR =1.019,95％CI:1.004-1.034,P =0.012),left atrial diameter (OR =1.086,95％ CI:1.021-1.156,P =0.009),previous stroke (OR =2.060,95％ CI:1.029-4.123,P =0.041) were independent risk factors for new-onset AF in acute myocardial infarction.Use of β-blockers before coronary intervention treatment can reduce the risk of new-onset atrial fibrillation(OR=0.222,95％CI:0.064-0.768,P=0.017).Conclusion Admission heart rate and left atrial diameter are independent predictors of new-onset atrial fibrillation,and β-blockers in early stage can effectively reduce the incidence of atrial fibrillation.

Objective To investigate causes and effects of medial meniscus extrusion in patients with knee osteoarthritis.Methods A total of 120 patients diagnosed as knee osteoarthritis between January 2011 and March 2012 were enrolled in this study,including 60 patients with medial meniscal extrusion confirmed by MRI (extrusion group) and other 60 patients without medial meniscal extrusion (control group).The extrusion distance of medial meniscus and tibiofemoral angle were measured on MRI.The correlation between tibiofemoral angle and extrusion distance were analyzed.The incidences of genu varum,medial meniscus injury and cartilage lesion of medial tibiofemoral joint were compared between two groups.The effect of medial meniscal extrusion on meniscus injury and effect of genu varum on meniscal extrusion were analyzed.Results In extrusion group,the extrusion distances of medial menisci ranged from 3.76 to 11.6 mm (average,8.3±1.79 mm); all patients had genu varum,and the tibiofemoral angle ranged from 174°to 181°(average,179.0°±2.2°); the incidence of medial meniscus injury was 50.0％ (30/60) in the anterior horn,93.3％ (56/60) in the body,and 93.3％ (56/60) in the posterior horn; the incidence of medial meniscus tear in the root of the posterior horn was 23.3％ (14/60); the incidences of cartilage degeneration in medial tibial plateau and medial femoral condyle both were 100％ (60/60); a significant negative correlation was observed between dimension of tibiofemoral angle and extrusion distance of medial meniscus.In control group,the extrusion distances of medial menisci ranged from 0 to 2.61 mm (average,0.57±0.80 mm); four patients had genu varum,and the tibiofemoral angle in all patients was 180°; the incidence of medial meniscus injury was 0 in the anterior horn,16.7％ (10/60) in the body,and 70.0％ (42/60) in the posterior horn; no medial meniscus tear was found in the root of the posterior horn; the incidence of cartilage degeneration was 26.7％(16/60) in medial tibial plateau and 30.0％ (18/60) in medial femoral condyle.The odd ratio of meniscus injury and the number of genu varum (extrusion group/control group) was 6.0 and 15.0,respectively.Compared with the control group,the incidences and severities of medial meniscus injury and cartilage lesion of medial tibiofemoral joint were higher in extrusion group.Conclusion Genu varum may be one cause of medial meniscal extrusion.Medial meniscal extrusion increases incidence of medial meniscus injury and has a significant influence on generation and development of osteoarthritis in medial tibiofemoral joint.

Objective To investigate the dosage and safety of insulin aspart in continuous subcutaneous insulin infusion plus oral antidiabetic drugs for the treatment of hyperglycemia in elderly hip fracture.Methods Patients with hip fracture and hyperglycemia who required insulin pump therapy were divided into 2 groups according to age:elderly group (patients aged over 65 years,n=42) and non-elderly group (patients aged under 65 years,n=43).All patients were treated with insulin aspart in continuous subcutaneous insulin infusion plus oral antidiabetic drugs combined with diet therapy.Dosages of aspart insulin and adverse effects were compared between the two groups.Results There were no significant differences in basic aspart dosage and additional premeal dosage between elderly and non-elderly groups [(0.29±0.09) IU/kg vs.(0.30±0.07) IU /kg,(0.27±0.09) IU/kg vs.(0.27±0.07) IU/kg,both P＞0.05].The incidences of hypoglycemia with and without symptoms in elderly versus non-elderly groups were 4.8％ vs.4.7％ and 14.3％ vs.18.6％,which had no significant differences between the two groups (P＞0.05).Hypoglycemia accompanied by consciousness disorders,allergy,nonhealing and slow healing wounds were not found in the two groups.The ratio of oral antidiabetic drugs including metformin,glimepiride,and glycosidase inhibitor had no differences between the two groups.Conclusions Aspart insulin in continuous subcutaneous insulin infusion is effective and safe in the treatment of acute severe hyperglycemia in elderly patients with hip fractures when combined with diet therapy and oral antidiabetic drugs.

A high-performance liquid chromatography/electrospray ionization tandem mass spectrometry (LC-ESI-MS/MS) method was developed and validated for the determination of mizoribine in human serum using thiamphenicol as internal standard (IS). The serum samples of mizoribine were precipitated with acetonitrile and separated by HPLC on a reversed phase C18 column with a mobile phase of 0.1% ammonium acetate water solution-methanol (47:53, v/v). Mizoribine and IS were detected in the multiple reaction monitoring mode with precursor/product ion transitions of m/z 258.2/126.0 and 354.1/185.2, respectively. The calibration curves were linear over the range of 0.02-2 microg mL(-1) for mizoribine. The limit of quantification (LOQ) was 0.02 microg mL(-1) with acceptable precision and accuracy. The validated method was successfully applied for the evaluation of a bioequivalence study on Chinese healthy volunteers. The main pharmacokinetics parameters after oral administration of 100 mg mizoribine test or reference formulation were as follows: Cmax (1.00 +/- 0.21), (1.00 +/- 0.22) microg mL(-1); AUC(0-infinity) (6.72 +/- 1.39), (6.48 +/- 1.44) microg h mL(-1); t1/2 (2.77 +/- 0.26), (2.66 +/- 0.29) h; tmax (2.95 +/- 0.78), (2.84 +/- 0.50) h.

Objective To observe the effect of acupuncture at the muscle region of meridians plus tuina on facial nerve function in peripheral facial paralysis. Method Sixty patients with peripheral facial paralysis (recovery stage) were randomized into a treatment group (intervened by acupuncture at the muscle region of meridians plus tuina) and a control group (intervened by conventional acupuncture), 30 cases in each group. Result The facial nerve electromyography (EMG) showed that the action potential latency and amplitude were changed significantly after the treatment in both groups (P<0.05), indicating that the two methods were both effective in recovering facial nerve function, while acupuncture at the muscle region of meridians plus tuina produced a more significant treatment effect compared to conventional acupuncture. In the treatment group, same treatment with different intervention times produced significantly different effects on the Toronto facial grading system (TFGS) (P<0.05), indicating that the earlier the intervention, the more significant the therapeutic efficacy. Conclusion Acupuncture at the muscle region of meridians plus tuina can produce a more significant effect in recovering facial nerve function in peripheral facial paralysis compared to conventional acupuncture.

Objective To compare the safety and effectiveness of power peripherally inserted central catheters (Power PICC) and double cavity central venous catheter (CVC) application in intensive care unit (ICU). Methods 458 cases were reviewed during January to September in 2014 and divided into two groups: Power PICC group (245 cases) and CVC group (213 cases) , and average retention time, successful rate of inserting catheter and the incidence of complications were compared. Results The average retention time of Power PICC group was (21.6±5.8) days which was longer than (13.1±3.4) days of CVC group (t=2.234, P <0.05). No statistics difference of successful rate between two groups (P>0.05). No significant difference for the total incidence of complications between two groups as 14.69% (36/245) and 19.72%(42/213)(P>0.05). No significant difference for the total incidence of complications in the operation time between two groups as 5.31% (13/245) and 4.23% (9/213)(P>0.05). But rate of catheter malposition for Power PICC group [ 2.86% (7/245) ] was higher than CVC group 0 (X2=4.428, P <0.05). Rate of the total incidence of complications in the retention time Power PICC group [ 9.39%(23/245) ] was lower than CVC group [ 15.96%(33/213)(P<0.05). And rate of catheter related blood stream infection of CVC group [3.29%(7/213)] was much more higher than Power PICC group (0)(X2=6.139,P<0.05). Conclusions Power PICC and CVC are both applicable for ICU, and Power PICC has more advantage regarding safety and effectiveness than CVC and can be one replacement for CVC.

AIM: To investigate the influence of GM-CSF on human vascular endothelial cells induced to form new blood vessels and the role of VEGF.METHODS: HUVECs were cultured by Matrigel to set up a stable angiogenesis system with the stimulating factors.The rhGM-CSF concentration-dependent and time-dependent effects and the role of VEGF165 were detected.CD34 was measured by immunochemical staining and numbers of vessel formation was calculated under microscopic observation.RESULTS: After treatment with rhGM-CSF at various concentrations and at different time points,the numbers of vessel formation increased in a dose-dependent and time-dependent manner.In the presence of VEGF165,the numbers of vessel formation increased evidently.CONCLUSION: HUVECs were induced to develop tubular structure in vitro cultured with Matrigel.GM-CSF promotes human vascular endothelial cells to form vessel-like structure in vitro in a dose-dependent and time-dependent manner.VEGF also in vitro promotes human vascular endothelial cells to form new vessel-like structure.

OBJECTIVE To explore the interventions for ventilator-associated pneumonia(VAP) caused by Acinetobacter baumannii by making investigation to the ICU patients on ventilators.METHODS Bacteria culture of bronchial discharge of patients on ventilators was conducted and followed by causation analysis of VAP caused by A.baumannii.RESULTS The prevalence of VAP caused by A.baumannii was 8.7%.The main reasons for VAP caused by A.baumannii were inappropriate use of antibiotics,long duration of mechanical assisted ventilation,contaminated ventilator and its accessories,unable to perform proper aseptic technique,and severity of the underlying illness.CONCLUSIONS For patients on ventilator,effective nursing interventions and sterilization and isolation techniques can reduce the infection and promote the treatment effects.

Objective To investigate the predictive value of CHADS2 and CHA2DS2-VASc score in left atrial (LA) or left atrial appendage (LAA) thrombus in patients with non-valvular atrial fibrillation (AF). Methods A total of 164 consecu?tive non-valvular AF patients confirmed by transesophageal echocardiography (TEE) were included in this study, and were divided into two groups, LA/LAA thrombus group and non LA/LAA thrombus group. The previous history was recorded in two groups of patients. Their CHADS2 and CHA2DS2-VASC scores were calculated based on the general data of two groups. The laboratory examinations and TEE indexes were compared between two gropes. Results Of all patients, the rate of LA/LAA thrombus was 19.5%. The CHADS2 and CHA2DS2-VASC scores were significantly higher in LA/LAA thrombus group than those of non LA/LAA thrombus group (2.1±1.3 vs 1.0±0.9, 3.4±1.8 vs 1.9±1.4,P<0.01). There were 13(11.9%) and 5 (8.8%) patients showed LA/LAA thrombus under low-moderate risk in the two score systems, respectively. Multivariate logis?tic regression analysis showed that CHADS2 score≥2 points(OR=3.735, 95%CI:1.508-9.251, P=0.004) and CHA2DS2-VASc score ≥2 points (OR=5.104, 95%CI:1.586-16.425, P=0.006) were independent risk factors of LA/LAA thrombus. ROC curve showed that AUC of CHADS2 and CHA2DS2-VASc scores to predict LA/LAA thrombus were 0.731 (95%CI:0.630-0.832, P<0.001) and 0.742 (95%CI:0.640-0.843, P<0.001), respectively. Conclusion CHADS2 and CHA2DS2-VASC score ≥2 points are independent risk factors of LA/LAA thrombus in patients with non-valvular atrial fibrillation. The pre?dictive values of both score systems are moderate. There are also LA/LAA thrombus in low-moderate risk patients when us?ing the two score systems, and with the increased risk stratification, the rate of LA/LAA thrombus is increased.