Objective:To observe the clinical effects of oral Tedral SA on the elderly patients with sinus bradycardia. 　　Methods:Tedral SA(1/2 to one tablet/day in two divided doses)was administered orally to 14 elderly patients with sinus bradycardia.Twenty-four-hour Holter monitoring was performed before and one month after oral Tedral SA. 　　Results:After oral Tedral SA,resting heart rate of 14 patients was maitained between 50 to 70 beats/min.The minimum heart rates before and during therapy has significant difference statistically(34.93±2.79 vs.44.21±2.91,p＜0.001).The heart rate during oral Tedral SA was significantly increased.A few patients complained of palpitation,which disappeared as the dosage of Tedral SA was decreased.Subjective symptoms associated with sinus bradycardia such as dizziness,faintness disappeared completely in 14 patients. 　　Conclusion:Tedral SA was a effective and safe drug for treatment of elderly patients with severe sinus bradycardia.

Objective To analyse the pathogeny of pregnancy with virus hepatitis,the change of index of hepatic function and the clinical pathogenetic characteristic,and to explore the relationship between pregnancy and hepatitis.Methods The clinical datas of 96 pregnant patients with virus hepatitis were retrospectively analyzed,and compared with non-pregnancy during the reprodective age in the corresponding period.The pathogeny,index of hepatic function and clinical pathogenetic characteristic were compared.Results Virus hepatitis in the pregnancy were mostly type B hepatits,the morbility of hepatitis increased gradually along with the progress of pregnant weeks,the prothrombin time(PT) significantly prolonged in pregnancy with virus hepatitis,and the albumin decreased significantly,the complications of hepatocerebral disease and hepatorenal syndrome were more than non-pregnancy with virus hepatits,the incidence rate of serious hepatiti was higher than non-pregnancy with virus hepatitis(P

Objective To explore the changes ofT lymphocyte subsets CD3+,CD4+,CD8+ in hepatitis B reactivation after chemotherapy.Methods Flow cytometry was used to detect T lymphocyte subsets of 32 patients with hepatitis B reactivation before and after chemotherapy.In addition,25 patients without hepatitis B reactivition were chosen as control group.Results After chemotherapy,the percentage of CD3+ and CD4+ T lymphocytes and the ratio of CD4+/CDs+ were significantly reduced than those before chemotherapy (P ＜ 0.05).However,the percentage of CD8+ T lymphocytes was not significantly changed(P ＞ 0.05).Conclusion The chemotherapy can change the number and ratio of T lymphocyte subsets,the inhibition of the cellular immune function is one of the reason of hepatitis B virus reactivation.

Objective To evaluate the effects of dexmedetomidine on the expression of tumor necrosis factor-α(TNF-α) and intercellular adhesion molecule-1 (ICAM-1 ) during cerebral ischemia-reperfusion (I/R ) in rats .Methods Thirty-six male Sprague-Dawley rats , aged 8-12 weeks ,weighing 280-320 g ,were randomly divided into 3 groups ( n= 12 each ):sham operation group (group S ) , cerebral I/R group (group I/R ) and dexmedetomidine group (group D ) .The animals were anesthetized with 10% chloral hydrate 3.5 ml/kg .The focal cerebral ischemia was induced by middle cerebral artery occlusion using a nylon thread with rounded tip inserted into internal carotid artery and advanced cranially until resistance was met .In group D ,dexmedetomidine 3μg/kg was injected intravenously immediately after beginning of ischemia ,followed by infusion at 3μg·kg-1 ·h-1 for 120 min ,while the equal volume of normal saline was given in group I/R .Four rats from each group were chosen at 24 ,48 and 72 h of reperfusion , and blood samples were taken from the left ventricle to determine the concentrations of serum S100B protein .The rats were then sacrificed and the brains were removed to determine the expression of TNF-αand ICAM-1 in brain tissues .Results Compared with group S ,the concentrations of serum S100B protein were significantly increased , and the expression of TNF-α and ICAM-1 in brain tissues was up-regulated in I/R and D groups ( P<0.05) .Compared with group I/R ,the concentrations of serum S100B protein were significantly decreased , and the expression of TNF-α and ICAM-1 in brain tissues was down-regulated in group D ( P<0.05 ) .Conclusion The mechanism by which dexmedetomidine reduces the cerebral I/R injury is related to down-regulation of TNF-αand ICAM-1 expression in rats .

Objective To investigate the relationship between hepatitis B virus reactivation and the level of blood T-lymphocyte subsets.Methods T lymphocyte subsets ( CD3,CD4,CDs ),CD4/CDs level of 40 patients with chronic carriers of hepatitis B virus and 35 patients with hepatitis B virus re-activation were detected by Flow cytometry(Epics XL).Results The hepatitis B virus reactivation in patients with CD3,CD4 and CD4/CDs levels were significantly lower than the chronic hepatitis B virus carriers,The difference between the two groups patients was significant[(71.31 ±5.20)％ vs (68.57 ±6.10)％,(37.82 ±4.90)％ vs (32.12 ±5.93)％,(1.37 ±0.28) vs (1.18 ±0.43 ),all P ＜ 0.05].Conclusion The levels of CD3,CD4 and CD4/CD8 ratio were significantly declined,it may be the one important reason of hepatitis B virus reactivation.

Objective To study the correlation between the level of serum ferritin(SF) and the degree of liver damagement with severe hepatitis B,and the clinical significance of SF changes in judging the prognosis.Methods The level of SF was detected by radioimmunoassay(RIA) from 62 cases with severe hepatitis B,the level of SF from acute hepatitis B,chronic hepatitis B,liver cirrhosis and normal men were served as contrast study.Results The level of SF from severe hepatitis B was significantly higher than those from acute hepatitis B,chronic hepatitis B,liver cirrhosis and normal men;the level of SF was positively correlated with total bilirubin(TB),prothrombin time(PT),total bile acid(TBA) and negatively with Alb,ALT,AST,CHE.The levels of SF of those who died were significantly higher than those of suvivals;the level of SF decreased as the disease controlled and increased as the disease deterio-rated.Conclusions There is a parallel correlationship between the level of SF and the degree of liver damagement with severe hepatitis B,the severer the hepatocyte damage was,the higher the ferritin was.It is helpful to judge the degree of damagement and prognosis of severe hepatitis by detecting the level of serum ferritin.

OBJECTIVE:To optimize the formulation of Dimemorfan phosphate tablets. METHODS:Using 60 min dissolution rate of dimemorfan phosphate as index,L9(34) orthogonal test was used to optimize the amount of starch,microcrystalline cellu-lose,croscarmellose sodium and concentration of HPMC E5 solution. The friability,hardness,60 min dissolution rate and main component were detected. The similarity of dissolution curves of Dimemorfan phosphate tablets was compared with that of imported tablets in 0.1 mol/L hydrochloric acid,pH 6.8 phosphate buffer,water and pH 4.0 acetate buffer. RESULTS:The optimized formu-lation of Dimemorfan phosphate tablet(1 000 tablets)was composed of dimemorfan phosphate 10 g,starch 60 g,microcrystalline cellulose 40 g,10% HPMC E5 solution and croscarmellose sodium 25 g. The friability,hardness,60 min dissolution rate and main component of 3 batches of Dimemorfan phosphate tablets prepared by optimized prescription were 0.42%-0.58%,9.8-10.5 kg,94.89%-96.21% and 99.21%-99.52%,respectively. In 4 dissolution mediums,similar factors f2 of dissolution curves between prepared tablets and imported tablets were above 50. CONCLUSIONS:Dimemorfan phosphate tablets were prepared successfully. The optimized formulation is rational. The dissolution behavior of prepared tablets is similar to that of imported tablets in vitro.

Background Conventional studies showed that the primary pathological change of diabetic retinopathy (DR) is retinal microangiopathy.However,recent studies found that the disorder of visual function appears prior to retinal microangiopathy in diabetic patients.Thereby,this findings can not be explained by conventional view.Objective The aim of the study was to find the change of retinal nerve fiber layer (RNFL) by frequency domain optical coherence tomography(OCT) in the diabetic patients without retinal microangiopathy and with non-proliferative DR (NPDR) and investigate the relationship between the change of RNFL thickness and DR.Methods Sixty eyes of 56 patients with 2 type diabetes mellitus were enrolled in Shanxi Eye Hospital from October 2012 to September 2013.The patients were divided into the non-diabetic retinopathy (NDR) group (30 eyes of 26 patients) and NPDR group (30 eyes of 30 patients) depending on the findings of fundus fluorescine angiography (FFA) according to the DR International Clinical Classification System.Thirty normal eyes of 30 age-and gendermatched healthy volunteers were included as controls.RNFL thicknesses around optical disc and macular zone were measured by OCT,including average RNFL thickness in 360°,superior nasal,superior temporal,temporal,inferior temporal,inferior nasal and nasal RNFL thicknesses.The measuring results were compared between the three groups.Results The total average thickness values of RNFL around the optic disc for the NDR group,NPDR group and the control group were (97.46-± 8.65) μm,(100.69 ± 16.35) pm and (109.22 ± 8.69) μm,respectively,and the parameters in the NDR group and NPDR group were significantly lower than those in the normal control group (P=0.001,0.006).The RNFL thicknesses were thinning at the superior temporal,temporal,inferior temporal,inferior nasal quadrants around optical disc in NDR group compared with the normal control group (P=0.001,0.001,0.001,0.010),and RNFL thickness values of all the quadrants were decresed in the NPDR group compared with the normal control group,and significant differences were seen in superior temporal and nasal quadrants (P =0.001,0.046).The total average thickness values of RNFL around macular zone for the NDR group,NPDR group and the normal control group were (33.47±3.39),(36.81±3.21) and (38.18±2.16) μm,and parameters in the NDR group was significantly lower than that in the normal control group (P =0.001).The RNFL thicknesses of all the quadrants around macular zone in the NDR group were thinned in comparison with the normal control group (all at P＜0.01),and the RNFL thicknesses at the superior nasal,superior temporal and temporal quadrants were significantly decreased in comparison with the normal control group (P=0.026,0.015,0.001).Conclusions The thinning of the RNFL thickness occurs prior to retinal microangiopathy in diabetic patients,and it may be an early pathological stage for DR.

Objective To carry out health education nursing intervention mode for patients with hemodialy-sis,and to study and analyze the clinical nursing effect.Methods 112 cases of hemodialysis patients were randomlydivided into the observation group and the control group according to random number table,56 cases in each group. The patients of the control group were given conventional nursing model,and the patients of the observation group were given nursing intervention model on the basis of health education.The blood pressure,the internal fistula blockage, indwelling catheter caused by the incidence of infection and blood phosphorus level of compliance rate were compared in the two groups.Results After nursing intervention,diastolic blood pressure(76.17 ±7.02)mmHg and systolic blood pressure (131.17 ±8.77)mmHg of the observation group were significantly better than the control group [(90.91 ±8.44)mmHg,(141.29 ±7.08)mmHg],there were statistically significant differences(t =10.49,13.75, all P <0.05).The incidence rate of fistula obstruction (1.79%)and the catheter infection incidence rate(1.79%) of the observation group were significantly lower than the control group (28.57%,26.79%),there were statistically significant differences(χ2 =8.22,9.17,all P <0.05).The blood phosphorus level standard rate(60.71%)of the observation group was significantly higher than the control group(33.93%),there was statistically significant differ-ence (χ2 =11.45,P <0.05).Conclusion The incidence of complications is significantly decreased after nursing intervention of health education in patients with hemodialysis,and the indexes are improved significantly,and there is no obvious conflict of interest.

Objective To explore the efficacy of endoscopic sphincterotomy with small incision combined with balloon dilatation (sEST+EPBD)in the treatment of patients with choledocholithiasis and juxtapapillary duodenal diverticula (JPDD).Methods From January 2011 to January 2015 ,149 patients with choledocholithiasis and JPDD who underwent endoscopic retrograde cholangio-pancreatography (ERCP)were enrolled.Among them,60 patients were in sEST+EPBD group and 89 were in endoscopic sphincterotomy (EST)group.Success rate of ERCP and first-time stone removal,changes of total bilirubin (TBil)and direct bilirubin (DBil)levels,as well as the incidence of postoperative complications between the two groups were compared.Chi-square test or t-test was performed for statistical analysis. Results The ERCP success rate sEST+EPBD group was 100.0% (60/60),and the first-time success rate of stone removal was 91 .7%(55/60);correspondingly,ERCP success rate of EST group was 98.9%(88/89),and the success rate of first-time stone removal was 77.5 %(69/89).There was no statistically significant difference in success rate of ERCP between the two groups (χ2 =0.19,P =0.410).The first-time success rate of stone removal of sEST +EPBD group was higher than that of EST group,and the difference was statistically significant (χ2 =5 .53,P =0.020).After operation,the TBil level of sEST+
EPBD group was (152.62 ±109.04 )μmol/L,which was lower than that before operation ((266.02 ± 143.31)μmol/L),and the difference was statistically significant (t =4.88,P <0.01 ).After operation, the DBil level of sEST +EPBD group was (87.13 ±65 .90)μmol/L,which was lower than that before operation ((175 .70 ± 100.53 )μmol/L),and the difference was statistically significant (t = 5 .71 ,P <0.01).After operation,the TBil level of EST group was (251 .90 ±247.90)μmol/L,which was lower than that before operation ((340.20 ±176.20 )μmol/L),and the difference was statistically significant (t=2.74,P <0.05).After operation,the DBil level of EST group was (168.10±140.60)μmol/L,which was lower than that before operation ((228.40 ±139.60 )μmol/L),and the difference was statistically significant (t = 2.87,P = 0.005).The complication rate of sEST + EPBD group after operation was 8.3%(5/60),which was lower than that of EST group (20.2%,18/89 ),and the difference was statistically significant (χ2 =3.88,P =0.049 ).Conclusion sEST+EPBD could increase the first-time success rate of stone removal in patients with choledocholithiasis and JPDD,and it is a safe and effective treatment.