Objective: To observe the relationship among blood pressure, left ventricular hypertrophy (LVH) and sinus heart rate turbulence (HRT) in patients with essential hypertension (EH) and its clinical significance. Methods: A total of 125 EH patients received 24h ambulatory blood pressure monitoring, dynamic electrocardiogram and echocardiography examination in order to measure 24h mean blood pressure, turbulence onset (TO), turbulence slope (TS) and left ventricular mass index (LVMI). According to 24h mean blood pressure, patients were divided into hypertension stage 1 group (n=46), stage 2 group (n=41) and stage 3 group (n=38); according to LVMI, patients were divided into non- LVH group (n=74) and LVH group (n=51). TO and TS were compared among all groups. Results: TO: Compared with hypertension stage 1 and stage 2 group, there was significant increase in TO [(-2.48±1.75) % vs. (-1.86±1.19) % vs. (-0.87±1.14) %] in hypertension stage 3 group, and that of stage 2 group was significantly higher than that of stage 1 group（P<0.05～<0.01）; compared with non- LVH group, there was significant increase in TO [(-0.15±0.45) % vs. (1.08±1.19) %] in LVH group, P<0.01. TS: compared with hypertension stage 1 and stage 2 group, there was significant decrease in TS [(3.76±1.87) ms/RR interval vs. (2.33±1.48) ms/RR interval vs. (1.55±1.06) ms/RR interval] in hypertension stage 3 group, and that of stage 2 group was significantly lower than that of stage 1 group （P<0.05～<0.01）; compared with non- LVH group, there was significant decrease in TS [(4.76±1.75) ms/RR interval vs. (3.02±1.08) ms/RR interval] in LVH group, P<0.01. Conclusion: The higher the blood pressure is, the more abnormality the heart rate turbulence is; the heart rate turbulence abnormality of patients complicated with LVH is more severe than that of non- LVH patients in patients with essential hypertension, so heart rate turbulence is help to judge prognosis and guide treatment.

OBJECTIVE: To study the inhibitory effect of Danggui Buxue Tang (DBT), a compound traditional Chinese herbal medicine for supplementing blood, on tumor growth in tumor-bearing mice after inoculation of EL-4 cells, and its immune mechanism as well as its synergic effect in reducing toxicity of cytoxan (CTX). METHODS: Experiment was carried out in tumor-bearing mice after inoculation of EL-4 cells. The mice were randomly divided into four groups after 7 days of the inoculation: untreated group, DBT-treated group [24 g/(kg x d)], CTX-treated group [7.5 mg/(kg x d)] and DBT plus CTX-treated group, with another ten normal mice as control. Inhibitory rate of tumor growth, survival time, immune function and variability of blood cells were measured in the mice during the experiment. RESULTS: After treatment of relevant interventions for 15 days, the tumor in the DBT-treated group, CTX-treated group and DBT plus CTX-treated group grew slower than the untreated group (P<0.05). Murine survival time in the DBT-treated group, CTX-treated group and DBT plus CTX-treated group was lengthened as compared with that in the untreated group (P<0.05). Compared with the untreated group, all kinds of immune indexes in the DBT-treated group and DBT plus CTX-treated group were significantly improved (P<0.05), while the immune indexes in the CTX-treated group were decreased (P<0.05). Compared with the CTX-treated group, all kinds of immune indexes in the DBT plus CTX-treated group were significantly improved (P<0.05). CONCLUSIONS: DBT can enhance the immune function in tumor-bearing mice and the inhibitory effect of DBT on tumor growth is related to the enhanced immune response. DBT can also increase the therapeutic effects and reduce the side effects of CTX.

Objective To evaluate the value of phased array probe of transesophageal echocardiography miniature (micro-TEE) in the neonatal and infant cardiac surgery intraoperation.Methods Micro-TEE probe was used in children with weight ≤5 kg undergoing cardiac surgery to detect the atrial and ventricular cavity size,the left and right ventricular outflow tract diameter were detected by transthoracic echocardiography(TTE) 3-7 d after operation,and compared with the measured value immediately after the TEE.Results Before and after intubation,airway index not statistically significant (P ＞ 0.05).Preoperative TEE and TTE inspection results were consistent with intraoperative diagnosis.Postoperative TEE measuring intracardiac structural data (each room,chamber size and left and right ventricular outflow tract diameter) and postoperative TTE measurement value representing the difference was not statistically significant (P ＞ 0.05).Conclusions Micro TEE intraoperative guardianship of low birth weight infants is safe and feasible,and can supplement and improve the preoperative diagnosis,and can accurately and timely evaluate postoperative curative effect.

Objective:To explore the application value of transesophageal echocardiography (TEE)in secondum atri-al septal defect (ASD)intervention and minimally invasive occlusion surgery in adult patients.Methods:A total of 134 cases adult patients (>15 years)with pure secondum ASD (including 91 cases undergoing interventional occlu-sion and 43 cases undergoing minimally invasive occlusion surgery),who were screened via transthoracic echocardio-graphy (TTE)and TEE from Jan 2012 to Dec 2012,were selected.Intervention group and minimally invasive sur-gery group received TTE and TEE monitoring respectively during operation.Preoperative TTE and TEE parameters and operation results were compared and analyzed.Results:The parameters of ASD diameter measured by TEE were significantly higher than those measured by TTE in two groups (P <0.01 all).Maximum defect diameter of ASD measured by TEE was significantly higher than that of measured by TTE [(19.8±5.2)mm vs.(18.7±4.9)mm], P <0.01. The correlation between maximum defect diameter measured by TTE and occluder size (intervention group r =0.926,minimally invasive surgery group r =0.215)was all lower than that of TEE (intervention group r=0.965,minimally invasive surgery group r =0.627),P <0.01 both.Conclusion:TEE is better than TTE in as-sessment of ASD size.It should be regarded as a routine preoperative screening method for adult ASD patients.It has important value in real-time monitoring,guidance and immediate evaluation of therapeutic effects during mini-mally invasive ASD occlusion surgery.

Objective To evaluate the value of single leaflet replacement of bovine pericardium in the treatment of aortic valve insufficiency using transthoracic echocardiography(TTE) and transesophageal echocardiography(TEE).Methods TTE and TEE examination were performed for 25 cases pre-operation,postpump intraoperative and 3-6 months after the operation,to judge the structure and the regurgitation of the aortic valve.And the inside diameter of left atrium(LA)and left ventricle(LV)in the same plane and the same phase were also been measured.Results The degree of aortic regurgitation(AR)before operation were significantly different with that postpump intraoperative(P＜0.001)evaluated by TEE.There was no difference in the degree of AR by postpump intraoperative TEE and those of AR by TTE 3-6 months after surgery(P＞0.1).The inside diameter of LA[(3.80±1.37)em]and LV[(5.75±1.32)cm]before repair were larger than those 3～6 months after surgery[LA(3.19±0.90)cm,LV(4.72±1.19)cm,P＜0.001].Conclusions The replacement of single aortic valve with bovine pericardium to treat aortic valve insufficiency is a good alternative for patients with satisfactory short-term results,but long-term results are not clear.

Objective To compare the diagnostic performances of strain elastography (SE) and shear-wave elastography (SWE) in differentiating benign and malignant solid breast lesions. Methods From January 2015 to December 2015, 150 patients with 155 lesions were examined with SE and SWE respectively in the First Affiliated Hospital with Nanjing Medical University. Elasticity scores on a improved 5-point scale,strain ratio (SR), maximum elasticity (Emax), mean elasticity (Emean), standard deviation of the elasticity (Esd) and the lesion-to-fat elasticity ratio (Eratio) were assessed. The receiver operating characteristic (ROC) curve of SE and SWE parameters were plotted to assess the value in distinguishing benign and malignant breast lesions. The results were compared using the area under the ROC curve (AUC). The accuracy of the parameters with the largest AUC were compared between SE and SWE by McNemar test in different breast imaging reporting and data system (BI-RADS) categories. Results The AUC of elasticity scores, SR, Emax,Emean, Esd and Eratio were 0.823, 0.810, 0.877, 0.835, 0.881 and 0.853, respectively. The SE and SWE parameter with the largest AUC were elasticity scores and Esd respectively. The accuracy of Esd was higher than that of elasticity scores(86.3% vs 64.7%)in 4A lesions (2=4.639, P < 0.05). There were no significant differences in accuracy in other BI-RADS categories. Conclusions Both SE and SWE were helpful for the differentiation of benign and malignant solid breast lesions, and the diagnostic performance of SE and SWE was similar. The optimization of elastography can be achieved by combination with BI-RADS.

Objective To explore a better medication by analyzing retrospectively 179 cases with confirmed auricle pseudocyst.Methods A comparative study was carried out for the clinical effects of injecting triamcinolone acetonide in cavity with that of washing the cyst using dexamethasone and fixing it with gypsum.Results There was significant difference between the two groups(P

At present, the development of hospital in transition period the doctor-patient contradiction, mutu-al trust foundation weak such outstanding contradictions and problems, based on the analysis of facing the outpatient service charge first overall service consciousness; Contradiction link concentration; Hospital information system support does not reach the designated position; Charge personnel are not familiar with services such as business management status, on the basis of train first service consciousness concrete measures are put forward. Namely:strengthen the psychological counseling, advocate humanistic care;carry out training assessment, improve human-istic quality;strengthen the construction of standardization, the standard outpatient service charging process;develop information platform, optimize charging way;strengthen the department cooperation, build a system integration work.

Assessment of the value of academic libraries is an effective means to describe the value of academic libraries themselves. The dimension and factors for the assessment of the value of domestic and foreign academic li-braries were analyzed according to the assessment of the value of Shanxi Medical University Library, and the frame-work for the assessment of the value of academic libraries was proposed in terms of the impact of academic libraries on higher education.

Objective:To survey the relation of different vertical skeletal facial type and the third molar agenesis.Methods:The vertical face type of 207 subjects was divided into high angle(n=45),average angle(n=99)and low angle(n=63)groups by the assessments of MP-SN angle.The assessment of the third molar was made from panoramic radiographs,then the third molar agenesis rate of different vertical skeletal facial types was analysed.Chi-square criterion examination was conducted with SPSS 17.0 software. Results:In the high angle group,whether in the maxillary or mandibular,unilateral or bilateral,the absent percentage of third molar was higher than that in low angle group(P<0.05).In the females the bilateral maxillary third molar absent percentage was higher than in the males(P<0.05).The absent percentage of maxillary third molar was higher than that of the mandibular third molar(P<0.05).Conclusion:The third molar absence depends on vertical skeletal facial type.The absent percentage of third molar in the in-dividuals with high angle type is higher than that in those with low angle type(P<0.05).