Objective:To explore risk factors for slow coronary flow (SCF) phenomenon in male patients .Methods:A total of 123 male patients ,who were suspecting coronary heart disease because of chest pain ,then coronary angiography indica‐ted there was no significant lesion in epicardial coronary arteries ,were selected .According to presence of SCF or not ,they were divided into SCF group (n=69) and normal group (n=54) .Case data of two groups were retrospectively analyzed , and Logistic regression analysis was use to analyze risk factors for male SCF .Results:Compared with normal group ,there were significant rise in body mass index [BMI , (24. 01 ± 1. 57 ) kg/m2 vs . (27. 06 ± 3. 40 ) kg/m2 ] , hemoglobin level [ (145.79 ± 9.63) g/L vs .(150.00 ± 11.84) g/L] and hematocrit [ (0.43 ± 0.03) L/L vs .(0.45 ± 0.06) L/L] in SCF group ,P<0.05 all .Logistic regression analysis indicated that BMI (OR= 1.373 ,95% CI 1.146~1.645 ,P=0.001) and hemoglobin (OR=1.037 ,95% CI 1.000~1.176 ,P=0.048) were independent risk factors for male SCF .Conclusion:El‐evated body mass index and hemoglobin level are independent risk factors for slow coronary flow in male patients ,so corre‐sponding preventive measures must be carried out to improve prognosis .

Objective To observe the effect of electronic colonoscopy on heart rate,blood pressure,arterial hemoglobin oxygen saturation and electrocardiography in elderly patients.Methods 60 patients were divided into two groups,elderly group (over 60 years old,n=30) and non-elderly group (＜ 60 years old,n =30).The changes in heart rate,blood pressure,arterial hemoglobin oxygen saturation and electrocardiography before and during colonoscopy were compared between the two groups.The increased heart rate was observed in both groups(the non-elderly group:t=10.746,P＜0.001; the elderly group:t=4.892,P＜0.001),and the increment of heart rate was higher in non-elderly group than in elderly group [(6.9±3.7) /min vs.(4.0±3.8) /min,t=2.88,P＜ 0.01].Results Systolic and diastolic pressures were increased in both groups during colonoscopy as compared with pre-colonoscopy(t=3.88,5.88,6.55 and 7.43,respectively,P＜0.01 or 0.001),but there were no significant differences in the increment between the two groups(t=0.31 and 0.32,bothP＞0.05).Arterial hemoglobin oxygen saturation was decreased in both groups during colonoscopy as compared with pre-colonoscopy(t=3.05 and 2.98,P＜0.05 or 0.01),and there was no significant difference in the decrease between the two groups(t=-0.13,P＞0.05).Abnormal ECG can be detected in both groups,but had no statistical significance between the two groups (20.0％ vs.16.7％,x2 =0.11,P＞ 0.05).Conclusions Electronic colonoscopy can be performed relatively safely in the elderly.

Objective To investigate the electrocardiogram analysis of electronic colonoscopy on patients with coronary artery heart disease,and to evaluate the safety of colonoscopy on patients with coronary artery heart disease.Methods Sixty patients who underwent colonoscopy from Jun.2012 to Jun.2013 were divided into experimental group (patients with coronary artery heart disease,Heart function class Ⅰ-Ⅲ) and control group (patients without coronary artery heart disease).The changes of electrocardiography during colonoscopy and before performance were compared between two groups through dynamic electrocardiogram.Results Heart rate of the two groups were no statistically significant difference before colonoscopy process (t =0.537,P ＞ 0.05).During the inspection process,there was heart rate increase at different degree in two groups.The heart rate in patients of experiments group was increased from (73.20 ± 7.91) times/min to (88.67 ± 7.79) times/min,which waas more than that in control group (from (73.40 ±6.44) times/min to (74.88 ±7.82) times/min),and the difference between the two groups was significant(t =4.462,P ＜ 0.05).During colonoscopy inspection,the arrhythmia rate arrhythmia in experiment and control group were 46.67％ (14/30),20.00％ (6/30),and the difference was statistically significant (x2 =4.8,P ＜0.05).Meanwhile,ST-T change rates in experimental group and control group were 26.7％ (8/30) and 10.0％ (3/30) (x2 =45.72,P ＜ 0.05).The rate of subjective discomfort the two groups were 40％,30％ (x2 =0.659,P ＞ 0.05).Conclusion During the inspection process of colonoscopy,patients with coronary heart disease are more susceptible to increase heart rate,cardiac arrhythmia,ST-T change than those without coronary heart disease.However,no serious electrocardiographic changes.It is relatively safe to get colonoscopy in patients with coronary heart disease.

Objective To summarize the placement, maintenance, and safety of a high-pressure resistant peripherally inserted central catheter. Methods Ten patients were peripherally placed with this catheter (included 4Fr-single lumen, 5Fr-dual lumen, and 6Fr-three lumen) using ultrasound-guided Seldinger technique in Peking Union Medical College Hospital in August 2010. The therapeutic effectiveness and safety were evaluated. Result Ten catheters were inserted successfully into the upper arms, with few complications noted during routine maintenance. Conclusions This peripherally inserted central catheter can be used for high-pressure injection, central venous pressure monitoring, and fast flow-speed transfusion. Therefore, it can be successfully applied for contrast-enhanced CT angiography and massive fluid infusion.

Objective To estimate the characteristics of gastroesophageal reflux (GER) and its clinical association with pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc) patients.Methods Two hundred and five patients with SSc,who fulfilled the American College of Rheumatology criteria were consecutively recruited.GER was recognized in patients with symptom of heartburn or regurgitation.Demographic,clinical,and laboratory data were analyzed.A six minute walk test,pulmonary function test and modified Rodnan's skin score (mRSS) were also calculated for GER and non-GER groups.x2 test,Fisher's exact test and t-test were used for statistical analysis.Logistic regression test was used for the analysis of risk factors.Results There were 90 patients with GER among 205 patients,the prevalence of GER was 43.9％.The presence of PAH (23.3％ vs 9.6％),Raynaud's phenomenon (98.9％ vs 92.2％ ) and fingertip ulcers (56.7％vs 51.3％) were significantly higher in patients with GER than those without GER.There was no difference in autoantibody profile between GER patients and non-GER patients (P＞0.05).The New York Heart Association (NYHA) functional class of SSc-related GER was worse than patients without GER (P=0.015).Pulmonary function test showed that diffuse capacity (DLCO)％,forced vital capacity (FVC)％,and forced expiratory volume (FEV1)％ were lower and the FVC％/DLCO％ ratio was higher in patients with GER than non-GER (P＜0.05).GER was an independent risk factor of PAH in SSc patients (P=0.047,OR=3.41 ).Conclusion GER frequently occurs in SSc patients,SSc patients presenting with GER should be screened for PAH.Targeting the underlying vascular dysfunction might prevent not only PAH,but also GER in SSc patients.

Objective To detecte the expression of COX-2,VEGF-C and lymphatic vessel density (LVD)in pancreatic cancerous and paracancerous tissues,and investigate their correlation.Methods The expression of COX-2.VEGF-C and LVD in 40 cases of pancreatic cancer tissues and paracancerous tissues and 12 cases of normal pancreas was detected by tissue chip and immunohistochemical assays,and the relationship between them and the cljnicopathological parameters was analyzed. Results The expression of COX-2,VEGF-C in pancreatic cancer tissues were 70.0%(28/40)and 67.5%(27/40),respectively,which were significantly higher than that in paracancerous tissues(42.5%,17/40)and(35.0%,14/40),and that in normal pancreas(8.3%,1/12)and(25.0%,3/12).The LVD in pancreatic cancerous,paracancerous and normal pancreatic tissues were 4.75±2.77,15.2 ±4.70 and 1.67±1.15,respectively.The expression of COX-2 in cancerous tissues and LVD in paracancerous tissues was correlated with tumor differentiation and lymph metastasis;the expression of VEGF-C Was correlated with lymph metastasis.LVD in paracancerous tissues was correlated with the expression of COX-2 and VEGF-C.Conclusions Pancreatic cancer lymphangiogenesis mainly existed in paracancerous tissues,COX-2 and VEGF-C may play an important role in the lymphangiogenesis.

BACKGROUND:Arterial stiffness is an independent risk factor for cardiovascular disease.Augmentation index(Alx)is an important marker which reflects the systemic arterial stiffness.OBJECTIVE:To investigate Alx and the affecting factors in Xinjiang Uygur health adults.METHODS:A total of 559 healthy adults(251 males and 308 females)with a mean age of(44.95±11.87)years were selected from Hetian,Xinjiang Uygur Autonomous Region.The following indexes of all subjects were measured,including questionnaire,physical examination,blood biochemistry and C-reactive protein(CRP).Central systolic blood pressure(cSBP)and central Alx were measured by Sphygmocor.Pearson correlation and partial correlation analysis were used for two-group analysis of correlation,and multiple regression analysis was used to analyze influential factors for Alx.RESULTS AND CONCULUSION:Alx was greater in female than in male and was positively related to age in both sexes(male:r=0.548,female:r =0.405,P < 0.05),as well as adjusted other influential factors(male:r=0.182,female:r =0.234,P < 0.05).Multiple regression analysis showed that cSBP,systolic blood pressure(SBP),sex,age and CRP were main factors which affected Alx in Uygur healthy adults,cSBP,SBP,age,body mass and CRP were main factors which affected Alx in the male,while cSBP,SBP,age,height and CRP were main factors which affected Alx in the female.Results revealed that Alx was greater in female than in male which was positively related to age in both sexes.Age,cSBP,SBP and CRP were main factors that affected Alx in Xinjiang Uygur healthy adults.

Objective To understand the changes of NKT cells in the livers and spleens of mice infected with Schistosoma japonicum.Methods Twenty-four female BALB/c mice aged 6-8 weeks were randomly divided into 4 groups.Three groups of mice were infected with(14?2)cercariae of S.japonicum.In 3,6 and 12 weeks post-infection,the mice were randomly chosen from each group and sacrificed resectively and the lymphocytes were harvested from the livers and spleens.The cells were stained with fluorescein-isothiocyanate(FITC)-conjugated anti-mouse pan-NK cells(CD49b)and phycoerythrin(PE)anti-mouse CD3e monoclonal antibodies,respectively.The proportion of NKT cells was analyzed by flow cytometry.In the experiment in vitro,the lymphocytes from spleens of normal mice were harvested and stimulated with SEA,the protein constituents of eggs and lipid constituents of eggs,respectively.The proportion of NKT cells was also analyzed by flow cytometry.Results The proprotion of splenic NKT cells in lymphocytes in 12 weeks post-infection was(4.73?0.41)%,which was significantly higher than that of the control(2.07?0.12)%(P

[Summary] Neuroischemic diabetic foot ulcer ( NDFU) is characterized by infection, ulceration of deep tissues, neurological abnormalities, and various degrees of peripheral vascular disease in the lower limbs. The patients often have multiple risk factors such as older, longer duration, cardiovascular disease. The treatment is very difficult. The prognosis depends on the severity of complications, tissue range of infections, and the peripheral vascular disease. In this article, the treatment process of an old inpatient with NDFU and severe complications was reviewed and to propose a standard pathway for its management.

Objective:To explore the health seeking behavior, utilization of health services and the economic burden of the elderly patients with diabetic foot ulcer ( DF) , with aim to provide policy evidence for improving their DF prevention and treatment outcomes. Methods: The purposive sampling method was applied to recruit 15 elderly DF patients treated in the 454 th Hospital of Chinese PLA from December 2013 to January 2014. After informed con-sent, they were in-depth interviewed. Results: The elderly with DF had a higher demand for the health services. They emphasized on treatment and neglected prevention. The utilization and efficiency of health services were affected by patients' economic level, medical insurance, capacity of community services, and so on. Conclusion:In order to improve the treatment outcome and quality of life for the elderly DF patients, it's necessary to strengthen patients' health education, to build a community-based and integrated health care system on DF prevention, treatment and management, and to develop the policies for reducing DF related economic burden.