Objective To investigate the the effect of Amiodaroneo on acute myocardial infarction (AMI) and atrial fibrillation (AF) in elderly patients,and provide the basis for the treatment.Methods A total of 108 patients with AMI and AF in our hospital from January 2009 to June 2013 were collected and randomly divided into control and experimental groups,each group of 54 cases.The control group was treated with cedilanid and the experimental group were treated with amiodarone.AF control rate,sinus rhythm maintenance rate and adverse reactions of the two groups were analyzed and compared after treatment.Results The AF control rate of experimental group was significantly higher than that of control group in 6 h,12 h,24 h and 48 h after treatment (x2=5.173,5.066,4.757,6.684,P＜0.05).Sinus rhythm maintenance rate of experimental group was increased compared with control group (47 cases vs.24 cases,x2=21.748,P＜0.01).Adverse reaction rates of the experimental group was lower than the control group (x2 =15.621,P＜0.01).Conclusions The treatment of AMI and AF by amiodarone is betterr and safe than cedilanid alone,so it is worth popularizing and applying on clinic.

Objective To investigate thickness of the hilar periportal space and caudate-right lobe ratio in the patients with chro-nic hepatitis B and liver cirrhosis after hepatitis B .Methods Eighty-four patients who were clinically and histologically diagnosed with chronic hepatitis B or cirrhosis and 18 healthy subjects without history of liver disease underwent abdominal MRI .The rela-tionship among liver fibrosis degree ,hilar periportal space and caudate-right lobe ratio were observed .Results There was signifi-cant correlation between the hilar periportal space and hepatic fibrosis for chronic hepatitis and cirrhosis (rs = 0 .546 ,P< 0 .01) . There was significant difference between S2 and S3 for thicknesses of the hilar periportal space(P<0 .01) ,and no significant differ-ence among S3 ,S4 and cirrhosis(P=0 .188) .A cutoff value of 9 mm for the hilar periportal space had a sensitivity of 85 .37% and a specificity of 76 .79% for a diagnosis of hepatic fibrosis with S3 or higher .There was no significant correlation between the caudate-right lobe ratio and hepatic fibrosis(rs = -0 .155 ,P=0 .119) .Conclusion Thicknesses of the hilar periportal space increase gradu-ally with hepatic fibrosis in patients with chronic hepatitis B and cirrhosis ,with a high sensitivity and specificity for a diagnosis of hepatic fibrosis with S3 or higher .

Objective To evaluate the clinical value of multislice spiral CT(MSCT) reconstruction in designing the pedicle screw trajectory before operation in atlantoaxial lesions.Methods 37 patients with upper cervical abnormality treated by surgery for atlantoaxial or occipitoaxial interfixation and/or fusion were undergone MSCT scan,and the 3D anatomical data(including the length,width and height of each pedicle,the angle between the pedicle and sagittal plane,and the thickness of internal occipital crest) were measured on volume reconstruction(VR) and multi-plane reconstruction(MPR) images and used for surgeon to select advisable pedicle screws(including the proper length and diameter) and to ensure the comfortable point,depth and direction for screw position at preoperation.The patients were followed up by atlantoaxial X-ray image and/or MSCT reconstruction to estimate the veracity of the screw position.Results All the patients were operated successfully,of them,5 patients were treated by simply atlantoaxial fixation,15 by atlantoaxial fixation and fusion,4 by simply occipitoaxial fixation,11 by occipitoaxial fixation and fusion,2 by atlantoaxial fixation and occipitoaxial fusion.X-ray images and/or MSCT reconstruction revealed that atlantoaxis were reposition entirely and all the screws were at predesigned trajectory.All the patients were followed up and no screw was broken or loosen and no atlantoaxial redislocation was found.Conclusion MSCT reconstruction for designing pedicle screw trajectory in atlantoaxial lesions before operation is satisfactory and valuable for clinical application.

OBJECTIVE: To investigate the irrational use of the infused drugs in our out-patient clinic.METHODS: In this retrospective study,the infusion prescriptions in our outpatient clinic from 2005 to 2007 were randomly selected for a statistical analysis of the irrational ones based on our knowledge on clinical pharmacology and literature.RESULTS: The problems manifested by the total 81 172 prescriptions were unsuitable solvent,improper dosage regimen,irrational drug combination and repeated drug of medicines etc.CONCLUSION: The use of infused antibiotics in our out-patient clinic were rational on the whole,however,there were some problems which remain to be solved and improved.

Objective To investigate the charaeteristcs of the acute poisoning patients in the emergency department of a general hospital in a new emerging district by analyzing the data of Hangzhou.Methods A retrospective study of the characteristics of the poisoning patients in emergency department of Tongde Hospital of Zhejiang Provinee from January 2004 to December 2004 was conducted and statistically analyzed.Results There were 318 poisoning patients in this year, accounting for 8.3% of the total patients in emergency department.Among these poisoning patients,female was 58.8% and male 41.2%;patients aged 21～30 years old accounted for 53.3%;alcoholic poisoning was the major cause and accounted for 34.3%,and 83.3% were male;as the second eanso,sedative accounted for 34.0%,and 72.4% were female;food poisoning accounted for 6.91%,and students was 90.9%.There was no relation between season and poisoning type.In the poisoning patients,30.8% were career men,and 19.5% were unemployed,19.6% were students,and 85.2 % were deliberate.Conclusion Young persons and career men were the high-risk group of poisoning, poisoning type was connected with work and gender.

Objective To evaluate the efficacy and safety of intravitreal ranibizumab injection combined with triamcinolone acetonide (TA) for macular edema secondary to type Ⅱ optic disc vasculitis.Methods Totally 19 cases(19 eyes) with macular edema secondary to type Ⅱ optic disc vasculitis from January 2013 to December 2015 were injected ranibizumab intravitreally and triamcinolone acetonide 2 weeks later.The visual acuity,intraocular pressure,ocular fundus,OCT,FFA and related complications were observed during the 6 months follow-up period.If the macuiar edema returns during the follow-up period,the eyes would be given ranibizumab and TA again until the macular edema subsided.Results The visual acuity was 0.16 ± 0.09 and the central retinal thickness was (694.88 ± 79.06) μm before treatment.Compared with pretreatment,the visual acuity of all cases were improved in different degree except for one at 1 month,3 months and 6 months (all P ＜ 0.05).Also central retinal thickness were decreased and macular edema were subsided,there were statistical differences (all P ＜0.05).Compared with results at 1 month,the visual acuity and central retinal thickness was no significant different at 3 months and 6 months (all P ＞ 0.05).The intraocular pressure of all cases were normal throughout the follow-up period but one was increased transitorily in the first day after intravitreal rauibizumab injection.FFA examination at 1 month showed retinal hemorrhage and effusion absorbed obviously,besides,the optic disc and macular fluorescein leakage reduced significantly.The macular edema of 1 eye returned at 3 months and subsided after giving ranibizumab and TA again.The average number of injected eyes was 2.11 times.No complications associated with intravitreal injection and drugs were observed during the follow-up period.Conclusion It is effective and safe that intravitreal ranibizumab junction combined with TA for macular edema secondary to type Ⅱ optic disc vasculitis,which not only shorten the period of treatment but also reduce the times of drug injection,surgical trauma and complications.

Objective:To observe the protective effect of Yulangsan polysaccharide ( YLSP) on liver injury induced by cyclophos-phamide(CTX) in mice. Methods:Liver injury induced by CTX in mice was used as the animal model and the mice were randomly di-vided into the normal group, CTX model group, biphenyldicarboxylate ( BPDC) group, YLSP group respectively with high, medium and low dose. Except the normal group, the other groups were injected with CTX, i. p. , for 7 days to make the model. Then the ani-mals in the YLSP groups were intragastrically administered with YLSP for 7 days. The activities of alanine aminotransferase( ALT) , as-partate aminotransferase( AST) in serum, malondialdehyde( MDA) , superoxide dismutase( SOD) , glutathione( GSH) and glutathione peroxidase ( GSH-Px) in liver tissue were investigated. Hematoxylin and eosin ( HE) stain was used to study the changes in hepatic tissue of the pathological mice. Results:Compared with the model group, YLSP could obviously reduce the activities of ALT, AST and the content of MDA, and increase the content of GSH, SOD and GSH-Px (P<0. 05 or P<0. 01). HE staining showed that YLSP had significant protective effect on liver injury induced by CTX. Conclusion:YLSP has protective effect on liver injury induced by CTX.

ObjectiveTo explore the screening and therapeutic efficacy of primary carnitine deficiency (PCD) in newborns and mothers.Methods164245 newborns and suspected mothers were investigated for PCD by tandem mass spectrometry (MS/MS).The overall epidemiology,prognosis,and follow-up of the screening program were investigated.ResultsTotally 55 suspected cases were identified at the primary screening stage.Four newborns and three mothers were confirmed as cases of PCD.The incidence rate of newborns was 1 ∶ 40076.All the patients showed normal growth and development during the follow-up.Blood free carnitine level was raised in all three mothers after treatment.ConclusionsScreening for PCD with MS/MS in newborns may represent a valuable procedure in preventive medicine by enabling early diagnosis and treatment before the onset of symptoms.This protocol is also highly efficient and applicable in diagnosis of mothers with PCD.

Purpose To explore the value of 64-slice spiral CT digital subtraction angiography in diagnosis of cerebral arteriovenous malformations (AVM).Materials and Methods 26 patients with AVM were performed with plain CT scan, enhanced arterial phase and venous phase CT scan on a 64-slice spiral CT scanner. The subtracted arterial phase data was obtained through subtracting the plain CT images from arterial phase images, then the subtracted venous phase data was obtained through subtracting arterial phase images from venous phase images, and subtracted mixed arterial-venous phase data through subtracting plain CT images from venous phase images. Then volume rendering (VR) and maximum intensity projection (MIP) were used to reconstruct the cerebral vessel images. Results The inference of cranial bones was completely removed in all subtracted cerebral vessel images, thus clearly demonstrating malformed vascular nest, feeding arteries and draining veins. And 7 malformed temporal vascular nests, 5 parietal vascular nests, 5 frontal vascular nests, 6 occipital vascular nests and 3 cerebellar vascular nests were revealed;39 feeding arteries were detected altogether. Single feeding artery was found in 15 cases, and multiple feeding arteries in 9 cases. Meanwhile 33 draining veins were observed, and single draining vein was found in 10 cases, multiple veins in 16 cases.Conclusion 64-slice subtraction angiography can remove the inference of cranial bones and clearly demonstrate the feeding arteries, malformed vascular nests, draining veins, potentially providing a reliable evidence for therapeutic planning and postoperative follow-up.

OBJECTIVE:To study the effect and thepossible mechanism of low molecular weight heparin(LMWH)on immunocytes' adhesion to fibroblast-like synovocytes(FLS)isolated from patients with rheumatoid arthritis(RA)and to study LMWH'S possible anti-inflammatory effect on RA.METHODS:LMWH's interference on the adhesion of peripheral blood monouclear cells(PBMC)isolated from healthy volunteers to FLS of RA patients was determined by quantitative counting using flow cytometry.The expression of CYR61 in the in vitro cultured FLS of RA patients was detected using real-time PCR technology.RESULTS:When FLS culture system was added with PBMC,PBMC were obviously found to adhere to FLS,but the number of adhered PBMC decreased after LMWH treatment,which manifested as increase of deciduous PBMC,increased more with the increase of LMWH dose.There was a high expression of CYR61 in synovium tissue in RA patients.CONCLUSION:LMWH inhibited the adheresion of PBMC to FLS from RA patients in a dose-dependent manner,which might be attributed to its competitive combination with heparin sulfate sites on CYR61.