【Objective】To investigate the therapeutic effect of Zhuyin Capsule(ZC)for the treatment of congestive heart failure(CHF).【Methods】Fifty SD rats were randomized into five groups: A(pseudo-operation),B(model),C(treated with hydrochlorothiazide 14.29?mg?kg~(-1)?d~(-1)),D(treated with ZC 0.26?g?kg~(-1)?d~(-1))and E(treated with ZC 0.51?g?kg~(-1)?d~(-1)).Except group A,rat models of CHF were established in other groups.Thirty-five days after the modeling,groups C,D and E were treated with corresponding drugs according to the experimental design for 2 days.Cardiac function and the pathological features of heart,liver and lung were examined.【Results】The changes in group A were as follows: heart rate became fast,blood pressure decreased,left ventricular end diastolic pressure(LVEDP)increased,the maximum rate of left ventricular pressure rise(+dp/dt_(max))decreased,ventricular cavity became enlarged and the wall was thin,and there appeared myocardial fibrosis,congested liver and edema in pulmonary alveoli,indicating the success of CHF model.High-dose ZC could relieved the above changes(P0.05).【Conclusion】ZC can decrease the preload and afterload of the heart,and reduce the pathological changes of heart,liver and lung in CHF rats,which may be one of its therapeutic mechanisms.

Objective To evaluate the value of magnetic source imaging(MSI) in localizing the epileptic foci of patients with histologically proved grey matter heterotopia(GMH) and seizure. Methods MSI examinations were performed on 8 patients with GMH and seizure. The location of the epileptic foci defined by MSI was compared with the results of the ECoG. After imaging examinations, all patients received operation with 13-48 months follow up to observe the effectiveness of the operation. Results Among the 8 patients, 1 had hippocampal sclerosis,2 had focal cortical dysplasiaof type Ⅰ B and 1 had focal cortical dysplasia of type Ⅱ B. MRI showed normal findings in 2 cases, subcortical heterotopia in 4 cases, and nodulor heterotopia in 2 cases with one having schizencephaly. The epileptic foci defined by MSI were at right temporal lobe in 2 cases, left frontal lobe in 2 cases, biparietal lobe in1 case, left parietal lobe in 1 case, left temporal lobe in 1 case, and left frontal-parietal lobe in 1 case. The epileptic foci defined by MSI were completely overlaid with area of GMH in 4 cases, closely behind the area of GMH in case, and partly overlaid with area of GMH in 1 cases with size larger than that of the latter. One patient showed two epileptic foci with one located within the area of GMH and the other one 2 centimeters anterior to the area of GMH.One case's epileptic focus located 2 centimeters posteolateral to the area of GMH . The locations of the epileptic foci defined by MSI showed no difference with those defined by ECoG in all patients. According to Engel classification of treatment effect of epilepsy, 6 patients achieved Engle class Ⅰ ( seizure free after operation ), and 2 patients Engel class Ⅳ ( no changes in the frequcenty of occurrence of seizures before and after operation ). Conclusion MSI can noninvasively and precisely localize the epileptic foci before operation in patients with GMH and seizure.

Objective To assess the diagnostic value of magnetic source imaging(MSI) in the preoperative localization of focal cortical dysplasia(FCD). Methods Eighty-two patients with intractable epilepsy resulting from FCD undergone preoperative assessment including MSI, video electroencephalography(VEEG) and electrocorticography(ECoG)from February 2006 to June 2012.The consistency between pre- and intra-surgical assessment was evaluated. For patients who had consistent results,postoperative curative effect was also recorded. The accuracy and predictive values of noninvasive preoperative tests were compared by χ2 test. Results For MSI and ECoG, their results were consistent in 57 cases, partially consistent in 14 cases, and inconsistent in 11 cases. In the postoperative follow-up of 57 patients with consistent results, there were 46 cases with Engel class Ⅰ, 3 cases with Engel class Ⅱ, 4 cases with Engel class Ⅲ, and 4 cases with Engel class IV. For VEEG and ECoG, the results were consistent in 43 cases, partially consistent in 33 cases, inconsistent in 6 cases.The postoperative follow-up showed that 27 cases were graded as Engel classⅠ, 5 cases as Engel classⅡ,7 cases as Engel classⅢ, and 4 cases as Engel class IV. There were statistically significant differences(χ2=5.023,P=0.025)of the concordance rate with ECoG between MSI(69.51%,57/82)and VEEG(52.44%,43/82). In the postoperative follow-up of patients with consistent results, the curative effect was better in group MSI than in group VEEG (χ2=3.989,P=0.046). Conclusions Preoperativelocalization by MSI shows advantage over VEEG, which meanswhen it achieves an agreement with ECoG, patients with FCD may get better prognosis from the surgical process.

Objective To study the association of serum L-kynurenine changes with nutritional status and vascular stiffness in maintenance hemodialysis (MHD) patients. Methods Twenty gender- and age-matched healthy volunteers (healthy group) and 40 MHD patients,including 20 cases with α-keto aicd(α-keto acid group)and 20 cases without α-keto aicd(non-α-keto acid group)were enrolled in the study.Serum L-kynurenine was measured by high performance liquid chromatography.C-reactive protein (CRP)and interleukin 6 (IL-6)were detected.Subjective global assessment(SGA)and malnutrition inflammation score(MIS)were applied to evaluate the nutritional status.Pulse wave velocity(PWV)was used to evaluate arterial stiffness for both groups of MHD patients. Results Serum L-kynurenine was significantly higher in MHD patients than that in healthy subjects[(3.20±1.12)μmol/L vs (1.74±0.27)μmol/L,P<0.01],while such difference was not found between α-keto aicd group and non-α-keto-aicd group [(3.20±0.88)μmol/L vs (3.29±1.34)μmol/L,P>0.05].IL-6 was significantly higher in MHD patients as compared to healthy subjects[(6.45±3.78)ng/L vs(1.38±1.59)ng/L,P<0.01],while such difference was found between α-keto aicd group and non-α-keto aicd group[(3.37±0.82)ng/L vs (9.62±2.48)ng/L,P<0.051.There was no difference of CRP concentration between two MHD groups.As compared to non-α-keto acid group,higher SGA score(26.00±1.75 vs 22.67±2.61,P=0.001),lower MIS score(5.82±2.27 vs 10.00±2.62,P=0.002),lower left side PWV[(21.11±8.21)m/s vs(24.57±5.45)m/s,P=0.244]and lower right side PWV[(19.27±3.22)m/s vs (24.19±5.41)m/s,P=0.015]were observed in α-keto aicd group.Pearson analysis showed positive correlation between serum L-kynurenine and IL-6(r=0.352,P=0.011)and negative correlation between L-kynurenine and pre-dialysis Scr(r=-0.412,P=0.019). Conclusions Inflammation is common in MHD patients.Tryptophan degeneration product L-kynurenine may indicate inflammation status.α-keto acid improves nutritional status,anemia and arterial stiffness maybe through the alleviation of inflammation in MHD patients.

Objective To study the Hainan Utstein templates used for cardiac arrest and resuscitation registries to evaluate the epidemiological characteristics and outcomes of the patients with CPR by multi-center study. Methodsccording to the Utstein templates for cardiac arrest and CPR set by International Liaison Committee on resuscitation in 2004, a Hainan Utstein CPR registry chart was designed and a prospective descriptive study was carried out to evaluate the epidemiological characteristics, impact factors and outcomes of the patients with resuscitation attempt in emergency departments of thirteen hospitals in Hainan Island between January 2007 and December 2010.Results Of 1125 patients with cardiac arrest, male accounted for 73. 8％ and female was 26. 2％. The mean ( ± S. D) age of the cardiac arrest patients was 53.9 ± 13. 1 years old.Coronary heart diseases and hypertension were the most common preexisting chronic diseases in the studied patients. The ROSC rate and discharge rates after survival in 1125 patients with CPR were 23. 8％ and 7.4％ respectively. The ROSC rate and discharge rates after survival were 36. 3％ and 11.6％ in the in-hospital cardiac arrest (IHCA) group, respectively whereas 11.5％ and 3. 3％ in out-hospital cardiac arrest (OHCA) group. Of 188 patients with ventricular fibrillation/Pulseless ventricular tachycardia, the ROSC rate and discharge rate after survival were 58.0％and 21.8％,respectively. Of them, 448 (39. 8％ ) of the cardiac arrest patients had underlying cardiac causes, and the ROSC rate and discharge rate after survival were 36. 3％ and 11.5％ respectively in IHCA group whereas 11.6％ and 3. 3％ in OHCA group. The ROSC rate and discharge rate after survival were 69. 8％ and 7. 4％respectively in the tertiary hospitals whereas 30. 2％ and 7. 3％ in the secondary hospitals. Conclusions Patients experienced cardiac arrest were predominantly male. Coronary heart disease and hypertension were the two most common preexisting chronic diseases. The ROSC rate and discharge rate of patients with IHCA were higher than those with OHCA. ROSC rate and discharge rate after survival were higher in the ventriculat fibrillation/Pulseless ventricular tachycardia group than the other cardiac rhythms first witnessed groups. The time delayed of starting CPR after onset of cardiac arrest had a critical impact on survival and discharge rate in both IHCA and OHCA groups.