Objective To observe the effect of Yixin Jiangya Capsule (YXJYC) on serum insulin-like growth factor-1 (IGF-1) level in patients of left ventricular hypertrophy (LVH) of primary hypertension at stageⅡ with Yinxu Yangkang and blood stasis syndrome (YXYKBSS). Methods 93 patients were randomly divided into the treated group (62 patients) and the control group (31 patients). The two groups were both treated with enalapril, and the treated group was treated with YXJYC simultaneously. Treatment course of the two groups was 6 months. Radioimmunoassay was used to examine the level of serum IGF-1 before and after treatment in the two groups, compared with that of 30 healthy persons. Results Before treatment, serum IGF-1 level was significantly higher in both groups than that in the healthy persons (P

Objective To evaluate, the long-term results of pacemaker implantation in 122 elderly patients. Methods A long-term follow-up was carried out in 122 elderly patients (≥ 70 years old, elderly group)and 109 non-elderly patients (< 70 years old,non-elderly group)who received pacemaker implantation. The elinical characteristics, complications and quality of life were compared. Results The mean follow-up time was (8.22±6.01) years and (7.74±5.82) years respectively. The successful rate of the follow-up was 100%. The overall postoperative complications about pacemaker pocket and the prevalence of atrial fibrillation occurred in elderly group were higher than those in non-elderly group (4.10% vs 0, 21.31% vs 10.09%, P< 0.05).The heart function failure was the main cause of the death in elderly group. The stroke and uremia were the main causes of the death in non-elderly group. There was no significant difference in the improvement of the life quality in both groups (P>0.05). Conclusions The pacemaker implantation is a safe and effective therapy for treatment of elderly patients with bradyeardia, and can improve the quality of elderly patients' life. Optimal mode for elderly patients will be given according to the physiological characteristics and the types of bradycardia.

Objective To evaluate role of intracoronary electrocardiogram (IcECG) in examining early myocardial damage during elective percutaneous coronary intervention (PCI). Methods Eighty-six patients of coronary heart disease with normal serum levels of creatine kinase-myoglobin (CK-MB) and cardiac troponin T (cTnT) before the procedure and undergone elective PCI were enrolled in the study.Their IcECG were recorded by a intracoronary guidewire and serum levels of CK-MB and cTnT were measured at baseline and eight and 24 hours after the procedure, respectively. The patients were divided into two group, abnormal and control, according to whether they had significant shift at ST-segment in IcECG.Cardiac events after intervention in the patients were followed-up and recorded. Myocardial damage was defined as serum level of cTnT increased to above the upper normal value after intervention. Results Significant shift at ST-segment in IcECG during PCI in 30 (35%, abnormal group) and no shift in other 56patients (65%, control group) of 86 patients with normal serum levels of cardiac markers before the procedure was observed, and all the procedure were successful Serum levels of cTuT and CK-MB significantly increased after intervention in 30 patients of abnormal group than those in control one ( P <0. 01 ). Sensitivity of intracoronary ST-segment shift was 77 percent for predicting myocardial damage, and specificity was 94 percent, with positive and negative predictive values of 90 percent and 86 percent,respectively. More cardiac events were observed at 4-week follow-up after intervention in abnormal group than those in control one (P<0. 05) and major coronary event-free survival was significantly lower in those with post-procedural ST-segment elevation in IeECG (P < 0. 05). Conclusions ST-segment shift in IcECG may be helpful for predicting myocardial damage during PCI procedure on time.

Objective To study the risk factors associated with death of patients suffered from acute exacerbation of interstitial pneumonia (AE-IP) with very high mortality and very difficult to handle so as to find the most suitable treatment strategy for these patients.Methods The data of 26 patients with AE-IP admitted to Emergency Intensive Care Unit in Peking Union Medical College Hospital from September 2010 to September 2013 were restrospectively analyzed.Comparison of general condition of patients,treatment strategy and response to non-invasive ventilation of patients was made between survival group and death group.Results There was no significant difference in general condition of patients between death group and survival group.But compared with idiopathic pulmonary fibrosis (IPF),connective tissue disease-related interstitial pneumonia had a tendency to accounting for higher proportion in the survival group.The rats of endotracheal intubation and invasive ventilation were significantly increased in death group (14％ vs.84％,P ＜ 0.05).There was significant improvement in PaO2/FiO2 after non-invasive ventilation for 2 hours in the survival group (176 ± i10 vs.218 ±64,P ＜0.05) while the death group had no significant improvement.Conclusions In patients with AE-IP,connective tissue disease associated interstitial pneumonia might have better outcome than IPF.AE-IP patients have a very high mortality rate once patients intubated,thus the decision of intubation in such patients needs to be very cautious.The patients with negligible improvement in PaO2/FiO2 after non-invasive ventilation for 2 hours may have a poor prognosis.

Objective To evaluate the effect of double-plate treatment on grade Ⅱsupination adduction ankle frac? tures with impaction of tibial plafond. Methods A total of 17 patients of gradeⅡsupination adduction ankle fractures with impaction of tibial plafond were treated surgically in our hospital. Anteromedial approach to the medial malleolus was taken to expose the tibial plafond and the vertical medial malleolus fractures. One distal radius plate was placed on the anteromei?dal tibial plafond, and another buttress plate was placed on the medial malleolus. Bone grafting was used to restore the height of the collapsed tibia. Lateral malleolus fractures were treated with reconstruction plate. The fracture union after operation was detected by X-ray examination. American Orthopedic Foot and Ankle Society (AOFAS) ankle hind foot score was used to assess the ankle function. Results Sixteen of 17 patients were followed up postoperatively for a mean period of 2.6 ± 0.9 years. CT cross-sectional study found that the collapsed articular surface of 12 (70.6%) patients was mainly located in the an?teromedial one-fourth area, with the worst at anterior margin. Bony fusion was achieved in all patients after an average peri?od of 2.9±0.5 months. No internal fixation loosening or fracture redisplacement was found by X-ray. The average range of an?kle joint activity was 16.4°±2.8° for dorsiflexion, and was 39.2°±5.3° for plantarflexion. According to AOFAS ankle hindfoot scale, ankle function was excellent in 14 patients and good in 2, with excellence rate of 100%. Conclusion The application of double-plate fixation to treat gradeⅡsupination adduction ankle fractures with impaction of tibial plafond can play a key role in reducing fracture redisplacement and osteoarthritis.

Objective:To analyze the experience of XU Peng-lin in using medicine in treating chronic gastritis,exploring the method for summarizing the experience of famous TCM practitioner.Methods:Professor Xu's 212 typical cases of chronic gastritis were collected,using related rules and point mutual information to analyze the prescription compatibility for the chronic gastritis.Results:Utilization of 12 kinds of drugs were over 30 percents,includinging Pinellia,dried ginger,mongolian milkvetch root,Medicinal Evodia Immature Fruit,and liquorice root,etc..The common compatibility rules were warming spleen-stomach to eliminat dampness,acridness and sweetness activating yang,sour-sweet herbs nourishing yin,pungency disperses while bitterness descends,application of both cold and heat,and combination of reinforcing and reducing.The basic prescriptions for chronic gastritis used by professor XU were Pinelliae Decoction for Purging Stomach-Fire,Zuojin Pill,Huangqi Jianzhong Decoction.Conclusion:Harmonizing yin and yang,reinforcing deficiency and reducing the excess,regulating the activities of qi,harmonizing zang and fu organs were the treatment for chronic gastritis by professor XU,which provided the methodological reference toTCM in treating the chronic gastritis.

Teaching reform for medical statistics in postgraduate students was undertaken in order to comply with the longitudinal thought of medical research and to cultivate student's abilities of solving actual problems. The contents of theory courses and practicum courses were re-enacted and some advanced statistical methods commonly used in medical research were added. Meanwhile,the contents of practicum courses were reformed following the guideline of ‘application of statistics in the research’ and the teaching method of task-driven teaching combined with problem-based learning was used in the process. Furthermore, evaluation on the teaching effect was made. The reformed teaching model greatly excited student's learning enthusiasm and developed their abilities of applying statistics in scientific research.

Objective Respiratory variations in the pulse oximetry plethysmographic waveform amplitude (△POP) have been popularly studied as a dynamic indicators for fluid responsiveness assessment.The authors hypothesized that △POP can indicate fluid responsiveness in septic shock patient in emergency department.Methods A prospective study of 28 patients with septic shock was carried out in Emergency Room and Emergency Intensive Care Unit from 1 October,2010 to 30 September,2011.Hemodynamic data including cardiac index,stroke volume Variation (SVV) and △POP were recorded before and after volume expansion treatment.Fluid responsiveness was defined as an increase in cardiac index of 15％ or greater.Results Changes in △POP after volume expansion were greater in responders than that in non-responders (P ＜ 0.01).There was a significant relation between △POP and SVV before volume expansion (r =0.900,P ＜ 0.0001).Conclusions △POPcan indicate fluid responsiveness non-invasively in septic shock patient in emergency department.This marker has potential clinical application with high sensitivity and reliability.

Objective To study the prognostic value of fragmented QRS (fQRS) in the recurrence of cardiac events in acute STEMI patients underwent emergency percutaneous coronary intervention (PCI). Methods Ninety-two acute STEMI patients who underwent emergency PCI were enrolled. The presence of fQRS was evaluated by a 12-lead ECG in 72 h after PCI. Cardiac events (myocardial infarction, need for revascularization or cardiac death) and all-cause mortality were recorded in all patients during 12 months follow-up. Results Cardiac event rate[15 (31.3%) vs. 4 (9.1%)]were higher in the fQRS group (n=48) compared with the non-fQRS group (n=44) during a mean follow-up of 12 months. A Kaplan-Meier survival analysis revealed significantly lower event-free survival for cardiac events in the fQRS group (P < 0.004). The results of Cox regression model analysis revealed that signiifcant fQRS was an independent signiifcant predictor for cardiac events (HR 2.19, 95%CI 1.38-3.50, P=0.023). Conclusions The presence fQRS is an independent risk factor for poor prognosis in STEMI patients undergoing emergency PCI.

BACKGROUND: Left ventricular hypertrophy induced by primary hyper tension is a risk factor which has a dependent effect on various cardiovas cular complications. Reversal left ventricular hypertrophy has been a keyobject for treating hypertension currently. Plasma neuropeptide Y has en dothelium-derived contracting blood vessel, and has adjusting effect on va somotor function through endothelial cell to participate in onset and main tenance of hypertension. OBJECTIVE: To investigate effect of yixin jiangya capsule on left ven tricular mass index (LVMI) and content of neuropeptide Y of primary grade2 hypertensive patiepts with left ventricular hypertrophy of hyperactivity ofyang due to yin deficiency blood stasis. DESIGN: Case analysis on the basis of patients. SETTING: Department of Traditional Chinese Medicine, General Hospitalof Jinan Military Area Command of Chinese PLA; Department of InternalMedicine, Affiliated Hospital of Shandong University of Traditional Chi nese Medicine. PARTICIPANTS: Totally 93 primary grade 2 hypertensive patients withleft ventricular hypertrophy of hyperactivity of yang due to yin deficiency blood stasis were selected from General Hospital of Jinan Military AreaCommand of Chinese PLA and Affiliated Hospital of Shandong University of Traditional Chinese Medicine from March 2003 to August 2005. All cases were divided into two groups according to random digital table. There were 62 cases in observational group including 40 males and 22 females aged from 46 to 70 years with mean age of 58.94 years and coursed from 2 to 19 years with mean course of 8.93 years. There were 31 cases in control group including 19 males and 12 females aged from 44 to 69 years with mean age of 59.27 years and coursed from 2.5 to 18 years with mean course of 9.11 years. Another 30 people were regarded as healthy group.METHODS: Patients in both groups were treated with enalaprol orally with 10 mg each time of once a day. Patients in observational group were also treated with yixin jiangya capsule (component: shengrlihuang, shengshouwu, sangjisheng, chuanniuxi, gouteng, shijueming, xiakucao, tianma,mudanpi, chishaoyao, dilong, chuanshanjia, etc. Mixed according to ratio,extracted, concentrated, made of capsule, 0.5 g/pill, 4.65 g/raw drug, provided by Shandong Jinan Hongjitang Pharmacy Limited-liability Company,batch number:. 021214), 5 pills once for 3 times every day. Courses in both groups were 24 weeks respectively. LVMI and content of neuropeptide Y were measured with ultrasonic cardiograph and radio-immunity analysis method before and after treatment. Meanwhile, indexes mentioned above were also measured in healthy group so as to regard as the controls.MAIN OUTCOME MEASURFS: LVMI, content of neuropeptide Y,changes of blood pressure, adverse events and side effects.RESULTS: Totally 93 patients entered the final analysis. ① LVMI and content of neuropeptide Y were increased both observational group and control group before treatment [(147.2±16.9), (146.7±17.2), (101.8±.22.4) g/m2;(135.4±33.2), (133.8±31.1), (78.6±24.5) ng/L.; P ＜ 0.01]. ② LVMI and content of neuropeptide Y were decreased both observational group and control group after 24-week treatment, and those in observational group were superior to those in control group [(103.9±24.6), (122.6±19.9) g/m2;(82.9±25.2), (113.7±26.2) ng/L; P ＜ 0.05-0.01]. ③ LVMI and content of neuropeptide Y in observational group were not significantly different from those in healthy group increased both in observational group and control group after treatment (P.＞ 0.05), and those in control group were higher than those in healthy group (P ＜ 0.01). ④ Descent levels of systolic pressure and diastolic pressure were not significantly different between observational group and control group [(137.4±12.8), (134.2:t:11.9) mm Hg;(80.1±8.3), (81.7±7.4) mm Hg, P ＞ 0.05]. Blood routine and liver-kidney function were not changed obviously both groups before and after treatment, and side effect was not observed during the process.CONCLUSION: LVMI and content of neuropeptide Y of primary grade 2 hypertensive patients with left ventricular hypertrophy of hyperactivity of yang due to yin deficiency blood stasis are higher than those of healthy people. Yixin jiangya capsule can deteriorate left ventricular hypertrophy and decrease the content of neuropeptide Y on the basis of application of enalaprol.