Objective To investigate the application of open beat to beat techniques recording His bundle activity without digital averaging. Methods Recording was performed with very low noise, high gain amplifiers and by analog filtering. 3 brigade amplifiers and 16 bite A/D were connected to a microcomputer by USB. The signal was processed by A pattern recognition plus digital filtering software. The subjects were in a supine position during the recording. Results A prominent waveform was observed between the atrial and ventricular complexes and corresponded to His bundle activity in 46 volunteers. Recordings in 8 patients were compared with records obtained by intracardiac electrode, and a good conformation was seen. Conclusion The noninvasive method of beat to beat surface recording of His bundle activity has broad clinical applicability and high utility for the patients with latent A-V block and eletrophysiologic study.

Objective To evaluate a noninvasive method which has been applied on human subjects to observe beat to beat activity of the His bundle potential. Methods Recording was performed with very low noise, high gain amplifiers and by analog filtering. 3-brigade amplifiers and 16-bite A/D were connected to a microcomputer by USB. The signal was processed by a combined pattern recognition and digital filtering software. Results The results of surface monitoring were compared with intracardiac method in 30 patients. The results of non-invasive method were consistent with that interventional method. A prominent waveform was observed between the atrial and ventricular complexes (A, H, V waves), and corresponded to His bundle activity in all patients. Conclusion The noninvasive method of beat to beat surface recording of His bundle activity has broad clinical applicability and high utility for the patients with latent A-V block and eletrophysiologic study.

Objective To investigate the clinical, hemorheology, transcranial Doppler (TCD) and auditory brainstem evoked response (ABR) features in senile sudden deafness.Methods The clinical manifestations, hemorheology, TCD, and ABR data in 82 patients with senile sudden deafness were analyzed retrospectively.Results (1) The primary symptoms mainly included tinnitus (65.9%) and vertigo (56.1%), which mostly occurred at daytime (53.7%).(2) Most of the patients had risk factors of arteriosclerosis such as hypertension (75.6%), diabetes (59.8%) and so on. These patients had more serious deafness.(3) There was no obvious relationship between high blood viscosity (61% of the patients) and the degree of deafness. (4) 85.4% of senile sudden deafness patients indicated vertebral-basilar artery insufficiency in TCD. There was a positive correlation between blood supply and degree of deafness. (5) The abnormal rate of ABR was 100%. WaveⅠdisappeared in most patients, which showed serious damage of auditory nerve. Disappearing of waveⅠ, Ⅲ, Ⅴ and Ⅰ～Ⅲ, Ⅲ～Ⅴ, Ⅰ～Ⅴ delitescence period delaying might be complicated with the damage of the structure of the brainstem and cochlea.Conclusions The morbidity and degree of senile sudden deafness are associated with insufficiency of blood supply of internal ears. TCD and ABR are sensitive and reliable methods in diagnosis, progression and prognosis of senile sudden deafness.

Stroke is a cerebrovascular disease type with high morbidity and mortality,of which ischemic stroke accounts for about 80％.Now,it is believed that the inflammatory mechanisms play an important role in the progress of pathological physiology of ischemic stroke.Peripheral T lymphocytes infiltrate to the damaged area within 24 hours after cerebral ischemia and are involved in the advance of inflammatory process of brain tissue.As a subtype of T lymphocytes,regulatory T cells are mainly located in the ischemic penumbra; however,at present,its role in ischemic brain injury remains controversial.The research on the mechanisms of regulatory T cells in ischemic stroke may contribute to further understanding of the pathogenesis of ischemic stroke and find new therapeutic targets.

Objective To evaluate the effect of early goal-directed fluid therapy with fresh frozen plasma in severe acute pancreatitis(SAP). Methods From January 2010 to June 2014,79 SAP patients were enrolled according to the continuous sampling method. All the patients were randomly divided into a control group who accept the traditional fluid therapy(group A),an experimental group 1 who accept early goal-directed fluid therapy(group B),and an experimental group 2 who accept the early goal-directed fluid therapy with fresh frozen plasma(group C). There were no significant differences of general conditions a-mong groups. The differences of ICU admission,mortality and occurrence rate of abdominal compartment syndrome(ACS)and MODS were compared among groups. Results Compared with group A,group B and C have a shorter length of ICU admission,a lower mortality and a lower occurrence rate of ACS and MODS (P < 0. 05). Compared with group B,group C have a shorter length of ICU admission,a lower mortality and a lower occurrence rate of ACS and MODS(P < 0. 05). Conclusion The method of early goal-direct-ed fluid therapy with fresh frozen plasma will contribute to shorten the length of ICU admission and reduce mortality and occurrence rate of ACS and MODS for patients with SAP.

Objective To evaluate the quality of the examination paper of the theory of Clinical Diagnostics,to explore and reflect on the teaching methods,so as to improve the quality of teaching.Methods Finals results of Clinical Diagnostics including 40 clinical undergraduates of Capital Medical University were analyzed.SPSS 20.0 was used to make analysis of the frequency,means statistics and normality of the examination paper.Kuder Richardson/Cmnbacha formula,percentage unification methods and so on were used to calculate confidence,validity,difficulty and degrees of distinction.Acquisition of relevant knowledge was assessed according to score distribution,while test paper quality was evaluated based on indicators including confidence,validity,difficulty and degrees of distinction.Results Test scores of 40 students were between 61 to 96 (83.64 ± 8.07).The degree of confidence (γ) for choice questions and subjective questions was 0.65 and 0.59 respectively;The validity (V) was 0.27;The overall difficulty (P) of the examination was 0.84;The degrees of distinction (D) were between 0.16 to 0.30.And the total points losing rate was 16.36％.Conclusion The examination is of medium difficulty and good degree of distinction,but the teaching strategies still need further adjustment in order to improve the students' ability of flexible application of the basic knowledge.

The clinical value of 18F-FDG PET/CT in tumor imaging has been widely recognized.However,the related cost is high.SPECT is used more widely.So 99Tcm-labeled radiopharmaceuticals can be easily accessed.The recent progress of glucose and its analogs labeled by 99Tcm in tumor imaging is focused.

BACKGROUND: The data of epidemiological survey on rheumatic diseases such as ankylosing spondylitis (AS) are very rare in China, especially in Shenzhen. The comprehensive understanding of epidemiological situation of AS in Shenzhen can be used to draw up treatment plans by Shenzhen Health Bureau and some other health organizations.OBJECTIVE: To investigate the epidemiological features of AS.DESIGN: Randomized complete collection and cross-sectional investigation.SETTING: Shenzhen Rheumatism Institute of Guangdong Medical College. PARTICIPANTS: From December 2001 to April 2004, totally 6 684 adults aged over 16 years were selected from three regions (one region of river and lakes, one local mountain region and one inhabitant region) of Shenzhen. Among them, 5 922 adults (2 659 males and 3 263 female) were actually investigated and the investigative rate was 88.6%. Males were accounted for 44.9% and females were 55.1%, and the ratio was 1:1.23.METHODS: Step 1 and 2, the investigated individuals were questioned and their answers were recorded by the investigators. The questionnaire proceeded one by one for every individual and proceeded at homes. Step 3,the individuals with positive findings at steps 1 and 2 were examined by rheumatologic doctors. Step 4, individuals with suspected AS were subjected to human leukocyte antigen B27 (HLA-B27) assays, radiographies including plain pelvic films, plain lumbar-vertebral films and if necessary, radiographies at other areas of spinal column as well as peripheral joints.MAIN OUTCOME MEASURES: Frequencies of rheumatic complaints,prevalence rate of AS, positive frequencies of hum an HLA-B27, and comparisons with relevant data abroad.RESULTS: ① General frequency of rheumatism was 21.6%, and the highest complaint was at knee joint, then at waist, shoulder, neck and hand. In female, the frequencies of complaints at every joint mentioned above were higher than those in male (P ＜ 0.05). A total of 13 patients (4.7%) had to discontinue their work because of rheumatic diseases. ②Prevalence rate of AS was accounted for 0.37%, and the ratio between male and female was 4.5: 1. The onset of AS began at middle age in majority patients. ③ Positive frequency of HLA-B27 was 5.0%. ④ Rate of misdiagnosis, the rate of early diagnosis and the rate of long-term irrational drug-usage were 64%, 27% and 73%, respectively.CONCLUSION: In Shenzhen, the prevalence rate of AS (0.37%) is ranked higher than that in Beijing (0.26%), Shantou (0.26%), America(0.20%) and the whites of Greece (0.24%). The differences among them may be connected with the fact that in Shenzhen the young people occupy a large proportion of population.

Objective To investigate the expression of p53 up-regulated modulator of apoptosis (PUMA) and p53 protein and relationship with clinicopatbological parameters in human gastric cancers. Methods Primary gastric carcinoma and adjacent normal mucosa were obtained from 84 consecutively enrolled patients undergoing gastric cancer resection at Peking University People's Hospital during the period from April 2001 to May 2003. Immunohistochemistry staining was used to measure the expression of PUMA and p53 proteins both in normal and malignant tissues. Results PUMA expression is significantly weaker in primary gastric carcinoma compared to adjacent normal mucosa (P <0. 01 ). Weak PUMA expression in gastric cancer correlates with depth of tumor invasion ( P < 0. 01 ), advanced pTNM stage ( P < 0. 05 ) and poor overall survival of patients ( P < 0. 05 ). p53 protein expression in gastric carcinoma is significantly higher than adjacent normal mucosa ( P < 0. 01 ). There was a significant negative correlation between the expression of PUMA protein and p53 protein in gastric carcinoma (P < 0. 05 ). Conclusion PUMA expression in gastric carcinoma is significantly lower compared to adjacent normal mucosa. Weak PUMA expression in gastric cancer correlates with depth of tumor invasion, later pTNM stage and poor overall patient survival.

Objective To investigate the relationship between infarct location and prognosis after emergency percutaneous coronary intervention (PCI) treatment in patients with acute myocardial infarction.Methods Consecutive 121 patients with ST elevation myocardial infarction (STEMI) who underwent primary PCI were divided into 3 groups according to the infarct location.Their clinical,ECG,echocardiography and coronary angiography features were analyzed,and the follow-up was made. Results Compared with inferior wall infarction group and inferior wall infarction combined with right ventricular infarction group,anterior wall myocardial infarction group had higher CPK-MB and cTnT,less frequent collateral,reduced ST-segment resolution,higher mortality rates in hospitalization and one year after discharge.On the other hand,inferior infarction combined with right ventricular infarction group had more occurrences of shock and atrial vetricular block or ventricular arrhythmia,more incidence of multivessel disease and thrombus,and higher readmission rate.Conclusion Patients with anterior wall myocardial infarction and inferior wall in