The characteristic of atypical atrial flutter episodes on electrocardiogram is different from the typical atrial flutter.Due to the poor diagnosis awareness about atypical atrial flutter,which is easily misdiagnosed as other arrhythmia,for example sinus arrhythmia,atrial fibrillation,and Ⅲ °atrioventricular block.Here we reported a case of atypical atrial flutter in child.In addition to the characteristics of typical atrial flutter,such as regular and more fixed atrial rhythm,fluctuated ventricular rate,faster atrial rate than the ventricular rate,the patient was found equipotential line,slow atrial rate,and uprighted F wave on the inferior wall leads and V 1 lead of electrocardiogram,which were different from typical atrial flutter.

Objective To investigate the methods and effect of the dual incision lock type golf combined with support plate in the treatment of tibial plateau fracture.Methods 80 cases with comminuted fracture of the tibial plateau were randomly divided into two groups.40 cases in the observation group were given the dual incision lock type golf combined with support plate.and the control group used traditional single incision T-shaped steel treatment.The clinical efficacy was compared between the two groups.Results 80 patients were followed up.Excellent rate of the observation group was 67.5％,which was significantly higher than 45.0％ of the control group.The incidence rate of complication in observation group was 2.5 ％,which was significantly lower than 22.5 ％ in the control group (P ＜ 0.05).The reset extent of patients,healing time,loading time,HSS score of the observation group were significantly better than those of the control group (P ＜ 0.05).Conclusion The dual incision lock type golf combined with support plate in the treatment of tibial plateau fracture has less trauma,reliable fixation,early functional exercise andfewer complications.

Objective To develop social integration scale of the disabled,and to test the reliability and validity of the scale.Methods 511 disabled persons were investigated by self-made social integration scale and Chinese version of positive and negative affect schedule (PANAS-C).Results The Scale was composed of three factors:self integration,relationship integration and affection integration,and they explained 47.39％ of variance.The theoretical model fit could be accepted (x2/df =2.051,P＜0.001;RMSEA =0.046;GFI =0.884;CFI =0.926;IFI =0.927).The factors had significant correlated with positive affect (r=0.34-0.55,P＜0.01)and positive affect (r=-0.12--0.32,P＜0.01).The high score group and low score group of social integration had significant differences in positive affect (t=13.77,P＜0.01)and negative affect(t=-7.58,P＜0.01).The cronbach's alpha coefficients of the scale and the three factors were 0.94,0.92,0.87 and 0.89 respectively,and the seven sub-factors'cronbach 's alpha coefficients were from 0.76 to 0.87.Conclusion The theory construct of social integration of the disabled is multi-hierarchical and multi-dimensional.The scale has acceptable reliability and validity,and can be used to assess the degree of social integration of the disabled.

Objective To explore the characteristics of resilience and the relationships between resilience and social integration of disabled people.Methods By convenient sampling,a total of 702 disabled people were investigated by Connor-Davidson Resilience Scale,Social Integration Scale of the Disabled and self-made general questionnaire.Results The score of resilience of disabled people(53.27± 18.21) was lower than chinese community people(65.4± 13.9,t=-13.19,P＜0.01).The resilience scores were significantly lower of the disabled people who came from rural areas,younger(≤ 24 years old) or older(≥ 60 years old),and were disabled from birth had poor family economic conditions,and had no insurances(P＜0.05,P＜0.01).But the disabled people who had university degree or above,married,working,and had warm and harmonious family atmosphere,had significantly higher resilience scores (P＜0.05,P＜0.01).The vesilience and three sub-factors were significantly correlated with social integration (r=0.38-0.66,P＜0.01).The high resilience group had higher score in integration and three dimensions compared with the low resilience group(t=11.60-19.02,P＜0.01).Tenacity and strength directly influenced the three dimensions of social integration (the path coefficient were 0.18-0.46,P＜0.01).Conclusion The resilience of the disabled people is lower,and there are close relationships between resilience and social integration.The training of tenacity and strength is beneficial to social integration of the disabled people.

Objective To explore the relationship between resilience and personality among the physically disabled people.Methods A total of 668 disabled persons were tested by Connor-Davidson Resilience Scale(CD-RISC), Eysenck Personality Questionnaire Short Scale (EPQ-RSC), Rosenberg Self-Esteem Scale (SES).Results The score of resilience of disabled people(53.42± 18.18) was than lower Chinese community people (65.4 ± 13.9, t =-16.83, P＜ 0.05).The scores of the three sub-factors were tenacity (27.19 ± 10.23), strength (18.11 ±6.42) ,optimism(8.09±3.00).The disabled persons' resilience was positively correlated with self-esteem(r=0.52,P＜0.01) ,extraversion(r=0.47, P＜0.01) ,and negatively correlated with psychoticism(r=-0.34, P＜0.01), neuroticism(r=-0.32, P＜0.01).Self-esteem and extraversion could make positive predictions,while psychoticism and neuroticism could make negative predictions to the resilience of disabled persons.Conclusion The disabled Persons' personality is closely related with resilience and has significant predictions to resilience.

Objective To investigate the feasibility and safety of using vasodilators in the treatment of neonates with patent ductus arteriosus (PDA) accompanied by acute heart failure and pulmonary edema. Methods The clinical data of a case of neonatal PDA accompanied by severe cardiac insufficiency and pulmonary edema in Department of Intensive Care Unit (ICU) of Hebei General Hospital, and the neonate's hemodynamic characteristics and the efficacy and adverse reactions of phentolamine, a vasodilator, in the treatment of PDA were retrospectively analyzed. Results In this neonate, on the 8th day after birth and the improvement of pulmonary hyaline membrane disease, the respiratory distress occurred again, which was related to the severe cardiac dysfunction caused by the opening of PDA. Phentolamine was given on the basis of routine treatment to reduce systemic circulatory resistance. Two hours later, the respiratory distress was relieved significantly, that was presumably related to the decline of the left to right shunt volume through the PDA. There were no adverse reactions such as blood pressure reduction and coronary insufficiency. Conclusion Neonatal PDA is easily to be complicated with severe cardiac insufficiency, and vasodilators can reduce systemic circulatory resistance, reduce left to right shunt volume through the ductus arteriosus, and reverse the acute cardiac insufficiency and pulmonary edema, the therapeutic effect of vasodilators is remarkable, safe and reliable in neonatal PDA.

ObjectiveTo explore the effects of recombinant human growth hormone(rhGH)on myocardial inflammatory cytokine expression and heart function in rats with acute myocardial infarction (AMI). MethodsRats with AMI induced by left anterior descending coronary branch ligation were randomized to rhGH and control groups compared with sham-operated group. The effects of 4 weeks of therapy with GH starting 24 hours after myocardial infarction on myocardial cytokines expression and heart function were studied. Myocardial inflammation was examined by analyzing the myocardial cytokine production including the pro-inflammatory cytokines: interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α and the anti-inflammatory cytokine: IL-10. Echocardiography was used to evaluate heart function. ResultsThe levels of TNF-α, IL-1β, IL-6 and IL-10 in the infarcted and non-infarcted region of control group were markedly elevated compared to sham-operated group (all P＜0.05). After 4 weeks therapy, rhGH reduced the expression of TNF -α, IL-1β, IL-6 and increased IL-10 expression in the infarcted and non-infarcted region of rhGH group compared to control group (all P＜0. 05 ). Echocardiography showed that rhGH markedly improved left heart function (P＜0. 05 ). ConclusionsEarly rhGH treatment can improve heart function and myocardial inflammatory cytokine expression after AMI. One of immunopharmacologic mechanisms underlying the beneficial effects of rhGH on heart function improvement may involve the attenuation of pro-inflammatory cytokines and the increase of anti-inflammatory cytokine levels in cardiac myocytes.

Objective To investigate the urinary iodine level and thyroid function during different trimesters of pregnancy in Hangzhou residents and to provide evidence for monitoring iodine nutrition or screening thyroid function. Methods The urinary iodine level and thyroid function of 395 subjects from 5 hospitals in Hanzhou were investigated. The urinary iodine level was measured by arsenic-cerium contact process method. The serum TSH, FT3 and FT4 were measured by chemiluminescence method. Results (1) The urinary iodine median concentration during pregnancy in the 1st, 2nd and 3rd trimesters were 170.3, 170.2, 162.4 μ/L respectively, all significantly lower than that of non-pregnant women (251.9 μg/L, all P < 0.05); (2) The mean value of TSH during the 1st trimester of pregnancy was significantly lower than that of non-preguant women (P < 0.05). The mean values of FT4 and FT3 in the 2nd and the 3rd trimesters of pregnancy were significantly lower than those of the control (P < 0.05); (3) During 2nd trimester, there were 8.7% (9/104, in FT4) and 9.6% (10/104, in FT3) pregnant women below normal lower range while during 3rd trimester, these figures reached 22.7% (22/97) and 17.5% (17/97) resfectively. Conclusions More than half of the pregnant women in Hangzhou have good nutritional status of iodine. There are significant differences in thyroid hormone levels between the non-pregnant and pregnant women as well as between gestation periods. Therefore, it is necessary to establish a trimester-specific reference range of thyroid hormones for normal pregnancy. The screening for thyroid function is recommended for pregnant women besides monitoring routine urinary iodine.

Objective: To investigate the change in expression of anti-senescence marker protein calmodulin (RGN) in liver tissues of rats with immune hepatic fibrosis, and to observe the effect of compound glutathione inosine injection (CGII) on it. Methods: Rat liver fibrosis model was induced by intraperitoneal injection of porcine serum, and CGII intervention was administered at the appropriate time. Rat liver tissues were stained with HE and Masson. RGN and protein expression at mRNA in liver tissues was detected by fluorescence quantitative PCR and immunohistochemistry. One-way Anova was used for measurement data. LDS test was used for two-way comparison, and pathological semi-quantitative results were analyzed by rank-sum test. Results: The relative expression of RGN mRNA and protein in liver tissue of fibrotic rats was 82.23 ± 15.21 and 12.52 ± 3.23, respectively, which were significantly lower than that of normal rats 176.39 ± 11.35 and 59.23 ± 9.13 (P < 0.01). The degree of liver fibrosis in fibrotic rats after CGII intervention was significantly lower than fibrotic rats. The relative expression of RGN mRNA and protein in the intervention group was 168.78 ± 21.31 and 46.42 ± 4.71, respectively, which were significantly higher than fibrosis and spontaneous recovery group. The difference was statistically significant (P < 0.01). The relative expression of RGN mRNA and protein in the spontaneous recovery group was 86.23 ± 17.16 and 14.34 ± 5.16, which was higher than model group. The difference was not statistically significant (P > 0.05). Conclusion The expression of RGN in liver tissue of rats with hepatic fibrosis induced by porcine serum is decreased, while the expression of RGN increases with the decrease of fibrosis after CGII intervention, suggesting that the protein may play an important role in the development of liver fibrosis.

Objective: To investigate the effect and mechanism of XTP4 gene in apoptotic hepatoblastoma HepG2 cell line. Methods: HepG2 cells were transiently transfected with small interfering RNA of XTP4 genes, plasmid pcDNA3.1/myc-His(-) A-XTP4, and hepatitis B virus X protein transactivated x gene 4 (HBX protein trans-activate gene4, XTP4) and their respective negative controls. After 48h, the overexpression and interference expression condition of XTP4 in HepG2 cells were detected by Western blot. HepG2 cells apoptosis was detected by flow cytometry. The expression levels of apoptosis-related proteins P53, Bcl-2, Bax and Caspase-3 in HepG2 cells were detected by Western blot, and Bcl-2/Bax ratio was calculated. The chemiluminescence assay was used to detect activity of caspase-3 in HepG2 cells. The measured data were presented as ( ± s), and independent sample t-test was used for comparison between the two groups. Results: HepG2 cells had successfully achieved the overexpression and interference expression of XTP4 protein. Compared with the control group, the overexpression of XTP4 in HepG2 cells had significantly decreased the number of apoptotic cells (P < 0.05), and increased Bcl-2/Bax (P < 0.05) ratio, but decreased the expression of P53 protein (P < 0.05). The protein expression of Caspase-3 and activity of caspase-3 was decreased (P < 0.05). However, interference with XTP4 expression in HepG2 cells had significantly increased the number of apoptotic cells (P < 0.05) and decreased Bcl-2/Bax (P < 0.05) ratio, but increased the expression of P53 protein (P < 0.05). The protein expression of Caspase-3 and activity of caspase-3 was increased (P<0.05). Conclusion In HepG2 apoptosis XTP4 has inhibitory effect, and its effect on inhibiting HepG2 apoptosis may be achieved by regulating the Bcl-2/Bax ratio, and the P53 protein may be involved.