The treatment for chronic heart failure has been changed significantly in recent 20 years.Therapeutic target in heart failure not only improves symptoms and quality of life,more important is for the mechanism of myocardial remodeling,prevent and delay the development of myocardial remodeling.Angiotensin converting enzyme inhibitor/angiotensin receptor blockers,beta blockers,and aldosterone inhibitors are used as the golden triangle drug therapy for chronic heart failure.In recent years,it has been or is about to carry out some clinical new drugs for the treatment of chronic heart failure.

Objective: China Heart Failure Registry Study (China-HF) is aimed to understand the etiology, clinical features and treatment of in-hospital heart failure (HF) patients in China. Methods: Based on geographic region and economic condition, we prospectively recruited the in-hospital patients with primarily diagnosed HF, and the demographic information, etiology, clinical features and treatment condition were collected by electronic case report form in all patients. Results: A total of 8516 HF patients from 88 participating hospitals between 2012-01 and 2014-12 were analyzed. The average age of patients was at 66 years with 54.5% male. There were 6777/7997 (84.7%) patients with NYHA functional classiifcation at III-IV, 4207/8516 (49.4%) with coronary artery disease (CAD), 4649 (54.6%) with hypertension, 2109/7102 (29.7%) with chronic kidney disease and 2478/6608 (37.5%) with left ventricular ejection fraction (LVEF) < 40%. The patients with infection 3909/8516 (45.9%) and exertion or stress 2214 (26.0%) and myocardial ischemia 1967 (23.1%) were the major cause of HF worsening. There were 6165/8516 (72.4%) patients treated by intravenous diuretics during hospitalization, and after discharge, 5722 (67.2%) patients received oral loop diuretics, 2563 (30.1%) received angiotensin converting enzyme inhibitor, 2095 (24.6%) received angiotensin II receptor antagonist. The median length of in-hospital stay was 11 days and the in-hospital mortality was 5.3% (451/8516). Conclusion: China-HF provides a comprehensive insight of clinical features for the in-hospital HF patients in China. There is still a gap for medications between our current condition and the guideline, it is important to educate both patients and physicians in clinical practice.

The aim of this review is to detect the difference in outcome of cardiac resynchronization therapy (CRT) between ischemic cardiomyopathy (ICM) and non-ischemic cardiomyopathy (NICM).By reviewing some clinical trials of large scale,we found that restore of heart structure and function in NICM was more significant than ICM.However,there were no significant differences in clinical outcome of improving cardiac function and quality of life,decreasing heart failure re-hospitalization and mortality.

Teacher portfolio is originally used for teacher assessment.The role of a teacher portfolio includes strengthening teaching ethics for improving faculty's quality of professional ethics,finding faculty's disadvantages and problems,enhancing faculty's training,providing the basis for faculty assessment,promotion and the appointment,and developing clinical teachers' teaching and research capacity.

Objective To investigate the effect of pretend play training based on Learn to Play program on pretend play capabilities of children with autism. Methods The researchers referred some training strategies in Learn to Play program, and designed a pretend play train-ing which adapted to autistic children's level of development. And then they conducted the pretend play training on three autistic children for four weeks. After that they used Child-Initiated Pretend Play Assessment to assess the effect of the intervention before, after and two weeks after training. Results The percentage of pretend play actions, the number of object substitutions and the number of imitated actions in-creased in some degrees in the children. Conclusion The pretend play training based on Learn to Play program can promote the pretend play capabilities of children with autism.

Objective:To research the application value of coronary CT angiography(CTA) detection for epicardial adipose tissue(EAT) and pericardial adipose tissue(PAT) in the diagnosis of coronary stent restenosis.Method:Selected 68 cases coronary atherosclerotic stenosis patients who were treated by coronary stent from June 2012 to June 2013 in hospital. All patients were detected after the operation of CTA within 3 years and they were divided into two groups (coronary stent restenosis positive group included 29 cases, negative group included 39 cases). To analyze the relationship between EAT and PAT through the statistical method and analyze the application value of EAT and PAT in the diagnosis of coronary stent restenosis based on calcification score image measurement of EAT and PAT volume.Results: Correlation analysis results showed there was correlation between EAT volume and PAT volume (r=0.859,P<0.05); through compared CAG and the diagnostic results of coronary artery stent restenosis by EAT and PAT, the sensitivity was 82.87%, specificity was 84.62%, CCTA positive predictive value was 80.00%, negative predictive value was 86.84% and diagnostic accuracy was 83.82% of the stent patency which was evaluated by CAG. The consistency evaluation marker Kappa was 0.554. The analysis of patients with coronary stent restenosis showed that there was significant correlation between Gensini score of coronary stent restenosis and EAT and PAT(P<0.05).Conclusion:There was significant correlation between EAT volume and PAT volume, and they can be used to evaluate the sensitivity and specificity of coronary stent operation restenosis and the results were higher. Besides, its clinical diagnostic value was similar with CAG.

Using the prime b(special to M. tuberculosis) to amplify 21 mycobacterium and 13 nonmycobacterium, the products amplified were detected by agarose gel electrophoresis. The sensitivity was 50fg at annealing temperature 61℃,and only M. tuberculosis, M. gastri were amplified, those results showed: the clinical isolated mycobacterium can be differentiated and detected quickly and efficiently by using the prime b(using the prime a when necessary) to amplify 16S～23S rDNA spacer sequence of mycobacterium.

Purpose:To study whether the inhibition of phosphatidylinositol 3-kinase (PI3K)/Akt survival pathway could sensitize the response of tumor cells to some chemotherapyeutic agents. Methods:The different tumor cells has been treated with the combination of isoform specific Akt inhibitor and either adriamycin or camptothecin; the quantitation of the induction of apoptosis by drugs has been estimated with caspase 3 assay; immunoprecipitation western blotting has been used to evaluate the inhibition of the phosphorylation of different isoforms of Akt after the treatment. Results:①The inhibitors could reduce the phosphorylation of Threonine 308 and Serine 473 of isoform specific Akt. ②The inhibition of any one isoform specific Akt could not reverse the resistance of tumor cells tested to chemotherapeutic drugs, but it is not the same case if blocking of two isoforms of both Akt1 and Akt2 was done at the same time. ③The synergistic effects of Akt inhibitors is maybe relative to the level of endogenous PTEN(phosphatase and tensin homolog deleted on chromosome 10) expression. Conclusions:It is required to inhibit two isoforms of both Akt1 and Akt2 in order to maximally sensitize the tumor cells to chemotherapy.

Objective To investigate the feasibility,operation design and postoperative rehabilitation in ankylosing spondylitis patients with bilateral hips and knees bony ankylosis,who were operated on the 4 joints during one hospitalization period. Method Two operations were performed in one hospitalization period in three ankylosing spondylitis patients on the 2 hip joints and 2 knee joints respectively.One case,the left hip replacement was operated in the first operation,and the right hip and the double knees were operated in the second operation;the other two cases,unilateral hip and knee were operated in two operations respectively.Patients began to contract their lower limbs’ muscles initiatively after narcosis.The limbs were put on the CPM,the hips and knees were bent and extended repeatedly on the third day after operations.The patients began to leave bed and learned to walk 2 weeks after operations.They could walk 100 steps with aids when they leaft hospital. Result In six-month follow-up,the range of hip motion(degree)were 105?~145?(average 135?);the range of knee motion(degree)was 45?~60?(average 54?).The hip’ function score adopted Harris score system:the average of 83 and were all good;the knee’ function score adopted American Association of Knee Surgery score system in 1989:all were excellent except a good one(left knee of first case,the score was 74/75). Conclusion Performing operations on the 2 bony ankylosis hips and 2 bony ankylosis knees in the ankylosing spondylitis patients in one hospitalization period can shorten the treatment cycle,release the distress,and lighten the economic load,meanwhile it is convenient for operation and postoperative rehabilitation.It is better to do the unilateral hip and knee in a single operation.

Objective To investigate the status of vitamin(Vit)B12 deficiency in elderly inpatients in department of neurology.Methods 827 patients admitted to the department of neurology of Shanghai Punan hospital from March 2007 to July 2008,aged 60 and older,with no severe hepatosis and renal disfunction,and without using VitB12 preparation for 3 months,were included in the study.The levels of serum VitB12,folate,homocysteine(Hcy) were tested to screened patients with VitB12 deficiency.The results of symptoms,positive signs of neurological system and the laboratory examination were analysed and compared between patients with or without VitB12 deficiency.Results There were 827 patients,with the mean age of(77.1?7.5)years old,fulfilled the enrolling criteria.VitB12 deficiency was found in 163 patients(19.7%).The prevalence was higher in female(21.9%)than male(17.4%),which had a tendency of increased with age.In the patients with VitB12 deficiency,the rate of complicating gastrointestinal diseases was higher.Compared with patients with normal serum VitB12 level,there were more cases suffered from unstable gait(27.0%),hypopallesthesia(34.4%),and more cases combined with some chronic diseases such as cerebral infarction(62.6%),hypertension(68.7%),coronary heart disease(39.9%).77% cases had neuroelectricphysiological abnormalities,but only 9.82% cases had megaloblastic anemia.Conclusions VitB12 deficiency is common in elderly inpatients in neurology department,whose clinical manifestations are various and atypical,and the neurological symptoms are more common than megaloblastic anemia.