OBJECTIVE:To compare the clinical efficacy and safety of amiodarone and propafenone in the treatment of chron-ic atrial fibrillation cardioversion. METHODS:60 patients with chronic atrial fibrillation cardioversion were randomly divided into propafenone group and amiodarone group. All patients were given conventional treatment,including treating primary disease,con-trolling symptoms,orally giving aspirin,intravenous infusion of GIK,monitoring heart rate,QT interval,P-R interval,QRS time,serum potassium and serum magnesium,etc. On this basis,propafenone group was orally given propafenone 450 mg for con-tinuous 3 months,3 times a day,and then the dose was decreased to 300 mg to maintain the sinus rhythm;amiodarone group was orally given amiodarone 200 mg for continuous 7 d a month,twice a day,and then the dose was decreased to 200 mg or 100 mg to maintain the sinus rhythm. The clinic data in 2 groups was observed,including clinical efficacy,simple drug cardioversion,elec-trical cardioversion,electrical cardioversion power,hospitalization time and incidence of adverse reactions,and the recurrence rate in 48 months was followed up. RESULTS:There were no significant differences in the clinical efficacy,simple drug cardiover-sion,electrical cardioversion,electrical cardioversion power,hospitalization time,incidence of adverse reactions and recurrence rate between 2 groups(P>0.05). CONCLUSIONS:Based on the conventinal treatment,amiodarone and propafenone have similar clinical efficacy and safety in the treatment of chronic atrial fibrillation cardioversion,and both of them can be used as the conven-tional drugs for treating chronic atrial fibrillation cardioversion.

Objective To explore the effects and mechanisms of hepatitis B virus-X protein (HBx) on invasion and migration of hepatocellular carcinoma (HCC) cells.Methods The retrospective cohort study was conducted.The clinicopathological data of 30 patients with liver tumor (20 with HCC and 10 with benign tumor of liver) who were admitted to the Affiliated Hospital of Xuzhou Medical College between July 2014 and July 2015 were collected.HCC tissues of 20 patients with HCC (with history of HBV infection) were collected by surgical resection and peritumoral normal tissues (outside of tumor capsule) of 10 patients with benign tumor of liver (without history of HBV infection) were collected.The expressions of epidermal growth factor receptor 3 (ErbB3)in HCC tissues and peritumoral normal tissues were detected by immunohistochemistry (IHC).The relative expressions of ErbB3 and HBx in HCC tissues and peritumoral normal tissues were detected by Western blot,and relative expressions of ErbB3 in HepG2 of which green fluorescent protein (GFP) and GFP-HBx were respectively transfected were detected.The relative expressions of ErbB3 mRNA in HepG2 transfected by GFP and GFP-HBx were detected by real-time polymerase chain reaction (RT-PCR).The migration and invasion of HepG2 were respectively detected by Transwell assay with and without matrix.The measurement data with normal distribution were represented as $± s.The comparisons between groups were evaluated with the independent-sample t test.Correlation analysis was done by the Pearson test.Results (1) The expressions of ErbB3 were detected by IHC:relative value of mean optical density (MOD) of ErbB3 in HCC tissues of 20 patients with HCC and peritumoral normal tissues of 10 patients with benign tumor of liver were 2.54± 1.33 and O.99±0.29,respectively,with a statistically significant difference (t =6.542,P ＜ 0.05).(2) The relative expressions of ErbB3 and HBx were detected by Western blot:relative expressions of ErbB3 and HBx were respectively 0.79±0.13,1.10±0.28 in HCC tissues of 10 patients with HCC and 1.07±0.17,0 in peritumoral normal tissues of 10 patients with benign tumor of liver,with statistically significant differences (t =3.229,19.486,P＜0.05).The results of Pearson test showed that there was a positive correlation of expression between ErbB3 and HBx in HCC tissues (r=O.637,P＜ 0.05).(3) The relative expressions and transcriptional levels of ErbB3 were detected by Western blot and RT-PCR:relative expressions of ErbB3 in HepG2 of which GFP and GFP-HBx were respectively transfected were O.75±0.11 and 1.10±0.10,respectively,with a statistically significant difference (t=4.291,P＜0.05).The relative expressions of ErbB3 mRNA in HepG2 of which GFP and GFP-HBx were respectively transfected were O.38±0.03 and O.94±0.07,respectively,with a statistically significant difference (t=11.703,P＜O.05).(4) The effects of ErbB3 on migration and invasion of HepG2:numbers of transmenbrane cell in HepG2 of which His and His-ErbB3 were respectively transfected by Transwell assay with matrix were respectively 271± 18 and 463± 31,respectively,with a statistically significant difference (t =8.202,P＜0.05).Numbers of transmenbrane cell in HepG2 of which His and His-ErbB3 were respectively transfected by Transwell assay without matrix were respectively 315±38 and 549±34,respectively,with a statistically significant difference (t =8.310,P＜0.05).Conclusion HBx protein can promote the invasion and migration of hepatocellular carcinoma cells through up-regulating expressions of ErbB3 protein.

Objective To analyze the epidemiological and clinical characteristics of an outbreak of tsutsugamushi disease in Taizhou region of Jiangsu Province,and to clarify new changes of endemic focus of tsutsugamushi disease in Jiangsu Province.Methods The definition of tsutsugamushi infected cases was determined,field epidemiological investigation with analysis of clinical features and polymerase chain reaction (PCR) results to diagnose tsutsugamushi disease were combined.Some of the positive samples were conducted genotyping by amplification and sequencing.Results The outbreak occurred from October to November,2011.The endemic focus located on the plain with humid climate and abundant rainfall.Fifteen cases of tsutsugamushi disease were found,including 6 PCR confirmed cases,5 clinically diagnosed cases,and 4 suspected cases.The main clinical symptoms were fever in 15 cases,skin rash in 14 cases,lymphadenectasis in 3 cases,skin eschar or ulcer in 12 cases,and liver dysfunction in 3 cases.None of the patients developed severe complications,and all recovered rapidly after the treatment.Comparing the sequencing results of positive samples with standard strains,the homology of base sequences was 99.00％ with that of Kawasaki.Conclusions The outbreak of tsutsugamushi disease in Jiangsu Province in 2011 is of autumn type in transitional endemic focus,and the pathogen is Kawasaki Orientia tsutsugamushi.

Objective To explore the effectiveness and safety of vaginal paravaginal repair(VPVR) plus vaginal bridge repair in the treatment of female pelvic organ prolapse (POP). Methods Sixty-five patients with different defects of pelvic floor underwent VPVR or plus vaginal bridge repair for posterior vaginal wall. Patients were followed up after operation. The cure rate was estimated subjectively and objectively. The patients' quality of life was evaluated by the pelvic floor distress inventory short form 20 (PFDI-20). Results All 65 cases were treated by vaginal hysterectomy and anterior vaginal repair, in which there were 33 cases underwent VPVR while 32 cases underwent VPVR plus middle area repair. Forty concomitant procedures for vaginal bridge repair were also performed. The average operative time was (110.00±20.12) min and blood loss was (119.52±45.33) ml. The symptom of stress urinary incontinence of 25 cases significantly released after operation. Four incision recovery delayed and there were no other complicatious occurred. Patients were followed up for 6-29 months,the objective cure rate was 100.00% (65/65) and subjective cure rate was 92.31%(60/65), and 58 cases (89.23%)improved significantly with the quality of life comparing with that of pre-operation by completing PFDI-20 (P<0.01). Conclusions It is an effective and safe procedure for VPVR plus vaginal bridge repair to correct median to severe anterior vaginal prolapse and posterior vaginal wall prolapse. More clinical trials are needed to evaluate their long-term outcome.

Objective To identify the influencing factors for rural doctors′ training effect,and suggest on the improvement of such training.Methods On the basis of rural doctors′ survey,the theory of pre-intervention was used to probe into the influencing factors for such training in five dimensions of attention notice,mega-cognitive strategies,advance organizer,goal orientation,and preparatory information.Results 73.2% of the groups were found with satisfying effect.In the single factor analysis,comparison of training effect involving such factors as age,gender,length of work life and pre-intervention revealed statistical significance(P<0.05).As shown in the logistic regression analysis,High motivation in meta-cognitive strategies,Clear goals in goal orientation,Tiered and categorized training in advance organizers,and Practical learning in preparatory information,as well as variants like age would influence rural doctors′ training effect significantly.Conclusions The key to better training effect lies in better motivation of the trainee,setting correct training goals,emphasis on the practicability of training contents and,the pertinence of the training objects.

To research piezoelectric immunosensor array for rapid detecting HIV(1+2), piezoelectric immunosensor array matrix was designed. HIV(1+2)C1 antigen was immobilized onto the silver electrodes of quartz-crystal microbalance, which was modified with adsorption and cross-linked method. In the clean air flow and monitoring environment, standard quality control and clinical serum sample were detected. The linear range for the measurement of HIV(1+2) was 0.01-0.2 NCU/ml. The sensitivity, specificity and accuracy of HIV(1+2) piezoelectric protein sensor array were 91.7%, 93.3% and 92.7% respectively.
Biosensing Techniques ; instrumentation ; methods ; Electrodes ; HIV ; isolation & purification ; HIV Antibodies ; blood ; Humans ; Immunoassay ; methods ; Protein Array Analysis ; instrumentation ; methods ; Quartz ; Reproducibility of Results ; Sensitivity and Specificity

Objective To explore the relation of sleep duration and control of HbA1Camong type 2 diabetes mellitus ( T2DM) under community management in Huai'an city. Methods There were 9 393 T2DM patients enrolled from Qinghe district and Huai'an district from Huai'an city using multi-stage cluster sampling method. The level of HbA1Cwas categorized as control group (＜7%) and uncontrolled group (≥7%), and sleeping duration was categorized as＜6 h, 6-8 h, and ＞8 h. Non-conditional logistic regression analysis was utilized to analyze the association between sleep duration and control of HbA1C. No confounders were adjusted in logistic regression model 1;and age, sex, and body mass index were adjusted in model 2 and furthermore, in model 3, smoking, drinking, education, duration of diabetes, familial history of diabetes, activity, and medication were adjusted plus variables in model 2. Stratified analyses were also used to explore the association above. Results Subjects with sleep duration＞8 h had a high risk of uncontrolled HbA1Cwhen compared with subjects for sleep duration of 6-8 h with OR＝1.188 ( P＝0.001) and the association were still existed with OR＝1.191 (P＝0.001) after Bonferroni adjusted and adjustment of age, sex, and body mass index. Whereas, with further adjustment of confounders in model 3, the association was vanished. Results of stratified analyses indicated that with Bonferroni adjustment, overweight patients with sleep duration of＜6 h had a lower risk of uncontrolled HbA1Cwith OR＝0.788 and 0.799, respectively, in model 1 and model 2 (both P＜0.05). Meanwhile, patients of female, or age≥60 years, or body mass index＜24 kg/m2, or disease duration≤3.58 years had high risk of uncontrolled HbA1Cwhen sleep duration＞8 h. Conclusion T2DM patients with sleep duration＞8 h were negative for HbA1Ccontrol, and this association was independent of age, sex, and body mass index, but was influenced by the duration of diabetes, activity, medication, familial history of diabetes, smoking, drinking, and education. Sleep duration in patients of female, age≥60 years, body mass index＜24 kg/m2, and short disease duration, should be appropriately adjusted.

Background: and Purpose Limited evidence exists on the effectiveness of endovascular treatment (EVT) for acute posterior circulation tandem lesion (PCTL). This study aimed to explore the role of extracranial vertebral artery (VA) stenting in patients with PCTL stroke undergoing EVT. Methods: Individual patient data were pooled from the BASILAR (EVT for Acute Basilar Artery Occlusion Study) and PERSIST (Posterior Circulation Ischemic Stroke) registries. Patients with PCTLs who underwent EVT were included in the present cohort and divided into the stenting and nonstenting groups based on the placement of extracranial VA stents. The primary efficacy outcome was the modified Rankin Scale (mRS) scores at 90 days and 1 year. Safety outcomes included 24-hour symptomatic intracranial hemorrhage (sICH) and all-cause mortality at 90 days and 1 year post-surgery. Results: A combined dataset of 1,320 patients with posterior circulation artery occlusion, including 263 (19.9%) with tandem lesions, of whom 217 (median age, 65 years; 82.9% male) met the inclusion criteria for the analysis. The stenting group had 84 (38.7%) patients, while the non-stenting group had 133 (61.3%). After adjustment for the potential confounders, extracranial VA stenting was associated with favorable shifts in mRS scores at both 90 days (adjusted common odds ratio [OR], 2.30; 95% confidence interval [CI], 1.23–4.28; P<0.01) and 1 year (adjusted OR [aOR], 2.04; 95% CI [1.05–3.97]; P=0.04), along with lower rate of mortality at both 90 days (aOR, 0.45; 95% CI [0.21–0.93]; P=0.01) and 1 year (aOR, 0.36; 95% CI [0.16–0.79]; P=0.01), with no significant difference in sICH incidence (aOR, 0.35; 95% CI [0.06–1.98]; P=0.24). Conclusion Extracranial VA stenting during EVT may improve functional outcomes and reduce mortality in patients with PCTL strokes.

Background: and Purpose Limited evidence exists on the effectiveness of endovascular treatment (EVT) for acute posterior circulation tandem lesion (PCTL). This study aimed to explore the role of extracranial vertebral artery (VA) stenting in patients with PCTL stroke undergoing EVT. Methods: Individual patient data were pooled from the BASILAR (EVT for Acute Basilar Artery Occlusion Study) and PERSIST (Posterior Circulation Ischemic Stroke) registries. Patients with PCTLs who underwent EVT were included in the present cohort and divided into the stenting and nonstenting groups based on the placement of extracranial VA stents. The primary efficacy outcome was the modified Rankin Scale (mRS) scores at 90 days and 1 year. Safety outcomes included 24-hour symptomatic intracranial hemorrhage (sICH) and all-cause mortality at 90 days and 1 year post-surgery. Results: A combined dataset of 1,320 patients with posterior circulation artery occlusion, including 263 (19.9%) with tandem lesions, of whom 217 (median age, 65 years; 82.9% male) met the inclusion criteria for the analysis. The stenting group had 84 (38.7%) patients, while the non-stenting group had 133 (61.3%). After adjustment for the potential confounders, extracranial VA stenting was associated with favorable shifts in mRS scores at both 90 days (adjusted common odds ratio [OR], 2.30; 95% confidence interval [CI], 1.23–4.28; P<0.01) and 1 year (adjusted OR [aOR], 2.04; 95% CI [1.05–3.97]; P=0.04), along with lower rate of mortality at both 90 days (aOR, 0.45; 95% CI [0.21–0.93]; P=0.01) and 1 year (aOR, 0.36; 95% CI [0.16–0.79]; P=0.01), with no significant difference in sICH incidence (aOR, 0.35; 95% CI [0.06–1.98]; P=0.24). Conclusion Extracranial VA stenting during EVT may improve functional outcomes and reduce mortality in patients with PCTL strokes.

Background: and Purpose Limited evidence exists on the effectiveness of endovascular treatment (EVT) for acute posterior circulation tandem lesion (PCTL). This study aimed to explore the role of extracranial vertebral artery (VA) stenting in patients with PCTL stroke undergoing EVT. Methods: Individual patient data were pooled from the BASILAR (EVT for Acute Basilar Artery Occlusion Study) and PERSIST (Posterior Circulation Ischemic Stroke) registries. Patients with PCTLs who underwent EVT were included in the present cohort and divided into the stenting and nonstenting groups based on the placement of extracranial VA stents. The primary efficacy outcome was the modified Rankin Scale (mRS) scores at 90 days and 1 year. Safety outcomes included 24-hour symptomatic intracranial hemorrhage (sICH) and all-cause mortality at 90 days and 1 year post-surgery. Results: A combined dataset of 1,320 patients with posterior circulation artery occlusion, including 263 (19.9%) with tandem lesions, of whom 217 (median age, 65 years; 82.9% male) met the inclusion criteria for the analysis. The stenting group had 84 (38.7%) patients, while the non-stenting group had 133 (61.3%). After adjustment for the potential confounders, extracranial VA stenting was associated with favorable shifts in mRS scores at both 90 days (adjusted common odds ratio [OR], 2.30; 95% confidence interval [CI], 1.23–4.28; P<0.01) and 1 year (adjusted OR [aOR], 2.04; 95% CI [1.05–3.97]; P=0.04), along with lower rate of mortality at both 90 days (aOR, 0.45; 95% CI [0.21–0.93]; P=0.01) and 1 year (aOR, 0.36; 95% CI [0.16–0.79]; P=0.01), with no significant difference in sICH incidence (aOR, 0.35; 95% CI [0.06–1.98]; P=0.24). Conclusion Extracranial VA stenting during EVT may improve functional outcomes and reduce mortality in patients with PCTL strokes.