Objective Study the differential diagnosis value of the axis of "no man's land" in wide QRS complex tachycardia.Methods Retrospectively analyse the axis of "no man's land" in 137 patients with wide complex tachycardia who had undergone intracardiac electrophysiologic studies,use the algebraic sum of the deflections in leads I and III to plot the QRS axis,to observe the rule of arrhythmia of "no man's land" appearance.Results Eighteen of 137 patients who had wide complex tachycardia had the axis of "no man's land",among which 16 patients had left idiopathic ventricular tachycardia,and 2 patients had wide complex supraventricular tachycardia they had accessory pathway conduct anterogradely.Conclusion The axis of "no man's land" is helpful in differential diagnosis of ventricular and supraventricular tachycardias with abberency or bundle branch block.

Treatment of gynaeeological cancer frequently results in the loss of ovarian function and menopausal syndrome.The most effective treatment is hormone replacement therapy (HRT).According to the current studies,HRT does not increase the risk of recurrence or death in patients with early stage endometrial cancer and uterine leiomyosarcomas. The safety of HRT in ovarian cancer patients is inconclusive. Cervical squamous cell carcinoma, vaginal cancer and vulvar cancer are not contraindications for HRT. Estrogen replacement therapy (ERT) is contraindicated for low-grade endometrial stromal sarcomas. Therefore,after integrated risk assessment and discussion,patients with severe menopausal symptoms can be treated with HRT to improve the quality of life.

ObjectiveTo investigate the influence of connective tissue growth factor (CTGF) onthe collagen metabolism in human keloid fibroblasts with RNA interference (RNAi).Methods Human keloid fibroblasts (KFB) in vitro were transfected by 3 pairs of specific small interfering RNA (siRNA) CTGF plasmid synthesized for human CTGF,respectively.Reverse transcriptase-polymerase chain reaction (RT-PCR) contributed to the screening of the best siRNA in interfering of CTGF expression in human keloid fibroblasts to construct the plasmids,with the application of RNAi,to test the changes of expression level and collagen content of CTGF in transfected keloid fibroblasts through RT-PCR and Western blotting compared to its control groups.ResultsThe 3rd pair (C3) siRNA- CTGF expression of genes and proteins was remarkably inhibited after being interfered with human keloid fibroblasts,with inhibitory rates of 86.8 ％ and 65.6 ％.ConclusionsKeloid fibroblasts transfected by plasmid siRNA-CTGF effectively inhibite the expression of CTGF and deposition of collagen,and CTGF promotes the collagen synthesis in keloid development.

Objective To comparatively study the difference status of lymphocyte subsets and activated T lymphocyte between preoperation and intraoperation,and to investigate the influence of operation on lymphocyte subsets and their activation in the pa-tients with malignant tumors.Methods The lymphocyte subsets and their activated cells were determined in 42 cases of common malignant tumors by the flow cytometry.Results The levels of CD3 + ,CD4 + ,CD8 + cells during intraoperation were obviously de-creased compared with preoperation,the difference in CD3 + and CD4 + had statistical significance(P <0.05),while the difference of CD8 + had no statistical significance(P >0.05).NK,CD19 + ,CD3 + HLA-DR+ were significantly increased,the difference of NK and CD19+ had no statistical significance(P >0.05),while the difference with CD3 + HLA-DR+ had statistical significance(P <0.05). Conclusion The cellular immune function in the patients with malignant tumor is in inhibitory status.Operation makes the cellular immune function to be further injured.The stress responses of operation and trauma increase the expression of NK,CD19 and acti-vated T lymphocytes.It is suggested that the patients with malignant tumor should use the immune response modifier before opera-tion to enhance the cellular immune function for ensuring the effect of postoperative radiochemotherapy sequential treatment.

Background Our previous study demonstrated that microglial activation is closely associated with photoreceptor apoptosis in rd mice.Recent studies on central nervous system (CNS) showed that activation of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase plays a key role in the microglia activation and neural cell death.However,the mechanism of NADPH oxidase during the retinal degeneration and the effect of NADPH oxidase inhibitor on photoreceptor apoptosis are concerned.Objective The aim of this study was to further explore the production of reactive oxygen species (ROS) by NADPH oxidase in the retinal degenerative process of rd mice and protection of NADPH oxidase inhibitor on photoreceptors.Methods Sixty rd mice at postnatal day 9 (P9) were randomized into the experimental group and the control group by throwing coins method.Apocynin,a NADPH oxidase inhibitor,was intraperitoneally injected in the dose of 10 mg/kg (0.01 ml/kg) once daily for 5 days (P13) in the experimental group,and the equal amount of PBS was used in the same way in the control group,and 10 C57BL/6N mice without injection of any drugs served as the wild type mice group.All the mice were sacrificed in P14 for the preparation of retinal sections.The expression of ROS in the retina was detected by dihydroethidium (DHE) fluorescence staining.Expression level of rhodopsin mRNA in the photoreceptor of the mice was determined by real-time PCR,and the thickness of retinal outer nuclear layer (ONL) in the mice of the experimental group and the control group was measured using hematoxylin & eosin staining.The use and care of the animals complied with the Statement of Association for Research in Vision and Ophthalmology.Results DHE staining showed that the ROS presented with the red fluorescence in the mouse retinas.In the rd mice of the experimental group,the ROS fluorescence intensity was dramatically enhanced in comparison with C57BL/6N mice,but weakened in comparison with the rd mice of the control group.Real-time PCR revealed that the relative expressing level of rhodopsin mRNA in the photoreceptor was (4.21±0.33) in the experimental group and (0.93±0.24) in the control group,showing a significant difference between them (t =2.360,P =0.000).The thickness value of retinal ONL was (35.95±1.63)μm in the mice of the experimental group,which was significantly higher than that in the mice of the control group ([23.17±1.38] μm) (t=3.850,P=0.016).Conclusions In the retinal degeneration of rd mice,activation of NADPH oxidase increases the ROS production.Apocynin can slow the apoptosis procedure of photoreceptor cells of rd mice.

Objective To identify the potential neoplastic risk in gonadal development abnormality with Y chromosome.Methods Inquiries about the illness history were made.Lymphocyte chromosoreal karyotype of peripheral blood Was analyzed.Sex determining region Y gene and relative steroids and enzymes were detected.Gonadal site was examined through medical imaging.Conadal excision Was performed by laparotomy or laparoscopy.Pathological examinations were done on all of the specimens.Results Among 41 cases of androgen insensitive syndrome,spermatogenie cell neoplasm occurred in 1 patient,sertoli cell tumor in 2,and interstitial cell hyperplasia in 5.Among 14 cases of 17a.hydroxylase deficiency(XY)syndrome,one was sertoli eell tumor,and one Was sertoli cell hyperplasia.In 4 cases of XY pure gonadal dysgenesis.one was gonadoblastoma with dysgerminomm One of 16 cases of X0/XY gonadal dysgenesis Was spermatogenic cell neoplasm with agenda cell tumor.Four cases of testes degeneration were all with dysgenetic testes.All of the gonadoblastoma and germ-cell tumor were located in the pelvis.Tumors occurred mostly during 15 years of age to 32 years.Conclusions The gonads of XY pure gonadal dysgenesis has high risks of gonadoblastoma and germ-cell tumor.The older the onset age after puberty. the higher the malignancy risk is.Once diagnosed,bilateral gonads should be excised as soon as possible.

Objective To compare the egicacy and security of intracoronary administration of tirofiban combined high-dose adenosine during percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (STEMI).Methods Eighty-eight cases with STEMI were randomly divided into observation group(44 cases) who were accepted 2 times intracoronary adenosine(2 mg,10 ml 0.9％ NaCl),and control group(44 cases) who were afforded only 10 ml 0.9％ NaCl by prospective,double-blind,and random study.The two groups were received10 g/kg tirofiban after aspiration catheter in the culprit lesion distal bolus injection of 3 rain,at the same time,continuous infusion of 0.15 g/(kg · min) for 24 h.The postoperative coronary arteriography and electrocardiogram were evaluated.Meanwhile,the postoperative myocardial blush grade(MBG),thrombolysis in myocardial infarction (TIMI),corrected TIMI frame counts (CTFC),ST-segment elevation resolution (STR) major adverse cardiac events (MACE),and adverse reactions of adenosine were recorded.Results There was no significant difference in terms of postoperative TIMI and STR between two groups (P ＞ 0.05).The CTFC of observation group was (24.4 ± 4.9) frames,significant better than that of control group((21.9 ±3.7) frames;t =2.701,P ＜0.01).The ratio of MBG in observation group was 24/44,higher than that of control group(14/44 ; x2 =4.632,P ＜ 0.05).There were no significant difference regarding of the ratio of death,MACE,target vessel revascularization,grade of NYHA between observation and control group at followed up for 1 and 12 month (P ＞ 0.05).The ratio of patients with blood pressure decrease ≥ 10 mm Hg,new second degree atrioventricular block in observation group were 15.9％ and 20.5％,higher than that in control group (2.3％ and 15.9％ ; x2 =4.950,7.221 ; P =0.026,0.007).The adverse reaction was transient.Conclusion The intracoronary administration of tirofiban combined high-dose adenosine during PCI in patients with STEMI plays an effective role on improvement of myocardial perfusion.

Objective To investigate the therapeutic effect of trimetazidine(TMZ) and atorvastatin on coronary no-flow/slow-flow phenomenon (CNFP/CSFP) emergency pereutaneous coronary intervention (PCI)Methods Thirty-two patients with acute myocardial infarction were selected as our subjects,who hospitalized from April 2007 to May 2012 after PCI with CNFP/CSFP.Patients were administrated with the TMZ (60 mg/d)and atorvastatin (20 mg/d) for 6 months besides the routine therapy.The changes of the clinical symptoms including ECG exercise test,coronary flow of coronary angiography(CAG) were recorded and the level of serum high sensitivity C-reactive protein (hs-CRP),matrix metalloproteinase-9 (MMP-9),tumor necrosis factor-α (TNF-α) and interleukin-6(IL-6) were measured before and after the treatment.Results (1)The symptoms of the patients were improved remarkably;the effective rate was 87.5％ (28/32).The improving rate of ECG was 90.6％.The CTFC of patients after treatment was (20.17 ± 4.36),significantly lower than that of before treatment (35.34 ± 7.43,t =2.409,P ＜ 0.05).(2) The levels of hs-CRP,MMP-9,TNF-a and IL-6 at after treatment were (3.34 ±0.47) mg/L,(173.09 ±42.19) μg/L,(8.47 ±2.09) μg/L,(89.37 ± 18.72) ng/L,lower than that of before treatment ((12.34 ± 2.43) mg/L,(972.68 ± 131.91) μg/L,(23.54 ± 7.48) μg/L,(154.39 ± 42.07) ng/L),and difference were significant (t =2.537,2.789,2.691,2.430,P ＜ 0.01 or P ＜0.05).Conclusion The therapy approach of TMZ and atorvastatin plus routine treatment of nitrate and aspirin showed a better therapeutic effect on CNFP/CSFP.The causes of CNFP/CSFP may relate to inflammation.

Objective To investigate the effect and safety of rotational power-driven thrombectomy therapy through intrapulmonary for acute massive pulmonary thromboembolism.Methods Sixteen patients of acute massive pulmonary thromboembolism diagnosed by CT and pulmonary angiography were treated with Straub Rotarex system.The successful rate,release of clinical manifestations and the blood hemodynamic changes were observed and analyzed.Results The clinical manifestations were improved remarkably in all the 16 patients,arterial partial pressure of oxygen,saturation of arterial blood oxygen,shock index,Miller score and mPAP were (56.7± 13.4) mm Hg,84.1 ± 10.4)％,(1.27 ±-0.39),(22.7±11.4) and (36.3 ±9.4) mm Hg respectively before treatment,and (92.2 ± 8.6) mm Hg,(96.6 ± 12.7) ％,(0.57 ± 0.42),(12.1 ± 7.8)points and (21.9 ± 7.3) mm Hg respectively after treatment,which were all improved significantly (t =-2.794,2.601,-2.592,-2.638,-2.617,P ＜ 0.01).Conclusion Rotational power-driven thrombectomy therapy through intrapulmonary is an effective and safe technique for the treatment of acute massive pulmonary embolism.

Objective To study the effect on the environmental radioactivity level and the health of the residents in Shanghai when Qinshan Nuclear Power Station(QNPS) has been in normal operational condition for 17 years. Methods The field monitoring and the sampling analytical method were used for monitoring the radioactivity level in outdoor environment, drinking water, food and soil. Results The outdoor natural radiation level and the radioactivity level in the sample of the environmental media were on the normal background level. There was no distinct change in the environmental radiation level of Jinshan Area when QNPS was in normal operational condition. The radioactivity level in the environmental media was far lower than the limit values specified by the national standard GB. The effective dose of the outdoor natural external exposure for the residents is about 0.102 mSv/a and the effective dose of the internal exposure from the artificial radionuclides 90Sr and 137Cs in food for the residents is about 0.488 μSv/a. Conclusions There is no effect of the radioactive contamination on the environmental radioactivity level and the health of the residents in Shanghai when QNPS has been in normal operational condition for 17 years.