Objective To study and analyze the 24 h ambulatory blood pressure and ambulatory electrocardiography in pa-tients with primary hypertension and coronary heart disease,the characteristics of blood pressure level of patients with hypertension and coronary heart disease and its correlation with myocardial ischemic burden in these patients were explored.Methods Selected by coronary angiography examination,139 cases of patients with high blood pressure,according to the results of coronary artery ex-amination were divided into high blood pressure with coronary heart disease group(observation group)74 cases and simple hyper-tension group(control group)65 cases.Two groups all were used 24 hours ambulatory blood pressure monitoring and ambulatory ECG monitoring.The relevant data were analyzed.Results (1)Observation group nocturnal systolic blood pressure was higher than the average in control group,the time of diastolic pressure was lower than the control group,24 hours and the average artery pres-sure was lower than the control group,the difference was statistically significant(P <0.05).(2)Total ischemia burden(TIB)and the corresponding systolic pressure,diastolic pressure,pulse pressure levels existed significant correlation(respectively r =0.409, P =0.000;r=-0.306,P =0.008;r =0.61 5,P =0.000);there was a significant positive correlation between day TIB and corre-sponding systolic pressure,pulse pressure level(r=0.41 7,P =0.000;r=0.402,P =0.001);there was a significant positive correla-tion between TIB and the corresponding nighttime systolic blood pressure,pulse pressure level(r=0.5 1 1,P =0.000;r=0.596,P =0.000).Conclusion The levels of nocturnal systolic pressure,diastolic pressure and the time of 24 hours are higher,and the average artery pressure levels are relatively low.There is a significant correlation with the myocardial ischemic burden.

Objective To characterize the clinical features and the prognosis of paediatric lobar pneumonia. Methods Clinical data of 45 cases with paediatric lobar pneumonia,such as clinical manifestations,symptom, pathogens and prognosis were retrospectively analyzed.Results Of the 45 patients,45 cases had cough,43 cases with fever,15 cases with pain in the chest,13 cases wtih cutaneous lesions,35 cases wtih antibody of mycoplasma positive, 6 cases wtih Staphylococcus aureus infection,21 cases wtih Streptococcus pneumonia infection,cardiovascular and digestive system were involved besides lung,secondly nervous system involved.After treatment,29 cases were cured, 15 cases improved,1 case transferred other hospital.Conclusion Paediatric lobar pneumonia caused by decreased gradually,but increased by virus and other bacteria.Cases of paediatric pneumonia with fever,cough,pulmonary symptom should be tested by laboratory finding,especially antibody and X ray or CT in order to identify pathogenesis of disease,thus to be treated correctly,dosage and course of antibiotics should be also enough.

Objective To study the application of complex surgical therapy of severe hepatic trauma and the flow line reasonable.Method To study the methods and reasonable process of complex surgical treatment of severe hepatic trauma pre-hospital or hospital treatment of 46 patients during the past 15 years.Results The time of sending to hospital was delayed.Patient has severe hepatic trauma or associated injuries.Patient can not be diagnosed definitely against time.Linear correlation was demonstrated between the three upon and shock (r=0.55,t=3.38,P

Objective: To determine the contents of thromboxane (TXA_2) and prostacyclin (PGI_2) in optic nerves after acute intraocular hypertension injury so as to provide experimental data for the treatment of the clinical intraocular hypertension. Methods: A rabbit acute intraocular hypertension injury model was established by 90-min anterior chamber douche. Thirty adult rabbits were equally randomized into 5 groups: 4 intraocular hypertension injury groups (60 min, 90 min, 24 h and 48 h after intraocular tension normalization) and a normal control group. The eyes of all rabbits were removed and the homogenate of optic nerves was used to determine the contents of TXB_2 and 6-Keto-PGF_ 1?, and the metabolites of TXA_2 and PGI_ 2 by radioimmunoassay. Results: The contents of TXB_2 and 6-Keto-PGF_ 1? in the 60 min and 90 min groups were significantly higher than those of the normal control group (P

Objective To evaluate the role of CT in diagnosis of the gastrointestinal tract rupture after blunt abdominal trauma . Methods Twenty preoperative CT scans and clini cal data were obtained in 20 patients who subsequently had bowel ruptures verifi ed surgically. CT findings were analyzed retrospectively in these patients. Retr ospective interpretation was made by consensus of at least two radiologists. Results Twenty cases of CT scan showed intraper itoneal fluid (18 cases), pneumoperitoneum (18 cases), extravasations of gastro intestinal tract contents (2 cases), bowel wall findings (14 cases) and mesenter ic injury (15 cases). Conclusion CT is fast, sensitive and noninvasi ve in diagnosis of the gastrointestinal tract rupture after blunt abdominal tra uma.

Objective To evaluate operative management of complex hypospadias.Methods Twenty-one cases with complex hypospadias were reviewed.Thiresch procedure at 12 cases were taken.Island scrotal septal flap urethroplasty at 7 cases.Snodgrass procedure at 1 case.Mathieu procedure at 1 case.Results Fifteen cases were satisfied without fistula and stricture.Four cases with fistula,1 case with chordee,urethral meatus stricture in 1 case.Overall,the complication rate was 28.5%.Conclusions Selection of surgical procedure should according to the different case circumstance.It′s essential that reduce separative procedure,protect blood supply and carefully manipulation to improve successful rate.

Objective To investigate the efficacy and safety of ERCP for biliary stricture with duct stone after liver transplantation.Methods Clinical data of 60 patients undergoing ERCP for biliary stricture with duct stone after liver transplantation between January 2013 and June 2014 were retrospectively analyzed.Results ERCP was successfully performed 78 times in 60 patients.Bile duct stenosis was cured in 24 cases (40％),improvement was observed in 27 cases (45％) and was not obvious in 9 cases (15％).Bile duct stones were successfully removed in 39 patients (65％).Incidence of post-ERCP complications was 13％ (8/60),including mild pancreatitis in 1 case,hyperamylasemia in 5 cases,biliary tract infection in 2 cases,which were all resolved after conservative treatment.Conclusion ERCP is a safe and effective treatment for biliary stricture with duct stone following liver transplantation.

Objective To summarize experiences in the perioperative management for combined aortic and mitral valve replacement. Methods One hundred and twenty patients undergoing double valves replacement(DVR) within 10 years were studied. Ameliorate patients' cardiac function before operation. Median sternotomy was performed. The inter-atrial sulcus approach or the right atrial septal approach was chosen, the posterior mitral leaflet and subvalvular apparatus were preserved as much as possible, and DeVega's or Kay's valvuloplasty was performed for moderate and severe tricuspid regurgitation. According to the patient's cardiac function and general condition, active medication with vasomotor drugs, and diuretics as well as intensive postoperative care were administered in the ICU. Results Seven patients died in the perioperative period (in 30 days), and the mortality rate was 5.8%. Early postoperative complications occurred in 22 cases (18%). Conclusion Comprehensive perioperative management could reduce both perioperative mortality and postoperative complications.

Objective: To explore the application value of ablation catheter for pacemaker atrial lead restoration in relevant patients.
Methods: A total of 6 patients with atrial lead dislodgement after pacemaker implantation were selected for our study. The atrial lead restoration was conducted by using ablation catheter via femoral vein pathway.
Results: The average operational time was (15.0 ± 3.7) min which was obviously less than traditional operational time. The position of electrode restoration was ideal with well immobilization.
Conclusion: Ablation catheter is feasible for arial lead restoration in patients with atrial lead dislodgement after pacemaker implantation.

Objective To evaluate the efficacy and safety of endoscopic retrograde cholangiopancre-atography (ERCP)by using a duodenoscope in patients with prior Billroth Ⅱ gastrectomy.Methods Data of 98 patients(including 7 who underwent Billroth Ⅱand Braun)with prior Billroth Ⅱ gastrectomy who un-derwent ERCP from January 2008 to May 2014 at Endoscopy Center of Ruijin Hospital were retrospectively studied.Results A total of 98 patients accepted 111 ERCP procedures,the overall success rate was 75.7%(84 /111).The success rate of accessing Vater′s papilla was 82.0%(91 /111)and the selective can-nulations success rate was 92.3%(84 /91).In the cases of successful access,therapeutic procedures were achieved in 100.0%(84 /84)of all patients.The overall rate of complications was 4.5%(5 /111),with mild post-procedure pancreatitis occurring in 3 cases,cholangitis in 2 cases,respectively.Conclusion ERCP u-sing a duodenoscope can be safely and effectively performed in patients with prior Billroth Ⅱ gastrectomy with high cannulation and treatment success rates.