OBJECTIVE:To observe the effects of bisoprolol combined with conventional triple therapy on the efficacy and re-lated indexes of patients with rheumatic heart valvular disease (RVD) combined chronic heart failure. METHODS:110 patients with RVD combined with chronic heart failure were randomly divided into observation group(55 cases)and control group(55 cas-es). All patients were treated with oxygen inhalation,anti-infection,correcting electrolyte imbalance,controlling arrhythmia,and giving digitalis drugs and diuretic drugs(it can be disabled after edema symptom being controlled);based on it,control group was given Enalapril tablet with initial dose of 2.5 mg,once to twice a day,then adjusted to 10-20 mg after 1 week,twice a day+20 mg Spironolactone tablet,once a day+10 mg Propranolol tablet,once a day. Observation group was additionally given Bisoprolol fuma-rate tablet initial dose of 1.25 mg,once a day,and then increased to 10 mg based on condition improved and tolerability after a meal,once a day. They were treated for 12 weeks. Clinical efficacy,and LVEF,LVEDD,LVESD,SBP,DBP,HR before and af-ter treatment and incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant (P<0.05). Before treatment,there were no significant differences in the LVEF,LVEDD,LVESD,SBP,DBP and HR between 2 groups(P>0.05). After treatment,LVEF in 2 groups were significantly higher than before,and observation group was higher than control group,LVEDD,LVESD,SBP, DBP and HR were significantly lower than before,and observation group was lower than control group,the differences were statis-tically significant(P<0.05). And there was no significant difference in the incidence of adverse reactions(P>0.05). CONCLU-SIONS:Based on conventional treatment,bisoprolol combined with conventional triple therapy shows good efficacy in the treat-ment of RVD combined chronic heart failure,it can improve cardiac function,with good safety.

Objective To study the clinical and pathological manifestation of simple polymyositis. To investigate the expression of costimulatory molecules CD28/CTLA-4: B7 in peripheral blood lymphocytes and their roles in the pathogenesis of SPM.Methods The clinical situation, serum emzymes, electromyography(EMG) and muscular pathology of 141 patients with SPM were investigated. The expression of costimulatory molecules CD28, CTLA-4, B7-1, BB-1 and B7-2 in peripheral blood lymphocytes of six patients with simple polymyositis was measured with one-color flow cytometry(FCM). The control group were healthy volunteers.Results Muscle weakless, myalgia, elevation of creatine kinase and abnormal EMG of myogenic damage were very frequently to see in SPM. The muscle biopsy showed degeneration, necrosis and regeneration of muscle fibres, sporadic muscle fibre atrophy and endomysial inflammatory infiltration. The expression levels of costimulatory molecules CD28, CTLA-4, B7-1 and B7-2 in peripheral blood lymphocytes increased in SPM. Compared to control group, the mean fluorescence intensity of these molecules in SPM group showed by FCM increased remarkably (CD28, B7-2, P

Objective Liver metastasis model of human primary gastric lymphoma in nude mice was reproduced for an experiment to evaluate the inhibitory effect of cytokine-induced killer (CIK) cells on the growth and liver metastasis of primary gastric lymphoma. Methods Surgical orthotopic implantation of a histologically intact liver metastasis fragment derived from a surgical specimen of a patient with metastatic gastric lymphoma was initally implanted, in order to reprodueing a liver metastasis model of human primary gastric lymphoma. Peripheral blood mononuclear cells (PBMC), isolated by blood cell separator from healthy donors and patients with primary gastric lymphoma, were incubated in vitro. rhIFN-?, rhIL-2 and anti-CD3 McAb were added to PBMC in order to prepare CIK cells as well as lymphokine-activated killer (LAK) cells. CIK and LAK cells from different donors were used in treating gastric malignant lymphoma, so as to investigate the inhibitory effect of 2 kinds of effector cells on the growth of the tumor and liver metastasis. Results The liver metastasis model of human primary gastric malignant lymphoma in nude mice was successfully reproduced. After administration of different agents continuously for 20 days (0.3ml/d), the inhibitory rates of the following 4 groups, healthy donors LAK group (2?1010/ml), healthy donors CIK group (2?1010/ml), patients CIK group (1?1010/ml) and patient CIK group (2?1010/ml), were 39.28%, 53.57%, 40.38% and 56.42%, respectively. The liver metastasis rates in control group, healthy donors LAK group, healthy donors CIK group, patients CIK group (1?1010/ml) and patient CIK group (2?1010/ml), were 100.0%, 62.5%, 50.0%, 62.5% and 37.5%, respectively. Tumor weights of all treatment groups were lighter than that of saline group (P

Objective To provide an ideal animal model for exploring the pathogenesis and experimental treatment of malignant melanoma in the small intestine.Methods Fresh tissue of lung metastatic lesions from patients with malignant melanoma of the smallintestine were transplanted into mucosa of the small intestine in nude mice.After 4 times of screening.the tissue of the lung metastatic lesions from the nude mice were transplanted into the small intestine of additionat nude mice.Tumorgenecity and metastasis of transplanted tumors were observed,and were analyzed by morphology,karyotype and flow cytometry.Results A lung metastatic model of human primary malignant melanoma of the small intestine in nude mice was successfully constructed and named HSIM-0601.Massive melanin granules and melanin complex were seen in cytoplasm of tumor cells.Immunohistochemical straining of S-100 and HMB-45 were positive.The number of chromosome was between 57 and 59.DNA index was 1.49.HSIM-0601 was passed for 26 generations.A total of 173 nude mice were used for tumor transplantation.The growth rate of the transplanted tumors and resuscitation rate of liquid nitrogen cryopreservation were both 100%.In HSIM-0601.lung metastasis rate was 100%(173/173)and lymph node metastasis rate was 61.3%(106/173).Conclusions The HSIM-0601 successfully mimics the natural clinicopathologic course of patients with primary small intestinal melanoma,and provides an ideal animal model for research on pathogenesis,metastasis and experimentM therapy of malignant lymphoma in the small intestine.

er analysis of the survival showed that there was significant difference between patients with and without OH. Conclusion At the introductory phase of haemodialysis, OH is an independent predictor of survival rate in haemodialysis patients.

Objective To evaluate the endoscopic managements of acute cholangitis of severe type (ACST) accompanied with multiple organ dysfunction syndrome (MODS). Methods A total of 122 ACST patients accompanied with MODS from January 2000 to October 2008 underwent endoscopic treatment in two time periods. In critical phase, emergent endoscopic retrograde cholangiopancreatography (ERCP) plus en-doscopic naso-biliary drainage (ENBD) were performed to correct critical situation of the patients. After sta-bilization, endoscopic sphincterotomy (EST) plus stone removal, EST plus stent placement, or laparoscopy was performed according to the causes of ACST. Results Emergent endoscopic managements succeeded in all patients of critical phase. At third day post-operation, a reduction in white blood cell count, serum total bilirubin, body temperature, and rate of patients with shock, mental symptoms and purulent bile juice was a-chieved. Recovery rate of dysfunction organs was 60.2% at one week after emergent procedure, and 82. 6% at 2 weeks post-operation. Selective EST plus stone removal was performed in 36 patients with a success rate n one session at 91.7%. Laparoscopic cholecystectomy was performed in 85 patients with a success rate of 95.3%. Stent was placed in 16 patients with an effective rate of 81.3% at 3 months post the procedure. No severe complication or death occurred during the whole therapeutic course. The 6-month survival rate of 10 cancer cases was 70%. Conclusion Therapeutic ERCP plus ENBD is the first choice for acute severe cholangitis accompanied with MODS, while EST plus biliary lithotomy, or EST plus stent placement, or com-bined laparoscopy are ideal methods for subsequent treatment.

Objective The study was conducted to investigate the acute phase of convulsion related problem on the clinical manifestations,imaging and electroencephalograph (EEG) examination of purulent meningitis.Methods Cluster sampling method was employed to select children in our hospital,a total of 301 cases with purulent meningitis was analyzed retrospectively.Among them,62 cases had convulsion.The incidence of convulsion in the acute phase of the purulent meningitis,risk factors,and prognosis were analyzed.Results The convulsion incidence rate of acute purulent meningitis was 20.60％.The partial seizure was eight cases (12.90％).The secondarily generalized seizure following partial seizure was 15 cases (24.19％).The generalized seizure was 32 cases (51.61％).The convulsive status was 7 cases (11.29％).The EEG abnormality was significantly different between the convulsion group and the no convulsion group (P ＜ 0.05).The incidence of brain organic damage was significantly different between two groups (P ＜0.05).The multivariate unconditional logistic regression analysis showed,cause of disease,first symptom,disturbance of consciousness,obvious signs,and cerebrospinal fluid culture with convulsion were the relevant factors (P ＜ 0.01).Conclusions The most common seizure of purulent meningitis was the generalized seizure.Brain organic damage easily resulted in convulsion of purulent meningitis.The days of hospitalization,cause of disease,first symptom,disturbance of consciousness,obvious signs,and cerebrospinal fluid culture with convulsion were the positively relevant factors.Those positively relevant factors in combination of the clinical manifestations,imaging,and EEG examination in children would play an important role in diagnosis,treatment,and prognosis evaluation of convulsion derived from purulent meningitis.Moreover,convulsion affects the disease recovery in children with purulent meningitis.

Objective To analyze the potential etiologies and risk factors of childhood stroke. Methods This study retrospectively reviewed the clinical data of 159 children who were admitted from Jan.2006 to Jan.2014. Results The 159 children were composed of 100 boys and 59 girls , with median onset age of 1.8 years (ranged from 1 day to 12 years old) and median peak age of 0.9 years (ranged from 3 months to 2.8 years old). Their initial symptoms included limb hemiplegia,language dififculties and convulsion. The common causes included infections found in 46 cases (central nervous system infection in 32 cases, respiratory and gastrointestinal tract infection in 14 case), head injury in 42 cases, vitamin K deifciency in 29 cases, Moyamoya disease in 8 cases, heart diseases in 11 cases, spontaneous hemorrhage in 11 cases and 12 cases of unknown reason. Infectious diseases were the most common cause of children acute ischemic stroke in toddler period;and vitamin K1 deifciency were the most common cause of children hemorrhage stroke in infancy. The most common region of infarction is basal ganglia and middle cerebral artery in neuronal imaging. The median age at the time of diagnosis was 1.4 days. The median time of inhospital was 28 days. The median apex time was 4.3 days. Conclusions Among 159 cases, acute ischemic stroke is much more common than hemorrhagic stroke in children stroke, and the major risk factors are infections and head injury;Vitamin K1 deifciency is a major risk factor in infants with hemorrhagic stroke.

Objectives To investigate etiology, clinical characteristics and outcome in children with epilepsia partialis continua (EPC). Methods Sixty-three pediatric patients with EPC were retrospectively analysed. The patients aged (5.53±3.65) years old, with brain CT scans or MRIs after diagnosis, basic laboratory tests, cerebrospinal lfuid analysis and electroencephalog-raphy. The average follow-up time was (22.19±21.19) months (6-72 months). Results The median duration of EPC was 11 days (1-180 days). The causes of EPC were inlfammatory and immune-mediation (36 cases, 57.14%, Rasmussen’s encephalitis included), metabolic disorders (8 cases, 12.70%), brain structure abnormalities (5 cases, 7.94%), vascular malformation (5 cases, 7.94%), dual causes (3 cases, 4.76%), post brain surgery (2 cases, 3.17%) and cryptogenic pathogenesis (4 cases, 6.35%). Neurological dysfunc-tions were observed in 44 cases (69.84%). Age, routine cerebrospinal lfuid abnormalities, the presence of inlfammation and im-mune mediated, EPC long duration, involving the right upper extremity were the risk factors of poor prognosis. Conclusions The most common causes of childhood EPC are inlfammation and immune-mediated central nervous system diseases. Patients with early age of onset, a great tendency of longer duration of EPC and cerebrospinal lfuid abnormalities, involving the right upper ex-tremity have a poor prognosis.

Objective To study the clinical features of the variants of benign childhood epilepsy with central temporal spikes (BECT).Methods The clinical data of 12 hospitalized pediatric patients with BECT from Jan 2007 to Jan 2014 were retrospectively reviewed. Results There were 7 boys and 5 girls in 12 patients. The age of onset was from 3 to 9 years old. Two cases were dizygotic twins. The atypical symptoms included atypical absence of 10 cases, negative myoclonic seizure of 8 cases, speech expression disorders and oral-pharynx apraxia of 4 cases. The electroencephalography (EEG) of all 12 patients showed abundance of spike and waves (SW) in rolandic areas during wake-up and sleep. The SW index was 50%-85% during slow sleep in all patients.Conclusions The variants of BECT are often associated with EEG deterioration. Understanding the clinical featuress and EEG characteristics can help the diagnosis of BECT variants.