Objective To apply 12-leads HOLTER monitoring and analysis to observe paroxysmal atrial fibrillation (PAF) and its related atrial arrhythmias so as to explore the triggering factors of PAF. Methods 47 patients with PAF, including 20 male patients and 27 female patients, were given 12-HOLTER monitoring and analysis. Their average age was 64.89 ±12.70 years-old.PAF patients were subdivided into 2 subgroups: the triggered PAF subgroup and the untriggered PAF subgroup. Patients with atrial premature beats but without PAF were selected into the control group. The PAF and its related atrial arrhythmias were detected and analyzed by 12-HOLTER.Results (1) 9 events of PAF were found in 47 patients by 12-HOLTER monitoring and analysis, among them 72 events of PAF were triggered by atrial premature (AP) (91.1%, 72/79), 6 events of PAF occurred automatically and suddenly (7.6%, 6/79);and only 1 events of PAF was triggered by atrial flutter (1.3%,1/79) . (2) The coupling interval of AP in the triggered PAF subgroup was significantly shorter than that of the untriggered PAF subgroup and control group (490 ±90ms vs. 590 ±140 ms and 630 ±90ms, <0.05);The index of AP was smaller significantly in the PAF group than that of the untriggered PAF subgroup and controll group (0.52±0.12 vs. 0.62±0.09 and 0.71±0.06, <0.05);TheP' on Tof AP was significantly higher in the PAF group than that of the untriggered PAF subgroup and control group (84.72%vs. 26.73%and 2.78%, <0.017);The interval before the AP in PAF group was prolonged more significantly than that of controlled group (990±280 ms vs. 940±210 ms, <0.05) . (3) During 2 min~30 s before the PAF occurrence control as total times,the AP appeared more frequently (from 0.43 beats/min to 3.5~6.00 beats/min, <0.017) . (4) Most of the AP which triggered PAF was originated from the upper part of the left atrium (61/72,84.7%) .Conclusions Most events of PAF are triggered by AP, the AP which can trigger PAF may be of some of the features such as a shorter coupling interval,a smaller AP index,P' on Tand a longer interval before the AP,PAF more occurrence while the AP may take place more frequently.Most of the AP which triggered PAF are originated from the upper part of left atrium.

Objective To understand the current situation of smoking and quitting smoking in patients with cardiovascular disease. Methods 184 cases of inpatients or outpatients with cardiovascular disease treated in the First People's Hospital of Kunming were surveyed about quitting smoking, and the smoking and smoking cessation-related clinical features of patients with cardiovascular disease were analyzed. Results ( 1) Cardiovascular diseases in smokers was male-dominated (100%), mainly hypertension and/or coronary heart disease (179, 97.3%) . (2) Average age of starting smoking was 21.5, 97.8%of patients had smoked more than 10 years, with an average of 35.1 ±13.4 years, 69.6% of patients smoked ≥10 cigarettes/day, with an average of 16.3 ± 10.1 cigarettes/day, 65.8%of patients were in the low level of nicotine dependence, 81.5%of the patients thought that quitting smoking was important, 76.1% had quitting smoking ideas, 67.4% had confidence in the success of quitting smoking, 50.5%thought that it was difficult to quit smoking, 127 (69%) patients had seriously quit smoking. (3) 65 cases (51.2%) who seriously quit smoking had succeeded, 54 patients (83.1%) received varying degrees of medical staff advised to quit smoking, 62 cases (48.8%) in relapse, only 34 patients (54.8%) accepted medical personnel advised to quit. Two sets of chi-square test, p=0.000, prompted difference was statistically significant. Relapse reasons were pressure, craving and around other smokers. Conclusions Smoking patients with cardiovascular disease are mainly constituted by male patients with hypertension and/or coronary heart disease. Most of the patients recognize that quitting smoking is important, and have idea and seriously quit smoking. However, lack of confidence and smoking which has also become a lifestyle significantly affect the success of smoking cessation. The medical staffs' recommending smoking cessation persuasion can largely improve the success of smoking cessation for patients.

Objective To explore the clinical features of acute retroperitoneal colon perforation. Methods A retrospective analysis and summary were made on the clinical data of 20 cases of various retroperitoneal colon perforation. Results All of the 20 cases had been misdiagnosed preoperatively. Eighteen cases received surgical treatment, of which 5 cases underwent one-stage tumor resection, 5 cases had two-stage tumor resection and anastomosis;of 8 cases with traumatic perforation,7 were treated by simple suture, 1 case underwent two-stage colonic anastomosis; 2 cases died,all the 2 cases were treated conservatively.Conclusions There are many differences between retroperitoneal colon perforation and intra-abdominal perforation in clinical symptoms, signs and supplementary examinations. Diagnosis of retroperitoneal colon perforation is difficult and the rate of misdiagnosis is high, so this condition must be highly regarded.Surgery is the best option to treat this disease.

Background The measurement of retinal nerve fiber layer (RNFL) by Cirrus optical coherence tomography (OCT) has been applied widely in ophthalmology.However,previous assessment of RNFL is based on spatial measurement,while the evaluation based on optical characteristics of OCT can offset the shortcomings of spatial measurement in some eye diseases.Objective This study was to analyze the optical characters of RNFL measured by OCT and its correlation with age in healthy Chinese individuals.Methods Four hundred and six normal healthy subjects were collected in Shanghai Shibei Hospital from June 2011 to June 2012,with the age of 40-83 years old.Macular RNFL was unilateral imaged using a Cirrus OCT device with 5 line raster macular scan mode under the approval of Ethic Committee of Shanghai Shibei Hospital and informed consent of subjects.A customized software was used to measure RNFL optical characters,including absorbance (A value) and attenuate coefficient.The difference of the measured parameters in different genders was compared.The correlations between RNFL optical characters and age were analyzed by linear regression analysis.Results The data of 353 eyes were included in the final outcomes.The RNFL thickness,A value and attenuate coefficient were (35.1 ±4.4) μm,121.6 ±5.3 and 2.06 ±0.25,respectively.RNFL thickness and A value showed significantly negative correlations with age (r=-0.487,-0.571,both at P＜0.01) with the regression equation Y=-0.17 X+45.23 and Y=-0.24 X+ 135.82,while a positive correlation was found between the attenuate coefficient and age (r=0.368,P＜0.01) with the regression equation Y=0.01 X+1.63.RNFL thickness and A value showed weaker positive correlations with OCT signal intensity (rs =0.128,P =0.016;rs =0.284,P＜0.01),but no remarked correlation was seen between the attenuate coefficient and OCT signal intensity (rs =-0.053,P=0.319).Conclusions Age of subjects affects the parameters of OCT optical characteristics in normal populaition.Age-related RNFL change in optical characters of OCT should be considered before concluding optical parameters.

Objective To establish a capillary gas chromatography method for determination of camphol and isoborneol in Shaoshang yuhe gao ( burn healing cream) . Methods The capillary gas chromatography was adopted under the following conditions: use PEG-2000 as the stationary liquid,nitrogen as carrier gas,ZB-WAX (30 m×0. 25 mm,0. 25 μm) as the chromatographic column,and the flame ionization detector. The column temperature was programmed at 80 ℃ for 5 min as the initial temperature,then raised to 180 ℃ at the rate of 5℃·min-1 and kept for 10 min. The shunt ratio was 101. Results The liner range for camphol was 0. 487 5-31. 25 μg ( r =0. 999 6),and the average recovery was 95. 95%( n =6). The liner range for isoborneol was 0. 487 5-31. 25 μg( r =0. 999 7),and the average recovery was 96. 44%( n =6). Conclusion The method is accurate,sensitive,and can be applied to quality control of shaoshang yuhe gao.

Objective To evaluate the effects of high glucose on autophagy and apoptosis of podocyte and explore the signaling pathway in high glucose-induce podocyte autophagy.Methods Differentiated mouse podocytes were exposed to high glucose(30 mmol/L) or rapamycin (autophagy enhancer,1 μg/L) or LY294002 (a selective PI3K inhibitor,50 mmol/L) for 24 h.The formations of autophagy were observed by electron microscopy and acridine orange staining.Apoptosis was evaluated by flow cytometry.The expression of autophagy protein LC3-Ⅱ/Ⅰ and Beclin-1 as well as the phosphorylation of AKT and mTOR were examined by Western blotting analysis.Results High glucose induced podocytes apoptosis,increased autophagy and the expression of autophagy-associated proteins (all P ＜ 0.05).Rapamycin further increased the expression of LC3-Ⅱ and Beclin-1 protein (all P ＜ 0.05),but LY294002 inhibited partialiy the protein expression of LC3-Ⅱ and Beclin-1 induced by high glucose (both P ＜ 0.05).Treatment with rapamycin increased the phosphorylation of AKT,but reduced that of mTOR in podocytes.Moreover,LY294002 inhibited phosphorylation of both AKT and mTOR (both P ＜ 0.05).Conclusions High glucose promotes podocyte autophagy and apoptosis.High glucose-induced autophagy is mediated partly through PI3K-AKT-mTOR signaling pathway.

Objective To investigate the expression of matrix metalloproteinase-2 (MMP-2)in pancreatic carcinoma and the relationship between MMP-2 with tumour clinicopatholngical features. Methods The expression of MMP-2 was detected by S-P immunohistochemistry in 36 cases with pancreatic carcinoma and 14 normal pancreat-ic tissues. Results The positive expression rate of MMP-2 was 66.7% (24/36) in pancreatic carcinoma tissue and 14.3% (2/14) in normal pancreatic tissues (χ2 = 3. 587, P < 0.01 ) ;The expression rate of MMP-2 in pancreatic carcinoma tissue with positive-node was 86.7% ( 13/15 ) ,which was higher than that with negative-node,which was 52.4% ( 11/21 ) ( P < 0.05 ) ; As to TNM staging in pancreatic carcinoma, the expression rate of MMP-2 was 41.2% (7/17) with Ⅰ,Ⅱ staging and 89.5% (17/19) with Ⅲ,Ⅳ staging(χ2=9.418,P <0. 01 ) ;The expression rate of MMP-2 was 50.0% (5/10) ,66.7% (10/15) and 72.8% (8/11) in highly,moderately and poorly differentiated pancreatic carcinoma(P > 0.05 ). Conclusions The expression of MMP-2 is strengthened significantly in pancreatic carcinoma tissue and involved in turnout invasion and metastasis features; MMP-2 might be regarded as one more marker for the invasive properties of pancreatic carcinoma.

Objective To observe the clinical effects of the adjustive tractor for cervical dislocation.Methods Forty-seven patients were included between September 2007 and November 2011.There were 36 males and 11 females with age ranged from 7 to 62 (mean,35 years).The mean interval from injury to admission was 8.6 h (range,0.5-72 h).There were atlanto-occipital dislocation in 2 cases,C1.2 in 2 cases,C2.3 dislocation in 5 cases,C3.4 dislocation in 2,C4.5 in 9,C5.6 in 13,C6.7 in 14.Thirty cases were complicated by fracture.No facet locking occurred in sixteen cases.Facet locking was found in ten cases and bilateral facet locking was in 21 cases.After reduction,brace or internal fixation followed.According to American Spinal Injury Association (ASIA) spinal function impairment scale standard,there were 4 cases in level A,10 cases in level B,18 in C,10 in D,and 5 in E.According to Japanese Orthopaedic Association (JOA) spinal function rating standard,the mean JOA score was 9 (range,2-14).Results All 47 cases were reduced successfully without neuronal function aggravation.Traction power ranged from 7 to 60 kg (mean,25.6 kg),the mean time of traction was 8 min (range,3-10 min).The mean follow-up was 38 (range,6-48) months.All the patients achieved normal alignment and intervertebral height.The intervertebral body fusion was observed in all of cases,the mean fusion time was 3.3 months (range,3-6 months).One patient who experienced nonunion of vertebral arch fracture didn't receive further treatment because of absence of symptoms.At last follow-up,there were 3 cases in level A,1 in level B,4 in C,8 in D,and 31 in E according to ASIA scale.The mean JOA score was 12 (range,2-17).Conclusion The adjustive tractor is simple and safe for prompt reduction.

Objective To investigate the effect of the optimal prescription of huiru yizeng on rats with hyperplasia of mammary gland and hyperprolactinemia. Methods Fifty-six female Wistar rats were randomly divided into 7 groups (n=8), including normal control group, model control group, sodium chloride group, bromocriptin group, rupi sanjie group, the original prescription group and optimizing prescription group. Rat model of mammary gland hyperplasia with hyperprolactinemia was replicated in 6 groups but not the normal control group. The successfully established experimental rats were given corresponding drugs by intragastric gavage. After 30 days, the levels of the estradiol, progesterone, and prolactin were detected, and the pathomrphology of glandular tissue was observed. Results Prolactin levels of model control group, the original prescription group and optimize prescription group were (69.47 ±6.08), (53.13 ±10.59), and (28.41 ±6.37) pg·mL-1, respectively . Compared with that in the model control group, the contents of prolactin in both the optimal prescription group and the original prescription group were reduced, but the optimal prescription group was better (P<0. 01). In the original prescription group, the lobules of mammary gland showed a few of hyperplasia, the individual alveoli and duct showed a slight hyperplasia, and a small amount of secretions was found in the duct. The degree of the hyperplasia was alleviated in the optimal prescription group similar to that observed in the normal control group, which showed that there was no hyperplasia in the lobules of mammary gland or no secretions in the duct. Conclusion The therapeutic effects of the optimal prescription are much better than the original prescription, which can effectively lower the level of prolactin, adjust the balance among the prolactin , estrogen and progesterone, and alleviate the pathological hyperplasia of mammary glands in the model rats.

Objective To investigate the inhibitory effects of RNA interference on expression of matrix metalloproteinase-2(MMP-2)gene and invasiveness of human pancreatic cancer cell line PANC-1 in vitro.Methods Small interference RNA targeting MMP-2 gene was designed and constructed to plasmid pGCsi-U6.Recombinant plasmids were transfected to pancreatic carcinoma PANC1 cells with Lipofectamine 2000.The efficiency of transfection was evaluated by flow cytometry.RQPCR was used to detect the expression of MMP-2 mRNA.The expression of MMP-2 protein was determined by ELISA.The invasiveness of PANC-1 cells was measured by transwell chamber experiment.MTT assay was used to detect the proliferation and growth of PANC-1 cells.Results Sequencing confirmed that the MMP-2 siRNA plasmid was successfully constructed.The best efficiency of transfecting recombinant plasmid was 82.1%.After transfection of the MMP-2 siRNA plasmid, the MMP-2 gene expression of PANC-1 cells was suppressed to 71.74 %(P＜0.05),and protein expression of MMP-2 fell to 49.82%(P＜0.05).The corresponding inhibition ratio of invasiveness was 33.0%(P＜0.05).There was no marked difference in proliferation rate measured by MTT assay among different groups(P＞0.05).Conclusions RNAi targeting MMP-2 can suppress invasiveness of PANC-1 cells in vitro.This suggests that MMP-2 could be a target for gene therapy of pancreatic carcinoma.RNAi is expected to open up a new prospect for tumor therapy.