A questionnaire survey on chronic heart failure management was conducted in 110 physicians from Xindu,Supo,Jiajiang and Xinhua community hospital in Chengdu from January 2007 to June 2010.Results showed that 77.3％ (85/110) of community physicians lacked knowledge about prevention,diagnosis and treatment of chronic heart failure,and the diagnostic accuracy rate was only 51.3％ (40/78) in these community hospitals.There was lack of awareness of the guideline of chronic heart failure:the rate of β blockers use was 15.0％ (6/40) and only 5.0％ (2/40) used the target dose; the rate of angiotensin converting enzyme inhibitor use was 17.5％ (7/40) and only 7.50％ (3/40) used the target dose.In addition,90％ (99/110) of community doctors lacked the education and management for patients with heart failure.The survey suggests that the current situation of chronic heart failure management in community physicians in Chengdu is unsatisfactory.It is necessary to strengthen the training of community physicians.

AIM: To investigate the feasibility and efficacy of tissue plasminogen activator (tPA) injection into the optic nerve as a treatment for retinal vein occlusion in rabbits. METHODS: Rose Bengal-mediated laser-induced retinal vein occlusions were produced in rabbit eyes. Fluorescein angiography (FA) was performed on each eye 3 days before laser irradiation and 30 minutes after laser irradiation.The treatment group (n=20 veins) received intra-optic nerve injection of tPA (12.5μg in 0.05mL BSS) and the controls (n=24 veins) received 0.05mL BSS. FA was repeated to determine the recanalization of the vessel at 3 and 7 days after treatment, followed by histological examination.RESULTS: Rose Bengal-mediated laser-induced retinal vein occlusions were successfully developed and confirmed by FA. The incidence of the recanalization of the vessels in treatment animals was 70.0%, while 16.7% in the control animals (P=0.001). CONCLUSION: Intra-optic nerve tPA injection increased the incidence of recanalization of the occluded vessels. Although further studies are needed, our data suggested that injection of tPA into the optic nerve may have a potential benefit in the treatment of central retinal vein occlusion.

AIM: To investigate the safety of tissue plasminogen activator (tPA) intra optic nerve injection in rabbits. METHODS: Group 1 and 2 (6 eyes in each group) received injection of tPA 25μg and 12.5μg in 0.1mL balanced saline solution (BSS). Group 3 (6 eyes) received injection of 0 1mL BSS. Six eyes in group four as a normal control received no injection. The eyes were examined with slit lamp biomicroscope, indirect ophthalmoscope, visual evoked potentials (VEP) and electroretinography (ERG) at 1, 3, 7, 14 and 28 days after injection. RESULTS: No evidence of optic nerve or retinal toxicity or physical damage were revealed by ophthalmoscopy, VEP, and ERGs after the injection of tPA into the optic nerve. The means of the latency of the first peak of the VEP were 24.6±1.5, 24.1±1.9, 24.0±2.0 and 24.6±1.3mS respectively for the above specified groups (P=0.4112). The means of the amplitude of the first peak of the VEPs were 124±42, 145±41, 132±48 and 117±29μV respectively (P=0.0649). The means of the latency of a-waves were 6.0±0.4, 5.9±0.4, 5.9±0.5 and 5.8±0.3 mS respectively (P=0.6279). The means of the amplitude of a-waves were 110±14, 112±15, 110±16 and 108±11μV respectively (P=0.7248). The means of the amplitude of b-waves were 151±12, 148±14, 144±16 and 141±20μV respectively (P =0.0957).CONCLUSION: Injection of tPA upto 25μg in 0.1mL into optic nerve is well tolerated.

Objective:Atrioventricular nodal reentrant tachycardia(AVNRT) is a common type of arrhythmia,for which radiofrequency ablation(RFCA) is the first therapeutic option.This study is to investigate the causes of 16 cases of temporary atrioventricular block(AVB) during RFCA and 2 cases of permanent AVB after RFCA in common and refractory AVNRT.Methods: We performed RFCA for 77 AVNRT patients by gradually increasing the ablation time,energy and frequency.Generally we chose the lower zone as the first position of ablation and,if invalid,moved the catheter gradually up to the middle or upper zone.Then we analyzed the correlation of AVB with A/V and H-wave in different positions.Results: The AVB risk was increased with the upward movement of the ablation zone and increase of A/V or H-wave(P 0.05). Conclusion: The method of gradually increasing the ablation time,energy and frequency can prevent temporary from permanent AVB.In the common AVNRT group,the middle and lower zone ablation,the multiple-peak A wave,small A wave and big V wave(A/V ≤ 0.45?0.37) with no H wave or H≤0.003?0.01 mV could significantly decrease the risk of RFCA related AVB,but the risk of AVB remains among the refractory AVNRT patients with CSO abnormality or expansion,even if with ablation in the lower zone.

Objective To investigate the effectiveness of electromyography-triggered stimulation on the hand function post stroke.Methods 40 stroke patients were divided into electromyography-triggered stimulation group and neuromuscular electric stimulation group.They were assessed with Fugl-Meyer Assessment (FMA), active range of motion of wrist extension (WE-AROM) and modified Barthel index (MBI) before and 6 weeks after treatment. Results The scores of all the assessments improved in both groups after treatment (P<0.001),and improved more in the electromyography-triggered stimulation group than in the neuromuscular electric stimulation group (P<0.05).Conclusion Compared with neuromuscular electrical stimulation, electromyography-triggered stimulation may further improve the hand function post stroke

OBJECTIVETo explore the effect of half circle external fixation for the treatment of open tibial fractures.

METHODSFrom March 2005 to March 2011, 94 patients with open tibiofibula fractures were treated by closed manipulative or Kirschner-wire poking reduction with half circle groove external fixation including 63 males and 31 females with an average age of 39 years old ranging from 17 to 65 years old. Among these patients, 5 cases were cross shaped fractures, 19 were oblique form and spiral fractures, 70 cases were comminuted fractures. According to the fracture Gustilo classification, 49 cases were type IIIA, 45 were type IIIB. The incidence of wound infection, fracture healing time were observed. The function was evaluated according to the Johner-Wruhs standard.

RESULTSAll patients were followed up for 14 to 63 months (averaged 29 months). The wound healing time was from 16 to 39 weeks (means 21.4 weeks). No fracture nonunion, osteomyelitis and calf compartment syndrome occurred. The wounds of 81 cases were healed at the first period,deep wound infection occurred in 2 cases. According to the function Johner-Wruhs evaluation criteria:the result was excellent in 52 cases, good in 37 cases, fair in 5 cases.

CONCLUSIONClosed manipulative or Kirschner-wire poking reduction and half circle groove external fixation can reduce the infection rate of open tibiofibula fractures. For open tibiofibula comminuted fractures, after the half circle groove external fixation for 3 to 6 weeks, a middle Kirschner-wire was removed according to fracture end healing situation to make fixation dynamic and promote fracture healing.

Adolescent ; Adult ; Aged ; Bone Wires ; External Fixators ; Female ; Fracture Fixation ; instrumentation ; Fractures, Comminuted ; surgery ; Fractures, Open ; surgery ; Fractures, Ununited ; surgery ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery ; Young Adult

OBJECTIVETo evaluate the outcome and analyze the methods of surgical treatment of traumatic endophthalmitis following penetrating eye injuries with retained eye foreign bodies.

METHODSA total of 62 consecutive cases (58 men, 4 women) from January 1999 to December 2001 with IOFBs following penetrating eye injuries were retrospectively studied. The ages ranged from 8 to 46 years (mean 23 years). Sixty patients (63 eyes) underwent pars plana vitreotomy and 1 patient underwent external magnet extraction. The follow-up ranged from 3 to 36 months (mean 12.5 months).

RESULTSTen eyes developed endophthalmitis, among which 7 (10.94%) were diagnosed preoperatively. The most frequently cultured organism was Staphylococcus epidermis (44.44%, 4/9). Postoperatively, retinal detachment due to vitreoretinal proliferation occurred in 5 patients with endophthalmitis and in 9 patients without endophthalmitis. All the retinal detachments were reattached with additional vitreoretinal surgery. Two eyes with endophthalmitis and two without endophthalmitis were eviscerated.

CONCLUSIONSPost-traumatic endophthalmitis with intraocular foreign bodies (IOFBs) deserves great attention because of its high incidence and poor prognosis. Vitrectomy is suggested for the treatment of IOFBs and its complications, and it should be performed as soon as possible. Routine intravenous administration of antibiotics combined with periocular injection and topical antibiotics postoperatively are recommended.

Adolescent ; Adult ; Anti-Bacterial Agents ; therapeutic use ; Child ; Endophthalmitis ; etiology ; Eye Foreign Bodies ; complications ; therapy ; Eye Infections, Bacterial ; drug therapy ; etiology ; Eye Injuries, Penetrating ; complications ; therapy ; Female ; Humans ; Injections ; Male ; Middle Aged ; Vitrectomy

A mutant strain RZ13 with high lipase productivity was obtained through treating the Rhizopus sp. RXF12 by UV and microwave,and its activity was 2.62-fold of the original one. The high lipase productivity of the mutant strain could be inherited after repetitious subcultures.The optimal culture conditions of the RZ13 for producing lipase were studied.The lipase with highest activity (67.32U/ml) was obtained on the conditions of 25℃,pH 8.0,5 %(v/v) single spore suspension (1?107spore/ml) and 120 r/min for 84h,and stable under 40℃ and pH 8.5. In addition,the lipase was immobilized by adsorption onto Mg-Al hydrotalcite at 25℃ for 4 h by screening carriers and optimizing the immobilization. The results showed that the optimal reaction temperature and pH were 35~55℃ and 7.5~9.0,respectively,much wider than the free lipase.

Objective To explore the urban population hyperlipidemia and chronic kidney disease relationship by epidemiological studies.Methods 800 health examiners were randomly investigation.To determine these blood pressure,height,weight;to determine these urinary albumin and creatinine in urine,serum creatinine,serum total cholesterol,triglyceride,high-density lipoprotein cholesterol.To calculate glomerular filtration rate and urinary albu- min and creatinine ratio according to serum creatinine.Diagnastic criteria of CKD was eGFR30mg/g and lasted three months or more.Results 238 patients with high blood lipids was found,the overall prevalence rate was 29.75 %,patients with high blood lipids compared with the normal popula- tion.the incidence of renal injury rates were respectively 15.13 % and 9.07 %.Kidney damage rates were respective- ly 19.69% and 9.91% in the hypercholesterolemia with and without obese patients.Conclusion Hyperlipidemia has become particularly important etiology of CKD.

Objective To explore the implementation situation and influencing factors of long-acting reversible contraception (LARC) after receiving post-abortion care (PAC) in artificial abortion women.Methods According to the demographic characteristics and abortion risks,4 068 artificial abortion women in the family planning clinic of our hospital were classified.The LARC implementation situation after receiving PAC was compared among different characteristic populations.The Chi square test was utilized to analyze the statistical significance of the data by SAS software.Results The LARC rate in young women was 7.9%),which was lower than 27.7% in 19-40 years old women and 11.8% in perimenopausal women;the LARC rate in nulliparous women was 10.6%,which was lower than 27.7% in parous women;the LARC rate in high-risk abortion women was 33.1%,which was higher than 16.6% in low-risk abortion women,these data analysis had statistically significant significance (P<0.05).The LARC rate in ≤ 20 years old women among high-risk abortion women,breastfeeding women,delivery women within three months,cesarean section women within six months and more than three times artificial abortion women was low (< 50%).However,the LARC rate in the scar pregnancy women and more than two times cesarean section women was high (> 80%).Conclusion Young women,nulliparous women and postpartum women in high-risk artificial abortion should be ranked the focus group for PAC consulting.