Objective To investigate the effect of telmisartan on the plasma brain natriuretic peptide (BNP) in patients with permanent cardiac pacing.Methods According to the method of simple random numbers,106 patients with permanent cardiac pacing were randomly divided into study group and control group,with 53 cases in each group.All patients received implanted operation of permanent pacemaker.The study group was given telmisartan tablets,1 time a day,1 tablet each time,until the end of follow-up.The control group was given valsartan.The plasma BNP was measured by the immunofluorescent assay before administration and at the end of follow-up.In addition,left ventricular ejection fraction (LVEF) and cardiac index (CI) was determined by echocardiography.Results The plasma BNP in two groups was lower than 100 ng/L before administration.At the end of follow-up,the plasma BNP changed slightly in study group,but increased in control group,and the plasma BNP in control group was higher than that in study group [(105.67 ± 15.64) ng/L vs.(73.23 ± 10.56) ng/L],and there was significant difference (P ＜ 0.05).LVEF and CI was stable within the normal range before administration and at the end of follow-up in study group [(58 ± 4)％ vs.(59 ± 5)％,(3.58 ± 0.32) L/(min· m2) vs.(3.56 ± 0.26) L/(min· m2)].LVEF and CI at the end of follow-up in control group was decreased compared with that before administration[(49 ± 3)％ vs.(56 ± 3)％,(2.97 ± 0.26) L/(min· m2) vs.(3.62 ± 0.29) L/(min· m2)],which was lower than that in study group[(49 ± 3)％ vs.(59 ±5)％,(2.97 ±0.26) L/(min·m2) vs.(3.56 ±0.26) L/(min·m2)],and there was significant difference(P ＜ 0.05).Conclusions Telmisartan can delay the increase of the plasma BNP in patients with permanent cardiac pacing,delay the onset of symptoms of heart failure,and improve the quality of life.So early administration of telmisartan is recommended for the patients with permanent cardiac pacing.

Objective To investigate the clinical effect of low molecular weight heparin calcium combined with urease on intravenous thrombolytic therapy for myocardial infarction,and evaluate its safety.Methods One hundred and seven patients diagnosed myocardial infarction were randomly divided into the observation group (n =54) and control group (n =53),who were hospitalized in Yantai Central Hospital from January 2011 to December 2012.Patients in control group were given regular treatment plus basic support treatment for the symptomatic.Patients in the observation group were treated intravenous thrombolysis,subcutaneous low molecular weight heparin besides the basic treatment,10 d as a course of treatment.Observed the therapeutic effect in patients,observed and evaluated the safety of using two drugs in combination therapy group.Results (1) The recanalization rate of coronary artery in observation group was 83.33％ (45/54),higher than that in the control group (60.38％ (32/53),x2 =4.296 ; P ＜ 0.05).(2) The time of ST-T dropped back to 50％ in the observation group was (2.0 ±0.6) h,and recanalization time was (1.3 ±0.4) h,less than that in the control group (3.4 ± 0.5) h,(2.1 ± 0.3) h respectively),and the difference were significant (t =2.948,P ＜0.05 ; t =3.186,P ＜ 0.05).(3) Incidence of complications in the observation group was 44.44％ (24/54),significantly less than that of the control group (77.36％ (41/53) ; x2 =3.918,P ＜ 0.05).Two cases of the observation group were with reinfarction,accounting for 3.70％ and 9 cases in the control accounting for 16.98％.The difference was statistically significance (x2 =4.142 ; P ＜ 0.05).Conclusion The therapy plan of low molecular heparin combined with urease intravenous thrombolytic therapy for myocardial infarction can significantly improve the clinical effect of patients,reduce the complications and the incidence of myocardial infarction.It was proved as a safe and effective therapy plan in improving the prognosis of patients.

At present,there are many problems in the cultivation for medical students including lack of humanistic education,insufficient healthy personality shaping and innovation education.We made explorations in aspects of updating education concept,enhancing faculty construction,emphasizing basic course teaching and promoting students' abilities so as to cultivate the comprehensive quality of students majored in medical imaging (ultrasonic medicine).

Paraquat is one kind of phytocide 2,2'-bipyridine. Oral administration is the most common way to be poisoned,and the mortality is high. As so far the mechanism of poison is not clear. It was believed that a lot of oxygen radical caused cell membrane lipid peroxidize, which lead to multiorgan disturbed. The most common and severe injury of lungs is pneumonedema and pulmonary fibrosis. There is no any antidote to paraquat poison. Treatment of paraquat poisoning is stomach washing, catharsis, blood purified, immune suppressed and antioxidation.

Objective To investigate the extraction technique for atractylenolide Ⅰ in Atractylodes macrocephala by supercritical CO_2 fluid extraction and develop a method used for determining the content of atractylenolide Ⅰ in the extract by HPLC. Methods The effects of seven facters, such as the extracting pressure, resolving pressure etc, to the extraction rate of atractylenolide Ⅰ in A. macrocephala by supercritical CO_2 extraction were investigated. RP-HPLC was used to determine the content of atractylenolide Ⅰ in extraction of A. macrocephala. The separation was performed on Hypersil ODS2 column with methanol-water (70∶30) as mobile phase. The flow rate was 1.0 mL/min and the wavelength of UV detector was 220 nm. Results The optimal extracting conditions: taking 10% alcohol as entraiter, the particle size of medicinal substances was 60 screen meshes, extracting pressure 25 MPa, resolving pressure 5 MPa, extracting temperature 40 ℃, resolving temperature 30 ℃, and the extracting time 4 h. Conclusion Supercritical extraction is time-shorter and efficient in extracting atractylenolide Ⅰ from A. macrocephala. It is suitable to both trial and industrialized production. The method established to determine the content of atractylenolide Ⅰ of A. macrocephala by supercritical extraction is simple, sensitive, and reliable.

Heavy chain antibodies (HcAb) without light chains are naturally produced by camelids.The single domain antigen-binding fragment of HcAb is referred to as VHH or nanobody (Nb),which is the smallest antigen-binding entity at present.Several characteristics such as low molecular weight,high stability,and low immunogenicity make the use of nanobodies superior to the conventional antibodies.Currently,nanobodies are highly valuable antibodies for various applications,including fundamental research,diagnostics,and therapeutics.A variety of nanobodies are investigated in clinical researches.The recent progresses of heterologous expression of nanobodies in seven expression systems,including Gram-negative and positive bacteria,yeasts,filamentous fungi,insect cells,mammalian cells and plant cells were focused on,and the expression systems,hosts,characteristics of vectors,construction of vectors and yield of nanobodies were summarized.The strategies to increase the yield of nanobodies are discussed from molecular level,expression level and rational design.

With the development of assisted reproductive technology , it brings the gospel to many infertility families , and it makes a new challenge to the moral and legal at the same time .Ministry of Health issued the notice on carrying out the special action to manage assisted reproductive technology .By thinking about the ethical and le-gal issues, this paper tried to explore a new response mode to advance the development of assisted reproductive technology and to ensure social harmony and stability .

Objective To find the features and diagnostic values of CT for adrenal ganglioneuroma.Methods CT examinations were performed in 16 cases(7 with plain scan and 9 with both plain and enhanced scan).All cases were confirmed by pathological evidence.Results 2 cases showed solid -cystic mass,14 were solid mass,and 5 accompanied with calcification.The average CT value was from 20 to 40 HU.In 9 cases with enhanced scan,5 slightly enhanced on delayed phase and no enhancement was seen in the others.Conclusion Adrenal ganglioneuroma showed some characteristic CT appearance and CT scanning plays an important role in diagnosis of adrenal ganglioneuroma.

Salivary gland damage with subsequent xerostomia has been an unavoidable complication in most head and neck cancer patients after radiotherapy.However,there were many shortcomings of each current detecting technique.Magnetic resonance sialography(MRS) and diffusion-weighted magnetic resonance imaging(DW MRI) ,as two of the most important progresses in the latest MRI techniques,with the virtue of non-invasion and non-ionizing radiation,has been rapidly developed in salivary function assessment in recent years,and it has kept on improving technically.This article mainly reviewed the clinical applications and research advances of these two MRI technologies in post-radiotherapy salivary function assessment in patients with head and neck cancers,so as to provide reference for further study.