Objective:To explore the influence of depression on heart rate variability(HRV) and short term prognosis of patients with acute myocardial infarction(AMI).Methods:120 AMI patients were evaluated with Zung's self-rating depression scale within 24 hours after admission.The patients were divided into depressive group(45 cases) and non-depressive group(75 cases) according to depressive index.Post-infarction angina pectoris,reinfarction,heart failure and ventricular fibrillation as well as cardiac death were observed during 4 weeks.HRV analysis with 24-hour holter of survivals was perfomed in 1 week after infarction.Results:The prevalence of post-infarction angina pectoris,ventricular fibrillation and cardiac death in depressive group was remarkably elevated compared with non-depressive group(40.0% vs 22.7%,20.0% vs 6.7%,17.8% vs 4.0%,respectively. P

Objective To evaluate the effectiveness of renal sympathetic denervation (RDN) for hypertensive heart dis-ease combined with systolic heart failure. Methods Two patients (mean age 35 years) with hypertensive heart disease com-bined with systolic heart failure on maximal tolerated heart failure therapy underwent bilateral renal denervation. Echocar-diography, the six minute walk distance, renal function, glycosylated hemoglobin and NT-proBNP were assessed at baseline and 1 year after renal denervation. Results Renal artery angiography showed that no stenosis and dissection. After 1 year follow up, the left ventricular ejection fraction (LVEF), six minute walk distance and NT-proBNP were significantly im-proved, and the size of left ventricular decreased. Conclusion RDN is effective and feasible for the treatment in patients with hypertensive heart disease and systolic heart failure.

Intracerebral hemorrhage is a disease with high mortality and morbidity. This article discussed the application of magnetic resonance diffusion tensor imaging for intracerebral hemorrhage clinical research, and its limitations and prospect.

Objective:To investigate the rationality of off-label use of tacrolimus combined with Wuzhi capsules in a membranous nephropathy patient. Methods:Based on the related literatures, the application rationality of tacrolimus combined with Wuzhi capsules in a membranous nephropathy patient was analyzed. Results:The combination of tacrolimus and Wuzhi capsules against membranous nephropathy was an off -label drug use, however, it showed certain clinical rationality and economic efficiency. Conclusion:Off-label drug use commonly exists in clinics. Clinical pharmacists should provide evidence support for off-label drug use through searching and analyzing clinical evidences and closely monitoring therapeutic outcome.

This study was based on the project prophase of expert consultation and literature consult, and aimed to analyze the medicine establishment from the perspective of traditional Chinese medicine (TCM) doctors, in order to further study the influence of medical insurance on the development of TCM. Detailed suggestions were made in or-der to promote the benign development trend of TCM and medical insurance. Questionnaire survey was used in the investigation on perceptions of TCM related with medical insurance among 253 TCM doctors in appointed medical institution of medical insurance. Data was processed with frequency statistics. The results showed that after becoming the appointed medical institution of medical insurance, the medical insurance patients have become the main service group (73.5%) of hospitals (68.4%) and incomes of TCM doctors (41.9%) have increased, which contribute to TCM hospitals of becoming bigger and stronger (63.6%). The medical insurance patients have chosen TCM treatment main-ly for its curative effect (37.9%) and safety (24.1%). The influence of reimbursement ratio in medical insurance was relatively low (1.2%). The reimbursement range of TCM medical insurance needs to be further expanded, such as Chinese medicine nosocomial preparation (90.5%), decoction preparation fee (78.3%), and etc. It was concluded that under the background of universal health coverage, medical insurance plays a more and more important role in the development of TCM. And TCM should ensure its safety and improve its curative effect through the standardization of TCM and other measures. Meanwhile, the formulation of medical security policy and medical insurance management service standards should also consider the characteristics of TCM, and encourage the service of TCM.

Despite a recent American Heart Association (AHA) consensus statement emphasizing the importance of resistant hypertension (RH), its control is still a challenge for conventional medicine. The Chinese herbal formula, Qutan Huayu Fang, has been used effectively to assist antihypertensive agents in blood pressure control, but its effect for RH patients is still unclear. This pilot study aims to explore the effects of taking the formula in addition to antihypertensive medication in the management of RH.

Objective To investigate the epidemic situation of coal-burning-fluorosis,and to explore key areas for implementing prevention and control measures in Guizhou Province.Methods Survey data of dental fluorosis of children aged 8-10,anti-fluoride knowledge and health-related behaviors of target students and their families before implementing the comprehensive disease control measures in 2010,were analyzed and evaluated using the method of factor analysis in 23 diseased districts.Results ①The three main factors (F) related to the endemic of coal-burning-fluorosis were economic factor (F 1),knowledge factor (F2) and behavior factor (F3):F1 included the detection rate of 8 to 12 years old children's dental fluorosis,iron stove ownership,corn correct drying rate and chili correct drying rate; F2 included stove correct utilization rate,students awareness and head of the household awareness; F3 included corn food washing rate before cooking and chili food washing rate.②In the economic factor score arrangement,the first three were Zunyi,Xiuwen and Qingzhen.In the F2 score arrangement,the first three were Zunyi,Xishui and Xixiu.In the F3 score arrangement,the first three was Liuzhi,Bijie and Xixiu.③After comprehensive score,Zunyi,Qingzhen,Xishui,Xixiu,Puding and Liuzhi Counties were found to be relatively stronger in control of the epidemic of coal-burning-fluorosis; Xiuwen,Renhuai,Guanling and so on 13 counties were found to be relatively moderate,and Tongzi,Hezhang,Shuicheng and Nayong Counties were found to be relatively weak.Conclusions ①The endemic of coal-burning-fluorosis is related with many factors,and the indexes we selected in this study have a strong correlation and sensitivity,which may be used in evaluating the prevention effect of control measures to coal-buming-fluorosis.②The endemic of coal-burning-fluorosis in Guizhou Province is quite different,and key prevention and control measures can be applied according to a comprehensive factor analysis.

Objective To explore the changes of children's dental fluorosis before and after implementation of comprehensive prevention and control intervention in coal-burning-borne endemic fluorosis areas of Guizhou Province,and to provide a scientific basis for making corresponding prevention and control measures.Methods In 2010,according to a simple random cluster sampling method,1/5 of the villages out of 1/5 of the towns of Zunyi,Kaiyang and Longli Counties,were selected as investigation sites for inspection of dental fluorosis in 8-12 years old children and a longitudinal comparison was done with historical related dental fluorosis (year 1986 and 2000).Dental fluorosis of children was diagnosed by Dean method.Results In Zunyi,Kaiyang and Longli Counties,the detection rates of 8-12 years old children's dental fluorosis were 23.76％(202/850),15.77％ (79/501) and 11.17％(42/376),respectively.The detection rates of dental fluorosis in the 8,9,10,11 and 12 years old age group of children were 11.52％(19/165),17.19％(44/256),20.20％ (81/401),18.61％ (75/403) and 20.72％ (104/502),respectively,and there was no significant difference between groups (x2 =2.90,P ＞ 0.05).The survey results of this investigation in the three counties in 2000 were 34.20％(7 805/22 821),39.77％(1 782/ 4 481),60.88％(2 806/4 609),and the differences were statistically significant between the results of 2010 and 2000(x2 =37.81,110.91,350.76,all P ＜ 0.01).And compared with the results of 1986[34.29％ (9 463/27 596),36.30％ (2 708/7 460),35.72％ (1 896/5 308)],the difference of Zunyi County was not statistically significant (x2 =0.045,P ＞ 0.05),but for Kaiyang and Longli the differences were statistically significant(x2 =14.35,626.39,all P ＜ 0.01).Conclusions The effect of comprehensive prevention and control intervention is very obvious.In the 3 counties,the incidence rates of 8-12 years old children's dental fluorosis are already dropped to below 30％ of the control standard.Subsequent management should be carried out and the state of disease should be evaluated for organization-assessment acceptance in accordance with relevant hygiene standards in a planned way.

Esters ; urine ; Humans ; Phthalic Acids ; urine

Objective To evaluate the effects of health education and improved stoves on control of coalburning-borne endemic fluorosis in Guizhou Province.Methods In 2014,according to the detectable rate of dental fluorosis of children aged 8-12 before implementing control measures,11 counties were divided into three layers:low detection rate (detection rate was less than 60％),medium detection rate (detection rate from 60％ to 90％) and high detection rate (detection rate was greater than 90％).One county was selected from each layer and two towns were selected in each county.According to the Diagnosis of Dental Fluorosis (WS/T 208-2011),dental fluorosis of all children aged 8-12 was examined in all towns;At the same time,in the 2 villages in each town,20households and students of one class in grade 4 to 6 were selected to survey knowledge about prevention and control of coal-burning-borne endemic fluorosis;and to survey the situation of improved stoves,drying and elutriation of corn and chillies,and related life behavior.Results The detectable rate of dental fluorosis of children aged 8-12was 5.49％ (198/3 607),8.33％ (72/864),12.46％ (179/1 437),and it was significantly lower than before implementing control measures [41.88％ (931/2 223),61.91％ (4 863/7 855),91.25％(2 439/2 673),x2 =1 166.43,909.56,2 508.96,all P ＜ 0.01].Correct answer rates of students about knowledge on endemic fluorosis were 78.03％ (792/1 015),84.93％ (1 465/1 725) and 80.18％ (910/1 135),the correct answer rates of knowledge were significantly higher than those before implementing control measures [23.19％ (640/2 760),47.41％ (2 368/4 995) and 40.25％ (3 405/8 460),x2 =947.96,736.61,644.69,all P ＜ 0.01].Correct answer rates of family householders about knowledge on endemic fluorosis were 86.75％ 047/400),95.25％ (381/400) and 86.25％ (345/400),the correct answer rates of knowledge were higher than those before implementing control measures [17.78％ (80/450),37.20％ (279/750) and 25.27％ (139/550);x2 =402.97,359.49,344.55,all P ＜ 0.01].The percentages of households whose stoves were qualified and can be used correctly to the total households were 96.25％ (77/80),96.25％ (77/80) and 93.75％ (75/80),and before implementing control measures [4.92％ (348/7 078),21.51％ (7 461/34 693) and 6.73％ (475/7 062)],and the differences were statistically significant (x2 =1 181.55,262.63,842.82,all P ＜ 0.01).The percentages of households using clean energy in heating season to the total households increased from 0 (0/7 078),0 (0/34 693),0(0/7 062) to 98.75％ (79/80),98.75％ (79/80),96.25％ (77/80).The rates of the three counties whose inhabitants could bake the chillies correctly were 96.25％ (77/80),95.00％ (76/80) and 97.50％ (78/80),which were significantly higher than before implementing control measures [5.55％(5/90),26.00％ (39/150),52.73％ (58/110),x2=139.52,99.36,45.64,all P ＜ 0.01].Who cooked chillies after washing were 93.75％ (75/80),95.00％ (76/80),93.75％ (75/80),which were significantly higher than before implementing control measures [74.44％ (67/90),87.33％ (131/150),34.55％ (38/110),x2 =11.47,3.91,67.36,all P ＜ 0.05].Conclusion The effects of health education and improving stoves on coal-burning-borne endemic fluorosis in the three counties of Guizhou Province are remarkable.