Objective To study the left atrial appendage (LAA) function and haemodynamics by transesophageal echocardiography,and predict high risk of thrombosis.Methods Eighty-nine consecutive patients were studied using transesophageal echocardiography.According to with spontaneous echo contrast (SEC) or not,all patients were divided into SEC group (n =17) and non-SEC group (n-=72).LAA emptying peak flow velocity (LAA-EV),filling peak flow velocity (LAA-FV) were measured by pulsed Doppler.The middle segment of the LAA medial wall systolic peak velocity (LAA-TSV) and diastolic peak velocity (LAA-TDV) were obtained by tissue Doppler imaging.LAA color Doppler and M-mode color Doppler images were acquired and derived the LAA emptying flow propagation velocity (LAA-EPV).Results LAA-EV,LAA-FV,LAA-TSV,LAA-TDV,LAA-EPV of SEC group were lower than those of non-SEC group (P ＜0.05).LAA M-mode color Doppler had four characteristic patterns,N pattern (normal pattern) which flow eject from LAA apical to LAA orifice,R pattern (reverse pattern) which flow eject from LAA orifice to LAA apical,V pattern (vertical pattern) vertical signals seen in systole and without efficient flow,S pattern (stasis pattern) almost no flow signal.V,R and S patterns may indicate high risk of SEC and thrombosis.LAA-EPV had strong correlation with LAA-EV (r =0.742,P ＜0.001),and moderate correlation with LAA-TSV (r =0.462,P ＜0.01),LAA-EV had strong correlation with LAA-TSV (r =0.600,P ＜0.01).Conclusions LAA dysfunction would result in hypokinetic LAA wall motion and reduced blood flow velocity.Emptying abnormalities of LAA might be the important reasons for blood stasis and thrombus formation.Emptying characteristic low patterns of V,R and S might be novel methods to predict high risk of thrombus.

Objective To investigate the neuropsychological features of different mild cognitive impairment (MCI) subtypes.Methods A neuropsychology battery was applied in this study.Seventy MCI participants were enrolled in the test and classified as:28 amnestic MCI ( aMCI),21 vascular MCI ( V-MCI),and 21 Parkinson' s disease MCI (PD-MCI).Forty six normal old people were also evaluated as control.Results First,there were significant differences in the CAMCOG-C and CAMCOG-C subscales of each MCI subtype compared with the normal control. aMCI patients showed significantly impaired orientation,language expression,recent memory,attention,calculation,abstraction and perception (t =4.580,5.150,3.053,4.070,5.918,2.121,2.952,3.175 ; all P ＜ 0.05).However,the ability of language comprehension,remote memory and execution were relatively reserved.V-MCI patients scored lower in the cognitive function of orientation,language expression,attention and execution compared with the normal control(t =2.974,3.165,4.216,3.197; all P ＜ 0.05),with no significant difference in memory,calculation,abstraction and perception.A boarder cognitive impairment was observed in PD-MCI patients who showed significantly impaired language expression,recent memory,remote memory,learning memory,attention and execution(t =4.433,3.065,3.821,3.447,5.344,0.348 ; all P ＜ 0.05).Second,aMCI (3.07 ± 0.81,11.07 ± 2.28 ) and PD-MCI (3.00 ± 0.89,11.33 ± 1.91 ) patients scored significantly lower in CAMCOG scores and CAMCOG subscales including recent memory and learning memory compared with V-MCI(3.52 ±0.87,12.48 ± 1.83;aMCI vs V-MCI:t =1.868,2.381,PD-MCI vs V-MCI:t =1.921,1.980 ; all P ＜ 0.05 ).The remote memory and execution function in PD-MCI were significantly impaired compared to the other two subtypes(PD-MCI vs aMCI:t =2.498,4.257; PD-MCI vs V-MCI:t =1.684,1.492 ;all P ＜ 0.05 ).Third,the GDS scores were different among the four groups. aMCI grouphad significant higher GDS score compared to the normal control group( t =2.850,P ＜ 0.05 ),while there were no similar changes in V-MCI and PD-MCI groups.Comparing different MCI subtypes with each other,aMCI and V-MCI groups had higher GDS scores than PD-MCI group.Conclusions The features of cognitive impairment in the 3 subtypes are all multiple domains.The characteristic impairment domains are memory in aMCI,executive function in V-MCI,and both memory and executive functions in PD-MCI.aMCI may show greater depression tendency compared to the other two subtypes.The different features in the subtypes of MCI may represent different pathophysiololgical changes in each MCI subtype.

Humans ; Hypertension, Pulmonary ; diagnosis

Objective To discuss the quantitative diagnosis of stagnation of Qi and blood stasis syndrome in chronic prostatitis. To make diagnosis chart and ensure diagnosis threshold level which provide statistics evidence for syndrome differentiation of TCM. Methods By the statistical ways, 168 cases of chronic prostatitis belong to stagnation of Qi blood and stasis syndrome and 198 cases of non-stagnation of Qi and blood stasis syndrome were investigated. To make a diagnosis chart and ensure diagnosis threshold level by applying the method of the maximum likelihood discriminatory analysis. Results The quantitative diagnosis chart was made and diagnosis threshold level was 26. According to the retrospective and prospective test, its sensitivity, especially degree, coincidence rate, error rate and positive likelihood ratio were 94.64%, 88.89%, 91.53%, 8.47%, 8.52 and 94.28%, 90.32%, 92.42%, 7.58%, 9.74. Conclusion The indexes of the quantitative diagnosis have good objectivity. According to the retrospective and prospective test, the diagnosis chart was proved to be practical.

BACKGROUND:During artificial knee replacement for al kinds of severe knee disease or conservative treatment for end-stage knee disease, Deluxe-PS knee prosthesis and PFC Sigma RP knee prosthesis have their advantages.
OBJECTIVE: To compare and analyze the matching of the Deluxe-PS and PFC Sigma RP knee prostheses with bone cross section.
METHODS:According to the use of the knee prosthesis, 87 gonarthritis patients undergoing bilateral knee replacement were divided into two groups. 46 cases in the test group received Deluxe-PS knee prosthesis replacement. 41 cases in the control group received PFC Sigma RP knee prosthesis replacement. Operation time and intraoperative blood loss were compared between the two groups. American Knee Society score, knee score of American Special Surgical Hospital and knee joint range of motion were used to evaluate knee joint function before replacement, 3 months after replacement and during final folow-up. Anteroposterior X-ray films were obtained after replacement to measure valgus angle and flexion angle of femoral prosthesis.
RESULTS AND CONCLUSION: (1) Operation time and intraoperative blood loss were significantly better in the test group than in the control group (P< 0.05). (2) No significant difference in American Knee Society score, knee score of American Special Surgical Hospital and knee joint motion was detected between the two groups before replacement and 3 months after replacement (P > 0.05). Above indexes were significantly improved in both groups at 3 months after replacement and during final follow-up (P < 0.05). (3) No significant difference in valgus angle and flexion angle of femoral prosthesis was identified between test and control groups during final follow-up (P > 0.05). (4) These findings indicate that effect of Deluxe-PS type artificial knee prosthesis was identical to that of PFC Sigma RP knee prosthesis in knee osteoarthritis patients receiving bilateral knee joint replacement. Deluxe-PS type artificial knee prosthesis can perfectly realize high-accuracy combination of the prosthesis and the bone cross section, and enhance the fusion suitability of the prosthesis and the bone surface. Deluxe-PS type artificial knee prosthesis has the advantage of operation. This advantage is possibly because Deluxe-PS type artificial knee prosthesis is more in line with the anatomical structure of the knee joint of Chinese.

Objective To investigate the effects of the HLA-Ⅰ and co-stimulators CD_(80)and CD_(86)on HT-29 cells surface, after heat killed Bifidobacterium and HT-29 cells were mingled culturing for 12 hours. Methods The HLA-Ⅰ and co-stimulators CD_(80)and CD_(86)on HT-29 cells surface were measured by Flow Cytometer. Results Heat killed Bifidobacterium can improve the expressions of HLA-1, CD_(80)and CD_(86)on HT-29 cells significantly, the livability of colon carcinoma cell was more than 90 %. Conclusion Heat killed Bifidobacterium have potential antitumorous features.

Objective To investigate clinical features and prognostic factors in acquired immune deficiency syndrome (AIDS) patients with opportunistic infections.Methods Forty-two cases of AIDS patients with opportunistic infections were enrolled in this study.Clinical data and major factors affecting the prognosis were analyzed using Logistic regression.Results Bacterial infection was the first etiological factor(57.1%) of opportunistic infections in AIDS patients.Eighty-three point three percent of patients infected with more than two kind of etiological agents.Fifty-seven point one per- cent of cases were infected in multiple sites.CD4~+ T cells count was associated with the opportunistic infections.Conclusions The CD4~- T lymphocytes count is the key factor affecting the prognosis of AIDS patients with opportunistic infections.The average of CD4~+ T lymphocytes count is significant- ly related with the major opportunistic infections in AIDS paitents.

AIM: To investigate the effect of peribulbar anesthesia on intraocular pressure(IOP)and ocular amplitude pulse(OPA).METHODS: Thirty-two consecutive adult patients with monocular cataract enrolled in this study. IOP and OPA were measured with dynamic contour tonometer(DCT)before and 3, 10 minutes after administration of lidocaine anesthesia. Data were analyzed with software SPSS 11.5.RESULTS: The IOP remained stable in the injected eyes and the non-injected eyes after administration of lidocaine anesthesia. The OPA was significantly decreased after injection of anesthesia agent in the injected eyes. The OPA in the non-injected eyes increased significantly 3 minutes after injection of the anesthesia agent, returning to preinjection level 10 minutes after the injection.CONCLUSION: Peribulbar anesthesia leads to decrease of OPA and shows no effect on IOP in the injected eyes.

Objective To study the indications for extubation of percutaneous transhepatic gallbladder drainage(PTGD).Methods Between January 2009 and December 2013,PTGD were performed on 104 patients with acute cholecystitis.The clinical data were analyzed retrospectively.Results PTGD were performed on all 104 patients successfully.In all the patients,after drainage the abdominal pain was relieved within 0.5 to 8 hours and mean time was(2.3 ± 1.9) h.The temperature decreased to normal in 1 days after drainage.The time of drainage was from 7 to 49 days,(22.4 ± 10.3) days on average.Thirteen patients'tubes were accidentally off during 3 to 12 days,5 patients were performed PTGD again,and 8 patients were given anti-infection,fluid infusion and other symptomatic treatments and all these patients were back to normal in time.Re-intubation rate was 4.8％.In 78 patients laparoscopic cholecystectomy (LC) were performed 1 to 2 months after PTGD.Operation time was between 35 to 95 min and mean time was(52.7 ± 15.0) min.There were 6 patients done open operation and the conservation rate was 7.7％.A mount of blood during LC was 30 to 150 mL,(61.7 ± 31.0) mL on average.No operative deaths occurred during therapeutic session.Conclusions Patients who formed PTGD obey the indications can extubate in time and reduce retrograde infection and skin irritation,also shorten the time during hospital's,which will have a positive impact about LC.

BACKGROUND:Intermittent negative pressure has been proven to promote the repairing of soft tissue and bone healing, but the effect of negative pressure on the tendon-bone healing after anterior cruciate ligament reconstruction has not been reported.
OBJECTIVE:To research the effect of intermittent negative pressure on tendon-bone healing after anterior cruciate ligament reconstruction and on the biomechanics of tendon grafts.
METHODS:A total of 24 New Zealand white rabbits were randomly selected to establish the models of anterior cruciate ligament reconstruction of autogenous semitendinosus. The hind leg of one side was selected randomly as the negative pressure group, and the joint of the negative pressure side was connected with the micro-negative pressure aspirator through drainage tube and maintained a low-intensity and intermittent negative pressure;the contralateral hind leg was as the control and connected with ordinary drainage tube. Drainage tubes of both sides were removed at the same time after 5 days. At 6 weeks after modeling, the joint fluid was drawn to detect the expression levels of interleukin-1β;femur-ligament-tibia complex was used for tension measurement of tendon graft, and histological observation of tendon-bone interface.
RESULTS AND CONCLUSION:One rabbit had joint infection, and final y 23 rabbits were included in the study. Tension measurement results showed that maximum load for breakage in negative group pressure was significantly greater than that in the control group (P<0.05). Histological observation found that the number of osteoblasts in the negative pressure group was significantly more than that in the control group, and the difference was statistical y significant (P<0.01). Detection of synovial fluid showed that iterleukin-1βcontent in synovial fluid of the negative pressure group was lower than that in the control group, and the difference was statistical y significant (P<0.01). Intermittent negative pressure may play an active role in tendon-bone healing and modeling of tendon graft after anterior cruciate ligament reconstruction.