Coronary heart disease (CHD) is a major disease greatly harmful to the health of human beings. The incidence and case fatality rate of female CHD show an increasing tendency due to lack of enough attention. Through analyzing the epidemiology, risk factors, and clinical characteristics of female CHD, we emphasized that it is necessary to pay enough attention to the particularity of female CHD, and put forward the thinking way of diagnosis and treatment of integrative medicine as "integrating Chinese medicine and Western medicine by mutual complement of advantages; combining syndrome typing and disease identification by grasping laws; treating physically and mentally by a wholism concept; spreading health education, preventing and treating comprehensively".
Coronary Disease ; diagnosis ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Integrative Medicine ; Medicine, Chinese Traditional ; methods ; Phytotherapy

0.05).It was revealed that all the patients followed up 3 to 6 months after treatment were free from complaints of the involved teeth,with nomal food intake and mastication.No abnormal adjacent tissues of dental roots were detected by imaging examination.Conclusion For the vital teeth,the similar clinical effect may be obtained by one-visit RCT and multi-visit RCT.

Objective To assess whether dynamic arterial elastance (Eadyn)can be used to predict the reduction of arterial pressure after decreasing norepinephrine (NE) dosage in patients with septic shock.Methods A prospective observational cohort study was conducted.Thirty-two patients with septic shock and mechanical ventilationwere enrolledfrom January 2014 to December 2015 in ICU of Wuxi People's Hospital of Nanjing Medical University.Hemodynamic parameters were recorded by pulse contour cardiac output(PiCCO) monitoring technology before and after decreasing norepinephrine dosage.Eadyn was defined as the ratio of pulse pressure variation (PPV) to stroke volume variation (SVV).Mean arterial pressure (MAP) variation was calculated after decreasing the dose of NE.Response was defined as a ≥ 15％decrease of MAP.AUC was plotted to assess the value of Eadyn in predicting MAP response.Results A total of 32 patients were enrolled in our study,with 13 responding to NE dose decrease where as the other 19 did not.Eadyn was lower in responders than in nonresponders (0.77 ± 0.13 vs 1.09 ± 0.31,P ＜ 0.05).Baseline Eadyn was positively correlated with systolic blood pressure variation,diastolic blood pressure variation,systemic vascular resistance variation and MAP variation (r =0.621,P =0.000;r =0.735,P =0.000;r =0.756,P =0.000;r =0.568,P =0.000 respectively).However,stoke volume variation,baseline level of systemic vascular resistance and NE baseline dose were not correlated with Eadyn baseline value (r =0.264,P =0.076;r =0.078,P =0.545;r =0.002,P =0.987 respectively).Eadyn ≤ 0.97 predicted a decrease of MAP when decreasing NE dose,with an area under the receiver-operating characteristic curve of 0.85.The sensitivity was 100.0％ and specificity was 73.7％.Conclusions In septic shock patients treated with NE,Eadyn is an index to predict the decrease of arterial pressure in response to NE dose reduction.

AIM: To investigate the change of corrected vision and stereo vision in anisometropic patients after laser in situ keratomileusis (LASIK).METHODS: The clinical data of 84 cases of anisometropic children(84 eyes) were retrospective analyzed.The changes of corrected visual acuity and stereopsis of different gender,age,type of amblyopia in children anisometropic before treatment,after treatment for 3,6mo and 1a were analyzed.The stereoscopic vision correction correlation were analyzed.RESULTS: Corrected Log MAR visual acuity and stereopsis of 84 patients after LASIK surgery treatment for 3mo,and 1a later significantly decreased than before treatment (P<0.05).The corrected Log MAR visual acuity and stereopsis of male and female after treatment for 3,6mo and 1a was not statistically significant (P>0.05).Corrected visual acuity of age <30 group for 3,6mo and 1a was significantly lower than the age ≥30 group (P<0.05).After 3,6mo and 1a stereo vision with hyperopic anisometropia amblyopia decreased more than that with myopic anisometropia amblyopia(P<0.05),but corrected Log MAR visual acuity after treatment was no statistically significant difference (P>0.05).Improved correctted vision of anisometropic patients after LASIK surgery had no connection with the decrease of stereo vision(P>0.05).CONCLUSION: LASIK surgery can improve visual acuity in patients with anisometropia amblyopia,but the course of treatment of visual acuity and stereopsis affected by age and type of amblyopia.

Humans ; Laryngopharyngeal Reflux

Humans ; Mining ; Noise, Occupational ; statistics & numerical data ; Occupational Exposure ; statistics & numerical data ; Work Schedule Tolerance

Objective To summarize the clinical features,diagnostic and treatment experience of severe hand,foot and mouth disease(HFMD) cases receiving mechanical ventilation from Jan 1 to Sep 6,2009 in our hospital and provide reference for reducing the occurrence of neurogenic pulmonary edema(NPE) and mortality. Methods 147 severe HFMD who received mechanical ventilation were analyzed by a retrospective investigation. Results 85.0% children were less than 3 years old and 100% patients had a fever. The mechanical ventilation occurred within 1 to 4 days after fever (3.06 ± 1. 02) d. Neurological complications presented as bad spirit,easy surprised, involuntary movement of the extremities and lethargy. Respiratory system complication presented as polypnea, hypepnea and irregular rhythm. Circulatory system complication presented as heart rate increase or decrease, hypertension or hypotension, piebald skin and low limb temperature.Some of the children had high white blood cell counting,glucose and lactic acid of the blood. The EV71-PCR positive rate was 34. 7% for throat swabs,and 42. 2% for anal swabs. Chest X-ray presented as increased broncho vascular shadows, exudation or nonapparent abnormality. Only three children were dead, fatality rate was 2. 0%. Conclusion The HFMD cases in this outbreak are relatively more serious,and change rapidly. It's difficult to treat as soon as NPE appeared,and it has high fatality rate. Early recognition of critical patients,timely giving mechanical ventilation,and the comprehensive treatment can reduce NPE incidence and the mortality.

Objective To investigate the clinical characteristics and prognosis of patients with different molecular subtypes of breast cancer.Methods A cohort of 716 breast cancer patients which had clear immunohistochemical detection were investiged.Their molecular subtypes were categorized as Luminal A,Luminal B,HER-2 over-expressing and basal-like subtypes,based on detection of ER,PR,HER-2 expression,and the clinical data including characteristics,relapse,prognosis and prognostic factors of the patients with different subtypes of breast cancer were analyzed retrospectively.Results There were no significant differences among different molecular subtypes at the age,menopausal status,production times,clinical stage,and radiation therapy(P ＞0.05).There were significant differences among different molecular subtypes at axillary lymph node starus (x2 =17.208,P =0.001),turner size (x2 =20.528,P =0.000) and operation method (x2 =24.242,P =0.000) and chemotherapy regimens (x2 =10.711,P =0.013).Univariate and multivariate analyses showed that clinical stage (x2 =17.005,P =0.002),axillary lymph node status (x2 =11.267,P =0.000) and molecular typing(x2 =125.634,P =0.000) were independent prognostic factors affecting long-term survisal rate.Conclusion Breast cancer patients in different subtypes have different long-term survival rate.The patients in basal-like subtype have the worst long-term survival rate.Molecular subtypes may provide important information to predict the prognosis of breast cancer.

BACKGROUND:Alcohol has become pathogenic factors of avascular necrosis, and the alcohol induced
abnormal lipid metabolism in bone marrow may be the important reason for the onset of avascular necrosis, but the mechanism is not clear yet.
OBJECTIVE:To observe the changes of structure and function of fat cel s under the action of alcohol, in order to analyze the pathogenesis of alcoholic femoral head necrosis.
METHODS:Primary adipocytes in vitro culture technique was used to obtain rabbit femoral head intramedul ary adipose tissue, and then the fat cel s were separated, and the phenotype was identified with oil red O staining. The passaged stable intramedul ary fat cel s were col ected. Coverslip was cut into 1 cm × 1 cm in size, and placed in the 24-wel culture plate before planting. The cel s were randomly divided into alcohol group and control group, 24 holes (each hole for a sample) in each group. The control group was without alcohol, while the alcohol group was added with 0.15 mol/L alcohol. At 4, 6, 8 and 10 days, the culture medium was replaced. Medium was changed and no longer adding alcohol, and then cultured for 10 days. When the culture terminated, the coverslip was removed for oil red O staining. Final y, the morphology and the number of the fat cel s were observed under light
microscope.
RESUTLS AND CONCLUSION:With time prolonging, the number of fat cel s in the alcohol group was significantly more than that in the control group (P<0.001). The lipid droplets in the two groups were gradual y increased and enlarged, but more significant in the alcohol group. The number of intramedul ary fat cel s in the alcohol group after cultured for 4, 6, 8 and 10 days was respectively (200.90±24.60), (1 102.30±76.73), (1 160.30±28.37) and (1 199.70±44.74)/cm2;the
number of intramedul ary fat cel s in the control group was respectively (99.80±10.82), (0.40±94.71), (1 000.20± 41.85) and (1 059.80±26.79)/cm2, the number of fat cel s increased with the time of alcohol influence. Alcohol can promote the intramedul ary fat cel s to increase and enlarge, and this may be the main reason for femoral head necrosis, as long-term alcoholism can lead to bone marrow fat tissue increasing, intraosseous pressure increasing and perfusion reducing, thus resulting ischemia.

Diabetic mellitus induced erectile dysfunction (DIED) is a common complication of type 2 diabetes mellitus (T2DM), which seriously affects the physical and mental health of male T2DM patients. The occurrence of DIED involves a variety of pathophysiological changes such as vascular tissue, nerve, endocrine and so on. But the traditional treatment of erectile dysfunction is not ideal for DIED. Glucagon like peptide (GLP)- 1 receptor agonist has been widely used as a new drug for the treatment of diabetes, and the representative drugs are exenatide and liraglutide. Existing research shows that it can improve endothelial cell function, neuropathy and sex hormone secretion, reduce body weight and insulin resistance. Therefore, these drugs may be a new choice for patients with DIED.