In the process of cultivating TCM clinical postgraduates of TCM clinical college in Shanxi university of Chinese medicine,we emphasized the importance of clinical application ability and innovation ability in scientific research,stressed the clinical practice and check management,to formulate the objective,effective and quantified assessment index system in keeping with the real institution of our college,so as to improve the all-round quality of TCM clinical postgraduates.

ObjectiveTo evaluate the value of application of spiral CT with 3D reconstructure on diagnosis and treatment of tibial plateau fractures.Methods15 cases of tibial fractures treated with x-ray and 16-slices spiral CT,3 D images were made,fractures were classified and evaluated with 3D images and treated with correct treatment.ResultsAll of the 15 patients got correct diagnosis by 16-slices spiral CT with 3D reconstructure,1 failed by x-ray.10 fractures were operated under 3D reconstructure guide and operation proved fractures revealed by 3D reconstructure finally.ConclusionSpiral CT with 3D reconstructure could offer more accurate location and classification of tibial plateau fractures,and it had obvious advantage on demonstration of spatial relationship,and it also could provide better planning and management for the tibial plateau fractures.

Objective Toinvestigate the role of dynamic dispersion of electrical recovery in ventricular fibrillation maintenance mechanism.Method Thirty-seren male Yorkshire pigs weighing (23?2.5) kg at 3 months age were randomly divided into Sham-operated group and myocardial infarction group in which the first branch of left anterior descending coronary artery of animals was hgated.After 4 weeks,according to VF occurrence by programmed electrical simulation,the myocardial infarction hearts were divided into two groups, twelve hearts in VF (+) group or six hearts in VF (-) group;and the normal hearts were divided into two groups,five hearts in VF (+) group or ten hearts in VF (-) group.Action potential duration (APD) of subendocardial,subepicardial and mid-layer myocardium of left ventricular anterior wall were recorded simultaneously.The relationship between APD and diastolic interval was quantified as an electrical restitution curve.A Student's-test was used to specify differences between groups.Results At the fourth week after coronary artery ligation,eighteen myocardial infarction hearts and fifteen normal hearts were investigated.When investigating transmural dispersion of reporlarization (TDR) of left ventricle,there was no difference between VF (+) group and VF (-) group [ (20.43?7.01) ms vs (22.32?7.53) ms,P=0.45],although there was statistically significant between normal hearts and myocardial infarction hearts [ (15.66?4.45) ms vs (25.72?6.70) ms,P =0.001].The percentage of APD restitution slope exceed 1 and APD restitution slope maximum were high in the VF (+) group with myocardial infarction hearts and in the VF (+) group with normal hearts, lower in the the VF (-) with normal hearts and lowest in the the VF (-) group with myocardial infarction hearts.Conclusion Dynamic APD restitution properties may play an important role in the ventricular fibrillation maintenance mechanism.The APD restitution slope and not static TDR have prognostic value regarding ventricular fibrillation events.The hearts with the steepest of APD restitution curves has the greatest liability of ventricular fibrillation to happen.

?AlM: To investigate the outcome and safety of Ahmed glaucoma valve implantation treatment in uncontrolled primary congenital glaucoma ( PCG) .
? METHODS: Twenty - two eyes in 22 children with uncontrolled PCG were reviewed retrospectively and underwent Ahmed glaucoma valve implantation treatment from January 2011 to December 2014. Main checking index included intraocular pressure ( lOP ) before and after operation, corneal diameter and complications.
?RESULTS: Preoperative mean age was 3. 74±2. 24y, and 2. 59 ± 1. 78y apart from the last operation. Postoperative average lOP was 35. 22 ± 6. 36mmHg. Average corneal diameter was 12. 79 ± 0. 75mm. Mitomycin C ( 0. 3 - 0. 5mg/mL ) was used in all operations for 3-5min. Glaucoma valves were implanted in the temporal or nose above the equator sclera. Postoperative lOP was 11. 4±4. 45mmHg at 1wk, and 16. 73± 7. 23mmHg after 12mo. As lOP< 21mmHg for success criteria, lOP of 16 eyes ( 73%) were controlled after 12mo. Preoperative 6 cases had shallow anterior chamber, recovered spontaneously. No serious complication was recorded, such as rejection of glaucoma valve, endoophthalmitis and corneal decompensation.
?CONCLUSlON:Ahmed glaucoma valve implantation in uncontrolled PCG is a safe and viable treatment.

OBJECTIVETo investigate the role of heterogeneous expression of calcium handling proteins and spatial heterogeneity of APD restitution in the maintenance mechanism of ventricular fibrillation.

METHODSDuring programmed electrical simulation, APD restitution curves in the endocardium and epicardium of LV were constructed by plotting APD100 and diastolic interval. APD alternans, delayed after depolarization events were recorded simultaneously. Endocardial and epicardial myocytes were isolated from LV base and apex. Real time-PCR and Western blotting were performed to determine the relative messenger RNA and protein expression levels of calcium handling proteins.

RESULTSThe normal hearts have spatial heterogeneity of action potential restitution property and transmural heterogeneity of calcium handling proteins. The slopes of the APD restitution curve in the endocardium were significantly steeper than those in epicardium, and the slopes of APD curve at the LV apex were significantly steeper than those in LV base. However, delayed after depolarization events with larger amplitude and earlier onset consistently occurred in the endocardium of LV base. After programmed electrical simulation, the expression of messenger RNA of RyR2, SERCA2a except for Calstabin2 significantly decreased (by 57% and 41%, respectively, P < 0.05) in the endocardium of the base, while the expression of RyR2, SERCA2a, Calstabin2 significantly increased (by 90%, 78%and 64%, respectively, P < 0.05) in the epicardium of LV base. Although transmural heterogeneity of calcium handling proteins at the LV apex were also observed after rapid pacing, there is no significant differences in the transmural heterogeneity at the LV apex compared to the LV base. The base of LV has unique calcium handling properties.

CONCLUSIONSIt has been shown that Calcium cycling could modulate APD restitution property in the intact heart. The interaction between action potential and calcium dynamics instabilities is one of the most important reasons why simple criterion such as the APD restitution slope > 1 may fail to accurately predict the onset of APD alternans.

Action Potentials ; Animals ; Calcium ; metabolism ; Calmodulin ; metabolism ; Male ; Swine ; Ventricular Fibrillation ; metabolism ; physiopathology

OBJECTIVETo investigate the effect of DDD pacing on vasovagal syncope (VVS).

METHODSEleven patients diagnosed VVS (7 with heart inhibiton type, 4 with combination type)by tilt table test (TTT) in Shanghai Chest Hospital were selected into the study. They all were implanted DDD pacemaker in whom 9 with rate-drop response (RDR) function. All of them were prescribed beta-receptor blocker. The patients were followed-up at 1, 3, 6, 12, 24 months after being discharged.

RESULTSAll the 11 patients with pacemaker implantation were free from syncope, in whom 4 still had pre-syncope discomfort, but the symptoms were slightly. Six patients took TTT again after pacemaker implantation. It was observed that pacing at an elevated rate started immediately when heart rate dropping to the lower threshold, and as a result syncope were prevented.

CONCLUSIONIn the VVS patients with recurrent syncope and severe heart inhibition, DDD pacing with RDR function could prevent from syncope efficiently.

Adult ; Aged ; Cardiac Pacing, Artificial ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Syncope, Vasovagal ; therapy

OBJECTIVETo compare therapeutic effects of abdominal electroacupuncture (EA) and western medicine on poststroke constipation.

METHODSEighty cases were randomly divided into an EA group and a medication group, 40 cases in each group. The EA group were treated with EA at Daheng (SP 15), Fujie (SP 14), Tianshu (ST 25), Shuidao (ST 28), etc., once a day, 30 min each session, and the medication group with oral administration of 10 mg Cisapride, thrice each day. Seven days constituted one course. After 2 courses, clinical therapeutic effects were evaluated by cumulative scores of symptoms.

RESULTSThe total effective rate of 92.5% in the EA group was significantly better than 72.5% in the medication group (P < 0.05). After treatment, the cumulative scores of clinical symptoms significantly decreased in the two groups (P < 0.05) and the improving degrees of symptoms in the EA group was significantly better than that in the medication group (P < 0.05).

CONCLUSIONAbdominal electroacupuncture has a definite therapeutic effect on poststroke constipation, accelerating gastrointestinal movement.

Abdomen ; Aged ; Constipation ; etiology ; therapy ; Electroacupuncture ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Stroke ; complications

OBJECTIVEHirschsprung's Disease (HD) and allied Hirschsprung's disorder (HAD) have very similar clinical manifestations, but there are many different theories about the two diseases. The present study was designed to understand the expression of Ret protein in HD and HAD, and to explore the role of Ret protein in the pathogenesis of HD and HAD.

METHODSColon specimens from patients with confirmed HD and HAD, including 15 cases of HD (male 12, female 3) and 11 cases of HAD (male 8, female 3) were collected for this study. At the same time normal colon specimens from 10 individuals with other diseases were used as control. The expression of Ret protein in the intestinal tissue was detected by using immunohistochemical SABC technique with mouse anti-Ret monoclonal antibody.

RESULTSIn the colon specimens from normal controls and the dilated segments of colon from HD and HAD patients, moderate to large number of Ret-positive cells were observed among the ganglion cells of myenteric plexuses and submucosal plexuses (P > 0.05). On the contrary, Ret-positive cells were not seen in the stenotic segment of colon from HD patients. But there was positive staining in the stenotic segment of the colon from HAD. Moreover, giant ganglion cells showing strongly positive staining could be seen. There were also displastic cells, small cells, and cells with irregular shape. Statistical analysis showed significant differences in Ret cells positivity between the stenotic segment of colon of HD and the normal control (P < 0.001) as well as between HD and HAD (P < 0.001).

CONCLUSIONRet protein may play an important role in the pathogenesis of HD and could not have definite relationship with HAD.

Case-Control Studies ; Child ; Child, Preschool ; Colon ; pathology ; Female ; Hirschsprung Disease ; genetics ; metabolism ; Humans ; Infant ; Male ; Neurons ; pathology ; Proto-Oncogene Proteins c-ret ; genetics ; metabolism

OBJECTIVETo develop a pulsed field gel electrophoresis (PFGE) method for molecular typing of Lactobacillus and Streptococcus thermophilus (S. thermophilus) and to apply it in identification and characterization of both bacteria isolated from yoghurt collected from Beijing supermarket.

METHODSThe five most useful restriction enzymes including Apa I, Not I, Sfi I, Xba I and Sma I were chosen to cut DNA of 52 strains of Lactobacillus, S. thermophilus as well as associated standard bacteria strains. The endonucleases and electrophoresis conditions for PFGE analysis were optimized and applied in molecular typing of Lactobacillus and S.thermophilus isolates. Cluster analysis based on the PFGE data was conducted. The identification results of PFGE were compared with those obtained in biochemical and 16s ribosomal RNA PCR identification tests.

RESULTSNot I was suitable for L. bulgaricus, L. fermentum and L. delbrueckii digestion. While Apa I was an appropriate endonuclease for S. thermophilus, L. acidophilus and L. casei digestion. The results of molecular typing indicated that 24 strains of L.bulgaricus and 15 strains of S. thermophilus were grouped into 8 types by PFGE method, respectively. While 7 strains of L.acidophilus were grouped into 3 types and 2 strains of L. delbrueckii were grouped into 2 different PFGE types.

CONCLUSIONThe results of PFGE analysis are in compliance with those of 16s rRNA PCR and biochemical identification. The PFGE method developed in this study is suitable for molecular characterization of both Lactobacillus and S. thermophilus.

Bacterial Typing Techniques ; methods ; Electrophoresis, Gel, Pulsed-Field ; methods ; Lactobacillus ; classification ; isolation & purification ; Streptococcus thermophilus ; classification ; isolation & purification

OBJECTIVETo compare therapeutic effects of acupuncture with pushing manipulation and routine acupuncture on finger flexion in the patient of poststroke.

METHODSEighty cases were randomly divided into a group of acupuncture with pushing manipulation and a routine acupuncture group. Hegu (LI 4), Houxi (SI 3), Waiguan (TE 5) were selected in the both groups. For the group of acupuncture with pushing manipulation (n=42), after arrival of qi acupuncture with pushing manipulation was given, the needle was inserted forcedly downwards, heavily thrust and lightly lifted with the thumb forward and the index-finger backward, and the needle was retained for 30 min. For the routine acupuncture group, after arrival of qi the needle was retained for 30 min. The therapeutic effects were assessed by modified Ashworth spastic rating and activity of metacarpophalangeal articulations after treatment of 30 days and 60 days in the two groups.

RESULTSThe total effective rate of 81.0% in the group of acupuncture with pushing manipulation was significantly better than 57.9% in the routine acupuncture group (P<0.05); there was a significant or a very significant difference between the two groups in changes of the spastic degree and the activity of metacarpophalangeal articulations after treatment (P<0.05, P<0.01).

CONCLUSIONAcupuncture with pushing manipulation has a definite therapeutic effect on finger flexion in the patient of poststroke.

Acupuncture Therapy ; methods ; Adult ; Female ; Fingers ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Muscle Spasticity ; therapy ; Physical Therapy Modalities ; Stroke Rehabilitation