AIM:To investigate the effects of microRNA-29a and 133a expression in the atrium on atrial fibril-lation (AF) and fibrosis.METHODS:Chronic rapid atrial pacing was used to establish the persistent AF dog model , and the sham group was also set up .The cardiac ultrasound measurement was used for determining the cardiac structure size . The Masson 3 color staining were used to evaluate the stage of fibrosis .The expression of microRNA-29a and 133a in the left atrium ( LA) was detected by real-time transcriptase polymerase chain reaction .RESULTS: Compared with before modeling , no statistical difference of atrial dilatation and decreased ejection fraction in the model dogs with persistent AF was observed (P>0.05).Compared with sham group, the degree of fibrosis and collagen volume fraction (CVF) in per-sistent AF model group were increased obviously (P<0.05).The expression of microRNA-29a and 133a were decreased obviously (P<0.01, P<0.05).CONCLUSION:Structural remodeling of the atrium and atrial fibrosis are the essential for development and maintenance of atrial fibrillation .Down-regulation of microRNA-29a and 133a expression may be very important molecular mechanism for atrial structural remodeling in the persistent AF model dogs .

Objective: To observe assessment effects of thromboelastogram (TEG) on patients with coronary heart disease (CHD) complicated hypertension.Methods: A total of 120 CHD patients were selected from our hospital.According to complicated with hypertension or not, they were divided into pure CHD group (n=58) and CHD + hypertension group (n=62).TEG indexes were compared between two groups.Results: Compared with pure CHD group, there were significant reductions in blood clot formation duration [K: (2.53±0.72)min vs.(1.82±0.64)min], coagulation reaction duration [R: (8.66±1.86)min vs.(7.18±1.85)min], arachidonic acid pathway-induced platelet activity [AA: (57.36±16.91)% vs.(46.73±20.73)%], and significant rise in maximum amplitude after clot formation [MA: (57.31±7.75)mm vs.(64.36±7.85)mm] and included angle value between the tangent from the blood clot forming point to the maximum curve radian of the chart and the horizontal line [Angle: (53.26±7.78) vs.(64.38±7.85)] in CHD + hypertension group, P<0.01 all.Spearman correlation analysis indicated that blood pressure level was significantly positive correlated with Angle and MA (r=0.607, 0.405, P<0.01 both), and significantly inversely correlated with R and K (r=-0.256,-0.541, P<0.01 both) in CHD + hypertension patients.Conclusion:Thrombosis possesses higher risk for CHD + hypertension patients, which is easier to cause acute cardiovascular events.Therefore, attention should be paid to coagulation function monitoring in order to prevent adverse cardiac events in these patients.

Objective The "heuristic" teaching rounds were applied to cardiovascular diseases and we observed the application effect . Methods From January to March 2017, 56 resident physicians at internal medicine base in the First Affiliated Hospital of Xinjiang Medical University were randomly divided into the experimental group and the control group, with 28 people of each group. The experimental group mainly adopted heuristic teaching rounds, and the control group adopted conventional teaching rounds. Interview method was used to interview the instructors , resident physicians , doctors and nurses in preparation for teaching rounds, the implementation process, the expected goals and effects. 56 resident physicians evaluated the preparation, guidance process, guidance methods and outcomes of ward rounds. SPSS 19.0 was used for statistical analysis, and rank sum test was used for evaluation results. Results As to the familiarity of the instructor on the condition (82.15％vs. 30.86％), guiding the training of humanistic care (92.86％ vs. 39.29％), physical examination (96.43％ vs. 28.57％), analysis of auxiliary examination (85.71％vs. 35.71％), writing medical records (85.72％ vs. 14.29％), summarizing the characteristics of cases (78.57％vs. 35.71％), diagnosis and differential diagnosis (85.71％vs. 21.43％), treatment plan making (85.71％vs. 25.00％), question formulation (89.29％vs. 30.72％), explanation of difficult problems and new progress ( 78 . 57％ vs . 17 . 86％) , content summary ( 92 . 85％ vs . 28 . 58％) the experimental group was significantly higher than the control group. In the experimental group, the teaching rounds of communication (96.43％vs. 46.43％), history acquisition techniques (85.72％vs. 21.43％), examination techniques (92.86％vs. 28.57％), clinical thinking (92.86％ vs. 28.57％), learning interests (96.43％ vs. 25.00％) and efficiency (85.71％ vs. 14.28％), the understanding and memory of knowledge (85.72％ vs. 28.57％), the problem solving ability (89.29％ vs. 21.43％), improvement of team collaboration (67.86％ vs. 28.57％) were significantly higher than those in the control group (P<0.05). Conclusion The "heuristic" teaching rounds attached great importance to preparation before and after class, focusing on resident physicians' active participation and teamwork, integrating humanistic care and communication skills, giving full play to the resident physicians motivation so as to ensure their efficient learning.

OBJECTIVETo investigate the incidence and associated factors of multicentricity in renal cell carcinoma (RCC) in Chinese patients.

METHODSOne hundred and two kidney samples from radical nephrectomy due to RCC were step sectioned at 3 mm intervals and examined. All tissue abnormalities were removed, stained and examined for multicentricity. Then, on each slice of the sample, both the parenchymal margin of 15 mm beyond the pseudocapsule and tissue around the renal sinus were continuously sectioned and examined for completeness of the pseudocapsule and vascular and lymph node invasion. The relationship between muliticentricity and other pathological parameters was evaluated.

RESULTSThe incidence of multicentricity was 15.7% (16/102); it was significantly lower in primary tumors < or = 4.0 cm than in tumors > 4.0 cm (4.9%, 2/41 vs 23.0%, 14/61; chi(2) = 6.055, P = 0.014). The incidence was 9.8% (8/82) in tumors without vascular invasion and 40.0% (8/20) in those with it (P = 0.003, Fisher's exact test). The incidence of multicentricity was 1.9% (1/53) in tumors with a complete pseudocapsule and 30.6% (15/49) in those without it (chi(2) = 15.885, P = 0.000). The grade, stage, subtypes and lymph node invasion of the primary tumor were not significantly associated with multicentricity. Multiple logistic regression analysis showed that pseudocapsular incompleteness and vascular invasion were two significant predictors of RCC multicentricity (P = 0.005 and 0.023).

CONCLUSIONSThe incidence of multicentricity of RCC in this group of patients was in accordance with published studies. Multifocality was significantly associated with tumor size, pseudocapsule completeness and vascular invasion. NSS should be limited to tumors less than 4.0 cm when the contralateral kidney is normal and careful long-term follow-up is necessary in tumors with positive vascular invasion and incomplete pseudocapsule.

Aged ; Carcinoma, Renal Cell ; epidemiology ; pathology ; surgery ; China ; epidemiology ; Female ; Humans ; Incidence ; Kidney Neoplasms ; epidemiology ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness