Objective To investigate the predictive value of epicardial adipose tissue(EAT) thickness for the recurrence of atrial fibrillation (RAF) after concomitant valve replacement and bipolar radiofrequency ablation.Methods From January 2012 to May 2014,156 patients with permanent atrial fibrillation and organic valvular diseases underwent concomitant valve replacement and successful bipolar radiofrequency ablation in the First People's Hospital of Shangqiu.After 1 year of follow-up,the recurrence of AF was analyzed and the correlation factors were analyzed statistically.Results All patients completed a regular follow-up.During a 12-month follow-up period,RAF was observed in 39 patients (25.0％).Echocardiography-derived regional EAT thickness was significantly greater in RAF patients than that in non-RAF patients((6.9±0.6) mm vs.(5.5±0.7) mm,t=4.649,P＜0.05).The EAT thickness strongly correlated with patients age,body mass index,Ratio of left atrial diameter,mitral diastolic blood flow velocity and early diastolic velocity of mitral annulus,low density lipoprotein-cholesterol and thyroglobulin (r =0.62,0.57,0.68,0.59,0.73,0.76;P ＜ 0.05).Cox multivariable analysis showed that,duration of AF history (95％CI:1.01-1.15,P =0.040),left atrial diameter (95％CI:1.07-1.24,P =0.021) and EAT thickness (95％CI:1.05-1.79,P =0.009) were independent predictors of RAF.Conclusion Echocardiography-derived regional EAT thickness combined with left atrial diameter may serve as effective parameters in identifying patients at the highest risk for RAF.

Objective To review the outcome of coronary artery bypass graft (CABG) using left internal thoracic artery grafts in the patients aged over 70 years old.Methods Two hundred and eighty-eight patients aged over 70 years old from January 2009 to January 2014 who underwent CABG were selected.All of the patients were divided into two groups on base of the graft:control group:only saphenous vein graft was used in 138 cases; observation group:the left internal thoracic artery to the left anterior descending artery was used in 150 cases,which also included total arterial grafting,facilitated by the use of the radial artery,right gastroepiploic artery was operated in 7 cases,beside these artery grafts,saphenous vein graft was used to anastomosis with other vessels.Results Operative mortality was 2.9％ (4/138) in control group and 2.0％ (3/150) in observation group,and there was no significance (P ＞ 0.05).The volume of blood drainage was larger in observation group [(796.2 ± 382.4) ml] than that in control group [(512.8 ± 387.5) ml],and there was significant difference (P ＜ 0.05).At the same time,there was no significant difference in the incidence rate of second thoractomy,malignant arrhythmia,stroke,poor wound healing,and usage of intraaortic balloon counterpulsation between two groups (P ＞ 0.05).Conclusion It does not increase the mortality and incidence of serious complications using the left internal thoracic artery to the left anterior descending artery in the patients aged over 70 years old during CABG.

[Objective] To guide the clinical application of Fuyang medicine through the study of San Jiao Theory of ZHENG Qin'an [Method] To study the foundation theory of ZHENG Qin'an and correlate the evidence with the concept of original yang, San Jiao, Emporer fire, Minister fire and middle earth. To explain the unity and inter-relation of San Jiao and the symptons of yang deficiency of San Jiao and the approach of the use of medicine with the support of case studies. [Result] Zheng Qin'an suggested that three Jiaos are of one Jiao. The yang of upper jiao is governed by Emperor fire while that of lower Jiao by Minister fire. The two fires are of one fire. The circulation of the two fires generates the middle earth. When the middle yang fails on circulating the upper and lower Jiaos cannot communicate. The root of original yang is the kidney which is nourished by the spleen. The unity of San Jiao, the use of lower yang as the root of upper and middle yang and the use of the circulation and root nourishing action of middle yang are the keys to application of medicine. [Conclusion] The use of medicine of ZHENG strongly adhered to the qi circulation of San Jiao. It showed to the later generations a simple but comprehensive thought of Chinese medicine. It was an important guidance for the use of Fuyang medicine.

Objective To study the effect of Bcl-2 gene transfer on apoptosis of myocardium in mice heart transplantation rejection. Methods Models of mice neck heterotopic heart transplantation were set up, and were randomly divided into transplant group, Bcl-2 group and control group. Bcl-2 was transfected into isolated donor heart, and after 1 hour the donor heart was transplanted to the recipient. At 1st,3rd,5th and 7th day after transplantation, apoptotic index was evalulated by the percentage of mycardial cells with TUNEL positive staining and the protein expression of Bcl-2 was measured by immunohistochemical method. Results The apoptotic myocardial cells significantly increased at 3rd day and the apoptotic peak was at 7th day after transplantation in transplant group.The protein expression of Bcl-2 in Bcl-2 group significantly increased at 3rd day, the expression peak was at 5th day after transplantation, and high level expression remained at 7th day. Apoptosis indices of mycardial cells in Bcl-2 group were significantly lower than those in transplant group (P

Objective To compare the clinical efficacy of once daily regimen with Glipizide GITS (Glucotrol XL) and multiple dose regimen with Gliclazide (Diamicron) in the treatment of Chinese patients with type 2 diabetes mellitus. Methods One hundred and fifty one Chinese type 2 diabetic patients meeting the 1985 WHO diagnostic criteria were recruited from 4 clinical centers. The patients were assigned to Glipizide GITS (78 cases) or Gliclazide (73 cases) treatment group. Results The trial consisted of 1 week washout period followed by 6 week dosage regulation period and 6 week dosage maintenance period. Comparing to the baseline, HbA 1c , fasting plasma glucose (FPG) and 24 hour glucose profile levels in two groups were significantly reduced after 3 month treatment. In Glipizide GITS group, the mean reductions of blood HbA 1c and FPG level were 0.55% and 2.05 mmol/L respectively (P

Objective To study the principle of chemokine stromal-dirived factors-1(SDF-1)in acute rejection,we test the expression of CXCR4 which is the receptor of SDF-1 in acute rejection following liver transplantation. Methods needle-biopsy specimens after liver transplantation were divided into four groups according to Banff schema.We analyzed the mRNA level of CXCR4 in each group by RT-PCR.Results In non-rejection group and control group,all samples expressed CXCR4 in small and medium dose.In rejection group,high level expression of CXCR4 related to high degree of acute rejection were found.Conclusion The CXCR4 plays an important role in acute allograft rejection of human liver after transplantation.To restrain the expression of CXCR4 may be au effective method of anti-acute rejection.

Objective To explore the mechanism by which urotensin Ⅱ induces hypertrophy of the cultured rat cardiomyocytes. Methods The cultured cardiomyocytes from neonatal SD rats were treated with urotensin Ⅱ, also with cyclosporine A for its blocking effect on urotensin Ⅱ induced cardiomyocytes hypertrophy. The mRNA and protein levels of ?-MHC and CaN were evaluated by real-time PCR and Western blotting, respectively. Results In the cells treated with 10-8 and 10-7 mol/L urotensin Ⅱ, the mRNA and protein levels of ?-MHC and CaN were significantly higher than that of control (P

Objective To assess the reliability and validity of Chinese version National Aeronautics and Space Administration Task Load Index (NASA-TLX) and Subjective Work Assessment Technique (SWAT) in evaluating mental workload of community physicians.Methods One hundred and ten community physicians selected by convenience sampling method from Shanghai were recruited.The split-half reliability,Cronbach's α coefficient and Item-total coefficients were adopted to assess the reliability and the validity of Chinese version NASA-TLX and SWAT scales in evaluating the metal workload of participants.Results For NASA-TLX,the Split-Half,Cronbach's α coefficient was 0.703 and 0.619 respectively,all Item-total coefficients (except for performance item) were greater than 0.4 (P ＜ 0.01).For SWAT,the Split-Half,Cronbach's α coefficient of was 0.647 and 0.669 respectively,Item-total coefficients were all greater than 0.4 (P ＜ 0.01).Factor analysis showed that two scales had good structure validity; item discrimination showed satisfactory item validity (except for performance item).The Spearman correlation coefficients between two scales ranged from 0.359 to 0.465 (P ＜ 0.01).Both of the modified versions of NASA-TLX had better reliability and validity than the original one,the one with removed both performance and frustrate item was better than one with removed performance item only.Conclusions The Chinese version NASA-TLX and SWAT can serve as reliable and valid instruments for assessing the community physicians' perception of mental workload in China; and the modified version of NASA-TLX especially the one with removed performance and frustrate item seems to work better than the original one.

Objective To explore the value of dual-source CT monoenergetic-plus imaging in the diagnosis of early gastric cancer. Methods Imaging data of 2 6 cases with pathologically proven early gastric cancer who underwent dual-energy scanning were analyzed retrospectively.Monoenergetic-plus images with energy levels at 40 keV,50 keV,60 keV and 70 keV were reconstructed by using an advanced monoenergetic software (syngo.via.VA30A,Dual energy Mono+).Contrast-to-noise ratio (CNR)of the lesion,image noise,overall image quality score and lesion conspicuity score were com pared between different monoenergetic-plus images and conventional polychromatic images at 1 2 0 kVp.Results The CNRs (3 .2 4 ± 0 .7 6 ,2 .9 4 ± 0 .9 2 ,2 .4 7 ± 0 .7 9 ,2 .3 7 ± 0.98 and 1.22±0.40 respectively)and image noises [(32.7±1.82)HU,(25.6±2.61)HU,(20.30±2.1 7)HU,(1 7.03±2.1 5)HU and (18.15±2.12)HU respectively]among 40 keV,50 keV,60 keV,70 keV and 120 kVp groups all had statistical differences (F =24.654 and 227.05,P <0.01).The CNR in 50 keV group was higher than that in 60 keV,70 keV and 120 kVp groups,but similar to that in 40 keV group (P >0.05).The SD value in 50 keV group was lower than that in 40 keV group,but higher than that in other three groups (P <0.05).The overall image quality score (3.08±0.27,3.65±0.49,3.31±0.47,3.23±0.43 and 3.1 5±0.37,respectively) and lesion conspicuity score (4.15±0.67,3.92±0.48,3.27 ±0.45,3.08±0.27 and 3.04±0.20)among the five groups all had statistical differences (Z =25.343 and 70.426,P <0.05).The overall image quality score of 50 keV group was higher than that of the other four groups (P <0.05).Lesion conspicuity score in 50 keV group was higher than that in 60 keV,70 keV and 120 kVp groups and similar to that in 40 keV group (P =0.1 52).Conclusion The 50 keV monoenergetic-plus images can increase the CNR value of early gastric cancer while maintaining the overall image quality.

Re-evaluation of bioequivalence of generic drugs is one of the key research focus currently. As a means to ensure consistency of the therapeutic effectiveness of drug products, clinical bioequivalence has been widely accepted as a gold standard test. In vitro dissolution testing based on the theory of the BCS is the best alternative to in vivo bioequivalence study. In this article, the conventional dissolution method and flow-through cell method were used to investigate the dissolution profiles of domestic amoxicillin capsules in different dissolution media, and the absorption behavior of the drugs with different release rates (t85% = 15-180 min) in the gastrointestinal tract was predicted by Gastro Plus. The flow-through cell method was thought better to reflect the release characteristics in vivo, and amoxicillin capsules with regard to the release rates up to 45 min (t85% = 45 min) were having a satisfied bioequivalence with the oral solution according to the C(max) and AUC. Although two different dissolution profiles of domestic amoxicillin capsules were found by flow-through cell methods, prediction results revealed that domestic capsules were probably bioequivalent to each other.