Objective To investigate the clinical features of Hashimoto′s Encephalopathy(HE).Methods To retrospectively analyze the clinical data of 6 HE patients,admitted in Shanghai Changhai Hospital between 2010 and 2013.Results The age of onset were between 41 and 71 years;the male-to-female ratio was 1:5;the most common manifest was memory loss (5 patients);the ATPO of all the patients were significantly high ,but the test of ce-rebrospinal fluid ,electroencephalography and iconography were all non -specific;all of 6 patients responded well to the steroid therapy .Conclusion HE should be considered in those whose memory deteriorated and ATPO elevated , especially when they were sensitive to steroid treatment .

Objective To determine the clinical efficac y of nuclear matrix protein 22(NMP22) as a novel urine marker for bladder cance r. Methods Urine NMP22 values were determined for 18 bla dder cancer patients and 20 urological benign disease patients by an enzyme-lin ked immunosorbent assay (ELISA). Results Median NMP22 va lue for the bladder cancers was 44.3 IU/L vs 5.8 IU/L for urological benign dise ases. The urinary NMP22 values in the bladder cancer group were significantly hi gher than those in the benign condition group (P

A retrospective analysis was made on clinical manifestations and autopsy results of 5 sudden deaths from aortic dissecting (AD).Sudden deaths from AD were almost induced by type Ⅰ and Ⅱ of DeBakey Typing.Most patients had a history of hypertension and prodromal symptoms of either chest pain,abdominal pain or back pain.Most common cause of death was cardiac tamponade induced by rupture of the ascending aorta.The clinicians should further recognize of AD so as to achieve the objective of early diagnosis and early treatment.

Objective To study the effect of implanted stent or selected operation in patients with acute occlusion of right coronary artery during the emergency coronary arteriongraphy. Methods Forty-three patients with acute occlusion of right coronary artery who underwent the emergency coronary arteriongraphy were divided into two groups: the implanted stent group ( n = 23) during the emergency coronary arteriongraphy and the selected operation group (n =20) during the emergency coronary arteriongraphy . Then we observed the general data, the coronary artery pathological changes, preoperative and postoperative thrombus, the blood flow, remained stenosis and the prognosis. Results The implanted stent group was similar to the control group in general condition, but implanted stent group was significantly different from the control group in the near, intermediate and distal coronary artery pathological changes ( <0.05) . The control group was significantly different from the implanted stent group in the thrombus and slowly blood flow ( <0.05) . After three months, we reviewed coronary arteriongraphy and selected operation, The implanted stent group was significantly different from the control in the remained stenosis and slowly blood flow (<0.05) . But the implanted stent group was similar to the control groug in the thrombus and new proceeding cardiovascular events. Conclusion When thrombus appears in acute occlusion of right coronary artery, we can implant stent during the emergency coronary arteriongraphy if the thrombus is little, or we can select operation after PTCA on the contrary.

Objective To discusse the mechanism and clinical significance of bradycardia -hypotension phenomenon which is caused by vagal reflex during and after the RFCA and present the experience of using appropriate measures to decrease the incidence of this situation. Methods The patients who were suffering from tachyarrhythmias and treated by RFCA were divided into two groups. The groups were as follows:148 patients who were not taken special measures in the early stage were selected in control group;1 540 patients who were taken measures to prevent vasovagal reflex were selected in observation group. Result During the RFCA, the incidence of bradycardia -hypotension phenomenon in control group was 13.5% (20/148), the incidence of bradycardia-hypotension phenomenon in observation group was 5.0%(77/1540) (<0.01) .Conclusions The incidence of bradycardia-hypotension phenomenon caused by vagal reflex during the RFCA is related to catheter irritation to the heart,pressure on the vessels and hypovolemia. The incidence of this phenomenon can be decreased obviously by some measures,such as non-restricted diet before RFCA,discretion rehydration during and after the RFCA and hemostasis with appropriate force after extubation. The key to rescue patients successfully are early detection and timely processing.

Objective To observe the changes of renal function in elderly patients with heart failure but normal ejection fraction,and explore its clinical significance. Methods A total of 145 cases diagnosed as coronary artery disease from Department of Geriatric Cardiology in The First Affili?ated Hospital of China Medical University were enrolled in the study. All of the cases were divided into HFPEF group(65 cases)and non HFPEF group(80 cases). All patients underwent cardiac ultrasound,BNP and renal function examination,and the glomerular filtration rate(GFR)was cal?culated. Results The average age of patients in HFPEF group was significantly higher than non HFPEF group(P<0.001),and the incidence of hypertension,diabetes,coronary heart disease,atrial fibrillation,or concomitant incidence of two or more kinds of these disease in HFPEF group was significantly higher than non HFPEF group(P1=0.046,P2<0.001,P3=0.002,P4=0.021,P5<0.001);the GFR of two groups of patients were lower than normal level,but the GFR of HFPEF group was significantly lower than non HFPEF group(P=0.046);E/Em was significantly higher (P<0.001),Em was significantly lower(P=0.002),left atrial diameter was significantly higher(P<0.001),LVEF was significantly lower(P=0.012),BNP values were significantly higher(P=0.001)in HFPEF group than in the non?HFPEF group;There were significant linear correlation between GFR and E/Em(r=-0.428,P=0.001),GFR and the BNP(r=-0.435,P=0.001),E/Em and BNP(r=0.392,P=0.002)in HFPEF group. Conclusion Elderly patients with heart failure but normal ejection fraction were older,and more of them were complicated with hyperten?sion,diabetes,coronary heart disease,atrial fibrillation,or concurrency of these diseases. Glomerular filtration rate was significantly decreased in el?derly patients with HFPEF,which has a significant correlation with diastolic function parameters.

y screen and prevent CAD in these people before diabetes sets in.

AIM: To evaluate the operative effect and time effectiveness of the conventional surgery versus retrograde gas injection under nasal endoscope combined 5-Fluorouracil for lacrimal canalicular rupture.
●METHODS:A total of 67 patients (67 eyes) with lower lacrimal canalicular rupture who received surgical treatment by Department of Ophthalmology in Qinhuangdao Haigang Hospital were consecutively recruited between Jan. 2009 and Dec. 2015. They were randomly divided into Group A or Group B. Group A (33 patients, 33 eyes) were treated by conventional surgery, and Group B ( 34 patients, 34 eyes ) were treated by retrograde gas injection under nasal endoscope combined 5-Fluorouracil. Time for finding out the cute end of the lower lacrimal canaliculus and postoperative effect were recorded. Comparisons between the two groups were done with lndependent sample t-test and Mann-Whitney Rank sum test.
●RESULTS: Time for finding out the cute end of the lower lacrimal canaliculus of Group A was (44. 42±10. 66) min, and the time of Group B was ( 30. 06 ± 6. 21 ) min. There was significant difference between the two groups (t=6. 72, P<0. 05). Lacrimal ducts flush was done at the 6mo after the survey, Group B had better effect than Group A, the difference between the two groups were significant (Z=2. 47,P<0. 05).
●CONCLUSION: Compared with conventional surgery, retrograde gas injection under nasal endoscope combined 5-Fluorouracil for lacrimal canalicular rupture can make the operation time shorter and has better effect.

AIM: To evaluate the efficiency and complications of single lacrimal duct intubation versus annular lacrimal duct intubation with 5-fluorouracil and tobramycin/dexamethasone eye ointment injection in lacrimal duct obstruction treatment.METHODS:A total of 74 patients (92 eyes) with lacrimal duct obstruction who received surgical treatment by Department of Ophthalmology in Qinhuangdao Haigang Hospital were consecutively recruited between August 2015 and September 2016.They were randomly allocated to Group A or Group B.After probing of lacrimal passage, Group A (46 eyes) were treated by using single lacrimal duct intubation.Group B (46 eyes) were treated by using annular lacrimal duct intubation combined with 5-fluorouracil and tobramycin/dexamethasone eye ointment injection.Between the two groups, Mann-Whitney Rank sum test was used to comparing the operative effect, and Chi-square test was used to comparing the occurrence of complications.RESULTS:The cure rate was 61% in Group A and 89% in Group B;the improvement rate was 22% in Group A and 4% in Group B.Group B had better effect and less complications (2 cases) than Group A (8 cases),the differences between the two groups were significantly(P<0.05).CONCLUSION: Compared with single lacrimal duct intubation, annular lacrimal duct intubation combined with 5-fluorouracil and tobramycin/dexamethasone eye ointment injection has better operative effect and less complication in lacrimal duct obstruction treatment.

Objective: To explore the clinical efficacy of Chinese and western integrative medicine (TCM-WM) in treating repeatedly recurrent chronic pyelonephritis (CPN) and its therapeutic mechanism. Methods: Ninety-one repeatedly recurrent CPN patients were randomly divided into 2 groups, the control group (45 cases) treated with sufficient amount of sensitive antibiotics and other WM, the treated group (46 cases) treated with above-mentioned WM complemented with TCM syndrome differentiation (SD). Results: In the treated group completely cured was 14 cases (30.4%), markedly effective 14 cases (30.4%), the total effective rate was 91.3%; while that of the control group was 4 (8.9%), 5 (11.1%), and 48.9% respectively, (P<0.05) and (P<0.01); the mean days of urinary bacteria and urinary routine negative conversion were in the treated group 19.6±12.6 days and 24.3±11.5 days, obviously shorter than those of the control group (35.6±14.6 days and 53.6±16.4 days), P<0.01; the various symptoms of the treated group improved or disappeared in a short time, while in the control group a few patients improved in a longer period (P<0.01); the various immune parameters improved in the treated group, while in the control group only IgA was elevated to some extent (P<0.05), in comparing these data, the difference was significant (P<0.01). Conclusion: The TCM-WM integrative treatment could obviously raise the clinical efficacy, accelerate the symptom improvement, and enhance the immune function.