Objective To optimize antiarrhythmic drugs in the treatment of atrial fibrillation and atrial flutter patient different duration,improve the success rate and safety of cardioversion.Methods Make a retrospective analysis of 180 atrial flutter and 180 atrial fibrillation patients data,which were divided into group ibutilide,propafenone group and amiodarone group,Each group were further divided into duration ≤ 3d ＞ 3d,n =30,cardioversion rate was compared after 1.5h,and aralyzed by SPSS16.0.Results Atrial flutter cardioversion rate of ibutilide group ≤3d and 3d was 90％ and 83.33％ ;propafenone≤3d and 3d were 76.67％ and 36.67％,amineamiodarone were 73.33％ and 33.33％,cardioversion rate of three groups had no significant difference when atrial flutter duration ≤3d,P ＞ 0.05 ;Ibutilide cardioversion was significantly higher than propafenone,amiodarone when atrial flutter duration ＞ 3d,P ＜0.05 ;atrial fibrillation cardioversion rate of ibutilide group≤3d and 3d was 80％ and 73.33％ ;propafenone≤3d and 3d were 43.33％ and 26.67％,amineamiodarone were 50％ and 36.67％,Ibutilide cardioversion was significantly higher than propafenone,amiodarone when atrial flutter duration ≤3d,P ＜ 0.05; Ibutilide cardioversion was significantly higher than propafenone,amiodarone when atrial flutter duration ＞ 3d,P ＜0.05 ;the atrial flutter,atrial fibrillation total cardioversion rate of three groups were 81.67％,45.83％,48.33％,ibutilide was significantly higher than propafenone,amiodarone (P ＜ 0.05 ) ;the atrial fluttercardioversion of ibutilide was significantly higher than the atrial fibrillation rate( P ＜ 0.05 ).Conclusion For the duration of ≤ 3d patients,atrial flutter cardioversion rate of ibutilide.oropafenone,and amiodarone did not differ significantly,but the atrial fibrillation cardioversion rate of ibutilide was significantly higher;For the duration of＞ 3d patients,the atrial flutter and atrial fibrillation cardioversion rate of Ibutilide were higher than propafenone and amiodarone,when choose ibutilide,propafenone,or amiodarone for treating atrial flutter and atrial fibrillation according to individual arrhythmia.

Primary intestinal lymphangiectasia is a rare disease, which is characterized by the obstruction of lymphatic return, dilated lymphatics and distorted structure of villi. Lymph fluid leaks into the small bowel lumen as a result of the obstruction of lymphatics and elevated pressure of lymphatics, and leads to malabsorption and loss of proteins. The causes and pathogenesis of PIL are not clear, hut the abnormal immunologic mechanism has got people's attention. Recently, the endoscopic technique has been improved, and the diagnosis rate of PIL has increased obviously. Antisecosis is the basic and effective treatment, especially for children.

Objective: To detect estrogen receptor α and β(ER-α, ER-β)protein expression in different age of mouse thymus.Methods:Protein expression of ER-α and ER-β in thymus was analyzed via immunohistochemistry.Moreover,the relationship between ER-α and cytokeratin 18(epithelial cell marker)was further tested through fluorescence double-staining.Results: Immunohistochemical analysis revealed that both ER-α and β protein was found in nuclei of some thymocytes of 3 month mice.However,expression of ER-β was absence while ER-α was still positive in aged mice, such as 12 months and 16 months old.Double staining further confirmed that lots of ER-α/β positive cells were Foxp3 negative cells.Conclusion: Expression of ER-β is absent while ER-α is still positive in thymus of aged mice, which indicates ER-α is the critical estrogen receptor that involves in thymic involution.Moreover, ER-α/β do not participate in Treg development within thymus.

Objective:To detect estrogen receptor ? and ?(ER-?,ER-?) protein expression in different age of mouse thymus.Methods:Protein expression of ER-? and ER-? in thymus was analyzed via immunohistochemistry.Moreover,the relationship between ER-? and cytokeratin 18(epithelial cell marker) was further tested through fluorescence double-staining.Results:Immunohistochemical analysis revealed that both ER-? and ? protein was found in nuclei of some thymocytes of 3 month mice.However,expression of ER-? was absence while ER-? was still positive in aged mice,such as 12 months and 16 months old.Double staining further confirmed that lots of ER-?/? positive cells were Foxp3 negative cells.Conclusion:Expression of ER-? is absent while ER-? is still positive in thymus of aged mice,which indicates ER-? is the critical estrogen receptor that involves in thymic involution.Moreover,ER-?/? do not participate in Treg development within thymus.

Objective To study the effects of Cad-Ⅱgene on osteogenic differentiation of human mesenchymal stem cells in vitro. Methods The human marrow mesenchymal stem cells (hBMSCs) were isolated and cultured in vitro before they were divided into 2 groups. In the transfeetion group, the hBMSCs were transfeeted with Cad- Ⅱgene;in the simple osteogenic inducement group, they were cultured in the condition medium. Then the expressions of Cad- Ⅱ protein were determined and the alkaline phosphatase (ALP) activities and the expressions of ostcocalein were measured at 3, 7, 14 and 21 days for comparison between the 2 groups. Results The ALP activity and positive expression of osteoealcin were regulated significantly higher in the transfeetion group than in the simple osteogenic inducement group at different times (P <0.05). The mineralized nodes began to appear at 14 days in the 2 groups and increased with time. Conclusion Cad-Ⅱgene transfeetion can promote differentiation of hBMSCs into the osteoblasts.

Objective To evaluate the effect of pre-emptive analgesia on pain and inflammation control in patients with severe multiple trauma.Methods Severe multiple trauma patients treated in the emergency department from September 2014 to December 2014 were prospectively included based on the inclusion criteria including injury severity score (ISS) of 16 to 25,Glasgow Coma Scale (GCS) ≥ 13 and visual analogue scale (VAS) ≥ 4.The patients were assigned to pre-emptive analgesia group,traditional analgesia group and non-analgesia group,according to the random number table.Pre-emptive analgesia group had patient-controlled intravenous analgesia (PCIA) with sufentanil and tramadol on admission.Traditional analgesia group were administered intramuscular pethidine or subcutaneous morphine for temporary analgesia when the pain could not be tolerated.Non-analgesia group received no analgesia.VAS,systemic inflammatory response syndrome (SIRS) score and serum interleukin (IL)-6 concentration were compared among the groups on admission day,24,48,72,120,168 and 240 h after admission.Results Fifty-seven patients (46 males and 11 females) were included,and age was (39.61 ± 12.05)years.There were 18 patients in pre-emptive analgesia group,20 patients in traditional analgesia group,and 19 patients in non-analgesia group.Comparison between pre-emptive analgesia,traditional analgesia and non-analgesia groups showed no significant differences on admission with respect toVAS [(6.5±1.5),(6.6±1.4),(6.4 ±1.4)points],SIRS [(3.3±0.7),(3.4±0.6),(3.4±0.8) points] and IL-6 concentration [(109.2 ± 47.9),(99.9 ± 44.3),(106.3 ± 50.0) ng/L] (P ＞0.05).Compared to traditional analgesia and non-analgesia groups,VAS and SIRS score in pre-emptive analgesia group differed significantly at 24,48,72,120,168 and 240 h after admission,and IL-6 in pre-emptive analgesia group differed significantly at 48,72,120,168 and 240 h after admission (all P ＜0.05).VAS,SIRS score and IL-6 concentration declined faster in pre-emptive analgesia group than other two groups (P ＜ 0.05),while there were no significant differences between traditional analgesia and nonanalgesia groups (P ＞ 0.05).Positive correlation was noted between VAS and SIRS score,and between VAS and t IL-6 concentration (P ＜ 0.05).Conclusion Pre-analgesia provides quick and effective pain relief and attenuate excessive systemic inflammation response that contributes to stabilization and recovery of the severe multiple trauma patients.

Objective To analyze the related factors of foot blisters caused by long-distance weight-bearing march and to explore the pathogenesis of foot blisters to provide a useful way for the prevention and treatment.Methods After the 300 km march,counted the number who had accomplished the march,and then recorded the number of foot blisters,location of blisters,and abrasion of sole.Collected the data of gender,age,body mass index (BMI),hand dominance,and whether had bliters before the march through questionnaire.And the data were coded for analysis with SPSS 13.0 statistical package.Results The 7 cases who complete the whole march and 17 cases who already had foot blisters before the march were ruled out of the final statistics.Among the remaining 590 cases,there were 554 cases (93.9%)suffered from foot blisters.And there were 1 282 blisters in total,among which the plantar blisters occupied 98% (1 257 cases).The analysis showed that the incidence of foot blisters had no significant correlation with gender,left/right foot,hand dominance,BMI and age.The predilection sites of blisters were the second and third metatarsals (28.2%),the hallux (21.3%),the fifth metatarsal (18.1%),and the calcaneus (15.8%)of the left foot.The predilection sites of blisters were the second and third metatarsals (33.3%),the hallux (22.4%),the fifth metatarsal (18.6%),and the calcaneus (14.5%)of the right foot.In terms of the abrasion of sole,the lateral heel was worn out the most (34.6% on the left and 34.2% on the right).Conclusion The study confirmed that the incidence of foot blisters had no significant correla-tion with gender,left/right foot,hand dominance,BMI and age,which may be affected by the particularity of this march.Most of the foot blisters occurred in the planta,and the predilection sites of blisters were in accord with sites of of the abrasion of sole and the distribution of plantar shear force,which demonstrated the shear force is the most critical factor on the pathogenesis of foot blisters.

We here investigated the effect of MS4A6D(the membrane spanning 4-domain subfamily A(MS4A)superfamily protein 6D),one of the tetraspanins which specifically expresses on the membrane of macrophages,on carrageenan(CGN)-induced mouse foot pad swelling and its possible mechanism.Male C57BL/6 wild-type(WT)and various gene knockout(including Ms4a6d-/-,Nlrp3-/-,Casp-1-/-and IlR1-/-)mice were recruited and injected with 100 μl 1%CGN(w/v)and 20 μl CaCl2(50 mmol/L)to establish the foot pad swelling model,and then the severity of foot pad swelling in WT and gene knockout mice were compared.H&E staining was performed to investigate the pathological changes,and immunofluorescence was used to detect the infiltration of F4/80+ macrophages in the foot pad tissue.Finally,Western blot was used to determine the protein expression of NLRP3,IL-1 β,TNF-α and IL-6.Data showed that the combined injection of 100 μl 1%CGN(w/v)and 20 μl CaCl2(50 mmol/L)significantly promoted the swelling of foot pads,while the degree of foot pad swelling in Ms4a6d-/-mice was significantly lower than that in WT littermates(P<0.05);Significant tissue damage and inflammatory infiltration as well as necrotic lesions were observed in the WT foot pads,whereas,the degrees from Ms4a6d-/-foot pads showed significantly reduced;The protein levels of Caspase-1 and IL-1β in the foot pad tissue of the WT model were significantly higher than those of the Ms4a6d-/-groups;Compared with WT controls,the degree of foot pad swelling in Nlrp3-/-,Casp-1-/-,and IlR1-/-mice induced by 1%CGN(w/v)and CaCl2(50 mmol/L)were also significantly reduced(P<0.05).Taken together,MS4A6D promotes the activation of NLRP3 inflammasome in macrophages and induces IL-1β secretion,by thus deteriorates CGN-mediated swelling of mouse foot pads.

【Objective】 To analyze the comprehensive factors causing adverse reactions to apheresis platelet donation(ARAPD), so as to provide references for effective prevention of ARAPD. 【Methods】 The 272 cases of ARAPD from 2012 to 2019 in Lanzhou were statistically analyzed, and factors that induced ARAPD were studied. Statistical analysis were performed according to the gender, nationality, occupation, age, weight, donation units, and number of donations. 【Results】 As to the factors inducing ARAPD, anticoagulant reactions accounted for the first(32.4%, 88/272). Women and students were prone to develop ARAPD. Among all age groups, 18~25 years old were most likely to develop ARAPD(53.68%, 10 572/35 265). The incidence of ARAPD were significantly different by ages and weights(P<0.05), and donors with lighter weight were more prone to develop ARAPD(P<0.05). The incidence of ARAPD were also significantly different between first-time and repeated donors(P<0.05), but not among the donation units. 【Conclusion】 The anticoagulant reactions are the leading reason for ARAPD. For female, student, young, light-weight, and first-time blood donors, special attention should be paid and corresponding interventions taken to them.

【Objective】 To study the current situation of apheresis platelets collection in various regions of Gansu province by comparing and analyzing relevant data from blood stations in 14 prefecture-level cities of Gansu province. 【Methods】 The units of collected platelets and rate of double-dose collection in 13 regional blood stations and 1 provincial blood center from 2016 to 2020, as well as the clinical supply and demand was statistically analyzed. 【Results】 From 2016 to 2020, the total units of platelets collected by 13 blood stations and 1 blood center in Gansu increased from 11 255 U to 15 270 U, with the increase rate at 35.7% in 5 years, and mainly were collected by the provincial blood center (74.57%, 50 253/ 67 392). Although the rate of double-dose collection in the province showed a steady upward trend, only 3 blood stations realized annual double-dose collection more than 20%. There was still a gap of about 10% between supply and clinical needs. 【Conclusion】 Although the number of platelet collections and units in each blood station in Gansu is on the rise in general, the units collected varies in each blood station. Therefore, further measures need to be taken from the aspects of publicity, recruitment, optimizing the collection process, improving the rate of double-dose collection, retention of regular blood donors and regional coordination to increase the collection units, narrow down the regional gap and ensure the balance between supply and demand.