Objective To evaluate left atrial function by velocity vector imaging (VVI) in patients with rheumatic mitral stenosis(RMS). Methods Thirty eight patients with RMS and 42 normal controls were studied with VVI analysis software. Peak systolic strain (S), systolic strain rate(SRs), early diastolic strain rate(SRe) and late diastolic strain rate(SRa) of each left atrial segments were measured,and also the SRa peak time delay(Td-SRa). Results Comparing to the controls group, the S, SRs and SRe of all segments were significantly lower(P<0.05). Except the base latero-aorta's SRa, the other segments' SRa were lower (P<0.05). In patients with atrial fibrillation(AF),56% segments had no SRa,and 18.6% had irregular low amplitude movement at late diastole, while 25.4% had discernible positive peak. The base and middle inferior SRa of patients with AF were lower (P<0.05 ) than those of the patients with sinus rhythm. While the Td-SRa of patients was longer than that of control group,especially what of the patients with AF. Conclusions The segmental and globe left atrial function of patients with RMS can be evaluated with VVI.

Objective To study the extraction process of Jiejiu Gankang granules by orthogonal test.Methods With the ethanol extraction rates of the medical materials like ginseng,radix salviae miltiorrhizae,the water extraction rates of the medical materials like hawthorn,and Tanshinone ⅡA as the parameters,the extract conditions of Jiejiu Gankang granules was optimized by orthogonal design.Results The optimal preparation process was as follows:the mixture of medical materials like ginseng and Schisandra chinensis was refluxed twice with total 10 times of 70% alcohol,2.0 hours for each time,and then the mixture of medical materials like hawthorn extracted twice with total 10 times of boiling water,2.0 hours for each time.Conclusion The optimal preparation process is reasonable and with high extraction rate of active components.

Objective To explore the application value of the diffusion-weighted imaging (DWI)and dynamic contrast-enhanced MRI in detection of peripheral zone of hepatic alveolar echinococcosis (HAE).Methods Twenty patients with HAE underwent abdominal plain scan,DWI and dynamic enhanced MRI.The ADC values and enhanced ratio of the central necrosis,solid component,peripheral zone and normal liver parenchyma were measured at a workstation,and further were analyzed and compared.Results 32 lesions were detected in 20 patients with HAE.Two groups were divided according to the lesion with central necrosis (group A)or not (group B).In group A, the ADC values of the solid part and normal liver parenchyma were (1.52±0.30)×10 -3 mm2/s and (1.22±0.30)×10 -3 mm2/s. Meanwhile,in group B those were (1.50±0.25)×10-3 mm2/s and (1.03±0.28)×10-3 mm2/s,exhibiting no statistical differences between the two groups.In group A and B,the ADC values of the peripheral zone of lesion were 1.34(1.10,1.61)×10 -3 mm2/s and 0.96 (0.86,1.22)×10 -3 mm2/s,exhibiting statistical differences (Z =2.867,P =0.004);meanwhile,the enhanced ratio were 1.70± 0.36 and 1.58±0.30,exhibiting no statistical difference.No correlation between ADC values and enhanced ratio was found in the peripheral zone.Conclusion DWI at 3.0T can display visually the HAE,and the ADC value may reflect the DWI features of periph-eral zone.The ADC values in combination with enhanced ratio may help for the diagnosis.

To explore the accuracy of simple selection method of Fengshi (GB 31). Through the study of the ancient and modern data,the analysis and integration of the acupuncture books,the comparison of the locations of Fengshi (GB 31) by doctors from all dynasties and the integration of modern anatomia, the modern simple selection method of Fengshi (GB 31) is definite, which is the same as the traditional way. It is believed that the simple selec tion method is in accord with the human-oriented thought of TCM. Treatment by acupoints should be based on the emerging nature and the individual difference of patients. Also, it is proposed that Fengshi (GB 31) should be located through the integration between the simple method and body surface anatomical mark.
Acupuncture Points ; Acupuncture Therapy ; history ; methods ; China ; History, Ancient ; Humans ; Medicine in Literature ; Meridians

ObjectiveTo evaluate the retinal function with central serous chorioretinopathy (CSC) and the fellow eyes (mf-ERG).MethodsTwenty patients (40 eyes) with unilateral CSC, diagnosed by fluorescein angiography, were examined on each eye of the patients by mf-ERG multifocal electroretinography. The patients aged from 31 to 53 (13 men, 7 women; mean age, 41 years), and the CSC eyes had visual acuities of 0.2 to 0.8. None of the patients had significant abnormality in the fellow eyes with visual acuities of 0.8 to 1.5. Twenty-four healthy people (29 normal eyes with visual acuities of 1.0 and more and without any retinal diseases) were studied simultaneously as the normal control. The stimulus matrix of 61 hexagonal elements were grouped into 5 concentric rings from the fovea outward to 30? of the degree of visual field. The first-order responses of mf-ERG were recorded. The first negative wave (N 1-wave) and positive wave (P-wave) of the mf-ERG were measured. Amplitude intensities and latechies for the two configurations were calculated and compared.ResultsCompared with the control eyes, the responses were not only depressed severely in P 1- and N 1-wave amplitude intensities in the ring 1~3 in the CSC eyes with CSC (P0.05). There were no significant differences in N 1- and P 1-wave latencies in 5 concentric rings among the control eyes, the fellow eyes or the CSC eyes.ConclusionsCSC is a kind of macular disease involving both eyes. It may cause the decrease of retinal function in macular area of CSC eyes and also influence the retinal function in macular area of the fellow eyes. mf-ERG is a sensitive way in examining visual function.

Objective To investigate the X-ray and clinic manifestations of hereditary multiple osteochondroma(HMO).Methods Five patients with HMO clinically and pathologically confirmed and 63 persons in their pedigree were studied.Results Of 63 cases inquired in this study,there were 21 patients with hereditary multiple exostosis,including 16 men and 5 women.In 5 cases confirmed pathologically,4 patients had hereditary history of pedigree and the members of three generation in 1 patient with HMO had no the history of pedigree.Conclusion HMO has the remarkable sex difference and the typical inherited trend including the location of exostosis.HMO has inherited character of skipping generation.

Objective To explore the clinical application of DKK-1,TFF3 and CA72-4 detection in the diagnosis and treatment of gastric cancer.Methods Seventy-five cases(gastric cancer group) of gastric cancer admitted to our hospital from January 2013 to May 2015 were selected.Seventy cases of benign gastric disease(benign gastric disease group) and 70 persons undergoing the physical examination(healthy control group) were selected as the research subjects.The concentration of CA72-4 in each group was detected by the electrochemiluminescence analyzer.The serum DKK-1 and TFF3 levels in each group were detected by enzyme linked immunosorbent assay(ELISA).The receiver operating characteristic(ROC) curve was drawn for evaluating the diagnostic efficiency of each index in each group.The sensitivity,specificity,positive predictive rate and negative predictive rate of 3 indicators for diagnosing gastric cancer before operation were compared.The concentration change of various indexes after gastric cancer radical resection were compared..Results The concentrations of DKK-1,TFF3 and CA72-4 in the gastric cancer group were significantly higher than those in the benign gastric disease group and healthy control group,the difference was statistically significant(P<0.05).The area under ROC curve of DKK-1,TFF3 and CA72-4 were 0.876(95%CI 0.803-0.950),0.944 4(95%CI 0.894-0.975) and 0.818(95%CI 0.726-0.884) respectively.The sensitivity of CA72-4 was 78.6% and the specificity was 84.3%,the sensitivity of DKK-1 was 93.6% and the specificity was 87.1%,the sensitivity and specificity of TFF3 was 92.4% and 90.1% respectively.The concentrations of DKK-1,TFF3 and CA72-4 after radical resection in the gastric cancer group were significantly reduced,the difference was statistically significant compared with before treatment(P<0.05).Conclusion The detection of DKK-1,TFF3 and CA72-4 has a certain clinical value for the diagnosis of gastric cancer.The combined detection of these 3 indicators is conducive to improve the specificity and sensitivity of gastric cancer diagnosis.

Objective To compare sleep electroencephalogram-modulated repetitive transcranial magnetic stimulation (SEM-rTMS) with routine repetitive transcranial magnetic stimulation (R-rTMS) in the treatment of primary insomnia. Methods One hundred and twenty six patients with insomnia were divided randomly into a SEM-rTMS group (44 cases) , a R-rTMS group (42 cases) and a sham rTMS group (40 cases). Each case was treated with rTMS for 30 min once a day for 10 d under double blinding of the patient and therapist. The clinical effect was observed along with Krakow sleep scores, electroencephalograms and blood pressure before and after a 10-day course of therapy and 30 days later. Results During rTMS treatment, some patients reported feeling sleepy, and this was confirmed by their EEGs at the time. After the entire course of therapy, 80% of the SEM-rTMS group and 45% of the R-rTMS group showed improvements, a significant difference. At the 30th day after therapy, the effect in the SEM-rTMS group was still significantly better than in the R-rTMS group. There were no obvious side effects in any group throughout the whole observation period. Conclusions SEM-rTMS is more effective and more reliable than R-rTMS. SEM-rTMS is safe to use with primary insomnia patients.

Objective To evaluate the long-term efficacy and safety of donepezil in treating patients with Alzheimer's disease(AD).Methods Totally 86 patients with AD were randomly divided into control group(n =43)and treatment group(n =43).The control grou,p received conventional therapy with aniracetam,nimoldipine and ginkgo tablet,while the study group was administrated with donepezil(10 mg/d)on the basis of conventional therapy.The improvements of recognitive ability,mental state,activities of daily life were graded by mini-mental state examination (MMSE),Alzheimer's disease assessment scale-cog(ADAS-cog),activity of daily living(ADL)and global deterioration scale(GDS).The scores were compared between the groups before the treatment and 3,6,12,18,24,30,36,42,48,54,60,66 and 72 months after the treatment,respectively.Results The scores of MMSE,ADAS-cog and GDS after 3 months and ADL score after 6 months (t=2.361,-2.198,-1.790,-2.420,P＜0.05 or P＜0.01)were improved in treatment group than in control group with the best effects at 12 months(all P＜0.01)and the scores continued to decrease after 36 months.At 72 months,the score improvements in treatment group were 7.5 for MMSE,20.3 for ADAS-cog,19.5 for ADL,and 1.4 for GDS as compared with control group(all P ＜0.01).In contrast to pretreatment,there were statistically significant differences in the scores of MMSE,ADAS-cog and GDS at 3,6,12,18 and 24 months,and in the score of ADL at 6,12,18,24 and 30 months after treatment(P＜0.05 or P＜0.01).The differences in the scores of ADAS-cog and GDS after 24 months as well as MMSE and ADL after 30 months were not found(P＞0.05)between pre-treatment and post-treatment.Conclusions Donepezil might be long term effective and safe in slowing down the recognitive and overall function deterioration of AD.

Objective To discuss the CT features and pathologic basis of hepatic alveolar echinococcosis. Methods Total 19 cases were confirmed by ELISA and IHA of antibody of echinococcosis. A part of them were confirmed by pathalogy. Results The main features of the disease were irregular,obscure contour and heterogeneous density with mainly hypodense in the liver. Almost of all accompanied with calcification. The calcification was showed some certainly signification. No contrast enhancement was observed within the lesions after administration of intravenous contrast medium. There were three type of this disease based on CT features including map type, halo type and pseudocystic type. Conclusion CT scanning has value of not only for diagnosis of hepatic alveolar echinococcosis but also useful to display each complications and metastasis.