Atrial fibrillation (AF) is one of the most common and age-related persistent arrhythmias. With the increase of age, the prevalence of AF and the incidence of atrial fibrillation-related stroke are increased. Due to the decline of cognition and function of various organs, coupled with the increase of comorbities and complications, the types of drug use also are increased in elderly patients, and their anticoagulant therapy has become complex. New anticoagulant drugs increase the choice of treatment in elderly patients with AF. This article reviews the clinical characteristics, necessity, challenge and drug selection of anticoagulant therapy in elderly patients with non-valvular AF to provide information for rational anticoagulant therapy.

There are significant correlations between hyperuricemia and risk factors for stroke, including hypertension, diabetes, hyperlipemia, and obesity, and it is also associated with ischemic stroke and its prognosis. This article reviews the correlations between hyperuricemia and risk factors for stroke and its influence on the prognosis of ischemic stroke.

ObjectiveTo observe the effect of selective posterior rhizotomy (SPR) on children with spastic cerebral palsy.Methods517 spastic cerebral palsy cases were operated on by SPR, and a following up was performed for 24 months. After operation, curative effect of SPR was examined and evaluated.Results298 cases had excellent effect (57.6%); 187 cases had good effect (36.2%).Conclusion SPR is very effective for children with spastic cerebral palsy.

BACKGROUND: Soft-start is a newly photoactivation mode, which has certain effect on composite resin. However, previous study mainly concentrated on the conventional resin-based composites, the reports regarding soft-start on packable resin-based composites is poorly understood. OBJECTIVE: It is assumed that soft-start photoactivation had effect on packable resin-based composites, in addition, to investigate its effect on the hardness of packable resin-based composites. DESIGN, TIME AND SETTING: A double factors design. The experiment was performed at the Department of Stomatology, First Affiliated Hospital, Sun Yat-sen University and Chemical Mine Metal Material Test Laboratory, Guangdong Inspection and Quarantine Technology Center in October 2007. MATERIALS: Three packable resin-based composites were Ecusphere-Carat (EC, DMG Company, Germany), Filtek P60 (P60, 3M EPSE Company, USA), Tetric Ceram HB (HB, Ivoclar Vivadent Company, Liechtenstein) and a conventional composite FiltekZ250 (Z250, 3M EPSE Company, USA). The color of composites was A3. METHODS: Three packable resin-based composites and a conventional composite were filling in a cylindrical container (7 mm diameter, 4 mm depth), to obtain 80 samples, and then were divided into different groups according to the composite and photoactivation mode (n=10). In the soft-start photoactivation, samples were irradiated by 300 mW/cm~2 for 10 s, and then 600 mW/cm~2 for 30 s. Standard photoactivation was irradiated with 600 mW/cm~2 for 40 s.MAIN OUTCOME MEASURES: The microhardness of the top and bottom of the specimens was determined by Vickers microhardness tester. RESULTS: Three packable composites had higher hardness values than conventional composite. Though soft-start photoactivation could decrease the hardness of packable composites, the difference had no significant difference to standard mode (P > 0.05). There was significant difference on the top hardness and on the bottom hardness of conventional composite between two photoactivation modes (P < 0.05). CONCLUSION: The soft-start mode and resin-based composites should be selected carefully according to different filing areas.

Objective To explore the complication and its cause and treatment of pace markers implantation in older patient.Methods Among 205 older patients aged 70 to 90 years,103 were male,the others were female.Of these patients,162 were implanted with single chamber pace marker,43 with dual chamber pace markers.Results 21 patients happened complication(10.2%),the common complications related to operation were blood effusion and hematoma formation in pocket 12 cases,lead dislodgement 4 cases and infection with or without pocket rapture 2 cases.Occurrence of blood effusion was related to aspirin administration,lead dislodgement and infection with or without pocket rapture were related to operation.Conclusion To pay attention to ample preparation,close operation and strict observation can decrease the complication rate when pace marker is implanted.The serious result will be avoided by timely and effective treatment.The older patient with pace markers implantation is safe.

AIM:To study the senescence of human umbilical vein endothelial cells(HUVECs) and Bcl-2,Bax gene expression associated with apoptosis induced by angiotensinⅡ(AngⅡ).METHODS:HUVECs were cultured in vitro and the cell viability was observed by methyl thiazolyl tetrazolium(MTT).HUVECs were intervened by AngⅡ and valsartan(AngⅡ type 1 receptor blocking) and divided into 3 groups:the control group,AngⅡ group(stimulated with AngⅡ10-6mol/L for 48 h),valsartan group(valsartan was added to cells 1 h before 10-6mol/L AngⅡ treatment).?-gal staining aod cell cycle analysis were used to identify the cell aging status.Morphologic changes and percentage of apoptosis were assayed with Hoechst33258 under fluorescent microscope.The expressions of Bcl-2 and Bax,and the apoptosis-associated genes were detected by immunocytochemical staining,RT-PCR and Western blotting.RESULTS:The cell viability by AngⅡ-induced cells was(81.9%?4.1)%,the positive cell number of ?-gal staining was significantly higher in AngⅡ-induced cells(80.10%?6.81)% than that in the control cells.The cell cycle was at G0-G1(91.36%?6.45)%,the apoptotic cells significantly increased(31.84?2.86)% under fluorescent microscope.In valsartan group,Bcl-2 mRNA and protein expression increased markedly(P

Objective To study the correlation between time of fever onset in the course of patients'illness and etiologies of fever of unknown origin (FUO).Methods A total of 1 570 patients with FUO admitted from January 2013 to December 2014 were retrospectively analyzed, and clinical data ( sex, age, time of fever onset) of 348 patients meeting FUO diagnosis criteria with definite etiology diagnosis and time of fever onset were collected for multivariate logistic regression analysis after bias check.Results No statistically significant bias was found between 348 selected cases and 1 570 overall cases in gender (χ2 =0.029, P=0.903) and age (t=-1.040, P=0.299), and multivariate logistic regression analysis showed positive correlation between fever onset during 13: 00-18: 00 and infection (P=0.044, B=1.275), 18:00-24: 00 and connective tissue diseases ( P =0.029, B =0.838 ) , and showed negative correlation between age and miscellaneous (P =0.010, B =-0.042).Conclusions Characteristics of fever onset time may have significant value in preliminary diagnosis and guiding the correct direction of final definite diagnosis by means of targeted examinations or diagnostic treatments.It is worth to be further studied and discussed.

Objective To examine the reliability and validity of the Connor-Davidson Resilience Scale (CD-RISC) in nurses in China.Methods Item analysis and confirmatory factor analysis of CD-RISC was conducted.A total of 1 084 nurses were randomly divided into 2 groups using random number table.One group was used to revise CD-RISC and the other to evaluate its reliability and validity.Results Confirmatory factor analysis of the original RSA showed thatx2/df,RMSEA,GFI,AGFI,CFI were 6.714,0.103,0.804,0.764,and 0.718,respectively.The number of item was reduced to 21 based on exploratory factor analysis results,including three factors which explained 54.034％ of the total variance.Factor loading ranged from 0.490 to 0.755.Coefficient of internal consistency ranged from 0.688 to 0.930 and the 4 week test-retest reliabilities ranged from 0.825 to 0.917.The factor scores were closely correlated with the total scores with correlation coefficient ranging from 0.683 to 0.943.The factors were closely correlated with each other with correlation coefficient ranging from 0.564 to 0765.The confirmatory factor analysis of the revised CD-RISC showed that x2/df,RMSEA,GFI,AGF,CFI were 3.304,0.065,0.902,0.878,and 0.913 respectively.The total scores and all factors were negatively correlated with depression and anxiety and somatization.Conclusions The revised CD-RISC has good psychometric properties and can be used to measure the resilience of nurses.

Objective To find out the present situation of hepatitis B infection or immunity in Tianjin city,and to provide the scientific basis for the hepatitis B control and prevention.Methods 2 594 samples were selected with the methods of different proportionate stratified and cluster sampling,and the hepatitis B infection markers were detected by ELISA.Results The positive rates of HBsAg,anti-HBs,anti-HBc and HBV were 2.62％,46.72％,10.60％ and 51.54％.Conclusion Compared with the results in 1992,the positive rates of HBsAg,anti-HBc and HBV were decreased significantly,while the positive rate of anti-HBs increased significandy,which ascribed to the comprehensive measure with the vaccination against hepatitis B as a main strategy for control hepatitis B.

Objective:To evaluate the effectiveness and safety of endovascular treatment in solving symptomatic cerebral artery tandem lesions.Methods:From June 201 2 to February 201 4,1 2 cases (24 lesions)with symptomatic cerebral artery tandem lesions were accepted for the endovascular treatment. The distributions of the tandem lesions were as follows:the common carotid artery and internal carotid ar-tery (1 case),the internal carotid artery and the proximal of the carotid cavernous sinus segment (3 ca-ses),the internal carotid artery and the distal of the carotid cavernous sinus segment (4 cases),the in-tracranial segment of internal carotid artery and middle cerebral artery M1 segment (2 cases),the first segment of vertebral artery and intracranial segment of vertebral artery (2 cases).All of these cases were treated from distal lesions to proximal lesions except for tandem lesions in the internal carotid artery and the distal of the carotid cavernous sinus segment in order to obtain better support.Tandem lesions were treated in the same operation with local anesthesia or general anesthesia.The procedures of the 1 2 cases retrospectively were analyzed and the peri-operation complications and responsibility region recurrent is-chemic stroke incidents observed.Results:All tandem lesions were solved successfully all at once.There were no peri-operation complications or recurrent ischemic stroke incidents.There were no recurrent is-chemic stroke incidents or stent restenosis cases in the follow-up.Conclusion:It is safe and effective for selective endovascular treatment in solving symptomatic cerebral artery tandem lesions at the same time, but we should take careful preoperative evaluation and improve the operation plan.