Objective To explore the characteristics of T wave alternans (TWA) in aortic stenosis (AS) in school-aged children. Methods TWA was analyzed in 15 AS patients and 60 age-matched normal children using Microvolt T-Wave Alternans and the incidence of sustained TWA was compared between two groups. Myocardial ischemia during treadmill test was studied in sustained TWA and non-sustained TWA in AS patients. Results Compared with normal children, the incidence of sustained TWA was signiifcantly increased in AS group (P<0.01). In AS school-aged patients, the incidence of myocardial ischemia is higher in sustained TWA than in non-sustained TWA during treadmill test (P<0.05). Conclusions AS school-aged children have electrophysiologic basis for sunstained TWA. TWA is closely related to myocardial ischemia during treadmill test. Sustained TWA could be used as an important electrophysiologic index to assess the cardiac function in children with AS.

Objective To assess the efficacy and safety of smoking intervention by anesthesiol-ogists in surgical patients.Methods A total of 182 male patients,aged 18-79 years,ASA grade Ⅰ-Ⅲ,scheduled for elective noncardiovascular and nonthoracic surgery,were assessed preoperatively. Patients were randomized to either the control group or the intervention group,n =91 each.The con-trol group did not receive specific smoking cessation intervention.The intervention group received brief counseling by the anesthesiologist,leaflets on smoking cessation,including pictorial health warning labels,smoking cessation clinic’s smokers’hot line and WeChat public number.Anesthesia methods,operation time,treatment time in PACU,the rate of smoking cessation at 30 days postop-eratively,perioperative complications and smoking status at 30 days postoperatively were recorded. Results One hundred and sixty-six patients were included in the analysis finally.There was no signif-icant difference between two groups in 30 days of follow-up postoperatively.Self-reported smoking re-duction in the postoperative 30 days the intervention group was significantly lower than that in the control group (36.9% vs.22.0%,P <0.05).For smokers,there was a relationship between the lev-el of eCO and the smoking cessation rate,it was 83.3% in the intervention group and 40.0% in the control group (P <0.05).There was no significant difference of overall rate of combined intraopera-tive and immediate postoperative complications between two groups.Conclusion Smoking cessation intervention launched by anesthesiologists promotes 30 days of abstinence postoperatively.

0.05) ;TNF-? 0.5 ?g and TNF-? 1.0 ?g pretreatment groups showed reduced volume of lesion(all P

BACKGROUND: Some studies suggest that pre-injection of tumor necrosis factor-α (TNF-α)can protect focal cerebral ischemia in mice. Cerebral ischemia tolerance is related to the increase of TNF-α level; on the other hand, TNF-α is an injurious cytokine associated with stroke. Circulating antibody against anti-TNF-α can protect reperfused injury.OBJECTIVE: To study the effects of TNF-α pretreatment and post-treatment on cerebral ischemia-reperfusion injury and explore possible mechanism.DESIGN: Randomized controlled study.SETTING: Neurological Department, the Second Hospital Affiliated to Harbin Medical University.MATERIALS: The experiment was conducted at the Animal Experiment Center of Harbin Medical University from January to April 2002. Totally 120 healthy adult male Wistar rats were randomly divided into the following 8 groups: TNF-α 0.05 μg, 0.5 μg and 1.0 μg pretreatment groups and PBS group, TNF-α 0.05 μg, 0.5 μg and 1.0 μg post-treatment groups and PBS group with 15 in each group.METHODS: The focal brain ischemia model of middle cerebral artery occlusion (MCAO) was made using inserting thread method. TNF-α of different doses (0.05 μg, 0.5 μg or 1.0 μg) or PBS was injected intracisternally and 22-hour reperfusion, 8 rats from each group were killed. Then the perhour reperfusion, 7 rats from each group were killed. Then pathological changes were observed, glial fibrillary acidic protein (GFAP) and intercellular adhesion molecule-1 (ICAM-1) expression were inspected by immunohistochemical method. Histopathological and immunohistochemical evaluation was made with the computer-assisted image analyzing system,and the number of GFAP positive cells and ICAM-1 positive vessels in each hemisphere was counted.riliary acidic protein and ICAM-1.infarct volume: TNF-α 0.5 μg and TNF-α 1.0 μg pretreatment groups showed reduced volume of lesion; infarct volume reduced by 70.9% in TNF-α 0.5 μg pretreatment rats and 66.5% in TNF-α 1.0 μg pretreatment rats. TNF-α 0.5 μg and TNF-α 1.0 μg post-treatment groups showed increased volume of lesion; infarct volume increased by 22.3% in TNF-α 0.5 μg post-treatment rats and 46.7% in TNF-α 1.0 μg post-treatment rats.TNF-α 0.05 μg and 1.0 μg pretreatment groups did not differ significantly (P ＞ 0.05), but there was an obvious difference between TNF-α 0.5 μg and pared with PBS pretreatment group, TNF-α 0.5 μg and 1.0 μg pretreatment groups showed lessened tissue damage and edema. Compared with PBS post-treatment group, TNF-α 0.5 μg and TNF-α 1.0 μg post-treatment fibriliary acidic protein and ICAM-1: TNF-α 0.5 μg and TNF-α 1.0 μg pretreatment groups showed reduced volume of glial fibriliary acidic protein and ICAM-1 (P ＜ 0.05); but TNF-α 0.5 μg and TNF-α 1.0 μg posttreatment groups showed increased volume of glial fibriliary acidic protein and ICAM-1 (P ＜ 0.05). TNF-α 0.05 μg and 1.0 μg pretreatment groups did not differ significantly (P ＞ 0.05); but there was an obvious difference between TNF-α 0.5 μg and 1.0 μg post-treatment groups (P ＜ 0.05).cerebral ischemia reperfusion injury. This effect is not related to the repair given after cerebral ischemia reperfusion, ischemia exacerbates, which is α are determined by whether TNF-αis given before or after cerebral ischemia in a dose-dependent manner.

Objective To investigate the risk factors of mild cognitive impairment (MCI) in patients with type 2 dia-betes (T2DM), and the clinical evidence for the early diagnosis and treatment thereof. Methods A total of 217 T2DM pa-tients were divided into T2DM with MCI group (n=92) and T2DM with normal cognitive function(NMCI) group (n=125). Mon-treal cognitive assessment scale (MoCA) and activities of daily living scale (ADL) were used to assess the functional status in two groups of patients. The general clinical data and biochemical indicators were obtained and compared in two groups. Re-sults There were statistical differences in age, smoking history, education status, high sensitive C reactive protein (hs-CRP), coronary heart disease, hypertension, glycated hemoglobin A1c (HbA1c) and T2DM history between two groups. Re-sults of univariate logistic regression analysis showed that old age, longer course of T2DM, smoking history, higher hs-CRP and HbA1c, complicated with coronary heart disease and hypertension were risk factors for T2DM with MCI, while the higher education status was a protective factor. Multiple logistic regression analysis showed that old age and longer T 2DM history were risk factors, and the higher education was a beneficial factor for T2DM with MCI. Conclusion Many risk factors may play a part in T2DM with MCI. Early detection and prompting medical attention may help prevent and decrease the preva-lence of MCI in patients with T2DM.

BACKGROUND:Cel membrane microparticles CD31 and CD54 lead to microvascular injury in the femoral head by mediating vascular inflammatory response, promoting blood clotting, affecting vasomotion and promoting vascular endothelial injury. Studies have verified that membrane particles play an important role in steroid-induced necrosis of the femoral head, but there is no studies concerning relationship between microparticles and alcohol-induced avascular necrosis of femoral head. METHODS/DESIGN:This is a randomized control ed animal study. Healthy male Wistar rats wil be randomly assigned to two groups. In the model group, rats wil be intragastrical y administered hard liquor for 6 consecutive months to prepare models of alcohol-induced avascular necrosis of the femoral head. Blank controls wil be intragastrical y given an equal volume of physiological saline. In 1-6 months of intervention, six rats wil be randomly selected from each group every month. Blood wil be col ected separately. Flow cytometry wil be used to detect serum cel membrane particles CD31, CD54 levels. Bilateral femoral head wil be fixed, decalcified, embedded in wax, and then sections. After hematoxylin-eosin staining, empty bone lacuna wil be quantified under a light microscope to identify femoral head necrosis. Verhoff’s staining and MSB microthrombosis staining wil be used to observe microvascular injury and microvascular thrombosis in the femoral head, and to analyze the correlation of CD31 and CD54 levels with femoral head necrosis, vascular endothelial injury and microvascular thrombosis. DISCUSSION:This study wil investigate the effects of CD31 and CD54 on alcohol-induced avascular necrosis of the femoral head, explore the pathogenesis of alcohol-induced avascular necrosis of the femoral head, provide a new theoretical basis for early diagnosis and early treatment, and may provide a new target for its treatment. ETHICS APPROVAL:The protocol has been approved by the Animal Experimental Ethics Committee of Inner Mongolia Medical University (approval number YKD2016154). Experimental procedures and materials of rats wil be in accordance with the Guide for the Care and Use of Laboratory Animals, which is consistent with the guide of National Institutes of Health. Subject headings:Femur Head Necrosis;Membrane Proteins;Tissue Engineering

BACKGROUND:The relationship between long-term heavy drinking and alcohol-induced necrosis of the femoral head has long been clear, but thepathogenesis of alcohol-induced necrosis of the femoral head is currently not fuly understood.
OBJECTIVE:To establish a rat model of alcohol-induced avascular necrosis of femoral head and to study its pathogenesis.
METHODS: Eighty Wistar rats were randomly divided into experimental and control groups (40 rats per group). Rats in the experimental group were intragastricaly administered strong wine 10 mL/kg, once a day, for 6 consecutive days. Rats in the control group were given physiological saline 10mL/kg, once a day, for 6 consecutive days. Bilateral femoral heads were randomly colected from six rats every month for histomorphological observation.
RESULTS AND CONCLUSION:(1) Osteonecrosis: in the experimental group, at 3 months, trabecular bone became thin, arranged disorderly, and the number of empty lacuna began to increase. At 6 months, typical osteonecrosis appeared, and vacant lacunaes increased significantly. In the control group, trabecular bone was complete and neatly arranged. Osteocytes were visible in bone lacuna, and normal morphology of cels was seen. (2) Injury of blood vessels: in the experimental group, at 3 months, micro-intimal hyperplasia was observed. Elastic fibers of partial vascular endothelium were reduced. Elastic fiber andmiddle-layer smooth muscle breakage and proliferation were found. At 6 months, above manifestations were more remarkable. In the control group, arteriole film was not thickened, and vessel wal was normal. (3) Formation of microthrombus, in the experimental group, the number of microthrombus was increased at 3 months, and became significant at 6 months. In the control group, the number of microthrombus was not altered. (4) Results indicated that chronic alcohol intake can lead to microvascular endothelial injury in the rat femoral head. Abnormal blood microcirculation was detected in local region, and resulted in avascular necrosis of the femoral head. The degree of necrosis was associated with alcohol intake.

OBJECTIVE To approach the distribution characteristic and drug resistance status in pathogens from infected urinary tract in Jingshan County and offer the scientific evidence for clinically reasonable use of antibiotics.METHODS Totally 218 strains of pathogens isolated from urinary tract were identified by routine methods according to the National Clinical Laboratory Operation Rules.Drug susceptibility testing was performed by K-B methods recommended by CLSI.RESULTS Among 218 strains of pathogens from infected urinary tract,Escherichia coli accounted for 61.0%,ranking the first and enterococci ranked the second,accounted for 11.5%.Except for 100% sensitivity to vancomycin and teicoplanin in Gram-positive bacteria and to imipenem and meropenem in Gram-negative bacteria,the pathogens from infected urinary tract had been resistant to commonly used antibiotics in some degrees.The detection rate of extended-spectrum beta-lactamases(ESBLs) producers was 32.9%.CONCLUSIONS The drug resistance in pathogens from infected urinary tract is on the rise.We should strengthen monitoring and controlling of it.

Objective To improve the understanding of Amiodarone in the treatment of intractable incessant tachycardia in children. MethodsData of 80 patients with intractable incessant tachycardia treated by Amiodarone were summarized. Among them 52 were male,38 were female,and average age was 2.5 years old. ResultsAmiodarone reduced heart rate effectively, with about 90% effective. Simultaneously, it could convert tachycardia into sinus rhythm and succeeded 67% in atrial tachycardia, 92% in paroxysmal supraventricular tachycardia,89% in junctional ectopic tachycardia, 56% in ventricular tachycardia respectively. Use of small dosage of β-receptor blocker together with Amiodarone showed synergy. Hypotension and bradycardia are the main side effects. ConclusionsToo rapid and sustained tachycardia can lead, to hemodynamic disorders and cause heart failure, it requires urgent and adequate treatment. Amiodarone can be used to treat different kinds of intractable incessant tachycardia, and is safe and effective in patients with relatively stable hemodynamis.

Objective To investigate the early diagnostic value of cornel confocal microscopy for the screening of small neuropathy in elderly patients with type 2 diabetic mellitus.Methods In the prospective study,96 elderly patients with diabetes as study group and 46 patients with non-diabetes as the control group were continuously collected from our hospital endocrinology and ophthalmology out patients during May 2014 to February 2016.The 96 cases of type 2 diabetes were subdivided into 47 patients with diabetic peripheral neuropathy (DPN)and 47 patients with nowdiabetic peripheral neuropathy(non DPN).Results The diabetes course was shorter in non-DPN group than in DPN group(P=0.000).The levels of glycosylated hemoglobin and urine albumin were lower in the nonDPN than in the DPN(P =0.072,0.007,respectively).The corneal nerve fiber density was lower in the DPN group than in NDPN group (P =0.000).Corneal nerve fiber density was higher in control group than in DPN and NDPN group.The differences in number of corneal nerve fibers showed no statistical significance between DPN and NDPN group (x2 =2.391,P =0.314).But the number of corneal nerve fibers was significant less in DPN and NDPN group than in control group(x2 =16.014,P =0.000).The negative correlation was found between the course of disease and corneal fibrous density by using single factor linear regression analysis.The number of corneal nerve fibers was lower in smoking group than in non-smoking group(P=0.003).The multiple linear regression analysis showed that duration of diabetes was a risk factor for diabetic neuropathy.Conclusions In some elderly diabetic patients with non-neuropathy,corneal nerve fiber density and number have been significantly decreased before nerve conductive velocity is reduced.Therefore,corneal confocal microscopy can be used to detect and diagnose small diabetic neuropathy in elderly patients with diabetes mellitus.