Objective To evaluate the radiofrequency catheter ablation for type I atrial flutter through application of Holo catheter labelling with anatomic imaging localization to ablate the isthmus of IVC TA during complete double way block.Methods Eleven cases with type I atrial flutter undergone Holo catheter labelling technique and consecution with conduction time change of coronary venous sinus orifice withright atrial lower lateral wall pace excitation ,were performed with radiofrequency catheter ablation for the isthmus outcoming with complete double way conduction block. Results All together 11 cases with 4 of atrial flutter and 7 of sinus rhythm were undergone radiofrequency catheter ablation resulting with double way conduction block of the isthmus accompanied by prolongation of right atrial conduction time 56.0?2.3ms and 53.0?4.6ms respectively.The right atrial excitation consecution during coronary venous sinus orifice and right atrial lower lateral wall pace excitation appeared to be in clockwise and counter clockwise of single direction. No recurrence occurred during 3-34 months follow up with only one showing atrial fibrollation.Conclusions The application of Holo catheter labelling technique with anatomic imaging localization to achrieve the double way conduction block by radiofrequency catheter ablation of TVC TA isthmus, is a reliable method for treating atrial flutter.

Children with biliary atresia generally present nutritional deficiency, and often have growth failure and neurodevelopmental impairments.Increasing evidence shows that malnutrition is not only a risk factor for growth failure and neurodevelopmental impairments in children with biliary atresia, but also a risk factor for morbidity and mortality.Nutritional support is extremely important to improve the prognosis.This article reviews the relationship between malnutrition, growth failure and neurodevelopmental impairments in children with BA, and discusses the timing and methods of nutritional support.

This paper introduces the standards and the market conditions of wheelchair in China, as well as the general quality of products of wheelchairs from the quality supervision and spot check, and puts forward some suggestions on how to improve the quality of wheelchairs in China.

Objective To measure the quality of manual wheelchairs made in China. Methods 20 wheelchairs was tested with ISO 7176-8, focused on the static strength, impact strength and fatigue strength. Results 8 (40%) wheelchairs passed the test. Conclusion The fatigue strength is the key factor of the wheelchair quality.

BACKGROUND: Different processes of thinking may lead to the same results, which represent one of the forms of the complexity of the human brain.OBJECTIVE: To analyze the similarity in the results of thinking and difference in the thinking process by means of questionnaires.DESIGN: A comparative analysis of the answers in the final term examination with the difference in answers analyzed by x2 test with contingency table.SETTING: Department of Physiology, Medical College of Henan University of Science and Technology.PARTICIPANTS: This study was conducted between June and November,2004, involving totally 300 volunteered second-year medical students (150male and 150 female, aged 20-22 years) of the medical school of Henan Science and Technology University who took their final examination in physiology.METHODS: The first "question for thinking" in the final examination was taken as an example, and the papers with full score for this question (completely correct group, n=42) and zero score (totally wrong group, n=49)were chosen, from which one paper was randomly selected from each group. The first 10 words in the answer to the question was used as the control and compared with the answers of the other papers word by word.Each same word was given a score of 1 and otherwise a score of 0, and the number of the same words and different words were counted for comparison. Meanwhile the total words of the answer were also counted and compared. The difference in the answers was analyzed with x2 test with contingency table.MAIN OUTCOME MEASURES: The difference in the first 10 words between completely correct group and totally wrong group.RESULTS: Totally 42 students in the complete correct group and 49 in totally wrong group were included in the final result analysis. The number of the total words of the answer was different between the students in spite of the same scores. The first 10 words of the chosen paper in completely correct group was significantly different from those in the other 41 papers (x2=270.978, P ＜ 0.01); there was also significant difference in the first 10words between the chosen paper and the other 41 papers in totally wrong group (x2=285.153, P ＜ 0.01).CONCLUSION: Longitudinal thinking as well as lateral thinking processes are different between persons.

Objective To investigate the status quo of the assurance and subsidy for severe diseases acquired by juvenile in rural areas in Qinghai, and provide evidences for building a subsidy system for such population. Methods Quantitative surveys were made to collect data on medical expenses and the compensation practice for such expenses for severe diseases of juvenile in the area, for a knowledge of the present medication and disease load in question; specialists in two hospitals were interviewed to learn the present treatnents for such a population, and their expenditures in case of such diseases. Results Juveniles in rural Qinghai rely on the new rural cooperative medical scheme, under which however the reimbursement rate was only 26% ～35%. Families with juvenile patients of severe diseases were found to suffer heavy burdens. As a result, a high percentage of the patients give up treatment. To make things worse, as only two hospitals in the provincial capital city can provide professional treatment for children with severe diseases, rural children have to pay heavy indirect costs other than medication such as heavy travel expenses. Conclusion It is critical to build a medical assurance system for juvenile with severe diseases. It is also imperative to build and strengthen the capacity of medical centers for such a population in Qinghai, and upgrade the diagnosis and treatment competence of local health providers, ensuring adequate medical resources for juvenile with severe diseases upon joint development of both healthcare providers and the medical insurance system.

Objective To investigate the drug resistance and homology status of Multi-drug Resistant AcinetobacterBauman-nii (MDR-AB)in orthopaedic hospital.Methods 34 strains MDR-AB were isolated from 2016.1~2016.7 for DNA extrac-tion and were typed by repetitive extragenic palindromie-polyrnerase chain reaction (REP-PCR).Results The resistance rate of MDR-AB were ≥70% to 15 of 17 antimicrobials,except to cotrimoxazole (14%)and levofloxacin (61%),34 strains of MDR-AB were divided into three types by REP-PCR including typeⅠ,typeⅡ and typeⅢ.Conclusion Drug resistance of MDR-AB was severe and mainly composed of the same genotype (typeⅠ).Rational use of antimicrobial and regular mo-nitoring of drug resistance is necessary to reduce the nosocomial transmission.

Microthrombosis may be involved in the pathogenesis of cardiac microangiopathy due to diabetes. Recent studies have shown that fibrinogen-like protein 2 (fgl2) plays a pivotal role in microthrombosis in viral hepatitis, acute vascular xenograft rejection and cytokine-induced fetal loss syndrome. The current study was designed to examine the expression of fgl2 in microvascular endothelial cells and investigate the effects of microthrombi due to fgl2 on cardiac function and structure in rats with type 2 diabetes. Following induction of type 2 diabetes, 24 rats were observed dynamically. Fgl2 expression and related cardiac microthrombosis were examined. Local or circulating TNF-α was measured. Coronary flow (CF) per min was calculated as an index of cardiac microcirculation. Cardiac function and morphology were evaluated. It was found that Fgl2 was highly expressed in cardiac microvascular endothelial cells of rats with type 2 diabetes, which was promoted by local or circulating TNF-α. The Fgl2 expression was associated with cardiac hyaline microthrombosis. In parallel with the fgl2 expression, CF per min, cardiac diastolic or systolic function and cardiac morphology were aggravated to some extent. It was concluded that in rats with type 2 diabetes, microthrombosis due to fgl2 contributes to the impairment of cardiac diastolic or systolic function and morphological changes.

Objective To synthesize 18F-AlF-NOTA-G-TMTP1 and evaluate its potential for PET imaging on nude mice bearing high-metastatic potential hepatoma cells.Methods NOTA-G-TMTP1 was synthesized by the standard Fmoc-solid phase synthetic protocols and radiolabeled with 18F using NOTA-AlF chelation method.The nude mice models bearing low-metastatic potential HCC97L and high-metastatic potential HCCLM3 xenografts were established separately.The tumor-targeting characteristics of 18F-AlF-NOTA-G-TMTP1 were assessed by microPET/CT and biodistribution assay.Results NOTA-G-TMTP1 was labeled with 18F in one step with (25±6)％ labeling yield (n=5).The radiochemical purity of 18F-AlF-NOTA-G-TMTP1 was more than 95％ with a specific activity more than 11.1 GBq/μmol.The octanol/water partition coefficient (logP) for 18F-AlF-NOTA-G-TMTP1 was-3.166±0.022.The tumor to muscle ratios were 1.8± 0.4 and 4.7±0.2 at 35 min post injection for HCC97L and HCCLM3,respectively.The uptake of 18F-AlF-NOTA-G-TMTP1 in HCCLM3 tumor was inhibited (61.4％) by unlabeled G-TMTP1.Conclusion 18F-AlF-NOTA-G-TMTP1 has been successfully synthesized.It shows specific uptake by tumor induced by the high-metastatic potential hepatoma cells.

Objective To evaluate pathogens and antimicrobial resistance of pathogens causing refractory pneumonia in children.Methods Children with refractory pneumonia who admitted to a hospital between May 2008 and December 2014 were performed bronchoscopy,and bronchoalveolar lavage fluid (BALF)were performed bacterial culture and antimicrobial resistance testing.Results 1 693 patients were recruited in the study,273 bacterial isolates were isolated from BALF speci-mens of 226 children,gram-positive bacteria accounted for 38.10% (104/273 ),the main gram-positive bacteria were Streptococcus pneumoniae (n=71)and Staphylococcus aureus (n=23);gram-negative bacteria accounted for 58.24%(159/273),including 44 isolates of Haemophilus parainfluenzae ,28 Klebsiella pneumoniae ,19 Escherichia coli ,and 17 Pseud-omonas aeruginosa ;10 isolates of fungi were also detected,8 of which were Candida albicans .The sensitivity of Streptococ-cus pneumoniae to quinolones,ceftriaxone and cefotaxime were high.Methicillin-resistant Staphylococcus aureus (MRSA) positive rate was 26.32%.ESBLs-producing rate of Haemophilus parainfluenzae and Klebsiella pneumoniae was 32.72% and 62.96% respectively.Conclusion The major pathogens causing refractory pneumonia were Streptococcus pneumoniae and Haemophilus parainfluenzae ,empirical treatment should be conducted accordingly,antimicrobial resist-ance should be considered if therapeutic effect is poor,and targeted therapy should be performed according to cultured re-sults and antimicrobial susceptibility testing result.