Objective:To explore the relationship between non-dipper heart rate (HR)and severity of cerebral em- bolism from atrial fibrillation in aged patients.Methods:A total of 95 aged patients with persistent atrial fibrillation complicated cerebral embolism received 24h Holter monitoring within 24h after hospitalization.According to 24h Holter monitoring results,patients were divided into dipper HR group (n=21),non-dipper HR group (n=56) and reverse dipper HR group (n=18).United States national institutes of health stroke score (NIHSS)was used to evaluate neurological deficit severity of three groups,and the relationship between HR and NIHSS score was retro- spectively analyzed.Results:Compared with dipper HR group,there were significant rise in mean HR [(83.09± 8.06)beats/min vs.(89.09±7.83)beats/min vs.(95.50±8.06)beats/min]and NIHSS score [(5.14±2.65) scores vs.(7.95±5.30)scores vs.(11.11±7.41)scores]in non-dipper HR group and reverse dipper HR group, and those of reverse dipper HR group were significantly higher than those of non-dipper HR group,P<0.05 or<0.01.Conclusion:Abnormal circadian changes of heart rate can aggravate patient's condition in aged patients with atrial fibrillation complicated cerebral embolism.So based on routine treatment,regulation of circadian rhythm of heart rate should also be noticed.

This study was aimed to determine trace elements in Peach pulp . The wet digestion method and car-bonize acid dissolution method were applied to digest the sample, and flame atomic absorption spectroscopy was used to determine the content of trace elements (Fe, Cu, Mn) in Peach pulp . The results showed that the content is not consistent among different pretreatment methods. However, the metalion content among these three methods are in the order of Fe > Mn > Cu, with the average recovery rate between 92.6% and 119.6%. The RSD is less than 2.86%. It was concluded that this method is with high accuracy and stability as well as reliable accurate re-sults. It also proved that Peach pulp . is rich in Fe, Cu and Mn. It provides some useful information for further pharmacological study of Peach pulp .

This paper aims to analyze the impact of splenic vein thrombosis (SVT) on the hemodynamic parameters in hepatic portal vein system. Based on computed tomography (CT) images of a patient with portal hypertension and commercial software MIMICS, the patient's portal venous system model was reconstructed. Color Doppler ultrasound method was used to measure the blood flow velocity in portal vein system and then the blood flow velocities were used as the inlet boundary conditions of simulation. By using the computational fluid dynamics (CFD) method, we simulated the changes of hemodynamic parameters in portal venous system with and without splenic vein thrombosis and analyzed the influence of physiological processes. The simulation results reproduced the blood flow process in portal venous system and the results showed that the splenic vein thrombosis caused serious impacts on hemodynamics. When blood flowed through the thrombosis, blood pressure reduced, flow velocity and wall shear stress increased. Flow resistance increased, blood flow velocity slowed down, the pressure gradient and wall shear stress distribution were more uniform in portal vein. The blood supply to liver decreased. Splenic vein thrombosis led to the possibility of forming new thrombosis in portal vein and surroundings.
Blood Flow Velocity ; Blood Pressure ; Computer Simulation ; Hemodynamics ; Humans ; Hypertension, Portal ; Liver Cirrhosis ; Portal Vein ; Splenic Vein ; pathology ; Thrombosis ; pathology ; Tomography, X-Ray Computed

Objective To evaluate the accuracy of bispectral index (BIS)-guided closed-loop target controlled infusion (TCI) system in comparison with opened-loop manual TCI during anesthesia of biliary tract and pancreas surgeries.Methods Forty adult patients undergoing open surgery of biliary tract or pancreas under total intravenous anesthesia, including 17 males and 23 females, aged 18-75 years, falling into ASA physical status Ⅱ or Ⅲ, were randomly allocated into closed-loop group (group C, n=20) and opened-loop manual group (group M, n=20).In group M, the propofol effect-site concentration was adapted at the discretion of the anesthesiologist to reach and maintain a BIS as close as possible to 42-52.In the closed-loop TCI group, propofol was administered using the closed-loop anesthesia delivery system to reach and maintain atarget BIS of 42-52.The BIS values would be recorded automatically by the system at each second after it began to run.The anesthesia duration, unconsciousness time, endotracheal intubation time, recovery time and endotracheal extubation time were recorded.The total usage of propfol and remifentanil were calculated.The incidence rates of emergence agitation, postoperative nausea and vomiting and intraoperative awareness were recorded.The frequencies of vasoactive drug were recorded.MDAPE, Wobble, GS through BIS values were calculated.Results BIS was maintained within ±10% of target (excellent) for significantly longer time in group C (52.1±10.5)% than that in group M (37.6±5.8)% (P<0.05).BIS was maintained within ±(10%-20%) of target (good) for the same time in both groups.MDAPE in group C (10.1±2.2)% were significantly lower than those in group M (15.3±6.4)% (P<0.05).GS in group C (23.1±8.9)% was significantly lower than that in group M (33.5±15.8)%.The usages of propofol in group C ·kg-1·min-1 were similar to those in group M (0.12±0.03) mg·kg-1·min-1, and the usages of remifentanil in group C (0.12±0.03) μg·kg-1·min-1 were similar to those in group M (0.15±0.05) μg·kg-1·min-1.The frequencies of vasoactive drug were similar in both groups.There was one incidence of emergence agitation in groups M.Postoperative nausea and vomiting and intraoperative awareness didn't occur in both groups.Conclusion The depth of the anesthesia is maitained more appropriately and stable in the closed-loop group than that in manual administration group.

The paper introduces the system design of internet platform in novelty assessment and selective dissemination of informa-tion of medical science and technology project in Zhejiang province, including the exploitation of environment , processing of novelty as-sessment and selective dissemination of information as well as main function design. This system has noticeable advantages, such as com-prehensive functions, multiple participation, transparent service process, which could finish the relevant work on the internet, improve the quality of information service and enhance the efficiency.

BACKGROUND: Ambulatory blood pressure monitoring can sensitively and objectively reflect blood pressure level, which is closely related to target organ damage and disease prognosis. In hypertension, vascular endothelial damage is the most common lesion to target organs. There is little known about how ambulatory pulse pressure correlates to large artery elasticity and vascular endothelial function. OBJECTIVE: To investigate changes of large artery elasticity and of vascular endothelial function in patients with primary hypertension using an automatic pulse wave velocity determinator and ultrasound techniques, and to analyze the correlation of ambulatory pulse pressure to large artery elasticity and vascular endothelial function.DESIGN: A non-randomized concurrent control clinical observation. SETTING: Diagnosis and Treatment Center for Coronary Heart Disease, the 305 Hospital of Chinese PLA. PARTICIPANTS: A total of 156 inpatients and/or outpatients, who were recently confirmed with primary hypertension, were recruited for this study between June 2005 and April 2007. Patients consisted of 114 males and 42 females. All patients averaged 56 ± 4 years of age (range: 40-75). Inclusive criteria: Corresponding to diagnostic standards for preventing and treating hypertension instituted in 2004 by Chinese scholars. Confirmed as primary hypertension within 1 month. Not receiving any blood pressure lowering, hypolipidemic or nitrate-like drug treatments. Written informed consents for laboratory measurements were obtained from all subjects. The study was approved by the hospital's Ethics Committee. METHODS: According to the mean pulse pressure over 24 hours, all patients were assigned into 3 groups: Group A (mean pulse pressure ＜ 40 mm Hg, n=92), group B (40 mm Hg ≤ mean pulse pressure ＜ 60 mm Hg, n=39) and group C (mean pulse pressure ＞ 60 mm Hg, n=25). In each group, daytime pulse pressure and night-time pulse pressure, as well as 24-hour mean pulse pressure were measured using a non-invasive portable ambulatory blood pressure monitor (ABPM-04, Meditech Inc, USA). Carotid-femoral and carotid-radial arterial pulse wave velocities were measured using an automatic pulse wave velocity determinator to evaluate large artery dilation. Blood flow mediated and nitroglycerin-dependent dilatation of the brachial artery was determined using a high-resolution ultrasound technique to evaluate vascular endothelial function. MAIN OUTCOME MEASURES: Correlations of ambulatory pulse pressure to large artery dilation and arterial endothelial function. RESULTS: All 156 patients were included in the final analysis. Correlation of ambulatory pulse pressure to large artery dilation: Carotid-femoral arterial pulse wave velocity was significantly positively correlated to daytime pulse pressure, night-time pulse pressure and 24-hour mean pulse pressure, with coefficient of partial correlation being 0.310, 0.281 and 0.303, respectively, P ＜ 0.01). There were no significant correlations of carotid-radial arterial pulse wave velocity to daytime pulse pressure, night-time pulse pressure or 24-hour pulse pressure (P ＞ 0.05). Correlation of ambulatory pulse pressure to arterial endothelial function: There was a linear relationship between ambulatory pulse pressure and blood flow-mediated blood vessel dilatation values. Linear correlation analysis was performed, taking ambulatory pulse pressure as an independent variable, and endothelial-dependent dilatation as a dependent variable. Results demonstrated that blood flow-mediated blood vessel dilatation was significantly negatively correlated to daytime pulse pressure, night-time pulse pressure and 24- hour mean pulse pressure (r = -0.684, -0.597, -0.668, P ＜ 0.01). There was no correlation of ambulatory pulse pressure to non-endothelial-dependent blood vessel dilatation. CONCLUSION: Ambulatory pulse pressure increase is closely related to large artery elasticity decrease and injury to endothelial function in patients with primary hypertension.

Objective To explore the instruction value of the color Doppler ultrasonography for the diagnosis and treatment of the pediatric intussusceptions .Methods Retrospective study the color Doppler ultrasonographic performance of 114 patients with diagnosis of pediatric intussusception in the affiliated hospital of Zunyi medical college ,from October 2009 to June 2012 ,reviewed the case ,groups were compared according to the ways of therapeutic methods .Results All the 114 cases of children of the intus-susception are subject to air enema reset or surgery cured confirmed .Age younger than 12 months intussusception children ,air ene-ma reset were more likely to success ;the diameter of concentric circles levy,the length of sleeve for and the thickness of bowel wall were smaller ,the more suitable for outsiders air enema reset .The blood supply of scabbard of bowel wall and the mesenteric was rich ,the air enema reset had a higher success rate ,blood supply was poor and the success rate was lower .The success rate of air enema reset was influenced by the part of intussusception .Conclusion Combined use of conventional color ultrasonic and high fre-quency probe checking ,can raise the diagnosis rate of pediatric intussusception ,the primary lesion confirmed and the detection rate in the position of the disease ,provide guidance for clinical choice reduction treatment .

Objective Comparison of clinical and pathological features of Henoch-Sch(o)nlein purpura nephritis with different proportions of crescent.Methods Patients with Henoch Schonlein nephritis diagnosed by renal biopsy in our hospital from 2012 to 2017 (proportions of crescent ＜ 50％)were enrolled and grouped according to the rate of crescent formation (A group:crescent formation rate ＜ 10％;B group:10％-24％;C group:＞ 24％-50％),their epidemiological,clinical manifestations,laboratory examination,clinicopathological features were compared.Results There was no significant difference between the three groups in sex,age and incidence of diabetes(P ＞ 0.05).The morbidity of hypertension in C group is higher than others (P ＜ 0.05).There were no different in the incidence of hematemesis,abdominal pain,joint pain in the three groups (P ＞0.05),while the incidence of edema and gross hematuria was significantly higher in group C than others.There were more patients had Nephritic syndrome (38.8％) in C group than the other groups (P ＜ 0.05).There was no significant difference in 24 h urinary protein,C-reactive protein (CRP),urine red blood cell,eosinophil granulocyte and immunoglobulin E (IgE) in the 3 groups.The levels of serum creatinine,blood urea nitrogen (BUN),and low density lipoprotein (LDL) increased significantly in group C,and the level of glomerular filtration rate (GFR) and albumin decreased significantly(P ＜ 0.05).The tubulointerstitial lesions,mesangial cell proliferation and deposition of C1q levels,C group was significantly higher than the other two groups (P ＜ 0.05).Conclusions In Henoch Sch(o)nlein purpura nephritis,with the increase of the proportion of the crescent body,the renal function and pathological changes of the kidney are gradually aggravated.Therefore,the crescent is important for the prognosis of Henoch Sch(o)nlein purpura nephritis.

Objective To investigate the levels of blood sugar and electrolyte in nonage of 125 patients with liver transplantation.Methods According to the parameters of blood sugar and electrolytes,the usage of insulin and electrolyte was adjusted whenever necessary.The levels of blood sugar and electrolytes were maintained respectively in 6～10 mmol/L and normal limits.The oxygen inhalation,antibiotics,immunosuppressant,liver protectant,diuretics and vasodilators were also used in the preoperative period.Results Of 125 cases of liver transplantation recipients,there were 50(40%) cases with blood sugar heightened remarkably.Massive potassium chloride and sodium chloride was used to keep electrolytes in normal limits.Conclusion The levels of blood sugar and electrolytes are not stable in nonage of liver transplantation and it is very important to maintain them in normal limits for the success of liver transplantation.