Objective To discuss the value of Duke treadmill score in the diagnosis of coronary heart disease.Methods 94 inpatients underwent treadmill test and coronary angiography,the relationship between the Duke treadmill score and the results of coronary angiography was analyzed.Results The prognostic accuracy and positive predictive value of Duke treadmill score to male and female were 88.9％,85.0％ ;those of traditional electrocardiogram ST standard were 89.6％,82.5 ％,the differences were significant (x2 =4.27,P ＜ 0.05).Conclusion The Duke treadmill score is much more significant than the traditional ST standard in the prognostic accuracy and positive predictive value of diagnosing coronary heart disease.

ObjectiveTo analyse the clinical characteristics of elderly patients with permanent cardiac pacemaker implanted. MethodsTo retrospectively analyze 41 elderly patients( ≥80 years) with permanent pacemakers implantation. Observing the clinical symptoms, bradyarrhythmia category, pacing mode, intraoperative pacing parameters,intraoperative and postoperative complications. ResultsAll patients were operated successfully. Pacing modes were,VVI 29 cases,VVIR 2 cases,DDD 9 cases and DDDR 1 case. Ventricular electrode located in right ventricular apical pacing. Atrial electrode located right heart ear. During the operateing, severe complications did not happen such as heart perforation, malignant arrhythmia. One case of postoperative dislocation electrode and one case of pocket hematocele were observed. After treatment, they were cured, no infection and pacemaker syndrome happened. 6 patients died during follow-up, postoperative from two months to 6 years. ConclusionPacing therapy in elderly patients is good. Surgical risk was not increased.

0.05), but not in other brain regions. The number of GFAP-immunopositive cells of the E.coli-treated pups was markedly increased in periventricular white matter and hippocampus at P7 compared with the control group (P0.05). CONCLUSION: Intrauterine infection induces an increased expression of GFAP in the neonatal brain. [

Chronic severe hepatitis is a critical disease with high mortality. Currently, effective drugs and therapy still lack. Comprehensive and supportive treatment, artificial liver and liver transplantation are the main therapies. A great number of studies on traditional Chinese medicine (TCM) in many ways combined with Western medicine treatment for chronic severe hepatitis have been reported, but the efficacy and safety still lack systematic evaluation.

Objective To observe the protective effect of gradual ischemic postconditioning (IP) capable of improving reperfusion on reperfusion injury in patients with ST-segment elevation acute myocardial infarction (STEAMl) undergoing primary percutaneous coronary intervention (PPCI).Methods 102 in-patients with STEAMI undergoing PPCI in the Department of Cardiology in the First People's Hospital of Kunshan City Affiliated to Jiangsu University from February 2011 to August 2014 were enrolled in this study. They were divided into three groups by a random number table: IP group (32 cases), gradual IP group (30 cases) and routine reperfusion group (40 cases). In IP group, after the opening of the infarction related blood vessel, ischemic postconditioning within the first minute of arterial reperfusion was made through three episodes of 1 minute inflation and 1 minute pressure withdrawn of an angioplasty balloon, and then persistent reperfusion was carried out. In the gradual IP group, the patients received three times of gradual angioplasty balloon inflation and denation, 1 minute/1minute, 30 seconds/30 seconds and 15 seconds/15 seconds respectively, presenting the gradual change of IP time. In the routine reperfusion group, after the opening of blocked blood vessel, the patients underwent routine PCI to persistently recover the coronary artery blood supply. The changes of related lead ST segment regression (Sum-STR), incidence of reperfusion arrhythmia, corrected thrombolysis in myocardial infarction (TIMI) franle count (CTFC), peaks of MB isoenzyme of creatine kinase (CK-MB), left ventricular ejection fraction (LVEF) and frequency of adverse events in follow-up period were compared among the three groups.Results The baseline characteristics were comparable in three groups. The incidence of ventricular premature beats was significantly lower in gradual IP group than that in routine reperfusion group [30.0% (9/30) vs. 55.0% (22/40),P < 0.05], and although theincidence of ventricular premature beats was lower in IP group than that in routine reperfusion group [34.4% (11/32) vs. 55.0% (22/40)], no statistically significant difference was found (P > 0.05). The incidence of ventricular tachycardia was significantly lower in IP and gradual IP groups than that in routine reperfusion group [15.6% (5/32), 13.3% (4/30) vs. 40.0% (16/40), bothP < 0.05]. The incidences of ventricular fibrillation, bradyarrhythmia and sinus arrest were lower in IP group and gradual IP group than those in routine reperfusion group, but no statistically significant differences were found (allP > 0.05). In IP group and gradual IP group, the Sum-STR incidence, CTFC, CK-MB peaks were lower than those of routine reperfusion group [Sum-STR: (56.7±18.3)%, (57.3±21.5)% vs. (44.6±21.6)%; CTFC: 25.47±5.37, 24.46±6.41 vs. 31.62±7.56; CK-MB peaks (U/L): 126.3±78.5, 121.6±82.5 vs. 147.4±72.5; allP < 0.05], the effect of gradual IP group being the best among the three groups. The levels of LVEF were slightly higher in IP and gradual IP groups than the level in routine reperfusion group (0.507±0.042, 0.511±0.062 vs. 0.497±0.062), but no statistically significant difference was found (bothP > 0.05). In routine reperfusion group, one patient died because the ventricular fibrillation could not be corrected and another one died of no-reflow during operation. Each group had 1 patient died during the 4 weeks of follow-up after operation, in the routine reperfusion group, one died of refractory heart failure, and the cause of death of other two patients, one in IP group and another in gradual IP group, was considered due to subacute thrombosis in stent. Major bleeding events were not found in each group.Conclusion Gradual IP can ameliorate myocardial reperfusion injury more significantly in patients with STEAMI undergoing PPCI.

Objective To evaluate the safety,feasibility and efficacy of emergency percutaneous coronary intervention(PCI)on the spot in the patients with acute myocardial infarction(AMI)in country hospitals by interventional cardiologists from higher-level hospitals(converse transport).Methods A total of 81 AMI patients received emergency PCI on the spot by interventional cardiologists from other higher-level hospitals (transported doctors)from Mar 2004 to Sep 2008 in our hospital.The mean age of patients was 68.6 ± 3.6 years (36.0-83.0 years).Forty-six patients were male and 35 were female.There were 56 cases with anterior myocardial infarction and 25 with inferior myocardial infarction(including 11 cases combined with right ventricular infarction).The average time from symptom onset to admission was 6.2 ± 1.8 hours(2.0-12.0hours).Results Three cases were transported to higher-level hospitals for CABG because of severe conditions.The other 78 cases received emergency PCI on the spot,among whom 66 cases received primary PCI.Another 12 cases received rescue PCI.Eight one stents were implanted in total into the infarcted arteries.One operation was failed because the balloon could not go through the lesion.The success.rate was 98.7％.Four patients occurred peri-operative cardiac adverse events and 2 cases died.Four cases died during the 32-86 months follow-up,of whom I was cardiac death and 3 was non-cardiac deaths.No fatal cardiovascular events occurred in the remained cases.Conclusion Emergency PCI on the spot by interventional cardiologists from other cities(converse transport PCI)in AMI is safe,feasible and effective.But it needs to be confirmed in a large-scale study in the future.

Objective To investigate the efficacy and safety ofQingre Huoxue Mixture in the treatment of blood heat type psoriasis vulgaris.Methods The patients were divided into treatment group and control group according to random number table method, with 52 cases in treatment group and 50 cases in the control group, 10 cases failed to complete the trial. Treatment group was givenQingre Huoxue Mixture, and the control group received oral administration of compoundQingdaiCapsule. The treatment lasted for 8 weeks. PASI score, TCM syndrome integrals, DLQI score, serum IFN-γ and IL-10 were detected, and hematuria routine and liver and kidney function were under safety testing before and after treatment.Results After treatment, PASI score, DLQI score and TCM syndrome integrals in the treatment group decreased significantly (P<0.001); the expression of serum IFN-γ decreased significantly (P<0.001); the expression of serum IL-10 increased significantly (P<0.001), with the total effective rate of 100% (52/52). After the treatment, TCM syndrome integrals in the both groups decreased significantly (P<0.001). After the treatment, the rash burning and itching scores in the treatment group were lower than the control group, with statistical significance (P<0.001). In terms of safety, the treatment group had no abnormal indicators.ConclusionQingre Huoxue Mixture has obvious curative effect, which can reduce the patients with psoriasis, improve the life quality of patients, and improve the clinical symptoms of rash burning and itching, reduce serum IFN-γ, and increase serum IL-10.

Objective To verify the antiviral effects of Siji Kangbingdu mixture (SJKBDM) against coxsackievirus A16 (CoxA16).Methods Vero cells and 5-day-old suckling mice, injected with 75/50 and 1×106 TCID50 CoxA16, were used as evaluation models.The preventive influences of SJKBDM against CoxA16 in Vero cells were assessed in the models.The effects of SJKBDM on the mortality, survival time, change rate of body weight, and clinical symptom scores of suckling mice were observed.Results ①The half maximal inhibitory concentration of SJKBDM on Vero cells was 9.59 mg·mL-1.②Toxic effects were not observed from 32.3 g·kg-1 single dose or continuous intraperitoneal injectin of SJKBDM in suckling BALB/c mice.③The SJKBDM had significant inhibitory effect against CoxA16 virus.Doses higher than 1.22 mg·mL-1 could significantly improve the Vero cell survival rate, and the SJKBDM inhibition of 75/50 TCID50 CoxA16 induced pathological changes in Vero cells.④The SJKBDM significantly improved clinical symptoms of mice with CoxA16 viral infection, especially with crude drug doses of higher than 1.62 g·kg-1.The survival rate and other indicators were comparable or slightly higher compared with ribavirin, and the clinical score was higher than that of ribavirin.Conclusion The SJKBDM has significant inhibitory effect on CoxA16 cell proliferation, significantly decreases death rate, and improves clinical symptoms of mice infected with CoxA16 virus.

Objective To analyze the clinicopathologic characteristics,treatment and prognosis of retinoblasto-ma without calcification.Methods The clinic and pathologic data of 20 cases of retinoblastoma without calcification were analyzed retrospectively.All the cases were selected from 710 cases of retinoblastoma archived in Beijing Tongren Hospital,Capital Medical University from April 2010 to April 2015.The inclusion criteria was no calcification on CT scan before treatment.The patients after enuclea-tion were diagnosed according to pathology;the patients without enu-cleation were diagnosed according to clinical manifestations,Retcam fundus,ophthalmic ultrasound and the reduction of tumor after chemotherapy.The clinical features,treatment and prognosis were summarized through statistical analysis of the 20 cases.The patients were followed -up through clinical reexamination and telephone calls.Results In this study,there were 14(70.0%)male and 6(30.0%)female patient′s;there were 19 cases(95.0%)less than 5 -year -old,14 cases (70.0%)less than 3 -year -old,1 case (5.0%)less than 1 -year -old.Eighteen cases (90.0%)were unilateral disease,and 2 cases (10.0%)were bilateral disease.According to international Intraocular Retinoblastoma Classification stage:4 cases (18.2%)in stage E ,17 cases (77.3%)in stage D ,1 case (4.5%)in stage C.Five cases (25.0%)were enucleated eyes,and pathology report was retinoblastoma.Nine cases (45.0%) were treated with pre -enucleation chemotherapy,and finally enucleated after poor tumor shrinkage or recurrence,and the pathology was retinoblastoma.Five cases (25.0%)without enucleation were stable.One case (5.0%)failed to follow -up owing to the patients irregular treatment.In 14 enucleation cases,histopathologic high risk factors could be found in 3 cases (21 .4%),and couldn′t be found in the other 11 cases (78.6%).In the cases that were not enuclea-ted,the tumor diminished in size or new calcification presented in the fundus examination,and in 12 cases,new calcifi-cation was pre-sented on follow -up CT scan.Follow -up failed in 1 case(5.0%),but follow -up was available for 19 cases,and among them 13 cases (68.4%)were disease -free survival and 6 cases (31 .6%)were alive with tumor. Conclusions Close attention should be paid to the untypical retinoblastoma with no calcification on CT scan through well -taken medical history and meticulous imaging examination,in order to give early diagnosis and therapy.

Objective To evaluate the role and technical advantages of CT in 125Ⅰseed implantation in the treatment of tumors. Methods CT-guided 125Ⅰ seed implantation in 45 cases of cancer patients treated 57 times in 51 lesions,CT were used to evaluate the progress of lesions after 125Ⅰ seed implantation 1,2,6 months. Results All procedures were once successful and the total effective rate was 74.5% without any serious complications. Fifty CT examinations immediately after implantation showed satisfactorily seeds distribution but seven cases less satisfactorily that include particles overlap,the location is too close to the lesion edge,the larger the radiation cold spots,etc. Follow-up CT reexamination in 1,2 and 6 months demonstrated that CT examinations showed satisfactorily seeds distribution but accurate seeds number,which could be solved by combined with MPR images and the positioning piece. Conclusions CT-guided 125Ⅰ seed implantation treatment of tumors was a safe,reliable and effective minimally invasive treatment. CT in the preoperative treatment of seed implants planning,precise intraoperative guidance,quality assurance and efficacy of postoperative assessment had a greater role and application advantages.