Objective:To explore diagnostic value of basic head-up tilt table test (HUT)and sublingual nitroglycerin head-up tilt table test (SNHUT)on vasovagal syncope (VVS).Methods:A total of 61 patients,who collapsed be-cause of unknown causes and were highly suspected as VVS,were regarded as VVS group,received HUT,and an-other 22 healthy subjects were regarded as healthy control group.Results:Among the 61 cases of VVS group,57 ca-ses were tilt test positive and the positive rate was 93.44%.Among them,there were 16 cases (26.23%)with posi-tive basic HUT and 41 cases (67.21%)with positive SNHUT.The 22 cases in healthy control group also received basic HUT and SNHUT,one case (4.54%)was basic HUT positive and three cases were SNHUT positive.Positive rates of SNHUT was higher than that of HUT,but there was no significant difference in VVS group (χ2 =0.175,P =0.683).Conclusion:HUT is a noninvasive,repeatable method easily accepted by patients for diagnosing VVS currently.It can elevate positive rate of test when combined with SNHUT.

Objective To explore the effect of radiofrequency catheter ablation( RFCA) on cardiac reverse remode-ling and improvement of life quality in cardiomyopathy patients with paroxysmal atrial fibrillation( PAF) . Methods 95 cardiomyopathy patients with PAF were enrolled in our study and divided into two groups. RFCA group:62 patients received circumferential pulmonary vein isolation, ( left ventricular end-diastolic ) LVEDD ≥55 mm (male), LVEDD ≥50 mm (female); Drug group:33 patients were treated with drug for controlling heart rate ( resting heart rate around 60~80 bpm, heart rate during daily activity <100 bpm) . 72 hours after admission or 6 months after surgery in RFCA group, when the heart rate returned to normal or 6 months after treatment in Drug group, Short-Form36(SF-36) was used to evaluate the quality of living in the patients respectively; transthoracic echocardiography was performed in sinus rhythm;LAD, LVEDD and LVEF of the patients were measured. Results in RFCA group, LAD and LVEDD of 62 patients reduced and LVEF increased in 6 months after surgery statisti-cally significant(P<0. 05). In Drug group, 6 months after treatment, LAD and LVEDD of 33 patients increased ( P<0. 05 ) , without significant change in LVEF. There was no statistical significance in psychological health, physical function and general health perceptions, but there was significant improvement in social function and phys-ical function,affective state, physical role and energy in both RFCA group and drug group (P<0. 05), and it was more obvious in RFCA group(P<0. 05). Conclusion RFCA can reverse cardiac structural remodeling via sinus rhythm maintenance and improve the quality of life in cardiomyopathy patients with PAF.

66 patients with sick sinus syndrome were enrolled in this study. All patients meeting the indications for dual chamber pacing were randomly divided into two groups: right atrial appendage(RAA) pacing group was made up of 36 patients and low atrial septal(LAS) pacing group was made up of 30 patients. Follow-up was 12 months. The incidence of atrial fibrillation(AF) was lower in LAS group(3. 3% ) compared with the RAA group(19. 4% );P wave dispersion in RAA group was significantly higher than that in the LAS group (P < 0. 01). After 3 months of the operation, left atrial volume index(LAVI) in RAA group was significantly larger than that in the LAS group. In LAS group compared with the RAA group P wave dispersion and LAVI were significantly lower after operation in sick sinus syndrome. LAS pacing was superior to RAA pacing in preventing new atrial fibrillation.

[Objective] Analyzing and summarizing the compatibility characters and the clinical applications of theAngle Medicinesof Aconite, in order to enlighten the modern applications. [Methods] According to the theories of classical prescriptions, arranging the compatibility characteristics and clinical applications of theAngle Medicinesof Aconite, there are three kinds ofAngle Medicines, including theAngles Medicineas independent prescriptions, theAngle Medicinesas the main part of prescriptions and theAngle Medicineas the combinations of prescriptions. At last, listing two cases of theAngle Medicinesof Aconite as the examples of clinical experience to demonstrate theAngle Medicines. [Results]This article sorted out 7 pairs ofAngle Medicinesof Aconite as the first kind, 8 pairsAngle Medicinesof Aconite as the second kind, and theAngle Medicinesof Aconite as combinations. In clinic, we use the Aconite, fried ginger and Licorice to treat long-term diarrhea, use Aconite, Semen Coicis and Patrinia to treat the hypogastralgia, and we gain the good effects, which can declare the clinical practicability of theAngle Medicines. [Conclusions]There are a lot of compatibility knowledge in classical prescriptions. Comprehending and grasping the compatibility characters and the clinical applications of the Angle Medicinesof Aconiteare is very unique and ingenious for modern clinic.

This paper studies the effect of personnality, motivation, environment, and professional skills on doctor's innovative ability,aimed to provide reference for personnel recruitment and assessment in tertiary hospitals and for improvement of doctors innovative ability. This research was based on a questionnaire that was conducted in 599 doctors from three tertiary hospitals in Guangzhou. The results indicate that four factors affect doctors' innovative ability with different degrees. Relevant measures are suggested

Objective:To establish an HPLC method for the determination of calcium disodium edetate in fosaprepitant dimeglu-mine for injection. Methods:The chromatographic column was Agilent Zorbax Eclipse XDB C18(250 mm ×4.6 mm,5μm). The mo-bile phase consisted of 0. 2% tetrabutylammonium hydroxide(adjusting pH to 4. 0 with phosphoric acid)-acetonitrile(85∶15). The flow rate was 1. 0 ml·min-1 . The detection wavelength was 254 nm. The chromatographic column temperature was 35℃. The injection volume was 20μl. Results:The calibration curve was linear within the range of 26. 06-104. 24μg·ml-1(r=0. 999 8) for calcium di-sodium edetate. The average recovery was 99. 51% (RSD=0. 25%, n=9). Conclusion: The method is simple, rapid, accurate, specific and reproducible, and can be used in the determination of calcium disodium edetate in fosaprepitant dimeglumine for injection.

Objective To explore the effect of azithromycin on the airway inflammation in children with bronchiolitis by detecting the se-rum concentration change of the eosinophile cationic protein(ECP),interleukin-8(IL-8) and nitrogen oxide(NO) in children.Methods One hundred and eighty-five cases of primary asthmatic attack with atopy subject were collected,and they were divided into 4 groups after asthmatic symptoms relived,group A oraled azithromycin,group B inhaled budesonide,group C oraled montelukast,and blank control was group D.The vein bloods were sampled on the first day in hospital,before and after medication,respectively when treatment of 3 months was completed.Serum concentration of ECP,IL-8 and NO were measured.They were followed up through clinic service and telephone analysis for 1 year.Analysis of all data was conduced with SPSS 15.0 sofware.Results The cases of asthma recurrence within 3 months and asthmatic recurrence within 1 year were no statistical difference between group A and group B,group C and group D,respectively.After 3 months intervention,there was significant difference of the serum concentration of ECP,IL-8 and NO at the 3 treatment groups compared with group D.There was no significant difference in decrease of ECP and NO in group A and group B,but decrease of ECP and NO in group C were significant compared with those in group A(Pa

OBJECTIVE:To observe clinical efficacy and safety of Kangfuxin liquid in the treatment of pediatric hand,foot and mouth disease. METHODS:128 children with hand,foot and mouth disease were randomly divided into observation group and control group,with 64 cases in each group. Control group was given routine treatment as herpes and oral care,antibiotics for infec-tive children reflected by hemogram elevation,fluid infusion and non-steroidal analgesic-antipyretic agent based on disease condi-tion. Observation group was additionally given Kangfuxin liquid,3 ml for below 3 year-old,tid and 5 ml for more than 3 year-old,tid. Clinical efficacy of 2 groups were observed as well as CRP,lactic acid,Ig,the level of myocardial enzyme before and after treatment;the time of symptoms and signs disappearance and ADR were compared between 2 groups after treatment. RE-SULTS:The total effective rate of observation group(89.06%)was significantly higher than that of control group(70.31%),with statistical significance(P<0.05). There was no statistical significance in CRP,lactic acid,Ig and myocardial enzyme before treat-ment and IgM level after treatment between 2 groups,with statistical significance(P>0.05). CRP,lactic acid creatine kinase and lactate dehydrogenase level of 2 groups decreased significantly,while IgA and IgG levels increased significantly,and the observa-tion group was higher than the control group,with statistical significance(P<0.05). Antipyretic time,hand foot skin rash subsided time and oral ulcer healing time of observation group were significantly shorter than those of control group,with statistical signifi-cance(P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:Kangfuxin liquid is effective in the treatment of hand,foot and mouth disease in children,and can effectively improve CRP,Ig,lactic acid,and myocardial enzyme level with good safety.

Objective To investigate the morbidity,clinical feature,diagnosis and therapy of ovarian disease in children.Methods Eighty-two children with ovarian disease were admitted and treated in Nanjing children's hospital from Jan.1992 to Jan.2007,were analyzed retrospectively with age,emergency admissions or not,dwell,pathology and method of operation.Results The age of 82 patients ranged from 1 day to 14 years old and the mean age was 6.7 years old.Thirty-one cases(37.8%) were emergency admissions and 51 cases(62.2%) were routine admissions.Twenty-seven cases(32.9%) were rural patients and 55 cases(67.1%) were urban patients.Forty-five cases(54.8%) were nontumorous disorder,31 cases(37.8%) were benign tumor and only 6 cases(7.4%) were malignant tumor.About the morbidity,12 patients(14.6%)were admitted from 1992 to 1996,24 patients(29.5%) from 1997 to 2001 and 46 patients(55.9%) from 2002 to 2007.Chemotherapy were carried out in 6 cases with malignant tumor in internal medicine,2 cases with sexual precosity kept observation,the others were cured.Conclusions Ovarian disease can occur at any age in children.The clinical manifestation is characterized mainly by acute abdomen.The incidence of ovarian disease of children in urban areas is higher than that children in rural areas.The morbidity continues to show an upward tendency and the pathologic manifestations are mostly benign,laparoscopic operation has obviously superiority.

Objective To investigate the expression of glucose-regulated protein 78(GRP78)and cysteine aspartic acid protease 12(Caspase-12) and evaluate the endoplasmic reticulum stress (ERS) in rats with contrast-induced nephropathy (CIN),and observe the protective effects of hydroxytyrosol on CIN rats.Methods Eighty-four Wistar rats,(220±20) g,were randomly divided into control group,CIN group,hydroxytyrosol treated group (group C+H).At 12th,24th,48th,72th day after the rats model were established,BUN and Scr were detected.ELISA were used to detect the expression of methane dicarboxylic aldehyde (MDA),superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px).HE staining were used to evaluate the pathological change of kidney.TUNEL were used to detect the apoptosis of tubular ceils.Real-time PCR were used to detect the expression of GRP78 mRNA and Caspase-12 mRNA in tubular cells.Immunohistochemistry and Western blotting were used to detect the expression of GRP78 and Caspase-12 protein in tubular cells.Results BUN,Scr,the mRNA and protein expression of GRP78,Caspase-12 in hydroxytyrosol treated group were higher than that in control group(P ＜ 0.05),but were significantly lower than that in CIN group (P ＜ 0.05).Pathological changes and the apoptosis of tubular cells in CIN group were more serious than that in hydroxytyrosol treated group (P ＜ 0.05).Conclusions Endoplasmic reticulum stress may be associated with contrast-induced nephropathy.Hydroxytyrosol can protect kidney from contrast medium via reducing the endoplasmic reticulum stress.