Objective The purpose of this study was to investigate the early outcome of radiofrequency ablation for the treatment of atri-al fibrillation (AF) during concomitant mitral valve replace procedures. Methods From January 2013 to September 2014,43 patients with mitral valvular disease with atrial fibrillation were enrolled in this study. The cases were classified into underwent mitral valve replace surgery concomitant with atrial fibrillation radiofrequency ablation ( RFA group) or underwent only mitral valve replace surgery ( control group) . Re-sults There was no perioperative death and stroke. RFA group’ s time of Cardiopulmonary bypass was more longer than control group. The comparison between RFA and control groups revealed no differences in terms of bleeding,24 hours’ Pleural fluid volume,the mechanical ven-tilation time and time in intensive care unit. One week after the operation,20 cases (87%) in RAF group were sinus rhythm while it was 6 cases(30%) in control group. After a follow-up of one month,RAF group had 78% remaind sinus rhythm while it was 25% in control group. Conclusion Radiofrequency ablation for the treatment of atrial fibrillation ( AF) during concomitant mitral valve replace is safe and effective.

Objective To examine plasma levels of protease C1 inhibitor (SERPING1) in adult patients with latent autoimmune diabetes (LADA), and their clinical significance thereof. Methods The levels of SERPING1 were detected and compared between LADA, type 1 diabetes (T1DM), type 2 diabetes (T2DM) and healthy control groups. The correlation between plasma levels of SERPING1 and other clinical indicators such as age, disease course, glycosylated hemoglobin (HbA1c), fasting blood glucose (FPG), 2 h postprandial plasma glucose (2 hPG), fasting c-peptide (FCP) and 2 h postprandi-al C peptide (2 hCP) was analyzed. Multi-factor regression analysis and receiver operating characteristic (ROC) were used to evaluate the predictive effect of SERPING1 in LADA at the early stage. Results The level of SERPING1 was significantly higher in LADA group than that of T2DM group and control group (P < 0.05). There was a negative correlation between SERPING1 and FCP, and a positive correlation between SERPING1 and HbA1c, FPG and 2 hPG (P<0.05). There were no significant correlation between SERPING1 and age, disease course and 2 hCP. FCP was analyzed by regression equation (P<0.05), and which was the main influence factor of the plasma level of SERPING1. The area under the ROC curve (AUC) of SERPING1 was 0.613 (P<0.05), 95%CI 0.514-0.712. The optimal cut-point of SERPING1 for early prediction of LADA was 289.71 mg/L, and the sensitivity and specificity were 69%and 48%respectively. Conclusion SERPING1 combined with other indicators will be useful for identifying LADA from T2DM at the early stage.

With the improvement of China's population aging and health care consciousness, female pelvic floor dysfunction gets increasing attention in society. Modern TCM scholars conclude TCM doctors’ theories about etiology and pathogenesis of pelvic floor dysfunction, summarized as debility of Chong Ren meridians and inability to lift, and then they advocated invigorating qi and elevating yang, with a purpose to protect pelvic floor stability. This article conducted relevant discussion on the significance of rehabilitation of pelvic floor dysfunction based on TCM adjusting qi activity.

AIM:To treat the chemotherapy-induced premature ovarian failure ( POF) rats with the methods of tonifying kidney yin and yang by observing the indicator changes in apoptosis of ovarian granulosa cells and related cyto -kines before and after medication .METHODS:SD rats ( n=36) were chronically given intraperitoneal injection of cyclo-phosphamide ( CTX) for 15 d in order to establish the animal model of POF .The rats were randomly divided into control group, CTX group, CTX+kidney yin group and CTX +kidney yang group.The levels of tumor necrosis factor alpha (TNF-α) and interferon gamma ( IFN-γ) in the peripheral blood were detected by ELISA .The apoptosis of ovarian granulosa cells was observed by TUNEL method .The levels of apoptosis related proteins were determined by Western blot .RE-SULTS:After modeling , the levels of TNF-αand IFN-γin the peripheral blood were significantly increased .The protein expression of Bax was up-regulated and Bcl-2 was down-regulated .The apoptosis of ovarian granulosa cells was significantly induced with a deep staining .After treatment with tonifying kidney yin and yang , the levels of TNF-αand IFN-γin the pe-ripheral blood were decreased , the protein expression of Bax was down-regulated and Bcl-2 was up-regulated, and the apop-tosis of ovarian granulosa cells was reduced .CONCLUSION:The reserve function of the ovarian can be recovered by pre-scriptions of tonifying the kidney yin and yang via regulating the expression of TNF -α, IFN-γ, Bax and Bcl-2, and inhibi-ting the apoptosis of ovarian granulosa cells .

Objective To find out evidence for the identification of the aerial roots of Ficus microcarpa Linn. f. and F. altissima Bl.. Methods The fresh aerial roots of the two kinds of plants were collected. The appearance traits were observed by stereoscopy. The velamen surface, cross section of root tip, cross section of the posterior root and powder of two kinds of aerial roots were observed under microscope. Results The number of aerial roots of F. microcarpa Linn. f. was more than that of F. altissima Bl., while the diameter was less than that of F. altissima Bl.. Differences were shown in primary xylems of the transverse section of root tip and posterior root of the two kinds of aerial roots, there were 5-7 vascular bundles in F. microcarpa Linn. f. and 7-10 vascular bundles in F. altissima Bl.. As for the powder, the powder of F. microcarpa Linn. f. was yellowish brown, while that of F. altissima Bl. was reddish brown; F. altissima Bl. had more fibers and longer diameter than F. microcarpa Linn. f. and had cluster crystals in order. Conclusion The appearance and microstructure features showed by the results can be used to distinguish the aerial roots of F. microcarpa Linn. f. and F. altissima Bl..

Objective To investigate the current situation of nurses' practice environment in tertiary general hospitals in Anhui Province,and to provide references for improving it.Methods The Nursing Work Index-Revised was used to investigate nurses from 35 tertiary general hospitals in Anhui Province.Results The mean score of Nursing Work Index-Revised was 64.79±26.07.The entry of hospital has a training program for newly recruited nurses,nurses in the work team are qualified for care received the highest score;the entry of the level of remuneration of nurses is appropriate in all sectors of society,nurses have the opportunity to participate in hospital internal management and nurses have the opportunity to participate in hospital management decisions got the lowest score.Whether a teaching hospital,the number of years of work,gender,education,department,title,age and whether recruited with authorized strength played important roles in nurses' practice environment.Conclusion The score for nurses practice environmental in Anhui Province was not high,and there were differences between regions.Hospital management mode and nurse salary distribution system need to be improved.Nursing managers should take appropriate measures to address existing problems and improve the nurses' practice environment according to different characteristics.

Objective To investigate the current status of healthcare-associated infection(HAI)and antimicrobial usage,so as to provide a scientific basis for improving the management of HAI. Methods A cross-sectional survey was conducted by combination of bedside visiting and medical records reviewing,HAI were investigated among all hospitalized patients between 0:00 and 24:00 on August 21 ,2014.Results A total of 2 216 patients were investiga-ted,the prevalence rate of HAI was 4.83% ,the case infection rate was 5.14% ;the main infection site was lower respiratory tract(63.16% ),antimicrobial usage rate was 39.71% ,the proportion of prophylactic and therapeutic use of antimicrobial agents was 32.27% and 61 .71% respectively.596 patients received therapeutic antimicrobial use,specimen detection rate was 56.21% (n= 335),the detection rate of pathogens was 15.52% (n= 52). The ma-jor detected bacteria were Pseudomonasaeruginosa,Klebsiellapneumoniae,Acinetobacterbaumannii,Escherichia coli,and Stenotrophomonasmaltophilia.Conclusion HAI prevalence survey is helpful for realizing the occurrence of HAI,respiratory tract is the main infection site,gram-negative bacteria is the major pathogen,management of prophylactic use of antimicrobial agents is the focus of HAI management.

Objective To observe the prevalence of hyperuricemia(HUA)among obese children,and to ex-plore the association between uric acid(UA)levels and cardiometabolic risk factors,acanthosis nigricans and non - al-cohol fatty liver disease(NAFLD). Methods By using representative sampling method,1 753 obese children aged 6 -17 years old from 18 schools in 3 districts of Beijing(Xicheng,Haidian,Miyun)were selected to participate in the clini-cal examinations,including anthropometric measurements(height,weight)and blood pressure. Serum biochemical pa-rameters were assessed,including fasting plasma glucose(FPG),total cholesterol(TC),triglyceride(TG),high - densi-ty lipoprotein cholesterol(HDL - C),low - density lipoprotein cholesterol(LDL - C)and UA. Acanthosis nigricans and B - model ultrasonography of the liver were conducted. Results The prevalence of hypertension,impaired fasting glu-cose,dyslipidemia,acanthosis nigricans,and NAFLD among these 1 753 obese children was 33. 6%(589 cases), 66. 5%(1 156 cases),54. 3%(943 cases),23. 3%(408 cases),and 17. 0%(298 cases),respectively. The preva-lence of HUA was 40. 70%(714 / 1 753 cases),with 50. 17%(581 / 1 158 cases)in boys and 22. 34%(133 / 595 ca-ses)in girls. There was a significant increase in body mass index,systolic blood pressure,diastolic blood pressure, FPG,TG and LDL - C with the increase of UA,but there was a decrease in HLD - C with the increase of UA(all P ﹤0. 05). In boys,the adjusted odds ratios( OR)and 95% CI of the highest quartile of UA for hypertension,impaired fasting glucose,dyslipidemia,acanthosis nigricans,and NAFLD were 1. 16(0. 77 - 1. 74),1. 34(0. 90 - 1. 99),1. 29 (0. 89 - 1. 87),1. 89(1. 17 - 3. 04),and 1. 71(1. 03 - 2. 84),respectively;in girls,the adjusted OR and 95% CI of the highest quartile of UA for hypertension,impaired fas-ting glucose,dyslipidemia,acanthosis nigricans,and NAFLD was 0. 70(0. 40 - 1. 24),0. 60(0. 40 - 1. 00),1. 69(1. 04 - 2. 70),1. 67(0. 80 - 3. 49),and 1. 33(0. 48 - 3. 66),re-spectively. Conclusions The prevalence of HUA is relatively high in obese children and there is a strong association between UA and some car-diovascular metabolic disorders,acanthosis nigricans and NAFLD.

BACKGROUND: Percutaneous vertebroplasty (PVP) is usually used for osteoporotic thoracolumbar fractures,which has various advantages such as easy to operate, short operation time, less trauma, rapid recovery,analgesic effect and so on. But its application is restricted due to nerve compression symptoms and pulmonary embolism caused by bone cement leakage. Thereafter, how to reduce the leakage of bone cement is an issue of concern.OBJECTIVE: To investigate the relationship between the lumbar quantitative computed tomography (QCT) values and contrast agent dispersion in osteoporotic thoracolumbar fractures. METHODS: Sixty cases of osteoporotic thoracolumbar fractures undergoing PVP were enrolled, and received QCT examination before surgery, and contrast agent was injected intraoperatively. X-ray examination was conducted to detect the bone mineral density, contrast agent dispersion and leakage of bone cement, and the relationship between the lumbar QCT values and contrast agent dispersion as well as leakage of bone cement.RESULTS AND CONCLUSION: (1) There were 110 vertebral fractures, and 74 vertebrae with contrast agent diffusing more than vertebral midline, accounting for 67.3%. There was significant difference in the contrast agent dispersion among groups (P < 0.05). (2) The bone cement leakage showed no significant difference among groups after injected with bone cement by unilateral or bilateral approach (P > 0.05). (3) These results suggest that contrast agent dispersion in osteoporotic thoracolumbar fractures has a certain relationship with the lumbar QCT values, and lumbar QCT values with more contrast agent dispersion, but the lumbar QCT values have no correlation with bone cement leakage. Therefore, choosing a appropriate approach based on the QCT values and contrast agent dispersion can reduce leakage and improve the safety of PVP.

Objective To explore the application of the model centering on organ system teaching in experimental diagnostics and evaluated its teaching effect.Methods A total of 185 clinical medical undergraduates of grade 2012 and 2013from School of Basic Medical Science in Tianjin Medical University joined the integrated curriculum of laboratory diagnostics for liver disease (abbreviated as integrated group).All of the teachers from varied professional fields were reconstituted into integrated teaching group.Training lecture was unified according to the new integrated teaching material.In order to make a contrast,180 clinical medical undergraduates of the grade 2010 and 2011 were involved in traditional laboratory diagnostics curriculum (abbreviated as traditional group).The results of terminal test of the integrated group and traditional group were analyzed with SPSS 21.0 software and Excel 2007.Glossary items,multiple choice,were indicated by scoring rate,and the objective items and subjective items total scores were indicted by real scores.Results Significant difference was found in the scoring rate of the glossary items,objective items,subjective items and the total scores between the two groups (P＜0.01).The records of students were [75.00％ (50.00％,100.00％)],(72.28 ± 22.63),(90.70 ± 22.36),(79.96 ± 18.59) in the integrated group and [66.67％ (33.33％,83.33％)],(61.43 ± 28.85),(72.92 ± 22.14),(69.10 ± 17.95) in the traditional group.The scoring rate in the integrated group was higher than that in the traditional group (P＜0.01).But the records of multiple choice were [100.00％ (0.00％,100.00％)] in the traditional group and [66.67％ (66.67％,100.00％)] in the integrated group.Conclusions The model centering on organ system teaching model is much more reliable and it may improve the teaching quality.