Objective To investigate the efficacy and safety of carvedilol in patients with chronic heart failure (CHF).Methods Forty-six patients with CHF were randomly divided into carvedilol group (n=26) and control group (n=20) on the basis of standard therapy including digitalis, diuretics and ACEI. Before and after treatment, NYHA class, echocardiography and adverse reaction were observed. Results The mean dose of carvedilol was titrated to 25.14?3.05mg/day. After treatment, NYHA class was improved in both groups. Left ventricular end-diastolic diameter (LVEDD) measured by echocardiography reduced [(58.79?8.99)mm vs (64.68?10.12) mm,P

Objective To investigate clinical effect and safety of ostium secundum atrial septal defect(ASD) treatment via one -stop hybrid and classical surgical procedures.Methods 45 patients were diagnosed ostium secun-dum simple ASD by ultrasound cardiogram and clinical manifestation,they were divided into one -stop hybrid proce-dure group (n =20)and classical surgical procedure (n =25).Age,gender,weight,post operation hospital day,on -pump time,blood transfusion amount,drainage flow,incision length and incidence of complication between the two groups were compared.Results Age and weight had no difference between the two groups(t =0.40 and 1.64,P >0.05),but the proportion of female cases in one -stop hybrid procedure group was higher than post operation(χ2 =9.45,P <0.05).Hospital day was shorter(t =11.11,P <0.05),drainage amount was fewer(t =81.68,P <0.05), incision length(t =22.51,P <0.05)was shorter.Incidence of complication had no statistically significant difference between the two groups(χ2 =0.35,P >0.05).And one -stop hybrid procedure group was off -pump without blood transfusion.Conclusion One -stop hybrid procedure was simple,could make a quick recovery post operation and was an ideal method for ostium secundum ASD treatment.

Multimedia teaching and SimMan,which is a portable and advanced patient simulator for team training,were used to develop a new course for the medical students of grade four. This course was named "SimMan clinical techniques training". The course of Sim-Man clinical techniques training can help students comprehend truly all kinds of cases in clinical practices,improve their capabilities of clinical thoughts and clinical techniques,and it makes fine basis for their clinical practices in the hospitals.

Objective To study the safety and efficacy of transhepatic arterial infusion embolization using microspheres combined with lipiodol for treatment of hepatocellular carcinoma(HCC).Methods Transhepatic arterial chemoembolization(TACE)was performed with 1-2 ml 300-500?m mierospheres and 10-20 ml lipiodol for treatment of HCC.Changes of liver function,AFP,responses of tumor and complications related to embolization were analyzed before and after TACE.Results Thirty six patients with HCC were enrolled into this study.After TACE,patients' liver function got worsen and tumor size decreased significantly(P＜0.05).Conclusion TACE with use of microspheres combined with lipiodol is an effective treatment for HCC,but should be taken carefully to avoid hepatic failure.

Objective To observe the early outcome and crisis onset after surgical treatment on myasthenia gravis with thymoma and analyze the relevant factors.Methods 436 patients with myasthenia gravis were treated surgically between January 1999 and Jan- uary 2005,58 patients with thymoma.The severity of MG disease was classified according to modified Osserman classification:type Ⅰ(n=17),type Ⅱ a(n=23),type Ⅱ b(n=12)and type Ⅲ(n=6).The distribution of thymomas by the Masaoka clinical stage showed 30 in stage Ⅰ,18 in stage Ⅱ,7 in stage Ⅲ and 3 in stage Ⅳ.The early outcome and crisis onset after surgical treat- ment were analyzed by statistical methods.Results After operation,symptoms improved in 16 eases(27.59%),no change in 18 eases(31.03%),deterioration in 11 cases(18.97%)and crisis onset or death in 13 cases.Logistic test showed that the possibility of crisis onset in patients with thymoma is 1.286 times higher than patients without thymoma.Patients with thymoma,type Ⅱ or above are in high risk group of crisis.The incidence rate of crsis in type Ⅱ group or above was significantly higher than type Ⅰ(P=0.048 0.05).Conclusion The risk of crsis onset after operation significantly raises in myasthenia gravis patients with thymoma.The staging of the disease are associated to development of crisis and crisis onset is independents to patho-staging of thymoma.

Objective To measure the phase values of the deep gray nuclei by using susceptibility weighted imaging(SWI) in underage brains,and to investigate the correlation between the phase value and age.Methods A total of 105 healthy juveniles were examined in this study by using MRI conventional sequence and SWI.Their ages ranged from 0 to 18 years(0-＜ 1 year,60 cases; 1-＜3 years,10 cases; 3-7 years,10 cases; 7-12 years,10 cases; 12-18 years,15 cases).Phase values of deep gray nuclei were measured.The correlation between phase value and age was analyzed by Spearman correlation method.Results During 0-3 years,the phase value of caudate nucleus was the lowest within the same age group (0-＜ 1 year:left-0.0433 ± 0.0291,right-0.0369 ± 0.0215 ; 1-＜ 3 years:left-0.0369 ± 0.0215,right-0.0384 ± 0.0259),whereas the phase value of red nucleus was the highest (0-＜ 1 year:left 0.0286-0.0380,right 0.0254 ±0.0361 ; 1-＜3 years:left 0.0325 ±0.0237,right 0.0395 ±0.0270).After 3 years old,the phase value of globus pallidus was the lowest within the same age group (3-＜7 years:left-0.0967 ± 0.0656,right-0.0953 ± 0.0617; 7-＜ 12 years:left-0.1870 ± 0.0531,right-0.1724 ±0.0547; 12-＜ 18 years:left-0.2037 ±0.0492,right-0.1849-±0.0324),whereas the phase value of thalamus was the highest (3-＜ 7 years:left-0.0019 ± 0.0225,right -0.0007 ± 0.0167 ; 7-＜ 12 years:left-0.0067 ± 0.0104,right-0.0064 ± 0.0118 ; 12-＜ 18 years:left-0.0204 ± 0.0181,right-0.0172 ± 0.0133).During 0-18 years,a moderate negative correlation between phase values of bilateral caudate nucleus,globus pallidus,red nucleus,substantia nigra and age were observed (rs =-0.483,-0.497,-0.67,-0.621,-0.489,-0.43,-0.552,-0.58 respectively) A low negative correlation between phase values of bilateral putamen,thalamus and age were observed (rs =-0.272,-0.213,-0.382,-0.366 respectively).Conclusions There is a negative correlation between phase value and age in the deep gray nuclei of underage brains.And the phase value may be a useful index in the diagnosis of iron deposition related diseases.

Objective To observe erythropoietin (EPO) and its mRNA expression changes in rats cortical neurons when suffering hypoxia and investigate the endogenous EPO protective effect of hypoxia neuronal cells.Methods Cultured cortical neurons were prepared from hypoxia rats and divided into control,hypoxia 12,24,48,72 h group.Using immunohistochemistry,reverse transcriptase polymerase chain reaction (RT-PCR) and Western blot,we observed EPO and its mRNA expression in cells,and also observe the culture medium containing lactate dehydrogenase to evaluate the activity of neurons in the whole process.Results Immunohistochemistry,RT-PCR and Western blot analysis showed:the EPO (20.79 ± 2.98) and its mRNA (0.78 ± 0.05) at 12 h had a basic expression in hypoxia group,compared with the control group (EPO:17.12 ± 1.99; mRNA:0.39 ± 0.05),and the difference was statistically significant (t =2.51,P ＜ 0.05 ; t =13.51,P ＜ 0.01) ; the strongest expression was observed at 48 h (EPO:28.88 ± 3.41,mRNA:1.45 ± 0.07),the difference was statistically significant (t =7.29,P ＜ 0.01 ; t =33.24,P ＜ 0.01) ; and neuronal activity was strongest.Lactate dehydrogenase activity was significantly decreased after hypoxia 72 h,and also a statistically significant difference was found between the groups at each point.Conclusions The EPO and EPO mRNA expression are increased after hypoxia in neuron cells,and may enhance the activity of neurons.Our study suggests that EPO might be involved in the development process of neuronal hypoxia and play an important role in neuronal hypoxia process.

Objective To observe the influence of nursing intervention on postpartum depression and breastfeeding compliance in primipara.Methods From August 2013 to April 2015,146 women received cesarean section in North Jiaochang Branch of Hanzhong Central Hospital were randomly divided into intervention group and control group with 73 cases in each group.The control group was treated with routine nursing measures,and the intervention group with both routine care and nursing intervention.Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) were used to evaluate the negative emotions of maternal postpartum.Breastfeeding Self-Efficacy Scale (BSES) were used to evaluate the confidence of maternal breast feeding.The breast feeding compliance between the two groups was compared.The breast feeding rates of the two groups were compared in 1 week and 1 month after discharge.Results Compared with the control group,the SDS and SAS scores of the intervention group were significantly lower (P＜0.05).The breastfeeding confidence of the intervention group was significantly better than the control group and the difference was statistically significant (P＜0.05).The compliance of breast feeding of the intervention group was 97.26％ significantly higher than that of the control group (78.08％)with a statistically significant difference (P＜0.05).After one-week and one-month follow-up,the rate of breastfeeding of the intervention group was significantly higher than that of the control group (95.89％ VS 83.56％;91.78％ VS 72.60％,P＜0.05).Concltsion The nursing intervention measures for primipara after cesarean section can significantly break bad mood,enhance maternal breastfeeding confidence,increase the rate of breastfeeding compliance and are worthy of promotion.

OBJECTIVE:To investigate the efficacy and safety of carvedilol in patients with chronic heart failure(CHF). METHODS:46patients with CHF were randomly divided into carvedilol group(n=26)and control group(n=20),thareinto,standard therapeutic scheme is used in control group,standard therapeutic scheme+carvedilol is used in carve diol greup.The treatment courses were6months in both groups.RESULTS:Left ventricular end-diastolic diameter(LVEDD)reduced and left ventricular ejection fraction(LVEF)increased in carvedilol group with significant difference comparing with control group(P

By means of comparing biomasses of biodegradation fungi,Fusarium sp.HG-P-01 for ?-cypermethrin,a synthetic pyrethroid insecticide used widely in China,in five different media,the Czapek-Dox medium was selected as the best medium for mycelia growth.Furthermore,an experiment of central composite rotatable design(CCRD) was used to optimize the content of nutrient components.The optimal composition of C,N and P in media for HG-P-01 were 20.94 g/L,1.82 g/L and 1.66 g/L,respec-tively,in which an expectant or real rate of ?-cypermethrin-degradation got to 96.34% or 93.78% by HPLC for a concentration of 50 mg/L after 24 h treatment.The predicted value in degradation rate model was con-sistent with that from HPLC method.