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

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 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.

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 evaluate the protective effect of aminophylline on myocardium in the patients undergoing prothetic valve replacement operation of heart.Mothods Thirty patients undergoing prothetic valve replacement operation of heart were randomized to be treated either with aminophylline(n=15)or without aminophylline treatment(n=15). Aminophylline(5mg/kg)was injected intravenously at 15 minutes after induction of anesthesia.Cardiac troponin I(cTnI), cyclic adenosine monophosphate(cAMP),myeloperoxidase(MPO),ratio of aortic blood neutrophil count to coronary vein sinus blood neutrophil count,hemodynamics,time of aortic cress-clamping and other clinical data were recorded during the operation.Results There were no differences between the two groups in the major perioperative variables.Plasm cTnI concentration in both groups increased after off-clamping than that before CPB,however,it was lower in aminophylline group than that in control group.Concentration of cAMP in both groups after off-clamping was lower than that before CPB, however cAMP concentration in aminophylline group after off-clamping was higher than that in control group.Myocardial MPO activity and neutrophil count ratio after aortic off-clamping in aminophylline group was significantly lower than that in control group.Conclusion These results suggest that aminophylline is helpful to unprotection of myocardial and decreases the sequestration of neutrophil in myocardium.The mechanism of the protection may be related to the cAMP increased in myocardium.

In this study, nattokinase gene was amplified by PCR using bacillus subtilis chromosomal DNA as template and cloned into expressed vector pBV220. After transforming recombinant plasmid into E.coli HB101, the recombinant strain was yielded. It was proved that expression products was secretive and expression protein was 12% of total cell protein by SDS-PAGE. Optimum culture time and inducing time was determined as 6h and 5h respectively. The plasmid stability studies showed that recombinant plasmid has excellent segregational stability but the structural stability was not good in the host cell.

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.

Objective To evaluate the efficacy and safety of ESHAP regimen,as a salvage regimen, in treating patients with relapsed or refractory aggressive NHL.Methods 38 patients with relapsed or refrac- tory aggressive NHL were selected to be treated by ESHAP regimen.Results The 38 patients received ES- HAP regimen with a range of 2～6 cycles. The total RR was 55.3 % with complete response(CR)rate of 26.3 %.The major toxicity was myelosuppression with infection,which was tolerable.Conclusion ESHAP regimen is one of safe and effective salvage regimens for the patients with relapsed or refractory aggressive NHL.

Objective To evaluate the value of iterative modal reconstruction (IMR) for reducing radiation dose and controlling image quality in cardiac CT. Methods Ten pigs were included. All pigs were scanned on a 256?slice prospectively ECG?gated cardiac CT utilizing routine dose (group A) and tube current reduced by 30%(group B), 50%(group C) and 70%(group D), respectively. Filtered back projection (FBP), hybrid iterative reconstruction (iDose4) and IMR were used for all data, respectively. Image noise and contrast?to?noise ratio (CNR) of ascending aortic root were measured, while overall image quality and coronary artery image quality was rated (five point scale). All results reconstructed by FBP, iDose 4 and IMR were compared. Objective measurements were compared with one?way analysis of variance, and subjective assessments were compared with Kruskal?Wallis H test andχ2 test. Results Compared with that of FBP and iDose4, image noise of IMR was(15.1 ± 6.1),(18.8 ± 5.5),(22.1 ± 4.8)and(33.0 ± 4.0)HU, respectively in group A, B, C and D with significant reduction (F=82.77, 90.71, 96.59, 95.51 respectively, all P<0.01). Using IMR, groups A, B, C, D had higher CNR (42.0±11.1, 37.2±10.4, 31.4±8.7, 23.7±7.0;F=50.65, 53.55, 76.60, 57.36, all P<0.01) and overall image quality (5.0 ± 0.0, 4.8 ± 0.4, 4.6 ± 0.5, 4.5 ± 0.5;H=20.96, 15.63, 18.66, 23.56, all P<0.01) than FBP and iDose4. Using IMR, group A (100%, 40/40) and group B (100%, 40/40) had no significant difference (P>0.05) in the diagnosis rates of proximal coronary arteries compared with that using FBP and iDose4, while group C (100%, 40/40) and group D(92%, 37/40) had significantly increased diagnosis rates (χ2=20.05, 45.72, both P<0.01). The diagnosis rates of distal coronary arteries of IMR reconstruction which were 100%(50/50), 98%(49/50), 90%(45/50), 78%(39/50), respectively in groups A, B, C, D had significant increase compared with that of FBP and iDose4 reconstruction (χ2=7.39, 16.75, 34.62, 81.33, all P<0.05). Conclusions IMR can significantly reduce image noise, improve CNR and image quality compared with iDose4. Application of IMR can reduce radiation dose but without compromising image quality.