Through developing resident standardization training,we established programs of resident standardization training,defined training aims,standardized training items,and established guarantee system,evaluation system,quality-monitoring system and encouragement system,which guaranteed the quality of residency training,and acquired satisfactory effects.

Objective To investigate the change of plasma visfatin in patients with coronary heart disease and its clinical significance.Methods A total of 310 patients with coronary heart disease (ACS group:n =217; SAP group:n =93) and of 90 healthy subjects with a matched age and gender were included in this study.The plasma concentration of visfatin of each subject was measured using ELISA assay,and each patient underwent selective coronary angiography examination.A total of 85 cases of patients in CHD group underwent 64-slice CT coronary imaging to evaluate the main plaque within the coronary.Results The visfatin,LDL,BMI,blood glucose levels was significantly higher in CHD group[ ( 128.18 ± 13.86)ng/ml,(3.63 ± 1.48) mmol/L,( 26.18 ± 1.82) kg/m2,(7.25 ± 2.03 ) mmol/L] than in control group [ (75.96 ± 10.27 )ng/ml,(2.64 ± 0.53 ) mmol/L,( 23.51 ± 0.89 ) kg/m2,(5.11 ± 1.53 ) mmol/L,P ＜ 0.05 ],respectively.The visfatin level in the ACS group [ ( 145.57 ± 19.95 ) ng/ml ] was significantly higher than the SAP group [ (110.79 ±7.78)ng/ml,P ＜0.05].The visfatin concentration gradually increased with the aggravation of the complexity of coronary lesion types and severity of coronary lesions( P ＜ 0.05).The plasma visfatin concentrations in Soft plaque group and the fibrous plaque group were significantly higher than calcified plaque (P ＜ 0.05).HDL-C and Gensini score of coronary lesions were negatively correlated ( r =- 0.055,P ＜0.05) ; LDL-C,Glu,and visfatin was positively correlated with coronary lesions Gensini score ( r =0.464,0.279,0.531,P ＜ 0.05 ),respectively.Conclusions The plasma visfatin level in patients with Coronary heart disease increased and affected its lipid metabolism.It may be an important inflammatory factors promoting arterial atherosclerosis occurs and development,which has a certain value to the judgment of coronary lesions and plaque stability combined with 64-slice spiral CT examination.

Objective To analyze the characterization of cognitive function in Parkinson's disease with dementia and Alzheimer's disease. Methods Cognitive function was examined in Parkinson's disease with dementia (PDD) patients ( n = 30) , Alzheimer's disease (AD) patients ( n = 30) and healthy elderly control subjects ( n = 60) . Neuropsychological evaluation contained semantic fluency test, phonemic fluency test, action fluency test, objective and action naming tests. Results In PDD group , the score of semantic fluency test is 9. 33 ±2. 78, 6. 17 ± 1.67 of phonemic fluency test and 7.03 ±2. 34 of action fluency test,it is 6.90 ±2.47, 7.87±2.01,8.30±3. 17 of AD group. The score of objective and action naming tests is 36.33 ±3.39, 17.63 ±2. 17 in PDD group,while AD patients is 33.23 ±3.56 and 22.33 ±2.37. The verbal fluency tests and naming tests were impaired in PDD and AD patients compared with the healthy elderly control group (P ＜ 0. 01 ), phonemic fluency, action fluency and action naming were more impaired in PDD patients compared with the AD group , while semantic fluency and objective naming were more impaired in AD patients (P ＜ 0. 01 ). Conclusions Executive function deficit and naming impairment are found in PDD and AD patients, it shows that PDD is characterized by the addition of cortical dysfunction upon a predominant and progressive fronto-subcortical impairment. There is subcortical dysfunction in AD patients.

Objective To determine the prevalence of microembolic signals (MES) by using transcranial Doppler (TCD) and to assess their association with neuropsychiatric systemic lupus erythematosus (NPSLE) and clinical presentations in patients with systemic lupus erythematosus (SLE).Methods Forty-four patients with SLE underwent TCD for 30 min were included for MES detection and their clinical information were recorded.In addition to the frequency of patients with MES,patients with MES were followed-up for sixmonth.Mann-Whitney U test and Fisher exact test were applied to investigate the clinical characteristics.Results There were 4 patients with history of NPSLE and the occurrence times were from 8 to 120 month before our study.There were 4 patients had the abnormal neuropsychiatric symptom during our study period.MES were detected in 5/44 patients (11％) with mean 17.6 per 30 min.MES were more prone to be detected in patients with higher systemic lupus erythematosus disease activity index (SLEDAI) score [16(12.5,19) vs 8(5,10),U=14.5,P=0.001],shorter course of disease [1(0.1,48.5) vs 26(13,55),U=38,P=0.028] and neuropsychiatric symptoms [3 vs 1,P=0.003].Conclusion MES may be detected in SLE patients.MES is associated with higher disease activity,shorter course of disease and NPSLE.TCD microemboli detection may be a noninvasive method to evaluate NPSLE patients.

Objective To analyze the research focuses and frontiers of exercise intervention on breast cancer patients. Methods We collected 7134 pieces of literature about exercise intervention on breast cancer in the Web of Science Core Collection database in recent five years, and CiteSpaceⅤ was used to conduct visual knowledge map analysis and generate a visual map including discipline distribution, country or region distribution, keyword co-occurrence or highlighting, keyword timeline maps, etc. Results In recent years, the domain of exercise intervention on breast cancer has achieved rapid development. The disciplines were mainly cardiovascular system and cardiology as well as oncology. Countries such as the United States, the United Kingdom and Italy ranked in the first places with regard to the number of papers. The body mass index and the quality of life betweeness centrality were respectively 0.81 and 0.52, which played an important role in the knowledge map. The keyword highlighting map and the timeline map showed that cardiac toxicity was a research focus in this domain. Conclusion The research focuses of exercise intervention on breast cancer are mainly cardiovascular and related fields, in a rapid development stage. Future research directions include weight control, quality of life and cardiac toxicity.

Objective To introduce a method of functional reparation for cleft lip with mini-approach.Methods We designed triangle flap in junctional zone between skin and mucosa,combined with intraoral incision approach,by means of repairing the orbicularis oris muscle,to obtain the reconstruction of labial arch,philtrum column and nasal wing.Results All cases in this study obtained perfect healing,with good augmentation at floor of the nose.Eight cases presented with good looking of philtrum and improvement in the shape of nostril.Conclusions Use of the method of functional reparation for cleft lip with mini-approach can decrease scar on skin,and hence decrease the contraction deform,as well as nice reconstruction of labial arch,philtrum column and nasal wing.

Objective To investigate the risk factors related to progressive intracranial hemorrhage (PIH) in patients with acute traumatic brain injury (TBI) and analyze their clinical significance.Methods PIH was validated by comparing the initial and repeated CT scans. Data including gender,age, injury causes, Glasgow Coma Score (GCS) on admission, time interval from injury to the first CT scan, initial CT scan manifestations, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fg), thrombin time (TT), platelet (PLT) and D-dimer (D-D) in both groups were compared with Logistic regression analysis to observe the risk factors related to PIH. Results The study involved 498 patients with acute TBI, of which 139 (27.91%) patients suffered from PIH. There were 116 patients (83.45%) with PIH who received the initial CT scan within two hours post injury.There was statistical difference in aspects of age, GCS on admission, time interval from injury to the first CT scan, initial CT scan manifestations ( including fractures, subarachnoid hematoma, contusion and onset hematoma), PT, Fg and D-D values in both groups (P ＜0.01 ). Logistic regression analysis showed that CT scans (subarachnoid hemorrhage, brain contusion and primary hematoma) and plasma D-D values were predictors of PIH ( P ＜ 0.01 ). Conclusions For patients with the initial CT scan manifestations including subarachnoid hemorrhage, brain contusion, primary hematoma together with D-D value increase within two hours post injury, a continuous CT scan should be performed promptly to detect PIH early.

Procedure of a bioelectric signal collection system for vivo critter is introduced in this paper. It is easy to measure the bioimpedance in the tip of appliance, when puncture into the tissue, especially puncture into the bone tissue. We can get a judgment on the position of appliance, thereby achieve assistance on the clinic operation.
Biopsy, Needle ; instrumentation ; Bone and Bones ; physiology ; Electrophysiological Phenomena ; Equipment Design ; Specimen Handling ; instrumentation

Objective To evaluate the effects of sodium-glucose cotransporter 2 ( SGLT2) inhibitors on the stroke risk for patients with type 2 diabetes mellitus (T2DM). Methods A systemic meta-analysis including 30 random control trails ( RCTs) was performed to compare the risk of stroke between type 2 diabetic patients treated with SGLT2 inhibitors and control drugs. Then their bias risk and quality were assessed and meta-analysis was conducted using Stata12.0 software. Results Thirty RCTs enrolling 74456 participants were selected for meta-analysis. The stroke incidence in the group receiving SGLT2 inhibitor monotherapy or combination therapy did not significantly differ from that in control group, with relative risk (RR) 1.01 (95％CI 0.93-1.10, P=0.978) and 1.00 (95％CI 0.92-1.09, P=0. 874 ) , respectively. Three SGLT2 inhibitors canagliflozin, dapagliflozin, and empagliflozin did not increase the risk of stroke, with similar RR values ( RR=0.91, 0.99, 1.13, respectively) . Subgroup analyses showed that there was no correlation between SGLT2 inhibitors and stroke risk in different gender, age, diabetes duration, body mass index, or HbA1C levels. Conclusions Whether administered as monotherapy or add-on therapy, SGLT2 inhibitors did not increase stroke incidence, and there were no significant within-class differences.

Objective    To evaluate the efficacy of a combination of beating-heart minimally invasive approach and leaflets augmentation technique treating severe tricuspid regurgitation (TR) after cardiac surgery. Methods    From January 2015 to August 2017, patients undergoing reoperative tricuspid valve repair (TVP) with minimally invasive approach and leaflets augmentation were enrolled. Cardiopulmonary bypass (CPB) was established via femoral vessels and the procedures were performed on beating heart with normothermic CPB. A bovine pericardial patch was sutured to leaflets to augment the native anterior and posterior leaflets. Other repair techniques, such as ring implantation and leaflet mobilization, were also applied as needed. Results    A total of 28 patients (mean age 55.6±10.1 years, 5 males, 23 females) were enrolled. One patient was converted to median sternotomy due to pleural cavity adhesion. Twenty-seven patients underwent totally endoscopic TVP with leaflets augmentation. No patients was transferred to tricuspid valve replacement. Two patients died in hospital. All patients were followed up for 7.4±5.0 months and there was no late death and reoperation. Regurgitation area was converted from 20.7±10.1 cm2 to 3.3±3.3 cm2 after TVP according to the latest echocardiography (P<0.001). Conclusion    Minimally TVP with leaflets augmentation is effective in treating severe isolated TR after primary cardiac surgery. It can significantly increase success rate of tricuspid valvuloplasty and decrease the surgical trauma.