Objective To assess the feasibility and the reliability of emergency temporary cardiac pacing under fluoroscopy and nofluoroscopy,and compare to the superiority and inferiority between two groups.Methods Fifty-seven patients were temporarily paced under fluoroscopy and nofluoroscopy by the way which the common bi-pole temporary endocardium pacing electrode was introduced into the right ventricle by the bi-subclavian vein and right internal jugular.Result Twenty-six patients were successfully paced under fluoroscopy,and 27 patients of 31 were successfully paced without fluoroscopy,the other 4 patients were not paced successfully.Besides,there was no any complication in all patients.Conclusion Emergency temporary cardiac pacing without fluoroscopy is utility,saving time and safety,Compared to other method,the effect is proximity and even superior than the way under fluoroscopy.The way of the emergency temporary cardiac pacing without fluoroscopy is applied widespreadly in the work of clinical first aid.

To study the status and patterns of the drug utilization in the diseases of lower respiratory tract, the drug utilization for 290 inpatients with respiratory tract diseases in a Shanghai hospital druing 1993-1997 was analyzed by using Acute Physiology, Age, Chronic Health Evaluation(APACHE) and index of defined daily dose numbers(DDDs). The relativity between APACHE and DDDs was studied. It was found that most common drugs was anti-infection agents and expectorants, accounting for 39.06% and 38.38 %, respectively. The quantitative relationship between drug consumption and disease severity was not observed. It is concluded that the status of the drug utilization can't be demonstrated by analyzing the frequency of drug use by using DDDs.

Objective To evaluate the association between hyperglycaemia at admission and in-hospital outcomes in acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI). Methods Three hundreds and fifty-four patients with AMI and underwent PCI were divided into 3 groups according to the glucose level on admission: group A (n=132), ＜7.80 mmol/L;group B (n=120), 7.80-11.00 mmol/L;group C (n=102), ≥11.00 mmol/L. Results Patients in group C had higher cholesterol, low-density lipoprotein and triglycerides levels than those in group A. Compared with group A, there were higher incidence of multi-vascular diseases and higher corrected TIMI frame count (CTFC) in angiography in group B and group C. Cardiac events and in-hospital mortality in group B and group C were higher than those of group A, while statistical difference was found between group C and group A. Conclusion Elevated admission glucose level in AMI patients with primary PCI is associated with worse prognosis, increased major adverse cardiac events and higher in-hospital mortality.

Objective To check the teaching effect of whole English presentation for surgery course.Methods Totally 29 eight-year program clinical majors were enrolled in the study.Questionnaire after class was conducted.Relationship between understanding level and English ability of students,abroad experiences,presentation ability or technical title of teachers was analyzed by x-test and nonparametric test.Results It showed that the understanding level of students was higher when being taught by teachers with longer abroad experience or with quality course (P =0.00).Understanding level of students was higher when students had higher English ability (P =0.00).There was no obvious relationships between understanding level and technical title of teachers (P =0.10).Conclusions Teaching effect of whole English presentation is closely correlated with teachers' teaching ability and students' English ability.

Objective Tocheck and evaluate on clinical practice teaching files for providing a foundation of improved clinical teaching levels with enhanced establishment of practice teaching files. Methods The practice teaching files of eighteen clinical departments in a military medical university were selected as the subject and were evenly divided into teaching plans and teaching records as well as teach-ing summary three parts and 15 items. Each item had 2 scores in which quantity had one score and quality has another one. Evaluation results were converted into 100 points system. Results Among practice teach-ing files of eighteen clinical departments, 4 scored more than 90, 8 scored between 80 to 89, 3 scored between 70 to 79, 3 scored between 60 to 69. Three advanced departments are obstetrics and gynecology, auxiliary department and emergency department. There were no significant differences in the scores of major surgery and internal medicine. Compared with that of other departments in the hospital, the specialty of hospital had low scores. It showed that most of the clinical practice of the file information was relatively sound with complete records and some departments had missing items or incomplete and non-standard doc-umentation records. Conclusion Qualitative study on practice teaching files can reflect clinical practice teaching quality. And it is meaningful for us to enhance teaching files construction and to improve clinical practice teaching levels.

Objective:To investigate the effect of miR-214 targeting sex determining region Y-box 4 (SOX4) on the proliferation and apoptosis of rheumatoid arthritis (RA) synovial fibroblasts.Methods:Synovial tissue samples from 45 patients with rheumatoid arthritis and 30 patients with joint trauma who underwent joint replacement surgery from 2017 to 2019 in Shangqiu First People's Hospital samples were collected. The expression levels of miR-214 and SOX4 in synovial tissues were detected by real time quantitative polymerase chain reaction (RT-qPCR); The expression levels of serum rheumatoid factor (RF) and C-reactive protein (CRP) were detected by enzyme-linked immunosorbent assay (ELISA) test. The correlation between miR-214 or SOX4 and RF, CRP, erythrocyte sedimentation rate (ESR) was tested by Pearson's analysis. Human fibroblast-like synoviocytes (HFLS)-RA cells were derived from the control group, miR-214 mimic group, mimic-NC group and miR-214 mimic+pcDNA3.1-SOX4 group and se-parated by Lipofectamine 3 000. The cell viability of each group was detected by CCK8, the apoptosis of each group was detected by flow cytometry, the target relationship was verified by dual luciferase experiment, Western-blot was used to detect the protein expression levels of related indicators. Independent sample t test was used for the comparison between the two groups, one-way nalysis of variance (ANOVA) was used for multi-group comparison, and LSD- t test was used for the comparison between the two groups. Results:Compared with the control group (4.6±0.7, 1.9±0.7) and HFLS cells (1.00±0.06, 1.00±0.09), miR-214 was expressed lower in RA tissues (2.6±0.9) and HFLS-RA (0.30±0.05) ( t=10.026, P<0.05; t=15.815, P<0.05). Compared with SOX4 was highly expressed in RA tissues (4.6±0.9) and HFLS-RA cells (3.89±0.41) ( t=14.772, P<0.05; t=12.020, P<0.05). Serum RF, ESR and CRP expression levels in RA group [(46±7) U/ml, (46.4±9.6) mm/1 h, (34.8±9.8) mg/ml] were signifi-cantly higherthan those in the control group [(16±4) U/ml, (9.2±2.0) mm/1 h, (2.1±0.7) mg/ml] ( t=22.906, P<0.05; t=25.338, P<0.05; t=22.314, P<0.05). miR-214 was negatively correlated with serum RF, CRP and ESR was negatively correlated with miRNA( r=-0.574, P<0.05; r=-0.448, P<0.05; r=-0.549, P<0.05), while was positively correlated with SOX4 ( r=0.492, P<0.05; r=0.369, P<0.05; r=0.325, P<0.05). Compared with the control group and the mimic-NC group, cell viability, Ki-67 and p-p65 protein expression decreased significantly after miR-214 mimic transfection for 24 h ( F24 h=16.980, P<0.05;, F48 h=42.735, P<0.05; F72 h=164.448, P<0.05; FKi-67=290.112, P<0.05; Fp-p65/p65=223.548, P<0.05), while the apoptosis rate and Bax protein expression increased significantly ( F=344.360, P<0.05; F=106.376, P<0.05). Overexpression of SOX4, reverses the effect of miR-214. Conclusion:miR-214 targets SOX4 to inhibit the proliferation of synovial fibroblasts and promote apoptosis in rheumatoid arthritis. This may relate to the inhibition of NF-κB signaling pathway by miR-214.

The blood compatibility of block copolymer membranes of poly(benzyl L-glutamate)/poly(ethylene glycol) and the effect of on the blood compatibility of copolymer were evaluated by the clotting time test, the platelet adhesion and deformation test, and the protein adsorption test. The results showed that in terms of blood compatibility, homopolymer was better than glass and silicone, copolymer was better than homopolymer, and the more the PEG in the copolymer, the better the blood compatibility.
Biocompatible Materials ; Drug Carriers ; Materials Testing ; Platelet Adhesiveness ; drug effects ; Polyethylene Glycols ; chemical synthesis ; chemistry ; Polyglutamic Acid ; analogs & derivatives ; chemical synthesis ; chemistry ; Polymers ; chemical synthesis ; chemistry

OBJECTIVETo present a special case with the karyotype and molecular marker of acute myeloid leukemia (AML)-M2 who was induced to complete remission by all-trans retinoic acid (ATRA) alone.

METHODSA recently hospitalized young female patient with acute leukemia was initially diagnosed as M3 subtype based on morphological French-American-British (FAB) classification. Karyotype analysis using standard G and R banding techniques and RT-PCR were applied to further define the diagnosis. After primarily cultured bone marrow cells from the iliac aspiration were tested for in vitro induced differentiation, the patient was treated with oral all-trans retinoic acid alone, 60 mg per day until complete remission was achieved. Peripheral blood and bone marrow changes were monitored over the whole treatment course.

RESULTSThe characteristic chromosomal aberration for M3, the t(15;17) reciprocal translocation, was not found while a t(8;21) translocation was verified. Furthermore, an amplified product of the AML-1/ETO fusion gene instead of the PML/RAR alpha fusion gene was detected by RT-PCR and the diagnosis was corrected from M3 to M2. Primary cultured bone marrow cells can be fully induced to terminal differentiation after 4 days exposure to ATRA. A hematological complete remission was achieved after 40 days treatment with ATRA as a single therapeutic agent, suggesting an alternative pathway mediating ATRA-induced myeloid differentiation.

CONCLUSIONA leukemia patient with a subtype other than M3, such as M2 in this case, may also be induced to complete remission by the mechanism of ATRA-induced terminal differentiation. This implies that there may be a pathway other than PML/RAR alpha fusion gene product which mediates ATRA-induced myeloid maturation in leukemia cells.

Adolescent ; Antineoplastic Agents ; therapeutic use ; Core Binding Factor Alpha 2 Subunit ; Female ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; genetics ; Neoplasm Proteins ; analysis ; genetics ; Oncogene Proteins, Fusion ; analysis ; genetics ; physiology ; RUNX1 Translocation Partner 1 Protein ; Reverse Transcriptase Polymerase Chain Reaction ; Transcription Factors ; genetics ; physiology ; Tretinoin ; therapeutic use

Objective: To explore the application of asymmetrical sculpture in the ear reconstruction with autologous cartilage through comparing the difference of the balanced sculpture and asymmetrical sculpture. Methods: We used the method of retrospective survey and classified the patients who had undergone ear reconstruction because of microtia into two groups. Group A included the patients who had undergone operation with the application of balanced sculpture method. Group B included the patients who had undergone operation with the application of unsymmetrical sculpture method. We picked out 35 patients containing 19 patients of group A and 16 patients of group B according to our grouping criteria and exclusion criteria. The number of cases with complications was recorded, such as collapse of framework, exposure of cartilage, necrosis of skin flap and reconstructed ear infection. The clinical outcomes of two methods in refining the delicate structures of the reconstructed ear were evaluated (that is the definition, shape, size, color and projection). The time for sculpture was compared. Then we analysed the results and evaluated the effectiveness, safety and feasibility of asymmetrical sculpture′s application in the ear reconstruction. Results: Group A had 2 cases which suffered skin flap necrosis. One of them had cartilage exposure and then had secondary infection leading to local cartilage necrosis and absorption, but after active treatment and local skin flap transplantation it was cured. Group B had no skin flap necrosis, cartilage extrusion, framework deformation and distortion, framework collapse and necrosis or absorption. Group B had a higher score in definition, shape, size, color and projection, and the difference was significant in definition, shape, color and projection. In our clinical practice, the sculpture time in both group was similarly about 40 minutes after the surgery operator had skillfully mastered both techniques. Conclusions Both methods are safe and feasible. The method of asymmetrical sculpture does not require additional operative time, and the method of asymmetrical sculpture is a better one compared with the method of balanced sculpture in refining the reconstructed ear.

Objective We aimed to investigate(i)the preventive and therapeutic effects of Huogu Muli Prescription(HGMLP),a Chinese medical compound consisting of epimedii folium,drynariae rhizoma,and ostreae concha,on postmenopausal osteoporosis(PMOP)rats and(ii)whether it exerts its effects by regulating the osteoclast-osteogenesis balance.Methods Forty-eight female Sprague-Dawley rats were randomly divided into the following six groups:(i)the sham-operated group,(ii)the model group,(iii)the Qianggu Capsule group,(iv)the calcium carbonate group,and(v,vi)the HGMLP low-dose and high-dose groups(n = 8 rats per group).After adaptive feeding,rats in all groups except the sham-operated group were treated with bilateral ovarian castration to establish the PMOP model.Each day,rats in the Qianggu Capsule group received 0.054 g/kg Qianggu Capsule suspension intragastrically,rats in the calcium carbonate group received 1.670 g/kg calcium carbonate suspension intragastrically,and rats in the HGMLP low-dose and high-dose groups received 0.188 g/kg and 0.375 g/kg HGMLP intragastrically.Rats in the sham-operated group and the model group received an equal volume of normal saline intragastrically.After 90 consecutive days,serum estradiol(E2),estrogen receptor α(ERα),procollagen typeⅠN propeptide(PINP),and tartrate-resistant acid phosphatase 5b(TRACP-5b)were detected by ELISA.Total antioxidant capacity(T-AOC),superoxide dismutase(SOD),catalase(CAT),and malondialdehyde(MDA)levels were measured by colorimetry.Bone mineral density(BMD),trabecular number(Tb.N),trabecular separation/spacing(Tb.Sp),trabecular thickness(Tb.Th),and structure model index(SMI)were measured by Micro-CT,and the microstructure of cancellous bone was observed.The expressions of osteoprotegerin(OPG),receptor activator of nuclear factor-κB(RANK),RANK ligand(RANKL),phosphorylation of forkhead box O3(FoxO3α),Wnt2,β-catenin,and peroxisome proliferator-activated receptor γ(PPARγ)in rat femur tissue were detected by Western blotting.Results(i)The serum levels of E2 and ERα increased in the Qianggu Capsule group and HGMLP groups,compared with the model group(all P<0.05).(ii)Compared with the model group,the serum levels of PINP,TRACP-5b decreased and PINP/TRACP-5b increased in both the Qianggu Capsule group and HGMLP high-dose group(all P<0.05).(iii)The activities of T-AOC,AOD,and CAT in the Qianggu Capsule group and HGMLP groups were higher than those in the model group,while the content of MDA lower(all P<0.05).(iv)Compared with the model group,the femoral BMD,Tb.Th,and Tb.N increased in the Qianggu Capsule group and HGMLP groups,while the femoral Tb.Sp and SMI decreased(all P<0.05);the femoral BMD increased and the Tb.Sp decreased in the calcium carbonate group(all P<0.05).(v)The protein expressions of RANKL,RANK,FoxO3α,and PPARγ in the Qianggu Capsule group and HGMLP groups were lower than those in the model group,while the protein expressions of OPG,Wnt2,and β-catenin were higher(all P<0.05).Conclusion HGMLP can significantly increase estrogen levels,inhibit osteoclast differentiation,and inhibit bone resorption in the PMOP rats.It also alleviates oxidative stress,promotes osteogenic differentiation,inhibits lipogenic differentiation,improves bone formation,and recovers the balance between osteoclasts and osteoblasts,thus achieving prevention and treatment of PMOP.The potential mechanism of HGMLP may be related to regulation via the OPG/RANKL/RANK or FoxO3α/Wnt2/β-catenin/PPARγ pathways.