Objective To assess the influence of the wall motion state and the infarct size of myocardial on left atrial(LA) function in patients with myocardial infarction(MI), and to investigate the main determinants of LA function. Methods LA function of the small area of MI group (group A), the large area of MI group (group B) and control.group were compared,and the influence of the infarct size on LA function was evaluated. The correlation between parameters of LA function and wall motion score index (WMSI) was analyzed. Stepwise regression was made to determine the influencing factors of LA function. index (VpreⅠ),LA active emptying volume index (AEVI), LA ejection force index (EFI) of group A and group B were larger than those of control group,and the parameters of group B were also larger than those of group A(P<0.05). LA passive emptying fraction (PEF) and atrial expansion index (AEI) of group A and group B were smaller than those of control group,and the parameters of group B were also smaller than regression equation. Conclusions With the increasing of areas of infarction and the aggravating of wall motion sate,the LA remodeling aggravated. The boost pump function of LA augmented, and the function of conduit and reservoir of LA was reduced. Wall motion state, LV remodeling and LV diastolic function were the major determinants of augmented LA function in MI patients.

Objective We aimed to assess systematically the effect of pressure treatment instrument on pre-venting deep venous thrombosis of lower extremity for hospitalized patients.Methods Relative literature was searched by computer at home according to the inclusion and the exclusion criteria,which were ana-lyzed by RevMan5.2 software and literature selection and repetition were used according to the Note Ex-press software.Results A total of 13 studies of randomized controlled or not randomized controlled trials were brought into the study by fixed effects model.A total of 1 194 were included into the study,599 in the experimental group and 595 in the control group.Literature analysis showed that pressure treatment in-strument can decrease the incidence rate of deep venous thrombosis of lower extremity (OR=0.24,OR95％ CI:0.15～0.37,P＜0.01) and increase venous blood flow velocity (OR=0.52,OR95％CI:0.25～0.80,P＜0.01).By replacing the statistical effect model,the sensitivity analysis showed a stable and reliable result conclusion.Conclusions Pressure treatment device can reduce the incidence rate of lower extremity deep venous thrombosis in hospitalized patients,prolong the survival time and improve the quality of life,and can also reduce the complications caused by anti-thromboembolic drugs.It is favored by clinical workers more and more,and it is worthy of further promotion and application.

Objective To study the pathologic characteristics of eutopic endometrium in patients with endometriosis.Methods Pathologic characteristics of eutopic endometrium were studied in 176 patients with endometriosis in Peking Union Medical College Hospital from January 2007 to December 2008 retrospectively.Results About 72.2％(127/176)of eutopic endometrium were in proliferative phase,19.9％(35/176)of were observed as endometrial polyp,including 32 cases with simple endometrial polyp and 3 cases with abnormal hyperplasia combined with endometrial polyp.And 4.0％(7/176)showed abnormal hyperplasia.The incidence of pathologic changes in eutopic endometrium was 22.2％(39/176).Among 53 endometriosis patients combined with infertility,the incidence of pathologic changes of eutopic endometrium was 35.9％(19/53),which was significantly higher than 16.3％ in non-infertile patients (x2 =8.24,P =0.004).Among 65 cases with irregular menstruation,the incidence of endometrial polypus and endometrial hyperplasia were 20.0％(13/65)and 10.8％(7/65),which were significantly higher than 17.1％(19/111)and 0 in normal menstruation patients(x2 =13.839,P =0.003).Conclusions The eutopic endometrium of endometriosis were in proliferative phase state.The pathologic changes of eutopic endometrium were more in patients combined with infertility and irregular menstruation.

Objective To investigate the correlation of variations of ABCB11 gene and primary intrahepatic stone (PIS).Methods The retrospective case-control study was conducted.The clinical data of 319 patients with PIS and 344 healthy controls who were admitted to the Southwest Hospital of the Third Military Medical University between December 2012 and December 2015 were collected.Three hundred and ninteen patients with PIS and 344 healthy controls were respectively allocated into the PIS and control groups.Twenty-seven exons in ABCB11 gene were detected via polymerase chain reaction (PCR) and DNA sanger sequencing.Observation indicators included:(1) variations and genotype frequency distribution of ABCB11 gene in the 2 groups;(2) correlation analysis between variations of ABCB11 gene and clinical data of patients with PIS:preoperative indicators of liver function test,recurrent episodes of cholangitis,preoperative obstructive jaundice,type and recurrence of stones.Comparison between groups in variations and genotype frequency distribution of ABCB11 gene was analyzed by the Logistic regression.The Kruskal-Wallis H test was performed to explore the correlation between genotype of ABCB11 gene and clinical test results of patients with PIS.Correlation between genotype of ABCB11 gene and clinicopathological data of patients with PIS was analyzed by the chi-square test.Results (1) Variations and genotype frequency distribution of ABCB11 gene in the 2 groups:whole-exome sequencing results showed that synonymous mutations of rs3815675,rs2287616 and rs497692 and missense mutations of rs2287617,rs2287622 and rs118109635 in the PIS group were respectively detected in exon 4,9,24 and 9,13,21.CT genotype frequency of rs118109635 was 4.70％(15/319) in the PIS group and 1.45％ (5/344) in the control group,respectively,with a statistically significant difference [OR=3.49,95％ confidence interval (CI):1.17-10.40,P＜0.05].GG and AG+GG genotype frequency of rs497692 were 46.08％ (147/319),87.46％ (279/319) in the PIS group and 37.79％ (130/344),79.36％ (273/344) in the control group,respectively,with a statistically significant difference (OR=1.73,1.65,95％ CI:1.05-2.83,1.04-2.61,P＜0.05).(2) Correlation analysis between variations of ABCB11 gene and clinical data of patients with PIS:levels of glutamyl-transpeptidase (GGT),alkaline phosphatase (ALP) and direct bilirubin (DBil) in the PIS group were 167 U/L (range,7-1 968 U/L),166 U/L (range,36-1 527 U/L),4 μmol/L(range,1-272 μmol/L) in the CC genotype of rs118109635 and 433 U/L(range,17-864 U/L),232 U/L (range,85-613 U/L),6 μmol/L(range,2-173 μmol/L) in the CT genotype of rs118109635,respectively,with a statistically significant difference (H=6.025,5.879,8.056,P＜0.05).Globulin level of PIS group was respectively 32 g/L (range,20-40 g/L),34 g/L(range,17-50 g/L) and 33 g/L(range,14-49 g/L) in the AA,AG and GG genotype of rs497692,respectively,with a statistically significant difference (H=12.119,P＜0.05).Of 81 patients with recurrence of PIS,GG and GA genotypes of rs2287617 were detected in 78 and 3 patients,respectively,with a statistically significant difference (x2=5.367,P＜0.05);TT,TC and CC genotypes of rs2287622 were detected in 12,39 and 30 patients,respectively,with a statistically significant difference (x2=6.153,P＜0.05).Of 127 patients with obstructive jaundice,116 and 11 patients had CC and CT genotypes of rs118109635,respectively,with a statistically significant difference (x2=7.381,P＜0.05);11,43 and 73 patients had AA,AG and GG genotypes of rs497692,respectively,with a statistically significant difference (x2 =11.364,P＜0.05).Conclusion There is a correlation between rs118109635 and rs497692 of ABCB11 gene and PIS,meanwhile,the above variation loci are associated with obstruction of biliary tract and cholestasis.

The aim of this study was to comprehensively investigate the correlations between foliar fungal endophyte communities and effective components accumulations in Salvia miltiorrhiza. Foliar samples of S. miltiorrhiza were collected in 5 different areas. Their fungal endophyte communities and effective component contents were determined by denaturing gradient gel electrophoresis (DGGE) and high performance liquid chromatography (HPLC), respectively. The results showed that, for characteristics of foliar fungal endophyte communities and effective component contents, there were both similarities and differences among the five samples. Correlation analysis of DGGEs' band and 24 effective components revealed a significant correlations (P < 0.01). For examples, 4 bands (15, 18, 23 and 26) were all significantly correlated with the accumulations of caffeic acid, salvianolic acid B, salvianolic acid C and dihydrotanshinone I.
Chromatography, High Pressure Liquid ; Cluster Analysis ; Denaturing Gradient Gel Electrophoresis ; Endophytes ; chemistry ; Fungi ; chemistry ; Salvia miltiorrhiza ; chemistry ; microbiology

OBJECTIVETo study features of brain gray matter injury in cerebral infarction patients and intervention of scalp acupuncture by using voxel-based morphology.

METHODSA total of 16 cerebral infarction patients were recruited in this study, and assigned to the scalp acupuncture group and the control group, 8 in each group. Another 16 healthy volunteers were recruited as a normal group. All patients received scanning of T1 structure. Images were managed using VBM8 Software package. Difference of the gray matter structure was compared among the scalp acupuncture group, the control group, and the healthy volunteers.

RESULTSCompared with healthy volunteers, gray matter injury of cerebral infarction patients mainly occurred in 14 brain regions such as cingulate gyrus, precuneus, cuneus, anterior central gyrus, insular lobe, and so on. They were mainly distributed in affected side. Two weeks after treatment when compared with healthy volunteers, gray matter injury of cerebral infarction patients in the scalp acupuncture group still existed in 8 brain regions such as bilateral lingual gyrus, posterior cingulate gyrus, left cuneus, right precuneus, and so on. New gray matter injury occurred in lingual gyrus and posterior cingulate gyrus. Two weeks after treatment when compared with healthy volunteers, gray matter injury of cerebral infarction patients in the control group existed in 23 brain regions: bilateral anterior cingulum, caudate nucleus, cuneate lobe, insular lobe, inferior frontal gyrus, medial frontal gyrus, precuneus, paracentral lobule, superior temporal gyrus, middle temporal gyrus, lingual gyrus, right postcentral gyrus, posterior cingulate gyrus, precentral gyrus, middle frontal gyrus, and so on. New gray matter injury still existed in 9 cerebral regions such as lingual gyrus, posterior cingulate gyrus, postcentral gyrus, and so on.

CONCLUSIONSBrain gray matter structure is widely injured after cerebral infarction. Brain gray matter volume gradually decreased as time went by. Combined use of scalp acupuncture might inhibit the progression of gray matter injury more effectively.

Acupuncture Therapy ; Brain ; physiopathology ; Brain Injuries ; therapy ; Cerebral Infarction ; therapy ; Gray Matter ; pathology ; Humans ; Magnetic Resonance Imaging ; Scalp ; Stroke ; therapy

Objective To analyze the characteristics of the genotype, phenotype, and follow-up of Gitelman's syndrome (GS) in the largest group of Chinese patients. Methods Sixty seven patients with GS underwent SLC12A3 gene analysis. Clinical characteristics and biochemical findings at the first presentation as well as follow-up were reviewed. Additionally, the associations of genotypes and phenotypes were explored. Results Forty-one different SLC12A3 mutations were identified in 67 patients with GS, including 11 novel ones, and 5 recurrent ones. 3 families (5. 7% ) had triple SLC12A3 mutations. Typical hypocalciuria and hypomagnesemia were not found in 6(9% ) and 8 (11. 9% )patients, respectively. In addition, male patients had an earlier age of onset and a higher urinary fraction excretion of electrolytes. 2 patients presented with chronic kidney disease, 13 (19. 4% ) with type 2 diabetes, 14 (20. 9% )with impaired glucose tolerance, and 5(7. 5% ) with impaired fasting glucose. Conclusion This study revealed 41 mutations in 67 Chinese patients with GS, including 11 novel variants and 5 high-frequency ones. Fraction excretion of electrolyte in urine may be more sensitive in the evaluation of phenotype compared with those of blood. It is difficult to correct hypokalemia and hypomagnesemia in GS. Patients with GS are at higher risk of the development of diabetes than ordinary people.

Objective To investigate the clinical features and prognostic factors in children with idi-opathic pulmonary arterial hypertension(IPAH). Methods The data of children with IPAH diagnosed in Beijing Children′s Hospital from January 2006 to December 2015 were collected. The cases were divided into survival group and death group according to the prognosis. The risk factors influencing prognosis in children with IPAH were identified by Logistic regression analysis. Results Total 26 patients were enrolled in this study,and 17 of them survived and 9 of them were dead. IPAH was found to be more common in school-age children. The average age of the patients was(6. 6 ± 3. 6)years and the male to female ratio was 1. 17∶1. All of the children had the symptoms with decreased activity tolerance and fatigue. The incidence of syncope and dyspnea and edema of lower extremity were 34. 6%,23. 1%. Accentuated pulmonic second sound(P2) was detected in 92. 3% of patients during physical examination, which was also the most common sign. About 50. 0% patients were functional class Ⅲ-Ⅳ. Echocardiography showed that all childrens′ mean pulmonary artery systolic pressure(PASP) was(79. 0 ± 20. 3) mmHg(1 mmHg=0. 133 kPa) and 16 of them with right ventricular dilatation. Electrocardiogram with ST-T changes and right ventricular high voltage were common. The average plasma level of brain natriuretic peptide(BNP) in all cases was(870. 4 ± 720. 9) pg/ml. The single factor analysis illustrated that syncope(OR=26. 25,95%CI 3. 04 -226. 60,P=0. 003),heart func-tional class Ⅲ-Ⅳ(OR=19. 199,95%CI 1. 88 -196. 53, P=0. 0128), PASP≥70 mmHg(OR =9. 936, 95%CI 1. 81-∞,P=0. 005),BNP≥850 pg/ml(OR=59. 991,95%CI 4. 69-767. 62,P=0. 002) indica-ted the worse outcome. Conclusion IPAH in children is rare and the prognosis is poor. Syncope, cardiac function grade,PASP and the levels of BNP are the main important factors affecting the prognosis of children with IPAH. BNP has important clinical significance for the evaluation of IPAH and the prognosis of the disease.

Objective To observe the clinical characteristics and prognosis in children with high take -off coronary artery.Methods The clinical characteristics,laboratory examinations and prognosis were retrospectively ana-lyzed in 49 children with high take -off coronary artery who had been admitted to Beijing Children′s Hospital Affiliated to Capital Medical University from April 2009 to December 201 2.Results Among 49 medical records of children with high take -off coronary artery,34 cases were male and 1 5 cases were female,with a mean age of (9.28 ±4.42)years old,and the youngest patient was 1 3 months old,and the oldest patient was 1 7 years and 2 months old.The 64 -section multidetector CT angiography of all patients showed one or both coronary arteries originated from 1 .0 cm higher than the junction area of sinus and aorta,including 38 high take -off of the left coronary artery,7 high take -off of the right coronary artery and 4 high take -off of both coronary arteries.The chief complaints of the patients included chest pain (22 cases,44.90%),chest tightness(1 3 cases,26.53%),declining of exercise tolerance(7 cases,1 4.29%),fatigue (5 cases,1 0.20%),palpitation(3 cases,6.21 %),syncope(1 case,2.04%).Electrocardiogram(ECG)of those pa-tients showed ST -T changes,atrioventricular block,sinus tachycardia,pathological Q -wave,proiosystole and bundle branch block.Ultrasonic cardiogram(UCG)indicated 1 4 patients with the enlarged left ventricle,including 2 patients with ejection fraction lower than 60%.After 1 0 days hospitalization,the anesis of chest pain and chest tightness were significantly different statistically(P <0.05),but there was no significant difference in ECG and UCG.Thirty -nine out of 49 children were followed for 1 year.After 3 months,6 patients with ST -T problem showed normal ST -T segment. After 6 months,1 0 patients with ST -T problem showed normal ST -T segment.After 1 year,1 7 patients with ST -T problem showed normal ST -T segment.Conclusions High take -off coronary artery is a rare malformation of the coronary artery,which can cause myocardial ischemic,leading to multiple clinical manifestations and may result in ECG changes and the left ventricle enlargement.High take -off coronary artery can be confused with myocarditis and myocar-dial lesion clinically.Patients receiving systemic treatment may have their symptoms released,but ECG and UCG may not relieve in a short term.Patients with high take -off coronary artery need long -term observation.

Objective To investigate the current status of moral distress in clinical nurses,and analyze its influential factors.Methods A total of 240 clinical nurses were recruited by stratified sampling method.They were investigated with general situation questionnaire and moral distress scale.Results The average score of moral distress was (2.66±0.41).Multiple linear regression analysis showed that department of work and qualification were influencing factors on moral distress of clinical nurses.Conclusions This study found that nurses' moral distress was above the middle level.Some targeted measures should be taken by nursing managers,in order to help decrease nurses' moral distress.