Objective To investigate the predictive value of epicardial adipose tissue(EAT) thickness for the recurrence of atrial fibrillation (RAF) after concomitant valve replacement and bipolar radiofrequency ablation.Methods From January 2012 to May 2014,156 patients with permanent atrial fibrillation and organic valvular diseases underwent concomitant valve replacement and successful bipolar radiofrequency ablation in the First People's Hospital of Shangqiu.After 1 year of follow-up,the recurrence of AF was analyzed and the correlation factors were analyzed statistically.Results All patients completed a regular follow-up.During a 12-month follow-up period,RAF was observed in 39 patients (25.0％).Echocardiography-derived regional EAT thickness was significantly greater in RAF patients than that in non-RAF patients((6.9±0.6) mm vs.(5.5±0.7) mm,t=4.649,P＜0.05).The EAT thickness strongly correlated with patients age,body mass index,Ratio of left atrial diameter,mitral diastolic blood flow velocity and early diastolic velocity of mitral annulus,low density lipoprotein-cholesterol and thyroglobulin (r =0.62,0.57,0.68,0.59,0.73,0.76;P ＜ 0.05).Cox multivariable analysis showed that,duration of AF history (95％CI:1.01-1.15,P =0.040),left atrial diameter (95％CI:1.07-1.24,P =0.021) and EAT thickness (95％CI:1.05-1.79,P =0.009) were independent predictors of RAF.Conclusion Echocardiography-derived regional EAT thickness combined with left atrial diameter may serve as effective parameters in identifying patients at the highest risk for RAF.

Objective To review the outcome of coronary artery bypass graft (CABG) using left internal thoracic artery grafts in the patients aged over 70 years old.Methods Two hundred and eighty-eight patients aged over 70 years old from January 2009 to January 2014 who underwent CABG were selected.All of the patients were divided into two groups on base of the graft:control group:only saphenous vein graft was used in 138 cases; observation group:the left internal thoracic artery to the left anterior descending artery was used in 150 cases,which also included total arterial grafting,facilitated by the use of the radial artery,right gastroepiploic artery was operated in 7 cases,beside these artery grafts,saphenous vein graft was used to anastomosis with other vessels.Results Operative mortality was 2.9％ (4/138) in control group and 2.0％ (3/150) in observation group,and there was no significance (P ＞ 0.05).The volume of blood drainage was larger in observation group [(796.2 ± 382.4) ml] than that in control group [(512.8 ± 387.5) ml],and there was significant difference (P ＜ 0.05).At the same time,there was no significant difference in the incidence rate of second thoractomy,malignant arrhythmia,stroke,poor wound healing,and usage of intraaortic balloon counterpulsation between two groups (P ＞ 0.05).Conclusion It does not increase the mortality and incidence of serious complications using the left internal thoracic artery to the left anterior descending artery in the patients aged over 70 years old during CABG.

Objective: To evaluate the effects of PD145065(non-selective endothelin(ET)receptor antagonist)on injured spinal cord and explore mechanisms of how ET plays a role in secondary injury following spinal cord injury(SCI).Methods:Spinal cord of rat was traumatized by compression(50g,1min).PD145065 or vehicle was administered intrathecally 10 minutes before SCI.Alterations of spinal cord blood flow(SCBF),molondialdehyde(MDA),the total content of intracellular calcium(［Ca2+］i),Evans blue(EB),and water in spinal cord were inspected.Results:SCBF of injured area decreased obviously 5 minutes after SCI.SCBF was 75.23±9.21% of baseline 5 minutes after SCI,57.06±7.35% 2 hours.SCBF of adjacent area decreased lower.SCBF was 79.82±7.98% of baseline 30 minutes after SCI.SCBF of injured and adjacent areas did not recover 4 hours after SCI.The contents of MDA,［Ca2+］i,EB and water in traumatized spinal cord were significantly more than that of sham(P＜0.05)。PD145065 ameliorated SCBF of injured area obviously and abolished the decrease of SCBF of adjacent area.The contents of MDA,［Ca2+］i,EB and water in spinal cord of PD145065 treated group were significantly less than that of saline treated group(P＜0.05).Conclusion:PD145065 has protective effects on traumatized spinal cord in early phase.ET and its receptors may play a role in secondary injury following SCI by multiple pathways.ETA/ETB receptor antagonist may be useful in treatment of clinical SCI.

Objective To investigate physical activity in patients with type 2 diabetes mellitus and to analyze its influencing factors,in order to provide references for the prevention and control of disease.Methods A total of 469 cases of patients with type 2 diabetes mellitus were enrolled in this study.The basic information,such as gender,age and so on,and situation of physical activity,including work,housework,transportation and entertainment,were surveyed via questionnaire.Results The total amount of physical activity of patients with type 2 diabetes mellitus in this survey was (1 581.59±743.65)MET-min per week,were mainly contributed from entertainment and housework which was (940.83 ± 547.06) and (407.20 ± 226.63)MET-min per week respectively.The amount of physical activity of patients in different age,occupation,duration of illness and BMI,and patients with or without other chronic diseases were significantly different (P＜0.05).Under 45 years old,being on-the-job,with other chronic disease were risk factors for lack of physical activity in patients with type 2 diabetes mellitus (P＜0.05),while aged 45-＜60 years old,light or normal weight was the protection factors of sufficient physical activity in patients with type 2 diabetes mellitus (P＜0.05).Condusion The overall physical activity of patients with type 2 diabetes mellitus is on the medium level,and its main types are entertainment and housework.Patients under 45 years old,being on-the-job,with other chronic diseases have higher risk of lacking physical activity.

Objective To investigate the clinical effect and safety of Chinese medicinal liniment pourmask and smearing in the treatment of acne. Methods Two-hundred and nine cases of acne were divided into two groups: treatment group (106 cases) was treated with Chinese medicinal liniment pourmask and smearing for 1 to 4 weeks, and control group was treated with gypsum fibrosum pourmask combining chloramphenicol and salicyic acid tincture for 1 to 4 weeks. Results At 8th week the cure rate, effective rate and improved rate in the treatment group and control group were 70.75 %, 29.25 %, 0 % and 34.95 %, 42.72 %, and 22.33 % respectively. Side effects were not found in the treatment group. Ten cases (9.71 %) in control group had contact dermatitis. Conclusion Chinese medicinal liniment pourmask and smearing have a good efficacy and safety in the treatment of acne.

As a commonly used non-contact flatness detection method, laser triangular detection method is designed with low cost, but it cannot avoid measurement errors caused by strip steel vibration effectively. This paper puts forward a dynamic flatness image processing method based on improved laser triangular detection method. According to the practical application of strip steel straightening, it completes the image pre-processing, image feature curve extraction and calculation of flatness elongation using digital image processing technology. Finally it eliminates elongation measurement errors caused by the vibration.

AIM: To determine the topographic and spactial changes of endothelin-1 (ET-1) mRNA in cords after spinal cord injury(SCI). METHODS: A SCI model of the rat was made by modified Allen's weight drop method(50g-cm). ET-1 mRNA in the spinal cords before and after injury was examined by in situ hybridization and the content of ET-1 mRNA was determined by semi-quantitative image pattern analysis. RESULIS: Compared with control, the ET-1 mRNA positive neurons, glial cells and endothelial cells increased and the positive signal enhanced in the adjacent cord of the contused region. There was also a significant increase in positive unit of ET-1 mRNA staining in injured spinal cord except 48 h-group. The quantity of neuron expressing ET-1 mRNA decreased gradually in contused region after SCI, while the quantity of glial cell expressing ET-1 mRNA increased. CONCLUSION: Expression of ET-1 mRNA upregulates in spinal cord after SCI. It suggests a pathophysiological role for ET-1 in SCI. Neuron is the main contributor to the increase for ET-1 in injured spinal cord.

Objective This study aimed to assess the adherence to guideline-recommended therapies according to risk stratification in the management of acute coronary syndrome(ACS). Methods We analyzed 1,001 consecutive patients admitted with ACS. Patients were stratified using the GRACE risk score into low- and high-predicted risk of mortality at 6 months. We evaluated the use of hospital angiography,revascularization,and guideline-recommended medications between high and low-risk patients. Results High-risk compared to low-risk patients were less likely to underwent coronary angiography and/or revascularization during the hospitalization. The use of hospital-initiated pharmacotherapies was also lower in high-risk patients(P<0.05). Advanced age, increased creatinine level and higher GRACE score were independent predictors for failure to administer evidence-based therapies. Conclusion Patients with ACS at high risk of mortality were paradoxically less likely to undergo revascularization or receive medications according to guidelines. Better adherence to evidence-based therapies in high-risk patients may improve clinical outcome and quality of health care.

Objective To investigate the application value of enhanced recovery after surgery(ERAS) in laparoscopic pancreaticoduodenectomy (LPD).Methods The retrospective cohort study was adopted.The clinical data of 64 patients who underwent LPD from January 2014 to January 2016 in the Shangjin Hospital of West China Hospital of Sichuan University were collected.Of the 64 patients,41 patients managed with ERAS program between March 2015 and January 2016 were allocated into the ERAS group,23 patients managed with traditional perioperative treatment between January 2014 and Febuary 2015 were allocated into the traditional group.The following indexes were observed:(l) intraoperative status:operation time,volume of intraoperative blood loss,conversion to open surgery,pylorus preservation.(2) Postoperative status:the time to out-of-bed activity,time to postoperative flatus,time of drainage tube removal,postoperative complications (pancreatic leakage,bile leakage,hemorrhage,delayed gastric emptying,abdominal infection,cardiovascular complications),duration of postoperative hospital stay,death within the postoperative 30 days.(3) Follow-up status:incidence of complications after discharge and survival of patients.The follow-up including incidence of complications after discharge and survival of patients was conducted by outpatient examination and telephone interview up to March 2016.Measurement data with normal distribution were presented as (x) ± s and analyzed by t test.Count data were analyzed using the chi-square test or Fisher exact probability.Results (1) Intraoperative status:the operation time,volume of intraoperative blood loss,number of patients with conversion to open surgery and pylorus preservation were (377 ± 38) minutes,(164 ± 48) mL,1,40 in the ERAS group and (392 ± 53) minutes,(152 ±31)mL,2,21 in the traditional group,showing no statistically significant difference between the 2 groups (t =5.02,8.43,x2=1.29,1.29,P ＞ 0.05).(2) Postoperative status:the time to out-of-bed activity,time to postoperative flatus,time of drainage tube removal and duration of postoperative hospital stay were (1.7 ± 0.6)days,(2.5 ± 0.6) days,(5.3 ± 1.7) days,(9.1 ± 1.3) days in the ERAS group and (2.1 ± 0.9) days,(3.8 ±1.2) days,(8.2 ± 2.6) days,(11.9 ± 1.8) days in the traditional group,showing statistically significant differences between the 2 groups(t =-5.28,-7.01,-16.20,-10.67,P ＜ 0.05).The numbers of patients with pancreatic leakage in stage A,B and C,bile leakage,hemorrhage,delayed gastric emptying,abdominal inflection,cardiovascular complications and death in the postoperative 30 days were 8,0,0,0,1,3,0,1,1 in the ERAS group and 5,1,0,1,1,3,2,1,0 in the traditional group,respectively,showing no significant difference between the 2 groups (x2=0.37,1.81,0.18,0.57,3.68,0.18,P ＞0.05).(3) Follow-up status:the 64 patients were followed up for a median time of 11 months (range,1-25 months).During the follow-up,number of patients complicated with diabetes,local tumor recurrence,liver metastasis and death were 5,4,1,0in the ERAS group and 2,5,2,3 (2 died of tumor recurrence and 1 died of myocardial infarction) in the traditonal group.Conclusion Application of ERAS in the perioperative management of LPD is safe and effective,meanwhile,it can accelerate the recovery of patients who underwent LPD and shorten the duration of hospital stay.

Endothelin (ET), recently isolated from culture supernatant of porcine aortic endothelial cells, is a novel potent vasoconstrictive substance. In this paper a highly specific rabbit antisera against endothelin was used to study the localization of ET in the isolated endothelial cells, from human umbilical veins and porcine arota, and that of ET in the cryostat cross sections of porcine aorta by using ABC immunohistochemical technique. The results demonstrate that a varied amounts of specific ET-like immunoreactive substance exist in the endothelial cytoplasm of human umbilical veins and porcine aorta which provides the mor- phological evidence for elucidating the endocrine function of vascular endothelial cells.