Objective To explore the prophylaxis and treatment of hypoxic spells on patients with TOF.Methods Retrospectively analysed and compared the case history of the inpatients with TOP in our hospital,to analyse the epilepticus cause of hypoxic spells and study the hypoxia mechanism and summarize the prevention and control measures.Results 4(17%)cases of TOF died after hypoxic spells,the epilepticus cause of hypoxic spells included suckling,early getting up,crying,standing abruptly after stool,scorching climate,infection fever and anemia,the hypoxia mechanism was likely to the increase of infundibulum cardiac muscle contraction,the systemic circulation resistance drop suddenly,hypezventilation,high-viscosity syndrome.Conclusion To control the epilepticus cause and perform operative treatment early can reduce the hypoxic spells.The prevention and control measures were strengthening the live nurse,disconnected oxygen inhalation,oral beta-blocker therapy and venons injection 5% sodium bicarbonate.Early operative treatment was the best redical treatment.

Objective To evaluate the left ventricle geometry shape and left heart regional function in mitral insufficiency (MI) by quantitative tissue velocity imaging (QTVI) and the left ventricle systolic and diastolic geometry spbericity index. Methods Thirty normal subjects and 62 MI patients underwent QTVI and color Doppler imaging (CDFI) were enrolled in this study in order to measure the left ven-tricular geometry shape and left ventrieular regional function along LV apical long-axis view. Off-line LV regional velocity images along LV apical long-axis view were synchronously obtained. Peak tissue velocities of LV regional muscular tissue during systole(Vs),systolic acceler-ation(a), early diastole(Ve), LA contraction(Va)were synchronously measured as the index of left ventricular regional systolic and dias-tolic function. The left ventricle geometry shape index were reflected from the systolic and diastolic geometry sphericity index (SIs and Sid) and the left ventrieular ejection fraction (LVEF) and the peak D and peak a (PVd/PVa) of pulmonary veins flowing spectrum reflected the global left ventricular function index. The Vs, Ve, Va, a, PVd/PVd ratio, LVEF, SIs, SId were recorded and their correlation between normal subjects and patients with MI were compared. Result Vs, Ve,Va,a,PVd/ PVa ratio,SIs,SId in patients with MI were significantly re-duced. There was positive relation between Sis and a(r=0.602)and Ve/Va and SId(r=0.635). Conclusion There was negative rela-tion between regional cardiac function and LV spberieity, the higher cardiac function was accompanied with the lower SI.

Objective To estimate the effects of camptothecin (CPT) on the expression of hypoxia-inducible factor-1α (HIF-1α) in HaCaT cells under hypoxic conditions (2％ O2),and to explore the potential therapeutic mechanism of topical CPT for psoriasis.Methods Some HaCaT cells were classified into 6 groups:5 test groups cultured in Dulbecco's modified Eagle's medium (DMEM) with the presence of CPT at 12.5,25,50,100 and 200 nmol/L respectively,and 1 control group cultured in DMEM with the presence of dimethyl sulfoxide (DMSO).All the 6 groups of cells were cultured under normoxic conditions for 12,24,48 or 72 hours or under hypoxic conditions for 12 hours.Cell counting kit-8 (CCK-8) assay was conducted to estimate the proliferation of HaCaT cells after the normoxic culture,and Western blot to quantify the protein expression of HIF-1α after the hypoxic culture.Some HaCaT cells were classified into a normoxia group (21％ O2) and a hypoxia group (2％ O2),and each group was divided into a CPT (100 nmol/L)-treated subgroup and a non-intervention subgroup (treated with the vehicle).After 12-hour culture,real-time fluorescencebased quantitative PCR was performed to measure the mRNA expression of HIF-1α.Statistical analysis was carried out by using Levene'.s test,one-way analysis of variance,Dunnett-t test and factorial analysis with the SPSS16.0 software.Results After treatment with CPT at 12.5-200 nmol/L for 12-72 hours,the proliferation of HaCaT cells was inhibited in a concentration-and time-dependent manner.More concretely,the cell proliferation rates were inhibited by 17.66％ ± 6.46％,33.11％ ± 4.63％ and 56.31％ ± 1.69％ respectively in HaCaT cells after 12-hour treatment with 200 nmol/L CPT as well as 24-hour treatment with 100 and 200 nmol/L CPT compared with the control group at the corresponding time points (all P ＜ 0.05).The protein expression level of HIF-1 α was significantly decreased in HaCaT cells after 12-hour treatment with CPT at 12.5,25,50,100 and 200 nmol/L under hypoxic conditions compared with the control group (0.348 ± 0.065,0.261 ± 0.112,0.115 ± 0.043,0.045 ± 0.024 vs.1.445 ± 0.329,all P＜ 0.05).The mRNA expression level of HIF-1α (expressed as △Ct) in the CPT-treated subgroup and non-intervention subgroup was-5.575 ± 0.29 and -5.451 ± 0.21 respectively in the normoxia group,significantly higher than that in the hypoxia group (-6.543 ± 0.57 and -6.203 ± 0.31 respectively,F =29.856,P ＜ 0.05),while there was no significant difference between the CPT-treated and non-intervention subgroups (F =1.667,P ＞ 0.05).Conclusions CPT at 100 nmol/L could inhibit the expression of HIF-1α protein,but had no obvious effect on that of HIF-1α mRNA.

Objective To determine the biomechanical parameters of left ventricular by using velocity vector imaging (VVI),and to indirectly assess the coronary artery stenosis with VVI in the patients with coronary artery disease (CAD).Methods 52 patients who had one coronary artery lesions at least diagnosed by coronary angiography (CAG)were divided into coronary artery mild stenosis group and severe stenosis group;2 1 patients in mild stenosis group had one coronary stenosis <75%;31 patients in severe stenosis group had one coronary artery stenosis ≥75% at least.At the same time,20 cases of normal people without coronary artery stenosis showed by CAG were selected as normal control group. VVI was used to detect the left ventricular wall segments of the overall longitudinal strain (GLS ), the overall circumferential strain (GCS ) and the overall radial strain (GRS ). Results The absolute values of GLS,GRS,GCS of the patients in mild and severe coronary artery stenosis groups were significantly decreased than those in normal control group(P<0.05),and the strain parameters in severe stenosis group were decreased more significantly, there were significant differences compared mild stenosis group (P<0.05 ). The distribution of the segments with decreased longitudinal strain matched the LV myocardial segment with the coronary stenosis rate ≥ 75%,and GLS had the most sensitivity.The GLS in normal control group,mild stenosis group and severe stenosis group were negatively correlated to left ventricular ejection fraction (LVEF)(r=-0.58,P<0.05;r=-0.51,P<0.05;r=-0.43,P<0.05).GLS-16.14 % was used to assess the severe coronary artery stenosis with requiring the implementation of PTCA treatment as the diagnostic cut-off point with sensitivity 96.8%, specificity of 70%, the highest Yuedden index 0.668. Conclusion The decreasing of left ventricular strain could be detected by VVI, which suggests that severe coronary artery stenosis exists in coronary artery;the distribution of the segments with significantly decreased strains can be used to assess the coronary lesions and stenosis degrees.

Objective To observe the clinical efficacy of needle warming therapy plus pelvic floor muscle training in treating post-stroke neurogenic bladder.Method A total of 124 patients with post-stroke neurogenic bladder were divided into a treatment group and a control group by random number table, 62 cases in each group. The treatment group was intervened by acupuncture, moxibustion plus pelvic floor muscle training; the control group was intervened by Chinese patent drugs. The intervention was conducted with 2 weeks as a treatment course, for 3 treatment courses in total. The daily voiding frequency test and maximum cystometric capacity (MCC) in the two groups were measured before and after the intervention, and the clinical efficacies were compared between the two groups.Result Each item of the daily voiding frequency test in the two groups was significantly changed after the treatment (P<0.01). Each item of the daily voiding frequency test in the treatment group was significantly different from that in the control group after the treatment (P<0.01). The MCC was significantly changed after the intervention in both groups (P<0.01). The MCC in the treatment group was significantly different from that in the control group after the treatment (P<0.01). The recovery rate and total effective rate were respectively 35.5% and 96.8% in the treatment group versus 19.4% and 77.4% in the control group. There were significant differences in comparing the total effective rate (P<0.01) and the recovery rate between the two groups (P<0.05).Conclusion Needle warming therapy plus pelvic floor muscletraining can produce a significant therapeutic efficacy in treating post-stroke neurogenic bladder, and the therapeutic efficacy is obviously better than that of medication.

The optimal plane for measurement of the right ventricular (RV) volumes by real-time three-dimensional echocardiography (RT3DE) was determined and the feasibility and accuracy of RT3DE in studying RV systolic function was assessed. RV "Full volume" images were acquired by RT3DE in 22 healthy subjects. RV end-diastolic volumes (RVEDV) and end-systolic volumes (RVESV) were outlined using apical biplane, 4-plane, 8-plane, 16-plane offline separately. RVSV and RVEF were calculated. Meanwhile tricuspid annual systolic excursion (TASE) was measured by M-mode echo. LVSV was outlined by 2-D echo according to the biplane Simpson's rule. The results showed: (1) There was a good correlation between RVSV measured from series planes and LVSV from 2-D echo (r = 0.73; r = 0.69; r = 0.63; r = 0.66, P < O. 25-0. 0025); (2) There were significant differences between RVEDV in biplane and those in 4-, 8-, 16-plane (P < 0.001). There was also difference between RV volume in 4-plane and that in 8-plane (P < 0.05), but there was no significant difference between RV volume in 8-plane and that in 16-plane (P > 0.05); (3) Inter-observers and intro-observers variability analysis showed that there were close agreements and relations for RV volumes (r = 0.986, P < 0.001; r = 0.93, P < 0.001); (4) There was a significantly positive correlation of TASE to RVSV and RVEF from RT3DE (r = 0.83; r = 0.90). So RV volume measures with RT3DE are rapid, accurate and reproducible. In view of RV's complex shape, apical 8-plane method is better in clinical use. It may allow early detection of RV systolic function.
Cardiac Volume ; Echocardiography, Three-Dimensional ; Electrocardiography ; Systole ; Ventricular Function, Right/*physiology

Objective To analyze the clinical characteristics of glenoid labral tear combined with rotator cuff tear so as to provide references for arthroscopic surgery.Methods A total of 50 patients (28 males and 22 females)at mean age of 45 years old(ranged from 30 to 58 years)were enrolled in the study.Clinical data including the mechanism and time of injury,symptoms,results of physical examination,X-ray and MRI were collected.Location and degree of rotator cuff and glenoid labral tears found during arthroscopic surgery were also recorded.There were 37 patients with anterior labral tears,eight with superior labrum tears and five with posterior labral tears.The rotator cuff tear was slight in 36 patients,moderate in 10 and severe in three.One patient had extra-large tear.Anterior part of rotator cuff was found torn in 21 patients,middle part in 16 and posterior part in 13.MRI of glenoid labral tears manifested disappearance of triangular appearance and enlarged joint capsule.MRI manifestations of rotator cuff tear were high signal in torn part and continuity loss.Results All patients were followed up for average 36 months(6-72 months),which showed satisfactory results.UCLA score was(15±3)points preoperatively and(32±3)points postoperatively(P＜0.01).Conclusions More attention should be paid to glenoid labral tear to avoid misdiagnosis and delayed treatment,for it is usually combined with rotator cuff tear.Location of rotator cuff tear has some relation to the range of glenoid labral tear,ie,the larger range of glenoid labral tear may induce more posterior part of rotator cuff torn.

Objective To assess clinical outcomes of FasT-Fix technique in repair of meniscal injury under arthroscope. Methods A total of 36 cases (37 knees) of mensical tears were repaired with FasF-Fix technique. There were 26 males and 10 females, at mean age of 26 years (14-51 years). Eighteen meniscal tears were located in zone Ⅱ, 16 in zone Ⅲ and 3 in zone Ⅳ. The average length of the tear was 2.2 cm (1.0-3.0 cm). Results There were no any signs of early complications after sur gery. All cases were followed up For 6-26 months (mean 16 months). According to Lysholm scoring scale system ,the average score of operated knees was increased from preoperative 44.13+12.56 to postopera tive 80.24+12.67 (P<0.01). After operation, all the patients could move the knee joint at normal range, except for one case who had a limitation of 20 degree flexion, with no pain or interlocking symptom. All cases returned to original work and/or could continue sports game. Conclusion The FasT-Fix technique is a simple, safe and effective method for repair of properly selected meniscal tears.

Objective To develope a new Real-time quantitative PCR assay using SYBR green as fluorescence reporter, which is rapid, specific, sensitive, cheap and accurate for the detection of mycoplasma pneumoniae(MP), and evaluated its clinical application value.Methods The sequence of the 23S rRNA gene in MP type strain FH was selected as amplified regions, and specific primers were designed.Then the related plasmids were extracted as standards,and the absolute quantitative standard curve was established.The sensitivity ,specificity of the fluorescence quantitative PCR assay was compared with the nest-PCR and kit;To calculate correlation coefficient, coincidence rate and kappa coefficient, clinical samples were detected using above-mentioned methods and cultivation,respectively.Results The detection sensitivity of the new real-time PCR and nest-PCR was 10 copies of FH DNA,while the kit 100 copies.In the specificity tests,the MP sample was positive,while mycoplasma hominis and other four bacteria were all negative.We applied this real-time PCR assay ,nest-PCR, kit and cultivation to 182 clinical specimens, and the detection rates were 55.49％, 52.75％, 47.25％ and 39.01％ ,respectively.The total consistency rate and Kappa coefficient of the new real-time PCR method and nest-PCR were 89.6％ ,0.790, respectively;while those of the new method and cultivation were 83.5 ％ ,0.678, respectively.The total consistency rate and Kappa coefficient of the new real-time PCR method and the kit were 89.6％ ,0.792,respectively;and the correlation coefficient of these two methods was 0.923,P ＜ 0.001.Conclusion Compared with other methods, the new real-time PCR assay could be used to detect mycoplasma pneumoniae quickly and economically, with high sensitivity and specificity ,revealing great utility value on varied instrumentation platforms.

The unsatisfactory operation of the existing mechanism for resolving medical disputes by doctors and patients may be contributed to the instability of this mechanism, as lack of regulation constraints results in huge discrepancies of outcomes between identical cases. Specifically, the uncertainty for doctor-patient consultation in the guidelines, evaluation and decision mechanism,consultation process, and compensation calculation. In this consideration, it is recommended to elevate the mechanism stability of this consultation by means of uniform guidelines, third-party evaluation and decision, standardized consultation process, and unified compensation standard.