Objective To assess the risk of acute myocardial infarction (AMI) and analyze its out‐come by studying the abnormal ECG presentations in AMI patients .Methods The clinical data and ECG presentations of 381 AMI patients were retrospectively analyzed .The abnrmal ECG presentations and the mortalty were comparatively analyzed in AMI patients with multiple lead pathological Q wave ,elevated ST‐segment ,atrial fibrillation (AF) ,bundle branch conduction block ,cardiogenic shock ,and heart failure .Results T he incidence of cardiogenic shock ,heart fail‐ure and the mortality were significantly higher in patients with multiple lead pathological Q wave than in those without multiple lead pathological Q wave (58 .1% vs 21 .4% ,54 .3% vs 23.2% , 40.0% vs 6 .5% ,P<0 .05) and in patients with abnormal presentations such as elevated ST‐seg‐ment and AF than in those without abnormal ECG presentations (P<0 .05 ,P<0 .01) .Conclusion Abnormal ECG presentations ,such as multiple lead pathological Q wave ,can be used as the evi‐dence for the risk and outcome of AMI .

Objective To establish HPLC method for the determination of the content of caffeic acid in Chanhou Tieshijin. Methods The determination was performed on HangBang C18 column (200 mm?4.6 mm, 5 ?m). The mobile phase was methanol-buffer phosphate (23∶77) at a flow rate of 1.0 mL/min. The UV detection wavelength was set at 323 nm and the sample size was 10 ?L. Results The linear range of caffeic acid was 0.052～0.26 ?g (r=0.999 8), with average recovery rate of 97.44% (RSD=0.78%). Conclusion The established method is simple, rapid and accurate, and suitable for the quality control of Chanhou Tieshijin.

Fine particles,less than 2.5 micrometer in diameter (PM2.5),are the main components of inhalable particles.Because of their relatively small size and large surface area,PM2.5 can absorb and retain chemicals,bacteria,viruses and other toxic substances,penetrate deeply into the respiratory tract and easily reach the alveolar ducts,exerting adverse effects on the lungs.PM2.5 can also be absorbed into the bloodstream through alveolar capillaries,causing serious damage to human health.The biological effects produced by PM2.5 are frequently attributed to the oxidative stress induced by intracellular reactive oxygen species alterations and abnormal release of inflammatory mediators closely involved in the development of lung diseases.This review discusses the research advances in relationships between PM2.5 exposure and inflammatory responses and oxidative stress based on experimental researches,in vivo and in vitro studies.Recent epidemiologic investigations have shown associations between increased incidence of respiratory diseases and lung cancer from exposure to low levels of various forms of respirable fibers and particulate matter.In vivo experiments have disclosed the association between PM2.5 exposure and the exacerbation of asthma,bronchitis,chronic obstructive pulmonary disease,and other lung damages.Cell damage mechanisms mainly include alterations of cell signaling pathways,DNA damage,immune injury,autophagy and apoptosis.

Objective To evaluate the efficacy of the parathyroidectomy (PTX) in the treatment of severe secondary hyperparathyroidism (SHPT) with Sagliker syndrome (SS). Methods A retrospective review was undertaken among 212 SS patients underwent PTX in our hospital and with more than 3 years' follow up. The definitions of the efficacy were based on the postoperative intact parathyroid hormone level (iPTH). Cure showed that the iPTH was ＜ 150 ng/L; marked effectiveness was 150-300 ng/L; effectiveness was 301-500 ng/L;ineffectiveness was ＞500 ng/L. The status was defined as persistent SHPT if iPTH was ＞ 150 ng/L after surgery. The status was considered as SHPT recurrence if iPTH was ＜ 100 ng/L in the first week after surgery, and gradually increased and ＞ 150 ng/L with the follow-up. Results ( 1) Ten patients were involved and the average dialysis time was 142 months [male/female: 4/6; age 30-54 (39. 3 ± 10. 4) years]. All patients had severe bone and joint pain, accompanied with progressive facial increases, chicken breast, kyphosis, hip bone deformities, and body height shortening. (2) Preoperative tests: the median of iPTH 2000(1800-2863) ng/L; serum calcium (2. 45 ±0. 21) mmol/L, phosphorus (2. 19 ±0. 51) mmol/L, alkaline phosphatase ( ALP) (1189. 8 ± 780. 0) IU/L. Two to four enlarged parathyroid glands were confirmed by ultrasound and 99Tcm-MIBI parathyroid scintigraphy. ( 3 ) Surgical procedures: local or general anesthesia for PTX. Supplement with calcium and calcitriol implemented low serum calcium after PTX. (4) Follow-up: symptoms, including bone pain, muscle weakness, skin itching, and insomnia, were significantly improved after surgery. Transient hoarseness occurred in 2 cases. The iPTHs of all patients were decreased significantly after surgery. The median of iPTH was 55.5 ( 10-967) ng/L at 1 month post PTX, and was significantly less than prior to PTX (P＜0. 001). Eight patients were cure , 1 marked effectiveness ,and 1 ineffectiveness. Two patients were persistent SHPT, and 1 died of heart failure in the 4th year after PTX. The development of bone deformities was stopped and malnutrition was improved in long-time follow up. The level of iPTH 135(28-390)ng/L(P＜0. 001 ) , serum calcium, phosphorus, and ALP showed normal in the third year. The SHPT recurrence was appeared in the 2nd and 3rd year in 2 out of 8 patients, respectively. Conclusions Total PTX can effectively treat SS by SHPT. It can improve prognosis for patients, such as bone pain disappearing, bone deformities stopping and malnutrition improving, etc. The level of iPTH may rise again in some patients in the future. Therefore, more attentions should be paid to monitoring.

Objective To investigate the clinical character istics of contrast-induced nephropathy(CIN)in patients with coronary artery disease after they used contrast media.Methods 268 patients used contrast media were divided into normal coronary artery group and pathological coronary artery group according to the results of angiography.And the pathological coronary artery group were divided into lesion with single-vessel group,lesion with doublevessel group and lesion with multi-vessel(or left main vessel lesion)group.The 268 patients also were divided into 3 groups according to the dose of contrast media,low dose group,middle dose group and high dose group.Analyse the relativity of grade of coronary artery disease,dose of contrast media and level of serunl ereatinine(Scr)after determination the level of Scr.Results Scr didn't increase after received contrast media in normal coronary artery group,while increased in the pathological COronary artery group and the increase Was remarkable(P＜0.05).The morbidity of CIN in the pathological coronary artery group was up to 14.5%with statistical significance(P＜0.05)from 0%in the normal group.And the recovery of Scr was slow in pathological coronary artery group.The level of Scr was still high with statistical significance in the forth day after angiography(P＜0.05).The dosages of contrast media significandy affected on the Scr and the rate of CIN.The higher dose of contrast media,the higher rate of CIN.Conclusion The CIN could be caused in patients with coronary artery disease,the dosages of contrast media should be controlled strictly.

Retrospective analyses were conducted for the clinical data of two cases with pseudoMeigs' syndrome at our hospital.Both had respiratory symptoms,such as cough and dyspnea.Radiological examinations revealed ascites,pleural effusion and pelvic mass.The definite pathological diagnosis was pelvic malignant tumor.After surgical tumor removal,ascites and pleural effusion disappeared without recurrence.Along with reviewed cases from PubMed in the last decade,a total of 49 cases had pseudoMeigs' syndrome.The age range was 11-73 years.Their clinical manifestations include dyspnea (78％),abdominal distension (69％),cough (14％),abdominal pain (12％),fatigue (10％),weight loss (6％) chest pain (4％),fever (4％),abdominal mass (4％),and oliguria (2％).CA125 was commonly elevated.The primary tumors in pelvic cavity accounted for 78％.And ovarian metastasis from colon cancer was one of the most common in metastatic tumor.

Objective To investigate the roles of high-resolution magnetic resonance imaging (HR-MRI) in the diagnosis and treatment of vertebrobasilar dissecting aneurysms (VBDA).Methods From January 2016 to December 2016,62 patients with VBDA admitted to Xuanwu Hospital,Capital Medical University using 3.0 T HR-MRI (3D-TOF-MRA,3D-T1WI,and 3D-T1WI+C sequence) and diagnosed by DSA were analyzed retrospectively.They were divided into either an asymptomatic group (n=18) or a symptomatic group (n=44) according to their medical histories.Their clinical features,imaging features,and the relationship with prognosis were analyzed.Results HR-MRI revealed that the double lumen sign/intimal flap accounted for 27.8% (n=5) and 54.5% (n=24) respectively in the asymptomatic group and symptomatic group.The intramural hematoma accounted for 22.2% (n=4) and 43.2% (n=19) respectively in both groups.The enhancement of aneurysmal wall accounted for 33.3% (n=6) and 77.3% (n=34) in the asymptomatic group and symptomatic group.There were significant differences in the above features between the two groups (all P<0.05).In the symptomatic group,18.2% (n=8) of patients had aneurysm recurrence,which was significantly higher than the asymptomatic group (5.6%,n=1).The difference between the two groups was statistically significant (P<0.05).Conclusions HR-MRI can better reveal the lesion characteristics of VBDA.The rates of aneurysmal wall enhancement and recurrence in symptomatic VBDAs are higher,which indicates that HR-MRI can assess the stability of the aneurysmal wall and identify the prognosis to a certain extent.

Objective: To study the relationship between the individual psychological characteristic of medical students and the way parents bring up them. Methods: Data on SCL-90, 16PF,EMBU of 1550 medical students were analysed. Results: It is showed that girl students have experienced more of the parents' emotion, understanding and favouritism, while the boy students have experienced more of their parents' refusal, deny, punishment, severity and excessive interference. There are more only-one-children who experience parents' emotion, understanding, interference and excessive protection. Conclusions: Parents' bad breeding attitude and behavior influence children's psychological health and forming of the individual characteristic directly or indirectly

0),whose mean calcification score was 1935.54(0～9833). Patients with calcification score ≥100 had significantly higher morbidity of cardiovascular diseases, serum phosphate level, calcium-phosphate product, C-reactive potein concentration and lower serum albumin than patients with calcification score