Objective: To explore auxiliary diagnostic value of fragmented QRS complex on ECG for acute myocardial infarction (AMI).Methods: Clinical data of 102 AMI patients (AMI group) and 132 CHD patients (CHD) group, who were treated in our hospital from Apr 2013 to Apr 2014, were retrospectively studied, another 120 healthy subjects undergoing physical examination in our hospital during the same period were regarded as normal control group.AMI was diagnosed by myocardial perfusion tomography, all subjects received ECG examination, and incidence rates of fragmented QRS complex and pathological Q wave at different sites were recorded.Sensitivity, specificity and accuracy of fragmented QRS complex and pathological Q wave diagnosing AMI were compared.Results: Incidence rate of fragmented QRS complex was highest on inferior wall in AMI group, and that of pathological Q wave was highest on anterior wall in AMI group.Except fragmented QRS complex in sidewall, compared with normal control group, there were significant rise in incidence rates of fragmented QRS complex on anterior wall (0.8% vs.22.5%, 13.6%) and inferior wall (6.7% vs.26.5%, 17.4%);pathological Q wave on anterior wall (0 vs.41.2%, 29.5%), inferior wall (0.8% vs.40.2%, 35.6%) and side wall (0 vs.2%, 2.3%) in AMI group and CHD group, P<0.01 all.Compared with pathological Q wave, there was significant rise in diagnosing sensitivity for AMI (40.00% vs.89.47%), for CHD (41.94% vs.91.50%) of fragmented QRS complex (P<0.01 both), but there were no significant difference in specificity and accuracy between them (P>0.05 all).Conclusion: Fragmented QRS complex can be used as an important auxiliary index diagnosing acute myocardial infarction.When combined with pathological Q wave, it can further improve diagnostic value of ECG for acute myocardial infarction.

Ischemic cerebrovascular disease is a common and frequently occurring disease in the elderly.It has the characteristics of high disability rate,high mortality rate,and high recurrence rate,which seriously threatens the life and health of the elderly.At present,clinical diagnosis and evaluation are mainly based on medical history,neurological symptoms and signs and imaging examination.The incidence of ischemic cerebrovascular disease is rapid,the existing diagnostic methods have different degrees of hysteresis and limitations in the diagnosis time.Related clinical study found that in the process of ischemic cerebrovascular disease accompanied by serum S-100 beta,matrix metalloproteinase-9 (MMP-9)-related indicators of change.This article reviews the recent progress of S-100 beta and MMP-9 in ischemic cerebrovascular disease.

A simple and rapid method was described for determining nitrogen content of a Kjeldahl digest by pulse polarography. The amount of sample needed was as small as 200mg. The digest was diluted and pipetted into a solution of formaldehyde in an acetate buffer. The hexamethylenetetramine produced by reaction between ammonia and formaldehyde was determined electrochemically at -0.9v.This method proved itself a better reproducibility. The recovery rate of nitrogen was 94.5% to 103.1%. Calibration curve of nitrogen in the range of 20 to 120 ?g/ml showed linear relation.Human milk and eleven different food-stuffs were analysed. There was no significant difference between the results by this method and Kjeldahl method.

BACKGROUND: Traditional anterolateral thigh flaps transplantation has been widely used in clinics; however, a new generation of perforator free flap transplantation is still in an initial phase at home.OBJECTIVE: To investigate the method, effectiveness and clinical application of anterolateral thigh perforator free flaps transplantation for reconstruction of soft tissue defects of the head and extremeties after tumor resection.DESIGN: Case analysis.SETTING: First Affiliated Hospital of Nanhua University.PARTICIPANTS: A total of 16 patients needing skin flap transplantation were selected from Department of Burns and Plastic Surgery, the First Affiliated Hospital of Nanhua University and Department of Plastic Surgery, General Hospital of Toronto, Toronto University from April 2004 to April of 2006. Soft tissues of all patients could not be directly sutured so as to cause the exposure of tendon, vessel, nerve and sclerotin. There were 13 males and 3 females aged from 26 to 72 years. The anterolateral thigh perforator free flap for reconstruction of the soft tissue defects and/or bone exposure occurred on the head (nine cases, mean age of 50 years) or extremities (seven cases, mean age of 39 years) following tumor resection. All patients provided the informed consent.METHODS: After general anaesthesia with tracheal intubation, a two-team approach was used for resection of the tumor, and harvest of the free flap simultaneously or successively. The tumor was removed by head and neck surgeon or orthopedic surgery. And the plastic surgeons assumed the responsibility for reconstruction of the defects following the tumor resection. The dissection of recipient blood vessels (e.g., superior thyroid artery, facial artery, a branch of internal jugular vein, or external jugular vein, artery and vein of dorsal of foot, anterior tibial artery or vein) was performed. In addition, the ends of sural nerve at recipient sites that need be repaired with the anterolateral thigh cutaneous nerve were utilized in two cases with soft tissue defect on the lateral malleolus. The dimensions of the anterolateral thigh perforator flaps were determined on the basis of the defect size. The perforator flap design: A line was drawn between anterosuperior iliac spine and lateral-superior patella for the longitudinal axis of the flap. The required perforator was sought at the middle point of the longitudinal axis in the anterolateral thigh. In general, there would be one to two major perforating branches were confirmed with an ultrasound Doppler monitoring device in the flap. In this article, the biggest anterolateral thigh perforator flap measured 28 cm×15 cm with two major perforating branches. Incision of the skin and subcutaneous tissue was carried out along the periphery of the flap, and dividing and separating subcutaneous tissue layer from deep fascia layer was performed under surgical loupe magnification little by little carefully and slowly to ensure preserving one to two major perforating branches. Retrograde dissection of the deep fascia and/or muscles and/or intermuscular tissue tracing the major perforating branches until the pedicle blood vessels length and diameter were enough for anastomosis with the blood vessels in the recipient sites. If an innervated flap is required, the lateral cutaneous nerve of the thigh can be harvested with the flap. In this article, two cases used flap innervation. The incision could be primary sutured usually and a suction drain should be put at donor sites. The anastomosis of the blood vessels or nerves with 9-0 or 10-0 nylon sutures was performed under the microscope. Interrupted sutures of the edges between the flap and defect region were made; and a suction drain should be put under the flaps. The sutures on the head would be removed at 9-11 days (but 12-15 days, on the extremities) days after operation. The drainage tube would be pulled out generally at 3 days after operation. Recovery condition was observed after operation. Healing phase was classified into phase Ⅰ(healing on time after operation) and phase Ⅱ (non-healing on time after operation). Meanwhile, whether skin flap was necrosis and wound was broken were observed at the same time.MAIN OUTCOME MEASURES: Survival state of patients after skin flap transplantation; shape and function of donor site and recipient site of skin flap.RESULTS: All 16 patients who needed skin flap transplantation were involved in the final analysis. Of the sixteen cases in this group, fifteen perforator flaps survived completely; one flap underwent partial failure. Primary wound healing was achieved (stage I) in all the donor sites, in14 recipient sites and delayed in two (stage Ⅱ). In one case a small portion (about 2.5 cm) necrosed at the distal end of the flap. After removing the necrotic tissue, the wound healed. In another case with a 3 cm long wound dehiscence in the face, the wound healed through dressing change and resuture. After wound healing, there was no significant scaring, and no effect on the lower limb weight bearing and walking. But, there was a sensory loss on a small piece of skin below the donor site, due to destruction of the anterolateral thigh cutaneous nerve on that area.CONCLUSION: Because of less dornor site morbidity, superior result at the reconstructed sites, use of anterolateral thigh perforator flap free grafting is a very acceptable technique for reconstruction of soft tissue defects on head and extremeties after tumor resection.

Objective To evaluate the clinical value of combined detection serum anti-HCG and estradiol and progesterone in infertile women.Methods Serum estradiol(E2) and progesterone(P) in infertile women were detected by ECLIA , Anti-HCG were detected by ELISA.Results the levels of estradiol(E2) and progesterone(P) in anti-HCG positive group were significantly lower than those in anti-HCG negative group.Conclusions The combined detection of anti-HCG and estradiol and progesterone were of important clinical value in diagnosis of infertile women.

Objective To investigate the significance of expression of peroxisome proliferator activated receptor ?(PPAR?) and retinoid X receptor ?(RXR?) in chronic gastritis, gastric mucosal dysplasia and gastric carcinoma and to identify the correlation between PPAR? and RXR?. Methods Avidin biotin peroxidase complex immunohistochemical methods were adopted to examine the expression of PPAR? and RXR? in 53 patients with gastric carcinoma, and 18 with gastric mucosal dysplasia, 31 with chronic non atrophic gastritis and 30 with chronic atrophic gastritis were served as controls. Results The positive rates of PPAR? and RXR? were 41.5% and 54.7% in gastric carcinoma respectively, 27.8% and 38.9% in gastric mucosal dysplasia, 10.0% and 20.0% in chronic atrophic gastritis, 6.5% and 16.1% in chronic non atrophic gastritis. From chronic non atrophic gastritis, chronic atrophic gastritis to gastric carcinoma, expressions of PPAR? and RXR? showed an ascending tendency. Compared with those in chronic gastritis, expressions of PPAR? and RXR? in gastric mucosal dysplasia and gastric carcinoma were significantly enhanced ( P0.05). There was a significant correlation between expressions of PPAR? and RXR? in gastric carcinoma ( r =0.54). Conclusion PPAR? and RXR? protein overexpression is a relatively early event in gastric carcinogenesis, and it may play both an independent and synergetic role in progression of gastric carcionma.

Objective:To analyze 3 123 cases of medical device adverse events(MDAE)and provide some suggestions for the MDAE monitoring.Method:By the retrospective case study,3 123 MDAE reports were analyzed in Hunan Province in 2007.Result:The reports mainly came from medical institutions and other drug-use units.Intrauterine devices (IUD),medical suture thread and orthopedic implants caused a higher proportion of adverse events.The quantities of MDAE reports were imbalanced in different regions.Conclusion:The MDAE monitoring should be promoted by propaganda and training in order to ensure the safe use of medical devices in public.

Simultaneous determination of zinc, cadmium, tin, lead and copper was studied in 0.2-0.3M hydrochloric acid-methanol by 1.5 grade differential anodic stripping voltammetry. A stick silver base mercurial film electrode was used as a working electrode. The peak potential of Zn, Cd, Sn, Pb and Cu was distinctly separated each other being -1.05V, -0.74V -0.55V, -0.44V and -0.25V vs SCE, respectivly, in the above solvent electrolyte.Calibration curves of Cd, Sn, Pb and Cu in range of 20 to 600 ng/ml and Zn in range of 0.2 to 4 ug/ml showed linear relation. Canned foods could be analyzed, by dilution with the supporting electrolyte after digestion of the samples with mixed acid. The juice samples could be analyzed directly without digestion, by simple 5-2000 times dilution with the supporting electrolyte. Coefficient of variation and recovey was 6.7-8.0% and 91.2-107% respectively.

Objective To investigate the characteristics of etiology,efficacy of endoscopic management for recurrent idiopathic pancreatitis (RIP).MethodsThe clinical data of 58 cases of RIP diagnosed in our hospital from April 2005 to April 2011 were retrospectively analyzed.All the patients underwent endoscopic retrograde cholangiopancreatography (ERCP),and patients with suspected sphincter of Oddi dysfunction received manometry.According to the clinical and ERCP manifestations,the etiologies of RIP were determined and individualized endoscopic treatment was applied.The patients were followed-up postoperatively about the improvement of abdominal pain and recurrence of RIP.ResuItsFifty-eight patients (29 males,29 females) were suffered from acute pancreatitis from 3 to more than 10 times.The etiologies were as follows:29 cases of biliary microlithiasis,19 case of sphincter of Oddi dysfunction ( 16 cases of pancreatic type,3 cases of mixed type),4 cases of anomalous arrangement of the pancreaticobiliary duct,and 6 cases of normal manifestations at ERCP.Biliary sphincterotomy alone was performed in 33 patients,while both biliary and pancreatic sphincterotomy was performed in 8 patients,and pancreatic sphincterotomy alone was performed in 17 patients,after sphincterotomy,pancreatic stent insertion was performed in 24 patients.The follow-up data was obtained from 41 out of 58 patients,the follow-up period ranged from 3 ～ 67 months ( average 33 months).During this period,9(22.0％ ) patients suffered from RIP,and the treatment efficiency was 78％.ConclusionsBiliary microlithiasis and sphincter of Oddi dysfunction are the main causes of RIP.Drink could induce RIP.ERCP has definite treatment efficacy for RIP.

BACKGROUND: There is still recrudescent risk in the convalescence stage of the acute myocardial infarction and the living condition is relatively poor. The study proved that it has relation to that the patients haven't mastered the scientific conformable life style for the myocardial infarction recovery.OBJECTIVE: Take the rehabilitation education to help the patients set up conformable life style so as to improve the quality of life.DESIGN: The patients in the convalescence stage of the acute myocardial infarction were chosen for the control study.SETTING: Nursing Institute of Beijing Medical University and two university hospitals.PARTICIPANTS: The cases were taken from the Cardiology Departm ents of the Second and Third Affiliated Hospital of Beijing Medical University from April 1999 to November 1999. Inclusive standard: the first onset of the acute myocardial infarction and voluntary for this study. Exclusive standard: not the first onset of the acute myocardial infarction. The control group contained 35 patients hospitalized from April 1999 to June 1999 conforming to the including standard. The experimental group contained 40 patients hospitalized from August 1999 to November 1999 conforming to the including standard. After eliminating the special unmatched cases and missed follow-up cases in the experimental group, the final 30 cases were respectively involved in the both groups. There were 23 male cases and 7 female cases in the control group with the mean age of(60 ± 14), and 22 male cases and 8 female cases in the experimental group with the mean age of(62 ± 10) . There was no significant difference in the age and sex in these two groups.METHODS: The Neuman health care system pattern was taken as the theoretical frame for the rehabilitation education of the patients in the convalescent stage of the acute myocardial infarction. That is the conver genceteaching and personal illustration accompanied the rehabilitation education hand books were adopted for the rehabilitation education in the experimental group before their leaving. Then the telephone education was taken for further direction and consultation during the first three months after being discharged. The evaluation information was obtained through the follow-up after the first three months.MAIN OUTCOME MEASURES: The quality of life and dimensions in the two groups.RESULTS: Compared with the control group, the scores of the quality of life, the dimensions of the body, the psychology, the duty role and the health consciousness in the experimental group were all significantly higher(t= 11.03,3.26,3.62,2.05,15.48, P < 0. 05), while there was no significant difference in the social degree( P > 0.05) .CONCLUSION: The rehabilitation education can significantly improve the quality of life of the patients in the convalescence stage of the acute myocardial infarction.