ObjectiveTo investigate the practical value of non-invasive positive pressure ventilation (NIPPV) in the treatment of acute left heart failure(ALHF).MethodsThe clinical effects and complications of NIPPV performed on 36 cases with severe ALHF on the basis of conventional treatment were evaluated and compared with previous treatment without NIPPV.ResultsOf 36 cases with ALHF treated by NIPPV,30 cases improved,6 cases were altered to receive invasive ventilation or dead.Total effective rate was 83.3%.Compared with 42 cases with severe ALHF treated only by conventional treatment in the past 5 years,with only 26 cases being successfully salvaged and effective rate being 61.9%,significant difference (P

Objective To study the clinical significance of molecular markers and routine coagulation tests in patients with cerebral infarction and to set up a serial programs of laboratory diagnosis,monitoring and treatment of cerebral infarction.Methods Prothrombin fragment 1+2(F1+2),thrombin antithrombin III complex(TAT), D-dimer(D-D),Von willebrand Factor(vWF),antithrombin(AT), protein C(PC),prothrombin time(PT),activated partial thromboplastin time(APTT) and thrombin time (TT) were determined in 90 patients with cerebral infarction and 60 normal control subjects.Results The levels of F1+2,TAT,D-D,vWF were significantly higher in patients with cerebral infarction than that in control subjects. But the levels of PC,AT,PT,APTT,TT in patients with cerebral infarction were no different from that in control subjects.Conclusion There were hypercoagulable states in patients with cerebral infarction.The activity of prothrombin is higher, thrombin is generated more, the activity of fibrinolysis is higher too, but anticoagulation system is not sufficiently activated .Meanwhile, perhaps endothelial lesion would be the main role of coagulation system activating and pathogenesis.Molecular markers such as F1+2,TAT,D-D,VWF can be as diagnositic signs but routine coagulable tests can not display the hypercoagulable states in patients with cerebral infarction.

Accessory pathway-induced dilated cardiomyopathy is a new diagnosis proposed recently.Pre-excitation of part of the myocardium may mediate electrical and mechanical dyssynchrony,which will result in decreased left ventricular systolic function and increased diameter of left ventricle in patients with right-sided overt accessory pathways (type B ventricular preexcitation).Its features are listed as follows:(1) Incessant and prolonged tachyarrhythmia never happened.Tachycardiomyopathy and other causes of dilated cardiomyopathy are excluded.(2) Right-sided overt accessory pathways are shown by electrocardiogram.(3)Echocardiography indicates dyssynchronous left ventricle contraction,decreased left ventricular systolic function and increased diameter of left ventricle.Normal interventricular septal motion,recovered left ventricular and reversed left ventricular remodeling can be realized by radiofrequency ablation with a good prognosis.To infant patients,taking anti arrhythmia drugs to inhibit the conduction of the accessory pathway was recommended.

Objectives In order to develop a rapid microsatellite genotyping assay for inter-strain differentiation of Candida albicans isolates and understand the transmission characteristics of the infections. Methods DNA was extracted from C. albicans isolates from genitals, anal canals and oral cavities of 39 women and 27 men with genital candidiasis. The microsatellite sequences in stabel genes(CDC3, EF3 and HIS3) were amplified by a fluorescence labeled PCR. Fluorescent signals were read with an automatic se- quencer, and the data were collected with GeneScan software followed by genotyping with Genotyper soft- ware to analyze polymorphic microsatellite loci. Results Combined analysis of the 3 microsatellite markers showed 18 gene allele associations in C. albicans from genital sites of all men and women, including 10 in women, 11 in men and 3 in both. The allele associations of dominant pathogenetic strains for both sexes were 116:124, 122:131,160:200, which covered 50% of pathogenetic infection. Three common allele associations for both sexes covered 71% of all infections. Genitals and anal canals shared strains of same allele associations in 80% of women and in only 3.8% of men. The strains of same allele associations were identified in both genitals and mouth in 2.7% of women but in none of men. In their genital sites 71% of couples shared the same allele strains, of which 80% were the dominant pathogenetic strains identified in both sexes. Conclusions The improved microsatellite genotyping assay is useful for rapid differentiation, identification of infective source, and contact tracing of C. albicans infection. There are pathogenetic C. albi- cans strains with predominant allele associations in genital infections.

Objective To study and compare the clinical efficacy between intravitreal conbercept injection and (or) macular grid pattern photocoagulation in treating macular edema secondary to non-ischemic branch retinal vein occlusion (BRVO).Methods Ninety eyes of 90 patients diagnosed as macular edema secondary to non-ischemic BRVO were enrolled in this study.Forty-eight patients (48 eyes) were male and 42 patients (42 eyes) were female.The average age was (51.25 ± 12.24) years and the course was 5-17 days.All patients were given best corrected visual acuity (BCVA),intraocular pressure,slit lamp with preset lens,fluorescence fundus angiography (FFA) and optic coherent tomography (OCT) examination.The patients were divided into conbercept and laser group (group Ⅰ),laser group (group Ⅱ) and conbercept group (group Ⅲ),with 30 eyes in each group.The BCVA and central macular thickness (CMT) in the three groups at baseline were statistically no difference (F=0.072,0.286;P=0.930,0.752).Patients in group Ⅰ received intravitreal injection of 0.05 ml of 10.00 mg/ml conbercept solution (conbercept 0.5 mg),and macular grid pattern photocoagulation 3 days later.Group Ⅱ patients were given macular grid pattern photocoagulation.Times of injection between group Ⅰ and Ⅲ,laser energy between group Ⅰ and Ⅱ,changes of BCVA and CMT among 3 groups at 1 week,1 month,3 months and 6 months after treatment were compared.Results Patients in group Ⅰ and Ⅲ had received conbercept injections (1.20 ± 0.41) and (2.23 ± 1.04) times respectively,and 6 eyes (group Ⅰ) and 22 eyes (group Ⅲ) received 2-4 times re-injections.The difference of injection times between two groups was significant (P＜0.001).Patients in group Ⅱ had received photocoagulation (1.43 ±0.63) times,9 eyes had received twice photocoagulation and 2 eyes had received 3 times of photocoagulation.The average laser energy was (96.05 ±2.34) μV in group Ⅰ and (117.41 ±6.85) μV in group Ⅱ,the difference was statistical significant (P=0.003).BCVA improved in all three groups at last follow-up.However,the final visual acuity in group Ⅰ and group Ⅲ were better than in group Ⅱ (t=4.607,-4.603;P＜0.001) and there is no statistical significant difference between group Ⅲ and group Ⅰ (t=-0.802,P=0.429).The mean CMT reduced in all three groups after treating for 1 week and 1 month,comparing that before treatment (t=-11.855,-10.620,-10.254;P＜0.001).There was no statistical difference of CMT between group Ⅰ and Ⅲ at each follow up (t=0.404,1.723,-1.819,-1.755;P=0.689,0.096,0.079,0.900).CMT reduction in group Ⅰ was more than that in group Ⅱ at 1 week and 1 month after treatments (t=-4.621,-3.230;P＜0.001,0.003).The CMT in group Ⅲ at 3 month after treatment had increased slightly comparing that at 1 month,but the difference was not statistically significant (t=1.995,P=0.056).All patients had no treatment-related complications,such as endophthalmitis,rubeosis iridis and retinal detachment.Conclusions Intravitreal conbercept injection combined with macular grid pattern photocoagulation is better than macular grid pattern photocoagulation alone in treating macular edema secondary to non-ischemic BRVO.Combined therapy also reduced injection times comparing to treatment using conbercept injection without laser photocoagulation.

Objective To investigate the differences in dosimetry between conformal radiotherapy (CRT),field-in-field intensity-modulated radiotherapy (FIF-IMRT),and intensity-modulated radiotherapy (IMRT) after breast-conserving surgery for left-sided breast cancer.Methods A total of 31 patients who underwent breast-conserving surgery for left-sided breast cancer were randomly selected,and the plans for CRT,FIF-IMRT,and IMRT were developed.The dose-volume histogram (DVH) was used for self-control study,and the non-parametric test was used to compare the differences in target volume and doses to organs at risk (OARs).Results All the three methods met the requirements of the prescribed doses.The CRT group had a higher V105 of the target volume and higher heart V30 and Dmax (P=0.000,0.000,0.000).The IMRT group had higher V5 and Dmean (P=0.000,0.000),as well as a higher lung V5 and a lower lung V40 (P=0.000,0.000).The FIF-IMRT group had the lowest Dmean (P=0.000),and the IMRT group had significantly higher Dmean and Dmax of the right lung and the spinal cord than the other two groups (P=0.000,0.000,0.000,0.000).The FIF-IMRT group had a significantly lower single hop count than the other two groups (P=0.000).Conclusions CRT has a good dose distribution in the target volume,but greatly injures the surrounding tissues.FIF-IMRT can well protect OARs and cause less damage to the device.

Objective To establish normal range of components of cord blood cells in healthy fetuses from 19 to 37 weeks' gestation and to provide proof for diagnosis of hematological disorders in prenatal fetuses and premature infants.Methods Twelve hematological parameters were determined in 182 fetuses using Coulter GENS system 2 full automated blood cell counter,and the blood cells were classified by microscope.Results The number of white blood cell(WBC) was increased gradually from 3.58?10~9/L to 5.76?10~9/L with the gestational weeks increasing from 19 to 37 weeks.The differential counts indicated that the lymphocytes represented the main population.The number of lymphocytes and normoblast was decreased gradually and that of neutrophils was increased gradually.The numbers of monocytes,eosinophils and basophils remained stable as the increasing of gestational weeks.The red blood cell(RBC),hemoglobin(HGB) and hematocrit(HCT) were increased gradually but mean corpuscular volume(MCV) was decreased.The differences between mean corpuscular hemoglobin(MCH),platelet volume distribution width(PDW),mean platelet volume(MPV),plateletcrit(PCT) and mean corpuscular hemoglobin concentration(MCHC) were not significant among different fetuses' ages.Conclusion The components of cord blood cells in healthy fetuses are dynamic and the establishment normal range of components of cord blood cells in healthy fetuses is helpful to diagnose the disorders in prenatal fetuses and premature infants.

AIM: To assess the differentiation of rat mesenchymal stem cell (MSC) in the microenvironment of retinitis pigmentosa(RP) induced by the administration of sodium iodate. METHODS: In vitro cultured Lewis rat MSC were injected into the subretinal space of NaIO3 induced RP rat eyes (30g/L NaIO3 100mg/kg). To observe the trace and differentiation of MSC by immuno-fluorescent method successively in 5 weeks after the surgery.RESULTS: The majority of the transplanted cells stay in retinal pigment epithelium(RPE) layer and cones and rods layer. From the 2nd week after transplantation, the engrafted MSC expressed PCK and rhodopsin under fluorescent microscope.CONCLUSION: MSC can survive mainly in the outer layer of retina in the microenvironment of RP and differentiate forward the RPE cell and photoreceptor.

AIM: To analyze the genotype of the allele distribution of a polymorphic G-954C within the 5 upstream promoter region of the nitric oxide synthetase 2A gene (NOS2A) in samples of diabetic retinopathy in patients with cystoid macular edema in the mainland of China.METHODS: Eighty-nine patients with diabetic retinopathy and cystoid macular edema and 90 healthy controls were enrolled in this study. Nest polymerase chain reaction (PCR)was performed, and restriction endonudease digestion and gene fragments sequence were examined to detect the genotype of NOS24 G-954C.RESULTS: The genotypes of the sample population of 89 cases and 90 healthy controls were all detected as GG.CONCLUSION: The distribution of G-954C of NOS2A polymorphism are at a lower frequency in China, with little relevancy to the frequency of diabetic retinopathy combined with cystoid macular edema.

This article applied stochastic frontier analysis to estimate the efficiency of the 2007 Beijing Medicine Development Foundation,and analyzed the dominant influencing factors of the performance.The following results were found out..(1) The performance of 2007 Beijing Medicine Development Foundation was good in general,however there was a 23％ gap between the actual output and the frontier output.As time passes by,the expected performance will get better.(2) There are large differences existed between various categories of projects and the different levels of institutions and project leaders.The relatively high profile projects,which means large input and more complexity,requires higher level of facility and environmental support,project manager's degree,professional title,while technical efficiency is not obvious for small scale independent innovation projects.