Objective To study some sensitive electrophysiological parameters in surveillance of allograft rejection.Methods Forty rats underwent heterotopic heart transplantations.IMEG was re- corded by an epicardiac unipolar pacing lead fixed at the right ventricular outflow tract.QRS amplitude and heart rate were determed daily in 10 syngeneic and 30 allogeneic transplants.Syngeneic transplants were killed at 7 th postoperative day,and allogeneic transplants killed at 3 rd,5 th and 7 th postopera- tive day.Histopathologie studies were performed at every transplanted heart.Results In syngeneic group,QRS amplitude kept constant after the transplantation while no significant differences were ob- served at the 3 rd,5 th and 7 th postoperative day.QRS amplitude was dropped obviously in allogeneic group after the first two postoperative days whereas significant differences were observed at the rejec- ting and non-rejecting hearts.Conclusions IMEG is a valid method to monitor acute allograft rejec- tion.QRS amplitude is a more sensitive electrophysiological parameter to diagnose severe rejections than heart rate,while mild rejections were not detected by this method.

Objective To study the prognostic value of procalcitonin(PCT) and C?reactive protein ( CRP ) in critically ill patients with ventilator?associated pneumonia ( VAP )?Methods A single?center prospective observational study was conducted?A total of 67 cases patients with VAP admitted into intensive care unit(ICU) from November 2013 to October 2015 were enrolled and grouped as survivors(43 cases) and non?survivors(24 cases)?Blood samples for PCT and CRP were collected on the day of the pneumonia diagnosis,and the 4th and 8th day after the diagnosis?Results There were 24 cases(35?8 %) died among the 28 days after the pneumonia diagnosis?There was no significant difference between the survivor and non?survivor groups in terms of PCT on the day of the pneumonia diagnosis( P>0?05) ,or CRP on the day of the pneumonia diagnosis, and the 4th and 8th day after the diagnosis ( P>0?05)?But the PCT values on the 4th and 8th day were significantly higher in the non?survivor group than the survivor group(4 d:0?4(0?3,1?1) μg/L vs?4?7(2?3, 10?8) μg/L,P<0?05;8 d:0?2(0?1,1?7) μg/L vs?3?9(3?2,14?8) μg/L,P<0?05)?PCT levels decreased significantly from the day of the pneumonia diagnosis(0?7(0?4,4?2) μg/L) to the 8th day after the diagnosis (0?2(0?1,1?7) μg/L,P<0?05) in the survivor group?The PCT level above 1 μg/L on the 4th day after the diagnosis was the strongest predictor of mortality,with an odds ratio of 23?Conclusion PCT is found to be a more important prognostic marker compared to CRP in terms of predicting mortality in critically ill patients with VAP?The PCT level on the 4th day after the diagnosis is the strongest predictor of mortality in VAP.

Objective To investigate the clinical features of rheumatoid arthritis combined with femur head necrosis. Methods The clinical data of 22 patients with rheumatoid arthritis combined with femur head necrosi were retrospectively analyzed. Results Among the 22 patients with rheumatoid arthritis combined with femur head necrosi, male was in 5 cases, female was in 17 cases, age was 28-69 (56.3 ± 1.9) years, and the disease duration of rheumatoid arthritis was 4-30 (14.1 ± 1.2) years. All patients had ≥ 2 grade femur head necrosis, with bilateral femur head necrosis in 9 cases, right femur head necrosis in 9 cases and left femur head necrosis in 4 cases. Only 2 cases did not take glucocorticosteroid, and the other 20 cases used glucocorticosteroid in the long-term. The treatment was no standardized. The multiple fracture was found in 4 cases by X-ray examination (the patients had no history of trauma); 4 cases examined bone density, and the results showed they all were osteoporosis. Conclusions Rheumatoid arthritis combined with femur head necrosis is not uncommon. The majority of patients receive long-term glucocorticosteroid treatment. Treatment is not standardized, and some patients are combined with osteoporosis.

Objective To explore the efficacy of long- and short-acting triptorelin on pituitary down-regulation in long protocol and the pregnancy outcome in vitro fertilization and embryo transfer (IVF-ET) . Methods Three hundred and seventeen patients for IVF-ET were enrolled as study and randomized them into two groups. In group A (n=145), patients received single dose subcutaneous injection of 1.25 mg long-acting diphereline in mid-luteal phase. In group B (n=172), patients received 0.1 mg/d subcutaneous injection of short-acting diphereline in mid-luteal phase for 14-18 days until pituitary suppression were got,and then reduced to 0.05 mg/d until the injection of HCG. Results The dose and the days of gonadotropin administration in group A were bigger and longer than those in group B ( <0.05) . There were no significant differences in the number of retrieved oocytes, fertilization rate,high quality embryos,implantation rate and clinical pregnancy rate between the two groups (all > 0.05) . But clinical pregnancy rate of group B had increasing trend. Conclusion Administration of short-acting diphereline has the similar effect with that of long-acting diphereline on pituitary down-regulation in long protocol. Short-acting diphereline requires lower amount of gonadotropin and is more flexible,so it should be recommended.

Objective To analyze the correlations of vascular structure, hemodynamic changes and surgical recanalization of carotid endarterectomy ( CEA) for the treatment of subtotal or complete occlusion of carotid artery. Methods A total of 107 patients with carotid artery occlusive disease diagnosed at Beijing Xuanwu Hospital,Capital Medical University received CEA therapy from January 2005 to January 2014 and were enrolled retrospectively. According to the findings of introperative ultrasound,they were divided into either a recanalization group (n=86) or a non-recanalization group (n=21). Preoperative and intraoperative carotid artery diameter and blood flow velocity were compared and analyzed with carotid ultrasonography. Intraoperative detected vascular abnormalities, residual vascular stenosis rate, blood flow velocity and pulsatility index of the ipsilateral middle cerebral artery ( MCA) were documented. Results (1) The peak systolic velocity (PSV) (82 ± 32 cm/s and 60 ± 17 cm/s),mean velocity (MV) (50 ± 19 cm/s and 42 ±13cm/s),and pulsatility index (PI) (0. 97 ± 0. 25 and 0. 67 ± 0. 14) on the ipsilateral MCA in patients of carotid artery recanalization before and after procedure were significantly higher than those during the procedure. There were significant differences (all P=0. 000). In patients failed to recanalize,the intraoperative and preoperative PSV,EDV,and MV of MCA were 46 ± 20 cm/s and. 63 ± 21 cm/s,24 ± 13 cm/s and 34 ± 12 cm/s, and 32 ± 16 cm/s and 44 ± 15 cm/s,respectively. They were reduced more significantly during the procedure than those after procedure. There were significant differences ( all P=0. 000 ) . But there was no significant difference in PI (0. 70 ± 0. 18 and 0. 67 ± 0. 15) compared with that before procedure (P=0. 317). (2) The diseased vascular diameter of the recanalization group was significantly widened (0. 6 ± 0. 4 mm vs. 3. 4 ± 0. 9 mm,P=0. 000) compared with before procedure. The overall recanalization rate was 80. 4% (86/107). Intraoperative ultrasound revealed that 13 patients had mild abnormal vascular structures among the recanalized patients. The non-recanalized patients had significantly abnormal vascular structure. Conclusion Intraoperative carotid ultrasound in combination with transcranial Doppler (TCD) for monitoring cerebral blood flow may effectively identify the carotid structure and the degree of cerebral hemodynamic improvement,and timely guide the secondary repair.

Objective Using transcranial Doppler (TCD) to evaluate the effect of selective shunt (SS) during carotid endarterectomy (CEA). Methods TCD was used for intraoperative bilateral middle cerebral artery (MCA) cerebral blood flow continuous monitoring in 169 patients with carotid stenosis treated with CEA. The patients were divided into shunt (n =32)and non-shunt (n = 137) groups according to whether they performed shunt or not. The open approaches of anterior collateral circulation were recorded. The peak systolic velocity (PSV),mean velocity (MV), pulsatility index (PI), and ratio of MV in bilateral MCA were compared after anesthesia, before and after carotid artery occlusion, before and after shunt, and after carotid artery open. Results MV before carotid artery occlusion in the shunt and non-shunt groups were 34.73 ± 13.54 cm/sand 35.32 ± 13.18 cm/s, respectively, and there was no significant difference (P = 0. 825). MV in the shunt group after carotid artery occlusion was significantly decreased in the non-shunt group (P =0. 000). The mean decline rate of MCA MV was 69.34% ± 20. 93%, and it was decreased more significantly than that in the non-shunt group (P=0. 000). The decline rate of MCA MV was increased significantly after shunt operation, the average increase was 35.68 ± 16.69 cm/s (P=0. 000). Conclusions TCD can objectively evaluate the hemodynamic changes before and after shunt operation.

Objective In the present study,we use GC/MS-based metabolomics approaches to make analysis of serum metabolic profiles of healthy people and the hyperactivity of liver yang type of constitution in patients with essential hypertension.Try to establish the discriminant model,to discover biomarkers (group) of the hyperactivity of liver yang type of essential hypertension,and to explore the essential material basis of Traditional Chinese medicine syndrome theory.Methods Classified according to the guiding principles of Chinese medicine research,the hyperactivity of liver yang type of constitution in male patients with essential hypertension (n=18),as well as health volunteers (n=15) were randomly selected from Guang An Men Hospital clinic,wards and medical center in the first half of 2010,selected patients with essential hypertension requirements are not taking any drugs or Chinese herbs,or stop taking the various drugs more than one week.Extracted Venous Blood of subjects fasting for 12 hours,and serum was separated through centrifugation.Serum samples are stored and at-86℃ refrigerator.Survey and evaluate endogenous metabolism in serum samples of health control group and types of syndrome mentioned above by gas chromatograph mass spectrometry (GCMS)analysis.Then,analyze the metabolites with Partial Least Squares-Discriminant Analysis.Further use PCA to analyze the principal component factor loadings matrix analysis,and for variable scatter plot (Loading plot),significant increase or decrease the variables can be found from the figure.The combination of these variables is the lesion biomarkers group.Results Compared with the health control group,13 differentially expressed metabolites in the essential hypertension hyperactivity of liver yang type group can be identified (P＜0.05).8 metabolites were up-regulated expression:Uric acid,citrate,Octadecanoic acid,Hexadecanoic acid,Octadecadienoic acid,Leucine,Cholesterol,Norvaline,and 5 metabolites were down-regulated expression:arachidonate,Oleate,Alanine,Aspartic acid,glycine.Conclusion We are incline to regard that the 13 of EH patient serum differentially expressed metabolites are EH hyperactivity of liver yang syndrome metabolic biomarkers:Uric acid,citrate,Octadecanoic acid,Hexadecanoic acid,Octadecadienoic acid,Leucine,Cholesterol,Norvaline,Arachidonate,Oleate,Alanine,Aspartic acid,glycine.

Objective To explore the correlation between plantar pressure and walking function in hemiplegic stroke patients.Methods Thirty hemiplegic patients with stroke (a hemiplegic group) and thirty age-matched healthy persons (a control group) were recruited.Gait and balance function training and assessment system (model:AL-600) were used to quantify the walking velocity,peak plantar pressure at heel-strike and push-off periods and displacement of center of pressure (DCOP) of all subjects during walking.The asymmetry of gait was calculated.Two independent sample t-test were used to compare the walking velocity,peak plantar pressure and DCOP for the two groups.Pearson correlation coefficients were applied to analyze the correlation between the walking velocity and peak plantar pressure and DCOP.Results The walking velocity,the peak plantar pressure at heel-strike and push-off periods and DCOP of the hemiplegic group were significantly lower than the control group.In the hemiplegic group,the asymmetry of peak plantar pressure and DCOPx significantly increased,while that of DCOPy became bigger without significant difference.Moreover,the walking capacity of the hemiplegic group was positively correlated with the peak plantar pressure and DCOP.Conclusion Among hemiplegic stroke patients,both the peak plantar pressure at heel-strike and push-off periods lower in a way.Their capacity of weight transfer decreases,which is closely related to their walking velocity.

Objective To research the fibrosis characteristics of Atrial Fibrillation(AF) patients under microscope and its effect to post-operative sinus conversion of Radiofrequency ablation treatment.Methods Based on Lefi Atrial Dimension (LAD).Left atrial appendage tissue samples of 60 AF patients who received bipolar radiofrequency ablation treatment during open heart surgery between July and December 2011,were divided into 4 groups:group a (LAD≤50 mm),group b (50 mm ＜ LAD≤60 mm),group c (60 mm＜ LAD ≤70 mm),group d (LAD ＞ 70 mm),15 patients in each group.The levels of atrial muscle fibrosis and cell size differences are compared for colored slides of samples.Research are done for the difference of sinus rhythm restoration rate among the 4 groups based on ECG records at immediate,leaving hospital,and 3,6,12 months postoperative are collected for all groups.Results Differences of CVF and atrial muscle cell size measured under microscope are statistically meaningful(P ＜ 0.001).Sinus rhythm restoration rate differences at 6 month(P =0.039) and 12 month (P =0.037) post-operative are statistically meaningful.Further,immediate,leaving hospital,and 3,6,12 months postoperative sinus rhythm restoration rates are 93.3％,93.3％,93.3％,100％,100％ for group a,80.0％,73.3％,80.0％,80.0％,80.0％ for group b,66.7％,66.7％,66.7％,73.3％,66.7％ for goup c,and 53.3％,53.3％,53.3％,60.0％,60.0％ for group d respectively.Conclusion For rheumatic heart valve diseases patients who at 6 and 12 month post-operative,the greater the LAD,the higher the atrial fibrosis level,the greater the cell size,the lower the sinus rhythm restoration rate is.

Objective To explore any correlation between gait asymmetry and the balance of hemiplegic stroke survivors.Methods Thirty patients with hemiplegia caused by stroke but who could walk more than 10 metres independently were recruited as the experimental group; 30 age-matched healthy elderly people served as the control group.An AL-600 gait analyzer was used to quantify the spatial and temporal gait parameters of all subjects.Gait asymmetry ratios were calculated.The 30 stroke patients were also assessed with the Berg balance scale (BBS).Two independent sample t-tests were used to compare the step length asymmetry (SLA),swing time asymmetry (SWTA) and STA (stance time asymmetry) ratios for the two groups and their average step widths.Pearson correlation coefficients were calculated relating the SLA,SWTA,STA,step width and BBS results.Results Among the experimental group,swing time and step length on the affected side were significantly different from the unaffected side,and stance time on the affected side was significantly shorter.The control group showed no such significant differences.All of the experimental group's average asymmetry ratios were significantly greater than those of the control group,as was their step width.Step width and BBS score were negative correlated,but step width was positively correlated with the step length and swing time asymmetry ratios.BBS scores were negatively correlated with the step length and swing time asymmetry ratios.Stance time asymmetry and step width showed no significant correlation with the BBS scores.Conclusion The gait of hemiplegic stroke patients is both spatially and temporally asymmetric,and a certain correlation exists between the degree of asymmetry and balance function.