Objective To discuss the influence of Saccharomyces boulardii on serum apolipoprotein levels in liver cirrhosis patients with spontaneous bacterial peritonitis (SBP).Methods 74 liver cirrhosis patients with SBP were selected and randomly divided into the observation group and control group.Patients in the two groups were given routine medical treatment such as liver protection and diuretic effect,correction of hypoproteinemia,anti-infection etc.Patients in the observation group were orally given Saccharomyces boulardii 0.5g for one time,two times daily for 4 weeks.The changes of serum apolipoprotein A1 and B levels in two groups were observed and compared,and the curative effect and safety were also observed.Results After treatment for 4 weeks,the serum apolipoprotein A1 and B levelsintwogroupswereobviouslyincreasedcomparedwithbeforetreatment (t =2.46,2.3 7,3.04,2.87,P ＜ 0.05or P ＜0.01),and the increase of observation group was much higher than that of control group(t =2.29,2.23,all P ＜ 0.05).Meanwhile,the total effective rate of the observation group (91.89％) was significantly higher than that of control group (72.97 ％) (x2 =4.57,P ＜ 0.05).3 cases and 5 cases of adverse reactions appeared in control group and observation group,the symptom was light and no serious drug adverse reaction(DAR) observed.The incidence rate of DAR between the two groups had no obviously statistical difference (x2 =0.14,P ＞ 0.05).Conclusion Saccharomyces boulardii has reliable curative effect and high security in the treatment of liver cirrhosis patients with SBP,the mechanism may be related with increasing the synthesis of apolipoprotein A1 and B in the liver and intestine,and increasing serum levels of apolipoprotein A1 and B.

Objective The purpose of this study was to explore the risk factors of recurrence of atrial fibrillation (AF) after surgical radiofrequency ablation in patients undergoing cardiac valve surgery.Metbods Retrospective analysis was made in 255 cardiac valve patients undergoing concomitant radiofrequency modified Maze operation from April 2010 to December 2012 in Nanjing Drum Tower Hospital.Multivariate logistic regression analysis was used to screen independent risk factors for predicting recurrence of AF.Results Excluding 8 patients died after surgery,11 cases who were junctional rhythm after ablation or received pacemaker implantation and 60 lost case,176 patients were finished follow-up.107 cases maintained stable sinus rhythm (SR),whereas other 69 cases developed AF recurrence.Multivariate logistic regression analysis found larger left atrial size,higher B-type natriuretic peptide,lower preoperative heart rate and postoperative AF rhythm before discharge were independent risk factors for predicting AF recurrence.Conclusion Larger left atrial size,higher B-type natriuretic peptide and lower preoperative heart rate before surgery can impact outcome of surgical radiofrequency ablation in patients undergoing cardiac valve surgery after following 12(4-38)months.They can be used in clinical practice to choose more suitable cardiac valve patients with AF for surgical ablation.Postoperative appearance of AF rhythm before discharge indicated a poor prognosis,which should be interfered with drugs or electrical cardioversion.

Objective To study the preventive effect of artemether (Art) in protecting the people from schistosome infection during flood fighting in schistosomiasis endemic area of Poyang Lake, Jiangxi Province. Methods From mid July to mid August in 1996, the water level in Poyang Lake rose due to torrential rains and 2 embankments, Zhedi and Jiangtongdi, which appeared in dangerous situation and were selected as the pilot spots. After those who went to fight against flood arrived at the pilots their sera were collected within 48 hours and were examined with indirect hemagglutination test (IHA), enzyme-linked immunosorbent assay (ELISA) and McAb-ELISA. Individuals with negative outcome in the 3 tests were then selected as the study subjects and were allocated randomly to the Art or the control group. The first dose of Art given to the individuals contacted with the infested water within 11-15 days was 6 mg/kg. If the individual continually contacted the infested water, the same dose of Art was given once every 15 days. After the individuals withdrew from the pilot, one more dose of Art was administered 7-15 days later. Placebo (starch) was given to individuals in the control group at the same period as in artemether group. Stool examinations were made in both groups 40-50 days after the last medication for evaluation of the preventive effect of artemether. Double blind method was used in the administration of both artemether and placebo. Results In Zhedi pilot, the individuals fought against flood for about 1 month. In Art group, 99 individuals receiving 3 doses of the drug completed the stool examination with egg-positive rate of 4% and no acute schistosomiasis was seen. In the control group, among 110 people who completed the observation, 44 were egg-positive with an infection rate of 40%, and 29 were identified as having acute schistosomiasis. In Jiangtondi, the studied individuals contacted the infested water for only about 4 hours. But in the control group 4 out of 102 individuals were egg-positive, while none of the 103 individuals in Art group receiving 2 doses of the drug showed schistosome infection. No apparent side effect was seen in the people treated with artemether.Conclusion After oral Art was given to the people fighting against flood in schistosomiasis endemic area of Poyang Lake, it was shown that the oral Art has a promising effect on controlling acute schistosomiasis and reducing the infection rate.