Objective To discuss both clinical and epidemiological features as well as the changing trend of aortic dissection(AD).Methods Retrospective analysis on 238 patients with AD over a 10 year period in the First Affiliated Hospital of Xinjiang Medical University.Hospital records and data on prognosis were compared between the two five-year periods.Results 238 cases with AD were hospitalized during the past 10 years with mesh age as 51.9±12.1.The male/female ratio was 3.67 to 1.Hypertension was present in 73.5%of all the patients.Heavy smoking history was elicited in 44.1% of all the patients.Type Ⅰdissection were identified in 35.3% of all the cases,7.6% in type Ⅱ and 57.1%in type Ⅲ.The mean age of the type A was much younger than in type B.In-hospital mortality of acute type A dissection was 36.5%and acute type B dissection was 9.5%.In the two five-year periods.the total number of cases increased by 240%,among which type Ⅰ the fastest which increased by 360%.Changes regarding mean age and male/female ratio were not obvious.For acute AD,one-year survival rate improved but did not reach statistical significance.Conclusion Our data provided insight into current regional profiles of AD.The number of hospitalized patients with AD was increasing dramatically.Also the mean age of the first-attack was much younger and proportion of males and in-hospital mortality of acute type A dissection were together with both much higher than reports provided by researchers from other regions.These data suggested that there was an urgent need for further improvement in prevention and treatment of AD.

Objective The aVR lead four steps is a new algorithm for differential diagnosis of wide QRS complex tachycardia(WCT). The study explores the clinical value of this new algorithm on differential diagnosis of WCT. Methods Application of aVR lead four steps to analysis the electrocardiogram of patients with WCT proved by electrophysiological study. Every step's accuracy rate, sensitivity and specificity to differential diagnosis of ventricular tachycardia(VT)were calculated. The first step diagnosed VT according to presence of an initial R wave in the aVR lead. The second step diagnosed VT according to width of an initial r or q wave ＞40 ms in the aVR lead. The third step diagnosed VT according to notching on the initial downstroke of a predominantly negative QRS complex in the aVR lead. The fourth step diagnosised VT according to ventricular activation-velocity ratio(Vi/Vt)in the aVR lead, Vi/Vt ≤ 1 suggested VT. Results derived from aVR lead four steps algorithm were compared with results derived from Brugada and Vereckei four steps algorithm. Results A total of 113 patients with WCT were analyzed(31 supraventricular tachycardia, SVT and 82 ventricular tachycardia, VT). The accuracy rate of differential diagnosis VT is 91.2%, sensitivity is 90. 2% and specificity is 77.4%. The accuracy and sensitivity of the aVR lead four steps algorithm for differential diagnosis of WCT were superior to the Brugada Vereckei four steps algorithm (P ＜ 0. 05). The specificity of the Vereckei four steps algorithm was superior to aVR lead and Brugada four steps algorithm(P ＜0. 05),while the specificity of the aVR lead four steps algorithm was similar as Brugada four steps algorithm(P ＞ 0. 05). Conclusions The aVR lead four steps algorithm is associated with excellent accuracy rate, sensitivity for differential diagnosis of WCT. This algorithm is simple and could be easily learned and applied by physician.

Objective To investigate the relationship between the fasting blood glucose level and the severity of coronary artery disease among the Kazakh population in Xinjiang. Methods A total of 411 Kazakh patients with no known history of diabetes mellitus were enrolled in this study for highly suspected of coronary artery disease(CAD) and subesquently underwent coronary artery angiography. Coronary artery disease was diagnosed in 280 patients after coronary artery argiography. The severity of the disease was expressed in terms of Gensini score. All subjects were classified into 4 groups according to the level of fasting plasma glucose (FPG)< 5.6 mmol / L, 5.6-6.1 mmol / L, 6.1-7.0 mmol / L and ≥7.0 mmol / L. All the biochemical parameters, clinical data and coronary artery angiographic data were compared, and the possible risk factors related to the severity of coronary artery disease were studied. Results Multivariate logistic regression analysis showed that FPG was significantly associated with coronary artery disease(OR 1.53, 95% CI 1.25-1.87,P<0.001).The results showed that the prevalence of angiographic CAD and the Gensini score increased with the increasing FPG levels among the four groups.The FPG level was significantly correlated with the Gensini score (P<0.001). Conclusions FPG is significantly associated with coronary artery disease and its severity in the Kazakh population in Xinjiang.