Purpose To evaluate the left ventricular regional diastolic function in coronary heart disease (CHD) patients without regional wall motion abnormality by real-time three-dimensional speckle tracking imaging (RT3D-STI) to investigate the value of RT3D-STI in the diagnosis of early CHD. Materials and Methods 140 CHD patients with 420 coronary artery main branches were enrolled and divided into 4 groups according to the results of coronary angiography (CAG): normal group (101 coronary artery branches without stenosis), mild stenosis group (112 coronary artery branches with stenosis<50%), moderate stenosis group (95 coronary artery branches with stenosis 50%-75%) and sever stenosis group (112 coronary artery branches with stenosis>75%). Three dimensional full volume images were collected through the chest, and the corresponding strain imaging diastolic index (SI-DI) of each direction was calculated, their value for the diagnosis of coronary artery disease was analyzed. Results The longitudinal, area and radial SI-DI of mild coronary artery stenosis group were lower than those of normal group (P<0.05);the longitudinal, area, radial and circumferential SI-DI of moderate coronary artery stenosis group were lower than normal group (P<0.05) and the area, longitudinal and circumferential SI-DI were lower than those of the mild stenosis group (P<0.05);the longitudinal, area, radial and circumferential SI-DI were all lower than those of normal and mild stenosis group (P<0.05), and the area, longitudinal and radial SI-DI were all lower than the moderate stenosis group (P<0.05). ROC curve showed that the sensitivity of longitudinal SI-DI (84.0%) was highest, while the specificity of area SI-DI (78.9%) was the highest. Conclusion RT3D-STI has important significance for early detection and diagnosis of CHD, regional diastolic function decrease of the coronary artery supply area occurs earlier than systolic function reduction, and diastolic function is more sensitive for myocardial ischemia, as a result, SI-DI is able to reflect the stenosis degree of coronary artery in a certain extent.

General practitioners from community health service institutions in Shijingshan,Mentougou,Haidian,Chaoyang,Fengtai and Dongcheng Districts of Beijing were selected to take the examination of chronic wounds management.Questionnaire survey was also performed on the status of community chronic wounds management,medical service motivation,influencing factors and their demand for training.Among 204 general practitioners,55 (27.0％) had mastered basic knowledge,98 (48.0％) passed the examination and 51 (25.0％) failed.The results showed that 179 (87.7％) had changing dressing service,36.8％ offered out-patient consulting service,17.6％ performed surgical debridement,only 10 (4.9％) provided home chronic wounds care service and 2 (0.9％) of them carried out long-term follow-up.According to the motivation survey,all the practitioners expressed the willingness to help the patients and win their trust.Most of the practitioners claimed no supporting from their institutions(91.7％) and chronic wounds management was excluded from daily routine.Furthermore,heavy work load(82.8％) and lack of professional knowledge(80.9％)were also considered to be main obstructive factors.The survey showed that the majority of physicians required classroom teaching (90.1％),case analysis (86.8％),operating video (92.6％) and other teaching forms.More low level doctors(97.1％)had the desire to pursue further specialist training than higher level physicians (56.7％).The results of our investigation indicate that general practitioners in community heath service institutions have strong learning motivation for chronic wounds management and systematic training of knowledge and practical skills in this field should be provided.

Objective To study the change of content of platelet calcium in patients with acute cerebral infarction.Explore the relationship between anterior and posterior circulation cereball infarction and the change of content of platelet calcium.Methods The content of platelet calcium in venous blood were detected by flow cytometry in 87 patients with acute cerebral infarction(40 cases of anterior circulation,47 cases of posterior)and 20 health persons(normal control group).The content of platelet calcium in venous blood of every group were compared.Results In the group of acute cerebral infarction,the content of platelet calcium was significantly higher than that in the control group(P

Objective To investigate the correlation between brain injury and premature infants with bronchopulmonary dysplasia (BPD)and to analyze the risk factors of brain injury in premature infants with BPD based on MRI changes.Methods A total of 1 13 premature infants diagnosed with BPD were studied as case group from January 2010 to December 2014 at the neonatal ward of Shengjing Hospital of China Medical University.One hundred and sixty-two premature infants without BPD were selected as control group.There were no significant differences in gestational age and birth weight between the two groups.All cases were per-formed MRI examination in hospital.The occurrence of brain injuries(white matter injury and intracranial hemorrhage)were compared based on MRI changes between the two groups,and the risk factors of brain in-jury in case group were analyzed.Results The case group and control group were performed MRI on (33.73 ±16.00)d,(24.40 ±12.29)d after birth respectively.The ratio of brain injury,intracranial hemor-rhage,cerebral white matter damage and severe brain injury of case group was higher than those of the control group(48.7% vs.32.7%,3 1.9% vs.21.6%,31.9% vs.21.6%,16.8% vs.8.6%,respectively).The differences were significant in the ratio of brain injury and severe brain injury (P =0.008,P =0.040,respec-tively).Logistic regression analysis showed that postnatal infection was a risk factor for brain injury of the case group(OR =2.21 ,95%CI 1.04 ~4.72,P ﹤0.05).Conclusion More brain injury(including the white matter injury and intracranial hemorrhage)and severe brain injury(including grade III ~IV intraventricular hemorrhage and periventricular leukomalacia)are detected in premature infants with BPD.Postnatal infection is a risk factor of brain injury for premature infants with BPD.

AIM: To evaluate the use of 23G minimally invasive vitreous cutting system in the first stage of anterior segment reconstruction on severe ocular injury.
METHODS: Fifteen patients with ocular injuries including the corneal and scleral rupture associated hyphema, vitreous hernia in anterior chamber, traumatic lens rupture, lens subluxation, applied 23G minimally invasive vitreous cutting system in the first stage of anterior segment reconstruction.
RESULTS: The anterior ocular media of early postoperative became transparent quickly. No exudative lemma and no complications were found relate to puncture incisions after operations.
CONCLUSION:23G minimally invasive vitreous cutting system can be used in the first stage of anterior segment reconstruction on sever ocular injury. It can reduce iatrogenic injury, operative complications and inflammatory response, also can shorten therapeutic time and create favorable conditions.

This article summarized two medical cases of Professor SHI Da-zhuo treating acute myocardial infarction by Yiqi Huoxue Tuodu Shengji TCM therapy on the basis of conventional Western medicine therapy. Comparison of echocardiography before and after treatment showed that Yiqi Huoxue Tuodu Shengji TCM combined with conventional Western medicine therapy could inhibit the expansion of atrium and ventricle, improve the cardiac ejection fraction and improve the cardiac function after acute myocardial infarction, which could provide references for integrated traditional Chinese and Western medicine therapy for acute myocardial infarction.

Objective To investigate the in-hospital death-related factors for acute encephalocele in patients with craniocerebral injury for craniotomy in order to provide evidence for clinical treatment and prognosis determina-tion.Methods The clinical data of 105 patients with craniocerebral injury occurring acute encephalocele during cra-niotomy were analyzed retrospectively.The correlations of the factors including sex,age,preoperative Glasgow coma scale(GCS)scores,preoperative intracranial pressure(ICP),postoperative pupil status,causes of encephalocel,post-operative GCS scores,postoperative ICP,coagulation mechanism,brain swelling,preoperative hypoxia,preoperative blood pressure and blood glucose were analyzed.Results The prognosis was assessed according to the Glasgow out-come scale(GOS)scores after procedure.There were 77 patients in death group(namely death cases)and 28 patients in survival group.Logistic regression analysis showed that postoperative GCS scores (Wald =14.127,Exp(B)=0.044,95%CI:0.032,0.448),causes of encephalocel(Wald =7.748,Exp(B)=8.183,95%CI:1.825,10.251), postoperative ICP(Wald =7.637,Exp(B)=7.637,95% CI:1.969,8.028),postoperative pupil status(Wald =4.001,Exp(B)=2.499,95%CI:1.019,5.122)and blood glucose(Wald =7.915,Exp(B)=8.891,95% CI:1.790,9.337)were closely associated with the in-hospital death in patients with acute encephalocele in craniocere-bral injury operation(P <0.05).Conclusion The postoperative GCS scores,causes of encephalocel,postoperative ICP,postoperative pupil status and blood glucose could be used as the important indexes for predicting in-hospital death of acute encephalocele in craniocerebral injury for craniotomy.To prevent the intraoperative encephalocele and reduce the intracranial pressure are the important measures to reduce the mortality rate of the patients with acute encephalocele.

Objective Through active intervention of nursing care to improve the cognitive rate of hy-pertension, rate of blood pressure control and treatment compliance for hypertensive patients to reach the aim of alleviation of prognosis and reduction of disability and mortality. Methods Free physical examinations were carried out in population groups of above 30 years old in a certain community in Xinjiang Uygur Autonomous Region and family health files were set up. Totally 108 patients were screened and standardized management was applied in them,besides their conditions before and after the application of the management were investi-gated and analyzed by self-designed "prevention and treatment of hypertension as a chronic disease" and "in-vestigation questionnaire of KAP of patients with hypertension". Results The cognitive rate and rate of con-trol of high blood pressure were more higher after intervention than that before. Conclusions Through a planned health education instruction, popularizing prevention and treatment knowledge of primary hypertension to residents, we can increase the cognitive rate and rate of control of high blood pressure for patients with hyper-tension.

Anti-Bacterial Agents ; adverse effects ; Azithromycin ; adverse effects ; Chemical and Drug Induced Liver Injury ; etiology ; Humans ; Infusions, Intravenous

Objective To observe temporal expression of matrix metalloproteinases(MMP-13) and tissue inhibitor of metalloproteina-ses-1 (TIMP-1) in lung of newborn rats with hyperoxia induced chronic lung disease (CLD),and to explore the relationship of CLD with MMPs.Methods The neonatal rats within 24 hours after birth were randomly divided into hyperoxia-exposed group(n=40) and control group(n=40).On postnatal 1,3,7,14 and 21 days,lung tissue of rats in 2 groups were collected.Lung histological changes were evaluated by hematoxylin and eosin and Masson stain;Collagen Ⅰ was detected by enzyme linked immunoadsorbent assay;MMP-13 and TIMP-1 were identifide by immunohistochemistry.Results Exposured to hyperoxia enviroment for 21 days,the number of alveolar decreased,terminal air space enlarged,inter-alveolar septa thickened,and deposition of interstitial collagen fibers.On 14 and 21 days,collagen Ⅰ in the lung of hyperoxia-exposed group increased significantly compared with that of control group(P0.05),obviously decreased on 21 day(P