Objective To investigate whether terminal QRS distortion on the electrocardiogram in acute inferior myocardial infarction could be as a standard for the infarct-related artery,through comparing to coronary angiography.Methods Fifty-seven patients with acute inferior myocardial infarction were enrolled,among which,the right coronary artery (RCA) occlusion (RCA occlusion group) was present in 29 cases,and left circumflex coronary artery (LCX) occlusion (LCX occlusion group) was in 28 cases.The changes of electrocardiogram was analyzed in 12 hours after the acute episode.Results The incidence of terminal QRS distortion in leads Ⅱ,Ⅲ,aVF in RCA occlusion group was 44.8％(13/29) and 39.3％(11/28)in LCX occlusion group,and there was no significant difference (P ＞ 0.05).The incidence of terminal QRS distortion in leads V4R-V5R in RCA occlusion group was 17.2％(5/29) and 7.1％(2/28) in LCX occlusion group,and there was no significant difference (P ＞ 0.05).The incidence of terminal QRS distortion in leads V7-V9 in RCA occlusion group was 6.9％(2/29),which was lower than that in LCX occlusion group[53.6％(15/28)],and there was significant difference (P ＜ 0.05).For identifying LCX as the infarct-related artery of acute inferior myocardial infarction,the sensitivity,specificity,positive and negative value in terminal QRS distortion in leads V7-V9 were 53.6％ (15/28),93.1％ (27/29),88.2％ (15/17),67.5％ (27/40).The area under curve of terminal QRS distortion in leads V7-V9 in identifying LCX as the infarct-related artery of acute inferior myocardial infarction was 0.733 (95％ CI 0.599-0.868).Conclusion Terminal QRS distortion in leads V7-V9 may be of diagnostic value in identifying the infarct-related artery in acute inferior myocardial infarction.

Objective To observe the effect of sulodexide combined with dipyridamole on postoperative period of internal arterio‐venous fistula in the patients with chronic renal failure complicating diabetes .Methods 72 cases of chronic renal failure complica‐ting diabetes were randomly divided into two groups :sulodexide combined with dipyridamole group(group A) and dipyridamole group (group B) .Platelet ,fibrinogen(FIB) ,prothrombin time ,activated partial thromboplastin time ,triglyceride ,total cholesterol and hemortheological indexes were tested at different time points .The internal fistula patency ,blood flow volume after internal fis‐tula maturation and time of initial internal fistula use after internal arteriovenous fistula operationwere observed .‐Results (1)The patency rate of internal arteriovenous fistula in the group A was higher than that in the group B .(2) Compared with the group B , FIB and low‐shear rate of whole blood viscosity in the group A were decreased .(3)The time of internal fistula maturation in the group A was shortened ,but the blood flow volume had no significant difference between the two groups .Conclusion Sulodexide combined with dipyridamole is safe and effective for preventing the thrombogenesis after internal arteriovenous fistula operation ,its effect is superior to single dipyridamole .

Objective To observe the impact of ginkgo biloba extract in rats with chronic cerebral ischemia on the expression of PSD-95 protein and the content of amino acid neurotransmitter.Methods A total of 42 SD rats were divided into the sham group (n=12), the model group (n=14) and the ginkgo biloba extract group (n=14) by random number table method. Cerebral ischemia rats were produced by permanent ligation of bilateral common carotid arteries . The rats in the ginkgo biloba group were intrgastric administrated with ginkgo biloba extract suspension 28 mg/kg daily for 40 days, since 2 hours later after the surgery. The rats in the sham and model groups were intragastric administrated with equal-Volume nomal saline daily for 40 days, since 2 hours later after the surgery. The expression of PSD-95 protein was detected by immunohistochemistry techniques with image analysis. The content of Glu and GABA in the thalamus was determinated by OPA-pre-column derivatization and HPLC fluorescence detection method.Results The expression of PSD-95 protein (cortex was 212.58 ± 45.02vs.244.20 ± 34.28, thalamus was 132.33 ± 28.32 vs.272.00 ± 62.14) were significantly lower in the cortex and thalamus of the model group than those of the sham group (P<0.01). The content of GABA (6 081.46 ± 2 388.91 mmol/Lvs.8 280.45 ± 3 388.49 mmol/L) in the thalamus of the model group rats was significantly lower than the sham group (P<0.05). Ginkgo biloba extract could significantly improve the expression of PSD-95 protein (cortex was 237.89 ± 34.41 vs.212.58 ± 45.02, thalamus was 226.18 ± 75.80 vs. 132.33 ± 28.32) in the cortex and thalamus of chronic cerebral ischemia rats (P<0.01), and significantly improve the content of Glu and GABA (Glu was 10 523.78 ± 3 639.72 mmol/L vs.6 081.46 ± 2 388.91 mmol/L, and GABA was 18 440.93 ± 7 476.88 mmol/Lvs.11 239.83 ± 4 411.79 mmol/L) in thalamus with chronic cerebral ischemic rats compared with the model group rats (P<0.01).Conclusion Ginkgo biloba extract could regulate the levels of Glu, GABA and selectly regulate the PSD-95 experssion in the cortex and thalamus of cerebral ischemia rats.

Objective: To observe the effect of acupuncture plus thunder-fire moxibustion on the expressions of matrix metalloproteinase-3 (MMP-3), tissue inhibitor of metalloproteinase-1 (TIMP-1) and transforming growth factor-β1 (TGF-β1) in cartilage of knee osteoarthritis (KOA) rats, and to explore the mechanism of acupuncture plus thunder-fire moxibustion in the treatment of KOA. Methods:Thirty Sprague-Dawley (SD) rats were randomly divided into a blank control group, a model group and an acupuncture-moxibustion group by random digits table, 10 rats in each group. Rats in the model group and the acupuncture-moxibustion group were injected with papain in the right posterior knee joint to prepare the models. The levels of MMP-3 and TIMP-1 in rat synovium of each group were measured by enzyme-linked immunosorbent assay (ELISA) after 2 weeks of treatment. The level of TGF-β1 was determined by Motic B5 Micro-camera system. Results:The levels of MMP-3 and TIMP-1 in the cartilage of the model group were significantly higher than those in the blank control group (allP<0.01); the levels of MMP-3 and TIMP-1 in the acupuncture-moxibustion group were lower than those in the model group, and the between-group differences were statistically significant (all P<0.05). The levels of MMP-3 and TIMP-1 in the acupuncture-moxibustion group were higher than those in the blank control group, and the differences were statistically significant (all P<0.05). The level of TGF-β1 in cartilage tissues of the model group was significantly lower than that in the blank control group (P<0.01); the level of TGF-β1 in the acupuncture-moxibustion group was higher than that in the model group (P<0.05), but it was lower than that in the blank control group, and the between-group difference was statistically significant (P<0.05). Conclusion: Acupuncture plus thunder-fire moxibustion can effectively recover the abnormal expressions of MMP-3 and TIMP-1 in KOA model rats and somewhat up-regulate TGF-β1, which may be one of its mechanisms of acupuncture plus thunder-fire for KOA.

OBJECTIVE: To discuss the supervision mode of traditional Chinese herbal medicines and traditional Chinese medicine pieces in the production of traditional Chinese medicine preparations, and provide advice for the scientific and effective supervision of traditional Chinese medicine preparations with Chinese herbal medicines and Chinese medicine pieces. METHODS: Through the study of relationship between the quality, processing, preservation of medicinal herbs and the quality of preparations, the relationship between the implementation of Good Manufacture Practice (GMP) of traditional Chinese medicine preparations, and the relationship between imperfect quality standards and the quality of traditional Chinese medicine preparations, we put forward measures to solve the problems. RESULTS AND CONCLUSION: In the supervision of Chinese herbal medicines and traditional Chinese medicine pieces during the production of traditional Chinese medicine preparations, we should be closely around the core to ensure the quality of traditional Chinese medicine preparations, and should take different supervision modes of herbs and pieces according to different types and characteristics of traditional Chinese medicine preparations. At the same time, we should ensure the stability of the sources and origins of Chinese herbal medicines and ensure that manufacturing comply with GMP. We should standardize the preparation process of Chinese herbal medicine pieces by the traditional Chinese medicine preparation enterprises and implementation of traditional Chinese medicine pieces production filing system. And the quality standard of Chinese medicinal herbs and Chinese prepared herbs should be improved, with the objective to ensure the safety and effectiveness of traditional Chinese medicine preparations.

Objective To investigate the efficacy and safety of percutaneous induced thrombosis closure on small patent ductus arteriosus (PDA) solely under echocardiography guidance.Methods From June 2013 to September 2016,276 PDA patients were treated by femoral artery retrograde approach under echocardiography guidance.Twenty-five patients (14 boys,11 girls) among them with small PDA received percutaneous induced thrombosis closure because the delivery sheath could not pass PDA,with mean age (3.7 ± 1.6) years,mean body weight (16.6 ±5.4) kg and the mean diameter of the most narrow PDA was (1.3 ± 0.4) mm.All patients were assessed by transthoracic echocardiography,chest radiography and electrocardiography preoperatively.The intraoperative and postoperative effects were evaluated by echocardiography.Outpatient assessment was performed at 1,3,6 and 12 months after operation with electrocardiography and echocardiography,and yearly thereafter.Results Twenty-five patients were successfully treated with percutaneous induced thrombosis closure solely under echocardiography guidance.The mean operation time was (35.2 ± 6.1) minutes.The immediate residual shunt rates and 24 hours after operation were 28.0％ (7/25 cases) and 16.0％ (4/25 cases),respectively.All patients recovered and were discharged from hospital.The average hospitalization stay was (3.0 ± 0.6) days.The mean follow-up was (16.8 ± 12.3) months,residual shunt was observed in 2 patients (8.0％),and it decreased from 1.5 mm and 2.0 mm preoperatively to 0.8 mm and 1.0 mm postoperatively,respectively.All patients survived without peripheral vascular injury,cardiac perforation,PDA rupture or thrombembolia.Conclusions Percutaneous induced thrombosis closure of small PDA solely under echocardiography guidance is safe and effective.It can avoid occluder implantation and radiation injury.However,the residual shunt after operation needs following up closely.

Adult ; Female ; Humans ; Lymphoma, Non-Hodgkin ; diagnosis ; pathology ; Tracheal Neoplasms ; diagnosis ; pathology

OBJECTIVETo compare the therapeutic effect on sudden deafness between acupuncture and moxibustion therapy of excitation-focus transfer and routine medication.

METHODSEighty cases of sudden deafness were randomly divided into two groups, 40 cases in each one. Acupuncture and moxibustion therapy of excitation-focus transfer was adopted in observation group on Yongquan (KI 1) (with reducing and slightly heavy manipulation), Tinggong (SI 19), Tinghui (GB 2) and Ermen (TE 21), and associated with suspending moxibustion for thermal sensitization on Yongquan (KI 1). In control group, the routine medications were given. The therapeutic effects of two groups were compared with each other.

RESULTSAfter three sessions of treatment, dB value of hearing loss in two groups decreased (P<0.05, P<0.01), but the improvement of hearing in observation group was superior to that in control group (P<0.05). The total effective rate was 80.0% (32/40) in observation group, which was better than that 55.0% (22/40) in control group (P<0.05).

CONCLUSIONAcupuncture and moxibustion therapy of excitation-focus transfer presents superior therapeutic effect on sudden deafness as compared with the routine western therapy.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Female ; Hearing Loss, Sudden ; drug therapy ; therapy ; Humans ; Male ; Middle Aged ; Moxibustion ; Young Adult

Objective To analyze the methods and effects for treating unstable posterior pelvic ring fracture combined with sacral nerve injury and further identify the relationships among the diagnostic methods,surgical approaches and clinical outcomes.Methods A total of 38 patients with posterior pelvic ring fracture combined with sacral plexus injury treated from January 2000 to January 2010 were enrolled in the study.There were 20 males and 18 females at an average age of 35 years (range,10 to 59 years).The causes of fractures included traffic injury in 20 patients,fall injury in 12,weighty object impingement injury in five,and stabbing injury in one.Classification of posterior pelvic ring fractures included fracture and dislocation of sacroiliac joints in eight patients,fracture of ilium wing in two and sacrum fracture in 28.According to the Denis typing of sacrum fractures,there was one patient with type Ⅰ fracture,14 with type Ⅱ fracture and 13 with type Ⅲ fracture.All 38 patients presented the decrease or loss of skin sensation around the lower extremities,perineal region and crissum.Simultaneously,30 patients suffered motor dysfunction of the lower extremities,while 20 patients had bladder and anus sphincter dysfunction or sexual disorder.Thirteen patients were suspected of sacral plexus avulsion and four of them were confirmed by myelography or MRI examination.All patients had at least one associated injury.The average ISS was 21.9 points ( range,9 to 47 points).Therapeutic methods were fracture reduction and fixation in the absence of nerve decompression for eight patients and nerve decompression for 30 patients including 26 patients being also managed by fracture reduction and fixation.Operation time ranged from 6 days to 6 months.The clinical outcomes were evaluated according to the British Medical Research Council (BMRC) evaluation criteria of sensation and movement function.Results Thirty-four patients were followed up for average 4.9 years ( range,1 to 10 years),during which their pelvis obtained stable recovery.The neurological outcome was excellent in two patients,good in four and unchanged in two in the nondecompression group and was excellent in 16 patients,good in nine and unchanged in one in the decompression group,with the decompression group superior to the non-decompression group ( P ＜ O.05 ).Conclusions For unstable posterior pelvic ring fracture combined with sacral nerve injury,nerve decompression and release combined with internal fixation can better improve the sacral nerve function and obtain good pelvic ring stability and is worth of clinical application.

Objective To study gender-related differences of clinical characteristics and vascular complications in patients with aldosterone-producing adenoma(APA).Method Consecutive 315 patients with APA confirmed by pathological diagnosis were included and the clinical features and vascular complications were compared based on gender.Results (1) Of the 315 patients with APA,female accounted for 52.7％ (166/315).Male patients with APA presented a higher BMI,compared with females [(25.4± 2.9) vs (24.1 ± 3.2) kg/m2,P＜0.01],and the history of smoking and drinking was more common in male patients.No significant difference was found in regard to the age,duration,hypokalemia,tumor size,and family history of hypertension between two groups (P＞0.05).(2) No significant difference was found in the prevalence of hypertension,duration of hypertension,blood pressure,and antihypertensive medieation between two groups.However,the patients with grade 3 hypertension tended to be more prevalent in males(P =0.08).(3) Serum aldosterone concentrations were similar in two groups,but 24 h urinary aldosterone showed an increased trend in male group (P =0.07).(4) The overall prevalences of cardiovascular (51.0％ vs 36.1％) and cerebrovascular (9.4％ vs 3.0％) complications were significantly higher in male group (P ＜ 0.05).Further analysis of cardiac events revealed significantly higher rates of left ventricular hypertrophy (23.5％ vs 13.9％) and arrhythmia (21.5％ vs 10.8％) in males (P＜0.05).However,no significant difference in the prevalence between two groups was found in regard to cerebral hemorrhage,infarction,and chronic renal insufficiency.(5) The fall of blood pressure and recovery from hypokalemia were comparable between males and females in two weeks after sugery.However,in the patients with persistent hypertension,the number of antihypertensive drugs used in males was greater than that in females and more male patients needed ≥ 2 types of antihypertensive drugs.Conclusion There were significant gender-related differences with regard to clinical features and vascular complications in patients with APA.