Objective To investigate the predictive value of epicardial adipose tissue(EAT) thickness for the recurrence of atrial fibrillation (RAF) after concomitant valve replacement and bipolar radiofrequency ablation.Methods From January 2012 to May 2014,156 patients with permanent atrial fibrillation and organic valvular diseases underwent concomitant valve replacement and successful bipolar radiofrequency ablation in the First People's Hospital of Shangqiu.After 1 year of follow-up,the recurrence of AF was analyzed and the correlation factors were analyzed statistically.Results All patients completed a regular follow-up.During a 12-month follow-up period,RAF was observed in 39 patients (25.0％).Echocardiography-derived regional EAT thickness was significantly greater in RAF patients than that in non-RAF patients((6.9±0.6) mm vs.(5.5±0.7) mm,t=4.649,P＜0.05).The EAT thickness strongly correlated with patients age,body mass index,Ratio of left atrial diameter,mitral diastolic blood flow velocity and early diastolic velocity of mitral annulus,low density lipoprotein-cholesterol and thyroglobulin (r =0.62,0.57,0.68,0.59,0.73,0.76;P ＜ 0.05).Cox multivariable analysis showed that,duration of AF history (95％CI:1.01-1.15,P =0.040),left atrial diameter (95％CI:1.07-1.24,P =0.021) and EAT thickness (95％CI:1.05-1.79,P =0.009) were independent predictors of RAF.Conclusion Echocardiography-derived regional EAT thickness combined with left atrial diameter may serve as effective parameters in identifying patients at the highest risk for RAF.

There are some major changes win the revised 2016 WHO Classification of Lymphoid Neoplasms.Based on the clinicopathological changes and genetic/molecular findings in the past years,the new classification clarified the diagnosis and clinical management of some very early stages of lymphoproliferative disorders,refined the diagnostic criteria for some lymphoid neoplasms,and further emphasized the significance of genetic/molecular studies in the diagnosis and clinical treatment of lymphomas.A small number of new provisional entities were added to the 2016 edition.

Oxidative stress and inflammation are two main factors in the progress of diabetic nephropathy(DN) and its complications. NF‐E2 p45‐related factor (Nrf2) is a crucial transcriptional factor which manipulates downstream genes that encode some antioxidant enzymes and phase Ⅱ detoxifying enzymes ,to maintain the redox homeostasis and cellular detoxification response. Therefore ,more and more researchers are focusing on the role of Nrf2 in DN. In this review ,the detailed role of Nrf2 in DN will be discussed. Hopefully ,our work can epitomize recent research progress and provide novel clues for diabetic nephropathy prevention and treatment.

Objective To review the outcome of coronary artery bypass graft (CABG) using left internal thoracic artery grafts in the patients aged over 70 years old.Methods Two hundred and eighty-eight patients aged over 70 years old from January 2009 to January 2014 who underwent CABG were selected.All of the patients were divided into two groups on base of the graft:control group:only saphenous vein graft was used in 138 cases; observation group:the left internal thoracic artery to the left anterior descending artery was used in 150 cases,which also included total arterial grafting,facilitated by the use of the radial artery,right gastroepiploic artery was operated in 7 cases,beside these artery grafts,saphenous vein graft was used to anastomosis with other vessels.Results Operative mortality was 2.9％ (4/138) in control group and 2.0％ (3/150) in observation group,and there was no significance (P ＞ 0.05).The volume of blood drainage was larger in observation group [(796.2 ± 382.4) ml] than that in control group [(512.8 ± 387.5) ml],and there was significant difference (P ＜ 0.05).At the same time,there was no significant difference in the incidence rate of second thoractomy,malignant arrhythmia,stroke,poor wound healing,and usage of intraaortic balloon counterpulsation between two groups (P ＞ 0.05).Conclusion It does not increase the mortality and incidence of serious complications using the left internal thoracic artery to the left anterior descending artery in the patients aged over 70 years old during CABG.

Tumor vaccine is one of the most promising therapeutic strategies in tumor immunotherapy. It promotes the antigen presentation process by delivering tumor antigen and then activates the anti-tumor immune response. As a new class of vaccines, messenger RNA (mRNA) vaccines can activate the immune system to achieve the purpose of immunotherapy by delivering the mRNA sequence of a specific antigen into the body and expressing the corresponding antigen protein. Compared with traditional vaccines, mRNA vaccines have the advantages of a short production cycle, high effectiveness, and strong immunogenicity. In recent years, the application of mRNA vaccines in tumor immunotherapy has attracted widespread attention, but the instability and low delivery efficiency of mRNA limit its application. Nano delivery system can effectively solve the problem of mRNA vaccine delivery, greatly promote the research process and clinical application of mRNA tumor vaccines, and has become a hot spot in the research of mRNA vaccines. In this review, we introduced the mRNA tumor vaccines, focusing on the application of nano delivery system in mRNA tumor vaccines, in order to provide new ideas and new methods for the efficient delivery of mRNA tumor vaccines and tumor immunotherapy.

The expression of proliferating cell nuclear antigen (PCNA) and B-cell lymphoma/leukemia-2 gene (Bcl-2) was detected in 25 cases of cholesteatoma tissues and 10 cases of normal skin by using immunohistochemical technique. The results showed that the PCNA index of cholesteatoma tissues was higher than that of normal skin, but Bcl-2 was not expressed in cholesteatoma tissues and normal skin. The PCNA index was correlated with the aggressiveness of cholesteatoma. It was suggested that PCNA could be considered to be a prognostic marker and an indicator of aggressive behavior in cholesteatoma. Although the cholesteatoma had a very high proliferating character, it wasn't a malignant tumor.

Objective:To compare the DNA character with in cholesteatoma tissues with that in normal skin.Method:DNA content within 25 cholesteatoma tissues and 10 normal postauricular skin was measured with flow cytometry.Result:The content of cholesteatoma tissues and postauricular skin specimens are a normal euploid.The cell number during S phase of cholesteatoma(10.9±2.32)% was higher than that in normal skin(7.31±2.82)%.Conclusion:Although the cholesteatoma has a very high proliferating character,the result suggest it isn′t a malignant tumor.

[Objective] To guide the clinical application of Fuyang medicine through the study of San Jiao Theory of ZHENG Qin'an [Method] To study the foundation theory of ZHENG Qin'an and correlate the evidence with the concept of original yang, San Jiao, Emporer fire, Minister fire and middle earth. To explain the unity and inter-relation of San Jiao and the symptons of yang deficiency of San Jiao and the approach of the use of medicine with the support of case studies. [Result] Zheng Qin'an suggested that three Jiaos are of one Jiao. The yang of upper jiao is governed by Emperor fire while that of lower Jiao by Minister fire. The two fires are of one fire. The circulation of the two fires generates the middle earth. When the middle yang fails on circulating the upper and lower Jiaos cannot communicate. The root of original yang is the kidney which is nourished by the spleen. The unity of San Jiao, the use of lower yang as the root of upper and middle yang and the use of the circulation and root nourishing action of middle yang are the keys to application of medicine. [Conclusion] The use of medicine of ZHENG strongly adhered to the qi circulation of San Jiao. It showed to the later generations a simple but comprehensive thought of Chinese medicine. It was an important guidance for the use of Fuyang medicine.

Objective: To investigate the situation of quality control of 3.0T magnetic resonance imaging (MRI) system. Methods: A series of indicators, including signal noise ratio(SNR), image uniformity, resolution of long-scale contrast, resolution of space, linearity and quality control of slice thickness, of 3.0T MRI system were measured by using Magphan SMR170 phantom (made by the phantom laboratory in American) on the Discovery MR 750 w system which made by GE company of American. And a series of formula, including SNR=(Sinside-Soutside)÷SDinside, U∑=(1-Smax-Smin/Smax+Smin ×100%, linearity=LR-LM/LR×100%、thickness=half of height and width ×0.25, were used to calculate SNR, image uniformity, linearity and quality control of slice thickness, and all of these results were used to evaluate the situation of quality control of 3.0T MRI system. Results:The results revealed that SNR of 3.0T MRI was 105, the imaging uniformity achieved to 99.13%, the resolution of long-scale contrast was 5mm/0.5mm, the resolution of space was 6 LP/cm, linearity achieved to 0.89% and the deviation of slice thickness was 0.6mm. All of these indicators has achieved the standards of detection. Conclusion: Through detecting the SNR, imaging uniformity, resolution, linearity and the deviation of slice thickness of 3.0T MRI system, the performance of the MRI can be accurately obtained, and these contribute to ensure the equipment operating in ideal situation.

OBJECTIVE:To offer guidance for pharmacy work and provide references for rational use of traditional Chinese medicines. METHODS: 3 425 outpatient prescriptions of traditional Chinese medicines in our hospital in 2006 were randomly collected for the analysis of the drug use pattern by tabulation method. RESULTS & CONCLUSION: The use of traditional Chinese medicines prescribed in our hospital was rational on the whole, but the prescriptions of traditional Chinese medicines for diseases of respiratory system were on the high side, and the diagnoses in the prescriptions were more like the diagnoses of west medicines but lacked the characteristics of traditional Chinese medicine, so that the international classification coding of disease was not suitable for traditional Chinese medicine. Medication frequency of traditional Chinese medicines serves as guidance for the dispensary of traditional Chinese medicine. The hospital information system is far from perfect.