Objective To explore the impact of concentrated teaching, self-help training, intensive training, scenario simulation and other systemic training methods on the health teaching level of community health education staff,and the impact of community health education on cultivation of residents' health behavior before and after training. Methods 60 community doctors and nurses involved in systematic training. Taught concentrated 8 hours every week, and continuous for 4 weeks with medicine, psychology, sociology, pedagogy, aesthetics and production of courseware. Trainees who awarded 80 points or more in examination took part in simulated scene training, which completed a 30-minute design of concentrated health lesson and a 15-minute design of one to one health lesson in written form and multimedia teaching. Teaching effect-site was evaluated by the residents of the community lectures. The impact on cultivation of residents' behaviors was evaluated with ruler evaluation method.Results The community health care workers' teaching ability had significant change after training: plan design (2.32 ± 1.41 vs 4.26 ±0.61 ), lectures (2.63 ±0.89 vs 4.09 ±0.93), teaching skills ( 1.97 ± 1.32 vs 3.89 ±1. 13 ), teaching aids configuration ( 1.68 ± 1. 43 vs 3.97 ± 1. 26 ), educational methods ( 2.01 ± 0. 96 vs 4.03 ±0.82), time control (2.83 ±0.26 vs 4.67 ±0.25), the classroom atmosphere (2.78 ± 1. 13 vs 4.12 ±0.67),courseware ( 2.48 ± 1. 08 vs 3.89 ± 1.02 ) , teaching the image ( 2.15 ± 1.15 vs 4.06 ± 0.78 ), overall evaluation (2.36 ± 1.21 vs 4. 16 ± 0.65 )(P ＜ 0. 0 1 ). After training, community residents' knowledge on community health care workers' one to one health education and collective health education training, and positive evaluation of helpful to students' behavior improved significantly ( x2 = 17.19,36.37 ;8.91,20.98 ;34.14,32.29) ,and all had remarkable difference( all P＜0. 01 ). Evaluating the impact of health care workers' teach on cultivating residents'health behavior after one year, it improved significantly (P ＜ 0. 01 ). Conclusion Systemic training can improve health education ability of community medical staff and the impact on cultivating residents' health behavior is remarkable.

Objective To investigate the independent echocardiographic pathogenesis associated with left atrial spontaneous echo contrast(SEC) formation in patients with atrial fibrillation(AF).Methods Twenty-one patients with valvular AF and twenty-three patients with nonvalvular AF undergoing transthoracic and transesophageal echocardiography(TTE/TEE) were studied.Morphological and functional parameters of the heart in patients with AF were detected by TTE,while the sizes of the left atrial appendage(LAA),its Doppler flow patterns,Doppler flow patterns of the left upper pulmonary vein and integrated backscatter(IBS) values of left atrial SEC relative to those of the left ventricle were measured by TEE.Results There were the following 10 variables significantly associated with the left atrial SEC,some of which associated positively with SEC were left atrial diameter(r=(0.40252),P=(0.0061)),diameter of the open mouth of LAA to the left atrium(r=(0.37816),P=(0.0161)),while the others of which associated negatively with SEC were antegrade/retrograde blood flow velocity peak,integrate(RVi) and retrograde blood flow velocity mean(RVm) values,and S/D wave peak,S wave integrate(Is) and D wave mean(Md) values,their r values ranged from(-0.40379) to(-0.32832),their P values between(0.0018) and(0.0386).Collinearity analyses suggested that RVi,RVm,Is,Md represented completely all the blood flow velocity parameters of LAA and the left upper pulmonary vein,respectively.Multivariate analyses demonstrated that RVm and Md were the independent predictors of the left atrial SEC in patients with AF(both P

OBJECTIVETo explore the therapeutic effect and safety of fire needling on rat with rheumatoid arthritis.

METHODSForty female Wistar rats were randomly divided into a normal group, a model group, a methotrexate (MTX) group and a fire needling group, 10 rats in each group. The 0.1 mL of normal saline was subcutaneously injected in rat's right back paw in the normal group, while the other groups received subcutaneous injection of 0.1 mL of complete Freund's adjuvant to establish the model. The pricking method was applied in the fire needling group at "Jiaji" (EX-B 2), "Zusanli" (ST 36) and Ashi points with a depth of 5 mm, once every three days, and totally eight times were required. In the MTX group, with intragastric administration of 2.0 mg/kg per rat, the treatment was given once every seven days, and totally four times were required. The weight, swelling rate of foot, joint pain score and polyarthritis index of rats in each group as well as the pathological change of liver tissue under light microscope were observed.

RESULTSThe weight, swelling rate of foot, joint pain score and polyarthritis index in the model group were significantly higher than those in the normal group (P < 0.05, P < 0.01), after the treatment, the above-mentioned indexes in the two treatment groups were obviouly dereased as componed with those in the model group (all P < 0.01), and there were statistical differences between the fire needling group and MTX group (P < 0.05, P < 0.01). Compared with the normal group, inflammatory cells were appeared with a cluster distribution in the liver cells of rats in the model group. The inflammatory cells were reduced in the MTX group and fire needling group, and liver cells had degenerative edema and cell nucleus were largen and deformed in the MTX group.

CONCLUSIONThe fire needling has significant efficacy for rats with adjuvant arthritis (AA) without any damage to the liver, which coud have a better control of disease progression of rheumatoid arthritis .

Acupuncture Therapy ; adverse effects ; instrumentation ; methods ; Animals ; Arthritis, Rheumatoid ; therapy ; Female ; Humans ; Rats ; Rats, Wistar

Objective To explore the residual undifferentiated mouse embryonic stem cells (ESCs) in embryoid bodies. Methods Mouse R1 and Oct-4-GFP transgenic ESCs were firstly cultured in suspension to form embryoid bodies (EBs). Twenty days later, EBs were digested into single cells and then re-plated in standard ESC culture condition. The morphology of residual undifferentiated cells in EBs was observed, and surface makers and in vitro redifferentiation potency of residual cells were examined by flow cytometry and immunofluoreseent staining. The residual cells were expanded and subcutaneously injected into nude mice, and the specimens were harvested from the injection site for histological analysis 6 weeks after injection. Results There were residual undifferentiated ESCs in EBs differentiated for 20 days, which displayed clonal morphology and expressed undifferentiated cell markers of ESCs, including SSEA1, CD31, CD9 and Oct-4. The cells could be differentiated to form EBs again, and could be re-expanded from secondary EBs. The residual cells were able to form teratoma at the injection site, and mature endoderm, mesoderm and ectoderm tissues could be found in teratoma tissues. Conclusion There are residual undifferentiated ESCs after differentiation of ESCs into EBs. The residual ESCs can differentiate again in vitro and in vivo, and can residue again in the in vitro differentiation.

As a part of the project for the Chinese Pharmacopoeia (2015 edition), the quality standard of Sophora flavescens root extract was investigated and established. According to the methods described in the Appendix of Chinese Pharmacopoeia (2010 edition), the water and ash inspections were carried out. The marker components trifolirhizin, sophoraflavanone G, oxymatrine and oxysophocarpine in the samples were identified by qualitative TLC. The determination of oxymatrine, matrine, oxysophocarpine and sophocarpine was conducted by HPLC and the total flavonoids were measured by ultraviolet spectrophotometry, using sophoraflavanone G as reference substance. The results indicated the spots on the plate were clear with good resolution and the contents of oxymatrine, matrine, oxysophocarpine and sophocarpine in the 13 batches of the samples were 3.87% - 11.1%, 0.970% - 4.33%, 1.30% - 2.59% and 0.260% - 1.14%, respectively. The total flavoids in the 13 batches of the samples were 3.88% - 7.93%. In the study, the validated methods were reproducible and the established quality standard was feasible, which could be used for the quality control of S. flavescens root extract and related preparations.
Chromatography, High Pressure Liquid ; Flavonoids ; analysis ; Plant Extracts ; analysis ; Plant Roots ; chemistry ; Sophora ; chemistry

OBJECTIVETo observe the coronary vessel lumen diameter and bifurcation angle in subjects with normal CT coronary angiography (CTCA) imaging.

METHODS64-row CT coronary angiography imaging from 526 adult people with excellent image quality and normal vascular image were analyzed in this study. The lumen diameter from the origin to distal with 2 mm lumen of left main coronary artery (LM), anterior descending branch (LAD), left circumflex branch (LCX) and right coronary artery (RCA) was measured at 1 cm interval in CPR image. The vascular tapered ratio was calculated. The bifurcation angle in the diagonal branch, obtuse marginal branch, posterior descending branch, acute marginal branch as well as the origin diameter was also measured in VR image.

RESULTSThe LAD average length was 13 cm and lumen diameter was 3.92 mm at origin and 2.10 mm at distal. The average decremented ratio of LAD was 7.7% (male 7.0%, female 8.4%). The maximal decremented ratio 8.0% - 10.0% occurred at 3 - 5 cm apart from the origin of LAD. The LCX average length was 13 cm and lumen diameter was 3.57 mm at origin and 2.10 mm at distal. The average decremented ratio of LCX was 9.7% (male 9.6%, female 9.7%). Lumen decremented ratio was less than 3.0% between origin and proximal 3 cm and 8.3% - 10.7% in the rest portion of the LCX. The RCA average length was 18 cm and lumen diameter was 3.97 mm at origin and 2.15 mm at distal. The average decremented ratio of RCA was 5.1% (male 4.9%, female 5.3%). The decremented ratio of RCR was less than 4.0% between origin and proximal 10 cm and 6.1% - 15.2% in the rest portion. The bifurcation angle was 50, 55, 66 and 76 degree for LAD with diagonal branch, LCX with obtuse marginal branch, RCA with posterior descending branch and RCA with obtuse marginal branch respectively.

CONCLUSIONCoronary artery length, lumen diameter and decremented ratio as well as bifurcation angel could be identified in 64 row CTCA image in vivo. This information could help us to understand the in vivo coronary artery anatomy.

Adult ; Aged ; Aged, 80 and over ; Coronary Angiography ; Coronary Stenosis ; diagnostic imaging ; Coronary Vessels ; anatomy & histology ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Tomography, Spiral Computed

BACKGROUND:There is a general consensus that patients undergoing joint arthroplasty surgery wil be in hypercoagulable state and easily to induce deep vein thrombosis. Thromboelastography is a new kind of method to monitor blood coagulation state, but not widely used in orthopaedics. No final conclusion has yet been reached on whether we can guide the clinical prevention of deep vein thrombosis and medication through using thromboelastography to monitor perioperative coagulation state of patients treated with joint arthroplasty. OBJECTIVE:To investigate the correlation between thromboelastography and routine coagulation functional tests, and evaluate the clinical application value of thromboelastography in monitoring the perioperative coagulation state of patients treated with joint arthroplasty.
METHODS:A total of 204 patients who treated with joint arthroplasty at First Affiliated Hospital of Soochow University from November 2014 to August 2015 were retrospectively analyzed. The thromboelastography, routine coagulation, platelet and other data before and after the replacement were respectively col ected. The correlative analysis was conducted between the thromboelastography result and the results of conventional coagulation test, that is, routine coagulation and platelet count. RESULTS AND CONCLUSION:In total knee arthroplasty group, activated partial thromboplastin time and reaction time showed good consistency (φ=0.713, Kappa value=0.647);Prothrombin time had moderate correlation and general consistency with reaction time (φ=0.392, Kappa value=0.362);Coagulation time and fibrinogen had moderate correlation and consistency (φ=0.392, Kappa value=0.488);Aggregates formation rate (αangle) and fibrinogen had moderate correlation and consistency;the remaining parameters had poor correlation and consistency. In total hip arthroplasty group, there was a weak correlation and consistency between the reaction time, activated partial thromboplastin time and prothrombin time;the other correlations were poor. However, there was a higher proportion of consistent clotting trend between some parameters of thrombelastography and routine coagulation. In total hip arthroplasty group, the consistent proportion of coagulation time and fibrinogen accounted for 67.6%;the consistent proportion of aggregates formation rate (αangle) and fibrinogen accounted for 78.3%. These results suggest that thromboelastography and routine coagulation tests have some correlations and consistency. Thromboelastography parameters have more consistent tendency on the data. Thrombelastography can serve as an auxiliary mean to monitor coagulation state of perioperative joint arthroplasty.

OBJECTIVETo determine the incidence and risk factors for in-hospital stroke in patients with acute myocardial infarction (AMI).

METHODSTwo thousand one hundred and thirty-three patients with acute myocardial infarction were studied retrospectively. History, demographic, clinical, thrombolytic and anticoagulant data of AMI were obtained through review of the medical record. The relative risk of in-hospital stroke in patients with AMI was estimated using multiple nonconditional logistic regression to adjust for potential confounding factors.

RESULTSAmong 2,133 consecutive patients admitted with acute myocardial infarction to hospitals in Shandong and Hubei provinces, 98 (4.59%) experienced strokes during hospitalization. In our analysis, anterior infarction was the most important risk factor for in-hospital stroke (ischemic and hemorrhagic) in patients with AMI (RR = 7.04), followed by history of hypertension (RR = 3.41), previous stroke (RR = 1.69), atrial fibrillation (RR = 2.22), advanced age (RR = 1.04), and higher heart rate at enrollment (RR = 1.03).

CONCLUSIONSThe incidence of in-hospital stroke in patients with AMI increased with lower rate of using thrombolytic agents. Thrombolytic therapy was noticed as a protective factor for stroke after AMI. The risk factors for in-hospital stroke with AMI were history of hypertension, previous stroke, atrial fibrillation, advanced age, anterior infarction, and higher heart rate at enrollment.

Adult ; Aged ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction ; complications ; Risk Factors ; Stroke ; epidemiology ; etiology

OBJECTIVETo study the effect of methylprednisolone (MP) and cyclophosphamide (CPA) intermittent intravenous pulse therapy and the clinical prognosis in children with severe juvenile onset systemic lupus erythematosus (JOSLE).

METHODSThirty patients with JOSLE, diagnosed by clinical, laboratory or renal histological examinations, were enrolled in this study. Of the 30 patients, 27 were females and 3 were males, the mean age was (12 +/- 3) years, and 20 of the 22 patients who had undergone initial therapy had LN, and the clinical courses before being involved in the study were 3 to 12 months in nine patients. Twenty-three of the 30 patients had clinical manifestations of renal damages, of whom 4 patients were proven by initial renal biopsy to have WHO type IV, 2 had type II,1 had type V and 1 had type III, and 7 patients had one or more manifestations of central nervous system, including chorea, seizures, cerebrovascular accident (CVA) and organic brain syndrome (OBS), simultaneously, 9 patients had nervous system symptoms without the clinical manifestations of renal damages, 3 patients had lupus crisis, 7 patients did not have any manifestations of renal or neurological damages. According to the protocol of the therapy, the patients were divided into 3 groups: group A (n = 18) patients were treated with MP plus CPA intermittent intravenous pulse for children with lupus nephritis, and with or without neuropsychiatric lupus erythematosus (NPLE), group B (n = 7) with pulsed doses of MP, followed by prednisone and tripterygium wilfordii hook f(T(whf)) for patients without renal or central nerves system damage, and group C (n = 5) with prednisone alone for patients with LN determined by clinical and laboratory features. The effects of those regimes and the clinical prognosis were observed.

RESULTSOn short-term follow-up, the SLEDAI-2K (by weight of the renal damage) showed significant difference between group A and group B, but there was no significant difference at the 9th months of the therapy. The long-term follow-up lasted in average for (37.2 +/- 24.8) months. Nineteen patients were followed up for more than 18 months. At the end of follow-up, the mean age was 14 to 19 years. There was no difference on the effect of both group A and group B, and no frequent infections were seen, ANAs were negative and SLEDAI-2K = 0-point in two patients of each group 12 months after discontinuation of the therapy. Four patients in group C died within 18 months.

CONCLUSIONThe immunosuppressive regimen MP + CPA in patients with severe JOSLE and MP + prednisone + T(whf) in patients without major organs damage were superior to the regimen of prednisone alone.

Adolescent ; Child ; Cyclophosphamide ; administration & dosage ; therapeutic use ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Glucocorticoids ; administration & dosage ; therapeutic use ; Humans ; Immunosuppressive Agents ; administration & dosage ; therapeutic use ; Lupus Erythematosus, Systemic ; drug therapy ; metabolism ; Male ; Methylprednisolone ; administration & dosage ; therapeutic use ; Pulse Therapy, Drug ; Treatment Outcome

BACKGROUNDThere are few studies on the clinical profile of Chinese patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). The purpose of this study was to describe the clinical characteristics of ARVD/C patients from China, particularly to define the features of electrocardiograph and treatment outcomes.

METHODSThirty-nine patients hospitalized in Fu Wai Cardiovascular Hospital from 1998 to 2006 were included. The data were obtained from the medical archive and the follow-up records.

RESULTSOf these patients 33 were male and 6 female (age at the first presentation was (34.9 +/- 9.8) years). The most common symptoms were palpitation (62%) and syncope (44%). Right precordial QRSd >or= 110 ms was detected in 69% of the patients, epsilon wave in 59%, and a ratio of QRSd in V(1) + V(2) + V(3)/V(4) + V(5) + V(6) >or= 1.2 in 82%. The most frequent features of electrocardiogram in patients without right bundle-branch block were T-wave inversions and S-wave upstroke in V(1)-V(3) >or= 55 ms (96% and 90% of 28 patients, respectively). Radiofrequency catheter ablation (RFCA) for ventricular tachycardia (VT) was successful in 15 (68%) of 22 patients. The recurrence rate of VT was 46% (7/15) during the follow-up of (16.7 +/- 11.2) months. Seven patients had cardioverter/defibrillator (ICD) implanted plus drug therapy and 17 patients took antiarrhythmic drugs alone. During the follow-up of (35.6 +/- 19.0) months, all patients with ICD implanted received at least one appropriate ICD shock. One patient died of ventricular fibrillation suddenly and one patient underwent heart transplantation for progressive biventricular heart failure during the drug therapy alone.

CONCLUSIONSThis study demonstrated the clinical and ECG features of the 39 ARVD/C Chinese patients. ICD provided life-saving protection by effectively terminating malignant arrhythmias, and the high recurrence of VT was the major problem of RFCA therapy.

Adolescent ; Adult ; Anti-Arrhythmia Agents ; therapeutic use ; Arrhythmogenic Right Ventricular Dysplasia ; diagnosis ; drug therapy ; physiopathology ; therapy ; Catheter Ablation ; Defibrillators, Implantable ; Electrocardiography ; Female ; Heart Transplantation ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Young Adult