Objective To discuss the significance of ventricular rate for patients with persistent a trial fibrillatio. Methods Patients with persistent atrial fibrillation more than 1 year were divided into cerebral embolism group (34 patients)and non- cerebral embolism group(32 patients). The data of patients in two groups were collected and compared ,including general clinical characteristics ,the highest ,lowest and average ventricular rate detected by Holter monitor system,left atria diameter and left ventricular ejecting fraction measured by echocardiography. Results There was no significant difference between two groups about general clinical characteristics, left atria diameter(P ＞ 0. 05).The highest, lowest and average ventricular rate were higher in cerebral embolism group than those in non-cerebral embolism group(P ＜ 0. 05). However, left ventricular ejecting fraction was much lower in cerebral embolism group( P ＜0. 05 ). Conclusion It is critical to control heart rate for patients with persistent atrial fibrillation to prevent cerebral embolism and left ventricular function.

AIM: To investigate the protective effects and mechanisms of Tongqiao Huoxue Decoction on the rats of cerebral ischemia. METHODS: Cerebral ischemia madel was established on the basis of cerebral thrombus and at the same time ligaturing bilateral carotid arteries.These models were used to observe the protective effects of Tongqiao Huoxue Decoction on contents of CGRP、ET、IL-1?,TNF? in rats′ cerebral ischemica. RESULTS: The results showed that Tongqiao Huoxue Decoction decreased the contents of IL-1?、TNF-?、 ET,and increased the contents of CGRP. CONCLUSION: Tongqiao Huoxue Decoction had effects on anti-cerebral ischemia.The protective effects of Tongqiao Huoxue Decoction are related to decreasing the contents of IL-1?,TNF-?,ET,and increasing the contents of CGRP.

Objective:To investigate the feasibility,surgical technique and effect of osteosynthesis for proximal humerus fractures through the minimal incision anterolateral acromion.Methods: In this study,32 patients of proximal humeral fractures were selected and treated through the minimal incision antero-lateral acromion between January 2012 and October 2014.Of these patients,there were 19 males and 13 females,with mean age 46 years old (range: 22-78 years).The mechanism of injury was a trauma of simple fall for 21 patients and motor vehicle accident for 11 patients.According to Neer classification,18 cases had two-part fractures,12 had three-part fractures,and 2 had four-part fractures.All patients were sustained operation of open reduction and internal fixation.The average delay between trauma and surgery was 4 d (0.5-10.0 d).The operations were performed in invariable operating room with general anesthesia.The fractures were reduced and immobilized with anatomical locking plate through the minimal incision anterolateral acromion during operation.Patients were received passive motion after operation.Results: All the 32 cases were followed up ranging from 3 to 34 months with an average of 11 months.All the fractures were healed.There was neither failure of internal fixation nor incision infection case.The functional results of the shoulder,according to Constant-Murley score was on an average 86 (range: 69-100).Conclusion: The treatment for proximal humeral fractures through the minimal incision anterola-teral acromion approach is a feasible and effective method,which shows good results for treating proximal humerus fractures with correct indication.There are several advantages compared with conventional deltopectoral approach.They are minimal soft tissue disruption,minimal blood loss and easily to manipulate technique.But it required selection of indication strictly and surgeon's experience.

Objective To explore the effective therapeutic methods for hepatolithiasis.Methods We retrospectively analyzed the clinical material of 178 hepatolithiasis patients who underwent surgical therapy.Among the 178 patients,107 patients were treated with T-tube drainage(including 7 patients with left hepatic lobe or quadlrate lobe resection),and 71 patients were treated with bile duct-intestinal anastomosis(including 11 patients with left hepatic lobe or quadrate lobe resection).Results Recurrence rate of postoperative angiocholitis in the two groups was 49.5 % and 24 % respectively,and the reoperation rate was 28.7 % and 8 % respectively.Conclusions The key to prevent recurrent angiocholitis and reduce the reoperation rate is to relieve biliary tract stricture,remove the focus of infection and provide unobstructed bile duct drainage.

The treatment of vasovagal syncope has been by far unsatisfactory. Beta-blockers may prevent vasovagal syncope, but they exacerbates heart asystole. Cardiac pacing prevents syncope but notpresyncope. The frequent, serious vasovagal syncope attacks of a 63- year-old woman patient were completely prevented by administration of 100 mg metoprolol (b.i.d) for 3 months until the patient experienced a complete heart block. A DDD pacemaker implantation abolished syncope but not the presyncope, which was eventually prevented in a follow-up period of 24 months by adding 75 mg atenalol twice a day. This case suggests a different mechanism involved in vasovagal syncope.

Objective To explore the clinical features of sentinel polyps (rectal polyps with proximal colon carcinoma) and its correlation with proximal colon carcinoma.Methods From January 2003 to December 2013,the clinical features of 963 hospitalized patients with rectal polyps were retrospectively analyzed.According to whether the patient with colon carcinoma,the clinical data of rectal polyps patients were divided into pure polyps group (n=855) and sentinel polyps group (n 108).The characteristics under endoscopy,clinical pathological features,treatment and prognosis of the two groups were observed.Chi square test was performed for differences comparison between groups.Results The length of stay in hospital of 963 patients was from four to 33 days,the average age was (49.7 ± 9.4) years,and the majority of the patients were male (n=610,63.3％).A total of 785 patients (81.5％) had non-specific abdominal symptoms,such as frequency or habit change of defecation,hematochezia,abdominal pain,abdominal distension.The relatives within three generation of 78 patients (8.1 ％) were diagnosed with tumor and some relatives of the patients diagnosed with familial adenomatous polyposis (2.2％,21/963).The positive rate of tumor marker of sentinel polyps group was higher (69.4％,75/ 108) than that of pure polyps group (6.8％,58/855; x2 =316.285,P＜0.01).The proximal colon carcinoma of patients with sentinel polyps appeared as neoplasma with circumferential growth,there was no specific appearance between distal rectal polyps and proximal colon carcinoma.When compared with pure polyps group,most polyps of sentinel polyps group were in maximum diameter over 1 cm (61.1％ (66/108) vs 46.9％ (401/855)),multi polyps (n＞5,38.9％ (42/108) vs 11.8％ (101/855)) and adenomatous polyp (83.3％ (90/108) vs 35.6％(304/855),x2=7.752,55.595 and 90.544,all P＜ 0.01).Majority of the proximal colon carcinoma with rectal polyps was papillary adenocarcinoma and tubular adenocarcinoma which was account for 75.9％ (82/108).Some were mucinous carcinoma and signet ring cell carcinoma.Most of the proximal colon carcinoma with rectal polys did not penetrate the serosa layer (Duk A-+Duk B,59.3％,64/108) and with little distant metastasis (Duke D,17.6％,19/ 108).Ninty-five point six percent (817/855) of patients with pure polyps underwent endoscopic treatment and all of them were cured and discharged.Forty-one point seven percent (45/108) of patients of sentinel polyps group accepted the radical operation and 19.4％ (21/108) received endoscopic submucosal dissection.Conclusions If multiple,maximum diameter over 1 cm and adenomatous rectal polyps were detected under colon endoscope,the possibility of carcinogenesis of the polyps or the proximal colon should be awared.If the endoscope is difficult to go further or the patient can not tolerate the whole colon examination,the patient should be followed up in short-term and complete the whole colon examination.

Objective To investigate the sleep architecture in dementia with Lewy bodies (DLB),and study the sleep architecture and cognitive functions in DLB.Methods We described polysomnography (PSG) findings in 34 consecutive subjects diagnosed with DLB.All the patients underwent Mini-Mental State Examination (MMSE),Montreal Cognitive Assessment (MoCA),Clinical Dementia Rating (CDR) to quantify cognitive functions.Results (1)Sleep architecture analysis:DLB group compared to normal control group,the sleep period time (SPT) was reduced (P ＜ 0.05),total sleep time (TST) and sleep efficiency (SE) were decreased,total wake time (TWT) and wake after sleep onset (WASO) were increased,1 non-rapid eye movement (NREM) sleep (TS1),2NREM sleep (TS2),total NREM sleep (TNREMS),and REM sleep (TREMS) time were significantly decreased (P ＜0.01).(2)The DLB patients were divided into groups based on MMSE,MoCA,qnd CDR scores,the sleep architecture of each group was no significant difference (P ＞ 0.05).Conclusions Patients with DLB exists sleep architecture disorder.The cognitive functions and sleep architecture changes in patients with DLB have no obvious correlation.It is different from other degenerative dementia.

Objectives:To study the effects of glutamine on the change of intestinal permeability and investigate its relationship with systemic inflammatory response in abdominal postoperative patients. Methods: A prospective, randomized, double blind and controlled trial was taken. 20 patients who underwent abdominal surgery were randomized into two groups: Gln group(orally administrated glutamine, 30 g/d, for 7 day, n =10) and placebo group(orally administrated placebo, 30 g/d, for 7 day, n =10). Temperatures and heart rates of all patients were daily recorded during administration. The white blood cell counts and biochemical variables were measured before operation and days 4 and 7 after administration. Serum concentrations of glutamine, endotoxin, diamine oxidase and malondialdehyde and urine lactulose/mannito(L/M) ratio were measured before and the 7th day after administration. Results:The patients in the two groups were comparable prior to the administration. Serum Gln concentration was significantly decreased in placebo group and increased in Gln group after 7 days of administration. Urine L/M ratio was significantly increased in placebo group and decreased in Gln group. The serum concentrations of endotoxin, diamine oxidase and malondialdehyde were significantly decreased in Gln group when compared with those in placebo group. Temperatures, heart rates and WBC counts were significantly lower in Gln group than in placebo group. Conclusions:The gut is one of the sources of the systemic inflammatory response in abdominal postoperative patients and the glutamine can decrease the intestinal permeability,maintain the intestinal barrier and attenuate the systemic inflammatory response in the early period of postoperative patients.

Adult ; Burkitt Lymphoma ; genetics ; Chromosome Duplication ; Chromosomes, Human, Pair 1 ; Chromosomes, Human, Pair 14 ; Chromosomes, Human, Pair 8 ; Female ; Humans ; Leukemia, B-Cell ; genetics ; Male ; Middle Aged ; Retrospective Studies ; Translocation, Genetic

Objective To observe the effect of transcranial low frequency electrical stimulation on the contents of monoamines in ischemic area of rats with middle cerebral artery occlusion(MCAO).MethodsPermanent MCAO model of Wistar rat was established with silk thread enveloped with polyammoniacum.The ischemic areas received various intensity of transcranial low frequency electrical stimulation for 1 hour in rats underwent 1 hour of ischemia.Then the affected tissue was processed with fluorospectrophotometry to determine the contents of dopamine(DA),noradrenalin(NE) and 5-hydroxytryptamine(5-HT).ResultsCompared with the sham-operation group,the contents of DA,NE and 5-HT in ischemic area of MCAO model rats decreased obviously(all P<0.01),while all three monoamines investigated in the sham-operation group with transcranial low frequency electrical stimulation had no significant change.In the MCAO groups stimulating with lower(10 V) and middle(30 V) intensity transcranial low frequency electrical field,the contents of DA,NE and 5-HT in ischemic area had no significant increase.But in the MCAO group stimulating with high(50 V) intensity transcranial low frequency electrical field,the contents of DA,NE and 5-HT in ischemic area increased significantly(P<0.05).ConclusionSome degree of intensity transcranial low frequency electrical field stimulation can increase the contents of DA,NE and 5-HT in ischemic area of rats subjected to MCAO.