Objective To evaluate the relationship between serum bilirubin and carotid atberosclerosis in aged patients with hypertension.Methods 141 aged patients with hypertension were detected by ultrasound were divided into in- creased IMT group,atberoma group and narrow luminal diameter group.Their serum bilirubin levels were measured and compared.Results Those with lower serum total bilirubin,Serum direct bilirubin and serum indirect bilirubin showed more severe carotid atherosclerosis.There was significant statistical difference between threeg roups (P

Objective To investigate the imaging diagnosis of vocal cord paralysis.Methods Of 58 patients,53 cases was unilateral and 5 bilateral.All patients underwent laryngeal tomography and 6 of them underwent CT.The imaging findings were analyzed.Results The tomography findings of unilateral vocal cord paralysis were as follows:dilated piriform sinus,41.5%;asymmetrical vestibule,39.6%;enlarged ventricle,71.7%;thinning cord,47.2%;paralyzed cord higher than intact cord,73.6%;cord fixed in adducent position during inspiration,100%;tilting of the thyroid cartilage,11.3%.The cord fixed in paramedian was the main appearance of bilateral vocal cord paralysis.The CT features of vocal cord paralysis included dilated piriform sinus(6 cases),enlarged laryngeal ventricle(4 cases),fixed cord in paramedian position(4 cases)and tilted anteromedially arytenoid cartilage(5 cases).Conclusion To evaluate the functional abnormality of larynx,tomography is useful and CT is well to display the laryngeal anatomic structures and changes,therefore,if the diagnosis is uncertain by tomography or the intrinsic lesions of larynx is suspected,CT is recommended.

Objective To study prevention and treatment for patients during the intermittent period of maintaining hemodialysis complicated by acute left heart failure. Methods The treating process of 126 examples suffered from acute left heart failure during the intermittent period of 14 225 person-time maintaining hemodialysis in 143 patients were retrospectively analyzed. Results In this case group, 0.89% suffered from acute left heart failure during the intermittent period of hemodialysis and the successful rescuing rate was 88.9%. Conclusions Applying the treatment of emergency hemodialysis, quickly filtering body fluid, the curative effect is reliable and rapid. It is one of the best ways to cure patients suffered from acute left heart failure during the intermittent period of maintaining hemodialysis. Combined with other treatments, it will be able to improve the successful rate, and ensure the sufficiency of hemodialysis. United with other steps of reducing blood pressure, such as using angiotensin converting enzyme inhibitors, angiotensin II receptor blocker, and ? receptor blocker, it is an effective countermeasure to prevent patients suffering from acute left heart failure during the intermittent period of maintaining hemodialysis, and effectively reduces its appearance as well.

In order to better understand the clinical manifestation of systemic lupus erythematosus (SLE) with intracranial hypertension syndrome (IHS), we analyzed the clinical features and treatment of a typical SLE patient with IHS. SLE is one of the most unpredictable autoimmune diseases involving multiple organ systems that is defined clinically and associated with antibodies directed against cell nuclei. IHS is an uncommon manifestation of neuropsychiatric SLE (NPSLE) and is characterized by an elevated intracranial pressure, papilledema, and headache with occasional abducens nerve paresis, absence of a space-occupying lesion or ventricular enlargement, and normal cerebrospinal fluid chemical and hematological constituents. IHS has been reported in a few sporadic cases in patients with SLE worldwide, but rarely has been reported in China. In this study, a 34-year-old female SLE patient with IHS was reported and pertinent literature reviewed. The clinical presentation, image logical features, and investigatory findings were discussed.
Diagnosis, Differential ; Intracranial Hypertension/diagnosis ; Intracranial Hypertension/*etiology ; Lupus Erythematosus, Systemic/*complications ; Lupus Erythematosus, Systemic/diagnosis

In order to strengthen the education for university students’all-round devel-opment,and to improve the quality of teaching,Shantou University,by making good use of higher education resources,built a digital campus consisting of virtual classrooms based on advantage of computer and Internet network environment,and plenty of general education programs were carried out.The teaching practice showed that virtual classroom,as a network platform,played an important role in general education programs.

AIM:To investigate whether the association of connexin 43 ( Cx43 ) and L-type calcium channel involved in the pathogenesis of atrial fibrillation ( AF) .METHODS:The biochemical assays and whole-cell patch-clamp technique were used to study the expression of Cx43 in human atrial tissue.The co-localization of Cx43 and L-type calcium channel, and the regulation of L-type calcium current in atrial myocytes were investigated.RESULTS:The expression of Cx43 at mRNA and protein levels was decreased in human atrial tissues of AF patients.In cultured atrium-derived myocytes ( HL-1 cells) , knockdown of Cx43 significantly inhibited the mRNA expression of L-type calcium channelα1c subunit, as well as L-type calcium current.Co-localization of Cx43 with L-type calcium channel α1c subunit in mouse atrial myocytes was observed.CONCLUSION:The decrease in Cx43 is involved in the pathogenesis of AF, probably through reducing the L-type calcium current in atrial myoctyes by co-localization with L-type calcium channel, thus representing the potential pathogenesis in atrial fibrillation.

AIM:Increasing evidence indicates that inflammation contributes to the initiation and perpetuation of atrial fibrillation ( AF) .Al-though tumor necrosis factor ( TNF)-αlevels are increased in patients with AF , the role of TNF-αin the pathogenesis of AF remains unclear.Recent research has revealed that T-type Ca2+currents ( ICa,T ) play an important role in the pathogenesis of AF .METH-ODS:In this study , we used the whole-cell voltage-clamp technique and biochemical assays to explore the role of TNF-αin the regula-tion of ICa,T in atrial myocytes.RESULTS:We found that compared with sinus rhythm (SR) controls, T-type calcium channel (TCC) subunit mRNA levels were decreased , while TNF-αexpression levels were increased , in human atrial tissue from patients with AF .In murine atrial myocyte HL-1 cells, after cultured for 24 h, 12.5, 25 and 50 μg/L TNF-αsignificantly reduced the protein expression levels of the TCC α1G subunit in a concentration-dependent manner .The peak current was reduced by the application of 12.5 or 25μg/L TNF-αin a concentration-dependent manner [from ( -15.08 ±1.11) pA/pF in controls to ( -11.89 ±0.83) pA/pF and (-8.54 ±1.55) pA/pF in 12.5 and 25 μg/L TNF-αgroups, respectively].TNF-αapplication also inhibited voltage-dependent inactivation of ICa,T shifted the inactivation curve to the left .CONCLUSION:These results suggest that TNF-αis involved in the path-ogenesis of AF, probably via decreasing ICa,T function in atrium-derived myocytes through impaired channel function and down -regula-tion of channel protein expression .This pathway thus represents a potential pathogenic mechanism in AF .

OBJECTIVE:To observe therapeutic efficacy and safety of cefoperazone sodium and sulbactam sodium combined with Shenmai injection in the treatment of elderly stroke associated pneumonia(SAP). METHODS:A total of 84 SAP patients in Dazhou Municipal Central Hospital during Mar. 2016-Mar. 2017 were divided into control group(42 cases)and observation group (42 cases)according to random number table. Based on routine treatment,control group was additionally given Cefoperazone sodium and sulbactam sodium for injection 3 g added into 5% Glucose injection 100 mL,intravenously,twice a day;suitable antibiotics were selected according to the results of pathogenic examination and drug sensitivity test. Observation group was additionally given Shenmai injection 100 mL added into 5% Glucose injection 250 mL intravenously,once a day,on the basis of control group. Both groups were treated for consecutive 2 weeks. Clinical efficacies of 2 groups were observed,and the levels of T-lymphocyte subsets(CD4+,CD8+,CD4+/CD8+)and inflammatory markers(TNF-α,hs-CRP,PCT),length of hospital stay before and after treatment. The ADR was recorded. RESULTS:The total response rate(95.24%)and marked response rate (47.62%)of observation group were significantly higher than those of control group(83.33%,23.81%);length of hospital stay in observation group [(15.24±3.53)d] was significantly shorter than control group [(18.43±4.21)d],with statistical significance (P<0.05).After treatment,the levels of CD4+and CD4+/CD8+in 2 groups were significantly higher than before treatment,and the observation group was significantly higher than the control group;the levels of CD8 +,TNF-α,hs-CRP and PCT in 2 groups were significantly lower than before treatment;the observation group was significantly lower than the control group,with statistical significance(P<0.05);there was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Based on routine treatment,cefoperazone sodium and sulbactam sodium combined with Shenmai injection treat SAP significantly,can effectively improve immune function, reduce inflammation level and shorten the length of hospital stay without increasing the occurrence of ADR.

OBJECTIVEThe objective of this study was to investigate the aspiratory resistance, filtration penetration and their influence factors of N95 filtering-facepiece respirators used widely in China.

METHODSThe total of 6 brands and 21 models of N95 filtering-facepiece respirators which are certified and big sales on the market. The aspiratory resistance and filtration efficiency filter penetration were measured while air pump ran from 10 L/min to 100 L/min using differential pressure gauge and the PortaCount, respectively.

RESULTSThe filtration penetrations for 2 of the 21 models were lower than 95%, and the qualified rate for all models was 90.47%. The filtration penetrations gradually decreased when ventilation flow of air pump increased. The negative correlation was observed between filtration penetration and ventilation flow (r(2) = 0.711, P < 0.05). The resistances of all 21 models of N95 respirators met the requirements of the national standard. The aspiratory resistance started to elevate with the increasing of ventilation flow, and a positive correlation between both (r(2) = 0.878, P < 0.05). Significant differences of filtration penetration and aspiratory resistance were observed among between different brands (P < 0.05) although no differences of filtration penetration existed among different models of one brand (P > 0.05). But the differences of the aspiratory resistance among different models of one brand were statistically significant (P < 0.05).

CONCLUSIONThe aspiratory resistances of all N95 filtering-facepiece respirators used in this study met the requirements of the national standard. And the qualified ratio of filtration penetration of all models was higher than 90%. The influencing factors of aspiratory resistance included materials, size and ventilation flow. And influencing factors for filtration penetration were materials and ventilation flow.

Air Pollutants, Occupational ; China ; Equipment Design ; Filtration ; instrumentation ; Masks ; standards ; Materials Testing ; Respiratory Protective Devices ; standards

Objective To investigate the curative effect of transarterial embolization (TAE) for the treatment of spontaneous rupture with bleeding of hepatocellular carcinoma (HCC),and to discuss the factors influencing prognosis.Methods A total of 57 patients with HCC complicated by spontaneous rupture and bleeding,who received initial TAE during the period from June 2012 and June 2016,were enrolled in this study.The last follow-up visit was in October 2016.Kaplan-Meier method was used to calculate the cumulative survival rate,and Cox regression model was adopted to analyze prognostic factors.Results In this series of 57 patients,the median survival time was 208 days.The 6-month,1-year and 2-year cumulative survival rates were 50.3％,35.9％ and 14.7％,respectively.Multivariate Cox regression analysis indicated that tumor size,Child-Pugh classification,history of shock,and the used embolization materials were the independent prognostic factors.Conclusion The use of selective TAE,as an initial therapy,for HCC complicated by spontaneous rupture and bleeding is safe and effective.This study reveals that larger diameter of the tumor,poor Child-Pugh classification,the presence of shock history indicate a poor prognosis.TACE using lipiodol combined with gelatin sponge particles can expect a better prognosis than TACE using PVA particles alone.