China ; Humans ; Liver Neoplasms ; surgery

It is difficult for medical students to understand electrocardiogram theory. The sec-ond clinical medical college of Wuhan University has explored clinical pathophysiology and therapy (CPPT) pattern in electrocardiogram education. Basic medical knowledge and clinic medical knowl-edge are combined with electrocardiogram theory to reinforce students ' comprehension and attract theit interest in order to obtain better teaching effect. Drawing themselves, analyzing electrocardiogram sys-tematically and memorizing theory with figure is aimed at solving forgetful problems. In addition, the problems such as lack of conformable teaching material, professional teaching teams and objective mode of examination are raised, and the solutions are explored under CPPT pattern.

Objective To investigate DSA- estimated hepatic arterial hemodynamics of hepatocellular carcinoma (HCC) determined shortly after transcatheter arterial chemoembolization (TACE) plus sorafenib treatment. Methods The clinical data of thirty HCC patients treated with TACE were retrospectively analyzed. The patients were divided into study group (n = 13) and control group (n = 17). Patients in the study group received additional oral administration of 400mg sorafenib twice a day one week before or two weeks after TACE procedure, while patients in the control group received TACE only. The initial DSA images as well as the images obtained at three months after TACE were analyzed. With the help of Photoshop software, the grey gradient of the tumor staining was measured on the series dynamic DSA images, based on which the time- density curve of the tumor was drawn. The peak density value (PV), the time to reach the peak (TP) and the slope of the upslope (SU) were determined, and the results were compared between the two groups. Results Photoshop software was used to measure the grey density values of the tumor staining on DSA images. In the study group, the post- treatment PV was smaller than the pre- treatment one, which were (38.0 ± 14.6) and (46.7 ± 18.4) respectively, the difference between the two groups was statistically significant (P = 0.040). The post- treatment PV of the study group was also smaller than that of the post -treatment PV of the control group (54.4 ± 19.8), and the difference between the two was also statistically significant (P = 0.011). No significant differences in TP values and SU values existed between the two groups as well as between the pre - treatment and post - treatment ones in each group. Conclusion After TACE.

This study was aimed to evaluate the relationship between the changes of plasma intermedin (IMD) and atrial fibrosis in hypertensive patients with atrial fibrillation. During the period from 2010 to 2011, appropriate 150 subjects of out-patients (female 50%, male 50%) were selected in West China Hospital, Sichuan University, and were divided into three groups: the hypertension-only group, the hypertension combined with paroxysmal atrial fibrillation group and the hypertension combined with persistent atrial fibrillation group. Firstly, we collected the Physical examination results and medical history records of the patients. We then performed ultrasound cardiogram and blood biochemical tests on the patients. We also detected the plasma IMD and transforming growth factor β1 (TGF-β1) using ELISA. The results showed that compared with the hypertensive group, the plasma level of IMD, TGF-β1 and left atrium director (LAD) in the hypertensive combined with atrial fibrillation group were higher significantly. Compared with the paroxymal atrial fibrillation group, the levels of IMD, TGF-β1 and LAD were higher significantly in persistent atrial fibrillation group. Analysis of correlation and partial correlation showed that IMD was positively correlated with TGF-p1 (r=0.51, P<0. 001), IMD was positively correlated with LAD(r=0.59, P< 0.001), and TGF-β1 was positively correlated with LAD (r = 0.57, P < 0.001). The results suggest that IMD might suppress the pathophysiological process of atrial fibrillation.
Atrial Fibrillation ; physiopathology ; Female ; Humans ; Hypertension ; physiopathology ; Male ; Peptide Hormones ; blood ; Transforming Growth Factor beta1 ; blood

Obejective To reform the electrocardiogram teaching mode under clinical pathophisioligy and therapy(CPPT) mode.Methods The junior students of Grade 2010 in Second Clinical Medical College of Wuhan University were selected as subjects.The students were randomly divided into experimental group (44 students) and control group(52 students).Control group was taught by using traditional methods for electrocardiogram(ECG) diagnostics theory,and by using Diagnostics department's own Atlas,while experimental group was taught by reformed teaching methods,and ECG reformed textbook was used in their theoretical lessons,strengthening electrocardiogram and electrophysiology,cardiovascular disease combined.Meanwhile,the practice of teaching was taught by using preview-speaking Figure-Picture stories-Case-Read figure,a way to strengthen the theory-practice-theory of the cycle.The questionnaire was carried out in two groups after ECG teaching.After the end of the course two groups were given packet electrocardiogram atlas test and ECG theoretical knowledge examination and the above evaluation results were statistically analyzed by using SPSS 10.Results The statistically significant differences between experimental group and the control group were in the right ventricular hypertrophy,ventricular fibrillation,WPW syndrome,et al(P＜0.05).The ratio of the experimental group students' liking electrocardiogram course and their recognition of electrocardiogram teaching mode was higher than that of the control group while the ratio of their thinking ECG difficult was lower than that of the control group and the difference was statistically significant difference(P＜0.05).The excellent rate and good rate of the experimental group students' theory knowledge examination results were higher than the control group,two groups of results distribution difference being statistically significant(P=-0.043).Conclusions CPPT teaching model can effectively help students overcome the difficulties in reading electrocardiogram and deepen their understanding of theoretical knowledge and memory.

Objective To evaluate the clinical effect of recombinant human epidermal growth factor (rhEGF) on the treatment of chronic tympanic membrane perforation and the function of inner ear. Methods From 2005 to 2008, the outpatients were randomly divided into three groups (A:control group, B:kangfuxin group, C:rhEGF group) . The patients were also divided into three groups (small, medium and large) . The hearing level and the function of inner ear in three groups were compared. Results The hearing level of rhEGF group was 4.5, which was significantly than that of other groups (7.3 and 9.4 respectively, <0.05) . There was no significant difference in the function of inner ear among the three groups ( >0.05) . Conclusion rhEGF can decrease the healing time significantly and increase the healing rates in the treatment of chronic tympanic membrane perforation, and it has no obvious adverse effects on the inner ear.

Carcinoid Tumor ; diagnosis ; pathology ; Carcinoma, Neuroendocrine ; diagnosis ; pathology ; Ear, Middle ; Humans ; Pharynx

Objective:To observe and analyze the superficial retinal blood flow density and its related influencing factors in the macular area of adolescents with different types of non-pathological high myopia (HM).Methods:A retrospective clinical study. From March to August 2022, 117 eyes of 117 adolescents who were admitted to Liaocheng Aier Eye Hospital due to myopia were included in the study. According to equivalent spherical degree (SE) and corneal curvature, subjects were divided into mild myopia or emmetropia group (control group), HM group, occult HM (OHM) group, and super HM (SHM) group, with 30 eyes, 28 eyes, 35 eyes, and 24 eyes, respectively. All subjects underwent medical optometry, intraocular pressure, optical coherence tomography (OCT), OCT angiography (OCTA), axial length (AL) and corneal curvature measurements. The diopter was SE. OCTA instrument was used to scan the macular region in the range of 6 mm×6 mm, and the software automatically divided it into three concentric circles centered on the fovea of the macular, namely, the central area with a diameter of 1 mm, the inner ring area with a diameter of 1-3 mm, and the outer ring area with a diameter of 3-6 mm. The superficial retinal vascular density (SRVD), vascular perfusion density (SBPD), the area, perimeter (PERIM), avascular index (AI) of foveal avascular area (FAZ) and retinal thickness were measured in the macular region as a whole and in different regions. One-way analysis of variance was used to compare the data among groups, and the least significant difference t-test was used to compare the data among groups. The correlation of AL, corneal curvature and intraocular pressure with SRVD and SBPD in macula was analyzed by Pearson correlation analysis. Results:There were significant differences in SRVD and SBPD in the central, inner and outer regions of macula in control group, HM group, OHM group and SHM group ( P<0.05). There were statistically significant differences in the thickness of the retina above, below and on the temporal side of the central and outer ring regions ( P<0.05). However, no statistically significant difference was in the thickness of the retina on the nasal side ( P>0.05). There was no significant difference in PERIM ( P>0.05). There were significant differences in FAZ area and AI ( P<0.05). Correlation analysis showed that AL was negatively correlated with SRVD and SBPD in macular whole and central, inner and outer ring regions ( P <0.05). Corneal curvature and SE were positively correlated with the SRVD and SBPD of macular whole, central area and outer ring area ( P<0.05). AL was negatively correlated with retinal thickness in the outer ring region ( P<0.05). SE was positively correlated with the thickness of the retina above, below and temporally in the outer ring region ( P<0.05). AL was negatively correlated with FAZ area and AI ( P<0.05). SE was positively correlated with FAZ area and PERIM ( P<0.05). Retinal thickness was positively correlated with SRVD and SBPD ( P<0.05). Conclusions:The SRVD and SBPD of different types of HM in adolescents decreases to different degrees. The thickness of the retina in the central region is thicker, and the retina in the outer ring region is thinner. With the decrease of SRVD, the retinal thickness gradually is thinner.

Objective To assess the technical feasibility and effectiveness of X-ray-guided implantation of inverted Y-type metal airway stent under local anesthesia by using a modified technique of exchanging guide wire in order to shorten operation time.Methods The clinical data of a total of 16 patients,who received inverted Y-type metal airway stent implantation under local anesthesia,were retrospectively analyzed.Routine gradual guide wire exchange method with a harder one was used in 6 patients (routine group),while in 10 patients (modification group) a modified technique of exchanging guide wire,i.e.inserting two hard wires at one time,was employed.Technical success rate and operation time were used as the main observation indexes.Results Under local anesthesia,the implantation of inverted Y-type metal airway stent was successfully accomplished in all 16 patients.The mean operation time of the routine group and the modification group was 15.6 minutes and 11.1 minutes respectively,the difference between the two groups was statistically significant (P＜0.05).Conclusion For the performance of implantation of inverted Ytype metal airway stent under local anesthesia to treat malignant carina stenosis,the use of modified technique of guide wire insertion,i.e.inserting two hard wires at one time,can effectively shorten the operation time.