Objective to investigate the clinical diagnosis of female hypertension with chest pain.Methods The clinical coronary angiography data of 77 female cases of hypertension with chest pain diagnosed as coronary heart diseased (CHD) and angina pectoris were analysed retrospectively.The comparison of the risk factors and clinical features in the two groups was made.Results Clinically,it was difficult to differentiate hypertension with chest pain and coronary heart failure,but dynamic EDG and typical angina pectoris suggested the possibility of coronary heart disease.Conclusion Coronary angiography is still essential to diagnose CHD.

OBJECTIVE:To provide reference for rational prophylactic application of antibiotics in perioperative period of per-manent cardiac pacemaker implantation. METHODS:600 cases performed permanent cardiac pacemaker implantation in 2010(be-fore rectification),2012(during rectification)and 2014(after rectification)were randomly sampled from our hospital,and divided into control group,intervention group one and intervention group two. The prophylactic application of antibiotics was investigated and analyzed in 3 groups. RESULTS:For control group,intervention group one and intervention group two,the rates of rational type selection of antibiotics for prophylactic use were 7.25%,31.00% and 91.96%,respectively. The rates of rational medication timing of antibiotics for prophylactic use were 0,100% and 100%;average duration of prophylactic use decreased from (3.6 ± 1.2)d before intervention to(1.1±0.5)d and(1.0±0.2)d. There was no statistical significance in the incidence of postoperative infection(P>0.05). Compared with control group,average drug cost,antibiotics cost and drug ratio decreased significantly in in-tervention group,with statistical significane (P<0.05). CONCLUSIONS:Antibiotics special rectification is effective and improve the rational application of antibiotics in our hospital.

Objective To analyze the clinical characteristics,treatment and prognosis of primary esophageal small cell carcinoma (PESC).Methods Fifty-five patients with PESC were analyzed retrospectively.The survival rate was calculated by the Kaplan-Meier method and the Log-rank test using SPSS 17.0 software.Results The median survival time of 55 patients was 12 months.The 6,12,24.36months survival rates of these patients were 87.3 ％ (48/55),50.9 ％ (32/55),12.7 ％ (7/55),7.3 ％ (4/55),respectively.In multivariate analysis,stage and type of treatment were shown to be independent predictive.Conclusion PESC is a malignant tumor with early metastasis and poor prognosis.Combined therapy may improve the survival time of PESC patients.

Objective To investigate the therapeutic effects and side effects of FLAG and MEA regimen in the treatment of relapsed and refractory adult acute myeloid leukemia.Methods Use retrospective analysis to Observe the therapeutic effects and side effects of the 51 cases of relapsed and refractory adult acute myeloid leukemia (M3 except) from January 2009 to June 2012 in our hospital,which are divided into FLAG group (23 cases) and MEA group (28 cases) according to chemotherapy.Results In FLAG group,the rate of complete remission was 30.4 ％ (7/23),the rate of partial remission was 17.4 ％ (4/23),the effective rate was 47.8 ％ (11/23).In MEA group,the rate of complete remission was 35.7 ％ (10/28),the rate of partial remission was 21.4 ％ (6/28),the effective rate was 57.1％ (16/28),difference between two groups was not statistically significant. Both groups appeared Ⅳ degrees myelosupression,and there were no significant differences between them on incidences of secondary infection [95.7 ％ (22/23) vs 89.3 ％ (25/28)] and haemorrhagia [82.6 ％ (19/23) vs 85.7 ％ (24/28)].Difference on cardiac toxicity was statistically significant.Conclusions Compared with MEA regimen, FLAG regimen are similar effective and can be well tolerated,which has lower cardiac toxicity. Thus, FLAG regimen can be used as first-line treatment for relapsed and refractory adult acute myeloid leukemia.

Objective To investigate the effect of postremission consolidation therapy with intermedium-dose cytarabine (MDAC) in elderly patients with acute myelogenous leukemia (AML). Methods Clinical data of 61 elderly AML patients (except M3) in postremission who achieved complete remission (CR) in two period of remission induction program were retrospectively analyzed. Results There were 26 cases in MDAC group and 35 cases in standard-dose cytarabine (SDAC) group. In MDAC group and SDAC group, the relapse free survival (RFS) time were 42.7 months and 16.0 months respectively (P= 0.002), the overall survival (OS) time were 44.6 months and 18.2 months respectively (P= 0.004), and the cumulative relapse frequencies rates were 26.9 % (7/26) and 54.3 % (19/35) respectively (x 2= 4.567, P= 0.033). However, 3 years OS rate of the two groups were 23.1%(6/26) and 8.6%(3/35) (x 2=2.496, P=0.114) , and there was no significant difference in the incidence of adverse reactions between the two groups (all P > 0.05). Conclusion MDAC could improve RFS and OS for the elderly AML patients in postremission who received CR in the early stage, and the incidence of adverse reactions is similar to that of SDAC.

Objective To explore the therapeutic effect of Jinkoubao on oral ulcer in rabbits and its action mechanism.Methods Among 60 SPF NewZealand rabbits,6 cases were randomly selected for the ulcer model identification,and the rest was randomly and equally divided into 3 groups:the control group (NC group),normal saline drug film group (NS group) and Jinkoubao film group (JK group).The rabbit model of oral ulcer was constructed by applying 40 ％ glacial acetic acid to burn rabbit oral mucosa for duplicating the oral ulcer model.of the change situation of oral ulcer was observed on the same day for constructing model,on 3,5,7 d after medication.The EGF level in oral mucosal tissue was detected by using RT-PCR and the local histopatho1ogical changes in oral ulcer was observed by using HE staining method.Results Compared with the NS group,the ulcer area on 3,5,7 d after medication in the JK group was significantly deceased (P＜0.01).Compared with the NS group,the EGF level in oral buccal mucosal tissue in the NS group and JK group was markedly increased (P＜0.01).But the EGF level increase in the JK group was faster than that in the NS group,the difference was statistically significant(P＜0.01).The HE staining section of rabbit oral ulcer on 3,5,7 d after medication showed that the inflammatory cells decrease in the JK group was more obvious than that in the NS group,fibroblasts proliferation was obvious and epithelial hyperplasia was good.Conclusion Jinkoubao could greatly improve the symptoms of oral ulcer in rabbits and promotes its healing,which is possible to strengthen the repair capacity of oral ulcer by regulating the EGF level.

Objective:To explore the method of establishing a modified demyelination and myelination regeneration model induced by dicyclohexanone oxalyl dihydrazone (CPZ) in mice with multiple sclerosis (MS), and to analyze the image markers of demyelination and myelination regeneration in mouse MS model.Methods:After the intragastrically administered with sodium carboxymethyl cellulose (CMCNa) for one week, a total of 30 C57BL/6 male mice were randomly divided into the control group ( n=10), the demyelination group ( n=10), and the remyelination group ( n=10). The mice of the control group were immediately performed MR scanning and pathological specimen obtaining; the mice in the demyelination group were administered with intragastrical CPZ-CMCNa once a day for 6 weeks for inducing demyelination, then received MR scanning and specimen obtaining with the same protocols used in control group; the mice in the remyelination group were administered with intragastrical CPZ-CMCNa once a day for six weeks for demyelination, then CPZ was withdrawn and normal diet was given for another four weeks. Then MR scanning and specimen obtaining were performed with the same protocols used in the other two groups. Regions of interest (ROIs) were set at the rostrum of corpus callosum (rCC), the bilateral normal appearing white matters (NAWM) of the rostrum of corpus callosum, and the bilateral cerebral cortex (Cx). The normalized T 2WI (T 2-normalized), fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) values were compared among the three groups by one-way ANOVA. Results:The demyelination and remyelination mice model of MS were successfully established. The T 2-normalized values of rCC in control group, demyelination group and remyelination group were 0.47±0.03, 0.72±0.04, 0.54±0.04, respectively, with statistically significant difference found ( F=90.511, P<0.05). Post-hoc multiple comparisons showed significant differences among those groups ( P<0.05). There was no significant difference of T 2-normalized value in NAWM and Cx among the three groups ( P>0.05). Moreover, there were significant differences in the FA values (0.36±0.04, 0.29±0.03, and 0.32±0.05), the MD values [(0.572±0.015), (0.598±0.034), and (0.626±0.043)×10 -3 mm 2/s], the AD values [(0.79±0.04), (0.77±0.06), and (0.83±0.04)×10 -3 mm 2/s], and the RD values [(0.46±0.02), (0.51±0.03), and (0.53±0.05)×10 -3 mm 2/s] of rCC of the control group, the demyelination group, and the remyelination group (all P<0.05). Significant difference was found in FA values between the demyelination group and the control group ( P<0.05), and in MD values between the remyelination group and the control group ( P<0.05), as well as in AD values between the remyelination group and the demyelination group ( P<0.05). There were also significant differences in RD values between the remyelination group and the control group, and the demyelination group and the control group (all P<0.05). However, no significant difference was found in all diffusion tensor imaging (DTI) metrics of NAWM and Cx among the three groups (all P>0.05). The LFB-eosin staining showed that the myelin sheath of rCC was lost in the demyelination group, and the rCC was partially regenerated and repaired in the remyelination group. Conclusion:The modified CPZ-CMCNa model can selectively induce demyelination and remyelination of rCC, and the changes of demyelination and remyelination of rCC in the modified CPZ-CMCNa model can be quantitatively detected by T 2WI combined with DTI, which might provide related theoretical basis for the study on dynamic changes of MS lesions.

OBJECTIVETo evaluate the clinical effect of implanted cardioverter-defibrillators (ICD) for primary prevention of sudden cardiac death.

METHODSAccording to ACC/AHA Guideline of ICD implantation (2005), 35 patients successfully received ICD/CRT-D implantation for primary prevention of sudden cardiac death in our hospital from January 2006 to December 2009. All the patients were followed up for a mean of 2 years.

RESULTSDuring the follow up, 11 (31.43%) patients experienced ventricular arrhythmic episodes, for which 16 defibrillation therapies and 75 anti-tachycardia pacing (ATP) therapies were delivered without mistaken shock or death. The incidence rate of NVM was 100%, that of PVT was 66.67%, Brugada syndrome 50%, HCM 25% and DCM 16.67%. Of these episodes, the incidence of VF episodes among PVC patients was 87.5% (14 beats), ventricular tachycardia PVC was 82.28% (65 times), 5 beats in NVM patients, 4 beats in HCM and Brugada syndrome patients, and 1 beat in DCM patients. No ICD implantation-related complication was detected, and no ventricular tachycardia induced syncope occurred in these cases. All patients showed improved quality of life after the implantation.

CONCLUSIONICD implantation can prevent malignant ventricular arrhythmia episodes, especially for PVT, NVM and Brugada syndrome in high risk SCD patients, demonstrating the value of implantation of ICD as a primary prevention in high-risk SCD patients.

Adult ; Aged ; Death, Sudden, Cardiac ; epidemiology ; prevention & control ; Defibrillators, Implantable ; Female ; Humans ; Male ; Middle Aged ; Primary Prevention

Objective: To detect the expression of basic fibroblast growth factor(bFGF) in oral mucosa with ulcer in rabbits. Methods: 72 New Zealand rabbits(with the weight of 3 000-3 500 g) were randomly divided into control group,model group,and treatment group(n = 24). 1,3,5 and 7 d after treatment buccal mucous membrane tissues of the rabbits were respectively taken from the 3 groups. The models of oral ulcer were examined by HE staining. The expression of bFGF mRNA was detected by RTPCR. The expression of bFGF protein was detected by immunohistochemistry. Results: The oral ulcer model of the rabbits was successfully established. Both RT-PCR and immunohistochemistry analyses showed that 1-7 d after treatment the expression levels of bFGF mRNA and protein were higher in treatment group than in model group(P ＜ 0. 05) and control group(P ＜ 0. 05),3-7 d after treatment were higher than in model group(P＞ 0. 05). Conclusion: bFGF may be a new therapeutic target for oral ulcer.

Objective To explore the status quo and influencing factors of caring efficacy of nursing undergraduate students so as to provide reference for improving their caring efficacy. Method A cross-sectional study was conducted. Totally 274 nursing undergraduate students from 10 general hospitals in Sichuan Province were surveyed by using general information questionnaire, professional model scale for nursing students, professional identity questionnaire for nursing students and caring efficacy scale. Results The average score of caring efficacy of undergraduate nursing students was (4.00 ±0.64), which was lower that of jurior nurse before training (4.55±0.34) and after training (4.98±0.27). The average score of career identity and professional model (3.63±0.68) were postively related with career effevtieness (all P＜0.001). The care from family, medical staffs, job-taking benefits and dimission risks, social comparison and self-reflection were the main factors influencing caring efficacy (P＜0.01), which explained 40.9％ of the varianceof caring efficacy among undergraduate nursing students. Conclusions Caring efficacy of the nursing students was above the middle level, but lower than that of clinical junior nurses. Their professional model and professional identity were positively correlated with caring efficacy. It is necessary to establish a good professional model, through example education, perfect career planning and improve the professional identity of nursing undergraduate students, so as to improve their caring efficacy of nursing students, and then improve the quality of nursing team reserves.