Objective To analyze the clinical efficacy and safety of amiodarone in the treatment of the elderly patients with ventricular arrhythmia.Methods 136 elderly patients with ventricular arrhythmia were randomly divided into the observation group (n =68cases) and control group (n =68cases).The observation group was given amiodarone by intravenous to treat the elderly ventricular arrhythmia,and patients in the control group were treated with combination therapy.After treatment for 4 weeks,the treatment outcomes were observed and compared.Results The obvious effective rate and total effective rate of the observation group was 51.47％,92.65％).which were significantly higher than those in the control group (51.47 ％,92.65 ％) (P ＜ 0.05).There was no significant difference in the incidence rate of adverse effect between the two groups (P ＞ 0.05).Conclusion Amiodarone has good clinical effect in treatment of elderly patients with ventricular arrhythmia,it is worthy of clinical use.

Objective To observe the effects of phenytoin and gabapentin in therapeutic dosage on low-dose veratridine-induced epileptiform discharge in rats' hippocampal CA1 neurons,and explore the involved mechanisms.Methods By means of whole-cell patch clamp technique,the epileptiform discharge model of rats' hippocampal CA1 neurons was constructed with extracellular perfusion of 0.5?mol/L veratridine,and the model should be regarded as successfully estabilshed if bursting discharge emerged within 30min perfusion.The effects of phenytoin(2.5,5,10 and 15?mol/L) and gabapentin(2.5,5 and 10?mol/L) on the epileptiform activity were observed under the voltage-clamp configuration,and the current changes for 1 hour in CA1 neurons was also observed.Results Nine-sixteen minutes after veratridine perfusion,the huge,rhythmic slow oscillation emerged,with 100～200Hz high-frequency discharge,in the hippocampal CA1 neurons,which was similar to the paroxysmal depolarization shifts(PDS),implying that the epileptiform activity was reproduced.Therapeutic dose of phenytoin blocked the veratridine-induced epileptiform activity.The bursting interval of the epileptiform activity was prolonged along with the increased phenytoin concentration,and the duration of bursting was not shortened.1h current decreased gradually in the generation of veratridine-induced epileptiform activity.Therapeutic dose of gabapentin did not block the epileptiform activity in this model.Conclusions In the epileptiform discharge model of rats' hippocampal CA1 neurons,phenytoin can block the epileptic activity in a dose-dependent manner,and the effect may be related to the inhibition of 1h currents.Gabapentin shows no influence on the epileptiform activity,and the possible mechanism may be its ineffectiveness to the persistent sodium currents,and vertridine-induced epileptiform activity does not enhance the 1h currents.

Objective To observe the effects of low dose of veratrine on the discharges of rat hippocampus pyramidal neurons,and to elucidate its possible cytological mechanism.Methods The discharge features of hippocampus CA1 pyramidal neurons of 14-day-aged healthy Sprague-Dawley rats induced by low dose(0.3～0.8?mol/L)of veratrine were observed by slice patch-clamp technique.Presynap- tic stimulation was given to Schaffer collaterals.Presynaptic receptor inhibitors such as 6-cyano-7-nitroquinoxaline-2,3-dione(CNQX, 5?mol/L),DL-2-amino-5-phosphonopentanoic acid(AP-5,12.5?mol/L),bicuculline(Bic,10?mol/L)and tetrodotoxin(TTX,40～80nmol/L)were used to investigate the influence on veratrine-induced epilepsy andⅠ-Ⅴcurves were plotted under these conditions.Elec- trophysiological mechanism of veratrine-induced epilepsy was elucidated on the basis of these experiments,Results After a perfusion with low dose of veratrine,the pyramidal neurons were found to discharge relatively fixed-mode slow wave epileptoid bursts accompanied with hyperpolarization of membrane potential.These epileptoid bursts were not blocked by a mixture of CNQX,AP-5 and Bic,but by low dose of TTX.After a perfusion with veratrine,Ⅰ-Ⅴrelationship tended to be nonlinear and the depolarization rectification was enhanced,which were reversed by administration of low dose of TTX.The subthreshold TTX-sensitive persistent sodium current of CA1 pyramidal cells was enhanced by veratrine in a voltage-dependent manner.Conclusion Inducing slow wave epileptoid bursts,the low dose of veratrine can remarkably change the discharge features of CA1 pyramidal neurons.Such epileptoid activities were not influenced by the synaptic receptor inhibitors,and were obviously related to the persistent sodium current.

BACKGROUND: The event of paroxysmal deplorizing shift (PDS) is the cellular hallmark of brain neurons of epileptiform activities. Its development used to be considered to be related to abnormal synaptic interactions. Recertly, the intrinsic nature of PDS has received more attention.OBJECTIVE: To observe the characteristics of epileptiform activities of rat hippocampal CA1 pyramidal neurons induced by low-dosage veratridine and investigate its possible ion mechanism.DESIGN: An exploratory and observational trial.SETTING: Institute of Neuroscience, Fourth Military Medical University of Chinese PLA.MATERIALS: This study was conducted at the Institute of Neuroscience,Fourth Military Medical University of Chinese PLA, from October 2002 to October 2004. Forty healthy SD rats of 14 days old were selected. Drugs were provided from Tianjin Drug Company and Sigma Company.METHODS: Rats were anesthetized by intraperitoneal injection, and their brain was removed and cut into slices. Epileptiform activities were induced by 0.5 μ mol/L veratridine. Then 80 nmol/L tetrodotoxin was added into the perfused solution on 6 cerebral slices, and 5 μmol/L phenytoin was used on another 5 cerebral slices. The electrophysiological characteristics of the cells under the effect of different kinds of drugs were observed.MAIN OUTCOME MEASURE: Discharge pattern of cells and tetrodotoxin-sensitive sodium currents under voltage-clamp configuration through Ⅰ-Ⅴ reaction.RESULTS: After perfusion of 0.5 μmol/L veratridine, the rat pyramidal neurons in CA1 area displayed relatively fixed-mode of runs of PDS bursting,followed by the hyperpolarization of cell membrane. Such epileptiform activities were blocked either by 80 nmol/L tetrodotoxin or 5 μnol/L phenytoin. The tetrodotoxin-sensitive sodium currents in epileptic neurons and normal controls under voltage-clamp configuration on holding potential of -55 rmV, -60 rmV, -65 mV. This shows that persistent sodium currents could be improved by low-dosage veratridine in a voltage-dependent manner.CONCLUSION: Low-dosage veratridine may induce runs of PDS like epileptiform activities on rat CA1 pyramidal neurons. Such changes can be blocked by low-dosage tetrodotoxin or phenytoin. Its ion mechanism may be related to persistent sodium currents.

Objective To explore the effect of virtual reality technology in the promotion of peer in?teraction ability in children with high functioning autism( HFA) . Methods 15 children with HFA were re?cruited and divided into control group( n=5) ,experimental group 1( n=5) and experimental group 2( n=5) with IQ and gender matching. The experimental group 1 received the attentional bias modification task,the flash animation technology task using virtual reality technology and the task in the real environment. The ex?perimental group 2 received the flash animation technology task using virtual reality technology and the task in the real environment. The control group received the task in the real environment only. Results ( 1) Af?ter the attentional bias modification,compared with the experimental group 2,the experimental group 1 was shorter on reaction time( T1=16.0,T2=39.0, U=1.0, P=0.016) ,and was higher on the accuracy( T1=40.0, T2=15.0, U=0.0, P=0.008).(2)The scores of the experimental group 1 in the other?regarding(T1=39.5, T2=15.5, U=0.5, P<0.01) and the using language( T1=38.0,T2=17.0, U=2.0, P<0.05) were higher than the experimental group 2.(3) The scores of the experimental group 1 in the other?regarding,using language and rule executor were higher than those of the control group(all P<0.01).(4) The score of the experimental group 2 in the other?regarding was higher than that of the control group(P<0.05) . Conclusion The attention bias correction based virtual reality peer interaction technology can effectively improve the ability of other?re?garding,language using and execution rules of children with HFA in the real environment.

Early small hepatocellular carcinoma (SHCC) can be cured by surgery and interventional operation to improve the survival rate of paitents,so the accurate diagnosis of SHCC is of great significance.Presently,the dynamic contrast-enhanced MR scan could only obtain single arterial phase imaging by single breath hold,and it had breathing motion artifact because of the long scanning time.The early arterial transient enhancement of SHCC was easy to be misdiagnosed.The CAIPIRINHA-Dixon-TWIST-VIBE (CDT-VIBE) sequence couldobtain high-quality multiple arterial phases images and hepatic arterial dominant (HAD) images in short-time scanning.And it could not only detect small focal lesions which were difficult to find by other imaging examination,but also find the start enhanced difference between lesions which were relevant to lesions property and blood supplement.The CDT-VIBE has a high clinical value in diagnosis and treatment of SHCC.The research progresses of CDT-VIBE in diagnosis of SHCC was reviewed in this article.

Purpose To investigate the positive rate and concordance rate of BRAF mutation in papillary thyroid carcinoma detected by real-time PCR method and Sanger sequencing. Methods 312 papillary thyroid carcinomas patients were enrolled in this study. Real-time PCR method and Sanger sequencing were performed to detect BRAF gene mutations. The frequency of BRAF mutation and the concordance of two methods were analyzed. Results BRAF mutation was detected in 65. 4% (204/312) and 63. 8% (199/312) of 312 papillary thyroid carcinoma samples by using real-time PCR method and Sanger sequencing, respectively. There was no significant correlation between BRAF gene mutations and patients’ gender. There was significant correlation between BRAF gene mutations and patients’ age. The overall concordance between real-time PCR method and Sanger sequencing for BRAF mutation detection was 98. 4%. Conclusion Real-time PCR method provides an effective method in BRAF gene mutation detection.

The standardized training of resident doctors is the main form of medical education after graduation. The standardization training of ultrasound doctors was guided by post competence, and was explored from the aspects, such as training target, teaching management, teaching method, teaching mode, and examination means. In this study, we adhered to the tutor responsibility system, and horizontal multi-module and vertical step-by-step teaching modes, made study plans according to local conditions, and improved the assessment system, so as to build a standardized and practical training system for ultrasound residents.

The clinical characteristics, diagnosis and treatment, and the gene mutation of 2 different phenotypes patients developed with tyrosine hydroxylase deficiency (THD) were retrospectively analyzed.Case 1 was a severe infantile parkinsonism accompanied with motor retardation, which started with psychomotor retardation without dystonia in infantile period.Clinical symptoms were fluctuating.Case 2 was a mild dopa-responsive dystonia, which started with progressive lower extremity dystonia in school age.The genetic study revealed that both patients had heterozygous mutations in tyrosine hydroxylase ( TH) gene.Case 1 was compound heterozygous mutations in the TH gene at c. 457C>T(paternal) and c. 698G>A (maternal). Case 2 was compound heterozygous mutations in the TH gene at c. 457C>T(paternal) and c. 1481C>T (maternal). Both patients dramatically improved after the treatment with Levodopa.THD should be considered in any children with or without mental retardation presenting with fluctuations symptoms or fluc-tuations dyskinesia.Genetic testing is the most important diagnostic method.

Objective: To compare the effect of combined therapy using lamivudine (LAM) plus adefovir (ADV) versus telbivudine (LdT) plus adefovir corresponding to the renal function of CHB patients. Methods: A total of 120 patients with chronic hepatitis B were enrolled. According to single daily dosing, they were divided into 4 groups: LdT + ADV group (n = 32), ADV+LdT group (n = 28), LAM + ADV group (n = 38) and ADV + LAM group (n = 22). Hepatorenal function, HBV serological markers, HBV DNA quantification, creatine kinase (CK) and other parameters were examined every 3 months. Serum alanine aminotransferase (ALT) normalization rate, undetectable HBV DNA rate, hepatitis B e antigen (HBeAg) seroconversion rate, level of serum creatinine (CR) and estimated glomerular filtration rate (eGFR) were analyzed at baseline time, and at weeks 24 and 52.Stastical data were analyzed by t- test and analysis of variance, count data using χ ² test. Results: There was no statistically significant difference between the four groups in terms of ALT normalization rate, HBeAg seroconversion rate, undetectable HBV DNA rate at 24 and 52 weeks. Compared with baseline, at 24 weeks of treatment, there was no significant change in serum creatinine and eGFR in the 4 groups, but after 52 weeks of treatment, serum creatinine decreased in LdT + ADV and ADV + LdT groups and eGFR increased (P < 0.05); Serum creatinine in ADV and ADV + LAM increased, and eGFR was decreased than before (P < 0.05). After treatment, there was no significant difference in renal function between the four groups at 24 weeks, but at week 52, eGFR increased and serum creatinine decreased in LdT + ADV group compared with LAM + ADV group (P < 0.05); ADV + LdT Compared with ADV + LAM group, eGFR increased and serum creatinine decreased (P < 0.05). At 52 weeks of treatment, 5 patients with mildly impaired renal function in the ADV + LdT group [n = 10, eGFR 60-90 ml·min^-1 ·(1.73 m²)^-1] returned to normal, and none of the ADV + LAM group (n = 9) returned to normal. Conclusion For patients with mild impaired renal function, adding LdT combined with ADV can improve renal function compared to that of LAM plus ADV.