Sixteen patients with congenital heart disease,4 males,12 females,aged 5-52 years,admitted to Department of Cardiology,Tianchang People's Hospital from October 2007 to November 2008 were retrospectively analyzed.All patients were diagnosed by echocardiography as 4 with congenital patent ductus arteriosus(PDA),6 atrial septal defect(ASD) and 6 ventricular septal defect(VSD).The diameter limitation of PDA,ASD and VSD are 5-17 mm,20-32 mm,and 4-10 mm,respectively.All patients received transcatheter-closure therapy by domestic-made occluders,and diameters of PDA,ASD and VSD were monitored using angiography and echocardiography.The treatment effect was evaluated by echocardiography 72 hours after procedure.The closure rate was 100%,without severe complications.No residual shunt was observed 72 hours after procedure.Four patients developed fever,including 2 acute respiratory infection and 2 pulmonary infection with balanced anesthesia;1 patient with ASD and 2 with VSDs developed arrhythmia.Results suggest that transcatheter closure of congenital heart defects(PDA,ASD and VSD) using domestic-made occluders is safe and effective according to strict indications.

Objective:To investigate the clinical efficacy and compliance with a new antidepressant mirtazapine to treat depressive patients.Methods:A open-labeled study was conducted and followed up six months for 60 depressive patients treated with mirtazapine, 62 cases with depression, as a control group, treated with Clomipramine and Fluoxetine, which were assessed by Hamilton Depression Rating Scale(HAMD), Asberg Rating Scale for Side Effects(SERS), Clinical Global Impression(CGI) and Attitudes Questionaire made by ourselves. Results:The group treated with mirtazapine was superior to a control group in aspect of responsive time, early variety of factors in scales, side effects, prescription compliance , treatment attitudes and falling off cases(P

Objective To investigate the clinical characters of death in AIDS patients with Penicilliosis marneffei (PSM), improving the diagnosis and treatment of PSM. Methods Retrospectively analyze the data of 27 AIDS patients died of PSM from January 2009 to December 2011 and review the relevant literatures in the past several years. Results The etiology diagnosis time ranged from 4 to 7 (4.9 ± 1.4) days from admission. There were 22 (81.5%) cases complicated with septic shock and 25 (92.6%) cases complicated with metabolic acidosis. There were 12 (44.4%) cases co-infected with pneumocyst pneumonia , 7 (25.9%) cases with TB. The main reasons accounting for the death were as follow:15(55.6%) cases died of septic shock, 5(18.5%) cases died of respiratory failure. Conclusion The death cases of AIDS patients with PSM showed the characters of relatively late etiology diagnosis and pathogenic therapy , mostly complicated with other opportunistic infections and often died of septic shock. Therefore, timely etiology diagnosis and earlier pathogenic therapy are the keys to treat the disease. Effectively controlling of the complications and co-infections may decrease the mortality.

Objective To investigate the urinary albumin excretion of the diabetes patients and application value in the monitoring of early impairment in kidney. Methods The random urine samples from diabetes patients and controls within three days were collectod. The changes of urinary albumin excretion within day and between days were analyzed. 24-hour urine albumin was used as a standard to evaluate early kidney damage. The correlations between results of random urine albumin at the different time points and different periods were comparod. The sensitivity and specificity of random urine albumin at the different time points and different periods was evaluated and compared to deduce the best diagnostic porformance of the random urine albumin. Results There are greater variations of the levels of urinary albumin of patients with diabetes and control. After the correction with urine creatinine and urine volume the variations can be reduced (CV:49%±23% and 64%±30%). Urinary albumin excretion rate change rhythmically within the 24 h in healthy and diabetes patients. We found the best correlation between overnight ratio of urinary concentrations of albumin and creatinine (ACR) and 24-hour urinary albumin (R2 = 0.976). It was superior to urina sanguinis (R~2 = 0.900), postprandial urine (R~2 = 0.584) and random urine (R~2 =0.791). When 24 h urinary albumin was taken as the standard, receiver operating characteristic (ROC) curve analysis showed there was significant difference between male and female(male 12.8 μg/mg urine creatinine vs female 27.0 μg/mg urine creatinine),and the the cut-off value of ACR was 27.7μg/mg urine creatinine. When the smallest available negative likelihood ratio (0.011) and the greatest positive likelihood ratio (481.000) were obtained,the concentration of 13.0 μg/mg creatinine and 87.4 μg/mg creatinine were set as the cut-off value of ACR. Conclusions The correction with urinary creatinine can reduce the variation between-days compared with urine volume, but still can not completely eliminate the variability. The ACR of overnight urine has the best correlation with the 24 h urinary albumin and can replace 24 h urinary albumin. Random urine as the most convenient collecting urine samples can also replace 24-hour urinary albumin, but the gender discrepancy need to be considered. When the concentration of 13.0 μg/mg and 87.4 μg/mg was set as a random ACR exclusion value and the confirmative value, it can basically rule out and confirm the existence of microalbuminuria.

Objective: To evaluate reliability and validity of ATQ. Methods: A total of 350 undergraduates and 102 Psychiatric patients were tested by ATQ and BDI. Results:The ATQ attained good psychometric properties: Cronbach α of ATQ was 0.95, spit-half correlations ranged from 0.90 to 0.94; correlation coefficient between ATQ and BDI was 0.54 for normal undergraduates, 0.60 for schizophrenics, and 0.75 for depressive subjects (p<0.001). There were significant difference among non-depressed undergraduates、depressed undergraduates、schizophrenics and depressive patients. Conclusion: The present study provided empirical support for the reliability and validity of ATQ.

Objective To compare the iodine contrast agent dosage,radiation dose and image quality in CT pulmonary angiogra-phy (CTPA)with low tube voltage and high tube current in 64-slice spiral CT.Methods 60 patients with suspected pulmonary em-bolism in our hospital were randomly chosen and divided into three groups:Group Ⅰ:20 patients,using 120 kV,180 mA,contrast dose of 70 mL.Group Ⅱ:20 patients,using 100 kV,280 mA,contrast dose of 50 mL.Group Ⅲ:20 patients,using 80 kV,automat-ic tube current modulation techniques (300-500 mA),comparative dose of 30 mL.CT values and image noise of three pulmonary central areas and a segment branch were measured in each group.Objective indicators,subjective image quality assessment,CT dose index volume (CTDIvol),dose-length product (DLP)and effective absorbed dose (ED)were compared in three groups to evaluate the value of low kV,high mA with low-contrast dose in CTPA.Analysis of variance and t-test was used for data analysis.Results Compared with those of the standard method of CTPA,all pulmonary dry in two groups of low dose were well displayed.There was no statistical significance between each two groups in image quality score (P > 0.05),but was statistical significance in CT values, noise,SNR and CNR (P < 0.01).The CT radiation dose,CTDIvol and DLP of Group Ⅱ and Group Ⅲ were significantly lower than those of Group Ⅰ (P < 0.01).Conclusion Compared with traditional methods,low dose contrast agent injections under 80 kV could reduce the dose of contrast agent and the effect of hardening artifacts due to contrast agent in superior vena cava on right pul-monary artery.It is helpful to reduce the risk of contrast induced nephropathy and reduce patients’exposure to X-ray radiation.

Objective To explore the clinical and laboratory characteristics of patients with dengue fever(DF)in Guangzhou from July to September in 2006 and to improve the awareness of dengue virus infection for physicians.Methods Clinical data of 277 patients with DF admitted to our hospital in Guangzhou were retrospectively analyzed.Dengue virus was isolated from patients' blood specimens by C6/36 cell culture and typed by reverse transcriptase-polymerase chain reaction(RT-PCR)assay and gene sequencing.Results Age of the 277 patients,148 males and 129 females,averaged 36 years with a standard deviation of 17 years,ranging from 9 months to 78 years.Their most common symptoms included fever(100.0%),skin rash(85.2%),headache(69.3%),myalgia(51.3%),bone soreness (39.0%)and nausea or vomiting(39.4%),and leucopenia and/hromboeytopenia occurred in 75.5% and 62.5% of them,respectively.Elevated alanine aminotransferase(ALT)was found in 59.6%,elevated aspartate aminotransferase(AST)in 81.6%,and hypopotassemia in 53.8% of them.Serum positivity of antibody against dengue virus IgM was 90.6%,which could be detected 3 to 10 days after onset of the illness,with a mean of 6.2 days with a standard deviation of 1.9 days.Cell-cultured virus from 20 patients were identified as typed by RT-PCR and RNA sequence analyses.All patients were clinically classified as typical DF and all of them completely recovered.Conclusions DF during this epidemic in Guangzhou was caused by dengue virus-1,with typical manifestations in all the patients but more damage in the liver.Some patients demonstrated hypopotassemia,but no dengue hemorrhagic fever or dengue shock syndrome was found.All the patients experienced a good prognosis with timely diagnosis and treatment.

Objective To analyze the characteristics of laboratory test resuits of dengue fever(DF)patients in Guangzhou area.Methods Routine tests were performed in the patients admission to hospital. Serology examination was performed in the patients in acute phase or recovery phase.The clinieal symptoms and teatures were analyzed and positive numbers and positivity ratios were calculated.Results The clinical symptoms of the dengue fever were typieal,with the features of fever,headache,myalgia and rash.The leukopenia rate was 76.0%,and the thromboeytopenia rate was 62.6%.The levels of ALT increased in 56.7%patients,and the levels of AST increased in 84.0%patients.Hypopotassemia was found in 46.1%patients.Dengue virus antibody IgM(DF-IgM)was detected positive from the first day to the 16th day of the onset,and the positive rate was 85.9% on the 8th day.Virus loads were positive by fluorescence real-time PCR in seven acute serum samples(within 3 days of the onset)of 51 cases whose DE-IgM were negative all the time, and the results was 105 -106 copies/ml(＜103 copies/ml means negative).Conclusions Clinical manifestations of this DF epidemic were typical including fever,headache,myalgia and skin rash.Most of the patients had decreased leukocyte and thrombocyte obviously.Liver damage was common but kidney damage was seldom.Halt of the patients got hypopotassemia.DF-IgM appeared in very early and persisted for a long time.The detection of DF-IgM within 7 days of the onset was helpful for diagnosis as early as possible.Viral load detected by real-time PCR could be another indicator of early pathogen diagnosis which provides complementation for antibody detection.

ObjectiveTo investigate and compare the prevalence,awareness and risk factors of chronic kidney disease (CKD) between urban and rural population in Guangxi province in order to provide information for prevention and treatment of CKD.MethodsBy a stratified multistage random sampling method,18 to 74 years old residents in Guangxi province were surveyed. They wereevaluatedbyquestionnaire,urinaryalbumin/creatinineratio, hematuria (microscopic examination of centrifuged urine sediment),kidney B-mode ultrasound,and abnormal results were reviewed 3 months later.Estimated glomerular filtration rate(eGFR) was calculated with the simplified MDRD equation modified by a Chinese coefficient.The risk factors associated with CKD were also investigated.Results There were no significant differences between urban and rural residents in the prevalence of albuminuria (5.22％ vs 5.47％) and hematuria (1.07％ vs 1.11％)(all P＞0.05).The prevalence of renal lithiasis in rural residents was significantly higher than that in the town(10.54％ vs 6.95％)(P＜0.05).The decreased renal function between urban and rural residents(3.87％ vs 4.04％,P＞0.05) had no significant difference.The prevalence of CKD was 9.58％ in urban and 9.42％ in rural(P＞0.05).The prevalence of albuminuria according to the age distribution was different between urban and rural,which increased along with the age in urban but showed two peaks(30-40 years old and 60-74 years old) in rural.Based on logistic regression analysis,the risk factors for albuminuria were diabetes,hyperuricemia,the history of cardiovascular disease,chronic tonsillitis and HBsAg positive.The risk factors for kidney function decline were age,hyperuricemia,hypertension,diabetes,renal lithiasis and history of cardiovascular disease.The awareness rate of CKD in urban was significantly higher than that in rural (14.45％ vs 6.27％,P＜0.05).Conclusions The prevalenceof CKD has no significant difference between urban and rural in Guangxi province.The awareness rate of CKD in urban is significantly higher than that in rural.It is needed to enhance the prevention and treatment of CKD in rural.

Objective:To evaluate the effect of electroacupuncture postconditioning on the expression of microRNA-1 (miRNA-1) in rats with arrhythmias induced by myocardial ischemia-reperfusion (I/R).Methods:Twenty-four clean-grade healthy adult male Sprague-Dawley rats, aged 2-3 months, weighing 280-320 g, were divided into 3 groups ( n=8 each) using a random number table method: sham operation group (S group), I/R group and electroacupuncture postconditioning group (EP group). The model of myocardial reperfusion arrhythmia was established by ligating the left anterior descending branch of coronary artery for 30 min followed by 30-min reperfusion in anesthetized rats.The artery was only isolated without ligation after thoracotomy in group S. Bilateral Neiguan acupoints were stimulated for 30 min starting from the time point immediately after reperfusion in EP group.The occurrence of arrhythmia during reperfusion was recorded.The rats were sacrificed at 30 min of reperfusion, and hearts were removed for examination of the pathological changes of the myocardium and for determination of miRNA-1 expression (by quantitative real-time polymerase chain reaction) and expression of Kir2.1 and connexin 43 (Cx43) (by Western blot). Results:Compared with S group, the incidence of arrhythmia was significantly increased, the expression of miRNA-1 was up-regulated, and the expression of Kir2.1 and Cx43 was down-regulated in I/R and EP groups ( P<0.05). Compared with I/R group, the incidence of arrhythmia was significantly decreased, the expression of miRNA-1 was down-regulated, and the expression of Kir2.1 and Cx43 was up-regulated in EP group ( P<0.05). The pathological changes of myocardium were accentuated in I/R and EP groups when compared with S group, and the pathological changes were significantly attenuated in EP group when compared with I/R group. Conclusion:The mechanism by which electroacupuncture postconditioning reduces the occurrence of reperfusion arrhythmia is related to up-regulation of Kir2.1 and Cx43 expression after down-regulation of miRNA-1 expression in rats.