Objective To investigate the electrophysiology mechanism of the P wave dispersion (Pd) and the maximum P wave duration (Pmax) in patients with paroxysmal atrial fibrillation (PAF),and evaluate the effect of the Pd and Pmax in the prediction of PAF. Methods Forty-eight patients with PAF (group PAF) were slected and divided into 2 sub-groups according to the organic heart disease,group PAF1 (20 cases, without organic heart disease) and group PAF2 ( 28 cases, with organic heart disease). Forty-six patients without PAF were selected as control group. The Pd and Pmax were measured from the 12-lead surface electrocardiogram (ECG). Results The Pd and Pmax in group PAF was higher than that in control group [(41.11 ± 4.97 ) ms vs. (27.77 ± 4.72) ms, ( 111.43 ± 8.01 ) ms vs. (95.57 ± 9.01 ) ms] (P ＜ 0.05 ). The Pmaxin group PAF2 was significantly higher than that in group PAF1 (P ＜ 0.05),and there was no significant difference in the Pd between group PAF2 and group PAF1 (P＞ 0.05 ). The specificity, sensitivity and positive predictive value of Pd ≥40 ms combined with Pmax ≥ 110 ms was 95.65%, 81.25% and 95.12%. Conclusion The Pd and Pmax in the patients with PAF are significantly higher than those in the patients without PAF, and Pd≥40 ms combined with Pmax≥ 110 ms can be used to predict the PAF more reliably and accurately.

Objective To explore the clinical significance of heart rate turbulence (HRT) in patients with chronic heart failure(CHF).Methods Thirty CHF patients(CHF group) and 28 non-organic heart disease persons (control group) were examined by 24 hours dynamic electrocardiogram (DCG).According to the NYHA grading of the cardiac function,CHF group were divided into low-degree heart failure (LdHF) sub-group (NYHA Ⅰ -Ⅱ,16 cases) and high-degree heart failure (HdHF) sub-group (NYHA Ⅲ-Ⅳ,14 cases).In CHF group,ischemic heart disease (IHD) patients were 18 cases and non-ischemic heart disease (NIHD) patients were 12 cases.Two indexes of HRT including turbulence onset (TO) and turbulence slope (TS) were measured and analyzed.Results The TO value in CHF group [(0.43 ±0.83)%] was significantly higher than that in control group [( - 1.49 ± 1.00)%] (P ＜0.05),and the TS value in CHF group[( 2.67 ± 0.66) ms/RRI] was significantly lower than that in control group [( 8.52 ± 2.09)ms/RRI] (P ＜0.05).The TO value in the HdHF sub-group [(0.79 ± 0.67)%] was significantly higher than that in LdHF sub-group[(0.12 ± 0.86)%] (P = 0.026),and the TS value in the HdHF sub-group [(2.88 ±0.79) ms/RRI] was significantly higher than that in LdHF sub-group [(2.40 ± 0.35) ms/RRI] (P= 0.045).The TO and TS values had no significant difference between the IHD and the NIHD patients (P＞0.05).In CHF group,53.3%(16/30) patients' TO and TS values were both abnormal (TO ≥ 0,TS ≤ 2.5 ms/RRI),and 40.0% (12/30) patients had only TO or TS value abnormal,93.3% (28/30) patients had abnormal HRT.Conclusion The phenomenon of HRT in the patients with CHF obviously decrease,and the HRT can be used to evaluate the severity of heart failure and predict the prognosis of the heart failure.

Objective To observe the effect of maxillary sinus floor augmentation with transalveolar tech-nique and simultaneous implant.Methods 50 cases of patients with missing tooth in maxillary posterior region with insufficient vertical bone treated by author were selected.Maxillary sinus floor augmentation with transalveolar tech-nique and simultaneous implantation were given after local anesthesia.X -ray was given on the right day,2 weeks, 3 months and 9 months after operation.And the situation of osseointegration was observed.Results There were 2 cases of injuries of maxillary sinus mucoperiosteum in the 50 cases (4%),and no obvious complication was found for timely treatment.There were 5 cases of gingiva with obviously swollen around implant and BOP(+),and the symptoms were obliterated one week after paradental basic therapy and oral health guidance were given.All the situations of the osseointegration of implants were good,and no loosening or dropping case was found in follow up.One year after operation,the mean obsorbation of bone around the neck of implant was (0.9 ±0.3)mm.There was no obvious absorption of bone around implant,and obvious continuous image of maxillary sinus floor could be observed by imaging examination.The satisfaction of chew,pronounce,aesthetics,maintenance and comfort was all 100%,and 49 cases were satisfied with operation tolerance,and satisfaction rate was 98%.Conclusion Ther effect is desired to apply maxillary sinus floor augmentation with transalveolar technique and simultaneous implant under strict indication.And the satisfaction degree is high.

Objective To investigate the status and capacity of eye care services in Yunnan Province in 2007. Design Cross-sectional questionnaire survey. Participants 165 medical institutions in Yunnan Province. Methods Using a standardized questionnaire designed by Ministry of Health,the all hospitals of county or above and eye hospitals in Yunnan Province were investigated during October to December 2007. Main Outcome Measures Number of ophthalmologists and ophthalmic nurses,surgical volume per year,out-patient volume per year and number of ophthalmologists who can operate cataract independently. Results Totally 165 hospitals covered Yunnan Province participated in this study (response rate was 100%). In all these institutions,there were 735 ophthalmologists and 771 nurses. 392 ophthalmologists could perform cataract surgery independently. Within 16 prefectures of Yunnan,Zhaotong prefecture had the least resources of ophthalmology (7 ophthalmologists per million population) while Kunming had 32 ophthalmologists per million populations. In 2006,58346 eye surgeries were performed in all these institutions,including 23833 cases of cataract surgeries. 27 hospitals were not able to provide cataract surgical services. Out 165 institutions,only 29 hospitals (17.6%) had advanced ophthalmic equipments and 6 hospitals (3.6%) did not have any ophthalmic equipment. Conclusion There are big differences of eye care services among different level and different location of medical institutions in Yunnan Province of China. Inappropriate distribution of human resources and low productivity are main issues. Further resources allocation and optimized use of resources in eye care services are needed to meet the needs of patients.

[Objective] To emphasize the importance of early prevention and treatment, this article discusses on the theory and application of preventive treatment of disease from traditional Chinese medicine in prevention and treatment of carotid atherosclerosis in patients with diabetes. [Methods] With de-tailed research into related study of risk factors affecting carotid atherosclerosis in type 2 diabetic patients from recent years, comprehensive summary of tra-ditional risk factors and risk factors of the latest findings were demonstrated. The prevention and treatment of carotid atherosclerosis in type 2 diabetes mel itus was discussed in two aspects by theory of“preventive treatment of disease. [Result] In diabetic patients without carotid atherosclerosis, early and timely intervention can prevent the occurrence and development of the diabetes vascular lesions; In diabetic patients with carotid atherosclerosis, active treatment can reduce the incidence of stroke, myocardial infarction and other critical care. [Conclusion] In patients with type 2 diabetes, risk factors affect-ing carotid atherosclerosis should be control ed and intervened early, which can effectively reduce the occurrence and development of the diabetes vascular lesions to improve the quality of life, but early diagnosis technology and indicators need to be further researched.

Pathogen incubation theory includes "no manifestation after infection" and "manifestation after incubation". Clinical data showed that the incidence and recurrence of tic disorders in children had a strong relevance to six exogenous factors. The pathogenesis is similar to the pathogenic mechanism based on incubation of pathogen theory, so we proposed a theory of "tic disorder induced by incubation of pathogen". Pathogenic wind can be classified into exterior wind and endogenous wind. Pathogenic wind is more apt to move, rise and migrate. The characteristics of pathogenic wind, especially easy mobility, determine the symptoms and signs of tic disorder, for pathogenic wind can be characterized by vibration and involuntary movement such as convulsion and tremor. If exogenous pathogenic wind moves into half-exterior and half-interior phase from the exterior, both the exterior and interior syndromes should be treated at the same time. We should regulate the function of the liver and the lung, expel pathogenic wind by dispersing the lung, and calm endogenous wind by removing obstruction in the collaterals and soothing the liver.

Objective] To analyse the course of treatment based on differentiation of signs of Hashimoto thyroiditis combined with many diseases, offering treating thought and medication experiences. [Method] Trace back and state the relative documents about the general conditions, diagnosis and therapy, symptoms-pointed treatment of 1 case of Hashimoto thyroiditis combined with many diseases, introducing Pro. Wumin's clinical experience in treating the patient. [Result] The patient was early or late diagnosed as fatness, hyperlipemia, hyperinsulinemia, sub-clinical Hypothyrea, thyroid nodule and type-2 diabetes, Pro. Wumin combined TCM with WM, the patient was control ed the diseases and kept stable. [Conclusion] Combination of TCM and WM treating Hashimoto thyroiditis accompanied with diseases above has good cure effect, the patient is satisfied with the improvement and result.

The authors through the analysis on the state food and drug administration for clinical drug agency qualification , the ethics committee to run the problem:ethics committee incomplete management system and SOP;Familiar with work system and review process to be;Track review is not standard;Pilot project information manage-ment confusion;Ethics committee hardware substandard housing .And puts forward the following measures to solve these problems , reasonable adjustment of organization structure , strengthen the system construction , standard re-view process , establish 3 levels training model and improve office conditions .

OBJECTIVE:To prepare Stemoninine orally disintegrating tablets,and to optimize its formulation and preparation technology. METHODS:Direct powder compression method was used to prepare Stemoninine orally disintegrating tablets. Using material angle of repose,disintegration time and taste evaluation as index,single factor test was used to screen several factors as bulking agent,disintegrating agent,glidant and flavoring agent;using disintegration time as index,L9(34) orthogonal test was used to optimize the formulation with ratio of MCC+mannitol,PVPP,silica powder and aspartame+stevia as factors. Validation test was also conducted. RESULTS:Optimized formulation was that MCC+mannitol(1∶1)was 50%,PVPP was 20%,silica powder was 2% and aspartame+stevia(10∶1)was 7%. 3 batches of prepared Stemoninine orally disintegrating tablets were smooth in sur-face and good in taste;their disintegrating time was(22.6±2.1)s,and weight variation,hardness,contents were within the speci-fied range (all RSD≤0.97%,n=3). CONCLUSIONS:The formulation and technology of Stemoninine orally disintegrating tab-lets are reasonable,and the quality indexes are all in line with the requirements of orally disintegrating tablets.

Yifeng (TE 17), Tinghui (GB 2), Zhongzhu (TE 3) and Xiaxi (GB 43) were selected as key acupoints plus hyperbaric oxygen to treat 50 cases of sudden deafness, and the total effective rate was 98%.