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 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 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.

ObjectiveTo determine the parameters of caudate lobe of the normal liver by ultrasonagraphy and compare with that of fatty liver and to evaluate caudate lobe's changes in patients.Methods 250 healthy subjects and 250 fatty liver patients were randomly enlisted to undergo ultrasonography to measure three diameters of length,width and thickness of the candate lobes.The differences between sexes,normal livers and fatty livers in different age groups were compared.Results In healthy adults: The measurement value of length,width and thickness of normal liver in adults were (5.068±0.45),(1.932±0.26) and 3.840±0.40 cm,respectively.The measurement value of length,width and thickness of fatty livers in adults were (5.341±0.54),(5.341±0.54) and(4.496±0.51 ) cm,respectively.Significant differences were observed in the size of caudate lobe between normal and fatty livers.Conclusion Our investigation results shows that all three parameters of fatty livers are higher compared with that of normal livers and increased size of candate lobe can be used as one indicator to diagnose the fatty liver.

The instance reality of medial equipment combined with the center problem of standardization management on medical equipment stock to discuss the questions of how to manage and what about manage.According to correlated management demand and the fact of medical procurement,from the point of view on frame construction flow to the problem of elementary demand on medical equipment procurement,the stock process of medical instrument,the stock process of medical consumable and the management of purchase invoice etc were analyzed.The beneficial research reference can be provided by the daily management jobs of stock and maintenance,the management question of more refinement and general standardization.

The general principles on maintenance and management of technical specification are discussed. Through summarizing many years maintenance experiences of the hospital or medical institutions technical support department, the beneficial mentalities and referential experiences are provided by standardized and effective management on maintenance of medical equipment, according to the medical technology level of medical equipment management department, the economic efficiency, the size of medical equipment, the quality of maintenance technicians, and service ability as well as the management methods of medical equipment material.

The operation of the culture and quality education is one of the best effective forms to execute education of various cultures and self-quality to our university students right in the classroom . But in the practical teaching work ,there is a series of questions such as the lower curricular quality , utilitarianism in teaching and studying , loose management and so on .The existing questions are analyzed and the appropriate measures are put forward in this paper.

Objective To explore the effect of sublingual immunotherapy (S-LIT) on the balance of Th17/Treg in children with mite allergic asthma. Methods All 124 cases with mite allergic asthma were randomly divided into two groups, the control group (62 cases) was treated with ladder type inhalation, and the treatment group (62 cases) was administered of dust mite drops on the basis of conventional treatment. The peripheral frequency of Th17 cell and Treg cell of all the subjects (before and after treatment) were detected by flow cytometry, the serum cytokine IL-10、IL-17 levels wer analyzed by ELISA. Results After 1 year treatment, the Th17 cells in treatment group (1.50 %±0.87 %) was significantly lower than that before treatment (3.39 % ± 1.58 %), and less than that of the control group after 1 year of treatment (2.42 %±1.32 %) (P <0.01);after 1 year treatment, the proportion of Treg cells in treatment group (4.05 %±1.36 %) was significantly higher than that before treatment (2.33 ± 0.81%), and more than that of the control group after 1 year of treatment (2.87 %± 0.87 %) (P <0.01). After 1 year treatment, the serum IL-10 levels in treatment group (64.76±27.79 pg/mL) was significantly higher than that before treatment (36.32 ± 11.53 pg/mL), and more than that of the control group after 1 years of treatment (50.32 ± 10.97 pg/mL) (P <0.01);after 1 year treatment, the serum IL-17 levels in treatment group (20.45±8.35 pg/mL) was significantly lower than that before treatment (86.48 ± 28.19 pg/mL), and significantly less than that of the control group after 1 year of treatment (46.32 ± 12.43 pg/mL) (P <0.01). After 1 year treatment, the Childhood Asthma Control Test (C-ACT)score in the treatment group (24.35 ± 8.47) was significantly higher than the control group (20.13 ± 6.86) (P <0.05). Conclusions SLIT can decrease airway inflammation and correct the imbalance of Th17/Treg in children with mite, allergic asthma.

Child ; China ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy