Objective: This paper focuses on the most commonly used Guiding Catheter and conduct study on material selection, push force, torque and twist controllability. Methods:In contrast to the method used in our clinical surgery three foreign manufacturers of medical guidelines for catheter materials, testing foreign manufacturers’ products. Conclusions analyzing t foreign products their own characteristics, provide the technical basis for better medical research and clinical guidelines for catheter performance. Results: Three foreign guiding catheter manufacturers selected the same materials, after testing, the guiding catheter has the best maximum pushing force, can quickly reach the site of disease. Conclusion: The guiding catheter has the best torque control, can better use in distorted vessel;the guiding catheter has the best twist controllability, can deal with complex vascular anatomy.

Tachycardia induced cardiomyopathy is a kind of cardiomyopathy caused by sustained or recurrent tachycardia.Various types of tachyarrhythmias can cause TIC, and the main clinical manifestations of it are cardiac dilatation and cardiac dysfunction.TIC can occur at all ages and is a reversible and acquired cardiomyopathy with a generally benign prognosis.After early diagnosis and reasonable treatment to relive the tachycardia, the function of the heart can partially or completely recover.In clinical practice, pediatricians do not fully understand the disease, as a result, it is easily missed, misdiagnosed, then the proper diagnosis and treatment will be delayed.This article provides a systematic overview of the pathogenesis, clinical characteristics, diagnosis, differential diagnosis, treatment and prognosis of TIC in children, and aims to provide a basis for clinical pediatricians to recognize it early and treat it promptly.

Objective To promote rational drug use by investigating quality of the outpatient and emergency prescriptions in the hospital .Methods We statistically summarized the evaluations of prescriptions and analyzed the drug use from January to Novem-ber ,2012 .Results The outpatient and emergency prescriptions were compliant to relevant writing standards ,without missing i-tems .The inaptitude of prescriptions were mainly in forms of inappropriate indication ,usage ,and dosage of drug and menstruum . The irrational prescriptions accounted for 5 .5% of those evaluated .Conclusion Rational drug use has been basically ensured through implementation of prescription evaluations and interventions .Irrational prescriptions exist in relatively small scale and are to be eliminated .

10 units allows identification of patients a high risk factors in development ARDS.The high risk fac- tors providing the greatest contribution to improve therapy in acute lung injury and prevent ARDS to occur.

Objective To investigate papillary muscle function and construction in myocardial infarction(MI) patients by two-dimensional speckles tracking imaging(2D-STI),and to analyze the influence factors of ischemic mitral regurgitation.Methods Fifty myocardial infarction with ischemic mitral regurgitation(IMR) patients were brought into case group.The patients were divided into two groups:Ant MI group and Inf-Pos-MI group.Forty-five health volunteers were involved as control group.Anterior,posterior papillary muscle longitudinal strain (ALS,PLS),delay time(DT),fractional shortening (FS),length between the posterior or anterior papillary muscle tips and the contralateral anterior mitral annualr (APM AMA,PPM AMA),mitral leaflet closure (MLC),inter distance papillary muscle (IPMD) were aquired respectively.Papillary muscle function and construction among the groups were compared,and the effective factors of IMR were evaluated.Results Between the control group and Ant-MI group,the left ventricular end-diastolic diameter(LVEDD),left ventricular end-diastolic and end-systolic volume(LVEDV,LVESV),left ventricular ejection fraction(LVEF),ALS,delay time(DT),A FS,IPMD,MLC,APM-AMA,PPM-AMA were significantly different(all P ＜0.05).Between the control group and Inf-Pos-MI group the LVEDD,LVEDV,LVESV,EF,DT,PPM-AMA,MLC,PLS,P-FS were significantly different(P ＜0.05).Between the Ant-MI group and Inf-Pos-MI group,the LVEDD,LVEDV,LVESV,EF,MLC,ALS,PPM-AMA,PLS were significantly different (all P ＜ 0.05).In the Ant-MI group,LVEDV,ALS,MLC were significantly correated with Gensini score(r =0.71,-0.65,0.56;P ＜0.05).In the Inf-Pos-MI group,PPM AMA,PLS were significantly correated with Gensini score(r =0.65,-0.76;P ＜0.05).In the Ant MI group and Inf-Pos-MI group,the ALS,PLS,PPM-AMA were significantly different (P ＜ 0.05).Its correlates in Logistic analysis of Ant-MI group included LVEDV,MLC,DT with OR 1.48,1.72,1.54(P ＜0.05),respectively.Its correlates in logistic analysis of Inf Pos-MI group included PLS,PPM-AMA,DT with OR 1.78,1.57,1.56 (P ＜0.05),respectively.Conclusions There are different extent of damage of papillary muscle function and construction in Ant-MI group and Inf-Pos-MI group.The increases of LVEDV and MLC and desynchronization of PMs are risk factors of IMR in Ant-MI group.The increases of PMP-AMA,decrease PLS and desynchronization of PMs are risk factors of IMR inInf-Pos-MI group.

ObjectiveTo investigate the association between a new identified Gly82Ser polymorphism of RAGE gene and diabetic microangiopathy,a case control study of 260 Chinese subjects (including 156 type 2 diabetics with or without nephropathy or retinopathy and 104 non diabetic control) was performed.MethodsGenotype frequencies of Gly82Ser polymorphism were studied by PCR RFLP analysis with AluI digestion.ResultsThe most frequent genotype and allele of Gly82Ser polymorphism of RAGE gene in Chinese were genotype GG and allele G.Their frequency distribution showed significant difference between Chinese and Caucasian.There was no difference in genotype frequencies or allele frequencies between type 2 diabetic patients (DN 0) and the control subjects.Genotype and allele frequencies did not differ in type 2 diabetic subjects with nephropathy or without nephropathy.Moreover,there were no associations between diabetic patients with or without retinopathy in genotype and allele frequencies as well (two tailed Fisher’s exactP >0.05).ConclusionOur results showed that Gly82Ser polymorphism in RAGE gene was not associated with diabetic microangiopathy,which suggests that these genetic variants may not be involved in the mechanism of diabetic microangiopathy in Chinese type 2 diabetics.

Objective To investigate the clinical efficiency and security of Fe(OH) 3-sncrose-compond combined with erythropoietin on renal anemia.Methods 30 cases of oral iron combined with erythropoietin in the unsatisfactory uremia patients undergoing maintenance hemodialysis,the cases were randomly divided into two groups:the treatment group(n =16) using intravenous sucrose iron 100mg,twice a week,after a total of 1000mg,then l00mg,once 1 -2 weeks;the control group(n =14) continue to oral:ferrous succinate 0.2g,three times everyday,erythropoietin dose was the same in lothgroups for g weeks.Results Hemoglobin was significantly higher(P ＜ 0.01) and hematocrit was significantly higher(P ＜0.01),and serum ferritin significant increased(P ＜0.0l) in sucrose iron treatment group than these of the control group;the patients of treatment group have obviously improved in spirit,appetite,physical and life quality and so on.Sometimes,nausea,vomiting,skin itching were complained lut without significant side effects.While in the control group limited increase in the level of hemoglobin was seen,the majority had nausea,abdominal discomfort,poor appetite.Conclusion The efficiency of intravenous sucmfer combined with erythropoietin in treatment of renal anemia was effective than conventional oral iron combined with erythropoietin and with fewe adverse reactions.

Objective To summarize and analyse the clinical data of death cases in the department of emergency internal medicine. Methods The clinical data of patients presenting at the department of emergency internal medicine from January 2005 to July 2010 were analyzed retrospectively. Results Among 13 211 patients of department of emergency internal medicine, 145 died. More cases died in winter( 32.0% , 39/122 ).More than half of deaths occurred within 6 hours after admission( 54.5% ,79/145 ). The top six death causes were sudden death, pulmonary infection, cerebrovascular accident, advanced cancer, gastrointestinal bleeding,cardiovascular diseases and the occurrence rates were 18. 6%, 13.8%, 13.8%, 10.3%, 9. 7% and 9.0%respectively. Conclusion The first three death causes in department of emergency internal medicine were sudden death, cerebrovascular accident, pulmonary infection. Prevention of these diseases, cooperation between emergency department and other departments and special training on standardized treatment of critically ill patients should be enhanced.

Objective To investigate the significance of peroxisome proliferator-activated receptor (PPAR)γexpression in the lung tissue of rats with chronic hypoxic pulmonary hypertension (HPAH). Methods Forty male Sprague-Dawley rats were randomly divided into four groups (n=10 for each group):normal control group (NC), hypoxia control group-one-week (HC-1w), hypoxia control group-two-week (HC-2w) and hypoxia control group-three-week (HC-3w). Normal control group was raised under normal oxygen condition in ventilated animal cage for three weeks. The other HC groups were placed in a low oxygen chamber (O2 concentration of 10%) from 9:00 AM-5:00 PM (8 h/d) everyday by one week, two weeks and three weeks. The mean pulmonary arterial pressure (mPAP), right ventricular systolic pressure (RVSP) were detected. The index of right ventricular hypertrophy RV/(LV+S) was measured by dissecting rat heart. The morphological changes of the small pul-monary arteries were observed by HE staining, and the percentage of vascular wall thickness (WT%) was calculated. The ex-pression level of PPARγprotein was detected by Westren blot assay. Results The mPAP, RVSP and RV/(LV+S) were sig-nificantly higher in HC groups than those of NC group (P<0.05). The morphology of pulmonary arteries showed vessel wall thickening and vessel lumina stenosis in HC groups compared with that of NC group. The PPARγexpression in lung tissue was significantly lower in HC groups than that of NC group, and the downward trend was more obvious with the extension of time. Conclusion PPARγplays an important role in the occurrence and development of chronic hypoxic pulmonary hyper-tension.

Esophageal variceal bleeding is a severe complication of cirrhotic portal hypertension and the main cause of mortality in patients. Studies revealed no significant differences in emergency hemostasis rate,fatality rate,and rebleeding rate between patients receiving endo-scopic treatment and vasoactive agents.The advances in emergency management of esophageal variceal bleeding,including endoscopic band ligation,sclerotherapy,and use of vasoactive agents,are reviewed,with emphasis on emergency endoscopic treatment and drug therapy for esophageal variceal bleeding.