Objective To develop a radiology algorithm and test its the accuracy in distinguish pacing in the septum from the other parts. Methods One hundred patients were implanted with double-chamber pacemakers. Sites of the leads were verified by two-dimensional echocardiography, and the patients were divided into 4 groups according to the echocar?diography:septal right ventricular outflow tract group(RVOT), RVOT anterior free wall group, mid septum group, and anteri?or septum group (near to the anterior free wall ). An algorithm was developed according to radiological characteristics in the 45° left anterior oblique (LAO45° ) view and the 30° right anterior oblique (RAO30° ) view. Then its sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were tested . Results The algorithm has high sensitivi?ty and specificity, which were 90%and 97%respectively. The positive predictive value and negative predictive value were 90% and 97% respectively. Conclusion The radiology algorithm we developed have a high sensitivity and specificity in identifying the site of the leads.

Objective To explore the value of procalcitonin (PCT)and interleukin -6 (IL -6)in the early diagnosis and prognostic evaluation of the patients with lumbar intervertebral disc herniation,and their correlation with the course and lumbar function.Methods 100 patients with lumbar disc herniation (study group)and 35 patients with lumbar non -borne diseases (control group)were collected,their preoperative clinical symptoms were scored on the basis of the lumbar scoring system of Japanese Orthopaedic Association (JOA),the enzyme -linked immunosor-bent assay was applied to determining the content changes of PCT and IL -6 of the two groups,and the linear correla-tion analysis was used to explore the relevance of PCT and IL -6 to the course.Results The contents of the PCT and IL -6 in the study group's serum were respectively (25.13 ±0.86)ng/L and (10.26 ±0.36)ng/L,while those in the control group's serum were respectively (223.85 ±0.61)ng/L and (50.11 ±1.23)ng/L,both with statistical sig-nificance (t =2.542,2.206,P <0.01).The IL -6 was positively correlated with the disease duration of the patients with lumbar disc herniation (r =0.32,P =0.000),and negatively correlated with their JOA score (r =-0.45,P =0.003),and the PCT was positively correlated with the patients'disease duration (r =0.35,P =0.001),and nega-tively correlated with their JOA score (r =-0.53,P =0.005).Conclusion The PCT and IL -6 have a certain role in the early diagnosis of lumbar disc herniation,and have some relevance to the course of disease and the lumbar func-tion changes.

Objectives:To clarify whether the bone mineral density (BMD) differed from normal and whether the mandibular BMD changed with age in young adults with moderate periodontitis. Methods:30 patients (20-35 years old) with moderate adult periodontitis and 30 individuals (20-35 years old) with normal periodontal condition as control group were included in present study. BMD of the mandible was measured using panoramic mandibular index(PMI) from panoramic radiographic film. Results:The sPMI and iPMI value were 0.275 0?0.034 and 0.527 3?0.096 (normal group), 0.223 3?0.024 and 0.367 3?0.069 (periodontitis patients) respectively.The PMI value of periodontitis patients was significantly decreased compared to that of normal group, and showed a significant correlation with age.Conclusions:Moderate periodontitis in young adults seem to be a local disorder associated with relatively low PMI in the jaws. Age-related decrease in mean PMI with increasing age in both normal and periodontitis patients is founded.Dental panoramic radiograph may serve as a simple tool in mandibular BMD defection.

Objective To understand the status quo of our young doctors' doctor-patient communi-cation and related influencing factors. Methods Among the doctors under the age of 40 in various clinical departments, according to 30% proportion, we randomly selected 32 doctors, and combined with revised Liverpool communication skills assessment scale (LCSAS) and standardized patients (SP), the doctors' ability of doctor-patient communication was evaluated. Descriptive statistics, t test and variance analysis were per-formed by SPSS 21.0 lines. Results The average score of communication etiquette of young doctors was (2.00±0.15), and the average score of their communication skills was (1.74±0.29), and the average score of their communication technical ability was (3.74±0.39). The detection rate of communication etiquette, communication skills and communication skills evaluation (less than 2) was 33.3%, 81.5%, and 85.2%, respectively. Physicians and surgeons' scores in communication etiquette and communication skills dimen-sion had significant difference (P<0.05). Significant difference was found in different ages doctor communi-cation protocol (F=3.641, P=0.028), and 20 to 25 years old doctors' score in communication manners was significantly lower than other ages (P<0.05). There were significant differences in the scores of doctors of different title in communication etiquette (F=4.410, P=0.023), and the trainee doctors' communication etiquette score was significantly lower than the physician and surgeon (P<0.05). Conclusion The commu-nication skills of young doctors in our hospital are generally in the middle state, and their communication etiquette is good, communication skills are general. There are great individual differences. Hospital should begin from those whose communication ability are low, cultivate their biology-psychology-social medicine thinking mode of the doctor-patient relationship , help new employees complete the role transformation , emotion management, and professional commitment, and encourage patients to participate in the medical process, so as to improve the doctors' communication ability in all directions and at different levels.

Objective To evaluate the practicability of video-assisted thoracoscopic lower esophageal myotomy in the treatment of achalasia. Methods A series of 21 consecutive patients with achalasia received video-assisted thoracoscopic lower esophageal myotomy between June 1997 and June 2005. The operation was performed under general anesthesia with double-lumen endotracheal intubation. The patient was positioned in the right lateral decubitus. Four thoracoscopic ports were introduced into the left hemithorax. A 6~11 cm incision at the lower esophageal sphincter with an extension to the gastric wall for 0.5~1 cm in length was made, to the depth of the submucous layer. A flexible gastroscope was inserted to check the integrity of the esophageal mucosa intraoperatively. No anti-reflux procedures were conducted. Results All the procedures were accomplished smoothly. The intraoperative hemorrhage volume was 50~100 ml (mean, 58 ml) and the operation time, 60~270 min (mean, 137 min). Esophageal mucosal perforation occurred in 3 patients, in 2 of whom the perforation was repaired thoracoscopically and in 1 of whom, through open thoracotomy. All the patients were recovered uneventfully, without severe complications. Follow-up checkups for 1~80 months found recurrence of dysphagia in 2 patients at 2 and 4 months after operation, respectively. Out of the 21 patients, the relief of dysphagia was classified as “excellent” results in 8 patients, “good” in 10 patients, “fair” in 1, and “poor” in 2, respectively. Conclusions Video-assisted thoracoscopic lower esophageal myotomy is a surgical approach with simple performance, minimal invasion, quick recovery and good efficacy. It can be employed as the first of choice for the management of achalasia.

Objective To discuss the feasibility of video assisted thoracoscopic surgery (VATS) in the diagnosis and treatment of small pulmonary nodules. Methods A total of 29 patients with small pulmonary nodules was diagnosed and treated by VATS from May 2000 to June 2005. During the operation, the lesion was detected by forefinger palpation to determine the location, size, feature, and relation to the pleura. In case of difficult location, the incision was extended to 4 cm in length, and the lesion was examined and palpated with operator’s two fingers. Pulmonary wedge resection was performed. Whether or not an open pulmonary lobectomy and mediastinal lymph node resection was required was determined according to pathological findings of intraoperative frozen-section biopsy. Results All the operations were successfully accomplished and no complications or deaths occurred peri-operatively. The location of nodule was determined with single forefinger palpation and no extended incision was needed. There were 11 patients with malignant nodules (11/29, 37.9%) and 18 benign nodules (18/29, 62.1%). A malignant nodule was confirmed eventually in 8 patients (57.1%) with suspected diagnosis of malignancy and in 3 patients with suspected diagnosis of benign lesions. Among 11 patients with “malignant” imaging signs, only 6 patients (54.5%) were at last confirmed to be malignant. Out of 21 patients with solitary pulmonary nodules, 7 were malignant; out of 8 patients with multiple pulmonary nodules, 4 were confirmed to be malignant. Eighteen patients with benign nodules were treated with wedge resection under VATS. In the remaining 11 patients with malignant nodules, a radical resection of the tumor and a mediastinal lymph node resection was conducted in 6 patients and a palliative wedge resection was performed in 5 patients. Conclusions Small pulmonary nodules are difficult to get a confirmative diagnosis. VATS can be used for the diagnosis and treatment of small pulmonary nodules and obtain a satisfactory prognosis.

0.05). After treating, the accumulating points of syndrome of the treatment group dropped more, the treatment group was superior to the control group. Conclusions The curative effects of Huoxin capsule on angina of coronary arheroselerosis heart disease is exact. It can take effect quickly and improve the whole symptom of the patients noticeably.

BACKGROUND:Basic fibroblast growth factor(bFGF)belongs to active peptide,which is an effective mitogenic factor.OBJECTIVE:To investigate the effect of bFGF on proliferation and differentiation of monkey bone marrow mesenchymal stem cells(BMMSCs)into neuronal precursor cells.METHODS:Monkey BMMSCs were in vitro cultured by density gradient centrifugation,and then divided into 4 groups after passaged,namely,control,bFGF with low,medium and high concentration groups.In the bFGF groups,0,3,6,10 μ/L bFGFwere applied.The proliferation of BMMSCs in each group were observed.The 5th BMMSCs were cultured with serum free L-DMEM culture medium containing 20 mg/L cryptotanshinone to differentiated into neuraMike cells.The expression of positive-nestin protein was detected by immunohistochemical method.RESULTS AND CONCLUSION:Compared with the control group,proliferation rate of BMMSCs in the bFGF groups were accelerated(P ＜ 0.05),which showed a positive correlation to the concentration of bFGF.The positive-nestin protein could be found in the low and medium concentration groups at 0.5 hours after induction,and reached a peak at 1.5 hours,which increased obviously in the low concentration group than that of the high concentration group(P ＜ 0.05).bFGF can promote BMMSCs proliferation in vitro,enhance inducing ratio of prophase neuron-like cells at lower concentration but inhibit differentiation at high level.

Objective To observe the behavioral effects of acute administration of dizocilpine (MK-801) in rats,and to determine an appropriate doses of the drug to mimicking memory deficits of schizophrenia.Methods 192 rats were randomly divided into model groups and control group,and given different doses of MK-801 or saline.Locomotor activity,pre-pulse inhibition (PPI) test and novel object recognition test were studied respectively.Results The spontaneous activity increased in a dose-dependent manner after the treatment of MK-801.The total distances of locomotor activity in 0.3 mg/kg group((127.04 ± 32.35) m) exhibited a significant difference compared with control group((35.34 ± 12.81) m,P ＜ 0.05).MK-801 decreased PPI in dose-dependent manner(P ＜ 0.01).MK-801 0.1 mg/kg((103.45 ± 68.04) ％) and 0.3 mg/kg ((41.55 ± 62.93) ％) groups showed significant differences compared to control group ((200.39 ± 30.97) ％) in PPI.The discrimination index of 0.03 mg/kg group((15.78 ± 6.23) ％) and 0.1 mg/kg group((22.42 ± 3.85) ％) were lower than that in control group((39.42 ±3.86)％,P＜0.05).Conclusion It is necessary for select right doses for model different endophenotypes of schizophrenia by MK-801.0.03 mg/kg of MK-801 is a relatively appropriate dosage to cause recognition memory damage.

Objective To compare the clinical effect of platelet rich plasma and sodium hyaluronate in the treatment of knee osteoarthritis .Methods According to the different treatment methods ,100 patients with knee osteo-arthritis were divided into the control group ( for treatment of platelet rich plasma ) and study group ( for treatment of sodium hyaluronate),each group 50 cases.The treatment effect would be compared between two groups ,and the patients were scored knee joint active function using Lysholms score standard ,using visual analogue score method on patients with knee joint pain .Results The excellent and good rate had no significant difference between the study group(98.0%) and control group(94.0%)(P>0.05);The knee joint activity of study group (76.81 ±9.24) was significantly better than that of the control group (60.46 ±7.41),the difference was statistically significant (t =-9.76,P<0.05);the knee joint pain degree of the study group (1.91 ±0.88) was lower than that of the control group (3.58 ±0.85),the difference was statistically significant (t=9.65,P<0.05).Conclusion Platelet rich plasma and the knee joint injection of sodium hyaluronate in the treatment of osteoarthritis were able to effectively alle -viate knee joint pain ,activity limitation and other clinical symptoms ,improve the curative rate ,but the treatment effect of sodium hyaluronate is more remarkable ,which is worthy of promotion .