Objective: To explore diagnostic value of dynamic electrocardiogram (DCG) on coronary artery disease. Methods: A total of 100 inpatients with “angina pectoris” history from our hospital were enrolled and received 24h DCG measurement. The DCG examination results were compared with those of coronary angiography (CAG) and analyzed then. Results: Among the 100 patients, there were 85 patients with positive DCG, including 70 cases with positive CAG and 15 cases with negative CAG; and 15 patients with normal (negative) DCG, including 10 cases with negative CAG and five cases with positive CAG. With CAG as golden standard, sensitivity, specificity, positive predictive value (accuracy) and negative predictive value of DCG in diagnosis of coronary heart disease were 93.3%, 40.0%, 82.4% and 66.7% respectively. Partial patients had “angina pectoris”, no stenosis in CAG but there’s slow blood flow. Conclusion: Dynamic electrocardiography is one of important measuring methods diagnosing coronary heart disease. It is simple, practical, safe, economic and appropriate for wide application in clinic, but its specificity is just 40.0%, so coronary heart disease cannot be excluded in negative patients.

Objective To evaluate the efficacy of self-disigned long-thick silicone prothesis in the treatment of severe microgenia.Methods A long-thick silicone prothesis was designed according to the measurement results gained by a coordinate caliper.The designed long-thick silicone prothesis was sterilized by uperization.The procedure commenced under local anesthesia for all patients.The prothesis was placed through an intraoral incision.The digital photographs were taken at the pretreatment visits and 3 months and 12 months after treatment follow-up to observe the change of the chin projection.Results 20 cases of severe microgenia were treated with this technique.All wounds healed primarily.There was no infection,extrusion and rejective reaction.The profiles of chins were improved obviously and reached aesthetic standard.Only one implant required adjustment 3 months after first operation because of displacement.After 12 months follow-up the reshaping contour of the chins were satisfied.Locations of silicone prothesis were stable.No differences of the chin projection were observed.All patients were satisfied with their cosmetic results.Conclusions Implanting long-thick silicone prothesis to correct severe microgenia is safe,effective,simply,cheap and less invasive.

Objective:To observe the clinical effect of combining four-channel electrical stimulation with electroacupuncture of the antagonistic muscles in treating post-stroke spastic foot drop.Methods:Ninety stroke survivors with spastic foot drop were randomly divided into a control group, an electrical stimulation group and an observation group, each of 30. In addition to routine rehabilitation training, the electrical stimulation group was given four-channel electrical stimulation for 4 weeks, the electrical stimulation was delivered with a pulse duration of 200μs and an intensity of motor threshold at 30Hz, while the observation group also received electroacupuncture of the antagonistic muscle. Before and after the treatment, the three groups were evaluated using the clinical spasticity index (CSI). Stride frequency, stride length, and the supporting and swing phases on the affected side were also measured. Electromyography (EMG) was also conducted.Results:After the treatment, the average CSI scores of all groups had decreased significantly, with that of the observation group significantly lower than the electrical stimulation group and control group′s averages. The average gait descriptors of the three groups had also improved significantly, with significantly greater improvement in the observation group than in the other two. The average H reflex latency was significantly longer and Hmax/Mmax was significantly smaller in all three groups, but the observation group′s average values were again significantly better than those of the electrical stimulation group.Conclusion:Electroacupuncture of the antagonistic muscle enhances the effectiveness of four-channel electrical stimulation in relieving foot drop symptoms and improving gait after a stroke.

ObjectiveTo induce human peripheral blood mononuclear cells differentiate into hepatocyte-like cells by hepatocyte growth factor (HGF) and fibroblast growth factor-4 (FGF-4) in vitro and determine whether PKH26 could be used to serve as an effective tracer for the cells,and observe the ability of transplanted hepatocyte-like cells differentiate into hepatic cells in nude mice.MethodsGroup A and B were set up respectively.In Group A,mononuclear cells were cultivated without hepatocyte growth factor (HGF) and fibroblast growth factor-4 (FGF-4) in cell culture.They were used as negative control group.In Group B,mononuclear cells were cultured with the administration of both HGF and FGF-4 to induce the differentiation into liver hepatocyte-like cells.The changes in cell morphology were observed and the expressions of AFP and CK 19 were detected by immunocytochemical staining in two groups at different times after induction.The hepatocyte-like cells differentiated from human peripheral blood mononuclear cells labeled by the fluorescent dye PKH26 injected into caudal vein in nude mice is experimental group.The nude mice injected with equal amount of normal saline in control group.The migration of the labeled cells into the liver are observed by the fluorescence microscope in the hepatic tissue sections of nude mice and the expressions of ALB were detected by immunocytochemical staining two weeks after the cells transplantation.ResultsCells in group B have a strong proliferative activity.It becomes large and oval,grows in colonies following induction.Cells in group A that showed spherical shape when peripheral blood mononuclear cells were just isolated are gradually becoming inconformity in morphology,spindle or fibroid,and a few cells are round:cells developed apoptosis and cracked following incubation.The expressions of AFP and CK19 were positive after induction in group B as detected by immunocytochemicat staining.Inversely,the expressions of AFP and CK19 were negative in group A after incubation.The experimental group showed numerous PKH26 labeled cells in the hepatic tissue sections of nude mice.But the control group did not show PKH26 labeled cells.The expressions of ALB were positive in the experimental group as detected by immunocytochemical staining after two weeks of the cells transplantation.ConclusionHuman peripheral blood mononuclear cells have the potential to differentiate into hepatocyte-like cells under the induction of HGF and FGF-4.Additionally,PKH26 is an effective tracer in hepatocyte-like cell transplantation.The hepatocyte-like cells settled in hepatic tissue begin to differentiate into mature hepatocyte after two weeks of the cells transplantation.It plays hepatic cells function and expresses alhnmin.

AIM: To investigate the effect of dihydroartemisinin (DHA) on the proliferation of murine T lymphocytes stimulated by Con A in vitro and its related immunosuppressive mechanism. METHODS: Murine T lymphocytes were stimulated by Con A and treated with different concentrations of DHA. Cell proliferation was measured by carboxyl fluoresce in diacetate succinmidyl ester (CFDA-SE) staining. The expression of CD69, CD25 and CD71,which was the marker of early, middle, later activation of CD3~+ T lymphocytes, was measured by flow cytometry (FCM) combined with two-color immunofluorescent staining of cell surface antigen. Fluorescence calcium indicator fluo-4/AM was used to measure the change of the intracellular calcium concentration ([Ca~(2+)]_i) of murine T lymphocytes. The distribution of the cell cycle was analyzed by PI staining. The expression of CD69, the early activation antigen on CD4~+CD25~(high) Treg was also measured by FCM combined with three-color immunofluorescent staining. RESULTS: The result of CFDA-SE staining showed that DHA efficiently inhibited the Con A-induced proliferation of T-lymphocytes in a time-and dose-dependent manners. DHA showed modestly increased proportions of CD69 and CD25 on Con A-stimulated CD3~+T cells, but inhibited the expression of CD25 in a dose dependent manner. DHA with Con A, but not DHA alone, caused an increase in intracellular calcium concentration of T cells. The results of FCM analysis with PI staining showed that DHA imposed a total cell cycle arrest in G_0/G_1 and prevented cells entering S phase and G_2/M phase. Furthermore, DHA reduced the expression of CD69 on CD4~+CD25~(high) Treg. CONCLUSION: DHA, which exhibits immunosuppressive effect on the proliferation of murine T-lymphocytes, is promising to be developed as an immunosuppressive reagent.

To screen common traditional Chinese medicine (TCM) syndrome factors of chronic renal failure (CRF) via questionnaire investigation among experts.

Objective:To discuss the effect of pharmacist intervention on the use of antimicrobial agents in the clinical pathway of community-acquired pneumonia ( CAP) in our hospital to standardize the rational medication and promote the rational use of antimicro-bial agents. Methods:Totally 100 bacterial CAP patients in 2013 ( before the intervention) and 2014 ( after the intervention) in the pneumology department were studied. The antibacterial drug cost, total hospitalization cost, use intensity of antimicrobial drugs, hospi-talization time, therapeutic effects and so on in the two groups were observed during the treatment. Results: There were significant differences between the two groups in antibacterial drug cost, total hospitalization cost, use intensity of antimicrobial drugs, hospitaliza-tion time and so on, whereas there was no significant difference in the curative effect. Conclusion:After the pharmacist intervention, the application of antibiotics is more rational, the antibiotics use density and per capita cost are reduced, the hospitalization day is shortened and the value of pharmacists is also improved.

Objective:To explore any effect of combining robot-assisted virtual scenario training of the upper limbs with scalp acupuncture on post-stroke cognitive impairment.Methods:Ninety patients with post-stroke cognitive impairment (PSCI) were divided at random into a control group, a scalp acupuncture group and a comprehensive group, each of 30. In addition to routine health education and rehabilitation training, the scalp acupuncture group was given scalp acupuncture, while the comprehensive group was treated with scalp acupuncture and virtual scenario training with an upper limb robot. Before and after 4 weeks of the treatment, the subjects′ cognitive functioning was assessed using the Mini-mental State Examination (MMSE) and the Montreal Cognitive Assessment scale (MoCA). Ability in the activities of daily living (ADL) was quantified using the Modified Barthel Index (MBI).Results:After the intervention, significant improvement was observed in the average MMSE, MoCA and MBI scores of all three groups. The average MMSE and MBI scores of the scalp acupuncture group were then significantly higher than the control group′s averages, while the average MMSE, MoCA and MBI scores of the comprehensive group were all significantly better than those of the other two groups.Conclusion:Robot-assisted virtual scenario upper limb training combined with scalp acupuncture can significantly improve the cognition and ADL ability of PSCI patients.

To investigate the influence of five?in?one management mode (standardized asthma treatment, asthma diary, peak expiratory flow (PEF) monitoring, reasonable diet and physical exercise) on disease prevention and control of school children with asthma. Methods From April to October 2018, 70 children with asthma in clinical remission were selected from Affiliated Hospital of Qingdao University using randomized controlled study design. These children were randomly divided into study group and control group, with 35 cases in each group. In the study group, 5 cases were lost to follow?up, and 30 cases were actually enrolled. In the control group, 6 cases were lost to follow?up, and 29 cases were actually enrolled. Children in the control group received routine medication and regular outpatient consultation, and children in the study group received the five?in?one asthma management model. In the first time of seeing a doctor, after 3 months and 6 months of follow?up, asthma control test score, medication compliance index score and lung function index (forced expiratory volume in 1 second (FEV1), PEF were evaluated respectively. Parental satisfaction, asthma acute episodes, weight, height and biochemical index were recorded during the 6 months of follow?up. Pulmonary function index, asthma control score and body mass index of overweight children with asthma were compared with t-test, medication compliance was compared with chi?square test, and the rank sum test was used for the comparison of the number of emergency visits of asthma attacks and parents'satisfaction. Results A total of 59 children with asthma were included, among them 30 were in the study group (8.1 ± 1.5) years old and 29 in the control group (9.2±1.1) years old. After 3 months of follow?up, FEV1, PEF, asthma control score in the study group were (86.3 ± 1.5)% , (83.3 ± 2.4)% , (24.7 ± 2.6) points respectively; and in the control group, FEV1, PEF, asthma control score were (84.4±2.5)%, (82.2±1.9)%, (21.1±1.3) points respectively. The indicators in the study group were higher than those in the control group (t=3.62, 1.97, 6.64, P<0.05). After 6 months of follow?up, FEV1, PEF, asthma control score in the study group were (88.4±2.3)%, (85.4±2.2)%, (26.8±1.8) points respectively; and in the control group, FEV1, PEF, asthma control score were (85.5±1.9)%, (83.2± 1.7)%, (22.5±1.4) points respectively. The indicators in the study group were significantly higher than those in the control group (t=5.34, 4.24, 10.41, P<0.05). During the 6?month follow up, the number of emergency visits of asthma attacks in the study group and in the control group were 0.42(0.36, 0.51) and 0.92(0.72, 1.27) respectively. The indicator in the study group was significantly lower than that in the control group (Z=3.21, P<0.05). After 3 months of follow?up, the proportions of children with good compliance in the study group and control group were 67% (20/30) and 62% (18/29), the proportions of poor compliance were 27% (8/30) and 34% (10/29), the proportions of non?compliance were 7% (2/30) and 7% (2/29). There were no statistically significant differences (χ2=0.14, 0.43, 0.00, P=0.71, 0.51, 0.97). After 6 months of follow?up, the proportions of children with good compliance in the study group and control group were 87% (26/30) and 69% (20/29), the proportion of poor compliance were 10% (3/30) and 28% (8/29), the proportion of non?compliance were 3% (1/30) and 7% (2/29), There were no statistically significant differences (χ2=2.70, 3.00, 0.39, P=0.10, 0.08, 0.53). After 6 months of follow?up, the number of great satisfaction, satisfaction and dissatisfaction in the study group were 20, 10 and 0 respectively, the satisfaction rate was 100%, meanwhile those indicators in the control group were 4, 15 and 10 respectively, the satisfaction rate was 66%, The indicator in the study group was significantly higher than that in the control group (Z=4.60, P<0.05). Conclusions The application of "five?in?one" asthma management model (standardized asthma treatment, asthma diary, PEF monitoring, reasonable diet and physical exercise) for school?age children with asthma can significantly improve lung function, as well as reduce the number of acute asthma attacks. It has a high parent satisfaction, therefore it should be recommended for clinical implementation.

Objective:To investigate the predictive factors of delayed high atrioventricular block(DH-AVB) after transcatheter aortic valve replacement(TAVR) and the risk of pacemaker implantation.Methods:Patients who underwent TAVR in the heart center of Qingdao Municipal Hospital from January 2019 to October 2022 were retrospectively analyzed. A total of 85 patients who met the criteria of transcatheter aortic valve replacement were included in this study. They were divided into DH-AVB group after TAVR and non-DH-AVB group after TAVR. The data were analyzed by univariate analysis and binary logistic regression analysis. Results:The results showed that the over-rate of valve implantation( OR=3.582, 95% CI: 0.923-13.902, P=0.048), the depth of valve implantation( OR=3.727, 95% CI: 1.138-12.204, P=0.030), the new postoperative CLBBB( OR=5.958, 95% CI: 1.258-28.220, P=0.025)and the prolonged PR time limit( OR=1.036, 95% CI: 1.008-1.065, P=0.011) were independent risk factors for DH-AVB after TAVR. With the progress of conduction block, patients in DH-AVB group had a higher pacemaker implantation rate(81.82 % vs.18.18 %, P<0.001). Conclusion:The excessive rate of valve implantation, the depth of valve implantation, the new complete left bundle branch block(CLBBB) and the prolonged PR time after operation are independent predictors of delayed complete atrioventricular block after TAVR. The incidence of pacemaker implantation in patients with delayed complete atrioventricular block after operation is higher.