Anticoagulants ; therapeutic use ; Atrial Fibrillation ; complications ; Humans ; Thromboembolism ; etiology ; prevention & control

Objective:To observe the characteristics of 24 hour ambulatory electrocardiogram in patients with chronic atrial fibrillation (AF) and optimal ventricular rate control. 　　Methods:Holter monitoring was performed in 122 hospitalized patients,aged 17—85 (mean 51.57±11.94) years,with organic heart disease and chronic AF (New York Heart Association functional class Ⅱ-Ⅲ) in whom the ventricular rate were well-controlled by digoxin.Maximum,minimum and mean ventricular rates,the number of ventricular pauses of ＞1.5 second,and the longest ventricular pauses during the monitoring were recorded.Follow-up data were collected in 72 patients. 　　Results:The mean,fastest and lowest ventricular rates over 24 hours were 78.53±8.12(65—90)，143.79±28.85(90-183) and 51.04±7.52(34—71) bpm,respectively.Bradycardia of less than 50 and 45 bpm occurred in 62 and 32 of the 122 patients,respectively.Ventricular pauses of more than 1.5 and 3.0 seconds were noted in 95 and 14 of the 122 patients,respectively.The longest ventricular pause was 2.38±0.55(4.64—1.60) seconds.During follow-up,there were no worsening in these patients. 　　Conclusion:Ventricular pauses at rest and nocturnal bradycardia were common in patients with chronic atrial fibrillation who had ventricular rates controlled.The dosage of digoxin should not be changed,nor pacemaker insertion is needed.

OBJECTIVETo explore clinical outcomes of talus neck fracture treated with mini-plate internal fixation through dual-incision approaches.

METHODSFrom August 2010 to February 2013,18 patients with closed talus neck fractures were treated (10 males and 8 females, aged from 31 to 66 years old with an average of 38.2 years old) with mini-plate internal fixation through dual-incision approaches. According to Hawkins classification, 12 cases were type II and 6 cases were type III. All cases were evaluated with X-ray and 3D CT scan preoperatively to define type and comminuted degree of fractures. Mini-plate fixation with dual-incision approaches was performed after swelling was resolved. X-ray films were taken during following up regularly. Functional evaluation was carried out according to Visual Analogue Scale (VAS), the ankle and hind-foot score of American Orthopedic Foot and Ankle Society (AOFAS). Complications were also recorded.

RESULTSSixteen patients were followed up with an average time of 22.6 months (ranged, 17 to 46 months). No wound infection, skin and flap necrosis or implant failure were found. Traumatic arthritis in subtalarjoint was found in 1 patient. Preoperative VAS (5.94±1.12) was decreased to postoperative (1.06±1.06) (t=27.13, P<0.05). The average AOFAS score was 88.7510.19 at the latest following up; and 11 cases obtained excellent results, 3 good and 2 moderate.

CONCLUSIONMini-plate fixation with dual-incision approaches for talus neck fracture especially for talus neck comminuted fracture, an effective method, could obtain stable fixation, decrease complications.

Adult ; Aged ; Ankle Fractures ; surgery ; Bone Nails ; Female ; Follow-Up Studies ; Foot Injuries ; surgery ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Closed ; surgery ; Humans ; Male ; Middle Aged ; Talus ; injuries ; surgery

OBJECTIVETo explore the clinical effect of interference screw and flexor hallucis longus tendon as augmentation material in repair of chronic Achilles tendon rupture.

METHODSFrom September 2010 to June 2012,26 patients with chronic Achilles tendon rupture were treated, including 18 males and 8 females with an average age of 44.2 years old (20 to 66 years old). All patients were unilateral damage. MRI showed the Achilles tendon.ends' distance was 6.0 to 9.0 cm. The postoperative complications were observed. The curative effect was assessed by American Orthopedic Foot and Ankle Society and Leppilahti score.

RESULTSAll the 26 patients were followed up for 18 to 68 months (means 30.4 months). No neurological injury and infection of incision occurred, all patients were stage I incision healing. The shape and function of the ankle were recovered well. The average AOFAS score increased from 52.27±12.30 preoperatively to 90.92±6.36 postoperatively. Leppilahti Achilles Tendon Repair score increased from 34.23±12.86 preoperatively to 90.00±5.10 postoperatively.

CONCLUSIONThe flexor hallucis tendon transfer with an interference screw technique for repairing the chronic Achilles tendon rupture of type IV of Kuwada had advantages of simple operation, quick recovery, firm tendon fixation, and less complications.

Achilles Tendon ; injuries ; physiopathology ; surgery ; Adult ; Bone Screws ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Range of Motion, Articular ; Reconstructive Surgical Procedures ; instrumentation ; methods ; Rupture ; physiopathology ; surgery ; Tendon Injuries ; physiopathology ; surgery ; Tendon Transfer ; Treatment Outcome ; Young Adult

To explore the theoretical basis of the heretability of servicemen's personalities and to provide references for the development of a set of scientific and effective psychological interventions, 1 306 servicemen were subjected to the 16-PF inventory questionaire and polymerase chain reaction (PCR) examination of angiotensin. The results showed that there was a significant correlation between the scores of self-will, social boldness, self-reliance, and self-restraint in the female servicemen, and the scores of self-will, boldness, self-reliance, emotional stability, and openness in the male servicemen were significantly correlated with the DD genotype of the ACE gene. The results suggested that the determination of the DD genotype of the ACE gene could be used as a useful tool in the research of heretability of personality factors.

AIM: To establish a RP-HPLC for determing the contents of naringin,hesperidin and baicalin in Qingfei Huatan Pill(Arisaema Cumbile,Fructus Aurantii,Pericarpium Citrireticulatae,Radix Scutellariae,etc.). METHODS: Naringin,hesperidin and baicalin were separated on a RP C_(18) column.Acetonitrile-water(20(∶)80)(adjusted to pH 2.2 with phosphoric acid) was used as the mobile phase.The detective wavelength was set at 280 nm. RESULTS: The linear ranges were in 1.24-6.2 ?g for naringin (r=(0.999 7))、1.1-5.5 ?g for hesperidin(r=(0.999 8)) and 2.32-11.6 ?g for baicalin(r=(0.999 9)).The recoveries were 99.29% with RSD of 1.78% for naringin、100.08% with RSD of 1.44% for hesperidin and 98.76% with RSD of 1.42% for baicalin respectively. CONCLUSION: The method is simple,accurate and reproducible.It may well be used for the quality control of this product.

Objectives To explore the influence of standardized treatment and technical flow improvement on the diagnosis and treatment of congenital diaphragmatic hernia (CDH) after prenatal diagnosis. Methods The clinical data of neonates diagnosed with CDH who were hospitalized in neonatal intensive care unit from January 2005 to August 2016 was analyzed retrospectively. Based on the start time of standardized treatment implementation, 93 cases of CDH hospitalized from January 2010 to August 2016 were divided into the intervention group while 15 cases of CDH hospitalized from January 2005 to December 2009 were divided into the control group. The survival rate and complications of clinical outcomes between two groups were compared. Results There was no significant difference in sex, gestational age, birth weight, Apgar score, and CDH position between two groups (P >0.05). The total survival rate was 81.7％ in the intervention group and 53.3％ in the control group, and there was statistical difference (P<0.05). The difference of mechanical ventilation mode and pneumothorax rate between two groups also had statistical difference (P >0.05). The median operation time in the control group was 4.5 h and the intervention group was 49.5 h. The postoperative survival rate was 61.5％ in the control group and 90.5％ in the intervention group, and the differences between two groups were significant (P >0.05). The first blood gas analysis of deaths cases in both groups showed that there were significant differences in pH and PCO2 values (P >0.05). Conclusions Optimization of the clinical management during perioperative period can improve the survival rate of CDH and reduce complications. However, the dead cases in the intervention group had more severe pulmonary hypoplasia.

Objective To establish ultra-high performance liquid chromatography-evaporative light scattering detector (UPLC-ELSD) method to determine the content of astragaloside in Guiqi Yiqi Yangxue Mixture and optimize the best water decoction process of the mixture.Methods The UPLC-ELSD conditions to determine the content of astragaloside in the mixture were as follow.The method was carried out on a Waters Acquity UPLC BEH C18 column (2.1 mm ×50 mm,1.7 μm) by using acetonitrile-water (35∶65) as mobile phase, and the flow rate was 0.3 mL/min and the column temperature 30℃.The parameter of ELSD:the drift tube temperature was set at 60℃, and the gas flow rate of N2 2.0 L/min.The content of paeoniflorin in the mixture was detected by previously established HPLC method.The orthogonal test was designed to optimize the water decoction process of the amount of water (A), decoction time (B) and decoction times (C), and the extract yield and the contents of astragaloside and paeoniflorin were evaluated as the comprehensive markers for the purpose.Results The UPLC-ELSD determination of astragaloside had a good linear relationship (r =0.9999), its mean recovery was 103.0%, and it had a good precision, specificity and repeatability.The orthogonal experimental results showed that decoction times (C) >the amount of water (A) >decoction time (B) were major factors affecting the decoction process in order and the ANOVA result showed that decoction times has significant effect on the decoction process (P<0.05).The optimal process of Guiqi Yiqi Yangxue Mixture was adding eight-fold water each time to decoct twice for 1.5 h totally.Conclusion This optimized water decoction process is feasible and stable, and suitable for industrialized production.

ObjectiveTo study the level of temperament and self-esteem of children aged 8～12 in Beijing city,as well as their interaction and influenced factor.Methods203 school children aged 8～12 were assessed with Carey's temperament questionnaire(8～12:MCTQ) and The Self-Esteem Scale(SES).ResultsTemperament and self-esteem of school children aged 8～12 were associated with the parental behavior,especially with work style of their fathers.The rhythmicity was found to be negative correlated to the self-esteem scores,and the intensity of reaction was found to be positive correlated to the self-esteem scores.ConclusionParents' behavior and family environment were important to the temperament and self-esteem of school children.

ObjectiveTo design a new operation approach:extreme lateral transforaminal lumbar interbody fusion (E-TLIF) via digital technology and to discuss its feasibility in treatment of degenerative lumbar diseases.MethodsCT scan image data of lumbar vertebra were obtained from volunteer (a healthy male of 26 years old,67 kg in weight and 172 cm in height).Mimics was used to read and reconstruct the data into 3D images.We observe the anatomical bone structures of intervertebral foramen and nerve roots through CT scan and 3D reconstruction in Mimics to analysis the feature of this area.Then E-TLIF operation,pedicle screw insertion and cage placement were simulated by computer via digital technology in Mimics.The feasibility of this new approach was proved through operating on lumbar of formalin doused body with E-TLIF approach.ResultsAn incision of 9 cm lateral form the central line and 45° from the sagittal plane is operated to fully expose the foraminal area.Remove superior facet while save inferior facet is feasible with this approach in E-TLIF.There is enough room for fully revealing and excision of intervertebral disc,and cage placement through enlarged foraminal area.Digital technology is a more economic,efficient way to design a new operation approach.The results are in accord with the formalin doused body test.ConclusionMimics is an effectively,reliable and economic method to design an operation approach.And the result suggested that E-TLIF is a safe,less minimal invasive and more efficient operation approach in treatment of degenerative lumbar diseases.