Objective To compare the Cosine and Dip methods in describing the rhythm of blood pressure(BP).Methods The BP was measured with non-traumatic ambulatory blood pressure monitoring(ABPM) for 24 h and analyzed with Cosine and Dip methods.The characters of the circadian rhythm of BP were studied and two methods were compared.Results The ratios of mesor and amplitude(A/M) of systolic blood pressure(SBP) and diastolic blood pressure(DBP) were(7.78?0.42)% and(7.98?0.39)%,respectively.The majority of acrophases of BP was on daytime,especially between 10∶00 am and 3∶00 pm.The amplitudes of acrophase in different periods analyzed with Cosine method were not significantly different each other,whereas analyzed with Dip method to be significant difference.Conclusion There is difference between Cosine and Dip methods in describing the rhythm of BP,since rhythms of acrophases of some cases were inaccurately described with Dip method.

Objective To observe the efficacy and safety of high-dose amiodarone administered by continuously intravenous infusion for cardioversion of paroxysmal atrial fibrillation.Methods From 2008 to 2010,109 patients suffered from paroxysmal atrial fibrillation were treated with high-dose arniodarone (125 mg/h) administered by continuously intravenous infusion.Before cardioversion,patients were treated with low molecular weight heparin anticoagulant therapy,Laboratory tests on FT3,FT4,TSH,serum ions,etc,and coloured Doppler ultrasound imaging of heart,and ECG and blood pressure monitoring were carried out.Amiodarone hydrochloride injectio of 150 mg was mixed with sodium chloride 50 mL homogeneously,and then infused continuously by micro-pump in a rate of 41 mL/h until resume of sinus rhythm or infusion was kept up to 24 h.After successful cardioversion,as appropriate,the intravenous amiodarone was maintained in a rate of 0.5-1.0 mg/min for 6-12 h joined with oral amiodarone dosing,and the total dose was limited up to 3000 mg.Results A cohort of 104 (95.4％) patients had the restoration of sinus rhythm after cardioversion.The mean dose of amiodarone for cardioversion was (774.52 t 700.53) mg,and time required for cardioversion was (6.3 ± 5.55) hours.Conclusions The patients with paroxysmal atrial fibrillation are given high-dose amiodarone (125 mg/h) continuously intravenous infusion therapy and have high cardioversion success rate,less complications and side effects,as well as other advantages at the basic hospital.The method above has broad application prospects.

Objective To investigate the etiologies and clinical features for bilateral acute sensorineural hearing loss (bi-ASNHL).Methods The clinical data of 19 cases presenting with bi-ASNHL were retrospectively analyzed,including the clinical features,systemic examinations,laboratory examinations,audiology and radiology results,as well as the prognosis.Results There were 15 nonotologic diseases in 19 patients,accounting for 78.9％ of the total cases,most of which were disorders with multisystem and multi-organ disorder.The central nervous system diseases including fungal meningitis,tuberculous meningitis,and viral encephalitis in 3 patients.The clinical features of deafness were bilateral,progressive,accompanied with fever,headache,dizziness,nausea,vomiting and change of mental status.There was a decrease in speech recognition score (SRS),and speech recognition threshold (SRT) was obviously inferior to pure tone average (PTA) disproportionally.Diseases of immune system including antineural cytoplasmic antibody (ANCA)-associated systemic vasculitis (AASV),relapsing polychondritis (RP),rheumatoid arthritis(RA),and systemic lupus erythematosus (SLE) in 5 patients.They showed the characteristics of bilateral,progressive and simultaneous autoimmune disease.Hematological and endocrine system diseases including diabetes mellitus,leukemia,and thyroid hypofunction in 5 patients.The deafness had the characteristics of symmetry and progressivity.Otologic diseases including large vestibular aqueduct syndrome (LVAS) and sudden sensorineural hearing loss (SSNHL) in 4 patients; Drug-induced sensorineural deafness happened in 2 patients.After the treatment aimed at the causes,1 case was cured,3 patients were markedly effective,7 patients were effective,and 8 patients were ineffective(including dead and refusal cases),with a total effective rate of 57.9％.Conclusions The most of bi-ASNHL cases are often associated with systemic diseases.Clinicians should analyze the history and clinical characteristics in detail,and complete specific laboratory examinations,audiology and imaging examinations in order to reveal the causative diseases.It should be treated aimed at the etiology.

Because of the limited effect of traditional treatment methods such as surgical treatment, radiotherapy and chemotherapy,the emergence of immunotherapy has brought new hope for the treatment of patients with bladder cancer. As an immune checkpoint inhibitor, programmed death receptor 1/programmed death receptor-ligand 1 (PD-1/PD-L1) inhibitor has shown good anti-tumor activity and safety in the treatment of advanced bladder cancer, and has been recommended for advanced bladder cancer as second-line treatment by NCCN guidelines. PD-1/PD-L1 inhibitor for the treatment of bladder cancer has covered the first-line and second-line treatment, as well as maintenance therapy after first-line chemotherapy of locally advanced or metastatic bladder cancer, adjuvant and neoadjuvant therapy of muscle-invasive bladder cancer, treatment of high-risk non-muscle invasive bladder cancer failed by Bacille Calmette-Guérin vaccine perfusion, and bladder preservation therapy of muscle-invasive bladder cancer. Some of related studies have achieved certain results, and some are in progress, both of which need to be further examined. Maybe it can provide new guidance and ideas for clinical treatment of bladder cancer.

Because of the limited effect of traditional treatment methods such as surgical treatment, radiotherapy and chemotherapy,the emergence of immunotherapy has brought new hope for the treatment of patients with bladder cancer. As an immune checkpoint inhibitor, programmed death receptor 1/programmed death receptor-ligand 1 (PD-1/PD-L1) inhibitor has shown good anti-tumor activity and safety in the treatment of advanced bladder cancer, and has been recommended for advanced bladder cancer as second-line treatment by NCCN guidelines. PD-1/PD-L1 inhibitor for the treatment of bladder cancer has covered the first-line and second-line treatment, as well as maintenance therapy after first-line chemotherapy of locally advanced or metastatic bladder cancer, adjuvant and neoadjuvant therapy of muscle-invasive bladder cancer, treatment of high-risk non-muscle invasive bladder cancer failed by Bacille Calmette-Guérin vaccine perfusion, and bladder preservation therapy of muscle-invasive bladder cancer. Some of related studies have achieved certain results, and some are in progress, both of which need to be further examined. Maybe it can provide new guidance and ideas for clinical treatment of bladder cancer.