Compared with 165 subjects without coronary artery disease(CAD),125 CAD pa-tients diagnosed bycoronary arteriography were investigated on the possibld relationship among psy-choosocial factors,including occupation,negative life events,type A behavior,and indexes of bloodlipid and blood rheology.The results showed that occupation type was one of the significantly correatesto the indexes of blood-lipid metabalism and blood rheology.The changes of neuroendocrinology andblood rheology following the occurrence of negative life events were correlated with the onset of lethalCAD.The physical and chemical indexes of hematology observed in subjects with Type A behaviorwere associated with atherogenesis and the pathogenesis of CAD.

Child ; Humans ; Hypertension, Pulmonary ; drug therapy ; Phosphodiesterase Inhibitors ; therapeutic use ; Piperazines ; administration & dosage ; therapeutic use ; Purines ; administration & dosage ; therapeutic use ; Sildenafil Citrate ; Sulfones ; administration & dosage ; therapeutic use

Objective To observe clinical effect of treating infantile cerebral palsy with acupuncture and massage. Methods 29 cases with cerebral palsy were randomly recurited into a control group and a treatment group. The treatment group was treated with acupuncture and massage, and the control group was treated with western medicine. The clinical effect of both groups was observed after the treatment. Results The total effective rate of the treatment group and the control group was 85.7% and 66.7% respectively, showing a significant difference (P<0.05) . Conclusion The treatment of infantile cerebral palsy with acupuncture and massage was better than treated with western medicine.

Objective To research a method for detecting metallo-β-lactamase(MBL)to provide the basis for rationally selecting antibacterial drugs in clinic.Methods A total of 104 strains of imipenem-resistant Acinetobacter baumanmii(IRAB)were collected. The MBL phenotype was detected by using the EDTA disk potentiation test and the detection results were compared with the PCR detection results of MBL.Results Among 104 strains of tested IRAB,21 strains were the MBL gene positive by using PCR;24 strains were the MBL gene positive by using the EDTA disk potentiation test.Compared with the PCR detection results,the sensi-tivity of the EDTA disk potentiation test was 95.2% and the specificity was 95.1%.Conclusion The EDTA disk potentiation test for detecting MBL of Acinetobacter baumanmii is simple,credible in the detection results and cheap in cost,which is suitable for the preliminary identification of the MBL-producing Acinetobacter baumanmii in the clinical microbiology laboratory of the primary hos-pitals.

A simple and rapid method was described for determining nitrogen content of a Kjeldahl digest by pulse polarography. The amount of sample needed was as small as 200mg. The digest was diluted and pipetted into a solution of formaldehyde in an acetate buffer. The hexamethylenetetramine produced by reaction between ammonia and formaldehyde was determined electrochemically at -0.9v.This method proved itself a better reproducibility. The recovery rate of nitrogen was 94.5% to 103.1%. Calibration curve of nitrogen in the range of 20 to 120 ?g/ml showed linear relation.Human milk and eleven different food-stuffs were analysed. There was no significant difference between the results by this method and Kjeldahl method.

Antihistamines,a group of drugs most commonly used for the treatment of allergic diseases in dermatology,exert favorable efficacy and are well tolerated in most people.Due to their wide application,the safety of medication is particularly important.When they are used in some special populations with allergic diseases,such as children,pregnant and lactating women,the elderly and people with hepatic or renal insufficiency,their pharmacodynamics,metabolic characteristics and interactions with other drugs should be fully considered,and profits of medication and potential adverse effects should be well weighed before choosing relatively safe antihistamines.In addition,decreasing the routine dose or prolonging intervals between the administration of antihistamines may also be attempted to achieve maximum safety.

AIM: To observe the clinical effect of amniotic membrane transplantation and penetrating keratoplasty in the treatment of atheromatous corneal ulcer.
METHODS: Thirteen patients ( 13 eyes ) diagnosed atheromatous corneal ulcer from February 2009 to May 2014 in our hospital were retrospectively analyzed. Surgical treatment including amniotic membrane transplantation and penetrating keratoplasty were used to deal the patients with no effects of drugs. All patients were followed up for 4mo to 2a ( mean 8mo ) after surgery. Visual acuity, healing and recipient of ulcer were examined.
RESULTS:There patients were treated conservatively with corneal ulcer slowly healing, healing time was 14~35 ( 21±12. 1 ) d. Seven cases were treated with amniotic membrane transplantation, 2 cases were treated with penetrating keratoplasty, 1 case of corneal ulcer perforation and lost light perception received enucleation of eyeball. Corneal ulcer were cured in patients performed amniotic membrane transplantation and penetrating keratoplasty. All patients had no recurrence during the follow-up period.
CONCLUSION:Atheromatous corneal ulcer is difficult to be cured by conservative treatment. Most patients need operation treatment. Amniotic membrane transplantation and penetrating keratoplasty can be performed to deal with atheromatous corneal ulcer and abtain satisfactory effect. But amniotic membrane transplantation is relatively simple and easy, and it is suitable for promotion in primary hospitals.

AIM: To investigate the preliminary clinical observation of excimer laser phototherapeutic keratectomy ( PTK ) assisted by anterior segment optical coherence tomography ( OCT ) in the treatment of non II type granular corneal dystrophy.
METHODS: A retrospective case series were studied. Totally 8 patients ( 12 eyes ) who were diagnosed as granular corneal dystrophy underwent PTK from April 2011 to January 2013 in our hospital. All patients were excluded from the II type granular corneal dystrophy ( Avellino corneal dystrophy ) by the Avellino corneal dystrophy rapid diagnostic kit and underwent preoperative anterior segment OCT examination, so as to determine the lesion morphology and depth, and used to guide the setting of PTK parameters. They were followed up for the complications after operation, postoperative recurrence, the recovery of visual acuity.
RESULTS: All patients were followed up for 6-12mo, average 9mo after operation. All patients' best corrected visual acuity were significantly improved, superficial corneal opacity lesions were effectively removed, and the corneal opacity recurrence or serious Haze were not found during the follow-up period after operation.
CONCLUSION: In patients with non type II granular corneal dystrophy, PTK assisted by anterior segment OCT can be accurate, effective removal of corneal lesions, obtain good effect after operation.

“Early clinical contact” is one of the teaching means of pre-clinical education.Internal medicine department of Tongji hospital attached to Huazhong university of science and technology has done many exploration and has gained many experiences in the stage of “Early clinical contact” of 8-year medical program.They put forward some ideas,including intensifying legal,ethics and morality sense; intensifying communication ability and clinical thinking ability cultivation; intensifying cultivation of scientific research and clinical scientific thinking consciousness ; intensifying learning of clinical medical English.They also summarize a set of effective teaching methods with characteristics.

Objective To compare the effects of snfentanil and fentanyl combined anesthesia on stress responses in pediatric patients undergoing surgical repair of congenital heart defect with cardiopulmonary bypass (CPB) .Methods Twenty-four pediatric patients aged 2-6 yr undergoing surgical repair of congenital heart defect were randomized into 2 groups (n=12 each): sufentanil combined anesthesia group (group S) and fetanyl combined anesthesia group (group F). The patients were premedicated with intramuscular morphine 0.2 mg/kg, scopolamine 0.01 mg/kg and ketamine 5 mg/kg. Anesthesia was induced with midazolam 0.1 mg/kg and snfentanil 0.7 μg/kg (in group S) or fentanyl 5 μg/kg (in group F). Tracheal intubation was facilitated with vecuronium 0.15 mg/kg. The patients were mechanically ventilated. PCO_2 was maintained at 35-45 mm Hg. Anesthesia was maintained with propofol infusion at 6-9 mg·kg~(-1)·h~(-1) and intermittent in boluses of midazolam,vecuronium and 3 doses of sufentanil (0.7, 1.5, 1.5 μg/kg) or fentanyl (5, 10, 10 μg/kg). Arterial blood samples were taken after entering the operation room, at 1 min after tracheal intubation, 1 min after splitting of sternum, immediately after rewarming, 10 min after termination of CPB and 24 h after operation for determination of plasma ACTH, cortisol, glucagon, lactic acid and blood glucose. Results The MAP and HR were maintained in the normal range during operation in both groups. The plasma concentrations of ACTH, cortisol, glucaon and lactic acid were significantly lower in group S than in group F. Plasma ACTH cortisol, glucagon, lactic acid and blood glucose increased significantly during operation as compared with the baseline before anesthesia in both groups. Conclusion Sufentanil combined anesthesia can inhibit stress response in pediatric patients more effectively during surgical repair of congenital cardiac defect performed under CPB.