Atrial Flutter ; diagnosis ; etiology ; therapy ; Electrocardiography ; Female ; Humans ; Infant, Newborn ; Infant, Premature ; Treatment Outcome

ObjectiveTo observe the effect of acupoints stimulation with silver spike point therapy on insomnia.Methods60 patients with insomnia were randomly divided into the trial group and control group with 30 cases in each group. Patients of the trial group were treated by acupoints stimulation with silver spike point therapy and patients of control group were treated only with Clonopin. All patients of two groups were tested with Self-Rating Scale of Sleep (SRSS) before and after treatment.ResultsThe curative effect rate of the trial group was 86.6%; that of the control group was 60%; the curative effect of the trial group was superior to the control group (P<0.05). SRSS difference of the trial group pre-and post-treatment was 12.79±3.20; that of the control group was 10.1±3.89. There was also a significant difference between two groups (P<0.01).ConclusionThe silver spike point therapy has the better curative effect on insomnia than Clonopin.

Objective To investigate the iron status in the newborns of maternal gestational diabetes mellitus(GDM) women,and explore the mechanism of iron deficiency in these newborns.Methods From June 2008 to October 2011,64 GDM women (GDM group) and 71 healthy pregnant women (control group)who delivered in the Second Affiliated Hospital of Wenzhou Medical College and their newborns were studied prospectively.Serum ferritin (SF),serum transferrin receptor (sTfR),erythropoietin (Epo),haemoglobin (Hb),serum level of insulin and plasma glucose in cord blood was measured.The neonatal birth weight (BW) and birth weight Z Score(WAZ) was recorded.The concentrations of serum fasting insulin (FINS),fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c)were tested for all the women before delivery.Results In the GDM group,the cord blood sTfR,Epo and serum level of insulin was (42 ± 10)nmol/L,(56 ±41) U/L and(18 ± 5) U/L,respectively.While in the control group,these were(35 ± 8)nmol/L,(41 ± 43) U/L and (10 ± 5) U/L,respectively.The cord blood sTfR,Epo and serum level of insulin in the GDM group were significantly higher than those in the control group (P ＜ 0.05).The cord blood SF in the GDM group[(60 ±36) μg/L] was significantly lower than that of the control group[(146 ±38) μg/L,P ＜ 0.01].The neonatal BW and WAZ in the GDM group [(3615 ± 538) g and 0.558] were significantly higher than those in the control group [(3449 ± 423) g and 0.224,P ＜ 0.05].No significant difference was found in the cord blood plasma glucose and Hb between the GDM group[(3.3 ± 1.0) mmol/L and (181 ± 18) g/L] and the control group [(3.0 ± 0.8) mmol/L and (176 ± 16) g/L,P ＞ 0.05].The FINS and HbA1c of the GDM group[(12.5 ±5.0) U/L and (6.5 ±0.7)％] were significantly higher than those in the control group [(10.9 ± 4.3) U/L and (5.3 ± 0.7) ％,P ＜ 0.05].The FPG of the GDM group and the control group were (5.3 ± 1.2) and (5.0 ± 1.0) mmol/L,respectively,with no statistically significant difference (P ＞ 0.05).Conclusion Maternal GDM may related to the iron deficiency of the newborns.

Objective To evaluate the clinical significance of the changes of microalbunminuria(MAU) levels in mechanical ventilated patients with severe pneumonia. Methods According to the ratio between the microalbunminuria and the urine creatinine (MAU/CR) (ACR), setting 25mg/mmol as the threshold, 78 mechanical ventilated patients with severe pneumonia were divided into two groups :ACR increasing group and ACR Non-increasing group,then the clinical significance of changes of MAU levels in 72 hours on prognosis of these patients was observed. Results MAU increased in 64 cases(82. 1%) ,of which 46 cases in ACR increasing group and 18 cases in ACR non-increasing group. There showed statistically significant differences on APACHE Ⅱ score, CPIS score,PCT、the success of getting out of mechanical ventilation and the mortality between two groups, (t = 3.50、2. 19 、x~2 = 3. 95、6. 70、5.38 ,P = 0.01,0.03,0.04,0.01,0.02, all P ＜ 0.05). Conclusion Changes of MAU levels have the clinical significance on prognosis of the mechanical ventilated patients with severe pneumonia.

ObjectiveTo explore the clinical therapeutic effect and safety of treating the vertebral artery type cervical spondylosis with rotational manipulation.Methods180 patients with vertebral artery type cervical spondylosis were treated by rotational manipulation.ResultsBy follow-up, 89 patients were evaluated as excellent, 73 as good and 18 as fair. The total rate of excellent and good results was 81%.ConclusionRotational manipulation is an effective method. The correct diagnosis and indication are keys to take good treatment results and safety.

A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for the determination of butoconazole in human plasma. Human plasma samples of 0.2 μL were pretreated by a single step protein precipitation procedure and analyzed using a high performance liquid chromatography (HPLC) electrospray tandem mass spectrometer system. The compounds were eluted isocratically on an Inertsil ODS-SP column (100 mm×2.1 mm, 3 μm), ionized using a positive ion atmospheric pressure electrospray ionization source and analyzed using multiple reaction monitoring (MRM) mode. The ion transitions monitored were m/z 412.8→165.1 for butoconazole and m/z 453.4→230.3 for the internal standard. The chromatographic run time was 3.5 min per injection, with retention time of 2.47 min and 2.15 min for butoconazole and repaglinide, respectively. The method was validated to be linear over the range of 20 to 8000 pg/mL (r>0.999) by using a weighted (1/x(2)) quadratic regression. The mean recovery rate was more than 86.7%, and the intra- and inter-day precision of the quality control samples (QCs) was less than 8.3% and the accuracy ranged from 96.0% to 110.2%, which indicated that the quantitative method was reliable and accurate. The method is simple, rapid, and has been applied successfully to a pharmacokinetics study of butoconazole nitrate suppositories in healthy Chinese females.

Objective To summarize our experience in hepatic artery reconstruction in adult-to-adult right lobe living donor liver transplantation(LDLT).Methods A retrospective analysis was made for 17 cases undergoing LDLT in our center from May 2007 to Oct 2008.Results All the 17 right lobe graft of the liver was supplied by single right hepatic artery and the mean diameter of right hepatic artery was 3.1 mm.The hepatic artery for segment 4 was mainly originated from left hepatic artery(12/17,70.1%).The recipient right or left hepatic artery was used in 14 cases of reconstruction,proper hepatic artery was used in 2 cases,and gastroduodenal artery was used in one case.Anastomosis was performed with interrupted 8-0 prolene and 12-16 stitches were made on the posterior wall first and then the anterior wall to avoid turning over the vessel.The mean anastomosis time was(51±26) minutes and all hepatic arteries were patent immediately after anastomosis.Hepatic arterial complications including hepatic artery thrombosis (HAT)did not occur after LDLT.Conclusions Detailed evaluation and careful protection of the hepatic artery of segment 4 are the key to successful reconstruction of hepatic artery in LDLT.Anastomosis was performed without flipping the artery wall helped to reduce the difficulty of operation remarkably and with a good result.

Objective To design a new Chinese mandarin version of speech sample text for perceptual assessment .Meth-ods The speech sample text included all phonemes and limit number of words .The correlation analysis of the constituent rati-os of all phonemes was performed between the speech text and the ones in Chinese language reported by the institute of Acous-tics Chinese Academy of Sciences using Pearson's correlation coefficient and Spearman correlation coefficient .And their differ-ences were tested by paired sample t test and Wilcoxon signed rank test .Legibility was alsotested .Results Our speech sarrple text contained 21 vowel ,38 consonant and 4 tones .The proportions of vowel ,consonant and tone in the speech text had high correlation with those in Chinese language (for proportions of vowel ,the Pearson's correlation coefficient was 0 .908 and Spearman correlation coefficient was 0 .775 ,P<0 .01 ,respectively ;for proportions of consonant ,the Pearson's correlation co-efficient was 0 .802 and Spearman correlation coefficient was 0 .808 ,respectively ,P<0 .01 ;for proportions of tone ,the Pear-son's correlation coefficient was 0 .967 and Spearman correlation coefficient was more than 0 .999 ,respectively , P< 0 .01) . There was no difference in the proportions of vowel ,consonant and tone between them(P>0 .2) .The value of legibility was 2 , indicating legibility of the speech sample text was good .Conclusion The new Chinese mandarin version of speech sample text can be used in perceptual assessment .The value for perceptual assessment still needs further clinical research .

Objective To analysis the influence factors of standardization in the hierarchical chain management of type 2 diabetes and to enhance the hierarchical chain management of type 2 diabetes.Methods ( 1 ) Six hundred and ninty patients with type 2 diabetes completed 1 years management were divided into well-controlled glycosylated hemoglobin ( HbAlc ) group (＜7.0％ ) and bad-controlled glycosylated hemoglobin (HbAlc) group ( ≥ 7.0％ ).The conditions of diet,physical activity,medication,self-blood sugar monitoring and participation in health seminars were investigated and analyzed.(2) The patients were divided into standardized management group and not standardized management group.Their age,sex,educational background,occupation,monthly income per person,medical security,the course,cognition for glycuresis,two-way transfer,and chronic complications were investigated and statistically analyzed.Results ( 1 ) The proportions of physical activity (70.1％ vs 54.2％,x2=6.163,P=0.018),self-blood sugar monitoring(60.4％ vs 43.8％,x2=6.268,P=0.016) and participation in health seminars (56.0％ vs 41.7％,x2=4.577,P=0.045) in the well-controlled HbAlc group were significantly higher than those in the bad-controlled HbAlc group.(2) Their age [(61.08 ±10.04) years old vs ( 57.75 ± 9.89 ) years old,t=2.539,P=0.012],educational background ( ratio of low educational attainment:8.3 ％ vs 17.2％,x2=6.426,P=0.041 ),medical security (own expense ratios:4.6％ vs 11.5％,x2=3.543,P=0.048 ),awareness of diabetes ( ratio of poor awareness of diabetes:19.4％ vs 41.0％,x2=17.518,P=0.000 ),two-way transfer ( ratio of not transfer treatment:4.6％ vs 14.8％,x2=7.662,P=0.022) and chronic complications ( ratio of chronic complication:41.7 ％ vs 26.2％,x2=6.130,P=0.017) were significantly different between the standardized management group and not standardized management group.(3) Logistic regression analyses indicated that the age ( OR=0.954,P=0.006),monthly income per person ( OR=4.101,P=0.018 ),medical security ( OR=7.617,P=0.003 ),cognition for glycuresis ( OR=0.030,P=0.000),two-way transfer ( OR=9.079,P=0.000) and chronic complications ( OR=0.456,P=0.031 ) were the risk factors of standardized management.Conclusion We should focus on the impact factors affecting the standardized management of patients including age,monthly income per person,medical security,awareness of diabetes,ratio of not transfer treatment,positive strategies for chronic complications,improve the hierarchical chain management of type 2 diabetes,and then make the diabetic patients to early participate in standardization management of diabetes mellitus and delay the appearance of complications.

Objective To investigate the relationship and mechanism of the heme oxygenase-1 expression in peripheral blood mononuclear cells (PBMC) and the oxidative stress in diabetic nephropathy. Methods Two groups of diabetic patients with or without diabetic nephropathy and a normal control group were enrolled in this study. Fasting blood glucose (FBG), HbA1c, serum MDA level, ROS level, HO-1 mRNA level and HO-1 protein expression in PBMC were determined. Results In control group, diabetic group and diabetic nephropathy group , the MDA levels significantly increased[(14.23±5.07)nmol/ml vs (24.90±7.12)nmol/ml vs (43.83±16.97)nmol/ml](F＝37.022,P＜0.01), the ROS levels significantly increased (113.18±58.59 vs 364.54±88.67 vs 524.35±162.51)(F＝68.369,P＜0.01) and the HO-1 protein expression also increased significantly (22.84±9.98 vs 36.72±15.85 vs 58.1±15.93)(F＝31.302,P＜0.01). There was a positive correlation among the HO-1 mRNA, protein expression and MDA level(r＝0.407,0.429,P＜0.05). Conclusions There existed a severer oxidative stress condition in patients with diabetic nephropathy compared with the patients without diabetic nephropathy. HO-1 could be a potential pathway to ameliorate oxidative stress in diabetic kidney disease patients.