Objective: To evaluate effects of atrioventricular nodal ablation, pacemaker and pharmaco logic agents on ventricular rate control. Methods:Three patients with chronic sustained atrial fibrillation ( AF) were treated by atrioventricular nodal ablation. Fast-slow junctional cardiac rhythm in this course meant the ablation was successful. Unless the ablation was able to get Ⅱ? Ⅱ type or Ⅲ? AVB, R-R intervals ≥3 s, ventricular rate≤40 bpm, it would be canceled. Otherwise implantation of a permanent pacemaker was performed. Results:One patients having complete atrioventricular block and a ventricular rate of 38 -40 bpm had implantation of a permanent pacemaker. Two patients having no atrioventricular block, prolongation of R-R intervals and ventricular rate of 90 - 120 bpm were given antiarrhythmic drugs. Conclusion: Patients with chronic sustained AF can be treaded with atrioventricular nodal ablation, pacemaker and pharmacologic agents effectively.

Objective To observe the relationship between homocysteine (Hcy),C-reactive protein (CRP) and type 2 diabetes peripheral vascular disease (PVD).Methods Fifty-eight patients with type 2 diabetes according to the condition of PVD were divided into simple type 2 diabetes mellitus group (DM group,30 cases) and PVD group (28 cases).Twenty-five healthy people were chosen at the same period as control group.The fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),total cholesterol(TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C),Hcy and CRP levels were detected among 3 groups,and the body mass index (BMI),ankle brachial index(ABI) was calculated.Results The BMI,TG,TC and HDL-C levels among 3 groups had no statistical significance (P ＞0.05).The FBG,HbA1c and LDL-C in DM group and PVD group were significantly higher than those in control group [(7.54 ± 1.25),(8.12 ± 1.57) mmol/L vs.(4.68 ±0.54)mmol/L; (6.92 ± 0.89)％,(7.54 ± 0.97)％ vs.(4.80 ± 0.54)％ ; (3.79 ± 0.73),(4.41 ± 0.93) mmol/L vs.(2.68 ± 0.54) mmol/L],and the difference was statistically significant (P ＜ 0.05).But the difference between PVD group and DM group had no statistical significance (P ＞ 0.05).Hcy and CRP in DM group and PVD group were higher than those in control group [(10.26 ± 3.62),(19.83 ± 5.54) μ mol/L vs.(8.92 ± 2.41)μ mol/L; (4.12 ±0.57),(5.47 ±0.85) mg/L vs.(2.73 ±0.54) mg/L],ABI was lower than that in control group(0.92 ± 0.18,0.81 ± 0.16 vs.1.02 ± 0.23),and the difference was statistically significant (P ＜ 0.05);Hcy,CRP in PVD group were obviously higher than those in DM group,ABI was lower than that in DM group,and the differences were statistically significant (P＜ 0.05).Spearman analysis showed that Hcy was negatively correlated with ABI (r =-0.635,P ＜ 0.05),CRP was negatively correlated with ABI (r =-0.529,P ＜ 0.05),and Hcy was positively correlated with CRP (r =0.528,P ＜ 0.05).The partial correlation analysis results showed that Hcy and ABI still showed a negative correlation (r =-0.315,P ＜ 0.05),CRP and ABI still showed a negative correlation (r =-0.243,P ＜ 0.05).Conclusion Hcy and CRP participating in the occurrence and development of type 2 diabetes PVD,can be used as a predictor of type 2 diabetes PVD.

Objective To analyze the correlation of visual acuity and metamorphopsia with foveal morphology before and after vitrectomy with internal limiting membrane peeling (ILMP) in idiopathic macular epiretinal membrane (IMEM) eyes.Methods This is a retrospective case series of 47 IMEM patients (49 eyes).All the patients underwent 25G pars plana vitrectomy with IMEM removal and ILMP.The best corrected visual acuity (BCVA) was measured using the international standard visual acuity chart,and the results were converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity.The severity of metamorphopsia was measured using M-charts.The central macular thickness (CMT),inner nuclear layer thickness (INT),inner retinal layer thickness (IRT),outer retinal layer thickness (ORT),the status of ellipsoid zone (EZ) were assessed with spectral-domain optical coherence tomography at baseline and each month postoperatively.The differences in BCVA,CMT,INT,IRT,ORT and status of EZ before and after surgery were analyzed,so did the correlations between these indexes at the same time.Results Compared with baseline,the postoperative BCVA was significantly increased (F=6.133,P＜0.001),but the M value,CMT,INT,IRT,ORT were significantly decreased (F=12.481,10.565,15.739,6.046,10.569;P＜0.001);the integrity of EZ was improved significantly (x2=12.309,P＜0.001).Preoperative BCVA was positively related to the CMT (r=0.720) and ORT (r=0.720,0.887;P＜0.05),while negatively related to preoperative integrity of EZ (r=-0.295,P＜0.05).The postoperative BCVA was positively related to the preoperative BCVA and postoperative CMT,ORT (r=0.774,0.754,0.842;P＜0.05),while negatively related to postoperative integrity of EZ (r=-0.676,P＜0.05).The preoperative M value was positively related to the preoperative CMT,INT,IRT,and ORT (r=0.931,0.668,0.840,0.637;P＜ 0.05).The postoperative M value was positively related to the preoperative M value and postoperative CMT,INT,IRT,and ORT (r=0.723,0.722,0.767,0.825,0.387;P＜0.05).Conclusions Vitrectomy with ILMP for IMEM can improve the visual acuity,metamorphopsia and foveal morphology.Both visual acuity and metamorphopsia correlate with foveal morphology.

AIM: To explore the effects of hyperbaric oxygen (HBO) therapy on language function of aphasics and it's mechanisms. METHODS: Forty patients with aphasics after mild and moderate cerebral trauma and stroke were chosen and divided into therapy group (20 patients) and control group (20 patients). All the patients in both groups received routine therapy.Besides routine therapy, patients in therapy group also received HBO therapy. The HBO treatment contained three courses, each lasts for 15 days at an interval of 3 days. The language functions ( including 11 sub - items) were tested with the Apparatus ZM2.1for Diagnosis and Treatmern of Language Disorders (Language Disorders ZM2.1) before and after each course of HBO and be compared between the two groups. RESULTS: The therapeutic effects between the therapy group and the control group: the scores of 10 sub- items are significantly higher than those of the control group after the 2nd course (P＜0. 05); After the 3rd course, all 11 sub - items were improved significantly ( P ＜ 0.05). The therapeutic effects before and after each course of the therapy group:the scores of the advanced dictation, voice expression and semantic expression increased significantly after the 1st and the 2nd course ( P ＜ 0.05). CONCLUSIONS: The HBO therapy might facilitate the recovery of the language function of the aphasics by promoting the recovery and the self- reparation of the neurocytes and alleviating the focal ischemia - reperfusion. The result of this effect would facilitate the original recovery velocity and not be focused on some language functions and much more obvious in the 1st and the 2nd course.

High fidelity human patient simulator has become more and more important in clinical medical practice education.Medical circle has more and more realized that non-technical skill (NTS) is closely associated with the improvement of medical quality.This paper attempted to carry out a preliminary discussion on theory and practice of applying NTS in simulation training of critical care medicine based on their own teaching experiences.

AIM:To investigate the effects of estrogen on the expression of matrix metalloproteinases-2(MMP-2), tissue inhibitor of metalloproteinases-2(TIMP-2) and transforming growth factor-β1(TGF-β1) in cultured human corneal stromal cells.METHODS: Inflammatory environments of human corneal stromal cells were simulated by using 1.5ng/mL IL-1β.The cells were then treated with or without different concentrations of estrogen(0, 1×10-4, 1×10-6, 1×10-8, 1×10-10mol/L estradiol)in vitro.Cell viability was evaluated by MTT.Expression levels of MMP-2, TIMP-2 and TGF-β1 proteins were measured by enzyme-linked immunosorbent assay(ELISA).RESULTS:Estrogen did not affect the viability of human corneal stromal cells.Compared with the control group, expression levels of MMP-2 and TGF-β1 proteins in E2 treatment group significantly decreased after being treated with estrogen, while the expression level of TIMP-2 significantly increased.CONCLUSION: Estrogen could, to some extent, down-regulate the expression of MMP-2 and TGF-β1 and up-regulate the expression of TIMP-2, which might contribute to protecting human cornea.

OBJECTIVETo investigate the association between 2 SNPs of ISL1 gene and congenital heart disease (CHD) in Tianjin Han children.

METHODSPolymerase chain reaction and DNA sequencing were used to detect 2 SNPs at rs41268421 and rs1017 sites of ISL1 gene, including 35 CHD cases and 30 non-CHD controls. Differences of genotype and allele frequencies of rs41268421 and rs1017 sites were compared, and haplotype analysis of the two sites was performed.

RESULTSThree genotypes (GG, GT and TT) were detected at ISL1 gene SNP rs41268421, and three genotypes (AA, AT and TT) were detected at SNP rs1017. At rs41268421, GT+TT genotypes and T allele frequencies in the CHD group were statistically higher than in the controls. The risk of CHD in children with T allele was significantly increased compared with children with G allele (OR=4.833). At rs1017, AT+TT genotypes and T allele frequencies in the CHD group were statistically higher than controls. The risk of CHD in children with T allele was greater compared with children with A allele (OR=4.491; P<0.05). Four kinds of haplotype were detected in the two SNPs sites and TT type increased the risk of CHD (OR=7.813).

CONCLUSIONSHaplotype TT may increase the risk of CHD in Tianjin Han children.

Child, Preschool ; Female ; Genotype ; Haplotypes ; Heart Defects, Congenital ; genetics ; Humans ; Infant ; LIM-Homeodomain Proteins ; genetics ; Male ; Polymorphism, Single Nucleotide ; Transcription Factors ; genetics

OBJECTIVETo systematically review the efficacy and safety of sodium ferulate (SF) for the treatment of diabetic nephropathy.

METHODSBy computerized retrieving the Cochrane Library, MEDLINE, EMBASE, CNKI, VIP, CBM (theses, conference and internet materials), as well as data from internet materials regarding randomized controlled clinical trials of sodium ferulate for the treatment of diabetic nephropathy were collected completely. Data were strictly extracted using the simple evaluation method recommended in Cochrane Handbook and Meta-analysis was performed using Revman 5.0 software.

RESULTSFourteen randomized controlled trials involving 906 patients met the inclusion criteria. Meta-analysis showed that as compared with the control group, the effects in SF group were superior in terms of reducing urinary albumin excretion rate (UAER) at early stage [WMD = 16.08, 95% confidence interval (95% CI): 11.01 to 21.15] and clinical stage (WMD = 82.66, 95% CI: 66.95 to 98.37), urinary endothelin/endothelin-1 (ET/ET-1, WMD = 10.78, 95% CI: 8.18 to 13.39), levels of serum creatinine (SCr, WMD = 6.42, 95% CI: 1.83 to 11.01), blood urea nitrogen (BUN, SMD = 1.45, 95% CI: 0.19 to 2.71) and total cholesterol (TC, WMD = 0.84, 95% CI: 0.56 to 1.21, as well as in increasing high density lipoprotein-cholesterol (HDL-C, WMD = 0.17, 95% CI: 0.09 to 0.26), showing significant difference between groups. However, the effects of SF were insignificantly different to those of control in reducing fasting blood glucose (FBG, WMD = 0.17, 95% CI: -0.03 to 0.37) and triglyceride (TG, SMD = -0.13, 95% CI -0.49 to 0.23).

CONCLUSIONSAt present the evidences show that SF is superior to the conventional treatment in reducing UAER, ET, SCr, BUN, TC and increasing HDL-C, but there is no evidence to show that SF is superior in reducing FBG and TG. However, the evidence is not strong enough due to the low quality of included literature. More large-scale, multi-center, randomized trials are needed to confirm the efficacy and safety of SF in treating diabetic nephropathy.

Coumaric Acids ; therapeutic use ; Diabetic Nephropathies ; drug therapy ; Humans ; Phytotherapy

The content of benzyl isothiocyanate (BITC) which as the enzymatic hydrolysis product of benzyl glucosinolate through thioglucosidase was determined by HPLC. The content of benzyl isothiocyanate (BITC) which as the enzymatic hydrolysis product of benzyl glucosinolate through thioglucosidase was determined by HPLC. The chromatography condition was as follows: Kaseisorb LC ODS 2000 (4.6 mm x 150 mm, 5 min) column with the mobile phase of acetonitrile(A)-water( B) under gradient elution (0-5 min, 3%-8% A; 5-9 min, 8%-48% A; 9-23 min, 48%-62% A; 23-28 min, 62%-99% A); the flow rate was 1.0 mL x min(-1) with 10 microL injection volume; detection wavelength was 246 nm and temperature of column was 40 degrees C. The content of benzyl glucosinolate was in the range of 10.76-17.91 g x L(-1). The method is simple, accurate and good reproducibility which can be used for the determination of benzyl glucosinolate in Lepidium meyenii, effectively.
Chromatography, High Pressure Liquid ; methods ; Glucosinolates ; analysis ; Lepidium ; chemistry ; Plant Extracts ; analysis