Objective To explore the application of echocardiography to guide interatrial septal puncture and evaluate the clinical effect in PBMV. Methods One hundren and sixty two patients were categorized into two groups according to whether echocardiography was applied in atrial septal puncture and real time monitoring. X-ray fluoroscopy guidence was used during atrial septal puncture in group 1 and in group 2, X-ray as well as echocardiography were used. The clinical outcomes were analyzed and contrasted between the 2 group. Results (1) The mean mitral pressure gradient dropped obviously in group 2 immediately after PBMV compared with group 1 (6.4?2.6 mm?Hg vs 10.2?3.7 mm?Hg,P

Objective To explore the causes and possible treatment for subacute coronary stent thrombosis (SST) after percutaneous coronary interventions (PCI) in the races of Han, Uygur and Kazak in Xin Jiang Province. Methods The variables of hemodynamic, blood coagulation, lesions characteristics, the course of operation and relative treatment of 21 cases of different races (Han. Uygur and Kazak) were reviewed and underwent logistic regression analysis. Results The incidence of SST were higher in the Uygur and the Kazak people than that in the Han group after PCI (1.4% vs 0.47%; 5.4% vs 0.47%, P

Objective To investigate the relation between homeostasis model assessment of insulin resistance(HOMA-IR) and the results of coronary angiography in coronary artery disease(CAD) patients complicated with hypertension.Methods One hundred and two CAD patients complicated with hypertension were enrolled into the investigation group and another 80 CAD patients without hypertension were considered as the control group.The HOMA-IR and the results of coronary angiography were compared between the 2 groups and their correlation was further analyzed.Results The HOMA-IR of the investigation group was higher than that of the control group(8.10?1.25 vs 4.70?2.13,P

BACKGROUND:Arterial stiffness is an independent risk factor for cardiovascular disease.Augmentation index(Alx)is an important marker which reflects the systemic arterial stiffness.OBJECTIVE:To investigate Alx and the affecting factors in Xinjiang Uygur health adults.METHODS:A total of 559 healthy adults(251 males and 308 females)with a mean age of(44.95±11.87)years were selected from Hetian,Xinjiang Uygur Autonomous Region.The following indexes of all subjects were measured,including questionnaire,physical examination,blood biochemistry and C-reactive protein(CRP).Central systolic blood pressure(cSBP)and central Alx were measured by Sphygmocor.Pearson correlation and partial correlation analysis were used for two-group analysis of correlation,and multiple regression analysis was used to analyze influential factors for Alx.RESULTS AND CONCULUSION:Alx was greater in female than in male and was positively related to age in both sexes(male:r=0.548,female:r =0.405,P < 0.05),as well as adjusted other influential factors(male:r=0.182,female:r =0.234,P < 0.05).Multiple regression analysis showed that cSBP,systolic blood pressure(SBP),sex,age and CRP were main factors which affected Alx in Uygur healthy adults,cSBP,SBP,age,body mass and CRP were main factors which affected Alx in the male,while cSBP,SBP,age,height and CRP were main factors which affected Alx in the female.Results revealed that Alx was greater in female than in male which was positively related to age in both sexes.Age,cSBP,SBP and CRP were main factors that affected Alx in Xinjiang Uygur healthy adults.

Objective To study the association between serum concentrations of total testosterone levels and coronary heart disease (CHD) in the postmenopausal women. Methods The study was designed as a case-control study.394 postmenopausal female patients were selected from Cardiology Center of the First Affiliated Hospital of Xinjiang Medical University.The case group included 183 women patients with CHD aged (62.7±8.0) years,the control group,211 women with normal coronary aged (60.0 ± 8.8) years. Blood samples were collected to determine total testosterone,fasting glucose and lipid profile. CHD severity was expressed as the numbers of coronary arteries that had a stenosis ≥50％.According to the level of testosteron,all cases were divided into 4 groups by interquartile range method:Q1＜3.5 nmol/L(n=190),3.5 nmol/L≤Q2 ＜10.4 nmol/L(n=64),10.4 nmol/L≤Q3 ＜26.0 nmol/L(n=120) and Q4≥26.0 nmol/L(n=20).The association between the serum total testosterone levels and severity of coronary atherosclerosis was analyzed. Results The average total testosterone was higher in case group than in control group[(10.4 ± 24.3 ) nmol/L vs. ( 6.9 ± 17.4 ) nmol/L,Z =0.79,P =0.555].In Quantitative adjusted models,higher levels of total testosterone had strong correlation with CHD,Q4 incidence of CHD (75.0％,15 cases) was significantly higher than Q1 (46.8％,89 cases),Q2 (40.6％,26 cases)and Q3 (44.2％,53 cases) (x2 =7.69,P=0.048).After adjustment for other risk factors,women in the top quartile of total testosterone levels had a more than 3-fold increase in odds of CHD(OR=3.47,95％CI:1.06-11.32,P＜0.05).In addition,the serum concentrations of total testosterone level were significantly associated with the severity of CHD (F=12.94,P＜0.05). Conclusions Higher levels of total testosterone may be associated with high prevalence and severity of CHD as an independent factor in postmenopausal women.

Objective:To evaluate the efficacy of dexmedetomidine for patient-controlled sleep regulation in improving postoperative sleep disorders in patients with gastrointestinal tumors.Methods:One hundred and fifty American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ patients, regardless of gender, aged 40-80 yr, with a preoperative Pittsburgh Sleep Quality Index (PSQI) score of ≤7 and a PSQI score of >7 on the 1st day after surgery, undergoing elective laparoscopic resection of gastrointestinal tumors from May 2023 to December 2023 in the Affiliated Changzhou No. 2 People′s Hospital of Nanjing Medical University, were divided into 3 groups ( n=50 each) using a random number table method: normal saline group and dexmedetomidine via different routes of administration groups (DEX1 group, DEX2 group). After the routine use of 48 h postoperative analgesia, dexmedetomidine 400 μg and atropine 1 mg in 100 ml of normal saline were added to the analgesic pump in DEX1 and DEX2 groups, DEX1 group received a background infusion at a rate of 2.5 ml/h, and after an initial dose of 6 ml, the patient-controlled analgesia (PCA) pump was programmed to deliver 4 ml with a lockout interval of 10 min and background infusion at 0.5 ml/h in DEX2 group. In NS group, normal saline was added to the PCA pump, and the methed of petient-controlled administration was the same as those previously described in DEX2 group. PSQI scores were recorded at days 1, 3 and 7 and 1 month postoperatively, and visual analogue scale scores were recorded on postoperative days 1, 3 and 7. Personal Health Questionnaire Depression Scale scores were assessed and the polysomnogram was monitored on the preoperative day 1, and 15-item Quality of Recovery (QoR-15) scale scores were assessed on postoperative day 7. The duration of PACU stay, consumption of anesthetic drugs, the total pressing times of PCA within 48 h, consumption of analgesic drugs and lenth of hospital stay were recorded. Results:Compared with NS group, the sleep stage N1 ratio and arousal index were significantly decreased and the sleep stage N2 ratio and sleep efficiency were increased on postoperative days 3 and 7, PSQI scores at days 3 and 7 and 1 month after operation and VAS score at postoperative day 7 were decreased, the length of hospital stay was shortened in DEX1 and DEX2 groups, and QoR-15 scale scores were significantly increased in DEX2 group ( P<0.05). Compared with DEX1 group, the sleep stage N3 ratio was significantly increased, PSQI scores were decreased on postoperative days 3 and 7, and QoR-15 scale scores were increased in DEX2 group ( P<0.05). Multivariate logistic regression analysis showed that dexmedetomidine for patient-controlled sleep regulation was a protective factor against postoperative sleep disturbances ( P<0.05). Conclusions:For the patients with postoperative sleep disorders following surgery for gastrointestinal tumors, self-controlled administration of dexmedetomidine for 3 consecutive days after surgery improves the sleep structure, raises the subjective sleep quality and promotes the postoperative recovery.

Objective To study the correlation between renal function and arterial stiffness of Uighur population over 35 years old in Xinjiang area. Methods From October 2007 to March 2010, four-stage stratified random sampling method was applied to collect a total of 4312 Uighur people over 35 years old in Urumqi, Karamay, Fukang, Turpan area, Hotan prefecture, Yili Kazak autonomous prefecture and Altai prefecture. The data of these 4312 general urban and rural Uygur residents were complete. Simplified MDRD formula was used to calculate the estimate glomerular filtration rate (eGFR). Arm-ankle pulse wave velocity (b-aPWV) of both sides was measured and the average value was used in correlation analysis with eCFR, and then the associated risk factors were adjusted. Results The eGFR was negatively correlated with b-aPWV (r=-0.174, P<0.01). Multiple linear regression showed that after adjusting some risk factors such as age, sex, body mass index, systolic blood pressure, diastolic blood pressure, waist circumference, hip circumference, uric acid, fasting blood glucose, total cholesterol, triglycerides, low density lipoprotein, eGFR was still negatively correlated with b-aPWV (P=0.012). Conclusions In Uygur population over 35 years old in Xinjiang, the glomerular filtration rate is negatively correlated with arterial stiffness.

Jiangsu Provincial People's Hospital takes the reform of DRG payment method as an opportunity,based on the theory of incentive behavior,uses literature research,expert consultation,and key performance indicator methods to develop evaluation indicators,and applies PDCA management tools to establish a continuously improving medical insurance service quality evaluation system.It introduces the process of medical insurance service quality evaluation system construction and its application in medical insurance performance management,and analyzes the implementation effect:DRG operation is improving,disease group structure is optimized,medical quality and efficiency continue to improve,and medical service evaluation scores are improving.