Objective: Cardiac resynchronization therapy defibrillator (CRT-D) increases ventricular transmural dispersion of repolarization (TDR). Our work evaluated the relationship between QTc interval of TDR indicators, TpTe, TpTe/QTc ratio and rapid ventricular arrhythmia in patients with CRT-D. Methods: A total of 160 consecutive patients who received CRT-D implantation in our hospital from 2011-01 to 2013-03 were studied. The immediate post operative ECG was collected to analyze lead V5 QTc interval, TpTe and TpTe/QTc ratio for assessing its TDR. The patients were divided into 2 groups: Treatment group, the patients with ventricular tachycardia or ventricular ifbrillation received CRT-D,n=30 (18.7%) and Non-treatments group,n=130 (81.3%). All patients were followed-up for (20 ± 10) months and the rapid ventricular arrhythmia was recorded by CRT-D devices. Results: The patients in Treatment group had increased TpTe/QTc (0.24 ± 0.05) vs (0.20 ± 0.04, and TpTe (119 ± 30) ms vs (95 ± 20) ms, bothP<0.001. The QTc interval was similar between 2 groups (480 ± 60) ms vs (470 ± 70) ms,P=0.6 and QTc interval was not related to the risk of CRT-D requirement. The sensitivity and speciifcity for TpTe/QTc ≥ 0.25 predicting the risk of ventricular arrhythmia in CRT-D patients were at 47% and 91%, while TpTe ≥ 120 ms were at 40% and 95%respectively. The post CRT-D surviving curve analysis indicated that TpTe/QTc ratio and TpTe could predict the prognosis in relevant patients,P<0.001. Conclusion: The elevated TpTe and TpTe/QT ratio may increase the incidence of CRT-D requirement in patients with ventricular arrhythmia after resynchronization.

Objective To correlate between the IQQA(R)-Liver system in planning liver resection and the actual operation performed by surgeons.Methods The data on 65 patients were retrospectively studied.Their preoperative enhanced CT images were analyzed by the IQQA(R)-Liver system to determine the operative plan (Group Q) including the operative technique,the major vessels which required to be transected and the virtual liver resection volume.The above results and the corresponding data collected from the actual operation (Group S) were statistically analyzed to find out whether there was any correlation between them,thus determining the clinical significance of the IQQA(R)-Liver system in preoperative evaluation.Results Group Q and Group S had good correlation in the operative techniques (O) and in the major vessels that required to be transected (A) (uO =0.835,uA =0.893) with no statistical difference between the 2 groups (PO =0.494,PA =0.331).The virtual liver resection volume was 633.96 ± 512.06 (78.30 ～2 559.38)cm3.Conclusion Preoperative evaluation by the IQQA(R)-Liver system had significance in planning partial hepatectomy.

Objective To explore self-emulsifying particle size characterization methods and compare the regularity of various methods. Methods By setting the clarity level of turbidity standard solution, with two less soluble drugs-diterpene lactone compounds Chuanhuning and dihydropyridine drug nifedipine as model drugs, 10-12 clarity level prescriptions were selected from six different ternary phase diagram. Laser particle size scanner was used to determine the particle size, and UV-visible spectrophotometry to determine its absorbance. Three methods of particle size characterization rules were compared by drawing charts. Results There was a positive correlationship among droplet particle size, absorbance and clarity grade of emulsion formed by prescription in the same phase diagram. But, there was no regularity among droplet particle size, absorbance and clarity grade of emulsion formed by prescription in different phase diagram. Conclusion The droplet particle size of emulsion formed by prescription containing the same drugs and excipients in different proportions can be compared by clarity with visual method or absorbance with UV-visible spectrophotometer.

AIM: To establish the experimental acute pulmonary embolism(APE) model and observe the left and right ventricular pressure-volume relationship in different overload situations. METHODS: The present study consisted of seven anesthetized mongrel dogs that were divided into the control group, moderate APE group and severe APE group according to the various phase and different pressure load during the experiment. APE model was induced by suture piece injection through right cardiac catheterization. The hemodynamic indexes were measured by the simultaneous cardiac catheterization and echocardiography.RESULTS: (1) In the group with moderate APE, the pressure-volume relationship of right ventricle tended to right-upward shift, the area of chart increased, the shape of chart transformed form triangle to rectangle. The mild parallel leftward shift, the area of chart decreased mildly and no change of chart shape was observed in the pressure-volume relationship of left ventricle. (2) In the group with severe APE, the chart of right ventricular pressure-volume relationship tended to right-upward shift continuously, the area of chart decreased. The chart of the left ventricle tended to left-downward shift and no change of chart shape was observed in the pressure-volume relationship of left ventricle, the area of chart decreased. The erose shape of charts was also found.CONCLUSION: The chart of ventricular pressure-volume relationships is a practical and reliable method to evaluate left and right ventricular hemodynamic in APE.

The internship is the transition period of a medico becoming a doctor,the cultivation of clinical work ability of interns is a comprehensive ability cultivation which includes the foundation theories' consolidation and use,the practical operative train- ing,the cultivation of clinical thought ability and communication between doctors and patients,etc.To educate pediatrics intern has its characteristics.

Objective:To explore therapeutic effect and safety of cilostazol combined clopidogrel +aspirin on aged pa‐tients after percutaneous coronary intervention (PCI) .Methods :A total of 100 aged patients with coronary heart disease undergoing PCI were randomly divided into routine treatment group (n=52 ,received aspirin and clopidogrel antiplatelet therapy) and cilostazol group (n= 48 ,received cilostazol therapy based on routine treatment group ) . Turbidimetry was used to measure platelet aggregation rate (PAR );PAR and mean platelet volume (MPV ) were compared between two groups before ,one week and one month after PCI .All subjects were followed up for six months ,incidence rates of major adverse cardiovascular events (MACE) and hemorrhage events were compared be‐tween two groups .Results:There were no significant difference in MPV and PAR between two groups before PCI . Compared with routine treatment group ,PAR significantly reduced [one week after PCI :(48.7 ± 6.3)% vs .(43.5 ± 5.7)% ,one month after PCI :(46.8 ± 5.8)% vs .(42.4 ± 5.4)% ] in cilostazol group , P<0.05 both . After six-month follow-up ,there was no significant difference in total incidence rate of MACE (16.7% vs .17.3% ) be‐tween cilostazol group and routine treatment group , P>0.05;incidence rate of hemorrhage in cilostazol group was significantly lower than that of routine treatment group (6.25% vs .19.23% , P< 0.01) .Conclusion:Compared with clopidogrel+aspirin therapy ,cilostazol combined clopidogrel+aspirin can more significantly inhibit platelet ag‐gregation ,and significantly reduce hemorrhage events ,so they are safe and effective in aged patients with coronary heart disease undergoing PCI .

Objective To understand the pattern of and influencing factors on leisure time physical exercises among adults in Zhejiang. Method Totally 17 437 residents aged 18 years and over selected by stratified cluster random sampling in Zhejiang in 2010 were investigated. Result Overall 21.82%(95%CI:17.12%-27.38%) of adults took part in leisure time physical exercises in 2010. The proportion was higher in urban (29.04%,95%CI:23.46%-35.33%) than in rural (18.81%,95%CI:12.89%-26.61%) (χ2=222.06, P<0.05) areas, and also higher in females (22.91%,95%CI:17.66%-29.15%) than in males (20.56%,95%CI:16.39%-25.48%) (χ2=13.94, P<0.05). Adults aged 18-24 and 55-74 years were more likely to take apart in physical exercises (χ2=266.73, P<0.05), and the lowest proportion was found among farmers (5.33%,95%CI:3.99%-7.11%) (χ2=2 078.40, P<0.05). These proportions both increased along with education level and family income increase (χ2=444.87, P<0.05;χ2=332.20, P<0.05). Overall 83.04%and 90.08%of physical exercisers took part in exercises at least 3 times per week and 30 minutes per time, only 30.67% of those reached moderate or vigorous intensity, and overall 5.38% (95%CI: 3.85%-7.48%) of adults took part in regular leisure time physical exercises in 2010. Multiple logistic regression showed that age, education level, occupation and chronic disease history have influence on regular physical exercises. Conclusion The leisure time physical exercises level was generally low among adults in Zhejiang. Young and middle-aged adults with less education and low income especially farmers should be put on emphasis.

Cancer is a group of various diseases, all of which involve unregulated cell growth. Many currently used chemotherapeutic drugs are derived from botanicals. Thus, searching botanical sources for novel oncology medications, including identifying the lead compounds and their derivatives for chemoprevention, is an essential step in advancing cancer therapeutics. This article mainly focuses on the data from our previous American ginseng anti-colon cancer studies. In addition to the potential role of American ginseng on cancer, the herb as an adjuvant for cancer treatment is presented, including describing the attenuation of adverse events induced by chemotherapeutic agents and increasing of quality of cancer patient life. Since heat-treated American ginseng and ginsenoside gut microbiome metabolites showed significant increases in cancer chemopreventive effects, active constituents of the steamed herb and their gut metabolites should be clearly identified, and the structure-activity relationship should be further explored. Data obtained from herbal medicine studies and clinical trials will help develop useful anticancer agents.
Animals ; Antineoplastic Agents, Phytogenic ; isolation & purification ; pharmacology ; Apoptosis ; drug effects ; Cell Proliferation ; drug effects ; Colorectal Neoplasms ; drug therapy ; pathology ; Ginsenosides ; isolation & purification ; metabolism ; pharmacology ; therapeutic use ; Hot Temperature ; Humans ; Panax ; chemistry ; Phytotherapy ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Structure-Activity Relationship

Objective:To observe the changes of glyeemia, urine protein, serum creatinine, blood urea nitrogen and glycosylated hemoglobin in diabetic nephropathy rats and treating effects of Xiaokekang. Methods: Streptozotocin (STZ) was abdominally administered and was feeded by high lipid diet to establish diabetic nephropathy model in rats. Animals were divided into three groups: model group, Xiaokekang treatment group and normal group. Changes in glycemia, serum lipids, serum creatinine, blood urea nitrogen were measured at the 8th, 12th and 16th week after STZ injection. Glycosylated hemoglobin was measured at the 16th weeks after STZ injection. Results: Glycemia, serum lipids, serum creatinine were higher at the 8th, 12th and 16th week compared with normal group. Serum creatinine was higher at the 12th and 16th week, and glycosylated hemoglobin was also highter than that of the normal group. Xiaokekang reduced these changes. Conclusion: Xiaokekang can reduce glycemia, serum lipids and protect renal function.

Objective: To analyze the predictors of left ventricular reverse remodeling in patients with III? atrio-ventricular block (AVB) combining left ventricular systolic dysfunction after cardiac re-synchronization therapy (CRT). Methods: A total of 65 III? AVB patients received CRT in our hospital from 2009-01 to 2015-05 were enrolled. Clinical information before and after the operation were recorded. Left ventricular reverse remodeling was deifned by left ventricular end systolic volume (LVESV) decreased 15% or left ventricular ejection fraction (LVEF) increased≥5% at 12 months after CRT. The patients were divided into 2 groups: Reversal group,n=36 and No reversal group,n=29. Clinical condition was compared between 2 groups, predictors for CRT reversing left ventricular remodeling were evaluated by two classiifcation Logistic regression analysis. Results: The patients' average age was (62±14) years and 36/65 (55.4%) with reverse remodeling. In Reversal group, the ratios of female (P=0.011), baseline QRS width>120ms (P=0.001), inter-ventricular mechanical delay (IVMD)≥40 ms (P=0.027) and standard deviation of time-to-minimum systolic volume of 16 segments [Tmsv16-SD (%R-R)≥8.3%, (P=0.001)] were higher than those in No reversal group. Two classiifcation Logisitic regression analysis indicated that female (OR=6.228, 95%CI 1.561-24.842, P=0.01), QRS duration>120 ms (OR=7.778, 95% CI 1.996-30.769,P=0.003) and Tmsv16-SD (%R-R)≥8.3% (OR=8.134, 95% CI 2.064-32.057,P=0.003) were the independent predictors for ventricular reverse remodeling . Conclusion: Female, QRS>120ms and Tmsv16-SD (%R-R)≥8.3% could be used as the predictors for CRT reversing left ventricular remodeling in III? AVB patients combining left ventricular systolic dysfunction.