Aged ; Catheter Ablation ; adverse effects ; Echocardiography ; Heart Atria ; Humans ; Male ; Postoperative Complications ; diagnostic imaging ; Tachycardia, Supraventricular ; diagnostic imaging ; surgery ; Thrombosis ; etiology

Objective To study the epidemic characteristics of falls among older female adults.Methods Stratified random sampling was applied in this study.Totally 969 elderly female adults aged 60 years and over from communities of Changning district were recruited and self-designed questionnaire was used in survey.Results Among 969 interviewees,238 (24.6％) had an injury in the past years,and 4.7％ had more than one fall.Among those who fell in the past year,84.5％ had suffered from different kinds of fall-related injury with injury incidence of 20.7 ％,and 32.4 ％ suffered from fracture with the fracture rate of 7.9％.There was a significant difference in fall incidence between different age groups,and the incidence increased with aging (x2 =30.26,P＜0.01).After a fall,71.6％ cases needed certain medical service,and 11.8％ were hospitalized for treatment.Among those suffered from fall-related injury,the activities of 29.3％ patients were decreased,and 3.0％ lost the ability to live independently.Most falls (31.2％) occurred at home.Among those,61.8％ of patients considered the reason of their falls was the interaction between intrinsic hazards and environmental hazards.Conclusions High incidence and severe consequence of fall appear among elderly female adults.More attention should be paid to this population.

Objective:To analyze the monitoring results of high resolution esophageal manometry (HRM) and 24-Hour impedance-pH for the patients with functional heartburn (FH)and non-erosive reflux disease(NERD), and explore the effect of Gastroesophageal junction morphology, transient lower esophageal sphincter relaxation and regurgitation of gastric acid in FH and NERD.Methods: 86 patients with continuous heartburn who were negative under endoscope were divided into FH group(38cases) and NERD group(48cases), and gastrointestinal symptom rating scales (GSRS), the results of HRM and 24h pH/impedance monitoring of the two groups were compared and analyzed.Results: The GSRS of sour regurgitation, abdominal distension, diarrhea and constipation of FH group were significantly higher than that of NERD group, respectively(t=-4.45,t=3.83,t=3.07,t=4.58,P<0.05). The ratio of esophagogastric junction-III(EGJ-III)of FH group was significantly lower than that of NERD group (Z=-3.27,P<0.05). And the ratio of esophageal hiatus hernia of FH group was significantly lower than that of NERD group(x2=16.01,P<0.05). In HRM parameters, the differences of lower esophageal sphincter pressure (LESP), upper esophageal sphincter pressure(UESP), distal contractile integral(DCI)and esophagogastric junction- contractile integral (EGJ-CI) between FH group and NERD group were statistically significant(t=6.99,t=-4.51,t=-2.91,t=-3.72;P<0.05), respectively. On the other hand, the times of sour regurgitation in erect position, the ratio of fluid regurgitation, exposed time of erect position and clinostatism, and DeMeester integral of NERD group was statistically significant higher than that of FH group(t=-9.48,t=-13.00,t=-13.56,t=-18.31;P<0.05).Conclusion:There are esophageal dysfunction in a certain degree and obvious regurgitation in both of two groups, and the detections of HRM and 24h-impedance pH contribute to differential diagnosis for NERG. Besides, the symptom of patients with FH may be relative with regurgitation of non-acidic material, especially may be relative with regurgitation of air.

Objective To study the application of magnetic resonance T2 -mapping and diffusion weighted imaging(DWI)in diagnosis of early cartilage degeneration of the knee joint.Methods 56 patients with clinical intends to diagnosis of early osteoarthritis of the knee were set as observation group,another 56 healthy volunteers were selected as healthy control group.The subjects of the two groups were given knee MRI T2 mapping and DWI,the T2 acquisition value and ADC value of the two groups were analyzed and compared.Results In the observation group, the side of the femoral (37.18 ±4.09),lateral tibial (32.16 ±2.75)and hip (34.56 ±4.21)were significantly lower than those in the healthy control group[femoral side (49.87 ±5.02),tibial side (47.34 ±5.01),hip surface (51.23 ±5.19)](t =20.16,18.36,23.65,all P <0.05).Conclusion Magnetic resonance T2 -mapping and DWI imaging can be found in the early knee cartilage degeneration,can lead to the rise of T2 and ADC value,so there is no cartilage damage to the cartilage damage.

Esophagus ; Foreign Bodies ; Humans ; Infant ; Male

Objective To investigate the diagnostic value of contrast-enhanced ultrasound (CEUS), and compare it with contrast-enhanced CT(CECT). Methods Eighty-one focal liver lesions were evaluated with CEUS and CECT, diagnostic value of two modalities were calculated, vaseularity manifestations of two modalities in arterial phase were compared. Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CEUS were 96.6 %, 86.9 %, 94.9 %, 90.9 %, 93. 80%, respectively, and the diagnostic value of CECT were 98.3%, 82. 6%, 93.4%, 95.0%, 93.8%, respectively. Among all the metastasis, hypervascular manifestation lesions in arterial phase of CEUS and CECT were 72% (18/25) and 32% (8/25)( P <0.05). Conclusions The diagnostic value of CEUS and CECT in focal liver lesions are comparably satisfying,and there is no significant difference between them, the combination use of two modalities would improve the diagnosis performance. CEUS can show more hypervaseular metastasis than CECT in arterial phase.

The article discusses the experiences of five-year minority medical students in internal medicine practice teaching.The content includes cultivating studnts’ ability of clinic thought,the application of casuistics methods,PBL method,combination of teaching and clinic,me-dia mix’s application,improving students’communication ability,adjusting teaching method in time,and so on.The purpose is to improve the effect of minority medical students in internal medicine practice teaching.

Objective·To analyze clinical and pathological characteristics of gastric malignancies from a single center of Ruijin Hospital,and provide references for making healthy policy on gastric tumors.Methods·The data sources were from hospital in-patients database including demographic information,family history,clinicopathological information,and census registering information during 2005 to 2014.The demographic data and clinicopathological data were analyzed.Results·The total number was 3 315 cases with gastric malignancies (2 184 male patients and 1 131 female patients).It was about 2 times as high in males as in females.The patient age was between 18 to 98 years old (mean 59.71 years old).Based on pathologic diagnosis,3 122 cases (94.2％) were gastric adenocarcinoma,others were gastrointestinal stromal tumors (5.5％),neuroendocrine tumor (0.2％) and malignant lymphoma (0.1％).Out of patients with gastric carcinoma,about 4.46％ of cases ran in families.Conclusion·Over 94％ cases of gastric malignancies are gastric carcinomas.Specific risk profiles of gastric carcinomas include age,gender and family factors.

Objective To evaluate the clinical value of medical thoracoscopy in the diagnosis of exudative pleural effusions with unknown etiology.Methods We analyzed retrospectively the clinical data of 180 patients with undiagnosed pleural effusions who underwent medical thoracoscopy and appraised clinical value regarding validity,effectivity and applicability of thoracoscopy.Result In 180 cases of pleural effusion,there were 178 cases of patients with a clear diagnosis,including 87 cases of tuberculous pleurisy,28 cases of malignant tumor,malignant breast bildes mesothelioma in 2,lung cancer in 24,bile duct carcinoma in 1,cercival cancer in 1),pneumonia 58 case fo pyothorax,5 caseso of pyothorax,and 2 cases withou clear diagnosis.No check failure and terminate,the 95％CI was 5 cases of 97.78％-99.98％.Conclusions Medical thoracoscopy is a safe and effective method in the diagnosis of exudative pleural effusions with unknown aetiology.The early application of this method is very helpful for the management of the pleural diseases in suitable patients.

Objective To investigate the placental transfer and neonatal effects of dexmedetomidine during the cesarean section under general anesthesia.Methods Thirty-eight nulliparous parturients,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 22-37 yr,weighing 56-82 kg,who were at full term with a singleton fetus,scheduled for elective caesarean section under general anesthesia,were randomly divided into 2 groups (n=19 each) using a random number table:dexmedetomidine group (group D) and normal saline group (group N).In group D,dexmedetomidine was infused in a loading dose of 0.6 μg/kg starting from 10 min before induction of anesthesia,followed by an infusion of 0.4 μg · kg-1 · h-1 until peritoneal closure.Group N received the equal volume of normal saline.Blood samples were collected from the maternal artery (MA),umbilical vein (UV),and umbilical artery (UA) for blood gas analysis and for determination of plasma dexmedetomidine concentrations (CMA,CUV and CUA) by high-performance liquid chromatography-mass spectrometry,and CUV/CMA and CUA/CUV were calculated.Apgar scores were recorded at 1 and 5 min after delivery,and the occurrence of respiratory depression was also recorded.The I-D interval (the time from administration of anesthetics to delivery) and U-D interval (the time from incision of the uterus to delivery) were recorded.Results There were no significant differences in the blood gas analysis parameters in blood samples collected from the MA,UV and UA,I-D interval,U-D interval,and Apgar scores between the two groups (P＞0.05).No neonatal respiratory depression was found in both groups.In group D,CMA,CUV and CUA were 471±119,359±88 and (321±78) ng/ml,respectively,CUV/CMA was 0.76±0.06,and CUA/CUV was 0.89±0.03.Conclusion Although the metabolism of dexmedetomidine is little after easy placental transfer,dexmedetomidine has no adverse effects on the newborn during the cesarean section under general anesthesia.