Coronary heart disease (CHD) is a frequently-occurring cardiovascular disease in the clinical setting with high mortality rate.Negative emotions, such as anxiety and depression, are common in patients with CHD. These negative emotions predict a worse prognosis and rehabilitation outcome and impair the patients' quality of life. Cardiac rehabilitation can improve the emotion of anxiety and depression effectively and provide superior benefits in quality of life in CHD patients.

Objective To explore the MRI features of primary spinal lymphoma,and aim at improving the understanding of the disease.Methods The MRI data of primary spinal lymphoma in 8 cases were analyzed retrospectively,which were confirmed by op-eration and pathology,all cases were experienced by the plain MRI scan and enhancement scan.Results There were 6 cases located in thoracic vertebra,5 cases located in lumbar spine,and 2 cases located in sacral vertebral,the MRI performance were the bone damage and bone marrow infiltration in vertebral bodies and accessories,which were showed low signal on T1 WI ,high signal on T2 WI;Compared to adjacent muscles,a obscure boundary of soft tissue masses were also showed low signal on T1 WI ,high signal on T2 WI,and were significantly enhanced.Conclusion MRI is helpful for localization and qualitative diagnosis of the primary spinal lymphoma.

Objective To investigation the serum sex hormone levels of 1 380 menstrual disorder women in Qingshan district of Wuhan city .Methods Applying Electrochemiluminescence immunoassay (ECLIA ) to detection the density of progesterone (PROG) ,testosterone(TEST) ,prolactin(PRL) ,estradiol(E2) ,luteinizing hormone(LH) and follicle‐stimulating hormone(FSH) in serum .Results 199 cases of PROG were abnormal ,which accounted for 14 .42% ;128 cases of TEST were abnormal ,which accoun‐ted for 9 .28% ;323 cases of PROL were abnormal ,which accounted for 23 .41% ;334 cases of E2 were abnormal ,which accounted for 24 .20% ;568 cases of LH were abnormal ,which accounted for 41 .16% ;553 cases of FSH were abnormal ,which accounted for 40 .07% .Conclusion In the menstrual disorder women in Qingshan district of Wuhan city ,LH and FSH anomaly is the highest proportion ,ovarian dysfunction may be the main reason for female menstrual disorder .

OBJECTIVE To study the status of the distribution and drug resistance of Enterococcus in hospital,in order to further provide the effective reference for rational use of antibacterial and the prevention of Enterococcus in clinical therapy. METHODS The drug sensitivity and resistance of 201 strains of Enterococcus were determined by MicroScan WalkAway40 automatic microorganism system. RESULTS The highest incidence rate of Enterococcus was E. faecium (48.8%),the second was E. faecalis (37.3%),and the others were E. gallinarum (13.9%). The drug resistance of E. faecium was much higher than that of E. faecalis. CONCLUSIONS The most of Enterococcus infection is due to E. faecium,and there is a lot of difference for drug resistance in the strains of Enterococcus. It is necessary to rationally use antibacterials on the basis of the drug resistance,infection sites and grade of infection.

Objective To observe the surgical results of modified percutaneous endoscopic interlaminar decompression(PEID) and traditional PEID in the treatment of degenerative lumbar spinal stenosis (DLSS),and to explore the optimizations scheme of PEID for DLSS.Methods 60 patients (36 males and 24 females) were brought into the research for DLSS.According to the different operation ways,the patients were randomly divided into the modified PEID group(observation group) and traditional PEID group (control group) according to the digital table method,30 cases in each group.The surgical outcome,indicators included the change in spinal canal,visual analogue scale (VAS) score and Oswestry disability index (ODI) at pre-operation,postoperative 3 d,postoperative 3 months and postoperative 6 months,operation time,headache and painful stiff nape incidence in the operation,postoperative complications were compared between the two groups.Results The VAS scores (postoperative 3 days,postoperative 3 months and postoperative 6 months) of the observation group were (4.37 ± 1.20) points,(2.59 ± 1.30) points,(1.29 ± 1.21)points respectively,which of the control group were (4.45 ± 1.22)points,(2.67 ± 1.36)points,(1.17 ± 1.10)points respectively,which were significantly better than (7.93 ± 1.56)points of the observation group and (8.22 ± 1.70) points of the control group before operation,the differences were statistically significant (F =1 254.387,512.762,all P ＜ 0.05).The ODI scores (postoperative 3 days,postoperative 3 months and postoperative 6 months) of the observation group were (48.64 ± 19.59) points,(27.66 ± 10.22) points,(10.69 ± 8.87) points respectively,which of the control group were (47.22 ± 20.96) points,(25.17 ± 11.93) points,(10.16 ± 7.89) points respectively,which were significantly better than (75.20 ± 23.20) points of the observation group and (70.35 ± 28.66) points of the control group before operation,the differences were statistically significant(F =1 254.387,512.762,all P ＜ 0.05).The VAS and ODI scores (pre-operation,postoperative 3 days,postoperative 3 months andpostoperative 6 months) of the observation group and control group had no statistically significant differences (VAS:t =2.088,2.124,3.021,3.173;ODI:t =2.366,1.079,1.694,1.573,all P ＞ 0.05).The incidence of neck pain and operation time of the observation group were 20.69％,(63 ± 7) min,which were significantly lower than 87.50％ and (157 ± 8)rin of the control group,the differences were statistically significant(t =3.601,2.167,all P ＜ 0.05).The central sagittal diameter of the spinal canal and the central transverse diameter of the spinal canal between the observation group and the control group had no statistically significant differences (x2 =4.260,t =3.694,all P ＞ 0.05).Conclusion Modified PEID has advantages in surgical efficiency,operation time and headache and painful stiff nape incidence compared with traditional PEID,so it can be chosen for DLSS.

Objective To study the incidence and prognosis of avascular necrosis after talus fracture. Methods A retrospective survey was performed in 12 patients ( 13 feet) with talus fractures admitted into hospital from July 2004 to November 2009 to analyze necrosis rate, ankle function recovery and disability rate. According to Hawkin' s classification system, there were two patients with type Ⅰ feet, four with type Ⅱ feet, five with type Ⅲ feet and two with type Ⅳ feet. Results All patients were followed up for average period of 19.6 months (range 11-52 months). Avascular necrosis was detected in eight feet, of which one foot was treated with ankle fusion, one with subtalar arthrodesis and one with bone implantation. The other five feet had good ankle and subtalar function, with no collapse or osteoarthritis. According to Maryland foot score, the result was excellent in eight patients, good in two, fair in one and failure in two, with excellence rate of 77%. Conclusion The incidence of avascular necrosis after talus fracture is related to the location and energy of trauma. However, the function prognosis of the talus shows no correlation with necrosis.

OBJECTIVETo observe the protective effect of combined administration of blood-activating drug and sedative drug on myocardial injury of acute myocardial infarction (AMI) rats.

METHODThe acute myocardial infarction (AMI) model was established by occluding the left descending coronary artery of Wistar rats. These rats were further divided into four groups (n = 15 per group): the sham-operated group, the AMI model group, the blood-activating drug group and the combined administration group.

RESULTCompared with the sham-operated group, the AMI model group showed significant decrease in ejection fraction (EF) and fractional shortening (FS) (P < 0.001) and notable increase in the left ventricular end-diastolic internal diameter (LVIDd) and left ventricular end-systolic internal diameter (LVIDs) (P < 0.01), with the infarct area of left ventricular front wall up to about 70%-90%. Besides, tissue was severely replaced by collagen deposition and fibrosis, the sarcomeres disorganized and mitochondrial abnormalized. Compared with the AMI model group, the blood-activating drug group and the combined administration group showed significant increase in the values of EF and FS (P < 0.05 or P < 0.01) and obvious reduction in LVIDd and LVIDs (P < 0.05 or P < 0.01), with the infarction area of left ventricular front wall up to about 40%-60%. The collagen deposition and myocardium fibrosis, the disorganized sarcomeres and mitochondrial abnormalities relieved significantly. And compared with blood-activating drug group, the combined administration group demonstrated further increase in the values of EF and FS and further decrease in LVIDd and LVIDs (P < 0.05), the collagen deposition and myocardium fibrosis, the disorganized sarcomeres and mitochondrial abnormalities relieved even more in Huoxue plus Anshen prescription group.

CONCLUSIONThe combined administration of blood-activating drug and sedative drug can further improve cardiac structure and function after myocardial ischemia infarction and have an obvious synergistic effect which may be related to sedative drug's effect of resisting lipid peroxide, stabling myocardial cell membrane and mitochondrial membrane and relieving cardiac cell injury.

Animals ; Drugs, Chinese Herbal ; therapeutic use ; Hypnotics and Sedatives ; therapeutic use ; Lipid Peroxidation ; drug effects ; Male ; Myocardial Infarction ; drug therapy ; pathology ; Rats ; Rats, Wistar

Objective:To investigate the effects of conventional anesthesia combined with low dose esketamine on pain and stress response in patients undergoing laparoscopic total hysterectomy.Methods:A total of 150 patients with laparoscopic total hysterectomy admitted to our hospital from Jan. 2022 to Dec. 2023 were selected as subjects. All patients were divided into control group and study group by coin toss method, with 75 cases in each group. The control group were given conventional anesthesia, and the study group were given a small dose of esketamine. Intraoperative sedation, hemodynamics at different times, postoperative pain, stress response and the incidence of adverse reactions were compared between the two groups.Results:There was no significant difference in hemodynamics between the two groups ( P>0.05). Mean arterial pressure (MAP) was (94.84±6.02), (86.14±5.99) mmHg, systolic blood pressure (SBP) was (96.48±5.72), (96.48±5.69) mmHg; Heart rate (HR) was 95.51±5.95, 84.05±5.57 times/min, while they were 102.05±6.13, 93.71±6.25, 105.03±6.07, 104.37±6.02 mmHg, 102.49±6.87, 90.51±5.86 times/min, respectively in the control group. The study group was significantly lower than the control group ( P<0.05). SpO2 at extubation and extravasation were (97.47±1.24) % and (98.11± 1.24) % in study group and (96.32±1.21) % and (97.03±1.23) % in the control group, significantly higher than those in the control group ( P<0.05). VAS scores at 3 h, 6 h, 12 h and 24 h were 1.71±0.35, 2.58±0.53, 3.27±0.68, 3.86±0.82 in the study group and 2.13±0.42, 3.74±0.75, 4.52±1.01, 4.53±1.04 in the control group. The study group was significantly lower than the control group ( P<0.05). Study group 5-hydroxytryptamine (5-HT), substance P (SP), norepinephrine, NE) levels were 29.53±7.68, 37.44±8.16, 49.71±9.56 ng/mL, and 52.81±10.04, 54.62±10.25, 61.23±10.08 ng/mL in the control group, significantly lower than those in the control group ( P<0.05). Postoperative 2 d study group calcitonin gene related peptide (calcitonin gene related peptide, CGRP), neuropeptide Y (NPY) and cortisol (Cor) levels were 158.41±27.06 pg/mL, 127.84±24.21 pg/mL and 240.37±31.55 nmol/L. The control group was 175.49±30.28 pg/mL, 153.92±28.63 pg/mL, 251.18±34.92 nmol/L, and the study group was significantly lower than the control group ( P<0.05). The incidence of adverse reactions in the study group was 10.67% (8/75), and the control group was 16.00% (12/75), with no statistical significance ( P>0.05) . Conclusion:Conventional anesthesia combined with low-dose esketamine can help reduce intraoperative hemodynamic changes in patients with laparoscopic total hysterectomy, improve sedation effect, relieve postoperative pain, reduce postoperative pain factors and oxidative stress related indexes of patients without increasing adverse reactions, and has good efficacy and safety.

Objective To investigate the early diagnosis value of MR by detecting spinal inflammatory lesions in ankylosing spon-dylitis (AS).Methods Forty patients were involved in this study,including 20 cases with short inflammatory back pain (IBP)histo-ry (duration ≤18 months)and 20 cases with long IBP history (duration ≥24 months).MR images were analyzed retrospectively. Results Patients with a short history of IBP had 7 lesions in vertebral bodies (anterior/posterior spondylitis and spondylodiscitis) and 33 lesions in posterior spinal structures (arthritis of costovertebral joints,costotransversal joints,zygapophyseal joints and en-thesitis of spinal ligaments).Patients with a long history of IBP had 27 lesions in vertebral bodies and 24 lesions in posterior spinal structures.Patients with a short history of IBP had significantly more lesions in posterior spinal structures than in vertebral bodies with 82.5% (33/40)vs 1 7.5% (7/40),respectively (P <0.01).In contrast,patients with a long history of IBP had significantly more inflammation in vertebral bodies with 79.4% (27/34)vs 20.6% (7/34),respectively (P <0.01).Conclusion Inflammatory spinal lesions in patients with a short history of IBP are seen more often in the posterior structures.Early detection of inflammatory spinal lesions by MRI is useful for early diagnosis of AS.

To retrospectively analyze the safety and efficacy of low dose rituximab regimen in patients with Epstein-Barr virus (EBV) infection after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Among 12 cases, 11 achieved complete remission (CR), 1 with partial remission (PR). Patients received 15 infusions with a median of 2.5(1-4) in each. The EBV DNA negative transformation period was 5-25 days with median 12 days. Low dose rituximab could be an alternative choice in patients with EBV infection after allo-HSCT.