Objective To study anticardiolipin antibody(ACLA)in elderly patients with essential hypertension(EH)and to investigate the influence of valsarta on the function of vascular endothelium.Methods The levels of ACLA were measured by an enzyme-linked immunoabsorbent assay in 120 patients with EH and 30 healthy controls.All parameters were compared in the EH patients with different stratification.Sixty elderly hypertension patients were treated with valsarta for 6 weeks of with the dose range from 80 to 160 mg/d and compared with 60 healthy elderly people before and after treatment by measuring the levels of ACLA.Results The concentration of ACLA were significantly higher in patients with risk,higher risk and very high risk group than those in healthy control group and patients with low risk group(P0.05).After 6 weeks of treatment with valsarta,systolic and diastolic pressures remarkably decreased and the levels of ACLA were decreased significantly;the higher the degree,the more notable the change of ACLA.Conclusion The patients with EH might have self-immunity.The results suggest that circulating ACLA might have clinical significance in forecasting the severity of EH.Valsarta is effective in treating hypertension,which may improve the function of vascular endothelium.

Objective To investigate the status and demands of prenatal education among pregnant women,and to provide reference for better prenatal education. Methods A total of 750 pregnant women were recruited from 20 hospitals in Chengdu and were investigated with a serf-designed questionnaire. Results 74.42% of the pregnant women had participated the prenatal education,25.58% of them didn't take even one prenatal class. The most preferred knowledge was newborn care. They most preferred to take prenatal classes at weekends in small group. The women's educational level,family income, delivery experience and times of prenatal check-up were the key factors to affect the participation in the prenatal educa-tion. Conclusions It is suggested to innovate the contents and means of prenatal education in order to attract the pregnant women to participate prenatal education actively.

Objective To investigate the clinical efficacy,safety and the correlation factors of recurrence of radiofrequency catheter ablation in treatment of atrial fibrillation.Methods The clinical data of 127 patients with atrial fibrillation having underwent circumferential pulmonary vein ablation guided by 3-D mapping system were analyzed retrospectively.Then they were followed up for 12 months.The status of patients after ablation and the success rate of ablation was recorded,then the relationship between the factors and the recurrence after ablation of atrial fibrillation was analyzed.Results After a follow up of 12 months,94 patients maintained sinus rhythm,and atrial fibrillation recurred in 33 cases.The first clinical success rate was 74.02％(94/127).Thirty-three patients with recurred atrial fibrillation received ablation again and 11 patients got success.The total clinical success rate was 82.68％ (105/127).The success rate of paroxysmal atrial fibrillation was 88.46％ (92/104) and success rate of persistent atrial fibrillation was 56.52％ (13/23).Univariate analysis showed that the type,the course,the diameters of left atrial,the early recurrence,the body mass index were related to the recurrence of atrial fibrillation,and multivariable Logistic analysis revealed only the type and the diameters of left atrial were independent risk factors responsible for the recurrence of atrial fibrillation (P ＜ 0.05).Conclusion Radiofrequency catheter ablation in treatment of atrial fibrillation is effective and safe,and the type and the diameters of left atrial are independent risk factors responsible for the recurrence of atrial fibrillation.

Objective To investigate the diagnostic value of the T-SPOT.TB test for diagnosing tuberculous meningitis(TBM) by meta-analysis.Methods A systematic retrieval from the databases of PubMed,EMBASE,etc.was performed.The literature on the T-SPOT.TB test for diagnosing TBM was collected.Two reviewers independently screened the literature,extracted the data and judged the quality.The meta analysis was conducted by the Meta-Disc 1.4 software.Results 8 articles were included,involving 425 patients including 232 cases of TBM.In the peripheral blood group,the combined sensitivity was 80%(95%CI:0.74-0.85),the combined specificity was 74%(95%CI:0.67-0.80),the area under the curve(AUC)of summary receiver operating characteristic (SROC)was 0.858 7;the diagnostic odds ratio(DOR)was 15.50.In the CSF group,the combined sensitivity was 76%(95%CI:0.70-0.82),the combined specificity was 83%(95%CI:0.77-0.88),AUC was 0.892 7;DOR was 22.62.Conclusion Adopting the T-SPOT.TB test conduces to increase the diagnostic rate of TBM.The diagnostic accuracy of the T-SPOT.TB test for CSF may be higher than that for peripheral blood.

The First Affiliated Hospital of Zhejiang University founded an online hospital campus leveraging the Internet-plus environment. Supported by the offline hospital, this campus made full use of Internet features and advantages in its attempts to optimize the distribution of medical resources,to improve the accessibility of medical service, to reduce medical costs, and to expand the service coverage among others. Meanwhile,this online system, via interconnection with the hospital′s HIS system, achieved online medical insurance payment,prescriptions checking and drug delivery service.

Objective To conclude nursing experience of full series artificial liver support system in the treatment of acute fatty liver in pregnancy. Methods Development of artificial liver support system according to patient's condition, total continuous renal replacement therapy 7days, double plasma molecular absorb system 3 times, plasma replacement 3 times, molecular adsorbent circulation system 2 times. Results After treatment, the patient was discharged after 20 days in hospital. Conclusions The full range of artificial liver support system can effectively treat the patients with acute fatty liver in pregnancy, it will greatly reduce the mortality of patients with acute fatty liver in pregnancy.

Objective:To explore the effect of Yifei-Huoxue Decoction combined with conventional western medicine on patients with oxidant-antioxidant imbalance with COPD. Methods:A total of 102 patients who met the inclusion criteria from January 2016 to December 2018 were divided into two groups, according to the random table method, 51 cases in each group. The control group was treated with conventional western medicine, while the research group was treated with Yifei-Huoxue Decoction based on control group. Both the two groups were treated for 14 days. The traditional Chinese medicine symptom scores of the two groups were compared before and after the treatment. The forced expiratory volume in one second/predicted value ratio (FEV1%pred) was measured by pulmonary function instrument, FEV1/forced vital capacity (FVC) was calculated. Partial pressure of oxygen (PaO 2) and partial pressure of carbon dioxide (PaCO 2) were measured by blood gas analyzer. The levels of MDA, SOD and Glutathioneperoxidase (GSH-Px) were detected by ELISA, and the clinical effect was evaluated. Results:The total effective rate of research group was 98.0% (50/51), the control group was 80.4% (41/51), and the difference between the two groups was statistically significant ( χ2=8.254, P=0.004). After the treatment, the scores of cough, expectoration, asthma, panic, chest distress and fatigue in the research group were significantly lower than those of the control group ( t values were 3.716, 6.524, 5.032, 2.516, 4.804 and 2.882, respectively, all Ps<0.05). After the treatment, the FEV1%pred (68.05% ± 6.11% vs. 59.02% ± 5.45%, t=7.876), FEV1/FVC (60.10 ± 5.83 vs. 54.05 ± 5.07, t=5.592), PaO 2 (67.79 ± 3.82 mmHg vs. 60.63 ± 3.55 mmHg, t=9.805) in the research group were significantly higher than those of the control group ( P<0.05), the PaCO 2 (56.08 ± 2.25 mmHg vs. 61.14 ± 2.13 mmHg, t=11.663) was significantly lower than that of the control group ( P<0.01), the levels of serum MDA (3.21 ± 0.63 μmol/L vs. 4.95 ± 0.87 μmol/L, t=11.568) was significantly lower than that of the control group ( P<0.01), the levels of SOD (73.35 ± 8.97 μU/ml vs. 61.68 ± 7.82 μU/ml, t=7.003), GSH-Px (170.35 ± 17.72 U/ml vs. 149.14 ± 15.04 U/ml, t=6.517) were significantly higher than those of the control group ( P<0.01). Conclusions:The Yifei-Huoxue Decoction combined with conventional western medicine could improve the lung function of children with COPD , adjust the imbalance condition of oxidation/antioxidation, so as to improve the clinical effect.

Objective To analyze and compare the curative effect of thoracic laparoscopy combined with resection of esophageal carcinoma and conventional three incision resection of esophageal carcinoma .Methods From January 2012 to January 2016,sixty-two patients received esophageal cancer resection in Shanxi Provincial Cancer Hospital were selected in the research.The patients were divided into laparoscopic group (28 cases) and traditional group(34 cases) according to surgical methods ,and they were treaded with thoracic laparoscopy combined with resection of esophageal carcinoma and three incision resection of esophageal carcinoma ,respectively.The amount of blood loss , the number of lymph node dissection ,the postoperative 1d flow,the ventilator use of 24h and the number of tracheotomy were recorded.The time of hospitalization,the time of closed drainage and the incidence of postoperative complications were recorded and compared between the two groups at discharge time.Results The operative time,amount of blood loss,drainage volume,drainage time and hospitalization time of the laparoscopic group were (3.22 ±0.64)h,(218.20 ± 45.42)mL,(235.67 ±42.15)mL,(3.32 ±1.81)d,(14.28 ±2.53)d,respectively,which were significantly lower than those of the traditional group [(4.52 ±1.11)h,(407.42 ±50.06)mL,(321.71 ±37.82)mL,(5.16 ±1.78)d, (17.35 ±4.38)d,t＝5.764,15.438,8.465,4.020,3.448,all P＜0.05].The incidence rates of pulmonary infection and atelectasis in the laparoscopic group were 3.57% and 0.00%,respectively,which were significantly lower than those in the traditional group (23.53% and 17.65%,χ2＝4.929,5.471,all P＜0.05).The ventilator -assisted breathing rate and postoperative tracheotomy rate of the laparoscopic group were both 0.00%,which were significantly lower than those of the traditional group (23.53%and 14.71%,χ2＝7.564,4.479,all P＜0.05).Conclusion It is safe and reliable to complete lymph node dissection and surgical treatment of thoracic laparoscopy combined with resection of esophageal carcinoma,and compared with conventional three incision resection of esophageal carcinoma it has the advantages of small trauma,low incidence rate of complication and fast recovery,which is worthy of further promotion.

Objective: To study the effect of doxofylline on acute exacerbation of chronic obstructive pulmonary disease (COPD) and reduce the risk of early recurrence. Methods: From January 2016 to January 2018, 164 patients with acute exacerbation of COPD in Binzhou Central Hospital were randomly divided into two groups by random digital table: control group (n=82) and observation group (n=82). The control group was given tiotropium bromide and budesonide/formoterol.The observation group was treated with oral doxophylline bid for 8 weeks on the basis of inhaled drugs.The recovery time, acute exacerbation rate, FEV₁, CAT score and 6-minute walking test were compared between the two groups. Results: The time of convalescent stage in the observation group was shorter than that in the control group[(16.89±5.15)d vs.(19.12±6.29)d, t=2.48, P=0.014], and the acute exacerbation rate of the observation group was lower than that of the control group (26.83% vs.41.46%, χ²=4.58, P=0.032). There was no statistically significant difference in FEV₁[(45.59±9.82)% vs.(44.26±9.03)%, t=0.90, P=0.369], and the CAT score of the observation group was better than that of the control group [(19.32±6.16)points vs.(21.71±6.62)points, t=2.39, P=0.018]. The 6-minute walking distance of the observation group was longer than that of the control group[(146.32±10.20)m vs.(135.69±11.59)m, t=6.23, P=0.000], and the finger pulse oxygen of the observation group was higher than that of the control group[(94.12±5.09)% vs.(92.06±6.21)%, t=2.23, P=0.026]. The respiratory rate in the observation group was slower than that in the control group[(20.38±7.32)times/min vs.(22.86±6.53)times/min, t=2.29, P=0.023], and there was no statistically significant difference in heart rate[(98.24±12.35)bpm vs.(101.38±15.03)bpm, t=1.46, P=0.146]. No serious adverse drug reactions were found in both two groups. Conclusion As a beneficial supplement of inhaled drugs in convalescent COPD, doxofylline can shorten the recovery time, reduce the early acute exacerbation rate and improve the symptoms, which is worthy of clinical reference.

ObjectiveTo investigate reproducibility of cardiac MRI for assessment of cardiac morphology and ventricular function in selected normal Chinese Han population.MethodsTwo hundred and sixty-nine normal volunteers underwent cardiac MRI using a 1.5 T MR system.HASTE and steady state free precession imaging were performed with long and short axis images and cine mode through the ventricle with wireless vector cardiac gating.The images were reviewed by two independent observers.The dimensions of cardiac chambers and ventricular function including ejection fraction (EF),end diastolic volume( EDV),end systolic volume (ESV) and myocardial mass were evaluated.The data between male and female were compared by using two-tailed unpaired t test.Results Total imaging time was (15 ± 3 ) min.The anteroposterior diameter of the left atrium was( 2.87 ± 0.77 ) cm,the right atrial diameter perpendicular to the atrial septum was ( 3.61 ± 0.57 ) cm,the end diastolic diameter of the left ventricle was (4.97 ±0.52) cm,the end diastolic diameter of the right ventricle was (2.65 ± 0.48) cm.On the left ventricle,EF was(60.62 ±7.08)％,EDV was (115.37 ±26.71) ml,ESV was (46.02+15.72) ml and LV mass was ( 82.97± 24.03 ) g.On the right ventricle,EF was (47.73 ± 6.50 ) ％,EDV was ( 128.27 ± 32.16 )ml,ESV was (67.7 ± 21.07) ml and RV mass was (48.24 ± 13.42) g.There were no statistically significant differences in LVESV( P =0.144 ),LVEDV index ( P =0.714 ),LVESV index ( P =0.113 ),LVCI ( P =0.199),RVEF ( P =0.296 ) and RV mass ( P =0.093 ),and statistically significant differences in other cardiac parameters between male and female.Conclusion Cardiac MRI can provide useful information about cardiac function and morphology with a high level of reproducibility in normal Chinese Han population.