Objective The cardiac synchronization therapy (CRT) was proven to have good treatment for the cardiac conduction disorders patients with serious heart failure. But many disadvantages were gradually be noticed, such as difficulty of sinus electrode implantation, coronary sinus injury and bleeding, still one third CRT cases remain unchanged cardiac function.Recently the epicardial lead CRT therapy by the cardiac surgeons appears promising to provide better clinic resynchronization.The aim of this research is to explore the clinical value of surgical epicardial lead CRT for the cardiomyopathy heart failure with micro-invasive thoracoscopy techniques. Methods During April 2007 to Sep 2009 eleven patients were diagnosed as advanced heart failure with cardiac dysynchronization proven by the ECG and tissue Doppler echo examination. The dysynchronization parameters of tissue Doppler echo includes left ventricle maximize delay time , the left dysynchronization index (Ts-SD), the inter-ventricle mechanical delay time (IVMD), left ventricle end-dilation diameters (LVEDD) and the left ventricle ejection fraction (LVEF). All the patients got the consent agreement before the surgery. In the hybrid operation room the right atrial and ventricle endocardial electrodes were placed firs guided by X ray under the general anesthesia and double lumnen incubation. Then the thoracoscope techniques were used to explore the left ventricle lateral wall. The right atrial and ventricle electrodes were connected into the three chamber pacemaker. The Tissue Doppler Echo TEE technique was used to check which part of the left ventricle lateral wall is suitable for the idea CRT therapy. Usually the latest activated part of the left ventricle wall is the goal place. Then the epicardial electrode was fixed with 4-0 prolene suture at the idea place. All the cases were performed by the same surgeons group in the same medical center. The resynchronization features were examined after surgery and during the follow up. Results The endocardial and epicardial electrodes were implanted successfully without any serious complication. All patients were weaned and discharged without any adverse cardiac episodes. There is no mortality during the follow up period. All the patients received the β-blokers, diuretics, ACEI/ARB and other traditional medicine for the heart failure.The Tissue Doppler showed the E peak wave separated form the A peak which means the good resynchronization between the atrium and the ventricle. After surgery during the follow up the left ventricle maximize delay time decreased from (393.4 ±40.2 ) ms to ( 102.1 ± 34.6) ms, the left dysynchronization index (Ts-SD) decreased from (145.2±29.3)ms to(51.0±21.4) ms, the inter-ventricle mechanical delay time (IVMD) decreased from (59.1 ±23.4) ms to (31.2 ± 11.5 ) ms, left ventricle end-dilation diameters increased from (73.1 ± 13.4) mm to (63.2 ± 6.7) mn and the left ventricle ejection fraction increased from 0.32 ±0.04 to 0.41 ±0.07. Conclusion The micro-invasive surgical synchronization therapy could get good CRT result for the cardiomyopathy heart failure patients. Some patients traditionally in the waiting list for the heart transplant could be considered for the CRT therapy candidates.

Baizi Yangxin tablets are common Chinese medicine used for the treatment of heart palpitations, insomnia and irritable forgetful. To evaluate the total amount of heavy metals evaluation, artificial gastric juice was used as juice samples and the extracted soluble heavy metals were extracted by microwave digestion technology. An analytical method of bionic extraction microwave digestion with inductively coupled plasma mass spectrometry ( ICP-MS ) was established for the determination of trace metals, such as Co, Cr, Cu, Ba, Cd, Mn, Ni, Pb, Hg, Sr and Zn, in 18 batches of Baizi Yangxin tablets. The correlation coefficient of linear regression equation for different elements ranged from 0. 9989 to 1. 0000, the detection limit was 0. 19-5. 6 μg / L, and the repeatability of the method was less than 6. 2% , the precision of the RSD value was less than 5. 6% , and the recovery rate was 87. 7% -101. 9% . According to “the standard of the heavy metal in the standard of import and export of medicinal plants and preparations”, the contents of Cd, Cu and Pb in the 18 batches were not exceed the standard, but the Hg content (7. 68 mg / kg) exceeded the standard value. The bionic extraction-ICP-MS method provide a reference basis for the safety of the proprietary Chinese medicine's study.

OBJECTIVE:To study the econamics effect of risperidone and quetiapine in treating of schizophrenia.METH ODS:64schizophrenia patients were randomly divided into risperidone group(34cases)and quetiapine group(30cases).The effects were evaluated based on the reduction of scores determined by brief psychiatric rating scale(BPRS);the adverse effects were evaluated by treatment emergent symptom scale(TESS).And then the cost-effectiveness analysis was carried through.RESULTS:The per capita costs for risperidone and quetiapine were3598.85yuan and3778.63yuan respectively;the re-duction of BPRS scores were(36.09?15.52)and(25.03?14.45)respectvely;the respective cost-effect ratio was99.72yuan and150.96yuan;the increment of the cost-effect ratio for the quetiapine group was-16.25compared with the risperidone group.CONCLUSION:Risperidone is more economical than quetiapine in the treatment of schizophrenia.

OBJECTIVE:To study the analgesic effect and mechanism of Gutongtie paste on model rats with formaldehyde-in-duced pain. METHODS:60 SD rats were randomly divided into blank group,model group,Gutongtie paste low-dose,medi-um-dose,high-dose groups(0.594,1.188. 2.376 g/paste,containing crude drug 0.48,0.96,1.92 g)and prednisone acetate group (ig,0.0054 g/kg,external bonding matrix). Model rats with pain was induced by formaldehyde method and immediately adminis-trated after modeling. Electronic tenderness instrument was adopted to determine the pain threshold of rats'ankle joint after adminis-tration of 1,2,3,4,6 h. After 6 h,blood sample 0.3 mL was taken from abdominal aorta then rats were sacrificed. Enzyme linked immunosorbent assay (ELISA) was conducted to determine the β-endorphin (β-EP),prostaglandin E2 (PGE2) contents;spectrophotometry was used to determine nitric oxide(NO)content in rats'serum and inflammatory tissue;and radioimmunoassay was adopted to detect the substance P content in rats'serum,inflammatory tissue and brain tissue. RESULTS:Compared with be-fore modeling,pain thresholds in model group at each period were significantly decreased (P<0.05 or P<0.01). Compared with blank group,PGE2,NO of rats,substance P content in inflammatory tissue and brain tissue in model group were significantly in-creased (P<0.05 or P<0.01). Compared with model group,pain thresholds in Gutongtie paste groups at corresponding time points were increased,PGE2 and substance P contents in inflammatory tissue and brain tissue were decreased (P<0.05 or P<0.01);β-EP and NO contents in serum in Gutongtie paste medium-dose,high-dose groups(P<0.05 or P<0.01),NO contents in serum in Gutongtie paste high-dose group were decreased(P<0.05). CONCLUSIONS:Gutongtie paste has a certain analgesic and anti-inflammatory effect,and the mechanism may be related to reducing PGE2, NO, substance P contents, increasing β-EP content.

Objective : To investigate the behavior problems and influencing factors of school-age students from the third to the sixth grade in Zhongshan,and to provide evidence for early intervention of behavior problems in children. Methods : According to the proportion of population in urban area and township in Zhongshan,students of Grade Three to Six from eight primary schools（three in urban area and five in township）were recruited by stratified sampling method. The behavior problems in children were assessed by the Conners Parent Symptom Questionnaire（PSQ）. Sociodemographic information,family discipline and so on was investigated by a general questionnaire. The influencing factors for behavior problems were analyzed by a logistic regression model. Results : A total of 2 292 questionnaires were issued,and 2 236 valid questionnaires were recycled,with an effective rate of 97.56%. The positive rate of behavioral problems was 11.72%. The results of multivariate logistic regression analysis showed that the risk factors for behavior problems were females（OR=1.594,95%CI：1.170-2.171）,birth asphyxia（OR=2.372,95%CI：1.320-4.261）,main family discipline（laissez-faire：OR=3.326,95%CI：1.450-7.630;doting：OR=3.244,95%CI：1.867-5.638;autocratic：OR=2.609,95%CI：1.584-4.296,mixed：OR=2.313,95%CI：1.669- 3.207）,less than four hours per week for father-child communication（OR=1.551,95%CI：1.052-2.286）,negative life events（OR=2.188,95%CI：1.448-3.308）,living in township（OR=2.031,95%CI：1.330-3.102）,academic performance （average：OR=2.786,95%CI：1.868-4.156;poor：OR=6.665,95%CI：3.236-13.727;very poor：OR=25.068,95%CI：5.786-108.617）;the protective factors were occupation of mother as civil servants or professional personnel（OR=0.449,95%CI：0.238-0.844）and higher grades（Grade Five：OR=0.496,95%CI：0.339-0.727;Grade Six：OR=0.468,95%CI：0.309-0.710）. Conclusion Females,birth asphyxia,main family discipline,less communication between father and child,occupation of mother,negative life events,place of residence,academic performance and grade were the influencing factors for behavior problems.

BACKGROUND: Obtaining synovial fluid for diagnostic test of periprosthetic joint infection is invasive and painful to patients. Platelet count is a regular blood test which has been used as a possible predictor of several infectious diseases. Presumably, it could be one of the indicators of periprosthetic joint infection. OBJECTIVE: To identify the accuracies of platelet combined with white blood cell, erythrocyte sedimentation rate or C-reactive protein in the diagnosis of periprosthetic joint infection. METHODS: Patients undergoing revision arthroplasty from March 2013 to December 2018 in the First Affiliated Hospital of Guangzhou University of Chinese Medicine were retrospectively enrolled. A diagnosis of periprosthetic joint infection was confirmed in 77 patients according to the criterions from the Musculoskeletal Infection Society; the remaining 137 patients were confirmed as aseptic cases. White blood cell, erythrocyte sedimentation rate, or C-reactive protein and platelet count were compared between the two groups. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated. RESULTS AND CONCLUSION: The platelet values were significantly increased in periprosthetic joint infection cases. Sensitivity and specificity of the platelet for periprosthetic joint infection were 64.94％ and 86.13％, respectively. Platelet demonstrated a higher accuracy when compared to erythrocyte sedimentation rate and C-reactive protein. In such cases, the platelet shows a certain reference value in confirming the diagnosis of periprosthetic joint infection. Platelet was enough used as adjunct diagnostic tool in patients suspected with periprosthetic joint infection.

OBJECTIVETo study the protective effects of garlic oil (GO) on the peripheral nerve injuries induced by n-hexane.

METHODSMale Wistar rats were randomly divided into four groups (10 rats in each group): the control, the n-hexane treatment (2000 mg/kg), the low dose GO, and the high dose GO groups. The rats in the low and high doses of GO groups were pretreated with GO (40 and 80 mg/kg) before exposure to n-hexane (2000 mg/ kg), while the animals of the n-hexane treatment group were given normal saline and then 2000 mg/ kg n-hexane. The rats were exposed to GO and n-hexane 6 times a week for 10 weeks. The gait scores and staying time on the rotating rod for all rats were detected every two weeks. The rats were sacrificed at the end of ten weeks, then the levels of alcohol dehydrogenase (ADH), maleic dialdehyde (MDA), reduced glutathione (GSH), glutathione peroxidase(GSH-Px), total antioxidation capacity(T-AOC) and the ability of inhibition of *OH in livers were examined.

RESULTSThe gait scores increased significantly and the time staying on the rotating rod obviously decreased in rats of n-hexane treatment group, as compared with control group (P < 0.05 or P < 0.01). In the hepatic tissues of n-hexane group, the levels of MDA and ADH significantly increased, the activities of GSH-Px, T-AOC and the ability of inhibition of *OH obviously decreased, as compared to control group (P < 0.05 or P < 0.01). In 2 GO groups, the gait scores and the staying time on the rotating rod were significantly improved, the levels of MDA and ADH significantly decreased, the activities of GSH-Px, T-AOC and the ability of inhibition of *OH obviously increased, as compared with n-hexane group (P < 0.05 or P < 0.01 ).

CONCLUSIONADH could play an important role in the protective effects induced by garlic oil on the peripheral nerve injuries produced by n-hexane.

Alcohol Dehydrogenase ; metabolism ; Animals ; Garlic ; Hexanes ; toxicity ; Lipid Peroxidation ; drug effects ; Liver ; enzymology ; metabolism ; Male ; Neuroprotective Agents ; pharmacology ; Peripheral Nerve Injuries ; chemically induced ; metabolism ; Plant Oils ; pharmacology ; Rats ; Rats, Wistar

OBJECTIVESTo study the contribution of the genes and environment to variation of serum levels of lipids and lipoprotein.

METHODSOne hundred and forty-three healthy monozygotic (MZ) twin pairs and 93 dizygotic (DZ) ones aged 5 to 19 [with a mean of (11.2 +/- 3.4) years]. Microsatellite polymorphism (STR) was used to diagnose zygosity of twins, and intraclass correlation coefficient method and Falconer formula were performed to investigate heritability of serum lipids and lipoproteins unadjusted or adjusted for age and sex. Logarithmic transformation was used for data with skewed distribution. Influence of relevant physical and biochemical indicators on serum lipids and other components was analyzed with partial coefficients of correlation adjusted for age and sex.

RESULTSIn the twin samples, difference in serum level of triglycerides (TG) between MZ and DZ was not statistically significant with intraclass variation and intraclass correlation. There was significant difference in serum levels of total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), and lipoprotein [Lp(a)] between MZ and DZ, with their heritability estimates of 0.56, 0.55, 0.49 and 0.58 unadjusted, respectively, and 0.63, 0.63, 0.55 and 0.64 adjusted for age and sex, respectively. Serum levels of TC, HDL-C, LDL-C and Lp(a) correlated reversely with age. Serum levels of TC, HDL-C and LDL-C in girls were slightly higher than those in boys. Most indicators for serum levels of lipids and lipoprotein, except for serum level of Lp(a) correlated with body mass index (BMI), body fat ratio, Pelidisi index, and other indexes such as blood pressure, blood sugar, serum level of calcium, adjusted for age and sex.

CONCLUSIONSSerum levels of TC, HDL-C and Lp(a) were influenced more greatly by genetic factors, and serum level of TG was mainly influenced by environmental ones. Levels of blood lipids in children were influenced by age and sex, and correlated with indicators that reflect their body fat and nutritional status.

Adolescent ; Adult ; Age Factors ; Child ; Cholesterol, HDL ; blood ; genetics ; Cholesterol, LDL ; blood ; genetics ; Female ; Humans ; Lipids ; blood ; genetics ; Lipoproteins ; blood ; genetics ; Male ; Sex Factors ; Triglycerides ; blood ; genetics ; Twin Studies as Topic ; Twins, Dizygotic ; Twins, Monozygotic

Objective To select the optimum process of granule spray for Tangwang Mingmu Granules, To improve the yield and finished product quality. Methods The effects of the relative density, the type of excipients, the ratio of the extract and the excipient, the inlet temperature-the material temperature, the spray rate and the atomization pressure were selected by single factor and orthogonal test respectively to determine the optimum preparation process. Validation for three batch sample, particle flow, hygroscopicity and other related content of the preparation were studied. Results The optimum spray granulation process of Tangwang Mingmu Granules: the relative density of extract (60 ℃ determination) was 1.15–1.20; the excipient was selected as dextrin; the ratio of dry extract and excipient was 58:42; inlet temperature - material temperature was 90-75 ℃; atomization pressure was 0.12 mPa;spray rate was 10 Hz.Conclusion The preparation technology of Tangwang Mingmu Granules optimized in this study is with high preparation rate, good fluidity and hygroscopicity, which can be used for the preparation of Tangwang Mingmu Granules.

Objective To establish a simple and specific method for the determination of rhaponticin in Rhei Radix et Rhizoma. Methods A comparison of the methods of polyamide, silica gel TLC and HPLC in the determination of rhaponticin was studied to investigate the optimum way to identify authentic Rhei Radix et Rhizoma. Results The durability of polyamide and silica gel TLC method for the determination of rhaponticin in Rhei Radix et Rhizoma was poor. HPLC method was more suitable for the detection of rhaponticin. Conclusion HPLC method is accurate and reliable, and can be used for the quality control of Rhei Radix et Rhizoma and provide references for the authenticity of Rhei Radix et Rhizoma.