Objective To probe into impacts of safflor yellow injection on rats with acute myocardial infarction and discuss its mechanism. Methods Forty Sprague-Dawley rats were divided into sham operation group ( 8 rats ) and operation groups(32 rats).The left anterior descending branch of coronary artery was ligated to establish an animal model with acute myocardial infarction.The rats with successful modeling were randomly divided into model control group, 3-, 7- and 14-days safflor yellow group.In the treatment group, the rats were injected with safflor yellow injection(2.5 mg.kg-1.d-1)for 3, 7 and 14 days, respectively.Rats in sham operation and model control group were injected 0.9% sodium chloride solution.Their weights were measured 24 h after the last drug administration, their hearts were removed, and the serum was obtained through centrifugation.The enzymic method was used to measure the lactate dehydrogenase(LDH)and creatine kinase(CK)contents of serum.Hematoxylin eosiny(HE)staining method was used to observe the change of myocardial cells.The chloride three phenyl-tetrazole( TTC) staining method was used to measure the area of myocardial infarction in the rats. The real-time fluorescent quantitative PCR method was used to measure the expression of VEGF and HIF mRNA at the marginal zone of myocardial infarction. Results The levels of LDH and CK were(106.12±35.52),(452.84±60.38)mmol.L-1 in sham operation group, and(385.66±137.58),(2 111.00±1 250.80)mmol.L-1 in model control group.LDH in 3-, 7-, 14-days treatment groups was (249.66±51.86),(104.33±51.08),(110.33±26.76)mmol.L-1, while CK was(1 713.00±584.74),(1 177.66±980.18), (421.33±54.60)mmol.L-1.LDH and CK levels of the 14-days treatment group were significantly lower than those in the model control group(both P<0.05).The area of myocardial infarction was (0.00±0.00)% in sham operation group,(13.12±6.69)% in the model control group, and(8.11±3.45)%,(7.01±2.98)%,(3.44±1.17)% in the 3-, 7-, 14-days treatment groups.The area of myocardial infarction in the 14-days treatment group was significantly lower than that of the model control group(P<0.05).The expression of VEGF and HIF mRNA was 1.99±0.27, 6.21±1.35 in the sham operation group, 1.03±0.15, 1.78±0.57 in the model control group.The expression of HIF mRNA in the 3-, 7-, 14-days treatment groups was 0.50±0.12, 1.23±0.24, 2.20± 0.32, and the expression of VEGF mRNA in the 3-, 7-, 14-days treatment groups was 0.43±1.27, 2.67±0.83, 5.78±1.23. Conclusion The safflor yellow injection has therapeutical effects on the rats with acute myocardial infarction, and the effects will become significant after 14 day.It can reduce the area of myocardial infarction and LDH and CK content at the drug administration groups, which might be related to the increase of the expression of VEGF and HIF mRNA.

Objective To describe the effect of loop diuretic on renal function in patients with chronic heart failure.Methods Data were of 211 impatients diagnosed as HF collected in a nested case-control study.The association of application of loop diuretic with renal function was assessed to identify whether loop diuretic was an independent risk factor of worsening renal function(WRF).To identify WRF,we defined serum creatinine level as a rise ≥26.5 μmol/L compared to the level at admission.Therefore,the subjects were divided into case group(serum creatinine level ≥ 26.5 μmol/L,n =66)and control group(serum creatinine level ＜ 26.5μmol/L,n =145).Results The doses of loop diuretic were higher in the case group([385.17 ± 49.37]mg)than the control group([244.50 ± 34.82]ag)(P ＜ 0.05),but it was not independent risk factor of WRF (P＞0.05).Creatinine level and NYHA class at admission were independent risk factor for WRF,with OR of 2.248(95 ％ CI:1.088-4.647)and 2.485(95 ％ CI:1.385-4.459)respectively(Ps ＜ 0.05).Conclusion The doses ofloop diuretic were not independent risk factor of WRF,creatinine level and severity of HF at admission are the most important predictors of the occurrence of WRF.

Objective To evaluate the effects of percutaneous cholecystostomy (PCT) for the treatment of acute cholecystitis (AC) in poor-risk patients.Methods A retrospective clinical analysis was undertaken in poor-risk AC patients receiving PCT or emergency cholecystectomy (CCY) from April 2007 to December 2012.The success rate,complications,hospital stay and mortality,and readmission rate were compared between PCT and CCY groups.Results Of the 51 poor-risk acute cholecystitis patients,25 underwent PCT drainages and 26 received emergency CCY at an average age of 75 and 74 years respectively.The average intensive care unit length of stay was 13 days in PCT group and 5 days in CCY group (t =5.175,P =0.001).The mean hospital length of stay in PCT patients (21.3 days) was longer than that in CCY patients (9.8 days) (t =3.213,P =0.002).However,there was no significant difference in the overall hospital mortality,complications and successful rate between the two groups.No recurrence was observed in 19 out of 25 PCT cases after removing PCT catheter.The remaining six patients were readmitted for recurrent AC.Three of them were conservatively treated,while another 3 patients had PCT drainage anew and one of the three underwent delayed CCY 4 weeks after PCT replacement.The overall successful rate of PCT treatment was 76％.Conclusions Compared with emergency CCY,PCT has similar treatment effects in the successful rate of surgical management,morbidity,and overall hospital mortality although it is associated with longer hospital stays and higher readmission rate,which indicated that PCT is a convenient,safe and effective treatment option for poor-risk AC patients.

ObjectiveTo explore the applied effects of microsurgical treatment on mesial temporal lobe epilepsy(MTLE)under the guidance of the intraoperative magnetic resonance imaging neuronavigation system.MethodsThe anterolateral temporal lobe,hippocampus and amygdala was resected by microsurgery under the guidance of the intraoperative magnetic resonance imaging neuronavigation system in 26 patients with intractable MTLE,with the help of electrocorticography monitoring during operation.ResultsAnterolateral temporal lobes were all resected in postoperative MRI and mesial structures certified to have atrophy or cirrhosis by pathology.All the patients were followed up from 3 to 6 months after the surgery.In 26 patients,twenty-three cases (88.5％) belonged in Engel grade I,two cases (7.7％) in grade Ⅱ and 1 case (3.8％) in gradeⅢ.No severe complications occurred and nervous functions were preserved well.ConclusionMicrosurgical treatment on MTLE under the guidance of the intraoperative magnetic resonance imaging neuronavigation system is effective due to epileptic focus all resected and protection for nervous functions,resulting in an accurate and safe improvemention of operation.

Standardized residency training is the only way for medical students to grow into clin-icians. At present, the number of under training residents in China has reached 190000 (excluding special-ized degree graduate students). It is very important to manage each stage of this training well, which is an guarantee for improving the effect of standardized training. The residents who attend the training are com-posed of "unit personnel" and "intra-industry social personnel", and after standardized and homogenized training, the two types of students have officially become the new force in the medical industry after passing the final examination. In order to do a good job in the management of standardized residency training, to achieve fine management at all stages , this paper focuses on the differences between the two types of students, analyzes in detail the characteristics of these two types of students in the recruitment, training and welfare guarantee stages. "Unit personnel" are given the security, supervision and containment of the origi-nal unit, while due to the pressure of job-hunting and the uncertainty of future welfare, "intra-industry so-cial personnel" are equipped with more initiative. Based on advanced management experience in Beijing,Shanghai, Sichuan and Tianjin, this paper aims to summarize the key points in management of the two types of students in training, propose countermeasures to the difficulties in management, innovative management solutions, and provide reference for the optimization management of standardized residency training.

This paper systematically discusses the construction of clinical skills information platform, including the goal, function design, module, content analysis of practical skills training and management system. The information platform for clinical skills training has played a significant role in innovating the teaching and management mode of clinical practice skills training, establishing a scientific assessment system, improving the clinical practice skills training system and enriching the teaching contents and means. At the same time, it has also promoted the communication between teachers and students during the clinical practice skills training, improved teachers' information-based teaching ability, and speeded up the construction of high-quality teachers.

Tandem occlusion of the anterior circulation is a specific acute large vessel occlusion, which is defined in most of the literature as a combination of intracranial large vessel occlusion and high degree of stenosis or occlusion of the ipsilateral extracranial internal carotid artery.Tandem occlusion is presented in approximately 15% patients with acute ischemic stroke in the anterior circulation who receive endovascular treatment. In patients with tandem occlusion, endovascular treatment is more effective than drug therapy; however, controversy still exists regarding the optimal management strategy of endovascular treatment. This article reviews the recent advance in endovascular treatment of tandem occlusion in the anterior circulation in recent years, to improve the overall care standard for acute ischemic stroke with tandem occlusion of the anterior circulation.

Early accurate detection of inferior myocardial infarction is an important way to reduce the mortality from inferior myocardial infarction. Regrading the existing problems in the detection of inferior myocardial infarction, complex model structures and redundant features, this paper proposed a novel inferior myocardial infarction detection algorithm. Firstly, based on the clinic pathological information, the peak and area features of QRS and ST-T wavebands as well as the slope feature of ST waveband were extracted from electrocardiogram (ECG) signals leads Ⅱ, Ⅲ and aVF. In addition, according to individual features and the dispersion between them, we applied genetic algorithm to make judgement and then input the feature with larger degree into support vector machine (SVM) to realize the accurate detection of inferior myocardial infarction. The proposed method in this paper was verified by Physikalisch-Technische Bundesanstalt (PTB) diagnostic electrocardio signal database and the accuracy rate was up to 98.33%. Conforming to the clinical diagnosis and the characteristics of specific changes in inferior myocardial infarction ECG signal, the proposed method can effectively make precise detection of inferior myocardial infarction by morphological features, and therefore is suitable to be applied in portable devices development for clinical promotion.
Algorithms ; Databases, Factual ; Electrocardiography ; Humans ; Inferior Wall Myocardial Infarction ; Support Vector Machine