Objective: To study the examination of coronary sinus (CS) and blood flow by transthoracic echocardiography(TTE) and transesophageal echocardiography(TEE).Methods: Thirty patients with supraventricular tachycardia were studied by TTE and TEE. The CS was visualized using modified 4 chamber view. The position of the probe was optimized until the coronary sinus with its ostium into the right atrium could be visualized. CS flow recordings were performed by TEE with Doppler sample volume placed in the CS within a distance of no more than 10 mm from its ostium. Results: In all patients the angle between the doppler beam and the long axis of the CS was <30°. The CS was fully displayed in 18 patients by TTE and 28 patients by TEE. The length and width of the CS were (16.53±2.57) mm and (4.51±1.30) mm by TTE, (24.11±2.46) mm and (5.06±0.97) mm by TEE.The CS flow was characterized by biphasic flow.Its flow velocity was (39±7.8), (31±6.1) and (21±4.7) cm/s respectively. The CS flow velocity-imeintegral was(43±11.6),(43±13.0),(27±8.2) cm/s. Conclusion: Echocardiography is reliable for detecting CS and its flow. TTE is more feasible for detecting CS and its flow than TEE.

Objective To investigate the early diagnosis of vitiligo and its differential diagnosis from other depigmentated diseases using polarized light dermoscopy(PD)imaging analysis.Methods Patients with localized depigmented macules were enrolled into this study.PD was used to observe the micromorphology,feature and color of skin lesions.Histopathology was performed to confirm the diagnosis of all cases except for those of pityriasis versicolor which were confirmed by clinical and laboratory examination.Results Of the 176 patients.97 were diagnosed as vitiligo.Residual perifollicular pigmentation Was observed in 91.94%(57/62)of patients with progressing vitiligo and 62.86%(22/35)of those with stable vitiligo,with significant difference between the two groups of patients(P<0.05).However.residual perifollicular pigmentation was absent in the 79 non-vitiligo depigrnented cases.The presence of telangiectasia,early reservoirs of pigmentation and perilesional hyperpigmentation were related to the stage of vitiligo and treatment history of patients.Conclusions PD,which efficiently eliminates the interference of reflected light on skin lesions of vililigo,is an imaging technique that allows for the visualization of minor structures and features of the skin lesions that are indiscernible to naked eyes.In a nutshell,the application of PD has offered references to the early diagnosis of vitiligo and its differential diagnosis from other depigmentation diseases.

Objective To investigate the value of image analysis technology of polari-light dermoscopy (PD) in diagnosing head and face tumors. Methods We randomly collected the head and face tumors from the patients in this hospital, and then diagnosed them with naked eyes and PD, respectively. After making sure the diagnosis by histopathology, we analyzed the results retrospectively. Results We summarized the diagnostic signs of 211 head and face tumors on dermoscopy, which shown a great specificity. Its diagnosis rate reached to 92.89 %, obviously higher than that (69.67 %)with naked eyes. Due to clinical misdiagnosis and erroneous treatment, the recurrence rate of skin lesions was 19.91 %. The top 3 of head and face tumors, in turn, was seborrheic keratosis, melanocytic tumor and basal cell carcinoma. Conclusions PD is a non-invasive image analysis technology, which is especially applicable to the early diagnosis of head and face tumors. It can make sense in decreasing blind biopsy, directing surgical excision areas effectively, and selecting reasonable remedy. It also has great significance in the recovery and beauty of skin lesions.

Objective To evaluate the efficacy of angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) in the treatment of idiopathic pulmonary fibrosis through the method of system evaluation. Methods A computer-based online search of Pubmed, Embase, Cochrane Library, CNKI, CBM and Wanfang were used for database retrieval. Revman 5.0 was used to assess the bias of the included studies. The Stata 14.0 was used to evaluate the extraction indexes of efficacy, p (O2), p (CO2), DLco, FEV1 and VC. GRADE score was used to evaluate the level of evidence. Results A total of 17 articles (related with 1381 patients) were included in this study, including 14 studies using ARB and 3 studies using ACEI. Compared with the control group ACEI and ARB drugs showed advantages in the treatment of pulmonary fibrosis (RR=1.34, 95%CI:1.24-1.44, Z=7.81, P<0.001). Auxiliary index analysis showed that the test groups were treated with enalapril (SMD=0.72, 95%CI:0.21-1.22, Z=2.77, P=0.006), telmisartan (SMD=3.86, 95%CI:2.44-5.27, Z=5.35, P<0.001), valsartan (SMD=1.94, 95%CI:1.33-2.55, Z=6.27, P<0.001) and captopril (SMD=0.60, 95%CI:0.11-1.09, Z=2.41, P=0.016), the p(O2) levels were significantly improved in patients ≥65 years old (SMD=0.76, 95%CI:0.52-1.00, Z=6.18, P<0.001) and patients < 65 years old (SMD=3.97, 95%CI:2.61-5.32, Z=5.73, P<0.001), and disease duration≥5 years (SMD=1.39, 95%CI:0.45-2.33, Z=2.89, P=0.004) and disease duration<5 years (SMD=3.26, 95%CI:2.06-4.46, Z=5.34, P<0.001) compared with those of control group (SMD=2.95, 95%CI:1.95-3.94, Z=5.82, P<0.001). The curative effect of telmisartan was better than that of other drug groups (P < 0.001), and which was much better for patients under 65 years old (P<0.001). There was no significant difference in the disease duration between two groups (P=0.307). The p (CO2) levels were significantly improved in patients treated with telmisartan [SMD=-12.94,95%CI:(-14.01)-(-11.86),Z=23.51,P<0.001), valsartan [SMD=-1.95,95%CI:(-2.56)-(-1.34),Z=6.29,P<0.001] compared with those of control group [SMD=-11.13,95%CI:(-17.03)-(-5.24),Z=3.70,P<0.001]. The effect of telmisartan was better than that of valsartan (P<0.001). In addition, values of DLco (SMD=0.64, 95%CI:0.45-0.83, Z=6.72, P<0.001), FEV1 (SMD=1.19, 95%CI:0.52-1.86, Z=3.47, P<0.001) and VC (SMD=0.51, 95%CI:0.16-0.85, Z=2.85, P=0.004) were improved in test group compare with those of control group. And the GRADE scores of relevant indexes were low quality to moderate quality. Conclusion ACEI and ARB can improve the efficacy, the p (O2) and p (CO2) in the treatment of pulmonary fibrosis. Patients with age<65 years old and treated with telmisartan have the best curative effect, and which is not related to the disease duration.

Objective To investigate the factors for retinopathy in premature infants. Methods Ophthalmologic mydri was conducted in premature infants and acording to the international classification of ROP, they were diagnosed as ROP. The risk factors of the incidence of ROP were statistically and respectively analyzed. Results Among total of 47 patients, 11 patients were found retinopathy of prematurity. Conclusion The body weight is lower, the gestation is shorter, incidence of ROP is the higher.

To estimate the tolerance limit and the tolerance interval of disease incubation,under the theory that the observations(samples)were subject to Poisson distribution,the tolerance limits and tolerance interval of disease incubation were calculated based on beta-distribution with integer parameter.Expressions on the relation were obtained,including the statistics on tolerance limits of both minimum and maximum orders while the tolerance was the difference between minimum and maximum order statistics and the parameters of Poisson distribution on the sample size.Using the incomplete observations as an example,reasonable unit of sample size was considered and chosen.

AIM:To establish a screening model based on muscarinic receptor type 1(M1) for drugs against Alzheimer's disease (AD). METHOD: Human M1 receptor was expressed in HEK293 (human embryonic kidney) cells, and its activation was measured by the intracellular cAMP (cyclic AMP) level. Exogeneous 3H-cAMP was used to compete the intracellular cAMP binding sites. Acetylcholine chloride was used as a positive drug to ensure the sensitivity of this model. RESULT: HEK293 cell expressing system of human M1 receptor was established. Different concentrations of acetylcholine chloride (10-9～10-4 mol/L) activation of M1 receptor leads to an increase of intracellular cAMP 10.343×10-4～33.754×10-4 pmol/μl. CONCLUTION:This screening model has positive response to M1 receptor agonist and can be used for drug screening.

Objective To investigate the relationship between the relevant platelet parameters and the thromboelastographic in-dexes with the the occurrence and development of diabetic vascular complications so as to early find the high-risk group of vascular complications or early patients .Methods According to the WHO diagnostic criteria for diabetes ,268 patients with diabetes and 80 retired people with the physical examination (normal control group) were selected as the research subjects .268 cases were divided into the group A(HbA1c <6 .2% without vascular complications) the group B(HbA1c >6 .5% without vascular complications) and the group C(HbA1c >8 .0% with vascular complications ) .The Siemens ADVIA2120 fully automatic blood analyzer was adopt-ed to detect the platelet parameters of mean platelet volume (MPV) ,platelet distribution width(PDW) ,large-platelet(L-PLT) , MPM and mean platelet concentration(MPC);The TEG@ 5000 coagulation analyzer was adopted to perform the thromboelastogra-phy for detecting the values of R ,K ,Angle A and MA .All obtained data were statistically analyzed .Results L-PLT in the group B and the platelet parameters in the group C had statistical differences compared with the normal control group (P<0 .05) .The val-ues of R ,K ,Angle A in the group B and the values of R ,K ,Angle A and Ma in the group C had statistical differences compared with the normal control group (P<0 .05) .Conclusion Relevant platelet parameters and the thrombelastogram detection have the important significance to help to the clinical diagnosis of diabetic angiopathy ,guide the treatment and the condition monitoring ;the thrombelastogram is more sensitive than the detection of the relevant platelet parameters in early finding the patients with diabetic angiopathy .

Objective To discuss the method and skill of prenatal diagnosis of fetal isolated pulmonary stenosis and thus to improve prenatal diagnostic ability. Methods The data of 18 fetuses diagnosed as isolated pulmonary stenois were reviewed and the ultrasonic characters of each section were analysised. Results Five of the 18 cases were confirmed as pulmonary stenosis by autopsy and 12 cases were confirmed by echocardiography after birth. One case was confirmed as pulmonary atresia by echocardiography after birth. Reversed blood flow in arterial duct was detected at the ductal arch section in all the cases and right atrial enlargement,right ventricular myocardial hypertrophy, tricuspid regurgitation, foramen ovale enlargement, reduced activity of foramen ovale valve were detected in partial cases. Conclusions It is important that reversed blood flow in arterial duct and in the two main artery could be observed at the ductal arch section and the three vessel section respectively. Ductal arch section,ventricular outflow tracts section and the three vessel section are very important in the diagnosis of fetal isolated pulmonary stenosis.

Objective To investigate the clinical effects and mechanism of naloxone treatment in drowing children.Methods A total of 97 drowing children were divided into treatment group(n=45)and control group(n=52)depending on whether the naloxone was administrated.General treatment was adopted in two groups.Treatment group Was given naloxone.The clinical effects were observed and the levels of betaendorphin(β-EP)in blood plasma were measured with radioimmunoassay(RIA)before and after treatment respectively.Results The total effective rate of treatment group(93.3%,42/45)Was significantly higher than that of control group(76.9%,40/52)(P＜0.05).As compared with that of control group(65.0%,26/40),nervous system disability rate in treatment group(33.3%,14/42)decreased significantly(P＜0.01).Continuous days of poor blood circulation,abnormal respiratory rhythm,convulsion and coma in treatment group were significantly shorter than those of control group respectively(P＜0.01).The level of β-EP was significantly lower in treatment group than that of control group(t=17.1,P＜0.01).Conclusion Clinical use of naloxone in the drowing children has curative result by reducing the level of blood plasma β-EP.