Acute Disease ; Adolescent ; Female ; Heart Neoplasms ; complications ; Humans ; Hypertrophy, Left Ventricular ; etiology ; Myocardial Infarction ; etiology ; Myxoma ; complications

Adult ; Child, Preschool ; Heart Ventricles ; pathology ; Humans ; Male ; Myocardium ; pathology ; Pre-Excitation Syndromes ; etiology ; pathology

Objective To compare the effectiveness and safety of different concentrations of elastin-like polypeptides (ELP) as novel submucosal injection material for endoscopic submucosal dissection.Methods Forty healthy New Zealand white rabbits were randomly divided into two groups (n=20).The first group by submucosal injection of different drugs were randomly divide into five groups (n=4).Four concentrations of 50 ku ELP (0.05,0.025,0.012 5,0.005 g/ml) were used separately in each group,while glycerin fructose was used for control group.Each solution (2 ml) was injected into the submucosa through the resected margin,the increase of mucosal thickness and surface changes were observed and recorded at 0,5,10,and 30 min.The subgroup by submucosal injection of different drugs were randomly divide into five groups (n=4).The injection pressure of each solution (2 ml) with the 25-gauge needle was calculated by a manometer,which was connected between the needle and syringe.Results The submucosal uplift heights in groups using the 0.05 g/ml ELP and 0.025 g/ml ELP injection were significantly thicker than that of glycerin fructose (P＜0.05),the 0.012 5 g/ml ELP and glycerin fructose injection showed no significant difference (P＞0.05),whereas the uplift height in glycerin fructose group was thicker than that of the 0.005 g/ml ELP (P＜0.05).The injection pressure correlated with the ELP concentration.The injection pressures of 0.05,0.025,0.012 5,0.005 g/ml ELP solutions were (332±36) kPa,(223±24) kPa,(174±22) kPa and (142±19) kPa,respectively,and that of glycerin fructose was (269±17) kPa.The 0.025 g/ml ELP solution was easily injected into the porcine stomach to create submucosal uplift.The injection pressure of the 0.025 g/ml ELP solution showed significantly lower value compared with that of glycerin fructose (P＜0.05).Conclusions ELP might be a promising agent for submucosal injection for endoscopic submucosal dissection (ESD),and 0.025 g/ml ELP might be efficient concentration for maintaining mucosal elevation,injection pressure and safety.

Accurate assessment of the degree of coronary artery stenosis is very important to guide the revascularization of patients with coronary heart disease. In recent years, functional assessment of the impact of coronary artery stenosis on the distal myocardium is changing the traditional concept of revascularization. The superiority of the fractional flow reserve(FFR) in guiding coronary interventional therapy has been widely verified in clinical practice. Due to its invasive operation, high cost, and high side effects of vasodilators during examinations, its application in my country is relatively limited. Quantitative flow ratio as a new, noninvasive, and rapid tool for assessing coronary stenosis, is being favored by researchers. This article reviews the clinical research progress of quantitative flow ratio and prospects its future clinical applications.

Objective To investigate the efficacy and safety of modified endoscopic submucosal dissection (ESD) and rubber band ligation assisted endoscopic dissection for treatment of small gastric submucosal tumors (SMT) originating from the muscularis propria layer. Methods A total of ninety-two patients diagnosed as gastric SMT (6 mm≤diameter≤13 mm) originating from the muscularis propria layer by EUS in our hospital were enrolled in this study. With intravenous anesthesia and tracheal intubation in all patients, modified ESD was performed firstly to stripe the small tumors. After being exposed to a certain extent, the tumors were ligated by rubber band and snared for endoscopic dissection. The situation of bleeding, perforation in both intraoperative and postoperative, the integrity and size of the resected specimens were observed and recorded. The resected specimens were identified with histopathological detection and immunohistochemistry assay. At the 6-month and 12-month after the operation, all patients were reviewed by gastroscopy and EUS in our hospital. Results All the 92 tumors were resected completely and successfully. The mean operating time was (19.2±2.3) min and the mean blood loss in operation was (2.6±0.5) mL. Perforation after resection occurred in 3 cases, which were closed with metal hemostatic clips and nylon ropes. No delayed bleeding and perforation occurred in one week after the operation. The tumor sizes ranged from 6 mm × 5 mm to 13 mm × 12 mm. Seventy-three gastric stromal tumors (risk classification:all were very low risk), 18 gastric leiomyomas and 1 gastric neurofibroma were identified. There were no residue or recurrence in all cases during the 12-month follow-up period. Conclusion The modified ESD and rubber band ligation assisted endoscopic dissection are effective and safe for treatment of small gastric submucosal tumors originating from the muscularis propria layer. The tumors are resected completely and successfully, showing certain significance to assess the nature, degree of malignancy of the tumor and prognosis of the patients.

Objective To learn the organizational management competency of state-owned hospitals and their weakness, providing references for decision makers. Methods In the principle of stratified random sampling, 5 677 doctors in hospitals of different grades from 12 cities in Shandong Province, Hubei Province, Hebei Province and Inner Mongolia were investigated with questionnaires. Factor analysis is applied to extract factors. With results of this factor analysis, an evaluation model was built, followed by a fuzzy comprehensive evaluation on the management competency. Results The total satisfaction score on the organizational management by the doctors investigated is 3. 25, and those for system building and leadership behavior are respectively 2.88 and 3.20. Conclusions Organizational management of the public hospitals needs improving, especially development of hospital management systems and implementation.

For clinical curricula of rehabilitation therapy, we take different teaching Methods , including combining lecturing and demonstrating together, and heuristic and problem-based approaches in the theory courses; combining demonstrating and practicing together, participating the clinical practice in the noviciate; requesting the students to make internship report and graduation project in the internship, which may improve the knowledge, capacity and quality structure of the students.

Previous studies have shown that paeonol can antagonize acute myocardial ischemia and infarction in rat. This study further researched the effects of paeonol on blood pressure and blood flow in the artery of spontaneously hypertensive rats and its mechanisms related on vasomotion. Firstly, thirty spontaneously hypertensive rats were randomly divided into spontaneously hypertensive control group and paeonol-treating groups of high dose and low dose, and also, the other ten Wistar rats as healthy control group. Before and after the intraduodenal administration of the drug, arterial blood pressure was measured by carotid artery and blood flow through the renal artery and carotid artery in vivo were measured by animal flowmeter. The same volume of solvent was given to the spontaneously hypertensive control group and the healthy control group, and the other operations were same. In order to further study the effect of paeonol on vasomotor function, the superior mesenteric artery, renal artery and coronary artery of the spontaneously hypertensive rat were removed and separated, precontracted by a certain concentration of potassium chloride (KCl) and 5-serotonin (5-HT) respectively, and dilatory responses were assessed by cumulative addition of paeonol. Results showed that after duodenal one-time delivery of paeonol, the blood pressure significantly lowered, the renal arterial blood flow and the carotid arterial blood flow significantly increased in spontaneously hypertensive rat. And also, paeonol relaxed the mesenteric artery, renal artery and the coronary artery of spontaneously hypertensive rat in a concentration-dependent manner. These results indicated that the effect of paeonol on decreasing arterial blood pressure and increasing the arterial blood flow was related to its vasodilative effect.
Acetophenones ; pharmacology ; Animals ; Blood Pressure ; drug effects ; Male ; Rats ; Rats, Inbred SHR ; Regional Blood Flow ; drug effects ; Vasodilator Agents ; pharmacology

Abscess ; surgery ; Humans ; Laparoscopy ; Male ; Middle Aged ; Pancreatic Diseases ; surgery

Objective To analyze the correlation factors that promote or impede the residents to preferentially use essential medicines.Methods Adopting stratified random sampling method,1 700 households selected from 5 cities of Shandong province were investigated with a questionnaire.The framework of Andersen behavior model of health service utilization was used as the framework,with such methods as descriptive analysis and univariate logistic regression models for the analysis and evaluation of relevant information.Results The residents′ tendency factor,ability factor and environmental factor influence their preference to use essential medicines,while the requirement factor plays a minimal role.There was a significant difference for the preference of combined medication,first visit preference and self-medication experience,the efficacy and policy response of essential medicine from logistic regression analysis.Conclusion At present,the government should focus on the construction of the formation mechanism of the residents′drug use behavior and the policy response mechanism of essential medicine system.