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 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.

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 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.

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.

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.

Objective To evaluate the cognitive function of chronic obstructive pulmonary disease (COPD) stable patients with ExtendedScale for Dementia (ESD). Methods 37 patients with stable COPD (COPD group) and 40 healthy persons (control group) were enrolled.The COPD patients were divided into different groups as their PaO2. They were assessed with ESD and Mini Mental Status Examination(MMSE). Results The total score of ESD and the subtest scores of ESD in leaning, memory, calculation, constructive function were significantlylower in the COPD group than in the control group (P<0.001). The total score of MMSE and the subtest scores of MMSE in memory,attention and calculation, short- and long-term memory were significantly lower in the COPD group than in the control group (P<0.05). Thetotal score and the subtest scores in learning, memory, calculation of ESD were lower in patients with PaO2<60 mmHg than those withPaO2≥60 mmHg (P<0.05), same as the total score and the subtest scores in memory, attention and calculation, short- and long-term memoryof MMSE (P<0.05). Both ESD and MMSE correlated significantly with PaO2 (P<0.01). Conclusion ESD can be used as an evaluationtool for cognitive function in stable patients with chronic obstructive pulmonary disease.

The results of isolation,screening and identification of Bacillus subtilis strains which produced fibronolysion were reported in this paper.20 Bacillus subtilis strains were screened from different withered straw samples.Among them,FM-S1,FM-S2,FM-S6,FM-S8 and FM-S11 produce fibronolysin with higher activity.According to morphological,physiological and biochemical characters,the screened strains were confirmed to be Bacillus subtilis. For FM-S2,the production of fibronolysin type in solid fermentation was considered to be synchronous with growth.

AIM: To evaluate the results of preservative free sodium hyaluronate and basic fibroblast growth factor(bFGF) eye drops in the treatment of dry eyes after eye operation.·METHODS: One hundred and thirty two patients of dryeyes underwent 149 different eye surgeries. The Schirmer test Ⅰ and tear break up time (BUT) were performed prior to surgery and post operatively after 2 weeks and after 4 weeks when the patients were using Oflaxacine, Tobramycin-dexamethasone eye drops. In addition, preservative free sodium hyaluronate and bFGF eye drops were given post operatively. The antibiotic-cortisone eye drops were stopped after the requirted period depending on the type of eye surgery done, and preservative free sodium hyaluronate and bFGF eye drops were stopped after 4 weeks.Then, after 5 weeks Schirmer test Ⅰ and BUT were done.·RESULTS: The Schirmer test Ⅰ and BUT results prior to surgery and after eye surgery showed a statistically significant improvement of the dry eye condition.·CONCLUSION: Usage of preservative free sodium hysluronate and bFGF eye drops help definitely in the management of dry eye after ophthalmic surgery.