Sick sinus syndrome (SSS) is a disease of multiple arrhythmias and symptoms.It has great impact on patients in the quality of life for the symptoms of high incidence.The asynchrony of myocardial electromechanical movement caused by the SSS electrophysiological changes are focused.The ultrasound can not only observe the electrical physiological activity,but also measure the mechanical movement caused by electrophysiological delay.The research progresses of ultrasound in quantitative evaluation of myocardial function in SSS patients was reviewed in this article.

Objective To manage calcaneal fractures with an U-shaped external fixator combined with close manipulative reduction. Methods From February 1997 to November 2002, 31 patients with 34 calcaneal fractures were treated with self-designed U-shaped external fixator combined with close manipulative reduction. All patients were males aging from 7 to 50 years with an average of 32 years. The external fixation device consisted of two partial rings, three modular connecting rods and several pins. According to Essex-Lopresti classification, there were 10 extra-articular fractures without involving the subtalar joint, and 24 intra-articular fractures involving the subtalar joint. Two upper pins were inserted in cross through the distal tibia, and one of two lower pins was inserted laterally through the anterior part of calcaneus, the other was posterior into the calcaneous tuberosity or larger fragment connecting with Achilles tendon. After the manipulative reduction, the frames were applied. Results 31 calcaneal fractures were found with satisfactory reductions after manipulation. The widths of the heels were restored in certain extent; the heights of foot arch and calcaneus were resumed to normal; the B hler angle increased from 15? to 40? (mean, 25?). The duration of hospitalization was on an average of 7 days. The duration of external fixation was averagely 8 weeks. All patients were followed up with a mean period of 8 months (range, 6 to 12 months). All of the fractures healed well. No nonunion, delayed healing of bone or other complications was found. All patients resumed to walk on foot after 2 to 4.5 months. According to Fernandez scoring system, results were graded as excellent and good in 31(91%). Conclusion Using U-shaped external fixator combined with close manipulative reduction is a satisfying technique to treat calcaneal fractures. By ankle joint spanned traction and fixation, this technique overcomes displacement of fragments caused by contracture of tendo calcaneus, maintains width of heel and biodynamic anatomy of foot, avoids complications of wound caused by open reduction and internal fixation.

AIM: To research the development of the content of total saponin in Platycodon grandifloeum(Jacq.) A.DC.and Platycodon grandifloeum(Jacq.) A.DC.var.Hort so that the best harvest time was found. METHODS: Using the methods of cluster analysis and according to the examination method ruled in the 2005 version 〈The People's Republic of China Prarmacopoeia〉,the content of total saponin in Platycodon grandiflorum in different harvest time was compared. RESULTS: Platycodon grandifloeum(Jacq.) A.DC and Platycodongrandifloeum(Jacq.) A.DC.var.Hort respectively on September 20,September 30 are the largest yield and the largest content of total saponin in root,that time is the best harvest time. CONCLUSION: The method is simple,accurate and reliable.

Objective To improve the technology of operation room video transmission for remote view and exchange.Methods The integrated controllable environment,the core technology of digital video transmission and video-on-demand were applied in the system.Results The system was easy to set up and operate.It had a strong network adaptability.Conclusion A feasible interactive platform is built for surgery teaching,research,medical management in the hospital.

Objective To establish the immunization model with synthetic M3-muscarinic receptor peptides in rats and investigate the role of autoantibodies against M3-muscarinic receptor in the pathogenesis of chronic obstructive pulmonary disease. Methods The control and immunization models were established. The rate of positive of autoantibodies against M3-muscarinic receptor and the pulmonary function were detected. The blood gas analysis was also detected on the next day after finishing immunization. The tissues of lung were observed by light microscope. Results In immunization group, the rate of positive of autoantibodies against M3-muscarinic receptor were 100%, the geometric means of autoantibody were 1:152. There was a statistical difference between the immunization group and control group (x2 =6. 68, P ＜0. 01). The inspiratory resistance (Ri) was [ ( 1. 77 ±0. 22) cm H2O/ml. sec] and [ ( 1.39±0. 21 )cmH2O/ml. sec] in immunization and control group, respectively. It was increased while the lung compliance (C1) and the percentage of forced expiratory volume in first 0. 3 second to forced vital capacity ( FEV0. 3/FVC% ) were decreased in immunization group. There was a statistical difference compared with control group ( t = 3. 11,2. 82,3.23, allP ＜ 0. 01 ). In immunization group, the PaCO2 was higher and the pH as well as the PaO2 were lower than that in control group. The values of blood gas analysis showed a statistical difference between the immunization group and control group ( t =3.86,3. 47 ,allP ＜0. 01 ). Lung tissueswere severely destroyed in immunization group. There were many inflammation cells and hyperplasia glands,alveolar septum was very thick, and part of pulmonary alveoli even expanded to form bullae lung. Positive correction were found between autoantibodies against M3-muscarinic receptor and pulmonary function as well as blood gas analysis in immunization group. Conclusion The autoantibodies against M3-muscarinic receptor maybe play an important role in the pathogenesis of chronic obstructive pulmonary disease.

In this study,the loop-mediated isothermal amplification(LAMP)method was used to develop a rapid and simple detection system for porcine circovirus type 2(PCV2).According to the PCV2 sequences published in GenBank,multiple LAMP primers were designed targeting conserved sequences of PCV2.Using the DNA extracted from PCV2 isolates HUN-09 and SD-09 as the template,LAMP reactions in a PCV2 LAMP system was performed,the amplification products were detected by adding SYBR Green I and could be observed directly by the naked eye.The results showed highly-efficient and specific amplification in 30 min at 63℃ with a LAMP real-time turbidimeter.Furthermore,PCV2 DNA templates,with a detection limit of 5.5×10-5ng of nucleic acid,indicated that this assay was highly sensitive.The results obtained with the naked eye after SYBR Green I staining were consistent with those detected by the real-time turbidimeter,showing the potential simplicity of interpretation of the assay results.The LAMP assay appeared to have greater accuracy than PCR and virus isolation for the analysis of 18 clinical samples.In addition it offers higher specificity and sensitivity,shorter reaction times and simpler procedures than the currently available methods of PCV2 detection.It is therefore a promising tool for the effective and efficient detection of PCV2.

The management of emerging infectious diseases has always been given a high priority in public health. Identification of the epidemiological characteristics and transmission patterns of emerging infectious diseases is of great significance to contain the disease transmission and reduce the damages to public health and socioeconomic developments. Currently, infectious disease dynamics models are mainly established based on infectious disease surveillance data to predict the epidemiological patterns and trends of emerging infectious diseases; however, many model-based predictions fail to achieve the expected results due to the presence of multiple uncertain factors during the integrated management of infectious diseases. This review describes the basic principles and variables of common infectious disease dynamics models, including the susceptible-infected-recovered ( SIR ) model, susceptible-infected-removed-susceptible ( SIRS ) model, susceptible-exposed-infected-removed ( SEIR ) model and improved SEIR model, compares the advantages and disadvantages of these models, and summarizes the advances of the infectious disease dynamics models in the prediction of trends in incidence of emerging infectious diseases, so as to provide insights into the effective application of infectious disease dynamics models in the management of infectious diseases.

BACKGROUND: Breast augmentation with polyacrylamide hydrogel injection has been used nearly for a decade in some Chinese medical therapy units. More patients need to be removing injections or a second augmentation due to complications. More attention should be paid for possibility of complications concomitant with breast malignant tumor. OBJECTIVE: Two cases of breast invasive duct carcinoma diagnosed after removing injection were analyzed retrospectively in order to increase the importance of detection rate of breast malignant tumor. METHODS: Two cases in all 41 assembled patients which were removed polyacrylamide hydrogel injections from 82 breasts were diagnosed with invasive carcinoma. The characteristics of medical history, physical diagnosis, image diagnosis and pathological examination were analyzed retrospectively. RESULTS AND CONCLUSION: The detection rate of breast malignant tumor should arise more attention in patients requiring removal of polyacrylamide hydrogel injection. The following aspects should be emphasized such as the comprehensive analysis for the results of physical diagnosis and image diagnosis, tumor-free operation with more samples from suspicious nodules and frozen pathological examination. The principles of cancer surgery should be followed in pathological diagnosed cases in case of iatrogenic metastasis and spread of breast malignant tumor.

Objective To discuss the treatment of renal or adrenal tumor with cancer thrombus in the inferior vena cava. Methods From Jan 1984 to Apr 2008,29 cases of renal or adrenal malignancy with thrombosis involving the inferior vena cava underwent treatment.The diagnoses were confirmed by Doppler uhrasonography,CT and MRI.In the 29 surgical patiens the tumor thrombus was level I in 7,level Ⅱ in 10,level Ⅲ in 8 and levelⅣin 4.According to TNM classification,23 cases were classified to T2N.M.,1 case was T2Nl Mo,1 case was TzNlMl,1 case was T3NoMo,2 case were T3NlMl and 1 case was T3N2Mo.The mean tumor size was 8.7(4.O-16.O)cm in diameter.The mean tumor thrombosis length was 3.2(2.5-4.0)cm in level I,5.3(4.5-6.0)cm in level Ⅱ,8.2(6.5-9.O)cm in levelⅢand 15.1(12.0-18.5)cm in level IV. Results The operation was performed succesgfullv in 29 patients Patholocieal examination showed that 18 cases of clear cellcarcinoma,3 cases sarcomatoid carcinoma,2 cases renal papillary adenocarcinoma,1 case renal cell carcinoma (undifferentiated),1 case granule carcinoma,3 cases adrenocortical carcinoma and 1 case metastatic malignant melanoma of adrenal gland.Of 29 patients,3 were out of contact.Twenty-six patients were followed up for 35(0-62)months after treatment,3-and 5-year survival rates were 15/26 and 11/26.Three-year survival rates for stage T2 and T3 were 14/22 and 1/4.Five-year survival rates for stage T2 and T3 were 10/22 and 1/4.Three-year survival rates for level I、Ⅱ、Ⅲ andⅣ were 4/6,5/8,5/8 and 1/4.Five-year survival rates for level I,Ⅱ、Ⅲ andⅣ were 3/6,4/8,3/8 and 1/4.Three-year survival rates for a tumor thrombus in the below or above diaphragm were 14/22 versus 1/4,5-year survival rates were 10/22 versus 1/4.Three-year and 5-year survival rates for the patients without distant metastases and lymph node involvement were 12/18 and 9/18.Three-year and 5-year surviral rates for the patients with distant metastases and lymph node involvement were 3/8 and 2/8.The 3 surgical patients with metastatic disease died at 6,10,22 months. Conclusions Surgical treatment could be the preferred approach for the patients of renal or adrenal tumor with cancer thrombus in the inferior vena cava without distant metastases and lymph node involvement.It could improve the quality of life and may prolong survival.

Objective To explore the clinical characteristics and prognosis of the patients of acute myocardial infarction complicated with heart failure by analyzing the prognostic factors of these patients.Methods This was a single-center prospective study of 349 patients with acute heart failure and ECG documented acute ST elevated myocardial infarction.All patients were treated with primary PCI.After PCI,clinical,angiographic and ECG characteristics,and prognosis of those with preserved (≥50％) or reduced (＜ 50％) left ventricular ejection fraction (LVEF) were assessed.Heart failure patients were divided into two groups:124 with reduced EF (HFREF) and 225 with preserved EF (HFPEF).After 367 days of average follow-up,the primary outcome and number of death were recorded.Results Of them,4 (1.8％) patients in the HFPEF group vs.6 (4.8％) in the HFREF group died.The difference in rate of death between two groups was not significant (P =0.314).There were significant difference in main adverse cardiac and cerebra vascular events (MACCE) occurred during follow-up period between the two groups (P =0.022).The Killip Classification of heart failure (HR =1.092,95％ CI 1.040 ～ 1.149,P ＜0.01) was significantly related to the death rate during follow-up.Conclusions The independent factors affecting prognosis in patients with acute heart failure after coronary revascularization were closely consistent with the stratums of the Killip Classification.Patients with HFPEF had a similar prognosis as those with HFREF after primary stenting.