Objective To compare the effects of intracoronary verapamil on coronary flow,myocardial perfusion and clinical outcome during primary percutaneous coronary intervention(PCI) for acute ST elevation myocardial infarction(STEMI).Methods A total of 99 consecutive STEMI patients undergoing primary PCI were randomly assigned to receive intracoronary verapamil or intracoronary heparinised saline immediately after stent deployment.Coronary flow was assessed by Thrombolysis in Myocardial Infarction(TIMI) flow grade(TFG) and corrected TIMI frame count(CTFC),and myocardial perfusion was assessed by TIMI myocardial perfusion grade(TMPG) and TIMI myocardial blush grades(MBG).Coronary and myocardial perfusion were assessed before and after PCI,as well as after drug administration by two doctors independently.Echocardiography were performed one week after PCI.Incidence of major adverse cardiac events in hospital and 3 months follow-up were compared between the two groups.Results Eight patients were excluded from the final analysis.Among the remaining 91 patients,47 patients were in the verapamil group and 44 patients were in control group.Baseline characteristics and angiographic characteristics were not significantly different between the two groups.CTFC,TFG,TMPG,and MBG before and after PCI were of no significant differences between the two groups.However,after drug administration,the verapamil group showed better outcome compared with the control group in CTFC(27.1?14.2 vs 39.0?23.8,P=0.011),TFG≥2(100% vs 90.9%,P=0.035),MBG≥2(91.5%% vs 75.5%,P=0.034),and TMPG≥2(89.4% vs 72.7%,P=0.042).LVEF measured by echocardiography was not significantly different between the two groups one week after PCI.The combined incidence of MACE in hospital(4.3% vs 9.1%,P=0.613) and at 3-month follow-up(23.9% vs 22.7%,P=0.894) was similar between the verapamil group and the control group.Conclusion Intracoronary administration of verapamil can improve coronary flow and myocardial perfusion in STEMI patients underwent primary PCI but show no obvious improvement in short-time clinical prognosis.

OBJECTIVE:Using in vitro studies,we evaluated the antibacterial activity of amoxicillin/tazobactam against 128 strains of pathogens isolated from patients and compared with amoxicillin/clavulanic acid and amoxicillin/sulbactam.METHODS:To detect the minimum inhibitory concentrations (MIC)of four ?-lactams against 128 clinically isolated strains with agar dilution method.RESULTS:The results indicated that the in vitro antibacterial activity of amoxicillin/tazobactam(2∶1) was the best.The MIC50 of amoxicillin/tazobactam(2∶1) is 1/4～1/8 times than those of amoxicillin/sulbutam and amoxicillin/clavulanic acid.The MIC90 of amoxicillin/tazobactam(2∶1) was 1/2～1/4 of those of amoxicillin/sulbutam and amoxicillin/clavulanic acid.The combination ratio 2∶1(amoxicillin/tazobactam)of the two compounds was more suitable than other combination ratios(4∶1 and 8∶1)for inactivating ?-lactamase.CONCLUSION:The in vitro antibacterial activities of amoxicillin/tazobactam(2∶1) against MRSA,MRSE,MSSA and E.coli are high.It showed that amoxicillin/tazobactam(2∶1)is stable to ?-lactamase and is an effective bactericidal agent.

Objective To evaluate the changes of urodynamics in female patients with diabetic cystopathy.Methods Fifty six female patients with diabetic cystopathy were enrolled in the study , including 31 cases with diabetic course <15 years ( groupⅠ) and 25 cases with diabetic course ≥15 years ( group Ⅱ) .Urodynamic examination was performed in all patients and the urodynamic parameters were compared between two groups.Results The average residual urine volume , the volume of first bladder sensation and the max bladder capacity in groups ⅠandⅡwere (35 ±16)ml and (65 ±24) ml,(220 ± 76)ml and (330 ±88) ml, (380 ±92) ml and (580 ±122) ml, respectively; 3 out 31 and 16 out of 25 patients in groups Ⅰ and Ⅱ showed low compliance .The above indexes between two groups were statistically significant ( P<0.01).Conclusion Urodynamics can indicate the severity of functional damage of urinary bladder in patients with diabetic cystopathy .

Objective To investigate the effects of dexamethasone on absorption of lung edema in rabbits with seawater drowning-induced acute lung injury.Methods Seawater(4 ml/kg body weight)was instilled into the lower trachea of ventilated and anesthetized rabbits.These rabbits were assigned randomly to receive intravenous injection of 1 mg/ kg body weight of dexamethasone(dexamethasone group,DG)or 2 ml of normal saline(control group,CG).Lung edema was measured by extravascular lung water index(EVLWI)using a gravimetric method.Three hours after treatment, epithelial Na~+ channel subunit-?(?-ENaC)mRNA and Na~+/K~+-adenosine triphosphatase subunit-?l(NKA-?l) protein abundances in lung tissues were respectively measured by reverse transcriptase-polymerase chain reaction and Western blotting,and NKA activity was measured by monitoring the release of inorganic phosphate(Pi)from adenosine triphosphate(ATP).Results The DG's EVLWI was significantly lower than the CG's[(0.508?0.089)vs.(0.648?0.102),P＜0.05)],but the DG's NKA activity,?-ENaC mRNA and NKA-?l protein abundances were significantly higher than the CG's,correspondingly(P＜0.05).Conclusions With up-regulation of the NKA activity and expressions of?-ENaC and NKA-?l,dexamethasone treatment could promote the absorption of lung edema in rabbits with seawater drowing-induced acute lung injury.

Objective To observe the degradation time and the intimal hyperplasia of biodegradable magnesium alloy stent (MPM) implanted in the abdominal aorta of experimental rabbits.Methods A total of 24 New Zealand white rabbits were randomly divided into four groups (30 d,60 d,90 d and 180 d) with 6 rabbits in each group.In cach rabbit one MPM stent was implanted in the abdominal aorta at the level of one cm below the left renal artery.Reexamination of abdominal aortography with DSA was separately performed at 30,60,90 and 180 d after stent implantation to check the stent condition.The rabbits of each group were sacrificed at the corresponding scheduled day,the stenting segment of aorta of each rabbit was removed and the specimen was sent for microscopic examination.The experimental results were analyzed with SPSS20.0 software.Results All the 24 experimental rabbits survived.During the follow-up period the stent showed gradual degradation changes,and basically complete degradation was not observed until to 180 days.Meanwhile,the intimal hyperplasia reached its peak at 90 days after implantation.The abdominal aorta remained unobstructed during the whole process of degradation.Conclusion The time of complete degradation for MPM stent is 182 days,which is long enough to meet the needs of vascular positive remodeling.

Objective To discuss the application of different types of bronchial arteriography catheter in performing bronchial artery embolization (BAE) for the treatment of hemoptysis.Methods The clinical data of a total of 97 patients with hemoptysis,who received BAE during the period from January 2013 to May 2016,were collected.According to angiographic findings in aspect of the opening and running direction of the arteries causing bleeding,the responsible arteries were divided into 4 types:upward opening,horizontal opening and running upwards,horizontal opening and running downwards,and downward opening.For each responsible artery,appropriate angiography catheter was selected from the following catheters:MIK catheter,left gastric artery catheter,Cobra catheter,Simmon-1 catheter and Simmon-2 catheter.With super-selective catheterization technique the selected suitable catheter was inserted into the responsible artery and angiography was subsequently performed.The effect of the selection of bronchial arteriography catheter in performing BAE for hemoptysis was analyzed.Results A total of 180 responsible arteries were detected in 97 patients.Of the 180 responsible arteries,artery with upward opening was seen in 42,artery with horizontal opening and running upwards was found in 54,artery with horizontal opening and running downwards was observed in 46,and artery with downward opening was detected in 38.The success rates of super-selective catheterization for MIK catheter,left gastric artery catheter,Cobra catheter and Simmon catheter were 83.3％ (35/42),92.6％ (50/54),87.0％ (40/46) and 89.5％ (34/38,including 30 Simmon-1 catheters and 4 Simmon-2 catheters) respectively.After BAE,the responsible arteries were occluded in all patients,and hemoptysis stopped immediately.The recurrence rate at 6 months after BAE was 7.2％ (7/97).Conclusion For the treatment of hemoptysis,BAE is safe and effective.The key point to ensure a successful BAE is that the selection of appropriate catheter should be based on the opening and running direction of the artery causing bleeding.

Objective To examine the effect of aqueous extracts of Scutellaria baicalensis Georgi and Radix paeoniae Alba on periodontitis mice and compare the results of the two herbs for the treatment of the periodontitis mice.Methods Sixty-four SPF 12-week-old male Kunming mice were selected and randomly divided into four groups:Control group (C) ;Experimental periodontitis group (P):the peridontitis models in Kunming mice were prepared by wrapping silk ligature and inoculating with putative periodontopathic bacteria; Scutellaria baicalensis Georgi treatment group(SG):periodontitis was induced by the same method described above,the mice were gavaged with Scutellaria baicalensis Georgi; Radix paeoniae Alba treatment group (RG):periodontitis was induced by the same method described above,the mice were gavaged with Radix paeoniae Alba.Four mice were sacrificed at each time point of the end of 4,6,8 and 10 weeks in each group.The histopathological changes of periodontal tissue were observed under microscope with HE staining.The level of serum IgG1 and IgG2a was measured by enzyme-linked immunosorbent assay(ELISA).Results A serious inflammatory response,alveolar progressive absorption and a large number of osteoclasts were observed in the experimental periodontitis group.However,in SG and RG,the inflammation of the periodontal tissue was decreased and tissue repair was significant.The level of serum IgG2a in SG(6 week:0.934 ± 0.006,8 week:0.743 ± 0.009,10 week:0.674 ± 0.008) and RG (6 week:1.023 ± 0.032,8 week:0.851 ± 0.032,10 week:0.790 ± 0.009) was significantly decreased after the mice were gavaged with the two herbs(P ＜ 0.01).The level of serum IgG2a in SG was significantly lower than that of RG(P ＜0.01).The level of serum IgG1 in SG(6 week:0.314 ±0.006,8 week:0.344 ± 0.004,10 week:0.367 ±0.006) and RG(6 week:0.287 ±0.005,8 week:0.303 ±0.058,10 week:0.336 ±0.006) were significantly increased(P ＜ 0.01).The level of serum IgG1 in SG was significantly higher than that of RG (P ＜ 0.0l).Conclusions Both the aqueous extracts of Scutellaria baicalensis Georgi and Radix paeoniae Alba showed therapeutic effect on periodontitis in mice.Scutellaria baicalensis Georgi was more effective than Radix paeoniae Alba.

At present, there are some problems in doctor-patient communication in standardized residency training in department of burns, such as insufficient understanding, lack of communication skills and short of teachers' guidance. Therefore, during the rotation of burns department, we should strengthen the cultivation of communication ability by improving humanistic care, professional level and communication training. At the same time, clinical teachers should strengthen their own quality and the assessment system should be improved. Through comprehensive efforts in many aspects, we will improve doctor-patient communication ability and build a harmonious doctor-patient relationship.

Objective:To evaluate the oncologic outcomes of different laparoscopic radical hysterectomy.Methods:From January 2011 to December 2014, the laparoscopic operation cases of cervical cancer at stage Ⅰb1, Ⅰb2, Ⅱa1 and Ⅱa2, including the histologic subtypes of squamous-cell carcinoma, adenocarcinoma and adenosquamous carcinoma, were collected in five clinical centers. The data were divided into two groups according to the surgical procedures, that is, modified laparoscopic-vaginal radical hysterectomy (mLVRH) and total laparoscopic radical hysterectomy (TLRH). The overall survival rate (OS), disease-free survival rate (DFS) at 5 years were retrospectively analyzed in this study.Results:There were 674 cases in total, including 377 cases of mLVRH, 297 cases of TLRH. (1) The OS at 5 years: the mLVRH was 96.1% and the TLRH was 92.0%, and the mLVRH was higher than that of TLRH （ P=0.010）. Stratify analysis， including stage of disease （Ⅰb1 and Ⅱa1）， histologic subtypes （squamous-cell carcinoma, adenocarcinoma）， lymph node metastasis， revealed that, ① Stage of disease: in stage Ⅰb1, the OS at five years of mLVRH was higher than that in TLRH group （98.6% vs 93.6%, P=0.012）. In stage Ⅱa1, there was significant difference between the two groups, the OS at five years of mLVRH and TLRH were 93.6% and 77.6% （ P=0.007）. ② Histologic subtypes: for the OS at five years of squamous-cell carcinoma, mLVRH and TLRH were 96.1% and 92.3%, and there was significant difference （ P=0.046）； for adenocarcinoma, the OS at five years were 91.0% and 88.6%， and there was no difference between two groups （ P=0.230）. ③ Lymph node metastasis： the mLVRH and TLRH with lymph node metastasis, the OS at five years were 98.6% and 96.4%; the mLVRH and TLRH without lymph node metastasis, the OS at five years were 89.3% and 80.8%. There were no significant differences between the two groups,respectively ( P=0.156， P=0.093）. (2) The DFS at 5 years: there was no significant difference between mLVRH and TLRH (94.1% vs 90.9%, P=0.220). Stratify analysis for stage of disease, the mLVRH group was higher than that in the TLRH group in stage Ⅰb1 (97.0% vs 92.8%, P=0.039). However, for stage Ⅱa1, there was no significant difference between mLVRH and TLRH group （88.2% vs 75.8%, P=0.074）. Conclusions:The results of this retrospective study indicated that different laparoscopy surgical procedures had diverse oncologic outcomes. The OS at 5 years of the mLVRH is superior to the TLRH. The DFS at 5 years in Ⅰb1 stage, the mLVRH is higher than the TLRH. Therefore, the modified laparoscopy is still an alternative surgery for early cervical cancer patients when following the principle of no-tumor-exposure.

Background::Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography (ERCP), the benefits and safety of high-carbohydrate fluid diet (CFD) intake 2 h before ERCP remain unclear. This study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’ recovery.Methods::This prospective, multicenter, randomized controlled trial involved 15 tertiary ERCP centers. A total of 1330 patients were randomized into CFD group ( n = 665) and fasting group ( n = 665). The CFD group received 400 mL of maltodextrin orally 2 h before ERCP, while the control group abstained from food/water overnight (>6 h) before ERCP. All ERCP procedures were performed using deep sedation with intravenous propofol. The investigators were blinded but not the patients. The primary outcomes included postoperative fatigue and abdominal pain score, and the secondary outcomes included complications and changes in metabolic indicators. The outcomes were analyzed according to a modified intention-to-treat principle. Results::The post-ERCP fatigue scores were significantly lower at 4 h (4.1 ± 2.6 vs. 4.8 ± 2.8, t = 4.23, P <0.001) and 20 h (2.4 ± 2.1 vs. 3.4 ± 2.4, t= 7.94, P <0.001) in the CFD group, with least-squares mean differences of 0.48 (95% confidence interval [CI]: 0.26–0.71, P <0.001) and 0.76 (95% CI: 0.57–0.95, P <0.001), respectively. The 4-h pain scores (2.1 ± 1.7 vs. 2.2 ± 1.7, t = 2.60, P = 0.009, with a least-squares mean difference of 0.21 [95% CI: 0.05–0.37]) and positive urine ketone levels (7.7% [39/509] vs. 15.4% [82/533], χ2 = 15.13, P <0.001) were lower in the CFD group. The CFD group had significantly less cholangitis (2.1% [13/634] vs. 4.0% [26/658], χ2 = 3.99, P = 0.046) but not pancreatitis (5.5% [35/634] vs. 6.5% [43/658], χ2 = 0.59, P = 0.444). Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla (odds ratio [OR]: 0.61, 95% CI: 0.39–0.95, P = 0.028) in the multivariable models. Conclusion::Ingesting 400 mL of CFD 2 h before ERCP is safe, with a reduction in post-ERCP fatigue, abdominal pain, and cholangitis during recovery.Trail Registration::ClinicalTrials.gov, No. NCT03075280.