Left atrial appendage ( LAA) arises from the left atrial free wall. It is the remnant of the original embryonic LA, distinct from the rest of the left atrium. It has a unique anatomical structure, physiological function, hemodynamic characteristics. LAA has complex surrounding structures, great variability, and close relation with thrombosis. This paper reviews the morphological and functional characteristics of LAA. Familiar with adjacent relationship of LAA and correlation between LAA and thrombus formation has important clinical significance that can reduce the risk of postoperative complications in interventional procedures, the incidence of car?dioembolic stroke, the clinical misdiagnosis on LAA thrombosis.

Objective To investigate the clinical effect of application of dezocine combined with sufentanil in patients under‐going thoracic surgery ,and discuss its security .Methods Selected 60 cases of patients undergoing thoracic surgery treatedn in the hospital from January to June 2013 ,then divided into two groups with 30 cases in each group randomly .ASA grade Ⅰ - Ⅱ ,the ob‐servation group took dezocine combined with sufentanil after the surgery ,the control group took sufentanil for analgesia ,then ob‐served the analgesia and sedative effect and the occurrence rate of adverse reaction between two groups of patients .Results The observation group′VAS pain score on postoperative 6 ,12 ,24 ,48 h were (3 .21 ± 0 .76)% ,(3 .01 ± 0 .77)% ,(2 .79 ± 0 .69)% , (2 .67 ± 0 .66)% and significantly better than the control group(P<0 .05);The observation group′Ramsay sedation score on post‐operative 6 ,12 ,24 ,48 h were (2 .12 ± 0 .23)% ,(2 .07 ± 0 .22)% ,(2 .02 ± 0 .24)% ,(2 .01 ± 0 .21)% ,the sedative effect was better than the control group(P<0 .05);48 h after the surgery the pressing times and effective analgesia pump frequency and adverse re‐action of the patients in the observation group were lower than that of the control group(P<0 .05) .Conclusion The effect for se‐dation and analgesia of dezocine combined with sufentanil in patients undergoing thoracic surgery is better and safe .

Objective To evaluate the effect of human milk fortification on short‐term growth of premature infants in NICU and its clinical safety .Methods According to different formulas ,the premature infants were divided into preterm formula group ,human milk group and human milk fortification group (HMF group) .Its growth rate ,blood biochemistry ,adverse event rate and so on were compared .Results There were 147 cases meeting requirements .the weight growth velocity of preterm formula group ,human milk group and HMF group were (19 .44 ± 5 .14) ,(14 .53 ± 5 .86) ,(17 .09 ± 5 .81) g · kg -1 · d-1 respectively with statistical sig‐nificance (P<0 .01);the growth velocity of head circumference of preterm formula group (0 .72 ± 0 .34)cm/w and HMF group (0 .71 ± 0 .29) cm/w were significantly higher than that of human milk group (0 .51 ± 0 .34)cm/w (P<0 .01);the time of regaining or overtopping birth weight of preterm formula group (8 .55 ± 3 .20)d and HMF group (9 .43 ± 4 .53)d was significantly shorter than that of human milk group (10 .93 ± 3 .02)d(P<0 .01);the EUGR occurrence rate of head circumference of preterm formula group and HMF group were significantly lower than that of human milk group(P<0 .01) .The feeding intolerance rate of preterm formula group (15 .52% ) was significantly higher than that of human milk group (2 .13% ) (P<0 .05);there were no significant difference in incidence rate of infection event in each group(P>0 .05) .Conclusion Human milk fortification can control the inci‐dence rate of infection event and feeding intolerance to increase growth velocity of weight and head circumference of premature in‐fants during hospital stay .

OBJECTIVE To investigate and analyze the application of prophylactic antibiotics in perioperation period in our hospital.METHODS According to the designed table with unified contents and standards,a retrospective investigation was made in 325 patients who had been discharged from our hospital.RESULTS Of the 325 patients in our study,antimicrobials use in 281 patients was rational,44 patients had irrational antimicrobials use.CONCLUSIONS The results show that it is very important to strengthen and improve the management of the antimicrobials use in a normal and standard way in our hospital.

Objective:To explore the effect of fortified human milk feeding on growth and complica-tions of infants with extremely and very low birth weight (ELBW/VLBW)during hospital stay by a pro-spective,random and controlled study.Methods:In the study,1 22 ELBW/VLBW infants were enrolled and divided into two groups.The infants fed with human breast milk,combined with human milk fortifi-cation (HMF)during hospital stay were named HMF group (n=62),and those fed exclusively with pre-mature formula were named premature formula feeding group (PF group,n=60 ).The data of the in-fants’growth (the velocity of increase on the weight,length,head circumference and upper arm circum-ference),the time of rebounding to birth weight,the time of needing intravenous nutrition,the time of hospitalizing,the proportion of extrauterine growth retardation (EUGR)during hospital stay,the level of hemoglobin,bone metabolism and incidence of complications were compared between the two groups. Results:Among the 1 22 infants included,(1 )the length increment in HMF group was higher than PF group [(0.89 ±0.23)cm/week vs.(0.79 ±0.34)cm/week,P=0.04];there were no significant differences in the weight gain,head circumference increment and upper arm circumference increment (P>0.05);(2)the age of rebounding to birth weight [(1 0.1 3 ±4.03)d vs.(8.03 ±3.28)d,P=0.002]and the duration of intravenous nutrition [(1 6.77 ±6.63)d vs.(1 4.23 ±4.1 5)d,P=0.01 ] in HMF group were longer than that in PF group,there were no significant differences between the two groups in the hospital stay and age achieved feeding;(3 )there were no significant differences between the two groups in the incidence rate of EUGR during hospital stay (P>0.05);(4)the level of calcium at birth in HMF group was lower than that in PF group [(2.1 9 ±0.22)mmol/L vs.(2.32 ±0.27) mmol/L,P=0.005 ],and the level of alkaline phosphatase (AKP)in HMF group at discharge was higher than in PF group [(363.98 ±1 22.49)mmol/L vs.(299.73 ±1 1 7.39)mmol/L,P=0.004];(5)the incidence of the feeding intolerance (6.5% vs.1 8.3%,P=0.04)and sepsis (4.8% vs. 1 6.7%,P=0.03)in HMF group were less than in PF group,there were no significant differences be-tween the two groups on the morbidity of necrotizing enterocditis,retinopathy of prematurity (ROP),and bronchopulmonary dysplasia (BPD)(P>0.05).Conclusion:HMF for premature infants may ensure the same growth pattern as those fed by premature formula,promote the calcium absorption,decrease the inci-dence of sepsis and feeding intolerance,and does not increase the incidence of necrotizing enterocolitis.

OBJECTIVE To investigate and analyze the application of antibiotics in non-surgical departments in our hospital.METHODS To make a survey of the use of antimicrobials in non-surgical departments from a total of 548 randomly selected medical records during Jan-Mar 2007,the data of reasonable use of antibacterials were obtained after evaluation and analysis.RESULTS Of the 548 patients in our study,229(41.79%)used antimicrobials.The use of antimicrobials for infection prevention was in 46 cases(20.09%),for infection treatment was in 183 cases(79.91%).From them 95 cases(41.48%)used a combination of two and more antimicrobials.The most widely used antibacterials were penicillins,cephalosporins,and quinolones.CONCLUSIONS The use of antimicrobials is generally reasonable,and meets the safe,effective,and economical goal in our hospital.

Objective To evaluate the clinical safety and efficacy of HIFU treatment of hepatic metastases from colorectal cancer.Methods 20 tumor lesions in 14 patients with hepatic metastases from colonectal cancer were treated with HIFU therapy.The vital signs,main organs'functions,examination of MRI and complications were observed.Results Vital signs of all the 14 patients were stable.The function of liver and kidney were normal and life quality were improved with elevation of Karnofsky in 5 patients.On MRI examination,the MRI signals of treating area of 20 tumor lesion in 14 patients decreased remarkably with disappearance of blood supply and a thin layer of edematous intensified zone was detected on the margin of lesion.6 patients were found to have cord-like burning scar on skin.Conclusion HIFU treatment is safe and effective in treatment of hepatic metastases from colorectal cancer.

The recombinant fusion protein staphylokinase-hirudin(rSFH) was purified from the high density-fermented engineered E.coli by means of ion-exchange chromatography (IEC) and gel filtration (GF). The purity of rSFH reached to more than 98% determined by RP-HPLC and SDS-PAGE, and the yield was up to 0.7g per liter of fermentation broth. The analysis of homologous dimmer of rSFH appeared during the purification and calculation of the surface hydrophobic area had been carried out by means of hydrophobic chromatography and MALD-TOF. The influence of sodium chloride and temperature on the behavior of rSFH reversible dimerization was analyzed by high performance sized- exclusive chromatography(HPSEC). It is concluded that the hydrophobic interaction played an important role in the reversible dimerization of rSFH.

OBJECTIVETo investigate diagnosis and therapeutic effects of knee joint synovial chondromatosis with arthroscopic.

METHODSFrom March 1995 to July 2011, 28 patients with knee joint synovial chondromatosis were treated. Among them, 18 males and 10 females ranging age from 25 to 81 (mean 55.2) years,the course of disease ranged from 0.5 to 15 (mean 5.6) years. Clinical manifestation mainly included pain, swell and functional limitation of knee joint. Knee open surgery (17 cases) and laparoscopic surgery (10 cases) were respectively used. Clinical symptom,image data,pathological manifestation and effects under arthroscopy were observed, Lysholm scoring was used to evaluate effects.

RESULTSAll patients were followed up except one lost, the duration ranging from 6 to 24 months. Lysholm score in knee open surgery was increased from (41.89 +/- 6.81) preoperatively to (67.73 +/- 7.62) postoperatively;while in laparoscopic surgery it was increased from (40.78 +/- 7.54) preoperatively to (77.46 +/- 8.43) postoperatively.

CONCLUSIONArthroscopic surgery, which has no risk of rupture of incision, nonunion, earlier to exercise, is a good method to diagnosis and treat knee joint synovial chondromatosis.

Adult ; Aged ; Aged, 80 and over ; Chondromatosis, Synovial ; diagnosis ; surgery ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; surgery ; Laparoscopy ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo control the quality of the product, quantitative fingerprint was used to evaluate the composition of the amino acids in the Xingnao Tongluo injection.

METHODThe method of the quantitative fingerprint to the amino acids composition was established through AccQ Tag precolumn derivatization. The quality was evaluated by the quantitative test of the amino acids and the similarity in ten batches.

RESULTThe Xingnao Tongluo injection contained 12 amino acids and the contents of these amino acids were stable. All the ten batches of the samples had similarity of more than 0.90.

CONCLUSIONThe method was accurate, feasible and could be a simple and effective way to evaluate the quality of the traditional Chinese medicine.

Amino Acids ; chemistry ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; chemistry ; Quality Control