ObjectiveTo compare the effect of amiodaron and propafenone on the cardioversion of paroxysmal auricular fibrillation (PAF). Methods58 PAF (≤48 h) cases were radomly divide into two groups: 30 cases who accepted amiodaron 150 mg intravenous injection, and 0.6～1.0 mg/min intravenous drip afterwards in amiodaron group, other 28 cases who accepted propafenone 1.4～2.0 mg/kg vein injection, and 0.28 mg/min intravenous drip afterwards in propafenone group.If propafenone was not effective, the cases in propafenone group were given amidoaron. ResultsThe successful reversion rate was 86.7% (26/30) in amidoaron group while 57.1% (16/28) in propafenone group(P<0.05). The mean time of recovering was (101±95) min (6～508 min) in amidoaron group, while (172±148) min (11～608 min) in propafenone group(P<0.05). ConclusionIt is more rapid and effective of amidoaron on the cardioversion of paroxysmal auricular fibrillation than propafenone is.

Objective To assess characteristics of coronary artery lesions and risk factors of coronary heart disease (CHD) in young people with coronary arteriography.Methods 192 patients with CHD diagnosed by coronary arteriography were divided into the young group (91 cases, 25—40 years old) and senile group (101 cases, 41—84 years old). Characteristics of coronary artery lesions and risk factors of CHD of two groups were analyzed, and risk factors were especially tested with logistic regression.Results Coronary artery lesions in the young group were characterized in most patients by singles vessel lesion (64%), while by multi vessels lesion (71%) in the senile group. Multiple logistic regression analysis showed that risk factors such as male, smoking, hyperlipemia, family history and increassed C-reactive protein (CRP) were highly related with CHD(P<0.01).Conclusion Single vessel lesion is a feature of young patients with CHD, and independent and related risk factors of CHD in the young group are male, smoking, hyperlipemia, CHD family history and CRP.

ObjectiveTo investigate the effect of volume embolization ratio(VER) in evaluating the embolization efficacy of aneurysms.MethodsFifty-three patients who received intracranial aneurysm embolization surgery were all treated with detachable coils endovascular embolization,While fifty-seven intracranial aneurysms were treated.The VER was calculated and the relationships between the VER values and the size,the neck,embolization degree of intracranial aneurysm were analyzed.ResultsThe VER of small,medium,large,and giant aneurysms were (40.8 ± 26.5 )％,( 18.6 ± 16.1 )％,(2.3 ± 2.1 )％,(0.4 ±0.1 )％,respectively,which had statistical significance (F =7.091,P ＜ 0.01 ).The VER of wide-necked and narrow-necked aneurysms were (27.5 ± 23.1 )％,(29.4 ± 26.6)％,which had no statistical significance(P ＞0.05 ).The VER of complete embolization,neck residual and partial embolization were (41.8 ± 29.3 )％,(31.4 ± 21.2)％,( 12.3 ± 15.1 )％,respectively,which had statistical differences (F =7.970,P ＜ 0.01 ).ConclusionsThe VER is an objective index to evaluate the embolization degree of aneurysms.It has certain prediction significance for the efficacy judgement of embolization of aneurysms.

OBJECTIVETo discuss the treatment strategy of acetabular fractures and unstable pelvic fracture of the hip and to evaluate its outcome.

METHODSRetrospective analysis of clinical data in 32 patients with unstable pelvic fracture and acetabular fractures from January 2007 to June 2013 were collected. There were 18 males and 14 females aged from 18 to 62 years old (means 38 years old). According to Tile classification of pelvic fracture, 11 cases were type B1, 8 were type B2.1, 7 were type B2.2, 3 were type C1.1, 2 were type C1.2, 1 was type C3. According to Judet-Letournel classification, anterior column fracture was in 1 case, transverse fracture in 8, transverse plus posterior wall fracture in 6, T-type fracture in 1, anterior column plus half transverse fractures in 5, double column fracture in 11. Other combined injuries were treated early, the surgical operation were performed after stable condition. The hip joint function and the fracture reduction were assessed during follow-up.

RESULTSThe operative time was from 1.8 to 6.5 hours (averaged 3 hours). Two fat patients' incision occurred in fat liquefaction and healed after dressing, no incision infection happened. Only 1 case was lost to follow-up, 31 patients were followed up with a mean time of 23 months (6 to 42 months). The healing time of pelvic fracture was from 8 to 18 weeks (averaged in 10.6 weeks). The hip function was evaluated according to the Matta and Tornetta standard postoperatively, the result was excellent in 15 cases, good in 14 cases, fair and poor in 1 case respectively. The Majeed score of the hip function was 83.65? 7.67, the result was excellent in 15 cases, good in 12 cases and fair in 4 cases. The healing time of acetabular fractures was from 8 to 16 weeks (averaged in 10.2 weeks). The fracture reduction was assessed by Matta standard, the result was excellent in 15 cases, good in 12 cases and fair in 4 cases. The heterotopic ossification was evaluated by Brooker standard, 4 cases were grade I, 1 case was grade II . There were no infection, nonunion and necrosis of the femoral head in all patients. The nerve damage symptoms in 5 patients disappeared during 4 to 6 months after operation.

CONCLUSIONPatients with unstable pelvic fractures and acetabulum fractures were in a critical condition early, using the concept of damage control to save lives in a timely manner. Grasp the operation time in the late treatment, acetabulum fractures reach anatomical reduction as far as possible, pelvic fractures are given priority to stable reconstruction. The operation order was fixed pelvic ring first, according to the condition to choose the appropriate surgical approach and fixed mode.

Acetabulum ; injuries ; surgery ; Adolescent ; Adult ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

Aim To establish a LC-MS/MS method for the determination of pirfenidone(BT)and its major metabolite 5-carboxy-pirfenidone(SBT)in human plasma.Methods Human plasma samples containing BT and SBT,as well as their corresponding deuterium-labeled internal standards pirfenidone-d5(dBT)and 5-carboxy-pirfenidone-d5(dSBT),were precipitated using methanol.Chromatographic separation was carried out on an Agilent ZORBAX SB C18(3.0 mm×100 mm,3.5 μm)column with the mobile phase of water(0.5％formic acid)and acetonitrile(50/50).The detection of analytes was performed on a tandem mass system equipped with an electrospray ionization source in positive ion mode using multiple-reaction monitoring.The MS/MS ion transitions monitored were m/z 185.958→77.1 for BT,m/z 215.944→77.0 for SBT,m/z 190.965→81.1 for dBT and m/z 220.948→99.1 for dSBT.Results There was no remarkable interference in blank solvent,plasma,and there was no mutual interference between analytes or internal standards.The proposed method showed good linearity over the concentration range of 0.020 59～25.14 mg·L-1 for BT and 0.016 73～20.42 mg·L-1 for SBT.The intra-batch and inter-batch precision and accuracy were proved to be acceptable.Human samples kept stable after 4 h at room temperature,the three freeze-thaw cycles and 10,29 and 52 days at-70 ℃,and the processed samples remained stable after 24 h in the autosampler.The average extraction recovery and matrix effect were precise,reproducible and acceptable.Conclusion Our current LC-MS/MS method is proved to be sensitive,accurate and convenient,and could be suitable for the clinical pharmacokinetic studies of BT-related preparations.

Objective To investigate the effects and safety of sequential treatments with methotrexate and mifepristone for ectopic pregnancy with fetal cardiac activity.Methods 4 cases of ectopic pregnancy with fetal car- diac activity in our hospital were given by sequential therapy with methotrexate and mifepristone.Serum?-HCG,liv- er function and renal function,blood routine and gastrointestinal response were observed.Results 4 cases of ectopic pregnancy with fetal cardiac activity with 1～4 periods of sequential treatments were cured.Except light gastroin- testinal response,and one had slight rise of serum ALT level and AST level,no one had rnyelosuppression and heavy hepatic injury.Conclusion The sequential therapy with methotrexate and mifepristone is an effective and safe method for the treatment to ectopic pregnancy with fetal cardiac activity.

Objective To explore the optimal methods to detect helicobacter pylori(Hp)antigen in children.Methods 13C labeled urea breath test(13C-UBT)was performed on 937 children of alimentary department from Sep.2000 to Feb.2006.Gastric mucosa biopsy of 96 children was detected.Hp stool antigen(HpSA)status of the 557 children were evaluated.Both 13C-UBT and HpSA were assayed in 105 children from Apr.2003 to Apr.2004.Method of 13C-UBT was taken as the golden standard on diagnosis of Hp infection.Results Forty-one point seven percent children was positive for 13C-UBT.Forty point six percent children was positive for gastric mucosa biopsy.Thirty-eight point two percent was positive for HpSA.The difference was not significant.2.Among the 105 children performed by both 13C-UBT and HpSA,41.9% was positive for 13C-UBT and 39.0% for HpSA.Taking 13C-UBT as the golden standard,sensitivity of HpSA to diagnose Hp infection was 91.8%,and its specificity was 81.8%.Consistency Kappa coefficient was 0.743(P=0),which denoted that there was no significant difference on the positive detection rate between 13C-UBT and HpSA(P=0.388).Conclusions 13C-UBT and HpSA as non-invasive technique is effective to detect the Hp antigen.Compared to 13C-UBT,as a convenient,noninvasive,economical method,HpSA detection is much more acceptable to children and their patients.

AIM: To better reveal the changing process of macula area after photodynamic therapy (PDT), the changes of tomographic imaging on macular fovea optical coherence tomography ( OCT ) scan at different follow- up time points after treating age-related macular degeneration ( AMD) by PDT were investigated.
METHODS: This cohort study included 30 eyes of 26 patients diagnosed as AMD. The dosage of verteporfin was calculated according to manufacturer's instruction. All participants got FFA, ICG, OCT scan and best corrected visual acuity before and followed up for 2wk, 1, 2, 3mo after PDT. The standard five lines combined with 6 lines OCT scan covered key parts of lesion and the scan locations before and after were kept the same. The bilaminar foveal thickness (BFT), outer high reflectivity band thickness ( OHRBT ) , and the total area of intraretinal fluid ( IRF ) and subretinal fluid ( SRF ) were measured at different time points. The relationship between the changes and follow up time was analyzed. Statistical analysis of the data was performed using SPSS for windows version 13. 0.
RESULTS: There months after treatment, an improvement of 2 lines or better on the Snellen chart was achieved on 22 eyes, visual acuity of 3 eyes without significant change, 3 eyes got decreased, 2 cases lost follow up. The average macular thickness of improved 22 eyes before treatment was 722. 5±55. 6μm, 2wk after treatment, 708. 3±45. 3μm, 1mo, 584. 4±49. 3μm, 2mo, 430. 7±50. 2μm and 180. 6 ±36. 3μm at 3mo. The OHRBT before and after treatment respectively were 302. 3 ±50-2μm, 277. 5±42. 3μm, 202. 7±40. 1μm, 180. 6±35. 7μm, 100. 8±22. 9μm. The total area of both IRF and SRF was estimated as 0. 34±0. 12mm2 , 0. 25±0. 07mm2 , 0. 10±0-05mm2 , 0. 08±0. 04mm2 , 0. 05±0. 01mm2 .
CONCLUSION:SRF and retinal edema of patients with AMD were absorbed 1mo after PDT, and the BFT, OHRBT were significantly tend to be thin.

Diagnosis, Differential ; Esophageal Neoplasms ; pathology ; surgery ; Granuloma, Pyogenic ; pathology ; surgery ; Hemangioma, Capillary ; pathology ; Hemangiosarcoma ; pathology ; Humans ; Male ; Middle Aged ; Sarcoma, Kaposi ; pathology

OBJECTIVETo explore the mechanism of acupuncture combined with medication for treatment of essential hypertension (EH).

METHODSSixty cases of EH were randomly divided into a combined acupuncture and medication group (group A) and a medication group (group B), 30 cases in each one, treated with acupuncture in combination with oral administration of Felodipine, and simple oral administration of Felodipine respectively. Before and after treatment, the changes of blood pressure, and the contents of E-selectin (Es), iNOS and eNOS were determined.

RESULTSAfter treatment, the blood pressure declined in either group. The total effective rate in group A was 86.7% (26/30), which was superior to that of 73.3% (22/30) in group B. After treatment, the plasma Es and iNOS contents in two groups decreased as compared with those before treatment (both P < 0.01), of which, plasma Es content in group A decreased apparently as compared with group B (P < 0.01). After treatment, the content of plasma eNOS increased as compared with that before treatment in group A (P < 0.01).

CONCLUSIONThe mechanism of acupuncture on anti-blood pressure probably relies on the improvements in vascular endothelial cellular function so that Es, iNOS and eNOS expression can be recovered to normal level and ultimately blood pressure is adjusted.

Acupuncture Therapy ; Adult ; Aged ; Blood Pressure ; Combined Modality Therapy ; E-Selectin ; blood ; Felodipine ; therapeutic use ; Female ; Humans ; Hypertension ; blood ; drug therapy ; physiopathology ; therapy ; Male ; Middle Aged ; Nitric Oxide Synthase Type II ; blood ; Treatment Outcome