Objective To analyze the biochemical characteristics and clinical characteristics of heart failure patients with intermediate ejection fraction.Methods From June 2012 to June 2017,nine hundred and thirty patients with heart failure who were hospitalized and treated in Beijing Anzhen Hospital were selected.According to left ventricular ejection fraction (LVEF),the patients were divided into heart failure with reduced left ventricular ejection fraction group (LVEF＜40％),heart failure with midrange left ventricular ejection fraction group (LVEF 40％-49％) and heart failure with preserved left ventricular ejection fraction group (LVEF ≥ 50％).The number of cases of acute heart failure and chronic stable heart failure was recorded.The general patient information (gender,age,body mass index (BMI),systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR),NYHA classification) laboratory test results (Brain Brain natriuretic peptide (BNP)) and echocardiography (left ventricular end-diastolic diameter (LVEDD),left atrium diameter (LAD),septal thickness (interventricular septum thickness,IVSD),left ventricle posterior wall thickness (LVPWT) were collected.Results The proportion of patients with acute heart failure in the midrange left ventricular ejection fraction heart failure was similar to the heart failure with reduced left ventricular ejection fraction (38.0％ (35/92) vs.45.4％ (210/463),P＞0.05),but significantly higher than the heart failure with preserved left ventricular ejection fraction (38.0％ (35/92) vs.10.4％(210/463),P=0.000).The proportion of NYHA class IV patients in the heart failure with midrange left ventricular ejection fraction was lower than the heart failure with reduced left ventricular ejection fraction(10.9％(10/92) vs.24.6％(114/463),P=0.000),and higher than the heart failure with preserved left ventricular ejection fraction (10.9 (10/92) ％ vs.2.9％ (11/375),P =0.000).Left atrial diameter,left ventricular end diastolic diameter in the heart failure with reduced left ventricular ejection fraction were maximum ((47 ± 8) mm,(67.3 ± 9.0) mm),the heart failure with midrange left ventricular ejection fraction were medium ((44 ± 7) mm,(60.0 ± 7.5) mm),the heart failure with preserved left ventricular ejection fraction were minimum((42±7) mm,(41.7±6.1)mm),and the difference between the three groups was statistically significant (F =44.200,F =648.426,P ＜ 0.05).Conclusion Some biochemical and echocardiographic features of heart failure with midrange left ventricular ejection fraction patients are located between heart failure with reduced left ventricular ejection fraction and heart failure with preserved left ventricular ejection fraction.The LVEDD is significantly increased in heart failure with midrange left ventricular ejection fraction and heart failure with reduced left ventricular ejection fraction group.The ventricular remodeling in heart failure with midrange left ventricular ejection fraction is similar to that of heart failure with reduced left ventricular ejection fraction.

Objective To study the clinical efficacy of LED blue light tube phototherapy in severe hyperbilirubinemia with acute bilirubin encephalopathy (ABE).Method Clinical data of newborns admitted to neonatal department of our hospital between Dec.2013 and Dec.2016 were retrospectively reviewed.Infants with gestational age ≥ 35 weeks who were diagnosed with severe hyperbilirubinemia and ABE were collected and analyzed.From Dec.2013 to Nov.2014,infants treated with common blue light tube were assigned into traditional blue light group (traditional group).From Dec.2014 to Dec.2016,infants treated with LED blue light tube were assigned to LED blue light group (LED group).Total serum bilirubin (TSB) levels and bilirubin induced neurological dysfunction (BIND) scores were analyzed between the two groups.Neuron specific enolase (NSE) levels before and after phototherapy were also compared.Follow-up data for three months after discharge were analyzed.Result Fifty-one infants with severe hyperbilirubinemia and ABE were included,with 24 cases in traditional group and 27 cases in LED group.There were no significant differences in TSB levels and BIND scores between the two groups before phototherapy (P ＞ 0.05).TSB levels at 4 h,24 h and 48 h after phototherapy in LED group were significantly lower than traditional group respectively [(331.3 ±21.8) μmol/L vs.(372.1 ±25.2) μmol/L,(233.6 ± 20.4) μmol/L vs.(269.4 ± 19.8) μmol/L,(184.5 ± 15.2) μmol/L vs.(226.3 ± 22.7) μmol/L,P ＜ 0.05].However,there was no significant difference in TSB levels at 12 h after phototherapy between the two groups (P ＞ 0.05).BIND scores at 4 h after phototherapy in LED group were significantly lower than traditional group [(4.0 ± 0.6) vs.(4.7 ± 0.8),P ＜ 0.05].There were no significant differences in BIND scores at other time points after phototherapy between the two groups (P ＞ 0.05).In both groups,serum NSE levels after phototherapy were lower than before phototherapy.Serum NSE level after phototherapy in the LED group was significantly lower than the traditional group (P ＜ 0.05).Total phototherapy duration of the LED group was significantly shorter than the traditional group (P ＜ 0.05).The incidence of exchange transfusion in LED group was significantly lower than traditional group.The incidence of abnormal brainstem auditory evoked potential in LED group were significantly lower than traditional group at 1 month and 3 months after birth (P ＜ 0.05).The proportion of abnormal cranial MRI between the two groups showed no statistical differences (P ＞ 0.05).Conclusion TSB levels and brain injury indicators should be closely monitored and evaluated in infants with severe hyperbilirubinemia and ABE.Active LED blue light phototherapy can rapidly reduce TSB levels,effectively control the progress of ABE,and reduce the ratio of exchange transfusion.Adverse reactions of LED blue light phototherapy are not observed in this study.

Objective: To observe the safety and efficiency of face-lift combined with fat grafting in facial rejuvenation. Methods: We performed a retrospective study, which included 23 patients. SMAS suspension and multi-site suspension were combined to correct the nasolabial fold, mid-cheek aging and malar mounds. Structural fat grafting was performed to treat the volume loss in mid-face. Results: All patients demonstrated a significant improvement in midfacial appearance. No infection or nerve injury were found in this study. Only three patients did not get primary healing in temple region, which led to temporal hair loss from secondary healing. Conclusions This study demonstrates that fat grafting and multiple layers face-lift are efficient method for facial rejuvenation. These approaches appear to be very promising for facial anti-aging techniques.

Objective:To investigate the clinical application of cognitive behavioral therapy (CBT) and the reasons of the choosing CBT.Method:Totally 14 psychotherapists accepted a semi-structured interview,including their backgrounds of CBT training,the application of CBT in psychotherapy,their attitude toward consultative relations,their opinion on comparing other schools with CBT,and their reasons for choosing CBT.Results:The main reasons for choosing CBT included the influence of important others,the characters of CBT and personal factors.In clinical practice,the most commonly used behavioral techniques included exposure therapy,roll play,relaxation Waining and so on.The most commonly used cognitive techniques included Socratic questioning,cognitive restructuring and challenge unreasonable cognition.Conclusion:Cognitive behavioral therapy (CBT) is suitable for those who are sensible and preferring structural therapy.Nevertheless,the trend in therapy is the integration of different psychotherapy schools.

Objects:To investigate the current situation of counselors'implementation and their attitude to informed consent in Beijing.Methods:Eleven counselors who worked in Beijing were interviewed,the average of their working years was (7.4 ± 4.4).A semi-structured interview was used to learn about their practicing processes in and viewpoints on informed consent,and their interview transcripts were analyzed through qualitative method.Results:The results could be categorized into four categories,including the content of informed consent,the influential factors of informed consent,problems and confusions,and the significance of informed consent.The crucial role of informed consent in psychotherapy was generally recognized by counselors,and they could obey the related rules as well.The therapists had some confusion and problems about informed consent,such as the form and length,the consent for special population and online consultation.Conclusion:Basically,the counselors in Beijing could comply with the ethical standards of informed consent.However,they also suggest that certain limitations of these rules should be noticed.

OBJECTIVE:To investigate clinical efficacy and safety of meglumine adenosine cyclophosphate in the treatment of acute myocardium infarction. METHODS:A total of 80 patients with acute myocardium infarction in our hospital during May 2015-Jan. 2016 were selected and divided into control group and observation group according to random number table,40 cases in each group. Control group was given conventional treatment. Observation group was additionally given Meglumine adenosine cyclo-phosphate injection 120 mg added into 5% Glucose injection 250 mL,ivgtt,qd,on the basis of control group. Both groups re-ceived treatment for 7 d. Clinical efficacies as well as the levels of serum hs-CRP and NT-proBNP before and after treatment were observed in 2 groups,and the occurrence of ADR was compared between 2 groups. RESULTS:Total response rate of observation group(92.50%)was significantly higher than that of control group(75.00%),with statistical significance(P<0.05). Before treat-ment,there was no statistical significance in the serum levels of hs-CRP or NT-proBNP between 2 groups(P>0.05). After treat-ment,the serum levels of hs-CRP and NT-proBNP in 2 groups were decreased significantly,and the observation group was signifi-cantly lower than the control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Meglumine adenosine cyclophosphate shows significant therapeutic efficacy for acute myocardium infarction,reduces serum levels of hs-CRP and NT-proBNP significantly with good safety.

Objective To study the influence of CTP-OD1-HA and CTP-OD2-HA fusion peptides and combined with imatinib on proliferation of K562 cells.Methods K562 cells were treated with CTP-OD1-HA and CTP-OD2-HA peptides or together with imatinib.The proliferation of cells were detected and compared by MTT and clone formation methods.Results MTT examination demonstrated that CTP-OD1-HA and CTP-OD2-HA peptides could inhibit the proliferation of K562 cells,and the effect was more obvious when acted along with imatinib;Clone formation showed that CTP-OD1-HA and CTP-OD2-HA peptides suppressed the continuous colony forming ability of K562 cells.Conclusion CTP-OD1-HA and CTP-OD2-HA could specially inhibit the proliferation of K562 cells,and increase the sensitivity of imatinib.

Objective To investigate the prevalence of genital Chlamydia trachomatis (GCT) infection and associated risk factors in male clients attending sexually transmitted disease (STD) clinics in Guangdong and provide integrated intervention strategy for this group.Methods Convenient sampling was used to recruit participants from April to June in 2015 in Guangdong province.The information about their socio-demographic characteristics and sexual behaviors were collected by using a questionnaire,and blood samples were taken from them to test the antibodies against HIV,syphilis and HCV.First pass urine was taken to test GCT and gonorrhea.Results A total of 1 749 participants with the average age of 39.53 years were recruited.The majority of them were married (73.87％,1 292/1 749),residents of Guangdong (92.28％,1 614/1 749) and in Han ethnic group (99.49％,1 740/1 749).The positive rates for GCT,HIV,syphilis,HCV,Neisseria gonorrhea,and WBC in urinalysis were 6.06％ (106/1 749),0.46％ (8/1 749),3.43％ (60/1 749),0.45％ (7/1 550),2.74％ (48/1 749),7.89％ (138/1 749) respectively.Multivariate analysis showed that risk factors for GCT infection include IDUs (OR=13.98,95％CI:3.35-58.38),anal sex with men (OR=3.11,95％ CI:1.45-6.71),Neisseria gonorrhea positive (OR =9.64,95％ CI:5.09-18.24),and WBC positive (OR =1.96,95％ CI:1.08-3.55).Conclusions This study demonstrated the high prevalence of GCT infection in male clients attending STD clinics in Guangdong.Therefore precision intervention should target this population at high-risk.

Objective A meta-analysis was conducted to evaluate the correlation between hepatitis C virus (HCV) infection and the incidence of intrahepatic cholangiocarcinoma (ICC).Methods EMBASE,MEDLINE,Web of Science,CNKI,Weipu and Wanfang databases were retrieved to identify eligible studies which were published between January 2000 and May 2015.Pooled odds ratios (OR) with 95％ confidence interval (95％ CI) were calculated using RevMAN 5.3.Results 14 case-control studies and 2 cohort studies were included in this study.As there was great heterogeneity among these 16 studies (Chi2 =53.18,df =15,I2 =72％,P ＜0.05),the random-effect model was employed.The combined risk estimates of all the studies showed a significant increase in ICC incidence with HCV infection (OR =3.96,95％ CI 2.63-5.95,P ＜ 0.05).The Begg funnel plot showed no evidence of publication bias.Conclusion HCV infection is related to an increased risk of ICC incidence.

Objective To compare the baroreflex sensitivity (BRS) when controlled hypotension was performed with sevoflurane versus isoflurane in the pediatric patients.Methods Sixty male American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 3-16 yr,with body mass index of 20-28 kg/m2,scheduled for elective scoliosis surgery under general anesthesia,were randomly divided into 2 groups (n=30 each) using a random number table:sevoflurane-induced hypotension group (group Sev) and isoflurane-induced hypotension group (group Iso).Anesthesia was induced with midazolam,sufentanil and propofol.Endotracheal intubation was facilitated with rocuronium.Anesthesia was maintained with closed-circuit low flow anesthesia with either sevoflurane or isoflurane,maintaining mean arterial pressure at 55-65 mmHg and bispectral index values at 40-60 during surgery.Cardiovascular BRS was measured before induction of anesthesia (T0),immediately after intubation (T1),immediately after the end-tidal inhalational anesthetic concentration reached 1 minimal alveolar concentration (T2),and at 10,20 and 30 min after target hypotension (mean arterial pressure 55-65 mmHg) was achieved (T3-5).Results There was no significant difference in BRS at T0-2 between the two groups (P＞0.05).Compared with the value at To,the BRS was significantly decreased at the other time points in the two groups (P＜0.05).Compared with the value at T1,the BRS was significantly increased at T2,and decreased at T3-5 in the two groups (P＜0.05).The BRS was significantly lower at T3-5 than at T2 in the two groups (P＜0.05).The BRS was significantly lower at T3-5 in group Sev than in group Iso in the two groups (P＜0.05).Conclusion Sevoflurane produces better efficacy than isoflurane when used for controlled hypotension in the pediatric patients.