Protection of Addition and Subtraction Therapy of Ditantang Combined with Taohong Siwutang to Brain Nerve of Patients with Cerebral Infarction and （Syndrome of Phlegm and Blood Stasis Blocking Collaterals） During Early Recovery / 中国实验方剂学杂志

Objective:To discuss clinical effect of addition and subtraction therapy of Ditantang combined with Taohong Siwutang to cerebral infarction and syndrome of phlegm and blood stasis blocking collaterals during early recovery， and to study protection to brain nerve. Method:One hundred and fifty-two patients were randomly divided into control group （76 cases） and observation group （76 cases） by random number table， 71 patients in control group completed the therapy （5 patients were falling off， missing visit or eliminated）， and 70 patients in observation group completed the therapy. Both groups' patients got comprehensive rehabilitation measures. Patients in control group got Zhongfeng Huichun pills， 1.5 g/time， 3 times/day. Patients in observation group got addition and subtraction therapy of Ditantang combined with Taohong Siwutang in the morning and at night， 1 dose/day. The treatment was continued for 12 weeks. Before and after treatment， scores of degree of neurological deficit， Barthel （BI） index， Fugl-Meyer scale （FMA）， modified Rankin scale （MRS） and syndrome of phlegm and blood stasis blocking collaterals were graded. And levels of malondialdehyde （MDA）， glutathione peroxidase （GSH-Px）， superoxide dismutase （SOD）， advanced oxidation protein products （AOPP）， vascular endothelial growth factor （VEGF）， brain-derived neurotrophic factor （BDNF） and neuron specific enolase （NSE）. And cerebral hemodynamics were detected， and peak flow velocity （VS）， vascular resistance index （RI）， pulsatility index （PI） and cerebrovascular reserve function （CVR） were recorded. Safety was evaluated. Result:After the 6th week and 12th week of treatment， scores of degree of neurological deficit， BI， FMA， MRS， syndrome of phlegm and blood stasis blocking collaterals， AOPP， MDA， NSE， RI and PI were lower than those in control group （P<0.01）， levels of SOD， GSH-Px， BDNF， VEGF， Vs and CVR were higher than those in control group （P<0.01）. The clinical effect was better than which in control group （Z=2.109， P<0.05）. Besides， there was no adverse reaction caused by Ditantang combined with Taohong Siwutang. Conclusion:Ditantang combined with Taohong Siwutang can ameliarate the hemodynamics， reduce the lipid peroxidation damage， regulate the neurovascular repair factor， so it can promote the repair of nerve tissue and function， clinically reduce the degree of nerve function defect， improve the ability of daily life and exercise when it used to cerebral infarction and syndrome of phlegm and blood stasis blocking collaterals during early recovery， and it is good for clinical effect and safe using.

Analysis of short-term efficacy of overlapping delta-shaped anastomosis in totally laparoscopic left hemicolectomy for digestive tract reconstruction / 中华胃肠外科杂志

Objective: At present, though the laparoscopic delta-shaped anastomosis and overlapping delta-shaped anastomosis have been gradually applied to complete laparoscopic radical resection of left hemicolon cancer, the comparative evaluation of their efficacy has not been mentioned in the published literatures. This study aims to explore the safety, feasibility and short-term efficacy of overlapping delta-shaped anastomosis (ODA) in totally laparoscopic left hemicolectomy. Methods: A retrospective cohort study was performed. The clinical and pathological data of patients who underwent totally laparoscopic left hemicolectomy at Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from May 2017 to October 2020 were retrospectively analyzed. The case inclusion criteria were as follows: (1) age of 18-75 years; (2) body mass index (BMI) of 18.5-30 kg/m(2); (3) descending colonic and proximal sigmoid colonic adenocarcinoma was confirmed by preoperative colonoscopy and pathology. The exclusion criteria: (1) multiple primary colorectal cancers; (2) uncontrolled or poorly controlled diabetes mellitus, immune system diseases, or hematological diseases; (3) severe intestinal obstruction; (4) left transverse colonic or splenic flexure colonic adenocarcinoma; (5) distant metastasis of liver, lung and other viscera determined by enhanced computed tomography in the chest, abdomen and pelvis. According to the above criteria, a total of 115 patients with left hemicolon cancer were enrolled. All the patients underwent totally laparoscopic left hemicolectomy. Patients who underwent laparoscopic traditional delta-shaped anastomosis were selected as the control group. Patients who underwent laparoscopic ODA were selected as the ODA group. Effects of these two laparoscopic reconstruction methods on postoperative recovery and perioperative complications were analyzed and compared. Results: A total of 60 patients were enrolled in the ODA group, including 32 males and 28 females, with mean age of (57.3±10.4) years and body mass index (BMI) of (25.0±3.1) kg/m(2). While mean 55 patients were enrolled in the control group, including 31 males and 24 females, with mean age of (56.7±9.9) years and BMI of (24.4±2.9) kg/m(2). There was no statistically significant differences between the two groups in gender, age, BMI, American Society of Anesthesiologist (ASA) classification, TNM staging, preoperative abdominal surgery history, neoadjuvant chemotherapy and nutritional status (levels of hemoglobin, lymphocyte count, prealbumin, and albumin) (all P>0.05). All the patients in both groups received R0 resection without conversion to open laparotomy or conversion to extra-abdominal anastomosis. The digestive tract reconstruction time of the ODA group was significantly shorter than that of the control group [(15.1±1.7) minutes vs. (15.9±2.4) minutes, t=-2.053, P=0.042]. There were no statistically significant differences in the total operation time, intraoperative blood loss, length of skin incision, tumor size, proximal and distal margins, harvested lymph nodes, postoperative first ambulatory time, and postoperative hospital stay (all P>0.05). However, the time to the first flatus and the first defecation in the ODA group was significantly shorter as compared to control group [(1.5±0.5) days vs. (1.7±0.5) days, t=-2.028, P=0.045; (3.1±0.6) days vs. (3.4±0.7) days, t=-2.095, P=0.039], indicating faster intestinal function recovery in patients with ODA. The morbidity of postoperative complication was 6.7% (4/60) in the ODA group and 7.3% (4/55) in the control group and no significant difference was found (χ(2)=0.016, P=0.898). Two cases of incision infection, 1 case of lung infection, and 1 case of intra-abdominal infection occurred in the ODA group, while 3 cases of lung infection and 1 case of intra-abdominal infection occurred in the control group. All these complications were resolved after conservative treatment, and no secondary operation was performed due to complications. Conclusion: Compared with the traditional delta-shaped anastomosis, ODA is associated with a faster recovery of postoperative intestinal function without increasing the morbidity of postoperative complications, and has the satisfactory short-term efficacy.

Screening and Verification of TPM1 and CALD1 Related to Diagnosis and Prognosis of Bladder Cancer / 肿瘤防治研究

Objective To screen and verify hub genes TPM1 and CALD1 that can affect the diagnosis and prognosis of bladder cancer (BLCA). Methods We obtained gene chip expression data of 414 and 188 cases of bladder cancer from TCGA and GEO, respectively. By constructing a weighted gene co-expression network analysis (WGCNA) and identifying differentially-expressed genes between tumor tissues and normal tissues, the pivotal genes that were highly associated with bladder cancer were obtained, and the STRING database was used to construct a protein interaction network to screen out prognostic-related pivotal genes. We took 29 cases of bladder cancer samples from People's Hospital of Zhengzhou as external verification results. Results A total of 915 and 464 differentially-expressed genes were screened from the TCGA database and GSE13507, respectively. Two modules with the strongest correlation were obtained through WGCNA: the blue module (Pearson cor=0.60, P=1E-44) and the cyan module (Pearson cor=0.52, P=7E-19), and 156 intersection genes were obtained. Through protein interaction network analysis, 10 pivotal genes were screened out. TPM1 and CALD1 genes had the greatest correlation with the survival of bladder cancer patients, which was verified by external experimental verification group. Conclusion TPM1 and CALD1 are closely related to the prognosis of bladder cancer patients. They are also pivotal genes to promote tumor progression.

Clinical and Laboratory Features of 6 Cases of Pemphigoid Nodularis / 中国医学科学院学报

To investigate the clinical manifestations and laboratory characteristics of 6 cases of pemphigoid nodularis (PN). The clinical and laboratory data of 6 patients with PN admitted to the Department of Dermatology,Peking Union Medical College Hospital from January 2016 to August 2019 were retrospectively analyzed. PN mainly occurred in middle-aged and elderly people,with an average age of (58±16) years. Eosinophils were elevated in 4 patients. Immunoglobulin E (IgE) level was (530±672) kU/L in five patients. Direct immunofluorescence showed IgG and/or C3 deposition on basal membrane zone. Indirect immunofluorescence showed positive IgG anti-basement membrane zone,with a titer of 1:40-1:320. Enzyme-linked immunosorbent assay showed the anti-BP180 antibodies were positive [24-85 U/ml,average(43±26) U/ml] in 5 patients. None of the patients had neurological disorders. One patient was lost to follow-up. The disease recurred in 3 of 5 patients during the follow-up,and two patients still received maintenance corticosteroids. PN mainly occurs in middle-aged and elderly individuals. It is featured by elevated eosinophils and total IgE and relatively low anti-BP180 antibody titers. Recurrence is common but PN is less likely to be associated with neurological diseases.

Risk factors for endophthalmitis in age-related cataract patients undergoing phacoemulsification / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To explore the risk factors for endophthalmitis in age - related cataract patients undergoing phacoemulsification, in order to provide reasonable intervention countermeasures to reduce the incidence of eddophthalmitis after phacoemulsification, increase the surgery efficacy.?METHODS:The 4500 cases (6180 eyes) of age-related cataract patients with phacoemulsification in our hospital were analyzed, and cases of endopathalmitis needed to have vitreous puncture to collect the sample for analysis, the infectious bacteria, funfal distribution and the operation time, patients age, complications, surgical incision were analyzed for the risk factors of endophthalmitis in senile cataract patients. Data were statistically analyzed by SPSS 18. 0.?RESULTS: In our study, among the 4500 cases ( 6180 eyes ) with phacoemulsification, the endophthalmitis infection rate was 0. 19％ (12/6180), the incidence of endophthalmitis was significantly higher in patients with age ≥75 years, with diabetes, hypertension, coronary heart disease history, and the temporal transparent corneal tunnel incision surgery (P<0. 05). The vitreous overflow and the posterior capsule broken in the operative process of the endophthalmitis infection were 60.00％ (9/15) and 66. 67％(8/12), more higher than patients with no symptoms obviously (P<0. 01).?CONCLUSION: For the cataract patients over 75 years old or with diabetes, interventions should be done well before surgery. Surgical incision should be selected in the surgical procedure and avoid complications such as vitreous overflow and posterior capsular rupture in order to reduce the incidence of intraocular infection and improve the postoperative recovery.

Angiographic characteristics of acute myocardial infarction with myocardial bridging / 中华急诊医学杂志

Objective Myocardial bridging is a congenital anomaly.However,little data is available for patients with myocardial bridging (MB) associated with acute myocardial infarction (AMI).The goals of this study are to evaluate characteristics of MB in patients with AMI.Methods From March 1999 to February 2006,137 patients with both MB and AMI,were identified by coronary angiography,including 117 men and 20 women with an average age of 60.77±12.01 years (range 30-83 years) were enrolled in the present study.Results There were 119 patients with MB at the middle segment of left anterior descending artery (LAD),15 patients at distal segment of LAD,2 patients at middle segment of left circumflex (LCX),and 1 at the proximal segment of the obtuse marginal branch (OM) of LCX.There are 36 patients with non-ST elevation acute myocardial infarction (NSTEAMI),38 patients with anterior ST elevation AMI (STEAMI),40 patients with inferior STEAMI and 23 patients with inferior-posterior STEAMI.Risk factors such as hypertension,diabetes,hyperlipidemia and smoking were not different among four groups.Patients with anterior AMI included 8 patients who showed no stenosis at the segment of MB.Conclusion Patients with MB and ST elevation AMI were mainly inferior AMI.MB might be one of the causes of AMI.

Effect of IL-8 on the Immune Function of Patients with Acute -Lymphoblastic Leukemia and Its Mechanism / 中国实验血液学杂志

OBJECTIVE@#To investigate the effect of interleukin -8 (IL-8) on immune function in acute lymphoblastic leukemia patients and its related mechanisms.@*METHODS@#Forty-five ALL patients were selected from January 2014 to September 2017 in our hospital. Out of them, 32 relieved patients were included in group A, 13 patients did not relieved patients after treatment and were included in the group B. The serum IL-8 level was detected by ELISA.Th1 and Th2 cells were measured by flow cytometry. After Th cells were treated with different concentration of IL-8, the Western blot was used to detect the translation levels of p-STAT3 and JAK in cells.@*RESULTS@#The difference of white blood cell count and clinical risk level between the 2 groups was statistically significant (P0.05).@*CONCLUSION@#IL-8 can interfere the balance of Th1/Th2 through STAT3 signaling pathway, and has effect on the immune function of ALL patients.

Safety and efficacy of rotational atherectomy in the interventional treatment of coronary chronic total occlusion lesions / 中华心血管病杂志

Objective@#To investigate the safety and efficacy of rotational atherectomy in the interventional treatment of coronary chronic total occlusion lesions.@*Methods@#In this retrospective study,a total of 31 consecutive patients with coronary chronic total occlusion(CTO) lesions underwent rotational atherectomy in our hospital from February 2004 to December 2016 were enrolled,and the clinical features were analyzed. Coronary atherectomy was performed if balloon failed to cross the CTO lesions or balloon could not be fully dilated in the CTO lesions after wire crossing. The definition of procedure success was defined as residual stenosis less than 20% after implantation of drug eluting stent and rotational atherectomy. After the procedure, the patients were followed up to observe major adverse cardiac and cerebral vascular events which including cardiogenic death, myocardial infarction, cerebrovascular accident, and target lesion revascularization.@*Results@#The 1.25 mm diameter burr was firstly selected in 80.6% (25/31) patients,and 96.8%(30/31) patients used only 1 burr to complete the rotational atherectomy procedure. The complication rate was 9.8% (3/31) including 1 patient with coronary dissection and 3 patients with slow flow or no flow. There was 1 patent with both coronary dissection and slow flow. The procedure success rate was 96.8%(30/31). Interventional treatment related myocardial infarction occurred in 3 patients during hospitalization.The 30 patients with procedure success were followed up 36(11, 96) months. The incidence rate of major adverse cardiac and cerebral vascular events was 13.3% (4/30), of which the cardiogenic death rate was 3.3% (1/30), the myocardial infarction rate was 6.7% (2/30), cerebrovascular accident rate was 3.3%(1/30),and the target lesion revascularization rate was 6.7% (2/30).@*Conclusion@#Rotational atherectomy is safe and effective in the interventional treatment of coronary CTO lesions.

Inductively Coupled Plasma Mass Spectrometry as a Reference Method to Evaluate Serum Calcium Measurement Bias and the Commutability of Processed Materials during Routine Measurements / 中华医学杂志(英文版)

<p><b>Background</b>Measuring total serum calcium is important for the diagnosis of diseases. Currently, results from commercial kits for calcium measurement are variable. Generally, the performance of serum calcium measurements is monitored by external quality assessment (EQA) or proficiency testing schemes. However, the commutability of the EQA samples and calibrators is often unknown, which limits the effectiveness of EQA schemes. The aim of this study was to evaluate the bias of serum calcium measurements and the commutability of processed materials.</p><p><b>Methods</b>Inductively coupled plasma mass spectrometry was applied as a comparative method, and 14 routine methods were chosen as test methods. Forty-eight serum samples from individual patients and 25 processed materials were quantified. A scatter plot was generated from patient samples, and 95% prediction intervals were calculated to evaluate the commutability of the processed materials and measurement bias at three concentration levels was used to determine the accuracy of routine assays.</p><p><b>Results</b>All assays showed high precision (total coefficient of variation [CV] <2.26%) and correlation coefficients (r > 0.99). For all assays, the mean bias for the 48 patient samples ranged from -0.13 mmol/L to 0.00 mmol/L (-5.61-0.01%), and the ranges for the three concentrations were -0.10-0.04 mmol/L (-5.71-2.35%), -0.14--0.01 mmol/L (-5.80--0.30%), and -0.19-0.04 mmol/L (-6.24-1.22%). The EQA samples, calibrators, and animal sera exhibited matrix effects in some assays; human serum pools were commutable in all assays; certificate reference materials were commutable in most assays, and only GBW09152 exhibited a matrix effect in one assay; and aqueous reference materials exhibited matrix effects in most assays.</p><p><b>Conclusions</b>Biases for most assays were within the acceptable range, although the accuracy of some assays needs improvement. Human serum pools prepared from patient samples were commutable, and the other tested materials exhibited a matrix effect.</p>

Antibacterial steroidal alkaloids from Holarrhena antidysenteriaca / 中国天然药物

Two new steroidal alkaloids, isoconkuressine and N-formylconessimine, together with 6 known steroidal alkaloids including conkuressine, conessine, isoconessimine, conimine, conarrhimine, and funtudienine, were isolated from the seeds of Holarrhena antidysenteriaca Wall.ex A.DC. Their intrinsic antibacterial activities and synergistic effects with penicillin and vancomycin were analyzed in methicillin sensitive staphylococcus aureus (MSSA) and methicillin resistant staphylococcus aureus (MRSA). Two of the steroidal alkaloids including one new compound (N-formylconessimine) showed potential antibacterial activity and possessed synergistic effects with penicillin and vancomycin, respectively.

Correlation analysis of NLR,PLR and tyrosine-kinase inhibitors in the treatment of advanced lung adenocarcinoma / 中国综合临床

Objective To analyze the correlation between neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR) in peripheral blood and the therapeutic effect and prognosis of patients with advanced lung adenocarcinoma treated with tyrosine-kinase inhibitors.Methods Retrospective analysis was utilized to measure the clinical pathological characteristics and follow-up data of 40 cases with advanced lung adenocarcinoma definitely diagnosed by pathology.Correlation analysis was performed by Spearman test,and comparison of the sample rate was measured by the chi square test.Survival analysis was performed by Kaplan-Meier method,Log-rank test was used to compare patients survival difference among different groups.COX regression model was utilized to analyze the prognostic factors of patients with lung cancer.Results Through the ROC curve,the optimal cut-off points of NLR and PLR were calculated to be 3.74 and 205.1 respectively.In NLR<3.74 group,objective response rate(ORR),the median progression-free survival(PFS) and the median overall survival(OS) were 86.9%(20/23),9.02 months and 12.37 months respectively.In NLR ≥3.74 group,ORR,the median PFS and the median OS was ORR were 35.2%(6/17),3.15 months and 5.12 months respectively.Compared with NLR ≥ 3.74 group,NLR<3.74 group had a higher ORR(P=0.036),PFS(P=0.011) and OS(P=0.021),the difference was statistically significant.In PLR<205.1 group,ORR,the median PFS and the median OS was ORR were 85.7%(18/21),9.67 months and 14.35 months respectively.In PLR ≥ 205.1 group,ORR,the median PFS and the median OS was ORR were 42.1%(8/19),3.21 months and 9.25 months respectively.Compared with group PLR ≥ 205.1,PLR<205.1 group had a higher ORR(P=0.045) and PFS(P=0.018),the difference was statistically significant.COX multivariate analysis showed that NLR was an independent prognostic factor for PFS(RR=1.091,95%CI:1.004-1.185,P=0.039) and OS(RR=0.986,95%CI:0.932-1.148,P=0.021).PLR was an independent prognostic indicator of PFS(RR=1.100,95%CI:0.996-1.005,P=0.024).Conclusion NLR and PLR may be independent prognostic factors in patients with advanced lung adenocarcinoma.

Treatment of acute ST-segment elevation myocardial infarction patients with high thrombus burden and failure primary percutaneous coronary intervention / 中国介入心脏病学杂志

Objective To observe the efficacy of antithrombotic treatment of acute ST-segment elevation myocardial infarction patients with failure primary percutaneous coronary intervention because of high thrombus burden,and its effect on elective percutaneous coronary intervention.Methods Eight acute ST-segment elevation myocardial infarction patients were enrolled,who suffered from failure of primary percutaneous coronary intervention because of high thrombus burden.Summarize the antithrombotic strategies in perioperative and postoperative period,the operative strategies and the follow-up coronary intervention were recorded and reviewed.Results All the patients were male and most of them had acute inferior myocardial infarction with right coronary occluded because of high thrombus burden.Four patients received thrombus aspiration and balloon dilation.One patient received thrombus aspiration and the other three patients did not receive coronary intervention.Tirofiban were given in perioperative period to all the patients.Low molecular weight heparin was given to 6 patients.Dual antiplatelet therapy was given to 6 patients (aspirin 100 mg/day plus clopidogrel 75 mg/day) and 1 patient required up-titration of aspirin to 200 mg/day.Coronary angiography were repeated (29.00 ± 23.25) days later,and the thrombus in the culprit vessels disappeared in two patients,and coronary stent implantation was performed in three patients.Conclusions The routine antithrombotic strategies play limited roles in thrombus clearance in acute ST segment elevation myocardial infarction patients with failure primary percutaneous coronary intervention because of high thrombus burden.The time for the thrombus to be totally organized and the timing of elective percutaneous coronary intervention are still uncertain and need to be further studied.

Inserting ureterovesical reimplantation by means of laparoscopy associated with six-stitch suture / 中国内镜杂志

Objective To discuss the safety and efficacy of inserting ureterovesical reimplantation by means of laparoscopy associated with six-stitch suture.Methods There was an retrospective analysis on operation videos and clinical data for 16 participants of inserting ureterovesical reimplantation by means of laparoscopy associated with six-stitch suture with the period from March in 2012 to September in 2015. And these were statistically analyzed including the operation time, intraoperative bleeding volume, postoperative drainage volume, removal time of drainage tube, admission time after operation and the incidence of postoperative complications of vesicoureteric reflux and stenosis.Results The operations of 16 participants were completed successfully without converting to open surgery. The operation time was 60 ~ 125 min (Mean time: 85 min); intraoperative bleeding volume was 20 ~ 50 ml (Mean volume: 32 ml); postoperative drainage volume was 60 ~ 400 ml (Mean volume: 106 ml); removal time of drainage tube was 3 ~ 6 d (Mean time: 4.2 d) and admission time after operation was 7 ~ 10 d (Mean time: 8.5 d). There was the follow-up with 6 ~ 18 months (Mean time: 12 months) for participants. No anastomotic stenosis was present. In addition, one participant was suffered from mild vesicoureteric relfux. And there was no aggravation during 18 months.Conclusions The inserting ureterovesical reimplantation by means of laparoscopy associated with six-stitch suture was safe and effective. It was found that the operation time was significantly shortened and the incidence of postoperative complications of vesicoureteric relfux and anastomotic stenosis was not increased. By contrast, the six-stitch suture could reduce the incidence of anastomotic stenosis.

Short-term efficacy of posterior chamber phakic intraocular lens implantation for moderate to high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To evaluate the short-term efficacy of posterior chamber phakic intraocular lens implantation for moderate to high myopia.METHODS:Fifty-three eyes of 27 patients with moderate to high myopia (-3.25 to-21.5D) were received posterior chamber phakic intraocular lens implantation with 2.8mm clear corneal incision.Changes of visual acuity, intraocular pressure(IOP), counts of endothelial cells and surgically induced astigmatism at 1mo after surgery were observed.RESULTS:The preoperative best corrected visual acuity (BCVA LogMAR) were 0.05±0.18, the postoperative BCVA at 1d were 0.02±0.14, the postoperative BCVA at 1wk were-0.05±0.11, the postoperative BCVA at 1mo were-0.07±0.10.The postoperative BCVA were statistically significant differences in different time(P<0.05).The preoperative endothelial cell count was 2932.5±270.8/mm2, the postoperative endothelial cell count at 1d was 2917.1±299.0/mm2;the postoperative endothelial cell count at 1wk was 2902.5±288.6/mm2;the postoperative endothelial cell count at 1mo was 2855.3±284.2/mm2.The postoperative endothelial cell count was not statistically significant differences in different time.The preoperative IOP was 15.8±2.5mmHg;the postoperative IOP at 1d was 15.3±2.9mmHg;the postoperative IOP at 1wk was 17.4±5.8mmHg;the postoperative IOP at 1mo were 15.8±2.6mmHg.The preoperative IOP was significantly different compared with postoperative IOP at 1d, 1wk and 1mo.The postoperative IOP at 1d and 1wk were statistically significant differences (P<0.05).The surgically induced astigmatism at 1d was 0.74±0.39D;the surgically induced astigmatism at 1wk was 0.57±0.28D;the surgically induced astigmatism at 1mo was 0.44±0.21D.The postoperative IOP were statistically significant differences in different time (P<0.05).The preoperative anterior chamber depth was 3.26±0.25mm;the postoperative central vault at 1d were 654.5±345.2μm;the postoperative central vault at 1mo were 683.0±211.7μm.The postoperative central vault were significantly different between that at 1d and 1mo after operations.Operations went without serious complications.CONCLUSION:Posterior chamber phakic intraocular lens implantation for moderate to high myopia were safe, effective and predictability.But long-term effect remains needed to be further follow-up.

Improvement effect of electromyographic biofeedback on wrist dorsiflexion function of patients with cerebral infarction at different Brunnstrom stages / 吉林大学学报(医学版)

Objective:To observe the effect of electromyographic biofeedback on the wrist dirsiflexion function of the patients with cerebral infarction at different Brunnstrom stages, and to clarify the treatment of electromyographic biofeedback,and to provide basis for its clinical application.Methods:A total of 100 cerebral infarction patients were selected.Among them 54 BrunnstromⅠ-Ⅱ patients were randomly divided into treatment group (n= 32)and control group (n = 22),and another 46 Brunnstrom Ⅲ patients were randomly divided into treatment group (n=23)and control group (n=23).The patients in four groups were treated with the same routine stroke rehabilitation therapy while the patients in treatment groups still received the electromyographic biofeedback therapy additionally.The maximum electromyographic contraction of muscle,active range of movement (AROM) and Fugl-Meyers Assessment (FMA)of the extension of wrist joint were evaluated before treatment and 4 and 8 weeks after treatment,respectively.Results:The maximum electromyographic contraction values of muscle of the patients in BrunnstromⅠ-Ⅱ treatment group and control group were significantly improved 8 weeks after treatment (P 0.05).The AROM in Brunnstrom Ⅲ treatment group and control group were significantly improved 4 weeks after treatment (P < 0.05 or P < 0.01 ), and the value in treatment group was significantly higher than that in control group (P < 0.05).The FMA in BrunnstromⅠ-Ⅱtreatment group and control group were significantly improved 8 weeks after treatment (P <0.05),while the value in treatment group was higher than that in control group (P <0.05);the FMA in Brunnstrom Ⅲ treatment group began to improve 4 weeks after treatment (P < 0.05)and it was significantly higher than that in control group (P <0.05). The FMA in control group began to improve 8 weeks after treatment (P <0.05). Conclusion:Electromyographic biofeedback can increase the strength and improve the body function of the patients with cerebral infaction.

Comparison of efficacy and safety between biphasic insulin aspart 50 and biphasic human insulin 50：A randomized crossover trial / 中华内分泌代谢杂志

Objective To investigate the efficacy of biphasic insulin aspart 50(BIAsp50)twice daily(bid) versusbiphasichumaninsulin50(BHI50)(bid)plusmetforminonbloodglucosecontrolfollowingastandardmealtest in Chinese patients with type 2 diabetes mellitus(T2DM). Methods A randomized, open-label, 2-sequence, crossover trial for two 4-week treatment periods was conducted in 14 Chines institutes. Eligible subjects inadequately controlled with BHI50(bid)plus metformin were randomized to two sequences in a 1 : 1 ratio(A:BIAsp50-BHI50, B:BHI50-BIAsp50 ) . Standard meal tests were performed at baseline and the ends of two periods within 4 weeks. Primary endpoint was 2h postprandial plasma glucose ( PPG) increment following standard meal test, with insulin dose standardized at 0. 3 IU/kg. Results A total of 161 subjects were randomized into two sequences(81 to sequence A, and 80 to sequence B) and finally analysed. After 4 weeks of treatment, mean 2h PPG increment with BIAsp50 was lower than that with BHI50 [ treatment difference of BIAsp50 vs BHI50: -1. 12 mmol/L ( 95% CI-1. 66,-0. 58), P<0. 01], suggesting superiority of BIAsp50 over BHI50. Incremental area under the curve for PPG(0-2 h)with BIAsp50 was lower than that with BHI50 [treatment difference:-38. 8 mmol·L-1·min-1(95%CI-77. 3,-0. 26), P=0. 049], as was the mean 2h PPG [treatment difference:-0. 58 mmol/L(95% CI -1. 13,-0. 03), P=0. 040]. The FPG value with BIAsp50 was higher than that with BHI50 [treatment difference:0. 52 mmol/L(95%CI 0. 18, 0. 86), P=0. 003]. The rate of nocturnal hypoglycemia with BIAsp50 was lower than that with BHI50(1. 13 vs 2. 86 events per subject year, P<0. 01). Conclusion In patients with T2DM inadequately controlled with BHI50 plus metformin, BIAsp50 was proven to be well-tolerated with improved postprandial glucose control compared with BHI50.

Evaluation the safety and efifcacy of corsair microcatheterin the recanalization for coronary chronic total occlusion with transradialantegrade approach / 中国介入心脏病学杂志

Objective The aim of this study was to evaluate the safety and efficacy of 135 cm Corsair microcatheter inpercutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO) with antegrade approach via radial artery. Methods From June 2010 to February 2014, a total of 81 patients with CTO lesions treated with 135cm Corsair microcatheter (Asahi Intec Co, Japan) and transradial antegrade approach was enrolled in this study. The success rate of CTO-PCI, the rate of Corsair microcatheter crossing the CTO lesions and the number of balloon catheters utilization were retrospectively analyzed. Unique complications related to the Corsair microcatheter were also documented. Results Success recanalization of CTO were achieved in 73 (90.1%) patients. Crossing the CTO body with Corsair microcatheter was found in 56(84.8%) patients. The number of balloon utilized after Corsair microcatheter crossing the CTO was much lower than that of patients who Corsair microcatheter failed to cross (1.3±0.6 per patient versus 2.8±1.2per patient, P < 0.05). The success recanalization rate of combined using Fielder XT guidewire with Corsair microcatheter was 51.5%. There was no complications related to Corsair microcatheter during the index procedure, no major adverse cardiac events during in-hospital clinical follow-up. Conclusions Corsair microcatheter was safe and effective in the recanalization for CTO with transradialantegrade approach. It can simplify the CTO-PCI procedure and reduce the number of balloon catheters.

Retrograde approach for the recanalization of coronary chronic total occlusion: collateral selection and collateral related complication / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The retrograde approach through collaterals has been applied in the treatment of chronic total occlusion (CTO) lesions during percutaneous recanalization of coronary arteries. This study was to investigate the success rate of recanalization and collateral related complications in patients when using the retrograde approach.</p><p><b>METHODS</b>Eighty-four cases subjected to retrograde approach identified from July 2005 to July 2012 were included in this study. Patient characteristics, procedural outcomes and in-hospital clinical events were evaluated.</p><p><b>RESULTS</b>Mean age of the patient was (59.6 ± 11.2) years old and 91.7% were men. The target CTO lesions were distributed among the left anterior descending artery in 45 cases (53.5%), left circumflex artery in one case (1.2%), right coronary artery in 34 cases (40.5%), and left main in four cases (4.8%). The overall success rate of recanalization was 79.8%. The septal collateral was three times more frequently used for retrograde access than the epicardial collateral, 68/84 (81%) vs. 16/84 (19%). Successful wire passage through the collateral channel was achieved in 58 (72.6%) patients. The success rate of recanalization was 93.1% (54/58) in patients with and 50% (13/26) in patients without successful retrograde wire passage of the collateral channel (P < 0.01). Successful retrograde wire passage through the collaterals was achieved in 49 of 68 septal collaterals (72.1%) and in 9 of 16 epicardial collaterals (56.3%) (P = NS). There was no significant difference between the septal collateral group and the epicardial group in the success rate of recanalization after retrograde wire crossing the collaterals (91.8% vs. 100%, P > 0.05). CART or reverse CART technique was used in 15 patients, and 14 patients (93.3%) were recanalized successfully. Collateral related perforation occurred in three (18.8%) cases with the epicardial collateral as the first choice (compared with the septal collateral group (0), P < 0.01). There were 17 (20.2%) patients failure of recanalize the CTO lesions, among which 13 (15.5%) were due to the failure of retrograde wire crossing the collaterals.</p><p><b>CONCLUSIONS</b>The retrograde approach is an effective technique to recanalize CTO lesions, the septal collateral was preferable. When the epicardial collateral is selected, careful manipulation of devices and wires is essential due to the potential risk of perforation of collateral channels.</p>

ACEI/ARB use among high risk patients with coronary heart disease in China: a cross-sectional study / 中华心血管病杂志

<p><b>OBJECTIVE</b>This study investigated current use of ACEI/ARB among high risk patients with coronary heart disease (CHD) in China and factors affecting ACEI/ARB use in these patients.</p><p><b>METHODS</b>This cross-sectional survey was performed between June to December 2007 and May to November 2009 in 51 hospitals from 14 cities. The characteristics of patients with established CHD were collected by electronic questionnaire.</p><p><b>RESULTS</b>Only 45.8% high risk CHD patients were taking ACEI/ARB and the ACEI/ARB medication decreased significantly with time after initial CHD diagnosis. ACEI/ARB was taken in 46.1% CHD patients complicated with diabetes mellitus and in 56.3% CHD patients complicated with hypertension. Logistic regression analysis showed that comorbid hypertension was the strongest factor associated with ACEI/ARB use. In addition, male gender, history of myocardial infarction (MI), PCI and the time after initial CHD diagnosis were independent factors affecting the use of ACEI/ARB. Captopril was the most commonly prescribed ACEI in this cohort.</p><p><b>CONCLUSION</b>ACEI/ARB is underused in secondary prevention among high risk CHD patients in China. It remains a major challenge for healthcare professionals and policy makers to make efforts on narrowing the gap between evidence and practice.</p>

Effect of dexmedetomidine sedation on perioperative hemodynamics and heart rate variability in the aged patients with cataract operation / 中国医师进修杂志

Objective To investigate the effect of dexmedetomidine sedation on perioperative hemodynamics and heart rate variability (HRV) in the aged patients with cataract operation.Methods Fifty aged patients with cataract who accepted phacoemulsification operation in local anesthesia,were divided into experiment group(dexmedetomidine group) and control group (0.9％ sodium chloride group) by random digits table method with 25 cases each.The experiment group was given local anesthesia,after dexmedetomidine load at 0.5 μg/kg intravenous infusion,dexmedetomidine continuous pumping [0.2-0.3 μg/ (kg ·h)] to maintain the depth of anesthesia.The control group was given the same dose 0.9％ sodium chloride intravenous infusion.Local anesthesia method:2％ lidocaine and 0.75％ bupivacaine 3 ml mixing for retrobulbar anesthesia.The changes of HRV and hemodynamics in the 2 groups before operation (T0),beginning operation (T1),perioperative10min (T2),perioperative30min (T3),postoperative (T4) were recorded,and hemodynamies was analyzed.Results The normalized units of low frequency (LFnu) and low frequency (LF)/high frequency (HF) at T1,T2,T3 in control group were significantly higher than those at T0 [(73.9 ± 9.2)％,(74.5 ± 9.0)％,(75.8 ± 8.5)％ vs.(61.3 ± 7.5)％ and 2.4 ± 1.1,2.6 ± 1.3,2.7 ± 0.9 vs.1.6 ± 0.5],total frequency power (TP) was significantly lower than that at T0 [(1372 ± 419),(915 ± 243),(1389 ± 142) Hz vs.(2351 ± 608) Hz],there were statistical differences (P ＜ 0.05).The LFnu and LF/HF at T1,T2,T3 in experiment group were higher than those at T0,but there were no statistical differences (P ＞0.05).The TP at T1,T2,T3 in experiment group was significantly lower than that at T0 [(1458 ± 325),(983 ±272),(1497 ± 210) Hz vs.(2235 ± 513) Hz],there was statistical difference (P ＜ 0.05).There was no statistical difference in normalized units of HF at all time points between the 2 groups (P ＞ 0.05).The LFnu,LF/HF and TP at T1,T2,T3 in experiment group were better than those in control group,there were statistical differences (P ＜ 0.05).The fluctuation of hemodynamics in experiment group was significantly lower than that in control group,there was statistical difference (P ＜ 0.05).Conclusion Dexmedetomidine sedation little effects on HRV during perioperative period in aged patients with cataract operation,can significantly reduce the influence of operation stimulation on autonomic nervous system and hemodynamics.