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Table of Content

    25 April 2017, Volume 38 Issue 4
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    Construction of digital 3D rotatable human heart specimen and the application program#br#
    WANG Qingqing, MENG Lingbing, LIU Huibing, LIU Yu, WU Yixuan, FAN Ping*
    2017, 37(4):  373-377.  doi:〓〓10.3969/j.issn.10073205.2017.04.001
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    ［Abstract］ Objective〖HTSS〗〓To provide guidance for medical students and clinical practice through the fine anatomy of the human heart and taking the pictures of the specimen, as well as by using  multimedia technology to generate threedimensional rotating digital images in the form of web pages and APP.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓①Dissect the hearts and paint the blood vessel. ②Introduce the specimen,write scripts and record it. ③Place the specimen on the turntable, photo it for 360 degrees, insert the script and recordings,make web page version of the courseware and mobile APP software.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The web page version of the courseware and mobile APP software were made successfully, through the questionnaire, the web page version of the courseware and mobile APP help to better study the heart.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Through the  questionnaire data analysis, threedimensional physical heart specimen is suitable to clinical teaching, which is convenient for learning and understanding the hearts.
    Analysis of influencing factors of refractory tuberculous meningitis
    CHEN Yanqiang1, LI Junxia1, ZHANG Xueping2, BAI Hongzhong3, ZHENG Liheng4, LI Wen5*
    2017, 37(4):  378-381.  doi:10.3969/j.issn.10073205.2017.04.002
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    ［Abstract］  Objective〖HTSS〗〓To investigate the influencing factors of refractory tuberculous meningitis.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Ninetynine patients with tuberculous meningitis were divided into ordinary tuberculous meningitis group and refractory tuberculous meningitis group. The clinical features, cerebrospinal fluid index, image credits, antituberculosis drugs, hormone application and vertebral canal injection medicin were analyzed of 2 groups.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Univariate analysis showed that disease progression(>3 months), applied antituberculosis drugs outside the hospital, difference of antituberculosis program, cerebrospinal fluid indicators(number of cells, chlorine value, adenosine deamianse), meninges strengthening in the 2 groups of patients were significantly different(P＜005). The results of Logistic regression analysis showed that prehospital antituberculosis treatment and chloride<120 mmol/L, antituberculosis program were the influencing factors of tuberculous meningitis.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Low chlorine of cerebrospinal fluid is an independent predictor of refractory tuberculous meningitis, the strength of the chemotherapy scheme has a great influence on tuberculous meningitis.
    Correlation between Hcy level and neurological impairment in patient with acute ischemic stroke
    JIANG He, WU Dongqin, LIN Yaqin
    2017, 37(4):  382-385.  doi:10.3969/j.issn.10073205.2017.04.003
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    ［Abstract］ Objective〖HTSS〗〓To determine the relationship between plasma homocysteine(Hcy) level and neurological impairment in patient with acute ischemic stroke.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Eighty cases of acute ischemic stroke disease were chosen as the research object. At the time of admission, the National Institute of Health Stroke Scale(NIHSS) was employed to divided the patients into the mild group(NIHSS score＜8 scores) and the severe group(NIHSS score≥8 scores), each group with 40 cases. And 40 healthy persons were selected as control group. The fasting bloodglucose(FBG), uric acid, total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterin(LDLC), high density lipoprotein cholesterol(HDLC), fibrinogen, Hcy levels of three groups were detected, and the correlation of Hcy levels and NIHSS score were analyzed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The FBG of severe group was higher than mild group and control group, the TG of severe group was higher than control group, and mild group. The difference has statistical significance(P＜005). There was no statistically significant difference for TC, LDLC, HDLC and lipoprotein in three groups(P＞005). The plasma Hcy levels of severe group and mild group was significantly higher than the control group, and severe group was higher than mild group. The difference was statistically significant(P＜005). The high Hcy number of patients with acute ischemic stroke was significantly higher than the control group, and severe group was higher than mild group. The difference was statistically significant(P＜005). There was a significantly positive correlation between Hcy levels and NIHSS score(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The levels of plasma Hcy and neurological impairment are significantly correlated.  Detection of Hcy levels may provide a reference value for evaluating the patient's condition and prognosis.
    Clinical analysis of 89 cases of acute ischemic stroke who accepted rtPA intravenous thrombolysis
    WU Lijuan， LI Zhiwen， KONG Yongmei， LI Guofeng， ZHAO Xuemeng， WEI Yuqing*
    2017, 37(4):  386-389，394.  doi:10.3969/j.issn.10073205.2017.04.004
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    ［Abstract］  Objective〖HTSS〗〓To evaluate the efficacy safety of intravenous thrombolysis(rtPA), and to analysis the factors that influence the prognosis of patients.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The clinical data of 89 patients with acute cerebral infraction who accepted rtPA, and the factors that affect efficacy and safety of rtPA were retrospetively analyzed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓There were 47 patients with favorable function outcome accounted for 52.81% after thrombolysis immediately, and 56 patients with favorable function outcome accounted for 62.92% at 7 days after thrombolysis. It has shown that the prognosis was better in the younger group than the elderly group(P＜005), and in the lower National Institute of Health Stroke Scale（NIHSS） score group than higher group before thrombolysis, and in the shorter door to needle time group than the longer group by comparing Modified Rankin Scale(mRS) score in 3 months. Compared with the group without intracranial hemorrhage，in intracranial hemorrhage group, the NIHSS score was higher，the door to needle time was longer，the rate of atrial fibrillation was higher.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓It is efficacy and safety to give intravenous thrombolysis therapy with rtPA to patients with acute cerebral infraction. The younger of the patients，the lower NIHSS score before thrombolysis，the shorter of the door to needle time indicate better prognosis after 3 months. In addition, the NIHSS score before thrombolysis，the door to needle time and atrial fibrillation were the risk factor that influence intracranial hemorrhage after thrombolysis, but intracranial hemorrhage did not affect the prognosis after 3 months.
    Clinical study on the effect of different dose of ibandronate on bone healing after spinal surgery#br#
    YANG Jianbo, LI Pengfei*, JIN Xianhui, BAI Pingzhang, JIA Nan, ZHANG Qingsheng
    2017, 37(4):  399-403.  doi:10.3969/j.issn.10073205.2017.04.007
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    ［Abstract］  Objective〖HTSS〗〓To investigate the clinical effects of sodium ibondronate treatment on posterior lumbar interbody fusion.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Lumbar posterior lumbar interbody fusion was performed in 106 patients which posterior decompression, pedicle screw fixation and interbody fusion were performed. On the basis of postoperative application of ibandronate treatment the patients were divided into experimental group and control group. The experimental group on the basis of ibandronic acid dose was divided into group A and group B. Thirtyfive cases in experimental group A used the ibandronate 2 mg by slow intravenous infusion every 3 months and 4 mg in the group B. Thirtysix patients were not treated with bisphosphonates in the control group. The Xray, CT scan and bone mineral density measurement were performed in all patients before and after surgery and the  followup. The clinical score, fusion rate, intervertebral height loss and bone mineral density were compared between the 3 groups.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓At last followedup, the Oswestry dability index(ODI) score and the back visual analogue scale(VAS) score were decreased significantly in group A and group B compared with control individual(P＜005), and there was no significant differences among 3 groups regarding the low limb pain VAS score(P＞005). The rate of fusion in experiment group A and group B were significantly higher than that in the control group. Experiment group B were significantly higher than in experiment group A(P＜005). In addition, the loss of intervertebral height was significant in control group compared with group A and group B(P＜005). The bone mineral density of lumbar spine and left femur were significantly higher in group A and group B than before treatment and higher than in the control group(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Ibandronate can effectively promote postoperative posterior lumbar interbody fusion, and help to improve the symptoms of osteoporosis lumbago. The pharmacological effects  was doserelated.
    Analysis of  application value of magnetic resonance imaging in the early diagnosis of occult fracture
    LIU Guobin， ZHANG Guoping， REN Qingyun， LEI Licun， ZHAO Feng， GAO Hongyang， ZHU Chaohua， LI Yaguang
    2017, 37(4):  412-414，432.  doi:10.3969/j.issn.10073205.2017.04.010
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    ［Abstract］ Objective〖HTSS〗〓To explore the early diagnostic value of magnetic resonance imaging(MRI) in patients with occult fracture .
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Forty cases were randomly selected, whose Xray examination were not find a clear fracture in emergency  but with suspected occult fractures infact. All these patients were divided into two groups. On the next day, the Xray group underwent Xray examination once again, MRI examination were performed in MRI group.  Two groups were performed CT scan to check the final diagnosis after two weeks, and then compare the two groups of patients with diagnostic accuracy to observe the MRI manifestations in different injured parts of body.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The accurate rate of diagnosis of  MRI group(95.0%) was significantly higher than the Xray group(15.0%), The difference was statistically significant(P＜005). MRI T1WI fat suppression sequence with short TI inversion recovery(Short TI inversion recovrey, STIR) showed better fracture line T2WI, T1WI line like low signal around. STIR showed edema and fracture line of good performance. In part of patients, MRI showed T1WI, T2WI strips or irregular low signal band around T2WI significantly high signal suppression sequence of T2 was T1WI and T2WI. Some cases can see obvious cortical bone fracture line and fracture features, with low signal around a small number of patients with T1WI showed high signal, the small patches or spotted, T1WI showed high signal.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓MRI can significantly improve the clinical diagnostic accuracy of occult fracture patients, and can clearly show the specific circumstances of different occult fractures, which is conducive to clinical early diagnosis and treatment,  and  has important clinical application value.
    Experience of offpump coronary artery bypass grafting accompany ventricular aneurysm treatment line like suture in 13 cases
    AN Jinghui, SHI Fengwu, MA Qianli, LIU Su*
    2017, 37(4):  415-418.  doi:10.3969/j.issn.10073205.2017.04.011
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    ［Abstract］ Objective〖HTSS〗〓To explore clinical experience of offpump surgical treatment on coronary aneurysm.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 13 cases of coronary heart disease patients with old myocardial infarction were included in this study. Their preoperative echocardiography showed the formation of left ventricular apex aneurysm without thrombosis. All the aneurysms were sutured associated with offpump coronary artery bypass grafting surgery. The cardiac function, ejection fraction, left ventricular end diastolic diameter postoperatively were compared with those preoperatively.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓No death was occurred in operation. The followup time ranged from 3 to 15 months, averaged at 9 months. The postoperative left ventricular ejection fraction was increased and left ventricular end diastolic diameter was decreased. The number of New York Heart Association(NYHA) Ⅱ level cases was increased. The difference was statistically significant.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Offpump coronary artery bypass grafting with left ventricular aneurysm suture is an effective method for some kind of infarction ventricular aneurysm, which can get satisfactory results. Operation is safe and reliable, which can significantly improve postoperative cardiac function, reduce postoperative thrombosis and cardiac rupture and other complications.
    Effect of drawing therapy on painting characteristics and executive function of  patients with schizophrenia
    CHEN Ran， CAI Jiajia， WANG Ning， ZHANG Bin， KANG Longfei， GE Jing, WANG Wei*
    2017, 37(4):  419-422，427.  doi:10.3969/j.issn.10073205.2017.04.012
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    ［Abstract］ Objective〖HTSS〗〓To explore the effect of painting therapy on the executive function in patients with schizophrenia, and the change of painting  characteristics in the painting course.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓According to the random number table method,66 patients were randomly divided into experimental group and control group, 33 patients  in each group. Patients in control group were treated with drug therapy and disease activity, the experimental group added painting therapy for a total of 6 weeks of painting therapy curriculum on the basis of comparison group. Before and after the experiment of the two groups were assessed: Wisconsin card sorting test, the change of  use in number and the color  in different painting classes periods.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Compared with the control group, the executive function，error response numbers, perseverative response, perseverative error response in painting therapy group had great improvement. The difference was statistically significant(P＜005). Compared with pretreatment, the completed classification number, Error response number, first calalogue, perseverative response, perseverative error response, nonperseverative error response in posttreatment painting therapy group showed the most significant differences . The difference was statistically significant(P＜005). In the middle and late stages, the number of painting colors is obviously increased. The difference was statistically significant(Hc=28.605, P<0.01). Use of painting color category in the middle and late of drawing therapy group was increased significantly（P＜005）. The distribution of use of color saturation is more wide. Late color saturation was distributed in 1 to 4 of all grades.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Painting therapy course could improve the executive function and change the painting  characteristics of patients with schizophrenia.
    Effect of edaravone on neurological function of newborn rats with cerebral ischemia and anoxia
    YU Peixia1， BO Lijun2， XUE Hui3, QIE Xiaojuan1, XU Guanjie1*
    2017, 37(4):  423-427.  doi:10.3969/j.issn.10073205.2017.04.013
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    ［Abstract］ Objective〖HTSS〗〓To investigate whether Edaravone has a protective effect in model for newborn rats of hypoxicischemia brain damage.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sevendayold(P7) SD rats 48 were randomly divided into 3 groups(n=16, each group):  control group(group S), hypoxiaischemia brain group(group R), edaravone group(group F). P7 rats were subjected to hypoxiaischemia brain damage for 2 h. Edaravone was treated after hypoxicischemia brain damage in group F. After 24h, neurological deficit scores were assessed. Matrix metalloprotein9（MMP9） was detected by enzymelinked immunosorbent assay in the ischemic penumbrae of the cerebral cortex. The nervous structure was detected by electron microscopic observation. The content of Evans blue（EB） in the brain of neonatal rats was determined.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓MMP9, EB, S score in group R were higher than that of group S. Turn over times in group R were less than that of group S. MMP9, EB, S score in group F were lower than that of group S. Turn over times in group R and group F were less than that of group S. Turn over times in group R were less than that of group F. The differences were statistically significant（P＜005）. There is one death of rat in group R, and no death in group F and S.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The expression of MMP9 in brain tissue of neonatal rats with cerebral ischemia and hypoxia was increased, and the permeability of blood brain barrier was increased. Edaravone treatment provides neuroprotection against cerebral ischemia and hypoxia in neonatal rats by protecting blood brain barrier permeability, improving neurological function. The mechanisms for the effect might be related to the inhibition of MMP9 expression in cerebral ischemia and hypoxia in neonatal rats.
    Comparison of dexmedetomidine or propofol combined with fentanyl in painless fiberoptic bronchoscopy
    ZHANG Ning1, CHENG Yan2, HAO Jiying1, LI Zhiguo3
    2017, 37(4):  428-432.  doi:10.3969/j.issn.10073205.2017.04.014
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    ［Abstract］ Objective〖HTSS〗〓To investigate the effect of dexmedetomidine or propofol combined with fentanyl in patients with fiberoptic bronchoscopy.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sixty patients undergoing selective general anesthesia fiberoptic bronchoscopy were randomly divided into two groups(n=30 each): dexmedetomidine group(D group) and propofol group(P group). Before induction of anesthesia, patients in both groups received an infusion dose of 1 μg/kg fentanyl. Thereafter, in group D, a loading dose of dexmedetomidine 1 μg/kg was injected at 15 min before induction of anesthesia, followed by infusion at 0.4 μg·kg-1·h-1 until the end of fiberoptic bronchoscopy. In group P, the initial effectsite target for propofol concentration was 4 mg/L. Subsequently, the concentration of propofol was maintained at a level between 2 and 3 mg/L. mean arterial pressure(MAP), heart rate(HR), oxygen saturation(SpO2) and Observer Assessment of Alertness/Sedation(OAA/S） score were recorded at baseline(T0), immediately after induction(T1), when the tip of fiberoptic bronchoscopy reached the glottis(T2)and carina(T3), at the end of bronchoscopy(T4). The duration of bronchoscopy, emergence time, anesthesia effect, adverse cardiovascular events and side effects such as hyoxemia, nausea and vomiting, regurgitation and aspiration were recorded.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The OAA/S score of two groups were obviously decreased at T1 time point, increased gradually and then decreased again. The difference in OAA/S score time dissimilarity in the two groups at the groups and time points were statistically significant(P＜005). However, there was no significant difference in the interblock and interaction between group and time(P＞005). The MAP， HR and SpO2 of two groups were gradually lower at T1 -T3 time point, and then gradually incredsed at T4 time point. In MAP， HR and SpO2,interblock、time dissimilarity and interaction of interblock with time dissimilarity of the two groups had statistically significant difference. Compared with group P, the recover time significantly longer〖JP2〗(P＜005), the incidence hypoxemia was significantly lower(P＜005). There was no 〖JP〗significantly difference in anesthesia effect and the duration bronchofiberscopy. No patients developed side effects such as nausea and vomiting, regurgitation and aspiration in both groups.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Dexmedetomidine combined with fentanyl is an ideal method for sedative analgesia painless bronchofibroscopy with more slighter cardiovascular response and less side effects. 
    Comparative analysis of interventional procedures and complications of high malignant biliary obstruction#br#
    WU Zhonglin, LI Zhigang, YANG Guang, WU Yongchao, RONG Xiaocui, LI Shunzong*
    2017, 37(4):  433-437.  doi:10.3969/j.issn.10073205.2017.04.015
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    ［Abstract］ Objective〖HTSS〗〓To analyze the application value of right single channel and bilateral double channel of biliary double stents implant combine with biliary extradrainage in treating malignant high biliary obstruction(MHBO).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and fortyone patients of MHBO, including 103 patients with digital subtraction angiography guiding, punctured on the right side of right billiary, established right single channel, implanted biliary double stents with biliary internal drainage, namely the right side of single channel of biliary double stents implant(right side single biliary double stent implantation, group A), and 38 cases are punctured on the right and left billiary, establish bilateral double channel, implanted biliary double stents with biliary internal drainage, namely bilateral double channel of biliary double stents implant(double channel double biliary stent implantation, group B). The different complications and short term curative effects of 2 groups were analyzed and compared.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Twentyfirst days after operation, the total bilirubin levels of the patients in the 2 groups were significantly lower than those before the operation. However, there was no significant difference between the 2 groups after operation(P＞005).The incidence rate of hemobilia, bile leakage,biliary cardiac reflex, puncture point pain, drainage tube slip in group A is lower than that in group B, and the difference is significant(P＜005). There was no significant difference between the 2 groups in the incidence of biliary infection and drainage tube(P＞005). Two groups of patients had no pleural injury, liver abscess, pancreatitis. There was no significant difference on the total bilirubin between the 2 groups before and after the operation at twentyfirst days(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The technique of single side biliary double stents is a safe and effective method for the treatment of MHBO, and has obvious clinical application value.
    The clinical significance of FDG uptake and the expression of VEGF and p53 in breast cancer with lymph node metastasis
    YIN Pei1, LIU Hao2， HUO Hongqi1, WANG Haidong1, YOU Zhixin1, ZHAO Gaihua3
    2017, 37(4):  438-441，445.  doi:10.3969/j.issn.10073205.2017.04.016
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    ［Abstract］  Objective〖HTSS〗〓To evaluate the relationship between the uptake of fluorodeoxyglucose（FDG） and the expression of vascular endothelial growth factor（VEGF） as well as  p53 in breast cancer with lymph node metastasis.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The selected 92 cases with breast cancer had been  performed positron emission computed tomography before operation,and recorded the maximal standard uptake value. The expression of VEGF or p53 of breast cancer tissue were tested after operation, and the positive expression rates of VEGF or p53were calculated. The relationship were analyzed between the uptake of FDG and the expression of VEGF and p53 in breast cancer with lymph node metastasis.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The positive expression rates of p53 and VEGF with lymph node metastasis were obviously higher than that without lymph node metastasis in breast cancer(P<0.05). The expression of VEGF was correlated with the expression of p53 in breast cancer tissue with lymph node metastasis(rs=0.563, P=0.000). The expression of VEGF was correlated with the expression of p53 in breast cancer tissue with no lymph node metastasis(rs=0.430, P=0.000). When the positive expression of VEGF or p53 became stronger, the SUVmax values was increased gradually(P<0.05). The SUVmax value showed positive correlation with the expression of VEGF or p53 in breast cancer tissue(rs=0.730, P=0.019, rs=0.610, P=0.035).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The  expressions of VEGF and p53 are associated with lymph node metastasis of breast cancer, and the SUVmax values are related to the expressions intensity of VEGF and p53. Maybe there is a synergistic effect between VEGF and p53. And the uptake of FDG maybe reflect the ability of lymph node metastasis and tumor invasion. It provides the basis for further clinical guidance for rational treatment.
    Evaluation of right heart function by twodimensional strain imaging in pregnant women after transcatheter closure of atrial septal defect
    DU Xin1, ZHANG Qingwen2*， SU Maolong1
    2017, 37(4):  442-445.  doi:10.3969/j.issn.10073205.2017.04.017
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    ［Abstract］ Objective〖HTSS〗〓To investigate of right heart function by twodimensional strain imaging in pregnant women after transcatheter closure of atrial septal defect.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Using twodimensional strain imaging，the right ventricular free wall base, middle sections of longitudinal peak systolicvelocities(strain of systole,S)，early diastolic peak strain rate（strain rate of early diastolic,SRe）, late diastolic peak strain rate(strain rate of atrial systole,SRa),SRe/SRa were calculated repeatedly in 25 pregnant women after transcatheter closure(PASD group),and 25 healthy pregnant women as controls(control group). Diameter of the right atrium and right ventricular, pulmonary artery systolic pressure estimated by tricuspid regurgitation velocity, right ventricular enddiastolic volume， right ventricular endsystolic volume, right vertricular ejection fraction were calculated.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Inner diameter of the right ventricular and pulmonary artery systolic pressure of two groups increased gradually over time. There were significant difference between the two groups, between time point, and between group & time point（P＜005）. SRe/SRa of base, middle sections in PASD group and control group showed decreasingly trend with the increase in pregnancy, and there were significant difference between the two groups, between time point, and between group & time point（P＜005）.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The parameters of right heart function in pregnant women after transcatheter closure of atrial septal defect had showed some significant change, especially by twodimensional strain imaging. The pregnant women which have the history transcatheter closure of atrial septal defect need to focus on their PASP and parameters of right heart function in duration of pregnancy.
    Effect of Xiakucao capsule on Hashimoto thyroiditis and the ultrasonic diagnosis of thyroid morphology before and after treatment
    FAN Zhiyuan， ZHANG Linlin， MI Rui
    2017, 37(4):  446-449.  doi:10.3969/j.issn.10073205.2017.04.018
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    ［Abstract］ Objective〖HTSS〗〓To study the effect of Xiakucao capsule in the treatment of Hashimoto thyroiditis and changes of thyroid morphology by ultrasound diagnosis before and after treatment.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Seventytwo cases of pontine Hashimoto thyroiditis were randomly divided into study group and control group, 36 cases in each group. All patients taking levothyroxine sodium tablets, study group while taking selfheal capsule, all patients before treatment and after treatment at the same time determination of the patients with
    free triiodothyronine(FT3), free thyroxine(FT4）, thyrotropin，thyroid stimulating hormone(TSH) levels and thyroid peroxidaseautoantibody(TPOAb）, thyroglobulinautoantibody(TGAb) antibody levels, differences between the groups were compared. In addition, the changes of thyroid morphology and adverse reactions were observed before and after treatment.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓①After treatment FT3, FT4 levels of patients in the two groups were increased and TSH were decreased. The improvement of  FT4 and TSH in the study group was significantly better than that in the control group(P＜005). ②After treatment, the levels of TPOAb and TGAb in the study group were significantly lower than those in the control group(P＜005), and both in the two groups were significantly lower than those before treatment(P＜005). ③After treatment, thyroid lobes and isthmus thickness of patients in study group were significantly lower than those in control group(P＜005); at the same time, various parts of the thickness of study group was reduced, with statistically significant difference(P＜005).  ④Serious adverse reactions and side effects were not found in patients, compared between groups, there were no significant difference of the incidence of adverse reactions.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Xiakucao capsule can improve thyroid function of patients with Hashimoto thyroiditis, and reduce the level of thyroid antibodies. The thickness of each part of the thyroid gland was significantly reduced and the morphology was normal.
    Evaluation of bilevel positive airway pressure ventilation therapy on right ventricular function in COPD patients combined with respiratory failure by Tei index
    CHEN Xiaoxue1, SONG Degang2, SUN Lijuan1
    2017, 37(4):  450-453,457.  doi:10.3969/j.issn.10073205.2017.04.019
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    ［Abstract］  Objective〖HTSS〗〓To examine the improvement of Bilevel positive airway pressure（BiPAP) ventilation therapy on right ventricular function in chronic obstructive pulmonary disease（COPD） patients combined with respiratory failure by Tei index. To discuss if Tei index is valuable to predict the time for taking off ventilatior.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Fortyeight cases of COPD patients combined with respiratory failure were selected in ICU of our hospital, all of whom were given invasive mechanical ventilation with oral trachea cannula. Then the blood gas analysis and bedside echocardiography were examined in the first day(before BiPAP therapy), the second day and the fifth day after entering ICU. The heart rate(HR), respiratory rate(RR), power of hydrogen(PH), partial pressure of oxygen(PO2), partial pressure of carbon dioxide(PCO2), saturation oxygen(SO2), right ventricular diameter（RV), right ventricular anterior wall thickness（RVAW), pulmonary arterial systolic pressure（PASP) and right ventricular Tei index were recorded and compared among the three time spot. The patients were divided into two groups called successful takingoff group and failure takingoff group according to if they had been taken off ventilatiors or not in the fifth day. Tei index was compared between the two groups in the three different time spots.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Compared with the indexes in the first day, the heart rate, respiratory rate and blood gas analysis of the patients were significantly improved and the PASP, right ventricular Tei index were significantly better in the second and fifth day(P＜005), and the difference was statistically significant. While the difference of RV and RVAW had no statistical significance. The difference of all the index between the second day and the fifth day had no statistical significance. With the time lapsing, The Tei index of the two groups was in a downward trend and the dates of the successful takingoff group declined by a large margin. The difference between groups,among time spots and among crossover effect of time and grouping factor had statistical significance.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Invasive BiPAP ventilation can obviously improve the right ventricular function and cure rate in COPD patients combined with respiratory failure. Tei index is a sensitive index for evaluating right heart function and may be valuable to predict the time for taking off ventilatior.
    Effect of heating on blood plasma IL8#br#
    SUN Nan1, WEN Zhuan2, HAN Lina1, PENG Hua1, LI Jie1
    2017, 37(4):  454-457.  doi:10.3969/j.issn.10073205.2017.04.020
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    〗［Abstract］ Objective〖HTSS〗〓To study the effects of storing suspending erythrocytes after water bath on interleukin8（IL8） in plasma, and further more to confirm the effect of water bath at various times and different degrees on IL8 in plasma. Our study will provide the theoretical basis for safe and effective use of storing suspending erythrocytes.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Fifty blood samples were selected randomly from blood center in HebeiProvince, with detection of all indicators qualified. Each divided into 8 groups（A, B, C, D, E, F, G, H） which were stored at 4 ℃, heated at 37 ℃ for various time(10, 20, 30, 60, 120, 180 min) and 40 ℃ for 30 min for subsequent experiments. IL8 concentration in plasma was detected by adopt double antibody sandwich enzymelinked immunosorbent assay.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Heating could significantly upregulated IL8 level, and with timedependence pattern. There was no significant difference in plasma IL8 concentration between B and C group compared with A group(P＞005). Plasma levels of IL8 in D, E, F, G, H were significantly higher than those in the A group, the difference was statistically significant(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓There was no significant effect on plasma IL8 concentration in water bath at 37 ℃ within 30 min，and then gradually increased with time extended.