简介：为了从期刊文献的学科属性实现族性检索，为文章的分类统计创造条件，本刊2005起均对具有文献标识码的文章采用《中国图书馆分类法》（第四版）进行分类后。标识分类号文章一般标识1个分类号，多个主题的文章可标识2个或3个分类号；主分类号排在第一位，多个分类号之间应以分号分隔。希望有条件查询的作者在来稿时自行标明中图分类号。

简介：objectivesTodemonstratethephenomenaandexplorethecausesofanemiainpatientswithchronicheartfailure(CHF).MethodsToobservethephenomenaofanemiainpatientswithCHF,atotalof276patientswithCHFwereincludedinthisretrospectivestudy.Theclinicalcharacteristicsofthepatientsare;meanage69.2±11.0years;male151,female125;NYHAⅢandⅣ115(41.7%).Results①Amongthe276patientswithCHF,81(29.4%)hadanemia(Meanhemoglobulinconcentration101.5±13.0g/L).②PatientswithAnemiaweremorelikelytobefemaleandtohavegreaterNYHA(ⅢorⅣ)(P<0.05),higherserumcreatinine,aswellaslowerserumalbuminandlow-densitylipoproteinlevels(P<0.01).③AweaknegativecorrelationwasalsonotedbetweenthelevelofNYHAandhemoglobulin.④Therewasnosignificantdifferenceinage,theprimarycardiacetiologyoftheCHF,thehistoryofdiabetes,leftventricularenddiastolicdiameter,andleftventricularejectionfractionbetweenCHFpatientwithandwithoutanemia.ConclusionsTheprevalenceofanemiaishighamongpatientswithCHF.TheanemiapatientswithCHFtendtobefemale,havegreatercardiacandrenalfunctionalimpairment,butwithlowerserumalbuminandLDLthatsuggestssomedegreeofmalnutrition.

简介：ObjectivesToinvestigatetheclinicalmanifestationsofhypertrophiccardiomyopathy(HCM),andtofindouttheclinicalcluestoavoidmisdiagnosisandprovidereferenceforfutureclinicaldiagnosisandtreatment.MethodsAretrospectiveanalysisof42consecutivepatientswithHCMhospitalizedinourhospitalbetweenJanuary1995andDecember2002wasexplored.BasedonthefamilyhistoryofHCM,clinicalmanifestations,electrocar-diogram,echocardiogram,coronaryangiographyandleftventriculography,theclinicalcharacteristicsbetweenHCMpatientswithleftventricularoutflowtractobstruction(HOCM)andHCMpatientswithoutobstruction(HNOCM)werecompared.Thecausesofmisdiagnosisandlosingdiagnosiswereanalysis.Results13patientswereinHOCMgroupand29patientswereinHNOCMgroup.MorepatientswithsyncopewereinHOCMgroupthaninHNOCMgroup(6/13vs.2/29,P<0.05).PatientswithejectivemurmurwereinHOCMgrouponly(P<0.01).Leftventricularoutflowtractpressuregradient(LVOTPG)onlyobservedinHOCMgroup(P<0.01).Ventriculartachycardiawasseeninbothgroups.28outof42patients(66.67%)hadmisdiagnosis,and4outof42patients(9.53%)hadlosingdiagnosis.Thus,coronaryheartdisease(CHD)hadthehighestrateofmisdiagnosis.Therewere20CHDpatients(71.43%)among28patientswithmisdiagnosis.Hypertensionwasin3,congenitalheartin2,cerebro-embolismin2,andmyocarditisin1.ConclusionsForapatientwithfamilyhistoryorsuddendeathhistoryofHCM,unexplainedsyncopeepisodes,chestpain(angina),especiallyinyoung,anejectionmurmuralongtheleftsternumborder,thepresenceofnarrowanddeepQwaves,orinversionofgiantTwavesinV3-V6,atrialfibrillationand/orcerebra-embolismechocardiogramshouldbegiven.CAGandLVGarenecessaryonlyiftheresultofechoisnegative,andthepatientswithsuspectedHCMorCHD.

简介：ObjectivesToinvestigatetheclinicalfeatureofacutepulmonaryembolism.MethodsRetrospectiveclinicalanalysiswasperformedaccordingtothedataof38casesofpulmonaryembolism.ResultsThereweregrounddiseasesandpredisposingfactorsin36casesofpulmonaryembolismamong38cases,theratiowas94.7%,amongthetotalpredisposingfactors,tumor,cardiovasculardisease,venousthrombosisoflowerextremity,smokingandlong-termbedwerecommon.Therewasnospecificityinclinicalfeature,physicalsignandroutchestXray,electrocardiography,andtheirappearanceswerediversified.Therewerespecificityandsensitivityinechocardiogram(UCG)andD-dimertosomeextent.But,thefinaldiagnosismustdependonsomespecialexaminations,suchasselectivepulmonaryarteriography,CTPA,MRAandsoon.ConclusionsThespecialexaminationsmustbedonetomakeadefinitediagnosistoconfirmpulmonaryembolismwhenthehighriskfactorsandgrounddiseasesareexisting.Itisnecessarytosomecaseswhentheclinicalfeaturecannotbeexplainedbyotherdiseases.

简介：OjbectiveTofindtheindependentpredictorsforrestenosisaftercoronarystenting.MethodsQuantitativeangiographywasperformedon60cases(67successfullydilatedlesions)afterangio-plastyover6-monthsfollow-up,andbothunivariateandmultivariatelogisticregressionanalysisweredonetoi-dentifythecorrelationsofrestenosiswithclinicalfactors.ResultsThetotalrestenosisratewas31.3%(21of67lesions),andaccordingtounivariateanalysisthepatientswhounderwentcoronarystenting≥3.5mmhadalowerrateofrestenosis(P<0.01).Collateralcirculationtotheobstructionsite,highmaximalinflationpressure,smokingandthelessminimallumendiameterafterPTCAmadetherateofrestenosishigherower(P<0.05).Multivariatelogisticregressionanalysisshowedthatcoronarystenting≥3.5mmhadalowrateofrestenosis,buthighmaximalinflationpressureandsmokingmadetherestenosisratehigher.ConclusionCoronarystentsize,maximalinflationpressureand.smokin

简介：BackgroundPregnancycomplicatingpulmonaryarterialhypertension(PAH)isalife-threateningobstetricalcomplication.FewstudieshavereportedtheclinicalcharacteristicsandoutcomesofpregnantwomenwithPAH.MethodsRetrospectivelyanalysiswasconductedon86casesofpregnantwomenwithPAHattheDepartmentofObstetricinGuangdongGeneralHospitalbetween2009and2014.Dataincludedpatients'age,theetiologiesofPAH,clinicalclassificationoftheNewYorkHeartAssociation(NYHA),gestationalweeks,deliverymode,maternalandfetaloutcomes.Results1Therewere2casesofidiopathicpulmonaryarterialhypertension(IPAH)and84casesofsecondarypulmonaryarterialhypertension.Thelatterwascomposedby40(47.61%)casesofcongenitalheartdisease(CHD),38(45.23%)casesofrheumaticheartdisease(RHD),3(3.57%)casesofsystemiclupuserythematosus(SLE)and1(1.19%)caseofpartialhydatidiformmole.ThenumberofpatientsclassifiedinNYHAI~IVwere8(9.30%),41(47.67%),26(30.23%)and11(12.7%),respectively.Andthemortalitywas3.48%(3/86).2Amongthe86patients,31(36.04%)womengavebirthattermand36(41.86%)hadprematuredelivery.Inaddition,16(18.6%)womenhadanabortionlessthan28weeks.Therewereatotalof65(75.58%)livebirths,61(93.84%)ofwhomweredeliveredviacesareansection,whiletheother4(6.15%)werevaginaldeliveries.3Patientsweredividedinto3groups,12ofmild(<40mmHg),35ofmoderate(40~70mmHg)and39ofsevere(≥70mmHg)regardingthepulmonaryarterysystolicpressure(sPAP)measuredbyultrasound.WedefinedtheformertwoasgroupAandthelatterasgroupB.Thesignificancewasseenstatisticallyingestationalweeks(32.86±8.86gvs28.76±9.84),therateoftransferringtoICU(19.14%vs53.84%),neonatalbirth-weight(2725.69±467.43vs2044.82±665.75g),APGARscoring(9.97±0.16vs8.68±2.08),maternalstatusofheartfunctionandadversepregnantoutcomes,whencomparedgroupAwithB.AlltheP-valuesmentionedabovew

简介：ObjectiveFortycasesofIAMIwereexaminedwithcoronaryangiographyinordertostudytherelationshipofthevesselswiththeECGofIAMI.MethodsForcoronaryangiographyJudkin’smethodwasused;IAMIwasdiagnosedbythe1979WHO’sstandardofISHDandECGwasseparatelymeasuredbytwodoctors.ResultsMostofIAMIwithpolybranchcoronaryoritscollateraldisease(32.5%and42.5%)andonly10cases(25%)withsinglebranchcoronarydisease,whoseECGswereuntypical.ConclusionIAMIwithsingle-branchcoronarydiseasemightexpressasmildsymptomsandhavenotypicalECGchange.WhiletypicalECGchangeemerges,thecoronaryarteryalwaysshowedpoly-branchdiseaseorcollateralbranchobstructionandthediseasewouldbeadvanced.ItisimportanttopaymoreattentiontothecasesofIAMIwithoutclassicECGchangesoastogivediagnosisandtreatmentthemintime.

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简介：摘要目的探讨鱼骨图分析法在护理不良事件管理中的应用。方法通过用鱼骨图分析法分析12例护理案例,讲述鱼骨图的具体实施方法。结论运用鱼骨图分析法进行护理不良事件管理,能有效降低护理不良事件的发生。

简介：BackgroundAtrialfibrillation(AF)wasusedtobeconsideredasnongeneticsdisorder,butrecentstudieshaverevealedthatgeneticsvariantsconferredsusceptibilitytoAFdevelopment,butmostwithlimitedevidence.Inordertosystematicallyevaluatetheoverallcontributionsofgene-diseaseassociationstudiestocurrentunderstandingsofthegeneticsusceptibilitytoatrialfibrillation,weperformasystematicreviewandmeta-analysisbasedoncomprehensivesearches.MethodAllstudiesontheassociationsofgeneticsvariantswithAFriskwereidentifiedbysearchingthefollowingdatabases:Medline,Embase,BIOSIS,GlobalHealth,LILACSandCBMDisc.Oddsratios(CI)and95%confidenceintervals(CI)werecalculatedunderhomozygotecomparison(HC),dominantmodel(DM)andrecessivemodel(RM),respectively.ResultsAtotalof41studieson32genesand72polymorphismslocationswereidentified.ThesummaryORwasstatisticallysignificantassociationsin23(31.94%)singlenucleotidepolymorphisms(SNPs).Thegenesinrenin-angiotensin-aldosteronesystem(RAAS)andionchannelswerethemostlystudied.FourSNPs(50.00%)inRAASgenesweresignificantlyassociatedwithAFsusceptibility:ACEI/D(HC:OR=1.53,95%CI:1.14-2.0DM:OR=1.47,95%CI:0.86-1.53;RM:OR=0.49,95%CI:0.41-0.59);AGTA-20C(HC:OR=1.56,95%CI:1.41-2.12);AGTM235T(HC:OR=2.37,95%CI:1.21-4.65).StatisticallysignificantassociationswerealsofoundinthefollowinggenesandSNPs:ABCA1G1051A,BCHEG1615A,CETPA1061G,I405V,TaqIB,CRPC1444T,EDN2A985G,eNOST-786C,IL-10T-819C,A-592C,MinKG38S,KCNH2rs1805120,Kir3.4C171T,G810T,MMP2C-1306T,FactorⅡG20210A,SCN5AH58R,SLC26A8I639V,G-proteinβ-subunitC825T,chromatosome4q25rs2200733andrs10033464.ConclusionsNearlyone-thirdofSNPswerestatisticallysignificantassociatedwithAFrisk,withvariantsinRAASgenesmosthighlysignificantassociation.Morestudiesonawiderangeofgenesaremerited.

简介：ObjectivesToanalyzetheriskfactorsforrecurrenthemorrhageaftercraniotomyforhypertensivecerebralhemorrhage(HCH).MethodsClinicaldatafrom162HCHpatientswhounderwentsurgerywereretrospectivelyanalyzedforthecorrelationbetweenrecurrenthemorrhageandgender,age,durationofhypertension,historyofdiabetesmellitusandhypercholesterolemia,siteandvolumeofhemorrhageandpost-surgicalsystolicanddiastolicpressure.ResultsPost-surgicalrecurrenthemorrhagewasfoundin24patients.Withmulti-variateregressionanalysis,historyofdiabetes,long-termhypertensionandhigherpost-surgicalsystolicpressurewereprovedpositivelycorrelatedtotheincidenceofrecurrenthemorrhageaftercraniotomyforhypertensivecerebralhemorrhage(P<0.05).ConclusionsRiskfactorsforrecurrenthemorrhageaftercraniotomyforhypertensivecerebralhemorrhagearehistoryofdiabetes,long-termhypertensionandhigherpost-surgicalsystolicpressure.Patientswithdiabetesandhypertensionareathigherriskforcerebralhemorrhageorpost-surgicalrecurrenthemorrhage.Effectivecontrolonbloodpressureaftersurgerycanreducetheincidenceofrecurrenthemorrhageaftersurgeryforhypertensivecerebralhemorrhage.

简介：小桥流水人家，风景这边独好，欢迎您到天然大“氧吧”疗养院（广州市第十一人民医院）。

简介：ObjectivesToassesswhetherstatinsreduceall-causemortalityandCVeventsinelderlypeoplewithoutestablishedCVdisease.BackgroundSinceageingofthepopulationissteadilyraising,preventionofcardiovascular(CV)diseaseintheelderlyisrelevant.InelderlypatientswithpreviousCVevents,useofstatinsisrecommendedbyguidelines,whereasbenefitsofthesedrugsinelderlysubjectswithoutpreviousCVeventsarestilldebated.MethodsRandomizedtrialscomparingstatinsversusplaceboandreportingall-causeandCVmortality,myocardialinfarction(MI),stroke,andnewcanceronsetinelderly(>65yearsold)subjectswithoutestablishedCVdiseasewereincluded.ResultsEighttrialsenrolling24,674subjects(42.7%females;meanage73.0+2.9;meanfollow-up3.5+1.5years)wereincludedinanalyses.Statins,comparedtoplacebo,significantlyreducedtheriskofMIby39.4%(relativerisk[RR]:0.606[95%confidenceinterval(CI):0.434to0.847];P=0.003),aswellastheriskofstrokeby23.8%(RR:0.762[CI:0.626to0.926];P=0.006).Incontrast,theriskofall-causedeath(RR:0.941[CI:0.856to1.035];P=0.210)andofCVdeath(RR:0.907[CI:0.686to1.199];P=0.493)werenotsignificantlyreduced.Newcanceronsetdidnotdifferbetweenstatin-comparedtoplacebotreatedsubjects(RR:0.989[CI:0.851to1.151];P=0.890).ConclusionsPInelderlysubjectsathighCVriskwithoutestablishedCVdisease,statinssignificantlyreducetheincidenceofMIandstroke,butdonotsignificantlyprolongsurvivalintheshort-term.

简介：Toanalyzetheclinicalcharacteristicsof216patientswithnon-STsegmentelevationmyocardialinfarction(NSTEMI).MethodsAretrospectiveanalysiswasused.TwohundredandsixteenNSTEMIpatientsweredividedintotwogroups:①accordingtotheage:age<65yearsgroupandage≥65yearsgroup;②accordingtothrombolysisinmyocardialischemiatrial(TIMI)IIBriskstratificationscoringsystem:score<4groupand≥4group;③accordingtoserumcreatinine(sCr)level:sCrlevel≤178μmol·L-1groupand>178μmol·L-1group.Sevenhundredandeightysixacutemyocardialinfarction(AMI)patientsduringthesameperiodweredividedintoSTsegmentelevationmyocardialinfarction(STEMI)groupandNSTEMIgroup.Clinicalcharacteristicsofthepatientsinthetwogroupswerecompared.Results①ThenumberofNSTEMIpatientsinage≥65yearsgroupissignificantlygreaterthanthatinage<65yearsgroup.Studyrevealedthatthepatientsinage≥65yearsgroupwerewithoutchestpain,hadhypertension,dyslipidemia,atrialfibrillation,cardiacandrenaldysfunction(sCr>178μmol·L-1)andtriplevesseldisease.Fewerpatientsinthisgroupreceivedcoronaryarteryangiography(CAG),percutaneouscoronaryintervention(PCI)andcoronaryarterybypassgraft(CABG).Morenumberofdeathsinthisgroupcomparedwiththeage<65yearsgroup.②ThenumberofNSTEMIpatientsinTIMIscore>4groupissignificantlygreaterthanthatinTIMIscore<4group.Fourmajorcomplicationssuchasacuteleftventricularfailure,cardiogenicshock,seriousarrhythmiaanddeaths,increasedsignificantlyinTIMIscore>4groupcomparingwithTIMIscore≤4group.③Obviously,morenumberofelderlypatients,non-insulindependantdiabetesmellitus(NIDDM),patientswithcardiactroponinT(CTnT)>3.0ng·L-1anddeathsoccurredinsCr>178μmol·L-1group.④STEMIandNSTEMIpatientswerecomparedinsametimeframeasfollows:fewerNSTEMIpatientsandmoreelderlypatientshadnochestpain,NIDDM,hypert

简介：ObjectivesTodeterminethesafetyandvalueofesophagealradiographyasameansoflocatingtransseptalpuncture.Methods486patientswhounderwenttransseptalpuncturewererandomizedintotwogroups.Anesophagusradiographicmethodoflocatingtansseptalpuncturesitewasappliedinthestudygroup(n=243)andmodified-Rosslocatingmethodwasusedinthecontrolgroup(n=243).Aftersuccessfullocation,transseptalpuncturewasmade.Weobservedthesuccessrateandincidencecomplicationsinthe2groups.ResultsLeftatriumimpressioninthestudygroupwasclearlyseen.Nonethelessin120casesofcontrolgroup,theleftatriasilhouettewasnotclearlyvisualised.Thesuccessrateoflocatingtransseptalpuncturesiteinthestudygroupandcontrolgroupwere100%and50.6%respectively(P<0.001).Thesuccessrateoftransseptalpunctureinthestudygroupandcontrolgroupwas99.6%and45.7%respectively(P<0.001).Therewerenocomplicationsassociatedwithpunctureinthestudygroupandpericardialtamponadeoccurredin1controlpatient.ConclusionsTheesophagusradiographicmethodoflocatingtransseptalpuncturesiteisaccurate,safeandsimpletoperform.Transseptalpuncturehasahighsuccessratewithfewcomplications.

简介：BackgroundRapidrightventricularpacingisoneofthemethodsforcounteractingthe'windsock'effectinthethoracicendovascularaorticrepair(TEVAR).Mostofthedoctorsaretocompletethisoperationundergeneralanesthesia.Now,ouroperationhasbeenperformedunderlocalanesthesia.Norelatedreportswerefoundastowhethercanthepatienttoleraterapidrightventricularpacingunderlocalanesthesia.MethodsFrom2009Januaryto2010January,inourhospitalalltheDeBakeyⅢaorticdissectionpatientswhounderwentTEVARwererandomlydividedintogeneralanesthesiagroup(n=50)andlocalanesthesiagroup(n=51).Allthedatawerecomparedbetweentwogroupsincludingthehemodynamicindexes,thegraftpositioningaccuracy,rapidpacingduration,operationtime,intraoperativediscomfortandpostoperativeneurologicalunderstandingfunctionchangesandthecomplications.ResultsThesuccessratewere100%inthetwogroups.Thedurationofrapidpacing,operationtime,theaccuracyofgraftlocalizationandtheintraoperativediscomfortscoresofNumericalPainRatingScaleshowednosignificantdifferencebetweenthetwogroups(P>0.05).Therewerenorapidrightventricularpacing-relatedcomplicationsinthetwogroups.ConclusionDuringthoracicendovascularaorticrepairprocedure,rapidrightventricularpacingunderlocalanesthesiaissafeandfeasible.Thusitisworthytobepopularizedinclinicalpractice.

简介：目的评价床边超声心动图在房间隔缺损（ASD）封堵术中的临床应用。方法25例ASD适合介入封堵的病人,术中床边超声心动图测量ASD最大直径,与测量球囊测量ASD直径比较,指导封堵器封堵、释放等过程,并观察有无残余分流及封堵器是否影响周围结构功能。结果25例患者ASD直径床边超声心动图测量值为（20.52±1.53）mm,球囊导管测量值为（21.41±1.52）mm,二者差异无统计学意义（P〉0.05）。25例患者全部一次堵闭成功,术后即刻超声心动图检查无残余分流,各瓣膜无病理性返流或原有返流加重,上、下腔静脉回流正常。结论床边超声心动图在ASD封堵术中能准确估测ASD直径,指导封堵过程,监测有无并发症发生,在ASD封堵术中具有重要指导作用。

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简介：BackgroundTheeffectofselectiveradiofrequencyablationfortreatingparoxysmalsupraventriculartachycardia(PSVT)anditsassociatedparoxysmalatrialfibrillation(PAF)wasassessed.MethodsDatawerecollectedretrospectivelyfrompatientsdiagnosedofPSVTandsubsequentlytreatedwithradiofrequencyablation.Regularmonthlyfollow-upbydynamicelectrocardiography(ECG)wasperformed.Incidentratesofatrialfibrillationbeforeandafterablationwerecompared.Results382PSVTpatientswith58havingatrialfibrillationwereenrolled.TheorderofcomplicatedPAFfromhightolowinthesepatientswasdisplayedas:atrialtachycardia(AT),atrioventricularreentranttachycardia(AVRT)andatrioventricularnodalreentranttachycardia(AVNRT).AmongAVRTpatients,PAFwasmorefrequentinpatientshavingaccessorypathways.AVNRTpatientshadsignificantlylowerPAFratecomparingtootherpatients.PAFincidentratewassignificantlyreducedbyradiofrequencyablationtherapy.ConclusionWeadviseregulardynamicECGforPSVTpatients,especiallythosewithatrialflutter,ATorpre-excitationsyndrome.SelectiveradiofrequencyablationisafeasibleapproachfortreatingAFcomplicatedPSVTpatients.

简介：BackgroundPrematureventricularcontractions(PVCs)arefrequentlyseeninchildren.However,therearelesssystematicandlongerfollowing-upstudiesexaminingtheprognosisofPVCsinchildren.TheaimofthisstudywastoevaluatethemediumtolongtermprognosisofPVCsinchildhoodandwhetherthereisadifferentialprognosisindifferentprimarydiseasesofPVCs.MethodsThisstudyreviewedthedataof106pediatricpatients(49F/57M,7.5±3.8years)seenattheAffiliatedHospitalofQingdaoUniversitywiththediagnosisofPVCsbetween1999and2005.Dataondemographics,clinicalpresentation,laboratorytests,andechocardiogramsofpatientswereextractedfromtheavailableclinicalrecords.ResultsAtotalof35(33.0%)childrenpresentedwithPVCsduetomyocarditis,7(6.6%)duetocardiomyopathies,7(6.6%)duetomitralvalveprolapse(MVP),10(9.4%)duetooperationforcongenitalheartdisease(O-CHD),16(15.2%)duetoleftventricularfalsetendons(LVFT),and31(29.2%)duetounknowncause.HolterdidnotshowPVCsduringfollow-upperiodin100%ofmyocarditispatients,57%ofcardiomyopathypatients,71%ofMVPpatients,60%ofO-CHDpatients,88%ofLVFTpatients,87%ofunknowncausepatients.ThePVCsdisappearedin93%ofpatientswhodidnotuseanti-arrhythmicdrugsandin76%ofpatientswhousedantiarrhythmicdrugs.Therewasnoasignificantdifferenceinprognosisbetweenmyocardialnutritioncombinedwithintravenousinjectionofimmunoglobulin(IVIG)groupandpropafenonegroup.ConclusionsPVCscausedbydifferentprimarydiseaseshasafavorableprognosisinchildren.Usually,thePVCswillreduceevendisappearduringfollow-up.ThepatientswithPVCsduetomyocarditisshouldbepreferredusemyocardialnutrientcombinedwithIVIG.