老年多发性脑梗死患者应用CT与MRI诊断的临床比较

目的:比较CT与MRI在诊断老年多发性脑梗死中的临床应用价值。方法:对我院收治的老年多发性脑梗死患者均行CT和MRI检查,比较其检查结果。结果:两种方法24h以内组梗死灶检出率比较差异有统计学意义(P0.05),24~72h与72h组的检出率比较差异无统计学意义(P0.05)。血管性痴呆和非血管性痴呆患者CT梗死检出率均低于MRI,其中非血管性痴呆组MRI梗死检出率明显高于CT(P0.05),血管性痴呆组两种方法的梗死检出率比较差异无统计学意义(P0.05)。结论:与CT相比,MRI在老年多发性脑梗死的诊断中更具优势,可作为早期病变检出的主要手段。     

糖尿病合并肺结核患者的肺部CT影像学特征分析

目的:分析糖尿病合并肺结核患者的肺部CT影像学特征。方法:选取60例糖尿病合并肺结核患者作为观察组,另选取同期单一的60例肺结核患者作为对照组。两组均行痰菌检查、CT扫描,两组的各项检查程序一致,比较两组病灶发病部位、病变类型及病灶分布范围。结果:观察组两肺上叶前段、右肺中叶发病率明显高于对照组,差异有统计学意义(P<0.05);两组右肺上叶尖段与后段、两肺下叶背段发病率比较,差异无统计学意义(P>0.05);观察组单发空洞、多发空洞、支气管播散灶、斑片状大片融合/大片状高密影病灶明显多于对照组,差异均有统计学意义(P<0.05);观察组单肺段、多个肺段病灶均明显多于对照组,差异有统计学意义(P<0.05)。结论:糖尿病合并肺结核患者肺部CT影像学特征具有一定的特异性,病灶分布范围广,肺结核少见发病部位的发病率也较高,且病灶形态呈现多样化特点。     

糖尿病合并肺结核患者的肺部CT影像特征分析

目的:探讨糖尿病合并肺结核患者的肺部CT影像特征。方法:选择我院2014年6月-2015年6月收治的20例糖尿病合并肺结核患者作为研究对象,所有患者均行肺部CT影像学检查,回顾性分析患者临床资料,就其检查结果进行对比分析。结果:20例糖尿病合并肺结核患者的病灶多呈现多肺段分布或单肺段病灶。其中多肺段45例、单肺段23例。患者行肺部CT检查显示存在斑片影、大片融合影、树芽状态、空洞和肿块、结节及纤维条影等情况。而20例非糖尿病合并肺结核患者则仅存在47个病变数,两者比较差异有统计学意义(P0.05)。结论:糖尿病和肺结核两者并不互相影响,在两者的诊断中应先行X线检查,后行CT检查,最后通过病例研究分析确诊。     

老年糖尿病无症状性脑梗死危险因素及特点

目的 探讨老年糖尿病合并无症状性脑梗死(SBI)的危险因素及临床特点.方法 50例老年糖尿病并SBI为观察组,50例非糖尿病并SBI为对照组,比较两组患者头颅CT特点及血胆固醇、甘油三脂、体重指数、高密度脂蛋白、纤维蛋白原、C-反应蛋白等指标.结果 观察组中患者高密度脂蛋白明显降低,纤维蛋白原、C-反应蛋白、血清总胆固醇等明显增高,与对照组比较差异有统计学意义(P＜0.05);两组患者甘油三酯比较差异无统计学意义(P＞0.05),但体重指数比较差异有统计学意义(P＜0.01).结论 老年糖尿病合并SBI以多灶性脑梗死多见,老年糖尿病合并高甘油三脂、高胆固醇,高密度脂蛋白降低,肥胖的患者易致无症状性脑梗死.     

糖尿病并肺结核患者的胸部CT表现分析

目的:探讨糖尿病并肺结核患者的胸部CT表现。方法:选择我院2014年10月-2015年10月收治的34例糖尿病合并肺结核患者,所有患者均行胸部CT检查,回顾性分析患者的临床资料,并就检查结果进行分析,总结糖尿病并肺结核患者的胸部CT表现。结果:34例患者行CT检查表现为多肺段分布或单肺段病灶,53例表现为多肺段,36例表现为单肺段。CT显示肺部存在斑片影、大片融合影、树芽状态、空洞和肿块、结节及纤维条影等情况。非糖尿病合并肺结核患者病变数仅有62个,两组比较差异有统计学意义(P0.05)。结论:糖尿病和肺结核两者并不互相影响,在两者的诊断中应先行X线检查,后行CT检查,最后通过病例研究分析确诊。     

老年2型糖尿病合并无症状性脑梗死41例的临床分析

目的探讨老年2型糖尿病合并无症状性脑梗死（SCI）的临床特点、危险因素及防治方法。方法对181例2型糖尿病病人按头颅CT和／或MRI的检查结果分为合并无症状性脑梗死组（SCI组）和未合并无症状性脑梗死组（非SCI组）,对两组病人的年龄、糖尿病病程、空腹血糖及控制血糖的疗效、合并症等情况进行临床比较分析。结果SCI组年龄≥70岁者占80．5％,糖尿病病程≥5年者占80．5％,血糖控制差者占39．0％,合并高血压、高血脂者占分别占82．9％、70．7％,多种疾病叠加者占87．8％～95．1％。与非SCI组比较差异均有统计学意义（P〈0．05）。结论高龄、糖尿病程长、高血糖和控制不良、高血压、高血脂及多种与中风有关的疾病叠加均是导致SCI的危险因素,进行早期干预对阻止SCI演变为症状性脑卒中意义重大。     

老年多发性脑梗死患者MRI与CT检查结果比较

目的探讨老年多发性脑梗死患者MRI与CT检查的优缺点,提高老年多发性脑梗死诊断水平。方法随机选取2011年12月~2012年12月江西省德安县人民医院收治的68例老年多发性脑梗死患者的临床资料进行回顾性分析。所有患者均例行MRI与CT检查,以检查患者的病灶大小、检查耗时、病灶个数、检查病灶距发病间隔等各项指标为参照标准,全面分析两种检查方法的差异性。结果 68例老年多发性脑梗死患者,CT共检查出136个梗死病灶,而MRI共检查出242个梗死病灶,两种检查方法病灶检出率、病灶大小以及检出时间等比较,差异有统计学意义（P〈0.05）。结论相对于CT检查,MRI检查老年多发性脑梗死的检出率更高、更准确、更及时,值得临床推广应用。     

2型糖尿病合并脑梗死的临床分析

目的分析2型糖尿病合并脑梗死的临床特点及治疗体会。方法回顾性分析117例脑梗死患者的临床资料,将其中合并2型糖尿病的51例患者分为观察组,余者66例未合并糖尿病的患者分为对照组,比较两组患者的临床生化检验指标,包括空腹血糖、TG、TC、LDL-C、HDL-C等,并比较两组患者的梗死灶类型及并发症情况。结果观察组患者的FBG、TG、TC、LDL-C等指标显著高于对照组,差异具统计学意义(P0.05),两组患者的HDL-C差异无统计学意义(P0.05)。与对照组相比,观察组大片梗死的比例显著高于对照组(P0.05),余者腔隙性梗死、多灶性梗死、出血性梗死等比例差异无统计学意义(P0.05)。观察组发生消化道出血、肺部感染、心律失常、肾功能损害等并发生(症)的比例均显著高于对照组,差异具统计学意义(P0.05)。结论糖尿病合并脑梗死患者血脂水平显著高于单纯脑梗死患者,且并发症发生率高于单纯脑梗死患者,临床上要加强糖尿病合并脑梗死患者血压、血糖及血脂的控制,以提高治疗效果,改善预后。     

糖尿病性与非糖尿病性脑梗死临床及CT影像特征的对比

目的：探讨糖尿病脑梗死的CT特点，方法：对30例糖尿病脑梗死与30例非糖尿病脑梗死的临床表现，CT特点进行比较。结果：30例糖尿病脑梗死中有26例腔隙性脑梗死，其中21例为多发性梗死病灶，病灶数目总共124个，平均4．8个；30例非糖尿病有15例腔隙性脑梗死，其中6例为多发性梗死病灶，病灶数目总共43个，平均2．8个，两组有显著差异（P＜0．05）；两组的临床表现及其它CT特点基本一致，无差异性，结论：糖尿病脑梗死以及多发性腔隙梗死为主要特点，但非糖尿病梗死的临床表现，病灶好发部位无本质区别。     

老年2型糖尿病合并无症状脑梗死患者90例临床观察

目的分析老年糖尿病合并无症状脑梗死（SBI）患者的临床特点。方法将老年2型糖尿病合并SBI患者90例作为观察组,非糖尿病合并SBI患者78例为对照组,比较2组患者临床症状、头颅CT特点及血脂、纤维蛋白原、超敏c反应蛋白等指标的水平。结果2组患者神经系统症状如头痛、头晕等症状相似,差异无统计学意义（x2=1．58,P〉0．05）;观察组脑梗死灶数目3个及以上的多见,与对照组比较差异有统计学意义（P〈0．05）;观察组组蛋白、纤维蛋白原、超敏C反应蛋白与对照比较差异有统计学意义（P〈0．05）。结论老年糖尿病无症状脑梗死症状轻,预防老年糖尿病无症状脑梗死发生有一定意义。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.