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??Diagnosis and treatment of hyperparathyroid crisis??a report of 4 cases BAI Yan-xia*, MA Qing-yong, YAN Li-ying, et al . *Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital, Medical College of Xi’an Jiaotong University??Xi’an 710061??China Corresponding Author?? MA Qing-yong, E-mail: qyma56@xjtu.edu.cn Abstract Objective To explore the diagnostic and therapeutic method of hyperparathyroid crisis. Methods The clinical data, the operative technique, the therapeutic effect of 4 cases which were treated in First Affiliated Hospital of Xi’an Jiaotong University from January 2005 to May 2007 were presented. Through reviewing pertinent literature, we discuss the qualitative diagnosis??level diagnosis and operative juncture of primary hyperparathyroidism complicating hyperparathyroid crisis. Results The three patients were healed by promptly exploratory parathyroidectomy and medical treatment. One patient died for complicating of multiple organ dysfunction. Conclusions Promptly exploratory parathyroidectomy after temporal medical treatment is an effective method to rescue the patient of primary hyperparathyroidism complicating hyperparathyroid crisis??The exploratory parathyroidectomy can be successed on preoperative definite diagnosis and accurate localization??frozen section and quickly PTH determination in the operation.     

湿疹-感染-血小板减少三联综合征1例

１病例报告患者，男，３岁。反复全身湿疹、出血、腹泻脓血便二年余，鼻出血再发３日于２００１－１１－２８入院。患儿自出生后７个月起，反复在口角、肢端等处皮肤出现皮疹、淤点、淤斑，并腹泻，曾于２０００年７月及１２月２次住我院，诊断为感染性腹泻伴中度脱水、湿疹，先后予头孢曲松、阿米卡星及输血浆治疗，痊愈出院。本次因鼻出血３日、皮疹出血、烦躁不安入院。家族中无人有类似病史。体格检查：体温３６．７℃，脉搏１２０次／分，呼吸３６次／分，体重１２．５kg。患儿哭闹不安，发育、营养不佳，重度贫血貌，全身皮肤有散在性…     

Interaction between angiotensin-converting enzyme genotype and glycaemic control influences lipoprotein levels in type 2 diabetes mellitus

AIMS: To evaluate the influence of the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism on lipid levels in patients with Type 2 diabetes. PATIENTS AND METHODS: 109 patients with Type 2 diabetes were included. The patients were not on any lipid-lowering treatment. The groups with different ACE genotypes had similar ages, sex distributions, body mass indices, systolic blood pressures and indices of glycaemic control. ACE gene I/D polymorphism was determined using polymerase chain reaction. RESULTS: The mean apolipoprotein B (apoB) level was significantly higher in the group of DD homozygotes compared with the subjects with at least one insertion allele (DD: 1.21 +/- 0.25 g/l vs. ID + II: 1.04 +/- 0.27 g/l; P = 0.007). Significant correlations between glycated haemoglobin (HbA1c) and both apoB and cholesterol levels were found (r = 0.27; P < 0.01). For the apoB, this correlation was highly significant in the DD-genotype subgroup (r = 0.54; P < 0.01), and was not significant in the subgroup of patients with genotypes ID or II. In the multivariate analysis, HbA1c and the interaction of genotype DD with HbA1c were significant independent predictors of apoB (r2 = 0.17) and cholesterol levels. CONCLUSION: The present study showed that the interaction between the DD genotype of angiotensin-converting enzyme and chronic hyperglycaemia (expressed by HbA1c level) is related to higher plasma levels of atherogenic lipoproteins, such as apoB and cholesterol, in patients with Type 2 diabetes.     

Serum prolidase I activity and some bone metabolic markers in patients with breast cancer: in relation to menopausal status

OBJECTIVES: The purpose of this study was to investigate the diagnostic value of some osteoblastic/osteoclastic biochemical markers and serum prolidase I activity in breast cancer (BC). DESIGN AND METHODS: Serum bone gla protein (BGP), prolidase I activity, urinary deoxypyridinoline (Dpy) and calcium excretions were measured, in metastatic and nonmetastatic BC patients, and in 52 healthy women. RESULTS: In patients with metastases, bone turnover markers were found to be significantly higher than those in the control group and in patients without metastases. Serum prolidase activity in patients with and without metastases was also significantly higher than those in the control group, but there was no difference between the two patient groups. CONCLUSIONS: Bone turnover has been suggested to be accelerated in BC patients with the more pronounced osteolytic activation, especially in metastatic state. Serum prolidase in premenopausal period appears to be valuable in discriminating cancer patients from controls. BGP and to a lesser degree of Dpy, may be useful markers for predicting the metastatic bone involvement, as well as for the more cost effective management of BC patients and monitoring the effects of antiresorptive therapy of malignant osteolysis before any metastasis could be detected by other invasive techniques.     

深圳市院前和急诊科心肺复苏单因素分析

目的 了解深圳市心肺复苏现状和影响因素.方法 对照做过心肺复苏1630例患者的病历填写调查表,用Epidata建立数据库,用SPSS13.0统计学软件进行统计学分析.结果 男:女=2.61: 1,男女院前急救生存到院率分别为6.20%和8.73%(P>0.05),急诊科急救生存入院率分别为16.96%和21.10%(P>0.05);院前和急诊科生存率分别为7.00%和18.10%(P<0 001);患者平均(38.23±22.23)岁,有机会生存到达急诊科的患者较仅进行了院前急救的患者年轻(P<0.001);循环系统疾患和外伤是前两位病因;心肺复苏术前呼吸心搏停止平均(19.69±20 29)min,院前和急诊科患者分别为(21.51±19.02)min和(17.93±21.31)min(P<0.005);院前采用不同人工通气复苏效果比较差异有统计学意义(P<0.05),气管插管优于面罩给氧和口对口人工呼吸,但在急诊科未显示出差异有统计学意义;院前和急诊科均显示,复苏术前不同心电图复苏效果比较差异有统计学意义(P<0.001),以室颤最佳,无脉搏电活动次之,心室静止最差.结论 深圳市院前和急诊科心肺复苏比较,复苏效果、年龄、通气方法和结果差异有统计学意义;复苏术前不同心电图患者复苏效果比较差异亦有统计学意义.     

磁共振弥散张量成像(DTI)技术对手术清除基底节区脑出血的应用性研究

目的:探讨磁共振弥散张量成像技术(DTI)对手术清除基底节区血肿侧皮质脊髓束神经纤维完整性的保护的应用性研究.方法:选取50例来我院治疗的基底节区脑出血患者作为研究对象.实验组:27例,采取手术清除血肿;对照组:23例,采取非手术治疗.所有患者在发病早期行DTI检查,观察皮质脊髓束(CST)特性并与健侧对比.结果:1级:CST完整;2级:CST完整,但轻度受压推移;3级:CST部分中断;4级:CST大部分甚至完全中断.实验组:1级1例,2级8例,3级12例,4级6例;对照组:1级0例,2级1例,3级9例,4级13例;两组在皮质脊髓束特性的差异上存在着统计学差别(P＜0.05).结论:手术清除基底节区脑出血对出血侧皮质脊髓束神经纤维的保护起到一定的促进作用.     

Ozone therapy efficiency and gerovital H3 as an additional way to the complex treatment of periodontal disease

The authors present the methodology of the ozone use and a method of chemical stimulation with Gerovital H3, applied within a complex therapy of the periodontal disease. Its efficiency is argued by the clinical images taken from the oral cavity and radiographic images of the patients with periodontal disease in various evolution stages. RESULTS: The images reveal the possibility of stopping the progressive disease and the improvement of the clinical aspect of the marginal periodontium. The X-ray images reveal the possibility of re-mineralization of the alveolar bone and healing processes in certain areas, at different periods of time. CONCLUSIONS: Favorable results are associated firstly with compliant patients that benefit of treatment planning elaborated after a correct evaluation of the clinical situation. The results prove the strong oxidant and antibacterial effects of ozone as well as the regenerative and biotrophic action of Gerovital H3 in periodontal tissues for patients with early and advanced periodontal disease.