Objective To investigate the therapeutic effect of nasal endoscope surgery on chronic sinusitis and nasal polyps in geriatric patients.Methods A total of 132 geriatric patients with chronic sinusitis and nasalpolyps underwent nasal endoscope surgery in our hospital from Jun.2010 to Jun.2014,and the therapeutic effect was investigated.Results In the 132 cases,92 cases were cured (69.7％).Therapeutic effects were excellent in 33 cases (25.0％),and invalid in 7 cases (5.3％).The total effective rate was 94.7％.The total effective rate was 100.0％ in type Ⅰ,97.4％ in type Ⅱ and 84.8％ in type Ⅲ.The total effective rate was higher in type Ⅰ and Ⅱ than in type Ⅲ (x2=3.506 and 6.218,P=0.035 and 0.012).Local complications occurred in 10 cases (7.6％),including 1 case with nasolacrimal duct injury,2 cases with orbital hematoma,5 cases with nasal adhesion,1 case with surgical cavity hemorrhage and 1 case with sinus atresia.Conclusions The therapeutic effects of nasal endoscopesurgery on chronic sinusitis and nasalpolyps are good in geriatric patients,especially in treating chronic sinusitis and nasalpolyps of type Ⅰ and Ⅱ,and the postoperative complications are less,which is worth clinical application.

Objective To investigate the clinical effects of open decompression drainage on acute pulpitis.Methods Totally 180 acute pulpitis patients hospitalized during January 2012 to September 2014 in our department were selected and randomly divided into control group and observation group (n=80 each).The control group was treated with pulp inactivating agent and the observation group was given open decompression drainage.The clinical effects,analgesia efficiencies at 7d after treatment,treatment course and the complications were compared between the 2 groups.Results There was significant difference in the effective rate between control and observation groups after treatment [61.3％ (49/80 cases) vs.86.3％ (69/80 cases),P＜0.05].The analgesia efficiencies at 7d after treatment was 46.3％ (37/80 cases) in control group and 73.8％ (59/80 cases)in observation group (P＜0.05).There was no significant difference in treatment course between two groups [(7.7±1.4) times vvs.(6.1± 1.2) times,P＞0.05]].6 patients developed periapical periodontitis in control group,and only 4 cases in the observation group (P＞0.05).Conclusions Early open decompression drainage has good clinical effects and analgesia efficiencies in treatment of acute pulpitis,which is worthy of clinical application.

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Objective To investigate the expressions of serum cystatin C CysC),retinolbinding protein (RBP),serum and urinary β2-microglobulin (β2-MG) and their effects on predicting renal damage in primary hypertension in elderly patients.Methods A total of 149 patients were divided into 3 groups of hypertension grade 1 (n =50),hypertension grade 2 (n =50) and hypertension grade 3 group (n=49).92 healthy controls who took physical examination were selected as control group.The levels of serum CysC,RBP,serum and uric β2-MG,blood urea nitrogen,creatinine and other biochemical indexes were detected.The complications of hypertension were observed.The differences in renal function indexes between groups and their correlations were analyzed.Results There were 86 cases with hyperlipidemia (57.7％),71 cases with atherosclerosis (47.7％),59 cases with type 2 diabetes mellitus (39.6％),56 cases with coronary heart disease (37.6％),and 49 cases with cerebral vascular disease (32.9％) in 149 hypertensive patients.The levels of serum CysC,RBP,serum and uric β2-microglobulin were increased in hypertensive patients as compared with healthy controls (P＜0.05 or 0.01),and the extents of increments in the above indexes were positively correlated with blood pressure level [CysC:(1.2± 0.5) mg/L,(1.7±0.6) mg/L,(2.2±0.9) mg/L;RBP:(53.1±10.2) mg/L,(65.2±16.3)mg/L,(75.8±17.5) mg/L;serum β2-MG:(2.7±1.5) mg/L,(4.0±2.1) mg/L,(4.9±2.0) mg/L;uric β2-MG:(178.3±73.9) ng/L,(237.9±78.6) ng/L,(277.5±87.5) ng/L;respectively,P＜0.05or 0.01].Conclusions Elderly hypertensive patients are complicated with a variety of diseases.The levels of serum CysC,retinol-binding protein,serum and uric β2 microglobulin have significant diagnostic values on renal impairment caused by hypertension,and can be considered as sensitive factors for early renal impairment in essential hypertension.

Objective To investigate the correlation of the S100B level with cardiac function and chronic heart failure.Methods A total of 80 elderly chronic heart failure (CHF) patients who accepted treatments in our hospital from March 2012 to December 2013 were recruited,and 80 subjects undergoing health examinations served as the control group.The New York Heart Association (NYHA) functional classification in the experimental group was determined.Serum levels of S100B and NT-proBNP,left ventricular end diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) were compared between the groups,and the correlation of the S100B level with NT proBNP,LVEF and the NYHA functional classification were analyzed.Results The serum S100B level was increased in the experimental group as compared with the control group [(91.4 ±31.9) pg/L vs.(74.9±26.0) pg/L,t=1.980,P=0.000].The serum NT-proBNP level was higher,LVEDD was longer,and LVEF was lower in the experimental group than in the control group (all P＜0.01).The serum S100B level was positively correlated with NT-proBNP (r=0.309,P=0.003) and the NYHA functional classification (r=0.508,P=0.001),and negatively correlated with the LVEF (r=-0.192,P=0.004).Conclusions The serum S100B level is increased in patients with CHF and negatively correlated with cardiac function,suggesting that the S100B protein may serve as a valuable tool for the diagnosis and assessment of CHF.However,more studies are needed to provide more evidence.

Objective To investigate the diagnostic significance of the difference values between Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)in elderly patients with dementia.Methods 331 elderly patients with dementia were collected from outpatients in our hospital.There were 148 people with Alzheimer's disease (AD),87 cases with vascular dementia (VaD),44 cases with mixed dementia (MD),41 cases with frontotemporal dementia (FTD) and 11 cases with dementia with Lewy bodies (DLB).MMSE and MoCA were applied to test the cognitive impairment separately.Results The difference values between MMSE and MoCA was (3.3±1.7) points,(6.6±2.1) points,(6.6±2.1) points,(5.4±2.3) points,(6.1 ± 1.9) points in AD,VaD,MD,FTD and DLB group respectively,and there were statistical differences among the five groups (F=46.420,P=0.000).Statistical differences were found in the difference values between MMSE and MoCA between dementia patients with AD and non-AD (t=-13.429,P=0.000).According to receiver operating characteristic curve (ROC curve),the optimal cut off point of the difference values between MMSE and MoCA for differential diagnosis between AD and non-AD dementia was 5 points,with 79.8％ sensitivity and 78.4％ specificity,and area under the curve was 0.848 (95％CI:0.807-0.890).Conclusions The difference values between MMSE and MoCA may be one of parameters for differential diagnosis between AD and non-AD dementia.

Objective To analyze the clinical manifestations,diagnosis and treatment of cerebral amyloid angiopathy (CAA) associated intracerebral hemorrhage.Methods The clinical manifestations,treatment and prognosis of CAA associated intracerebral hemorrhage were analyzed in 4 patients who were identified as CAA-related hemorrhage (CAAH) by pathology.Results All of the 4 patients showed massive lobar intracranial hemorrhage,and underwent craniotomy evacuation of hematoma.One patient had postoperative hemorrhage,and 2 patients were treated with recombinant activated factor Ⅶ after operation.In the next 6 months,re-hemorrhage was found in 3 patients in whom one patient died due to massive hemorrhage.Conclusions CAAH has varied clinical manifestations with high risk of cerebral hemorrhage,and pathological diagnosis is necessary for a definite diagnosis.The very elderly patients with CAAH can benefit from the craniotomy evacuation of hematoma.Although surgery for massive hemorrhage has risks in very elderly patients,it is a better treatment to save their lives.

Objective To investigate the application value of low kilovolt technique combined with lower contrast in the head and neck angiography by the second-generation dual source CT.Methods From October 2013 to January 2015,120 patients undergoing head and neck computed tomography angiography (CTA) were randomly divided into groups A,B,C,D.Each group was given a different tube current and different dose of contrast agent and saline solution 50 ml.Group A received current 100 mA and contrast agent 50 ml,group B received current 100 mA and contrast agent 40 ml,group C received current 80 mA and contrast agent 50 ml,and group D received current 80 mA and contrast agent 40 ml.CT values of aortic arch,bilateral common carotid artery bifurcation,double sided M1 segment of middle cerebral artery,basilar artery enhanced degree of the straight sinus were measured in each group.Residual artifacts caused by contrast agent in brachiocephalic vein and subclavian vein were observed.5-score method was used to assess the quality of reconstructed image,and the radiation exposure dose was calculated.Results The mean effective dose was reduced by 29％ in group C as compared with group A [(0.53±0.17) mGy vs.(0.74±0.04) mGy].There was no significant difference in developing strength in cerebral arteries angiography between group C and group A (P=0.247),but the inage noise was slightly larger in group C than group A,without significant differences (P=0.203).The average effective dose in group A was almost the same as that in group B [(0.74 ± 0.04) mGy vs.(0.73 ± 0.05) mGy].Structure display of cerebral arteries on CT volume rendering (VR) and multiplane reformation (MPR) images had no significant differences between group A and group B (P=0.114).The average effective dose in group C was almost the same as that in group D[(0.53 ± 0.17) mGy vs.(0.53 ±0.01) mGy].Structure display of cerebral arteries on CT volume rendering (VR) and muhiplane reformation (MPR) images had no significant differences between group C and group D (P=0.109).The mean effective dose was reduced by 28％ in group D as compared with group B[(0.53±0.01)mGy vs.(0.73±0.05) mGy].There was no significant difference in developing strength in cerebral arteries angiography between group C and group A (P=0.236),but the image noise was sligbtly larger in group C than group A (P =0.212).Conclusions Application of low tube current combined with low concentration of contrast agent in the head and neck dual-source CT angiography is feasible in clinical diagnosis,with good clinical value.It can not only get better image quality,but also meet the needs of clinical diagnosis.