Objective To study the clinical characters of coronary artery triple vessel lesion, and to provide a theoretical basis for the therapy to the disease. Methods The clinical data of 68 cases of coronary artery triple vessel lesion (group A) and 71 cases of coronary artery of single or double vessel lesion (group B) were analyzed retrospectively. Results The related risk factors (hypertension, hyperlipidemia, diabetes and smoking) and the clustering of these factors were not significantly different between the two groups (P>0.05). While the positive rate of the exercise stress test existed remarkable difference between the two groups(P<0.01).The extreme differences between the two groups existed also in the cases of building collateral circulation (P<0.001), and in LVEF and LVEDP (P<0.0001) demonstrated by left ventricular angiography. The majority of the coronary artery lesion in group A was on level Ⅳ, and much more lesions of level Ⅲ and level Ⅳ occurred in group A than in group B. Most patients in group A accepted the coronary intervention, while after operation the angina pectoris emerged in a high rate, then the rebuilding of coronary circulation had to be done. Conclusions The best treatment for the patients with coronary artery triple vessel lesion should be the operation of coronary artery bypass graft (CABG), if it's possible.

Along with the mediated society,there are the problems in students'current media literacy,such as the alienation of media using,inability to distinguish'media reality'and'objective reality',lacking of media ethics and consciousness of self-discipline.Based on the analysis of these problems,in combination with the actual college education,we put forward the realization ways and the corresponding strategies to improve the students'media literacy.

Acupuncture Therapy ; Adult ; Aged ; Bloodletting ; Combined Modality Therapy ; Female ; Humans ; Low Back Pain ; therapy ; Male ; Middle Aged

Objective To investigate the clinical value of bloodβ-hydroxybutyric acid and urine ketone in the diagnosis of diabetic ketosis. Methods One hundred and fifteen patients with non-ketosis diabetics (NDK group), 85 patients with diabetic ketosis (DK group) and 105 healthy people (control group) were enrolled in Chengmai People's Hospital from May 2012 to May 2014. Blood β-hydroxybutyric acid, urine ketone and blood glucose were detected; the correlation index of blood β-hydroxybutyric acid, urine ketone and blood glucose in NDK group and DK group were analyzed. The receiver operating characteristic curve (ROC) was performed in determining the diagnostic value of bloodβ-hydroxybutyric acid for diabetic ketosis. Results The level of bloodβ-hydroxybutyric acid, positive rate of bloodβ-hydroxybutyric acid, urine ketone and level of blood glucose in DK group were higher than those in NDK group and NC group (P<0.01) . Blood β-hydroxybutyric acid was positively correlated with urine ketone and blood glucose (r=0.552,P=0.000;r=0.405,P=0.010) . When urine ketone was used as diagnostic standard, the area under curve of bloodβ-hydroxybutyric acid was 0.839, the best cutoff value ofβ-hydroxybutyric acid was 0.64 mmol/L with the sensitivity was 81.6%and specificity was 89.2%. Conclusions Examinations of bloodβ-hydroxybutyric acid and urine ketone have great significance for the diagnosis of diabetic ketosis. The co-monitoring of blood β-hydroxybutyric acid and urine ketone can reduce the rates of missed diagnosis and misdiagnosis. The best cutoff value of β-hydroxybutyric acid to diagnose diabetic ketosis was 0.64 mmol/L.

Objective To investigate the application value of the Mini-Nutritional Assessment (MNA) in assessing the nutritional status in middle-aged women with diabetes.Methods Using the normal range of traditional nutritional index as the reference standard,two hundred and forty middle-aged women with diabetes were recruited and their nutritional status were assessed by MNA and laboratory test (including PAB,Fib,TLC,CHOL),respectively.Finally,the results were analyzed and compared.Results The correlation coefficient of MNA value and BMI、PAB,Hb,TLC,CHOL were 0.571,0.614,0.781,0.568,0.218.MNA had good correlations with several traditional laboratory indicators regarding with nutritional status,with signifi-cant difference.In this study,the results of investigation by MNA showed that:the rates of malnutrition,potential malnutrition,and normal nutritional were 30％(72 cases),65％(156 cases),and 5％(12 cases),respectively.The sensitivity and specificity of MNA were 96.1％ and 98.2％ respectively.Laboratory testing resuits:malnutrition and normal nutrition were 31％ (74 cases) and 4％ (10 cases).Kappa test(Kappa=0.922):the results of MNA and laboratory testing had strong consistency.Conclusions MNA is feasible in assessing nutritional status in the domestic middle-aged women with diabetes.

Objective To investigate the clinical manifestations, diagnosis and treatment of Bartter syndrome in children. Methods Clinical data of 15 patients with Bartter syndrome in Children`s Hospital Afifliated to Chongqing Medical University was analyzed, and pertinent literatures were reviewed. Results Bartter syndrome is an autosomal recessive inherited renal disorder characterized by hypokalemia, hypochloremia, metabolic alkalosis, vomiting, growth retardation, the activation of the renin-aldosterone axis, normal blood pressure. Genetic analysis is the most reliable way for diagnosis. Comprehensive therapy with antisterone, indomethacin, catopril and potassium have remarkable effect. Conclusions Bartter syndrome should be considered when children have unreasonable continuous hypokalemia, hypochloremia, metabolic alkalosis and growth retardation. It can be clinically diagnosed by clinical manifestation and hydrochlorothiazide test, and genetic analysis is the most reliable way. It can be ameliorated by potassium and magnesium supplementation, antialdosterone medications, prostaglandin inhibitors and antisterone. Considering the following electrolyte disturbances, infections, growth retardation, kidney failure and even death,Bartter syndrome need lifelong treatment, early diagnosis and treatment is of the most importance.

The superoxide dismutase (SOD) activity of liver, lung, stomach and kid-ney of rabbits with schistosomiasis (n=10), normal animals with SMAO (n=7), andsham operative group (n=6) were measured. The results showed that SOD activity inanimals of rabbits organ decreased significantly during SMAO shock (P

Objective To analyze the clinical and pathological characteristics and laboratory outcomes in henoch-schonlein purpura nephritis(HSPN) patients.Methods Twenty patients with HSPN were respectively studied. The clinical characteristics and laboratory outcomes were compared between patients with different glomerulus and renal tubule pathologic classification respectively. Results Patients with grade Ⅲ had a higher proteinuria rate than those with grade Ⅱ,and the glomerulus and renal tubule pathologic markedly changed in grade Ⅲ than that in grade Ⅱ.The HSPN patients had a higher concentration of IgA,C 3 in plasma and of minimal protein in urine than that in normal groups.Conclusions There are both glomerulus and renal tubule pathologic changes in HSPN patients. The basic pathologic changes are parallel and correlated with clinical manifestation.

Objective:To observe the clinical efficacy of rh-BNP combined with continuous renal replacement therapy on the re-fractory heart failure in cardiorenal syndrome. Methods:Totally 48 patients with refractory heart failure in cardiorenal syndrome in our hospital were selected and randomly divided into the observation group and the control group. The control group was received the con-ventional drug therapy combined with continuous renal replacement therapy, and the observation group was received rh-BNP therapy ad-ditionally. After 7 days, NT-ProBNP, heart rate, LVEF, SV, BUN, Scr and GFR of the two groups were compared, and the clinical efficacy of the two groups was evaluated. Results:After the treatment, all the observed indicators in the two groups were significantly improved than those before the treatment, and the improvement in the observation group was better than that in the control group ( P<0. 05). The total effective rate of the observation group was higher than that of the control group(91. 67% vs 79. 17%, P<0. 05). Conclusion:The combination of rh-BNP and continuous renal replacement therapy can improve heart and kidney function of the refrac-tory heart failure in cardiorenal syndrome with better efficacy.

Objective: By sorting and analyzing pertinent modern studies targeting auricular point therapy treating primary insomnia (PI), to summarize the point selection rules and clinical efficacy of using auricular points alone or combining it with other therapies in treating PI. Methods: A search on China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), PubMed, Springer and Ovid were conducted from January 1, 1998 till January 31, 2020. Point selection, diagnostic criteria and Pittsburgh sleep quality index (PSQI) in the eligible studies were analyzed and summarized. Results: The difference in PSQI before and after using auricular point therapy alone was more significant than that of using Chinese medication alone (P<0.05), but less significant than that of combining auricular point therapy and acupuncture-moxibustion and Chinese therapeutic massage (tuina) (P<0.05). In the included studies, Shenmen (TF4) was the most commonly used (370 times), followed by Heart (CO15), which was 344 times, and Subcortex (AT4), which was 325 times. In terms of auricular points distribution, points in the auricular concha were the most commonly used (1500 times), followed by those in the antitragus (474 times) and triangular fossa (387 times). Correlation analysis showed that Shenmen (TF4) and Liver (CO12), Sympathetic (AH6a) and Heart (CO15) were used together more often, followed by Shenmen (TF4), Liver (CO12), Spleen (CO13), Kidney (CO10) and Subcortex (AT4), and then Shenmen (TF4), Liver (CO12), Sympathetic (AH6a), Subcortex (AT4) and Heart (CO15). Cluster analysis showed that the auricular points used for PI can be divided into 6 clusters in 2 major groups. One group was Heart (CO15), Subcortex (AT4), Shenmen (TF4), Sympathetic (AH6a), Spleen (CO13), Kidney (CO10), Liver (CO12) and Endocrine (CO18); the other was Occiput (AT3), Stomach (CO4), Pancrease-gallbladder (CO11), Chuiqian (LO4), Small Intestine (CO6), Central Rim (AT2,3,4i) and Sanjiao (CO17). In terms of patterns in traditional Chinese medicine, the pattern of dual deficiency of heart and spleen accounted for the largest proportion in the studies of using auricular points alone or combining it with other treatments to treatment PI, and then it was the pattern of liver depression transforming into fire. Conclusion: In treatment of PI with auricular points alone or combo therapy involving auricular points, Shenmen (TF4) was commonly used, and the commonly used point group consisted of Shenmen (TF4), Liver (CO12), Sympathetic (AH6a) and Heart (CO15). Auricular point therapy can be taken as a complementary therapy in treating PI.