Objective To evaluate whether the prognosis of 6 months major adverse cardiac events(MACE)after acute myocardial infarction,and the reperfusion state of myocardial tissue are related to the white blood cell(WBC)count in elderly patients.Methods A total of 101 consecutive patients aged≥60 years(mean age 70?6 years)who had a primary percutaneous coronary intervention as their first-line therapy for ST-elevation myocardial infarction(STEMI)were enrolled, and both their WBC count on admission and ST-monitoring were available.A prospectively defined cut-off value of WBC count was 10,000/?l,a cut-off 50% measured after 60 min was used as ST -segment resolution(STR).Results The high WBC count group(n=48)showed the significantly higher(52.1% vs 22.6%,P＜0.01)incidence of 6 months major adverse cardiac events(MACE)than did the,low WBC count group(n=53).The low WBC count group had 45 patients with STR≥50%, high WBC count group had 23 patients with STR≥50%,STR after PCI was significantly different between the 2 groups(P＜0.01).Conclusions The WBC count is a predictor of the adverse outcome in elderly patients with STEMI.Furthermore,elevation in WBC count is associated with poor myocardial microcirculatory reperfusion.

Objective To explore the clinical and imaging features of primary lateral sclerosis(PLS).Methods The clinical and imaging data of 3 patients with PLS were analysed.Results 3 patients included 2 females and 1 male.The onset of the disease was insidious.The initial symptoms included rigidity and weakness of right upper limb(case 1),rigidity and weakness of legs(case 2),and pseudobulbar palsy(case 3). As the disease progressed slowly,the patients presented with spastic paralysis of four extremities,reduced muscle strength(3 to 4 degree),clasp-knife like of muscular tension,hyperactivity of tendon reflexes,ankle clonus and presence of Babinski sign.In T2-weighted images of the brain MRI,the abnormal high signals were symmetrically situated in the motor cortex,the posterior limbs of internal capsules,cerebral peduncles and basilar part of pons.1H magnetic resonance spectroscopy(1HMRS) showed decreases of N-acetylasartate(NAA) and the ratio of N-acetylaspartate/Creatine(NAA/Cr) in the focal regions.Conclusion PLS presents with characteristic features of clinical symptoms,signs and abnormal changes of MRI.In addition,1HMRS may be helpful in diagnosis of this disease.

Objective To assess the predictive value of coronary angiography TIMI myocardial perfusion grade (TMPG), electrocardiogram (ECG) single-lend ST segment resolution (STR), ECG Max-ST-segment deviation (MaxSTE) on judging myocardial reperfusion after primary angioplasty in the patients with acute myocardial infarction (AMI). Methods Primary percutaneous coronary intervention(PCI) was performed in 42 patients within 12 hours after AMI onset. Coronary angiography and ECG was done before and after angioplasty. TMPG, ECG single-leed STR and MaxSTE were used to assess myocardial reperfusion immediately after PCI. Myocardial perfusion scan was examined in all the patients using99mTc-MIBI SPECT on day 7±2. Results Compared with the level of myocardial perfusion demonstrated in myocardial scan of 99mTc-MIBI SPECT, the sensitivity, specificity and accuracy of TMPG, single-lead STR and MaxSTE was calculated. The sensitivity of TMPG, single-lead STR and MaxSTE was 93.75%, 87.50% and 81.25%, respectively, the specificity of them was 20.00%, 80.00% and 80.00%, respectively, and the accuracy was 76.19%, 85.71% and 80.95%, respectively. The findings in single-lead STR and MaxSTE matched well with the results of myocardial scan of 99mTc-MIBI SPECT. Conclusion In the patients suffering from AMI treated with PCI, ECG is an effective method to assess myocardial tissue reperfusion.

Animals ; Base Sequence ; Gene Expression Regulation ; Humans ; MicroRNAs ; genetics ; metabolism ; Molecular Sequence Data ; RNA, Viral ; genetics ; Virus Diseases ; genetics ; metabolism ; virology ; Virus Physiological Phenomena ; Viruses ; genetics ; metabolism

OBJECTIVE:To investigate the quality differences of Betamethasone tablet from different enterprises,and provide reference for the eventual establishment of the drug relative quality evaluation system. METHODS:According to the principle and steps of the ideal point method,a mathematical model was established. And the perfect point of the 3 inspection parameters (content,content uniformity and dissolution)of Betamethasone tablet was regarded as the upper limit theoretically,and the permis-sible point as the prescribed minimum in the model. After homogenizing the initial data or ones to be quantifiable were translated in-to evaluation parameters;and the evaluation parameters were calculated by ideal point method to receive comprehensive evaluation results. RESULTS:According to variance analysis,there was no significant difference in the comprehensive evaluation results of Betamethasone tablet from different enterprises(P=0.54>0.05),indicating that the overall quality of Betamehasone tablet was good. CONCLUSIONS:The mathematical model of quality evaluation with different drug has certain feasibility and operability.

Objective To study the MRI findings of HE and the pathological mechanism and to improve the diagnosis and differential diagnosis of HE. Methods Five patients of HE diagnosed by clinical and laboratory examination were examined with conventional MRI scan. Additional DWI, MRA and enhancement MRI scan were performed on 3 patients in which abnormal findings was detected on the conventional MRI. The distribution of lesions and signal characteristics were analyzed. The ADC values of the lesions and of the contralateral non-lesion area were measured. Moreover, the possible pathological mechanisms of HE were discussed on the basis of changes of clinical and imaging manifestations in the two cases with serial clinical and MRI data. Results Of 5 patients, brain abnormalities were found in 3 cases,which showed scattered spotted supratentorial white matter lesions of isointensity on T1 WI and DWI, and high signal intensity on T2WI and fluid-attenuated inversion recovery (FLAIR). Meanwhile, multiple plaque-like lesions involving both white matter and gray matter were found, mainly located at the basal ganglia nuclei, hippocampus and cingulate cortex. The lesions demonstrated iso-or hypo-intensity on T1 WI,and iso-or hyper-intensity on T2 WI, FIAIR and DWI at the initial stage. No enhancement was found in these lesions and MRA disclosed no remarkable findings. The ADC value of the lesions [ (0. 449 ± 0. 092) ×10-3 mm2/s] was decreased significantly compared with the contralateral noninvolved area [ (0. 838 ±0. 062) × 10-3 mm2/s] at the early onset. In 2 cases with glucocorticoid therapy, together with symptom relief, MRI follow-up scan demonstrated the reduction of lesion volume, the signal change to hyperintensity on T1 WI and hypo-intensity on DWL The ADC of the lesions increased significantly. Conclusion The MRI could be one of the effective tools for diagnosis, differential diagnosis, and judging the prognosis and therapeutic results of HE. Meanwhile, it may be a non-invasive method to study the pathological mechanism of HE.

Objective To discuss perioperative features, operative approach and surgical effects of spinal tuberculosis in older patients. Methods Retrospective analysis was conducted to analyze the clinical data of 45 patients with spinal tuberculosis ranging in age from 61 to 78 years (average, 67 years). The lesion was located in thoracic vertebrae in 9 patients, thoracolumbar vertebrae in 14, lumbar in 16, and lumbosacral in 6. Preoperative Frankel grades were B in 7 cases, C in 21, D in 11 and E in 6. Among them, 21 had cardio-cerebrovascular disease, 10 had diabetes mellitus. With preoperative medicine and chemotherapy for 2-3 weeks, all patients were treated surgically. The surgical procedures included: 1) Posterior focus debridement, bone grafting and one-stage posterior transpedicular screw system fixation in thoracic vertebrae (T2-T7). 2) Anterior debridement, bone grafting and one-stage posterior transpedicular instrumental fixation in lumbosacral vertebrae (L5-S1). 3) Anterior focus elimination, bone grafting and one-stage anterior plate fixation in the other vertebrae. Results Forty-five patients were followed up for 24 to 40 months, with the average of 28.5 months. No severe complication occurred during and after operation. Forty-four cases had recovered and 1 recurred. Spinal fusion occurred 12-18 months after operation. Frankel neurological grades improved significantly. Conclusion With the effective management of comorbidities in perioperative period,the elderly could tolerate surgical treatment. The appropriate approaches, thorough debridement and reasonable bone grafting with internal fixation are key to therapeutic success.

Automatic Data Processing ; Data Mining ; Humans ; Medicine, Chinese Traditional ; methods

Objective To observe the value of the high frequency color Doppler uItrasonography in emergency operation of flexor tendon injuries in the hand.Methods Totally 21 patients of flexor tendon injuries in the hand underwent surgical exploration with high frequency probe.The extent of the tendon injuries,the retracted parts of the ruptured tendon and the blood supply were observed.Results The extent of the tendon injuries,the poison of broken ends were clearly distinguished with high frequency probe.The continuous tendon fibrous of layered high echo and sheath thin layer low echo complete broke and replaced with low or no echo.Conclusion Intraoperative uhrasonography of flexor tendon iniuries is important tO shorten operation time,reduce the injury of surrounding tissues,relieve local adhesion and ensure vascular recanalization after operation.

Objective To analyze CT features of retroperitoneal tumors or tumor-like lesion and to evaluate CT in localizating and qualitative diagnosis of diseases.Methods CT findings in 45 cases with pathologically-proved retroperitoneal tumor were retrospectively analyzed and compared with pathological results.Results There were 25 cases of benign tumors and 20 cases of malignant tumors.The CT features of benign tumors were homogeneous density,smooth peripheria with clear border,while mixed density,large and irregular in malignant tumors.The accuracy of localizating lesions was 89%,the accuracy of qualitative diagnosis was 78%,the accuracy of histologic evaluation was 49%.Conclusion CT imaging is valuable in diagnosing retroperitoneal tumors.CT can make accurate localization of tumors and identify the nature of tumors,but is limited in evaluating histologic types.