Objective To evaluate the clinical effects of two different revascularization approaches,one via percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and the other via coronary artery bypass graft (CABG),on short-and long-term prognosis in elderly patients with diabetes and multi-vessel coronary artery disease.Methods A retrospective analysis was conducted on 254 elderly patients with diabetes and multi-vessel coronary artery disease.Based on the revascularization approach,patients were divided into the PCI group (n=93) and the CABG group (n =161).The incidence of major cardiovascular events (MACE) were observed during hospitalization and 1-year after follow-up.Results All-cause mortality and the incidence of non-fatal myocardial infarction were higher in the CABG group than in the PCI group during hospitalization [4.9％ (8 cases) vs.1.1％ (1 cases),5.6％ (9 cases) vs.2.2％ (2 cases),each P＜0.05],while there was no significant difference in the incidence of MACE between the two groups1-year after follow-up (P＞ 0.05).The incidence of cerebrovascular events was lower in the PCI group than in the CABG group [2.2 ％ (2 cases) vs.6.2％ (10 cases),P＜0.05],while the rate of revascularization was higher in thePCI group than in the CABG group [6.5％ (6 cases) vs.1.9％ (3 cases),P＜0.05].Cox regression analysis showed that diabetes (OR =1.65,95％ CI:1.013-1.926,P =0.024) and left ventricular ejection fraction (OR =1.30,95 ％ CI:1.018-1.652,P =0.027) were independent risk factors for revascularization and cerebrovascular events.Conclusions MACEs during hospitalization are fewer in elderly patients with diabetes and multi-vessel coronary artery heart disease who received PCI than in those who received CABG.PCI has a similar mid-and long-term effect as CABG,bur PCI has a higher revascularization rate and lower risk of MACEs than CABG.

Objective To investigate and compare the predictive value of 2 prediction scoring systems for diagnosis of coronary heart disease (CHD) in patients with suspected symptom, and provide information for diagnosis and therapy. Methods By prospectively studying a database of 272 patients with suspected CHD,the total score was calculated by prediction scoring system including PROCAM (The Prospective Cardiovascular Munster Study) and SCP(Suspected CHD Prediction Scoring System) with the data of clinic parameters and risk factors. All patients received coronary angiography and they were categorized into the CHD group (n =94) and non CHD group ( =178) according to the angiography result. The relationship between total scores and the SYNTAX score was evaluated by Spearman analysis and the value of the prediction scoring system was evaluated by the ROC (receiver operating characteristic) system. Results The score of PROCAM was from 6. 00 -77. 00(41. 76 ± 19. 91), and the score was significantly correlated with the extent and severity of coronary artery atherosclerosis (rs = 0. 420,P = 0. 023). The score of SCP was from 1. 00 - 13. 00(8. 64 ± 3. 42), and it was significantly correlated with the SYNTAX score (rs = 0. 482,P = 0. 016). The areas under ROC was 0. 770 (P = 0. 007) in PROCAM and that was 0. 733 (P = 0. 012) in SCP. Conclusions The nature and extent of coronary artery atherosclerosis could be evaluated by the scoring system effectively,which had a good correlation with CAG result.

The top-quality course construction,in comprehensive medical university,is very important for the undergraduate teaching evaluation. The paper discussed the top-quality course construction in forensic pathology and the relevant issues in medical college course teaching,such as the status of the course,characteristic in school-running and enforcement measures,which aimed to improve cognition and enhance teaching quality and teaching level.

The series postmortemautopsy examination and histopat hology research in 20 cases heroin-addicts are accomplished． Research result s show that injection marks, tattoo，skin pigmentation，emaciation and harmed-self scar usua1ly point out addiction behavior: Various chronic infective diseases of organs are complicated by heroi n addiction, and the main complicated diseases are bronchopneumonia, lung absces s,chronic hepatitis，liver cirrhosis, reactive follicular hyperplasia in lymphn ode,spleen,infective angiitis, chronic inflammation in suprarenal , thyoadennitis overflowi ng degeneration and necrosis of neurocytes etc． in 20 cases, 50% cases died of ac ute heroin poison, 40% cases died of chronic infective diseases, and l0% died from violent injury．

Objective: To evaluate the impact of anemia on prognosis of elder patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI).
Methods: A total of 908 consecutive ACS patients elder than 60 years of age with PCI in our hospital from 2010-06 to 2012-06 were studied. According to WHO deifnition of anemia (HB<12.0 g/dL in female and HB<13.0 g/dL in male), the patients were classiifed as Anemia group, n=283 and Non-anemia group, n=625. The patients were followed-up for 1 year. The basic clinical characteristics, incidences of mortality and major adverse cardiovascular and cerebravascular events (MACCE) were compared between 2 groups by cardiac death, myocardial re-infarction, worsening of cardiac function, target vessel revascularization, cerebral hemorrhage and cerebral infarction.
Results: There were 31%of patients suffering from anemia. Anemia group had more patients with the elder age, female gender, diabetes, hypertension, chronic kidney disease, decreased LVEF, more patients with 3 vessel-disease, and higher mortality at 1 year after PCI, higher rate of MACCE than those in Non-anemia group, all P<0.05. Multiple regression analysis indicated that anemia is the independent predictor for mortality in elder ACS patients at 1 year after PCI, P<0.05.
Conclusion: Anemia may increase the incidences of mortality and MACCE in elder ACS patients after PCI for a long-term.

This investigation introduces GPU (Graphics Processing Unit)- based CUDA (Compute Unified Device Architecture) technology into signal processing of ophthalmic FD-OCT (Fourier-Domain Optical Coherence Tomography) imaging system, can realize parallel data processing, using CUDA to optimize relevant operations and algorithms, in order to solve the technical bottlenecks that currently affect ophthalmic real-time imaging in OCT system. Laboratory results showed that with GPU as a general parallel computing processor, the speed of imaging data processing using GPU+CPU mode is more than dozens times faster than traditional CPU platform based serial computing and imaging mode when executing the same data processing, which reaches the clinical requirements for two dimensional real-time imaging.
Computer Graphics ; Image Interpretation, Computer-Assisted ; Tomography, Optical Coherence ; instrumentation ; methods

Objective To explore the influence of nursing intervention based on APACHE Ⅱ score on the gastrointestinal function and clinical outcomes in patients with severe pancreatitis.Methods A total of 80 cases with severe pancreatitis were randomly divided into study group and control group,with 40 cases in each group.The control group was given routine nursing for pancreatitis,while the study group was given nursing based on APACHE Ⅱ score.The recovery time of gastrointestinal function,clinical indicators and complications of two groups were compared.Results The time of symptom relief,recovery time of bowel sounds,anal exhaust time,the first time to defecation and average hospital stay of study group were significantly shorter than that in the control group (P ＜ 0.05).After nursing,the intra-abdominal pressure,lactic acid and CRP levels of two groups were reduced significantly,and study group was significantly lower than the control group (P ＜ 0.05).The albumin levels of two groups were improved significantly,and study group was significantly higher than the control group (P ＜ 0.05).The endotoxin level of study group was reduced significantly,was improved significantly control group,and study group was significantly lower than the control group (P ＜ 0.05).The pancreatic infection rate,pneumonia rate,respiratory failure rate and MODS rate of study group were significantly lower than that in the control group (P ＜ 0.05).Conclusion Nursing intervention based on APACHE Ⅱ score for severe pancreatitis patients can promote recovery of gastrointestinal function,and improve the clinical outcomes,so it is worthy of clinical application.

Objective To explore the influence of nursing intervention based on APACHE Ⅱ score on the gastrointestinal function and clinical outcomes in patients with severe pancreatitis.Methods A total of 80 cases with severe pancreatitis were randomly divided into study group and control group,with 40 cases in each group.The control group was given routine nursing for pancreatitis,while the study group was given nursing based on APACHE Ⅱ score.The recovery time of gastrointestinal function,clinical indicators and complications of two groups were compared.Results The time of symptom relief,recovery time of bowel sounds,anal exhaust time,the first time to defecation and average hospital stay of study group were significantly shorter than that in the control group (P ＜ 0.05).After nursing,the intra-abdominal pressure,lactic acid and CRP levels of two groups were reduced significantly,and study group was significantly lower than the control group (P ＜ 0.05).The albumin levels of two groups were improved significantly,and study group was significantly higher than the control group (P ＜ 0.05).The endotoxin level of study group was reduced significantly,was improved significantly control group,and study group was significantly lower than the control group (P ＜ 0.05).The pancreatic infection rate,pneumonia rate,respiratory failure rate and MODS rate of study group were significantly lower than that in the control group (P ＜ 0.05).Conclusion Nursing intervention based on APACHE Ⅱ score for severe pancreatitis patients can promote recovery of gastrointestinal function,and improve the clinical outcomes,so it is worthy of clinical application.

Objective Excimer laser coronary atherecomy ( ELCA) has been recently used for the treatment of complex coronary lesions including calcified stenosis , chronic total occlusions and in-stent restenosis. Such complex lesions are difficult to adequately treat with balloon angioplasty and /or intracoronary stenting.The aim of this study was to introduce our early experiences in using ELCA in China . Methods Fifteen patients were enrolled through our center from March 2015 to April 2016 , and excimer laser coronary angioplasty was performed on 15 lesions.Eleven patients were previously failed cases either from uncrossable balloon ( 9 lesions ) or expandable balloon ( 6 lesions ) . The procedure and clinical endpoints were recorded .Results Laser catheter with 0.9 mm diameters were used in all 15 coronary lesions.All the lesions were successfully crossed with laser catheter and finally dilated with balloon .The procedural success rate was 100%.Drug eluting stents ( DES ) were implanted in 86.7% lesions and 2 cases were treated with drug eluting balloon .Clinical success was obtained in all patients (100%).There was no dissection , major side branch occlusion , spasm, no-reflow phenomenon nor acute vessel closure . Conclusions This study shows that laser-facilitated coronary angioplasty is a simple , safe and effective device for the management of complex coronary lesions .

OBJECTIVETo evaluate the safety and effectiveness of direct gastroscopy for detecting gastric cancer.

METHODSClinical screening by direct gastroscopy was performed for gastric cancer (GC) from September 1985 to July 1998. 3048 elderly people were screened. Their age ranged from 60 to 93 years, and 2034 of the 3084 were followed up.

RESULTSNinety-two patients with gastric cancer were discovered by gastroscopy, representing 3.02% of the screened population. The rate of early gastric cancer (EGC) was 63.04% (58/92) of all gastric cancers detected. The rate was up to 79.59% (39/49) on follow-up, and was 74.14% (43/51) in asymptomatic patients with gastric cancer. The excision rate was 88.89% for patients with gastric cancer, and 100% for patients with early gastric cancer. The 5-year survival rate was 91.89% for patients with gastric cancer, and 96.30% for patients with early gastric cancer.

CONCLUSIONClinical screening and follow-up by direct gastroscopy in persons over 60 years of age are a safe and effective method for raising the 5-year survival and detection rate of gastric cancer, especially early gastric cancer.

Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Gastroscopy ; Humans ; Male ; Middle Aged ; Prognosis ; Stomach Neoplasms ; diagnosis ; mortality ; Survival Rate