The statistical index of diagnosis coincidence was the base for the evaluation of diagnostic quality. By the problem analysis of diagnostic coincidence assessing, we were to establish standard criteria uniform and strict methods of evaluation; to enhance diagnosis coincidence rate, and to make full use of statistical index.

AIM:To study the effects of domestic glimepiride(Gli) on blood sugar,glucose tolerance and release of insulin in rabbits and rats METHODS:Taken the changes of blood sugar level and glucose tolerance before and after giving drug as parameters,the hypoglycemic effect of Gli was observed in rabbits and rats RESULTS:Gli dose-dependly decreased the levels of blood glucose in rats with a decrease of 23% in high-dose group and seemed to be similar to glibenclamide in potency of lowering blood sugar Gli increased release of insulin by 40%～70% in rats and rabbits and was twice as potent as glibenclamide;Glucose tolerance test showed that Gli could restrain the rising of blood glucose at 30 min and 60 min after glucose was administrated ig in rabbits Time-response relation displayed that blood glucose began to drop 30 min after Gli 1 0mg/kg administered and the levels of blood glucose dropped by 40% 3 h later CONCLUSION:The domestic Gli has similar effects to glibenclamide on lowering blood sugar However,its effect on lowering blood sugar seems to be quicker,shorter and more moderate than that of glibenclamide

OBJECTIVE:To evaluate the preventive and therapeutic effects of extract of Curcuma on experimental hyper?lipidemia models in rats and rabbits.METHODS:Hyperlipidemia models of healthy rats and rabbits,fed on a forage containing cholesterol,fat and etc,were established.TG,TC,LDL,HDL and LDL/HDL in serum of animals were measured.RESULTS:The preventive administration of extract of Curcuma could significantly reduce the serum TC,LDL,LDL/HDL and increase serum HDL in hyperlipidemic rats in a dose-dependent manner.Its hypolipidemic action was stronger than that of positive contrast agent lovastatin.The serum levels of TC,TG,LDL and HDL not of LDL/HDL obviously decreased in hyperlipidemic rabbits after either preventive or therapeutic administration and its hypolipidemic action was weaker than that of positive con?trast agent lovastatin.CONCLUSION:Extract of Curcuma could obviouly reduce hyperlipidemic in rats and rabbits.Its action is stronger than that of lovastatin in rats,but weaker in rabbits.

Objective: To explore the features of ascending aortic distensibility (AAD) and risk factors in pre-hypertension (PHT) patients. Methods: A total of 206 participants who received retrospective ECG-triggered coronary CTA by physical check-up or by clinically suspected coronary artery disease (CTA) were enrolled. The participants were divided into 2 groups: Control group, the subjects with normal blood pressure,n=85 and Pre-hypertension group,n=121. A 128 slice dual-source CT scanner was used and the image was automatically reconstructed at every 5% absolute phases in entire R-R interval. The beginning of left coronary artery plane was deifned as the reference and 25 mm above the reference plane was deifned as interested region. ADD value was calculated. Results: Compared with Control group, Pre-hypertension group had decreased AAD,P<0.01 and similar normalized cross-sectional area (Ss),P>0.05; ADD value was similar among different gender and blood lipid levels. Correlation analysis presented that AAD was negatively related to age (r=-0.69,P=0.001), systolic blood pressure (r=-0.37,P=0.001), pulse pressure(r=-0.43,P=0.001) and glycosylated hemoglobin (r=-0.43,P<0.05). Age and systolic blood pressure were the independent risk factors for AAD decline (standardized β=-0.66,P=0.001) and (standardized β=-0.44,P=0.001). Conclusion: Without additional contrast media consumption and radiation dosage, retrospective ECG-triggered coronary CTA may detect AAD changes with risk factors at the early stage in pre-hypertension patients which is helpful to distinguish the high risk individuals.

Aim To investigate the effects of heme oxygenase-1(HO-1) on brain damage due to cerebral ischemia/reperfusion.Methods 120 male mice were divided into four groups randomly and the cerebral ischemia/reperfusion(I/R) model was established through drawing out and reperfusing 40% of the whole blood volume in combination with clamping the carotid arteries for 20 min after anesthesia with 40 g?L-1chloral hydrate(400 mg?kg-1 ip).The mice were intracerebraventricularly(icv) injected with 3(l of150 ?mol?L-1 hemin,150 ?mol?L-1 ZnPPIX,or artificial cerebrospinal fluid(ACSF),respectively 16 h before the model established.Sham operation group only received anesthesia and operation without I/R and icv injection.The hippocampal HO activity and cerebral cortex xanthine oxidase(XO) activity,the levels of malonaldehyde(MDA) and reactive oxygen species(ROS),hippocampal neuron apoptosis,and hippocampal HO-1 expression were determined by spectrophotometer,TUNEL method,and Western blot,respectively.Results The increased hippocampal HO-1 expression and HO activity,decreased XO activity,MDA and ROS levels,and diminished hippocampal apoptosis were observed in the hemin group,compared with ACSF group(P0.05),but inhibited the activity of HO with the elevation of XO activity,MDA and ROS levels,as well as cellular apoptosis(vs ACSF,P

Objective To explore the effect of psychological rehabilitation on patients with limb motor dysfunction. Methods 136 cases of hospitalized patients who needed rehabilitation therapy and training were divided into observation group and control group. The control group received conventional rehabilitation, and the observation group received psychological rehabilitation (psychotherapy and medicine) in addition. Symptom Checklist-90 (SCL-90), Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) were assessed before and 8 weeks after treatment. Results Most of the 136 patients were involved in psychological problems, including anxiety, depression, somatization,fear, hostility. There was no difference in the scores of SCL-90, FMA and MBI between 2 groups before treatment (P>0.05). After 8 weeks treatment, the scores of SCL-90 were lower, except psychotism (P>0.05), in the observation group than in the control group (P<0.05),the scores of FMA and MBI were higher in the observation group than in the control group (P<0.01). Conclusion The psychological rehabilitation plays an important role in rehabilitation of limb motor dysfunction.

Objective To study the mortality and risk factors of death of critical patients treated in emergency department for initial stabilization and life support. Method The clinical data of 1240 critical patients from January 2005 to December 2006 were retrospectively analyzed. The patients were divided into death group and survival group. The differences of demographics, symptoms, physical signs and laboratory findings of patients between two groups were analyzed by using univariate and multivariate logistic regression analysis, sex, age, visiting time after attack, the history of chronic diseases, temperature, respiratory rate, heart rate, mean arterial pressure, respiratory dysfunction, circulatory dysfunction, hepatic dysfunction, gastrointestinal dysfunction, renal dysfunction, coagulation disorders, acid base and electrolyte disturbances, lencocyte count,platelet count, Glasgow coma scale (GCS) score and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ). Results There were higher mortality and morbidities of patients with diseases of respiratory, digestive, circulatory and nervous systems. The mortality of patients with the history of chronic diseases was higher (P < 0.01) ,and there were more patients with chronic obstructive pulmonary disease(COPD), chronic cardiac insufficiency, diabetes mellitus or cirrhosis of liver in death group (P < 0.05). The mortality of patients with 3 dysfunctional organs was 32.81%, and the mortality of lity of those with five dysfunctional organs was 76.67% . Logistic regression analysis indicated that male gender, age between 46 and 65, respiratory dysfunction, circulatory dysfunction, gastrointestinal dysfunction, hepatic dysfunction, low Glasgow coma scale (GCS) score and high APACHE II score were risk factors of the death of critical patients. Conclusions The mortality of patients with the history of critical diseases is higher. The more dysfunctional organs, the higher mortality is. Age between 46 and 65, male gender, and dysfunction of lung, circulation, gastrointestinal tract,and liver,and low CCS score and high APACHE II score are risk factors of the death of emergency and critical disease.

Objective To investigate the experience of laparoscopic complete mesocolic excision ( CME) for colon cancer. Methods There were102 patients,of which 68 cases with colon cancer were performed laparoscopic CME,34 cases were treated by traditional surgery. The 2 groups were reviewed retrospectively. Results As compared with the traditional group,the operation time,time of first flatus,hospital stay in the CME group increased. The postoperative suction drainage was decreased in CME group. The CME group had less blood loss and more mean lymph nodes clearance than the traditional group. The complication incidences had no significant differences between 2 groups. Conclusion Laparoscopic CME for colon cancer,with the advantages of less tumor spreading and more thoroughly lymph node dissection,is worthy of clinical application.

Objective To explore the double blood vessels bridge application and efficacy in multiple localized narrow of the anterior descending coronary artery.Methods The clinical data of 106 patients with multiple localized narrow of the anterior descending coronary artery were retrospectively analyzed.The patients were divided into two groups according to the operation methods.Fifty-six patients (improvement group) were conducted double blood vessels bridge on the anterior descending coronary artery,50 patients (control group) were conducted a single blood vessel bridge on the anterior descending coronary artery.Results The age,sex,body mass index,left ventricular ejection fraction,extracorporeal circulation time,endotracheal intubation time,length of hospital stay between two groups had no significant difference (P ＞ 0.05).One case in improvement group occurred angina pectoris,left ventricular size was (51 ± 6) mm,left ventricular ejection fraction was (60.8 ± 8.0)％.Nine cases in control group occurred angina pectoris,left ventricular size was(43 ± 6) mm,left ventricular ejection fraction was(55.1 ± 10.0)％.There was significant difference between two groups(P ＜ 0.05).Conclusion Double blood vessels bridge is safe and effective in multiple localized narrow of the anterior descending coronary artery.

Objective To summarize the clinical characteristics of adrenal tumors combined with renal carcinoma and to extend the clinical understanding of the situation.Methods To analyze the data of 1 100 patients with adrenal tumors hospitalized in Peking University First Hospital from Jan.1994 to Mar.2012 retrospectively,in the series there were 42 combined with renal carcinoma.Results There were 27 males,15 females,aged 29 to 83 years,mean 60.5 years old.In 42 renal carcinomas,there were 29 (69.0％) clear cell carcinomas,5 (11.9 ％) cystic renal carcinomas,2 (4.8％)clear cell with granulosa cell hybrid carcinomas,1 renal lymphoma,1 (2.4％) spindle cell tumor,1 acidophilic cell adenoma,and 1 undifferentiated type of renal cell carcinoma and pathologically not clear in 2 cases (4.8％).Clinical manifestations were not specific.In 42 adrenal tumors,20 situated in the left,and 17 right,and 5 were bilateral.35 cases were considered primary adrenal tumors,in which 3 were diagnosed primary hyperaldosteronism,32 were non-functional tumors.Other 7 were non-functional matastatic carcinomas.25 patients underwent resection of adrenal tumors,and pathology revealed 22 (88.0％) were primary,in which 12 (54.6％) were cortical adenomas,7 (31.9％) hyperplasia,1 (4.5 ％) pheochromocytoma,1 (4.5 ％) ganglioneuroma,1 (4.5 ％)adenoma with hyperplasia;2 (8.0％)metastatic tumors,and 1 (4.0％) non-Hodgkin' s lymphoma.The mean diameter of primary adrenal tumors was 1.9 cm,while that of metastatic carcinoma was 3.84 cm.25 underwent abdominal ultrasonography,40 underwent computed tomography (CT) scan,6 underwent magnetic resonance imaging (MRI) scan,positive rate was 72.0％,97.5％,and 100.0％ respectively.25 patients who underwent surgery were followed up,17 survived for 8 months-6 years,4 died,in which 1 metastatic carcinoma died of intraoperative bleeding,1 died of adrenal lymphoma,2 died because of other disease,4 were lost to follow-up.Conclusions The most common type of renal carcinoma combined with adrenal tumors was clear cell carcinoma,while majority of the adrenal tumors were primary with non-specific clinical manifestations and function.The adrenal tumors might be located in the same or the opposite side of renal carcinoma,also might be bilateral which were more common in metastatic carcinomas and always bigger than primary ones.CT/MRI scans were important in judging the nature of the tumors and pathology was the gold standard.The non-functioning primary adrenal tumors could be safely followed up,and the isolated metastatic carcinoma should be resected.Prognosis depends mainly on that of renal carcinoma.