To investigate the effect of calcium concentration in dialysate on the QT interval (QT) and QT interval dispersion (QTd) during hemodialysis(HD) in patients with end stage renal disease (ESRD), Ca 2+ concentrations of 1 25mmol/L (dCa 2+ 1 25), 1 5mmol/L (dCa 2+ 1 5) and 1 75mmol/L (dCa 2+ 1 75) in dialysate were given to 15 ESRD patients for five times. The QT and QTd were measured before and after the five HD sessions. The results showed: With the dCa 2+ 1 25 HD, serum Ca 2+ and plasma calcium were decreased (1 22?0 08 vs 1 17?0 07 mmol/L and 2 43?0 34 vs 2 28?0 16mmol/L, P 0 05). The changes in the QT correlated inversely with the changes in serum Ca 2+ and plasma calcium ( P

Leukoencephalopathy with ataxia (LKPAT) is a rare autosomal recessive disorder caused by mutations of CLCN2 gene. LKPAT is clinically characterized by cerebellar ataxia, headache and cognition impairment. Brain magnetic resonance imaging showed characteristic hyperintensities along the pyramidal fiber tracts. Few cases have been reported so far. This article reported the clinical data of a 48 years old female patient with LKPAT for clinical reference.

Objective To evaluate the clinical value of early alterations of carotid arterial intima-media thickness (IMT) and elastic function in patients with hypertriglyceridemia (HTG) using ultrasound radio-frequency technique.Methods 48 patients (triglyceride value ≥ 1.8 mmol/L) were chosen as HTG group.Quantitative intimamedia thickness (QIMT) and quantitative arterial stiffness (QAS) techniques were used to observe the alterations of carotid arterial IMT and elastic index,including diameter of carotid artery (D),distensibility coefficient (DC),compliance coefficient (CC),elasticity coefficient (α),elasticity coefficient (β) and pulse wave velocity (PWV).50 healthy subjects were recruited in control group.Differences of the above-mentioned parameters were analyzed,as well as the elastic index connections between the two groups.Results IMT,α,β,and PWV index of bilateral carotid arteries in HTG group was higher than that of the control group,while the DC and CC index was lower,and the differences was statistically significant (P＜0.05).Within the groups there were differences between the elastic indexes of bilateral carotid arteries.In control group and the HTG group:CCL＞CCR,αL＞αR,βL＞βR,PWVL＞PWVR.CC was negatively correlated to α,β and PWV (P＜0.05).Meanwhile,there was positive correlation among α,β and PWV (P＜0.05).The differences of D between two groups had no statistical significance (P＞0.05).Conclusions The abnormity of arterial occurs earlier than the morphological change,while the ultrasound radio-frequency technique can provide information of earlier alteration of common carotid arteries structure and elastic function in patients with HTG,which is a significant method of testing early alteration of carotid elastic in patients with HTG.

OBJECTIVE:To consolidate the results of special antibacterial drug rectification so as to improve the rational medi-cation of antibacterial drugs. METHODS:By using the method of retrospective analysis,the antibacterial drug application data in 2011(before rectification and initial stage of rectification),2012(middle stage thereof)and 2013(later stage thereof)were sum-marized,compared and analyzed. RESULTS:After special rectification(Jan. 2011 vs. Dec. 2013),the utilization rate of antibacte-rial drugs in perioperative period for class I incision decreased from 80.42% to 24.49%. That of antibacterial drugs in emergency treatment decreased from 53.79% to 36.23%. The examination rate of microbial samples in inpatients who would use special-grade antibacterial drugs increased from 16.12% to 94.17%. The use intensity of antibacterial drugs by inpatients decreased from 70.28 DDDs/(100 persons·d) to 27.44 DDDs/(100 persons·d). The utilization rate of antibacterial drugs by inpatients decreased from 65.99% to 46.45%. CONCLUSIONS:Special rectification has remarkable effects on rational clinical application of antibacterial drugs. Regulation and evaluation should be strengthened to maintain the effects and continuously improvement should be made.

Objective To investigate the clinic characteristics and treatment methods of coronary ectasia. Methods One hundred and fifty-four cases in Anzhen hospital during the last 10 years, whom with coronary aneurysm diagnosed by coronary artery angiogram and summarized the characteristics of symptom, sign, diagnosis and treatment. Results All patients were proved with coronary angiography. There were 112(72.7%)patients presenting angina, but with no specific manifestation in electrocardiogram, X-ray and echocardiogram.Thrombolysis in emergency were taken to 3 cases with acute myocardial infarction patients. One hundred and fifty-four cases were treated with aspirin or heparinizeation, and with nitroglycerin, Calcium channel blocker to dilate vessel. The followed up of 154 cases about 1-20 years, six cases were suffered with acute myocardial infarction. One of the 6 cases was reinfarction and one case was sudden death. Conclusions Angina is the main clinical manifestation and coronary angiography is the accurate diagnostic method. Long-term application with anticoagulant agent and vasodilator should be done to prevent coronary spasm and myocardial infarction. If acute myocardial infarction occurs, prompt thrombolysis should be used, if it is ineffective, coronary artery bypass grafting should be carried out.

Objective To investigate the effectiveness of deep brain stimulation (DBS) treating Parkinson's disease.Methods Forty cases of Parkinson's disease were selected from March 2014 to August 2015.The clinical symptoms of these patients were described and quantitatively analyzed with Unified Parkinson's Disease Rating Scale (UPDRS) before and after the procedure of DBS surgery.Results After deep brain stimulation surgery,the symptoms including muscle stiffness,static tremor,bradykinesia were improved,UPDRS scores were significantly lower and the demanding dosage of Parkinson disease drugs such as L-dopa/benserazide and L-dopa/carbidopa were also reduced.Conclusion Deep brain stimulation for Parkinson's disease is safe and effective.It can obviously control the symptoms,reduce the dosage of oral drugs,and improve the quality of life.

Objective To discuss the relationship between serum 25-hydroxy vitamin D[25(OH)D] level and the severity of diabetic retinopathy in type 2 diabetes mellitus.Methods 1474 cases of type 2 diabetic patients were classified into three groups according to their severity of diabetic retinopathy, the non-diabetic retinopathy group(NDR group, n =640), the background diabetic retinopathy group(BDR group, n =494) and the proliferative diabetic retinopathy group(PDR group, n=340).640 healthy people with normal level of glycosylated hemoglobin(HbA1c) were selected as control group(NDM group, n=640).Disease duration, body mass index(BMI), systolic pressure, low density lipoprotein-cholesterol(LDL-C), HbA1c and 25(OH)D were detected and compared among groups.Results Disease duration and HbA1c were increasing significantly, and the levels were NDM groupNDR group>BDR group>PDR group(all P<0.05).The level of 25(OH)D was negatively related to disease duration and HbA1c (P<0.001), and it was negatively associated to the severity of diabetic retinopathy(r=-0.855,P<0.001).Conclusion The decrease of 25(OH)D level is closely associated with the severity of diabetic retinopathy in patients with type 2 diabetes mellitus, and it might be an important predictor for the severity of diabetic retinopathy.

Authors described the patterns,core measures and mechanisms of coordinated care delivery in the localities and analyzed initial outcomes of this practice.It is found that such practice has optimized distribution of regional healthcare resources,implemented first visit to primary institutions, and the care delivery to separate emergency from outpatient service.In addition,the paper analyzed problems found in localities in terms of policy,public hospitals and primary institutions,and proposed elements required for coordinated care delivery system to succeed,such as enhanced policy support, enhanced multi-departmental coordination,and public hospital reform to explore feasible approaches.

Objective: Clinical study on Jangzhuo Decoction for treating plasma concentrations of oxidized low density lipoprotein, d dimer of ischemic stroke and its relation to preventing repeated stroke.Methods: 72 cases with ischemic stroke were divided randomly and blindly into two groups. 36 patients with ischemic stroke in therapeutic group were treated with Jangzhuo Decoction M ASA, and 36 patients in control group were treated with M ASA alone. The follow up survey for six months was conducted when physical signs and symptoms of the paints with ischemic stroke begain to be stable. Results: The incidence of the repeated stroke in therapeutic group were one case(2.7%) and in control group were three cases(8.3%) respectively. Ox LDL levels of therapeutic group was 1021?102?g/dl( ?s ), decreased to 604?77?g/dl( P 0.05). There was significant difference between the two groups. D dimer levels of two grouups were all increased significantly( P

Objective To investigate the risk factors of cerebral microbleeds (CMBs) in patients with acute isch?emic stroke of large-artery atherosclerosis. Methods One hundred twelve patients with acute ischemic stroke of large-ar?tery atherosclerosis admitted from July 2013 to January 2014 in Nanjing First Hospital affiliated to Nanjing Medical Uni?versity were enrolled. According to the results of MRI magnetic sensitive weighted imaging, the patients were divided into CMBs group or non-CMBs group. The history, general clinical data, serum biochemical results and MRI in both groups were enrolled. All the data were analyzed by the univariate and multivariate analysis. Results The results of univariate analysis showed that there were significant differences in age (61.620±11.479 vs. 70.620±11.185), serum uric acid (UA) level (278.920±69.512 vs. 353.460±111.206), serum creatinine (Cr) level (71.360±19.797 vs. 90.450±44.989), serum ho?mocysteine (Hcy) level (12.587±2.664 vs. 21.715±10.437) between the two groups (P<0.05). There were significant differ?ences in constituent ratio of Fazekas' s grade of periventricular hyperintensities and deep white matter hyperintensities between the two groups (P<0.05). The results of multivariate analysis showed that age (OR=0.963, 95%CI:0.905~1.025, P<0.05) and serum Hcy level (OR=1.487, 95%CI:1.219~1.813, P<0.05) were the independent risk factors for CMBs in patients with acute ischemic stroke of large-artery atherosclerosis. Conclusions Age and serum Hcy level are the inde?pendent risk factors for CMBs in patients with acute ischemic stroke of large-artery atherosclerosis.