Objective To explore the correlation difference between dynamic and routine electrocardiogram when used to diagnose asymptomatic myocardial ischemia.Methods Totally 92 coronary disease patients confirmed clinically from April 2014 to May 2016 were divided equally and randomly into an observation group and a control group.The patients in the control group underwent conventional ECG examination,and the ones in the observation group went through 24 h 12-lead dynamic ECG examination.The positive rates of asymptomatic myocardial ischemia were compared in the two groups,and the onset time and the patient state at that moment were analyzed in the observation group,Results The positive rates in the control group and observation group were 47.83％ and 84.78％ respectively,and there was significant difference between them (P＜0.05).The onset time was restrained within 6:00 and 12:00,when the patient was in the state of manual labor,brain work or excitement.Conclusion 24 h 12-lead dynamic ECG gains advantages in early and timely diagnosis of asymptomatic myocardial ischemia,and thus is worthy promoting clinically.

Objective To explore the influencing factors of hypotension in hemodialysis patients with end stage of diabetic nephropathy.Methods 106 patients of advanced diabetic nephropathy who received maintenance hemodialysis were selected in the present study.According to the patients'condition needs, chose different dialysis modes,dialyzers, dialysis blood flow and ultrafiltration rate, compared the frequency of occurrence of hypotension during treatment.Results By multivariate regression analysis,gender,dialysis mode,dialysis and blood flow had no correlation with hypotension during dialysis.The age, hemoglobin, serum albumin, cardiac function and individual ultrafiltration rate were correlated with the incidence of hypotension in patients with diabetic nephropathy.Individual-ized ultrafiltration rate was less than or equal to 10 mL · kg-1 · min-1 and individual ultrafiltration rate was up to 10 mL· kg-1 · min-1 ,the incidence rates of hypotension were 18.9% and 25.9%,the difference was statistically significant (χ2 =7.102,P<0.05).Conclusion Diabetic nephropathy patients during dialysis,ultrafiltration rate control individuals can effectively reduce the frequency of occurrence of hypotension during dialysis, hemodialysis patients may improve tolerability.

Objective To study the relationship between the enhancement of renal cortex and medulla during the conventional CT scans with and without contrast enhancement and the renal glornerular filtration rate (GFR). Methods Thirty five cases with unilateral posternal obstructive hydronephrosis According to GFR, the 70 kidneys were divided into 4 groups: normal, slightly impaired, moderately impaired and severely impaired. In the cortical phase of enhanced CT scan, the enhancing intensity of the renal cortex and medullar was measured and following measures were calculated: CTce - CTcp, CTmc -CTmp,ratio of enhancement of affected and unaffected renal cortex and medullar, and the ratio of those of each case: CTac/CTnc, CTam/CTum, CTac/CTam, CTnc/CTnm, (CTac/CTam) / (CTuc/CTum). The differences of these measures in different groups were analyzed with one-way ANOVA and their correlation with GFR was studied with Pearson test. The best indicator to reflect enhancement of renal cortex was selected from these measures, and all the kidneys were divided into 4 groups accordingly: strong, less strong, medium and weak. Then its consistency with GFR groups were calculated. Result (1) The differences of CTce - CTcp ( 154. 98 ± 28. 70 ), ( 122.67 ± 39. 32 ), ( 81.30 ± 32.94 ) and ( 57.60 ±23.49) HU respectively, CTac/CTuc 0. 97 ±0. 09, 0. 79 ±0. 18, 0. 64 ±0. 24 and 0. 51 ±0. 13 respectively,CTam/CTum 0. 98 ±0. 26, 0. 89 ±0. 18, 0. 86 ±0. 31 and 0. 75 ±0. 28 respectively, CTam/CTum 2. 76 ±0. 35,2. 35 ± 0. 79, 1. 83 ± 0. 68 and 1.73 ± 0. 28 respectively, CTac/CTam and ( CTac/CTam)/( CTuc/CTum) 1.00 ±0. 28,0. 89 ±0. 34, 0. 75 ±0. 17 and 0. 69 ±0. 14 respectively of different GFR groups were evident( P < 0. 05 ) . ( 2 ) Positive correlation was found between GFR and CTce-CTcp ( r = 0. 887, P <0. 01 ), CTac/CTuc ( r = 0. 872, P < 0. 01 ), CTam/CTum ( r = 0. 504, P < 0. 01 ), CTac/CTam ( r =0. 772, P < 0. 01 ), (CTac/CTam) / (CTuc/CTum) ( r = 0. 663, P < 0. 01 ). ( 3 ) Selecting CTac/CTam to reflect enhancement of renal cortex, the diseased kidneys can be divided into groups of strong ( CTac/CTam ≥2. 60); less strong (2. 20 ≤CTac/CTam <2. 60); medium ( 1.80 ≤CTac/CTam <2. 20); and weak ( CTac/CTam < 1. 80). The consistency with GFR grouping was 80. 0%. Conclusions There is significant correlation between renal cortex-related indicators and GFR, especially CTac/CTam, which can be used as the indicator of renal function in patients with unilateral or bilateral postrenal obstructive hydronephrosis. The conventional contrast enhanced CT scan can be taken as a semi-quantitative method of GFR measuring with relative low X-ray dosage compared with CT perfusion.

Objective To explore the effects of self-management strategies on self-efficacy and selfmanagement behavior in female college students with primary dysmenorrhea.Methods Implementing the plan that the interventional group (n=195) received self-management strategies,while the control group (n =196) did not received any intervention.Followed up six months,the self-efficacy and self-management behaviors and Visual Analogue Scale/Score (VAS) of dysmenorrhea pain were compared between two groups before and after the intervention.Results At the 6th month of observation period,the scores of self-efficacy in the intervention group (2.61 ±0.48) were significantly improved compared with the baseline (2.37 ± 0.36) and the control group(2.43±0.46) (both P＜0.05).Besides taking medicine to alleviate dysmenorrhea,other items in the self-management behaviors were significantly higher than baseline and control group (both P＜ 0.05).The mean of dysmenorrhea pain VAS of 6th menstrual period in the intervention group was lower than baseline and the control group (P＜0.05).Conclusion The self-management strategies can effectively improve the self-efficacy and self-management behaviors among female college students,and alleviate the degree of dysmenorrhea pain.

s Objective To assess the correlation between the features of optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) in clinically significant diabetic macular edema. Design Prospective case series. Participants 102 patients(177 eyes) with clinically significant diabetic macular edema. Methods Optical coherence tomography and fluorescein angiography typing were done separately in a double-masked manner in each case of clinically significant macular edema. The correlation between FFA types and OCT types were analyzed, and their associations with the best visual acuity, central foveal thickness were evaluated. Main Outcome Measures The FFA features and OCT features of clinically significant diabetic macular edema, central foveal thickness, best visual acuity. Results The prevalence of focal leakage type was higher in the OCT type 1 (70.6%) than in the diffuse leakage type (27.2%) and diffuse cystoid leakage type (2.2%) of fluorescein angiography (P

Objective To explore the clinical application of two different fixation methods for nasal continuous positive airway pressure (NCPAP) in newborns. Methods One hundred and forty newborns who had NCPAP treatment were selected and divided into experimental group and control group with 70 cases in each group by random digits table method.The newborns in experimental group received self- made caps to fix the prong systems,while the newborns in control group received U shape towel. The incidence of nose, head of facial skin injury, frequency of detachment for nasal prongs and duration mechanical ventilation were compared between two groups. Results The frequency of detachment for nasal prongs per 24 h was (0.65±0.18) times in experimental group and (1.64±0.22) times in control group, and there was significant difference (t=28.68, P<0.01). The incidence of nose, head of facial skin injury were 8.6%(6/70), 2.9%(2/70) in experimental group and 27.1%(19/70), 14.3%(10/70) in control group,and there were significant differences ( χ2 =8.23, 5.83, P<0.01 or 0.05). There was no significant difference in duration mechanical ventilation between two groups(P>0.05). Conclusions Use of the self- made caps for NCPAP in newborns is associated with significant reduction in the incidence of nose, head of facial skin injury,and the frequency of detachment for nasal prongs.The fixation should be prompted in clinic.

Autoimmune Diseases ; Humans ; Laryngeal Diseases ; Sarcoidosis ; Vocal Cords ; pathology

The running cost of medical equipment embodies in every stage of the whole process of the equipment using. The control of the running cost in procurement phase is discussed in four aspects: chemical reagent, maintenance, training and quantity control, i.e. controlling the running cost in the beginning. This is a good method for controlling the running cost.

AIM:To compare the effects of different histogram enhancement algorithms on improving the quality of MRI image.METHODS:Three processing algorithms,including histogram equalization,adaptive histogram equalization and histogram specification,were applied to enhance a MRI cervical spine T2-weighted image based on programming software interactive data language.The capability of representation of details in dark area and the level of noise were evaluated by means of peak signal to noise ratio and image information entropy.RESULTS:Histogram equalization cannot enhance the details in dark region obviously,but decline the contrast of whole image;adaptive histogram equalization can improve details but enlarge noise and engender shadow at edges simultaneously;histogram specification can choose the type of histogram function to match;it reveals the details in dark area sufficiently,and there is the lowest level of noise among these three algorithms.CONCLUSION:MRI cervical spine T2-weighted image processing with different algorithms of histogram enhancement,histogram specification is more outstanding than histogram equalization and adaptive histogram equalization in the representation of details and the low-level of noise.

Objective To summarize the types and reasons of misdiagnosis in multiple myeloma (MM),and the approaches of avoiding misdiagnosis by analyzing the misdiagnosis data in MM.Methods 197 references of misdiagnosed MM were retrieved from Wanfang medicine net by using the key words multiple myeloma and misdiagnosis from the year 2000 to 2012,and 62 of them with complete data and statistical certainty from level 2 or higher national hospitals were analyzed and summarized.Results In 62 references,2110 patients were misdiagnosis.There were more than 160 misdiagnosed MM.The shortest time of delay in diagnosis was one week,and the longest was tcn years.The rate of misdiagnosis in MM was 56.44 ％ (1406/2491).The onset age of the youngest was 16 years old and the oldest was 87 years old.A difference of nearly 20 years was found between the maximum and minimum average age of onset.MM was misdiagnosed as 10 kinds of diseases.They were including bone joint disease 32.23 ％ (680/2110),other blood diseases 11.75 ％ (248/2110),infection 14.5 ％ (306/2110),solid tumor 6.35 ％ (134/2110),kidney disease 18.58 ％ (392/2110),digestive system disease 3.13 ％ (66/2110),rheumatism 4.64 ％ (98/2110),heart disease 4.64 ％ (57/2110),nervous system disease 2.99 ％ (63/2110),endocrine disease 0.38 ％ (8/2110).Conclusion MM could occur in all ages except children and may be mistaken for a variety of diseases.It is key to prevent misdiagnosis by strengthening the comprehensive understanding of MM by taking detailed history,careful physical examination,comprehensive laboratory examination,and comprehensive clinical thinking.