A total of 101 lipid metabolism disorder patients with traditional Chinese medicine (TCM) syndrome of phlegm and turbidity retardation were collected and randomly divided into group A:Jiangzhi Decoction (JZF) alone (n =30),group B:atorvastatin (ATV) alone (n =39) and group C:JZF plus ATV (n =32).Lipid level,liver and kidney function,total effective rate and TCM scores were observed after a course of 2 weeks.Total effective rate:Group C was significantly superior to group B (90.62％ vs.76.92％,u =1.97,P ＜ 0.05) ; TCM score:Group C had a statistically superior advantage over groups A andB (C vs.A,90.62％ vs.80.00％,u=1.98,P＜0.05; Cvs.B,90.62％ vs.51.28％,u=4.11,P ＜0.01); TC and Improvements of total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C):Group C demonstrated marked decreases in both TC and LDL (CTC & CLDL-C vs.group A,P ＜ 0.01 ; CTC & CLDL-C vs.group B,P ＜ 0.01),no abnormal liver or kidney function occurred during the follow-up period.Thus JZF and ATV may have synergic lipid-lowering effects.And single uses of JZF and ATV have no marked differences in short term efficacy.

Objective:To investigate the diagnostic value of spiral CT head and neck angiography on carotid artery stenosis in patients with acute cerebral infarction.Methods:A total of 60 patients with acute cerebral infarction(ACI),who were treated in Affiliated Hospital of Yan'an University from January 2014 to January 2016,were selected as observation group,and 60 patients with non-acute cerebral infarction,as control group.The two groups of patients underwent spiral CT head and neck angiography.The degrees of carotid artery stenosis and the distribution of vascular plaques were compared between the two groups.The diagnostic value of spiral CT head and neck angiography in the diagnosis of carotid artery stenosis of the patients with ACI was evaluated.Results:The detection rates of mild and moderate stenosis in the observation group were significantly higher than those in the control group (P＜0.05),while the detection rates of severe stenosis and occlusion had no significant difference compared with the control group (P＞0.05).The total detection rate of stenosis in the observation group was higher than that in the control group (P＜0.05).There were plaques detected in the carotid bifurcation,common carotid artery,internal carotid artery and external carotid artery in the two groups.The total detection rate (69.4％) of the observation group was significantly higher than that (41.2％) of the control group (P＜0.05).Conclusion:Application of 128-slice spiral CT can effectively assess the head and neck angiography on carotid artery stenosis in patients with acute cerebral infarction.This method has a higher detection rate from mild to moderate stenosis and bilateral carotid artery plaques in the patients with ACI,and it has application value in the clinical diagnosis and prognosis.

Objective To investigate the difference of amplitude of low-frequency fluctuation (ALFF) and fraction of amplitude of low-frequency fluctuation(fALFF) between Alzheimer's disease (AD)patients and normal aging (NA) controls by voxel-based analysis.Methods Thirty-one AD patients and 44 NA controls were enrolled in the study.Blood oxygen level dependent functional (BOLD) EPI data were obtained during resting-state by using 32-channel head coil.Data were realigned,normalized and then smoothed with 8 mm FWHM kernel.Resting-state fMRI toolkit(version 1.6) was used to generate ALFF and fALFF images.Independent two sample t-test was performed with SPM5 to compare ALFF and fALFF of AD and NA controls.Pearson correlation analysis was performed to examine the relationship between MMSE score and ALFF,fALFF parameters.The significance level was set to be uncorrected O.001 on the voxel level and 0.05 on the cluster level.Results AD patients showed increased ALFF in left temporal lobe (0.492 ±0.119) and right cingulated cortex (0.434 ± 0.093) of AD patients,which were 0.443 ± 0.068 and 0.380 ±0.081 in NA controls (t =2.658,2.227,P ＜ 0.05).Decreased fALFF was found in bilateral posterior cingulate cortices (1.167 ± 0.203) and increased fALFF was found in bilateral temporal lobes (left 1.226 ±0.127,right 1.146 ±0.214) with left side dominance,which were 1.453 ±0.269,1.134 ±0.088,1.014 ± O.132 in NA controls (t =5.001,3.695,3.285,P ＜ 0.05).Bilateral temporal ALFF and fALFF correlated with MMSE positively (r =0.768—0.909,P ＜ 0.05) with left dominance.Conclusion AD patients showed increased resting-state functional MRI changes correlated with MMSE score in the temporal lobes with left dominance,which indicated left temporal lobe may be the best location for the observation of disease progression in AD patients.

Objective To evaluate the possibility and reliability of laparoscopic management of cholelithiasis merging extrahepatic and acalculous and benign obstructive jaundice. Methods Eleven patients with cholelithiasis merging extrahepatic and acalculous and benign obstructive jaundice who underwent laparoscopic management were retrospectively studied.Results Ten cases were successful with laparoscopic management,among the total,4 patients were underwent laparoscopic cholecystectomy (LC),6 cases were experienced LC and laparoscopic common bile duct exploration (LCBDE).One case was converted to open operation.No serious complications were observed.All the patients were cured after the operative treatment.None of the complications could be traced after follow-up for 6 months. Conclusions Cholelithiasis merging extrahepatic and acalculous and benign obstructive jaundice is a challenge to laparoscopic surgeons.Intraoperative diagnosis is very difficultly,but very important.It is better prognosis by careful and skilled operators and reasonable operative method to be chose.

Objective To systematically evaluate the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) in the investigation of bile duct anatomy of liver transplantation living donors.Methods A search in Cochrane library,MEDLINE,EMBASE,CBMdisc (China Biology Medicine disc) was performed to identify relevant English and Chinese-language abstracts,supplemented by Springer,OVID,Sciencedirect full text database,etc.Criteria for inclusion were based on validity criteria for diagnostic research published by the Cochrane collaboration.With Meta analysis package for Stata10.1,heterogeneity of the included articles was tested,which was used to select proper effect model to calculate pooled weighted sensitivity and specificity,positive likelihood ratio,negative likelihood ratio. Summary receiver operating characteristic (SROC) curve was performed and the area under the curve (AUC) was calculated. Finally,sensitivity analysis was performed.Results Seventeen articles with 34 studies were included.Heterogeneity analysis revealed heterogeneity between studies and the source was MRCP imaging methods spotted by meta-regression analysis. Subgroup analysis according to MRCP imaging methods showed homogeneity within subgroups.The pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odd ratio of breath-holding thick slice MRCP,3D MRCP,the combination of the prior two methods,contrast enhance MRCP were 0.89,0.78,4.1,0.14,29; 0.92,0.80,4.5,0.10,45;0.95,0.82,5.2,0.06,85; and 1.00,0.76,4.1,0,1228,respectively with fixed effect model analysis.The area under the SROC curve was 0.83,0.92,0.96 and 0.99 respectively.Conclusion The combination of thick slice and 3D MRCP is a practical and effective method with good sensitivity and specificity to investigate bile duct anatomy of living liver transplantation donors,which fully meets the requirements of the preoperative assessment of bile duct structure.

Objective To study effects of early non-invasive ventilation (NIV) application in treating elderly patients with acute left ventricular failure induced respiratory failure. Method Totally 32 elderly patients with acute left ventrieular failure induced respiratory failure, admitted from August 1997 to February 2007, received NIV treatment, and were retrospectively studied. There were 22 male and 10 female, aged (81.5?8.6) yearsdd. The changes of rahs, respiration rate, heart rate, arterial blood gas, cardiac function before and after NIV application were compared. According to the application time of NIV, 32 patients were divided into two groups: group A (early NIV application group, n=17) and group B (non-early NIV application group, n= 15). The time to improve the symptoms, the application time of NIV, cure rates, tracheal intubation rates and mortality were compared between the two groups. Results Thirty of the 32 patients survived, cardiac function was improved from New York classⅣtoⅠ～Ⅱ, respiratory rate, heart rate and blood pressure significantly decreased, PaO_2 and SaO_2 significantly increased and PaCO_2 significantly decreased. The tracheal intubation was performed in 4 patients. The time needed to improve the symptoms and the application time of NIV were significantly different between group A and group B (P

Objective To systemically evaluate the accuracy of CT and MR estimating whole liver volume with evidence based medicine methods.Method Published papers about whole liver volume estimation with CT or MR modality were searched in Cochrane library,MEDLINE,EMBASE,CMBdisc(China biology medicine disc) for English and Chinese abstracts.Inclusion criteria were formulated according to validity criteria for diagnostic research published by the Cochrane collaboration.Heterogeneity test of extracted data of Eligible papers was performed first to determine the appropriate statistical model used to pool the result.Finally,sensitivity and publish bias analysis was performed.Result Seventeen articles with 37 studies including 351 patients met the inclusion criteria.There was no heterogeneity between included studies (I2 =0％,Q =5.85,P =1).Fixed effect model was selected for the meta analysis and there was no statistically significant difference between true and radiological estimated whole liver volume (WMD =21.61 mL,95％ confidence interval:-6.33-49.57 mL,z =1.51,P =0.13).Sensitivity analysis revealed the result was robust which was not affected by excluding any of the included studies.Funnel plot and publish bias analysis showed no publish bias (t =-1.55,P=0.13).Conclusion CT and MR volume estimation is accurate for liver volume measurement,which provides important information for preoperative evaluation,postoperative monitoring and follow-up studies of other hepatic pathologies.aximum benefit to patients.

Objective To evaluate the applications of magnetic resonance cholangiopancreatography (MRCP) after fat meal in the preoperative evaluation of biliary anatomy of living liver donors.Methods Fifty cases of the preoperative donors for living liver transplantation were included and all had the corresponding intraoperative cholangiography (IOC) information. The MRCP of the donors for living liver transplantation was performed before and after fat meal (two fried eggs). The visualization and diameter of the secondary bile duct were analyzed before and after the fat meal. The results of the biliary branching pattern by MRCP after fat meal were compared with the corresponding IOC results. The accuracy, sensitivity,specificity, positive predictive value and negative predictive value of MRCP after the fat meal in distinguishing normal and any type of variant biliary anatomy were calculated. Results In all cases,82% of the 50 cases in MRCP before the fat meal could meet the diagnosis needs of the preoperative evaluation,and 100% of the 50 cases in MRCP after the fat meal could meet the diagnosis needs. There was significant difference in the demonstration quality and diameter of the secondary bile duct in MRCP before and after the fat meal (P＜0. 05). MRCP showed accurate anatomy of the biliary system, using IOC as the reference standard, in 49(98%) subjects. The sensitivity, specificity, positive predictive value and negative predictive value of MRC in distinguishing normal and any type of variant biliary anatomy were 98%,94. 7%, 100%, 10% and 96. 9%,respectively. Conclusion The MRCP after fat meal can clearly demonstrate the secondary bile duct and perfectly meet the needs of the preoperative evaluation of the living liver transplantation. The MRCP after fat meal and routine MRCP should be considered complementary to one another in order to avoid complications in living liver transplantation donors.

Objective To observe the effect of Xuebijing on coagulation function in patients with sepsis. Methods Sixty-two patients with severe sepsis were admitted to Department of Emergency and Intensive Care Unit (ICU) of Kunming Municipal Hospital of Traditional Chinese Medicine from February 2015 to June 2017, and they were divided into Xuebijing group and routine treatment control group according to the random number table method, 31 cases in each group. Both groups were treated with symptomatic supportive therapy, and the Xuebijing group was treated with Xuebijing injection 50 mL intravenous drip on the basis of routine treatment, twice a day for consecutive 7 days. The differences in platelet count (PLT), 5 items of coagulation: D-dimer, fibrinogen (Fib), activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) score were compared between the two groups before and after treatment. Results After treatment, in both groups, the levels of PLT and Fib were significantly higher than those before treatment, the level of D-dimer, APACHE Ⅱ were obviously lower than those before treatment, APTT, PT and TT were significantly shorter than those before treatment, and the changes in Xuebijing group were more marked than those in the routine treatment control group [PLT (×109/L):186.63±45.29 vs. 119.96±59.76, Fib (g/L): 3.88±1.82 vs. 2.33±1.33, D-dimer (mg/L): 0.40±0.11 vs. 0.65±0.14, APTT (s): 30.95±8.48 vs. 42.25±7.73, PT (s): 10.97±1.51 vs. 13.16±2.22, TT (s): 16.17±1.28 vs. 18.98±1.12, APACHE Ⅱ score: 6.62±2.91 vs. 12.87±4.54, all P ＜ 0.05]. Conclusion Xuebijing can regulate coagulation disorder in patients with severe sepsis, ameliorate the disease condition of patients, block the deterioration of disease development, and improve the prognosis of patients.

OBJECTIVETo investigate the characteristics of HCV genotypes of Han and Korean in Yanbian area of Jilin Province.

METHODSThe HCV RNA load and genotypes of the 119 chronic hepatitis C patients in Yanbian area of Jilin Province were determined by real-time PCR and LiPA. The differences of the HCV genotypes in Han and Korean cases, in severity of the diseases, in HCV-RNA load, and in the relation with type 2 diabetes mellitus were analyzed.

RESULTSThere was no significant difference in the distribution of each HCV genotype between Han and Korean patients (P > 0.05) with chronic hepatitis C. The difference between HCV genotype and HCV-RNA load was not significant (P > 0.05). With and without type 2 diabetes mellitus in these patients. The distribution of HCV genotype was also not significantly different (P > 0.05). The type 1b of HCV genotype in the moderate to severe chronic hepatitis C patients accounted for 58.06%. It was different compared with mild chronic hepatitis C patients (P < 0.05).

CONCLUSION1) The type 1b is the most popular HCV genotype in Yanbian area of Jilin Province, type 2a is the second and there are still a few other genotypes. 2) There is no significant difference in the distribution of HCV genotypes between Han and Korean cases. 3) The HCV genotypes has nothing to do with the load of HCV-RNA. 4) The distribution of HCV genotypes in chronic hepatitis C patients with and without diabetes mellitus is not significantly different. 5) Type 1b of HCV infection is relatively severe.

Adolescent ; Adult ; Aged ; Diabetes Mellitus, Type 2 ; complications ; Female ; Genotype ; Hepacivirus ; genetics ; Hepatitis C ; complications ; epidemiology ; virology ; Humans ; Korea ; epidemiology ; Male ; Middle Aged ; Polymerase Chain Reaction ; Young Adult