Objective To assess the left ventricular systolic asynchronicity in chronic ischemic model with real-time three-dimensional echocardiography (RT-3DE), and to explore the affection of low-dose dobutamine to it. Methods A chronic ischemic model was induced by placing an Ameroid constrictor in the left circumflex(LCX) in swines,then full volume RT-3DE was performed by Philips iE33 with X3-1 probe combining rest and stress(dobutamine stress echocardiography, DSE) every week after LCX constriction.Ten normal pigs before operation served as controls (group A). Examination of all the models post operation were grouped into group B (mild stenosis, LCX stenosis＜50% ), group C (moderate stenosis, LCX stenosis 50%～75%) and group D (severe stenosis, LCX stenosis≥75%) according to the results of coronary angiography. Images were copied to QLAB 5.2 postprocess workstation,and 3DQA software was used to analyze the full volume data sets. The time to the point with minimal systolic volume (Tmsv) in each segment was taken to derive the following indexes of systolic synchrony: the maximum difference of Tmsv (Tmsv-dif) and standard deviation(Tmsv-SD) among various segments and standard index (Tmsv-dif% and Tmsv-SD%), to evaluate left ventricular dyssynchrony. Tmsv3-6 represented the maximum difference of Tmsv between lateral segment and posterior septum (Tmsv3-5: between lateral segment and inferior) in basal level. Results Tmsvl2-Dif%, Tmsv6-Dif%, Tmsv3-6% and Tmsv3-5% under stress condition in group C and D were significantly higher than those at rest;all the data in group D were significantly higher than in group A and B, and in group C higher than group A ( P ＜0.05,0.01 ). Compared with group A,Tmsv6-Dif,Tmsv3-6 and Tmsv3-5 in group B were significantly increased under stress condition,and so did their standardize data under both rest and stress conditions ( P ＜ 0.05, 0. 01 ). Conclusions RT-3DEcombined with DSE could display sensitively the left ventricular asynchrony caused by chronic ischemia,and that will be more significant in lateral wall in LCX stenosis than in normal segments.

One hundred and fourty-nine normal persons were tested to gain the normal scale of Comprehensive Function Evaluation(CFE).It includes seven items eighteen categories.The result demonstrated that fifteen categories of normal persons in age of twenty to sixty-nine incuding understanding and expressing,feeding,grooming,dressing clothes,dressing trousers and skirts,bathing,bowel and bladder management,control of sphincter of bowel and bladder,bed wheelchair mobility,bathtub-wheelchair mobility,ambulation,up and down the stairs,which gained one hundred degrees each,memory ninty eight to one hundred degrees,problem solving ability eighty-four to one hundred degrees,social communication ninty-nine to one hundred degrees.We conclude preliminarily:CFE is an individual ability evaluation of preson,demonstrating the comprehensive function of presons which were in aga of twenty to sixty nine,educated in and above primary school.It can be used as a main scale to evaluate the guality and effect of rehabilitation sequence,and has practical value to improve rehabilitation medical level.

Presented in this paper is a preliminary report on reliability study of comprehensive function evaluation.One hundred and five normal persons were evaluated twice in the interval of one month.The result revealed significant statistical difference,Kappa=0.79,u=7.938>2.56,P<0.01,demonstrating the substantial agreement of these two evaluations.The result suggests that the scale has substantial intra observer agreement and high reliability.The personal comprehensive function could be evaluated completely in the scale.It would be significant not only in practice but also in theory to improve the rehabilitation evaluation and rehabilitation medical level.

Objective To evaluate the efficiency and safety of drug-eluting stents (DES) and bare metal stents (BMS) in elderly with coronary artery disease (CAD).Methods PubMed,Embase,Cochrane Library,CNKI and Wanfang databases were searched before October 28,2017.The pertinent randomized controlled trials (RCTs) and cohort studies (CS) were included.The outcomes were all-cause mortality (ACM),myocardial infarction (MI),target vessel revascularization (TVR),cardiac death (CD),stent thrombosis (ST) and bleeding.Relative risk (RR) with 95％ confidence interval (95％CI) was analyzed.Results A total of 17 studies with 10 813 patients were included.Overall and in CS group,there were significant lower risks of ACM (RR＝0.71,0.68,both P＜0.001),MI (RR＝0.66,P＜0.001;RR＝0.60,P＝0.008),TVR (RR＝0.50,0.54,both P＜0.001),CD (RR＝0.73,0.72,P＝0.003,0.020) and ST (RR＝0.68,0.59,P＝ 0.02,0.01) in DES patients compared with BMS patients,but the risk of bleeding was not significantly different (RR ＝ 1.00,1.00,P ＝ 0.96,0.97).In RCT group,DES (compared with BMS) was only associated with significantly lower risks of MI (RR＝0.68,P＝0.003) and TVR (RR＝0.43,P＜0.001),no difference was detected in other indexes.Conclusion DES is more efficacious and safer than BMS for elderly patients with CAD.

: Rehabilitation medicine is a medical branch which focused on functional recovery. Function Evaluation is very important in assessing the function of patients, the effect of treatment and the efficiency of rehabilitation. Comprehensive Function Evaluation includes evaluation of physical, psychological, speech and society. Vocal, mental and social evaluation have deep cultural and national background. Therefore every country must have its own Function Evaluation Method. Now we present our design for Comprehensive Evaluation. Based on the cooperation of Department of Rehabilitation, Department of Neurology, Department of Spinal Cord Injury, Department of Speech Therapy and Department of Psychology. The advantages of this method are as follows: 1. The style of ADL, speech and thinking are suitable for the condition of our country. 2. The evaluation result adopts hundred work system, it is easy for medical staff, patients and their family to understand and communicate the result. 3. We make it more accurate, comprehensive and reliable by some simple tests on speech pathology and psychology. 4. We overcome some disadvantages of evaluation indexes because it is not correct and is difficult to be understood before. Now every evaluation index has quantity standard. 5. It is simple and practical. Each subtest takes 20 minutes or more. 6. It has been tested by normal people. The norm and severity grade had been developed. 7. The reliability is tested and is proved to be dependable.

康复医学是以恢复患者功能为中心的医学分支。因此，功能评定无论是在客观地评定患者的功能方面，还是在最终评定治疗结果和康复效率方面都是极为重要的。全面的功能评定包括躯体、精神、言语和社会四个方面。其中，言语、社会功能和认知功能中的思维方式，都具有强烈的民族文化色彩。因此，每个国家都应该有切合自己国情的功能评定方法。但由于我国康复医学发展较晚，至今尚无一套既切合国情，又全面、实用和可靠的功能评定方法。有鉴于此，我们在“中心”顾问室、神经康复科、脊髓损伤康复科、言语治疗科、心理科和老年病科的通力合作下，经过近2年的研究，在吸收国际先进经验的基础上，密切结合国情，设计了本文所述的综合功能评定法。其优点有：1．在饮食、起居等生活方式方面以及在言语、社会、思维等方面，均切合我国国情。2．评定结果采用群众熟悉的100分制，使医务人员、患者和患者家属均易于理解，便于交流和沟通。3．在言语、认知等功能的评定方面，直接由言语和心理学家选择一些简易的言语和心理学测试项目，提高了量表的准确性、全面性和可靠性。4．各项评定指标的量化程度高，在言语、认知和社会方面尤其如此，克服了一些量表中对此类项目的评定指标不够具体和不易掌握的不足。5.简便实用，一次检查对正常人仅需20分钟左右，对患者则无负担。6.本法已在128名正常人中应用，并求出了正常值，据此拟定了功能障碍严重程度的等级，可供参考和应用。7.信度经过检验，证明可靠。 综合功能评定法的正常值、功能障碍严重程度分级及信度研究结果，将陆续报道。

Objective: To discuss the characteristics of symptoms improvement based on the follow-up evaluation of Eustachian tube balloon dilation medium to long-term efficacy in patients with symptomatic Eustachian tube dysfunction (SETD). Methods: Patients from 2015 to 2017 were followed up after Eustachian tube balloon dilation (with the sense of aural fullness, or tinnitus and hearing ambiguity). All participants had been done ETDQ-7 before surgery and were re-evaluated with ETDQ-7 in follow-up. The improvement of overall and individual symptoms scores in ETDQ-7, the effects of gender and the difference of scores at different stages (12-18 months, 18-24 months and 24-30 months) after the operation were analyzed. Results: There were 29 patients, including 16 males and 13 females, whose age ranged from 20 to 62 years old. The medium to long-term score of ETDQ-7 significantly declined after surgery (27.0±7.9 vs. 14.1±7.5, P<0.05). Among all symptoms, symptoms like "blockage feeling in ear or being like under the water, constriction feeling" , "sound of blisters or explosions in the ear" decreased obviously (P<0.05). Comparing different stages after surgery, the scores of ETDQ-7 existed no difference (P>0.05). And the difference of gender showed no significant influence on surgery effects. Conclusion The subjective symptoms of patients with Eustachian tube dysfunction diagnosed with SETD can be significantly improved in the medium to long-term follow-up after Eustachian tube balloon dilation, and the degree of improvement is not linearly related to the postoperative time.