Objective To study the relationship between chronic obstructive pulmonary disease (COPD) and osteoporosis by measuring the bone mineral density (BMD),lung function,blood gas analysis,calcium ion,high sensitive C reactive protein (hs-CRP) and the quality of life.Methods BMD measuring was performed by ultrasound dry bone densitometer in 32 patients with COPD (COPD group) and 35 healthy controls (control group).The ultrasonic transmission speed (SOS),SOS T,fracture risk factor (OSI) and bone strength (TI) were measured at the sites of the left calcaneus.COPD group was divided into three groups according to lung function,3 cases of mild,14 cases of moderate and 15 cases of severe.According to the level of BMD,there were another three groups,3 cases with normal BMD,24 cases with lower BMD,and 5 cases with osteoporosis.According to the history of systemic glucocorticoid application,COPD group was divided into two groups,10 cases with glucocorticoid application and 22 cases without glucocorticoid application.The levels of BMD between COPD group and control group were compared,and the correlation between BMD and lung function,blood gas analysis,calcium ion,hs-CRP and the quality of life in patients with COPD was analyzed.Results COPD group had lower BMD than that in control group (P ＜ 0.05).In COPD group,the severe patients had lower BMD than the moderate patients (P ＜ 0.05),and the severe patients had only lower SOS than the mild patients(P ＜ 0.05),but there was no statistic significant difference in BMD between the moderate and mild patients(P ＞ 0.05).According to the level of BMD,the osteoporosis patients had lower arterial oxygen tension (PaO2) and higher hs-CRP and COPD assessment test (CAT) than the normal BMD and lower BMD patients,and the lower BMD patients had lower PaO2 and higher CAT than the normal BMD patients (P ＜ 0.05),but there was no statistic significant difference in calcium ion among them(P ＞ 0.05).According to the history of systemic glucocorticoid application,the patients with glucocorticoid application had lower level of BMD than the other patients (P ＜ 0.05).SOS,SOS T,OSI and TI was correlated with one second forced expiratory volume percent predicted (FEV1％) (r =0.389,0.262,-0.295,0.265; P＜0.05),also correlated with PaO2 (r =0.391,0.100,-0.374,0.122;P＜0.05),and also correlated with CAT (r =-0.659,-0.463,0.175,-0.178 ; P ＜ 0.05).There was only a negative correlation between SOS and hs-CRP (r =-0.390,P ＜ 0.05).Further in Logistic regression analysis,the results showed that both PaO2 and FEV1％ were the risk factors of BMD reduction.Conclusions Patients with COPD have lower BMD than their peers of healthy.The reduction of blood oxygen pressure and lung function are the risk factors of BMD reduction.There is a conjecture that the reduced BMD is correlated with chronic inflammation in patients with COPD.

Accidents, Occupational ; statistics & numerical data ; Adolescent ; Adult ; Factor Analysis, Statistical ; Humans ; Male ; Middle Aged ; Occupational Injuries ; epidemiology ; Risk Factors ; Young Adult

Objective To assess the consistency of diagnostic results using optical coherence tomography angiography (OCTA) and fundus fluorescein angiography (FFA) in the central retinal vein occlusion (CRVO).Methods This is a retrospective case series of 26 eyes of 26 patients with CRVO.There were 10 females (10 eyes) and 16 males (16 eyes).The mean age was (49.19±10.50) years.The mean course of the disease was (27.81± 21.60) days.Simultaneous OCTA and FFA were performed in all patients using 7-standard field of Early Treatment Diabetic Retinopathy Study (ETDRS) to evaluate the microaneurysms,nonperfused areas,optical disc/retinal neovascularization and maeular edema.The consistency was evaluated using weighted Kappa statistic values.Kappa≥0.76,consistency is excellent;0.60≤Kappa＜0.75,consistency is good;0.40≤Kappa＜0.60,consistency is general;Kappa＜0.40,consistency is poor.Results Based on OCTA,microaneurysms were found in 23 eyes,nonperfused areas in 16 eyes,optical disc/retinal neovascularization in 8 eyes and macular edema in 21 eyes.Based on FFA,23 eyes were diagnosed to have microaneurysms,14 eyes have nonperfused area,8 eyes have optical disc/retinal neovascularization,22 eyes have macular edema.The consistency was excellent for microaneurysms and optical disc/retinal neovascularization (Kappa=0.772,0.766;P＜0.01),good for nonperfused areas and macular edema (Kappa =0.703,0.600,P＜ 0v01).Conclusion There is high consistency between OCTA and FFA in the diagnosis of microaneurysms,macular edema,nonperfused areas and optical disc/retinal neovascularization in CRVO patients.

Objective To investigate the effect of PBL combined with EBM applied in the teaching of fever of unknown origin. Methods PBL combined with EBM teaching was applied in fever of unknown origin course for 30 clinical medicine specialty(eight years) students of Tongji class of grade 2009(experiment group), while PBL teaching was applied in fever of unknown origin course for 30 clinical medicine specialty (eight years) students of Tongji class of grade 2008 (control group). After teaching, the theory examination for both basic knowledge and case analysis was organized for all students of both groups. At the same time the questionnaire survey was conducted to 30 students of grade 2009 to evaluate the teaching effect. The results were assessed by using SPSS 18.0 statistical software for the T-test of the experimental group and the control group.Inspection level was α=0.05. Results The theory test score of students in the experimental group was (93.5±3.2) point, signifi-cantly higher than that of the students in the control group(84.7±2.8). There was statistically signifi-cant difference between the scores of the two groups of students (P=0.00). Survey results showed 19 students ( 63 . 33%) thought that the development of PBL teaching combined with evidence-based medicine teaching had its necessity, and 16 students(53.33%) thought that the teaching method im-proved their clinical thinking ability of logical reasoning. Conclusion The concept of PBL combined with EBM has achieved significant resultsinthe teaching offever of unknown origin, and it is necessary to carry out this teaching mode in medical colleges with certain teaching strength.

Objective: To observe the clinical effect of Zheng's Jin Gou Diao Yu (gold-hook-fishing) acupuncture method versus ordinary acupuncture on superficial fascia for treating neck type cervical spondylopathy in Kyrgyz. Methods:A total of 64 Kyrgyz patients conforming to the diagnostic criteria of neck type cervical spondylopathy were included. The patients were randomized into a Zheng's Jin Gou Diao Yu (gold-hook-fishing) acupuncture group and a conventional acupuncture group, with 32 cases in each group. Patients in the Zheng's Jin Gou Diao Yu (gold-hook-fishing) acupuncture group were treated with Zheng's Jin Gou Diao Yu (gold-hook-fishing) acupuncture method to stimulate the superficial fascia, the stimulation sites were primarily located at bilateral sides of the cervical vertebra as well as the trigger points in shoulder-neck region; patients in the conventional acupuncture group were punctured at the same acupoints, with twirling reducing method, and the depth of insertion was determined by the treated region. Patients in both groups received treatment every day for a succession of 5 d as a course, with a 2-day interval between 2 courses, and the whole treatment lasted for 3 courses. After 3 courses of treatment, the McGill pain questionnaire (MPQ) and neck disability index (NDI) were measured to compare the clinical effect between the two groups. Results: After treatment, scores of MPQ and NDI scale dropped when compared with those before treatment, and the differences showed statistical significance (allP<0.05); scores of MPQ and NDI in the Jin Gou Diao Yu (gold-hook-fishing) acupuncture group were substantially lower than those in the conventional acupuncture group, and the differences showed statistical significance (allP<0.05). The total effective rate was 96.9％ in the Jin Gou Diao Yu (gold-hook-fishing) acupuncture group and the cured rate was 78.1％, which were higher than 81.3％ and 40.6％ in the conventional acupuncture group, and the differences showed statistical significance (bothP<0.05). Conclusion: Zheng's Jin Gou Diao Yu (gold-hook-fishing) acupuncture method by stimulating superficial fascia to treat cervical spondylopathy in Kyrgyz can produce a better clinical effect than conventional acupuncture treatment, and is effective in improving pain and stiffness in patients, and thus is worth clinical popularization.

Objective: To observe the clinical effects of Shu-acupuncture method in Nei Jing (Classic of Internal Medicine) in the treatment of shoulder and arm pain. Methods: A total of 90 patients with shoulder and arm pain were randomly divided into an observation group and a control group, 45 cases in each group. The treatment of Shu-acupuncture method in Nei Jing (Classic of Internal Medicine) was adopted in the observation group, routine acupuncture was used in the control group. The two groups were treated once every day, with 5 treatments as one course, and a 2-day rest between two courses. After 3 courses, pain was assessed by visual analog scale (VAS), and the clinical effects were compared between the two groups. Results: After the treatment, VAS scores were significantly changed in both groups (both P<0.01). The VAS score was lower in the observation group than that in the control group, with a statistical difference between the two groups (P<0.05). The total effective rate was 100% in the observation group, versus 91.1% in the control group, the difference was statistically significant (P<0.05). Conclusion: The therapeutic effect of Shu-acupuncture method in Nei Jing (Classic of Internal Medicine) is better than that of routine acupuncture in treating shoulder and arm pain.

ObjectiveTo evaluate the effects of cardiac resynchronization therapy (CRT) on improving left ventricle (LV) function and LV asynchrony in patients with dilated cardiomyopathy(DCM)using three-dimensional ultrasound speckle tracking imaging(3D-STI).MethodsTwenty one patients with DCM and 25 normal subjects were enrolled in this study.Parameters including LV mean longitudinal peak strain (MLS),LV mean circumferential peak strain (MCS),LV mean radial peak strain (MRS),LV ejection fraction(3D-LVEF),maximal temporal difference in area strain of LV 16 segments (A-MaxTs) and its standard deviation (A-Ts-SD) were investigated by 3D-STI.LV ejection fraction (ECT-LVEF) and LV phase angle width (LVW) were obtained by radionuclide ventriculography and phase image analysis.Results The indexes of MLS,MCS,MRS and 3D-LVEF were decreased and A-MaxTs,A-Ts-SD were prolonged in DCM group compared with those of control group.There was a slightly improvement in MRS and ECTLVEF 1 week after CRT,but other Parameters including MLS,MCS,A-MaxTs,A-Ts-SD and 3D-LVEF had no significant change.Compared with corresponding values before and 1 week after CRT,all parameters (MCS,MRS,A-MaxTs,A-Ts-SD,3D-LVEF and ECT-LVEF) were further improved 6 months after CRT.MLS,MCS,MRS and 3D-LVEF had good relationship with ECT-LVEF,and A-MaxTs,A-Ts-SD had good relationship with LVW in DCM group.Conclusions3D-STI is a simple and accurate method for evaluating effects of CRT on improving LV function and LV asynchrony in patients with DCM.

OBJECTIVETo observe the changes of electrocardiogram (ECG) and pregnancy outcome of the late pregnancy women.

METHODSLate pregnancy women were divided into two groups by age: over 35 group and under 35 group. The incidence of abnormal electrocardiogram was recorded when the patients were subjected to routine ECG examination. Then the pregnancy, delivery outcome and if there's low birth weight newborn were recorded later.

RESULTSThe incidence of abnormal ECG in over 35 group was significantly higher than that in under 35 group (P < 0.05). And the incidence of ST segment changes, arrhythmia in the group of former was higher than that in the group of latter (P < 0.05). Among the different type of arrhythmia, the incidence of sinus bradycardia and ventricular premature beat in the group of former were higher than those in the group of latter (P < 0.05). But the incidence of sinus tachycardia in the former group was obviously lower than that in the latter group (P < 0.05). The incidence of pregnancy loss in over 35 with abnormal ECG group was significantly higher than that in under 35 with normal or abnormal ECG groups (P < 0.05). The incidence of premature birth in over 35 with abnormal ECG group was significantly higher than that in over 35 with normal ECG group (P < 0.05). The incidence of low body weight in over 35 with abnormal ECG group was significantly higher than that in under 35 with normal ECG group (P < 0.05).

CONCLUSIONThe late pregnancy women with the age of over 35 are more likely to have ECG abnormalities, such as arrhythmia, myocardial ischemia and so on. The older pregnant women with abnormal ECG easily suffer from pregnancy losing, premature birth and having a low birth weight baby.

Adult ; Age Factors ; Arrhythmias, Cardiac ; epidemiology ; Electrocardiography ; Female ; Humans ; Pregnancy ; Pregnancy Outcome ; epidemiology

OBJECTIVETo observe analgesic and sedative effect of acupuncture combined with medicine (ACM) on patients undergiong cardiac surgery.

METHODSA total of 50 patients with cardiac surgery from January 2012 to October 2014 were randomly assigned to the conventional analgesia group (group A) and the ACM analgesia group (group B), 25 in each group. Patients in group A were subjected to analgesia and sedation by injecting dexmedetomidine, while patients in group B were subjected to analgesia and sedation by electro-acupuncture [EA, Shenting (GV24); Yintang (EX-HN3)] combined with injection of dexmedetomidine. Morphine hydrochloride injection was performed when analgesia and sedation effect was ineffective in the two groups. The indicators of patients at different time points in the two groups were observed, such as static and dynamic VAS scores, SAS scores, mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SpO2). The injection dosage of dexmedetomidine and morphine hydrochloride, analgesia satisfaction rate, sedation satisfaction rate, the incidences of adverse reactions during treatment such as bradycardia and low blood pressure, mechanical ventilation time, ICU time, and hospitalization expense were observed and recorded in the two groups.

RESULTSThere was no statistical difference in static and dynamic VAS scores, SAS score, MAP, HR and SpO2 between the two groups at different time points (P > 0.05). The injection dosage of dexmedetomidine and morphine hydrochloride was significantly reduced in group B than in group A (P < 0.05). The analgesia satisfaction rate of patients in group B was much higher than that in group A (P < 0.05). The incidence of bradycardia also obviously decreased more in group B than in group A (P < 0.05). There was no statistical difference in patients' sedation satisfaction rate, incidences of low blood pressure, delirium, vomiting; mechanical ventilation time, ICU time, or hospitalization expense between the two groups (P > 0.05).

CONCLUSIONThe analgesia method of ACM could reduce the dosage of traditional analgesic drugs and the occurrence of partial adverse reactions.

Acupuncture Analgesia ; Analgesia ; methods ; Analgesics ; therapeutic use ; Cardiac Surgical Procedures ; Dexmedetomidine ; therapeutic use ; Electroacupuncture ; Heart Rate ; Humans ; Hypnotics and Sedatives ; therapeutic use ; Morphine ; therapeutic use ; Pain ; prevention & control ; Pain Management ; methods ; Respiration, Artificial

Objectives To evaluate the lung function in patients of severe secondary hyperparathyroidism caused by uremia and to analyze related factors.Methods The pulmonary function of 70 patients with uremia ( 40 patients with severe secondary hyperparathyroidism, 30 MHD patients without SHPT) and 30 healthy people was determined.Correlative analysis was performed between parameters such as pulmonary function indexes and clinical or laboratory parameters. Results Lung function was significantly different between patients with uremia and healthy subjects(P<0.05, respectively). A number of lung function indicators were negatively correlated with iPTH,C reactive protein( CRP) ,dialysis age but were positively correlated with hemoglobin (Hb) and albumin(Alb) (P <0.05).Conclusion Patients with SHPT show impaired lung function.IPTH, dialysis age, Hb, Alb and CRP can be used as important indicators of lung function.