OBJECTIVE:To compare the preventive effects and safety of aspirin and clopodogrel respectively used for vascular restenosis after coronary intimal striping with coronary artery bypass grafting. METHODS:110 patients with coronary atherosclerot-ic heart disease were divided into aspirin group (55 cases) and clopodogrel group (55 cases). All patients intravenously mi-cro-pumped Nitroglycerin injection 10 mg+5% Glucose injection totally 20 mL for maintaining 48-72 h after coronary intimal strip-ing with coronary artery bypass grafting,intravenously pumped Dopamine hydrochloride injection 1-5 μg/kg if necessary. Unplug the endotracheal tube after surgery,patients received Cefuroxime sodium for injection 1.5 g adding into Sterile water for injection 50 mL,intravenous injection,3 times a day,for 2-3 d. Meanwhile,patients were orally given Rosuvastatin calcium tablet 10 mg 30 min after daily dinner,8-week was a course,for 3 courses. Based on it,aspirin group received Aspirin enteric-coated tablet with initial dose of 300 mg,once a day,orally taking 100 mg from the second day,once a day,for 6 months;clopodogrel group received Clopidogrel hydrogen sulfate tablet with initial dose of 300 mg,once a day,orally taking 75 mg from the second day, once a day,for 6 months. Graft patency rate,and platelet aggregation rate,platelet aggregation compliance rate,fibrinogen(Fg), D-dimer (D-D),platelet count (PLT),tissue-type plasminogen activator (t-PA) before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:There were no significant differences in the graft patency rate and inci-dence of adverse reactions in 2 groups (P>0.05). Before treatment,there were no significant differences in platelet aggregation rate,platelet aggregation compliance rate,Fg,D-D,PLT and t-PA in 2 groups (P>0.05). After treatment,platelet aggregation rate,Fg and D-D level in 2 groups were significantly lower than before,platelet aggregation compliance rate,PLT and t-PA level were significantly higher than before,with statistical significance(P<0.05),while there were no significant differences between 2 groups(P>0.05). CONCLUSIONS:Based on conventional treatment,both aspirin and clopidogrel used for coronary intimal strip-ing with coronary artery bypass grafting can inhibit platelet aggregation,reduce thrombosis,maintain vascular patency and prevent vascular restenosis,with good safety.

ObjectiveTo explore the influence of the CT scanning mode on the gross tumor volume (GTV) delineation of solitary pulmonary lesion (SPL),and to evaluate the feasibility of the spiral CT scan in CT simulation.Methods Sixteen patients with SPL underwent axial scan,spiral scan during free breathing.Compare the target position,volume between GTVS and GTVA (paired t-test).The matching index (MI) between GTVS and GTVA and correlations between MI and the tumor volume were calculated ( bivariate correlation analysis).ResultsGTVS and GTVA volume was 8.95 cm3 and 9.38 cm3 ( t =0.43,P =0.667),respectively.The centroid position for GTVS and GTVA in x,y and z axises were 6.80 cm and 6.81 cm (t =0.27,P =0.794),36.19 cm and 36.05 cm (t =0.37,P =0.717),and 4.99 cm and 4.96cm (t =0.65,P =0.526),respectively.There were also no statistically significant difference in the distance between the centroidal position and origin of coordinates for GTVS and GTVA (38.31 cm∶ 38.23 cm,t =0.47,P =0.646 ).MI between GTVS and GTVA was 0.36 ( range 0-0.77 ),correlated with the tumor volume (r =0.587,P =0.017).ConclusionsThere was no significant difference between the axial scan and spiral scan in the GTV volume and position for SPL,but MI between GTVS and GTVA were small.A correlation was found for the MI between GTVS and GTVA with the tumor volume.Spiral CT scan was more timesaving,and was feasible in CT simulation scan.

Objective To investigate the epidemiological information of patients in pre-hospital medical care for our large and medium-sized cities and probe the patients' characteristic. Method The data in 2008 were exported from the computer databases of 8 large and medium-sized cities' emergency medical centers in our country.The thorough records of data were conducted to statistical analysis. Results ( 1 ) The scheduling time, running time, rescue time, returning time, total time and service radius in the pre-hospital medical care group were 2.16± 1.10(min), 14.01 ±6.82(min), 12.12±5.96(min), 14.08± 6.85(min), 42.34± 20.21(min)and 8.50±4.18(km), and the above parameter in the non-death group were 2.19 ± 1.13(min), 14.15 ± 7.14(min),11.60±6.72(min), 14.92 ±6.89(min), 41.86± 19.53(minutes) and 8.63±4.31(Km), and the above parameter in the death group were 2.10± 1.08(min), 13.68 ± 7.14(min), 25.25 ± 12.34(min), 13.75±6.48(min), 54.74 ± 25.47(min) and 7.86± 3.91(Km), and the above parameter in the non-sudden cardiac death group were2.09± 1.03(min), 13.58±6.78(min), 25.53± 12.34(min), 13.60± 6.54(min), 53.79±23.77(min) and 7.67 ± 3.86(Km), and the above parameter in the sudden cardiac death group were 2.12 ±1.02(min), 14.10±7.05(min), 24.79± 12.08(min), 13.79±6.61(min), 54. 80 ± 25. 36( min) and 7.90±3.92(Km) respectively. The scheduling time, running time, returning time and service radius in the death group were less than those of the non-death group, but the rescue time and total time of the former were more than those of the latter respectively ( P ＜ 0.05 or P ＜ 0. 001 ). The scheduling time and returning time didn' t have significant difference between the sudden cardiac death group and the non-sudden cardiac death group respectively ( P ＞ 0.05), but the running time, total time and service radius of the sudden cardiac death group were more than those of the non-sudden cardiac death group, and the rescue time of the former was less than that of the latter respectively ( P ＜ 0.05 or P ＜ 0.001 ). (2)The patients' amount in pre-hospital medical care group, the non-death group, the death group, the non-sudden cardiac death group and the sudden cardiac death group were at most in first quarter, and the least time slice of patients' amount were 4:00～ 6:00, 4:00～6:00, 4:00～ 6:00, 22:00～ 24:00, 2:00～4:00 respectively, and the most time slice of patients' amount were 20:00～ 22:00, 20:00～22:00, 8:00～ 10:00, 2:00 ～ 4:00, 8:00 ～ 10:00 respectively. (3)In 241 876 cases of pre-hospital medical care group, the patients' amount of trauma was at most, whose age grades was by far among21 ～50, and the others in sequence were nervous system, circulatory system, other group, digestive system, respiratory system and poisoning group respectively, whose age grades in nervous system, circulatory system and respiratory system was by far above 51, especially above 70. The patients' age grades in other group and digestive system had two climax age groups, which the one was 21 ～ 30, and the other was above 70. The patients' age grades in poisoning group was by far among 21 ～ 50, which the patients' amount of acute alcoholism was at the most. (4) In 12 568 cases of death group, the death amount of circulatory system, other group, respiratory system, nervous system and digestive system ranked at the lst,2nd,4th,5th 8th respectively, whose age grades was by far above 51, especially above 70,and the patients' amount of sudden cardiac death was at the most in the death amount of circulatory system. The death amount of trauma and poisoning group ranked at the 3rd, 6th respectively, whose age grades was by far among 21 ～ 50. (5)The total amount, the death amount and the sudden cardiac death amount of male patients were more than those of female patients. (6)The percentage of the death group to the pre-hospital medical care group was 5.20%, and the percentage of the sudden cardiac death group to the pre-hospital medical care group was 1.29%,and the percentage of the sudden cardiac death group to the death group was 24.87 %, and the percentage of the sudden cardiac death group to the circulatory system group was 67.33 %. Conclusions ( 1 )The trauma and the sudden cardiac death are the overriding reason of disease and the overriding reason of death in our large and medium-sized cities respectively. (2) It is very important to cut the death rate of the middle-old age patients by strengthening prevention and cure of cardiovascular and cerebrovascular diseases, discerning the critical illness early and improving the level of pre-hospital medical care. (3)It is a strong method to decrease the total amount and the death amount of the trauma, especially in traffic accident, by strengthening safety in production, observing traffic regulation and enhancing the legal awareness.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.