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Application of continue performance test in screening of attention deficit hyperactivity disorder

Guoxing QIN ; Jianguang GAN ; Guoqiang TIAN ; Caiying XUAN ; Tianlai GAO

Chinese Journal of Postgraduates of Medicine.2011;34(3):19-21. doi:10.3760/cma.j.issn.1673-4904.2011.03.007

Objective To explore the effect of application of continue performance test (CPT) in screening of attention deficit hyperactivity disorder( ADHD ). Methods Thirty-five children with ADHD and65 normal children had been applied with CPT and Conner questionnaire test. Used rank sum test to examine the outcome, established receiver operating characteristic (ROC) curve, analyzed the most valuable index among various data, formulated abnormal critical value, and carried on a consistency check between CPT screening outcome and clinical diagnosis outcome. Results Each CPT index of 35 children with ADHD was obviously higher than those of normal children(P＜ 0.05 ). Most indexes' area under the ROC curve exceeded 0.7, reactive time of VST was the highest among each index which achieved 0.915. It was high conformity between CPT screening outcome and clinical diagnosis outcome (Kappa = 0.935 ). Conclusion CPT can be applied in ADHD screening.

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Application of Supreme laryngeal mask airway to the anesthesia of poster laparoscopic surgery with lateral position

Zhengfeng GU ; Yiping HU ; Haoxing WANG ; Zhaoping ZHANG

Chinese Journal of Postgraduates of Medicine.2010;33(36):14-16. doi:10.3760/cma.j.issn.1673-4904.2010.36.006

Objective To study the application of Supreme laryngeal mask airway (SLMA) with new type to the general anesthesia of lateral position. Methods Sixty patients with ASA Ⅰ - Ⅱ who planned to receive selective poster laparoscopic surgery were divided into SLMA group and general tracheal tuber (GTT) group with 30 cases of each by random digits table. After fast intravenous induction SLMA and GTT were intubated respectively to obtain artificial airway in each group. The time of intubation, efficiency of success,heart rate(HR), invasive blood pressure(IVBP),airway pressure,side effects were observed and recorded. Results The intubation time in SLMA group [(15.1 ±4.0) s] was shorter than that in GTT group [(30.5 ±: 16.2) s] (t' =-5.05,P ＜0.05); there was no significant difference in efficiency of success between two groups [96.7%(29/30) vs. 76.7%(23/30),P＞ 0.05]. There was no significant difference in HR and IVBP during the time of intubation and extubation in SLMA group(P＞ 0.05), but not in GTT group(P＜0.05). There was no significant difference in the change of the airway pressure between two groups during the ventilation. There were no complications in two groups. Conclusions The time of SLMA intubation in the general anesthesia with lateral position is short. The effect of intubation and extubation to HR and blood pressure is light. The SLMA intubation is another way to set up safely artificial airway.

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Effect of repeat transurethral resection for superficial bladder cancer

Hanjin SU ; Zhanping XU ; Yongquan DING ; Hanqiang LI

Chinese Journal of Postgraduates of Medicine.2011;34(8):24-26. doi:10.3760/cma.j.issn.1673-4904.2011.08.010

Objective To investigate the effect of repeat transurethral resection for superficial bladder cancer. Methods One hundred and twenty patients who were newly diagnosed superficial bladder cancer were divided randomly in to two groups by mechanical sampling method,60 patients underwent second of prostate TUPKVP 4 weeks after initial transurethral and received adjuvant MMC intravesically (experiment group) and the other 60 patients received adjuvant MMC following the initial TUPKVP(control group). The two groups were followed up by cystoscopy at 3-month intervals,and then compared the recurrences between the two groups. Carcinoma in situ or muscle invasive disease were excluded from the study. Results Mean following up time was 6-24 (12.0 ±6.5) months, within the following up period,recurrence was observed in 13 (21.7%, 13/60) patients in experiment group and in 38 (63.3%,38/60)patients in control group, there was signiticantly statistical difference between the two groups (P＜ 0.01). Of all the recurrences, the recurrence rate of high grade tumor was 26.2% (11/42) in experiment group and 70.0% (35/50) in control group,the recurrence rate in experiment group was obviously less than that in control group (P ＜ 0.01). Conclusions Repeat transurethral resection can lower the recurrence of superficial bladder cancer (especially for the high grade tumor) which with initial resection, it can improve the classification of malignant rumor, and find the residual tumor, so it has value in clinical treatment.

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The effectiveness of different-dose atorvastatin on soluble CD105,high sensitive-C reactive protein and heart rate turbulence in patients with acute coronary syndrome

Zenglei HAN ; Yuying ZHANG ; Qingbo CAO ; Jinwen WANG

Chinese Journal of Postgraduates of Medicine.2011;34(7):14-17. doi:10.3760/cma.j.issn.1673-4904.2011.07.005

Objective To investigate the clinical effects and significance of different-dose atorvastatin on soluble CD105(sCD105),high sensitive-C reactive protein(hs-CRP)and the parameters of heart rate turbulence in patients with acute coronary syndrome(ACS). Methods One hundred and six ACS patients were divided into three groups by random digits table: control group(30 patients, routine treatment),treatment group Ⅰ(38 patients, routine treatment + atorvastatin 20 mg), and treatment group Ⅱ(38patients, routine treatment + atorvastatin 40 mg). All patients were treated for 4 weeks. The levels of serum sCD105,hs-CRP,and the parameters of heart rate turbulence before and after treatment. Results Before treatment, the levels of turbulence onset(TO), turbulence slope(TS),sCD105 and hs-CRP in three groups had no significant difference(P ＞ 0.05). After treatment, TO,sCD105 and hs-CRP decreased significantly,and TS increased significantly(P＜ 0.05 or ＜ 0.01). The change amplitude of treatment group Ⅱ was the most obvious, and the levels of above mentioned index showed significantly difference compared with that of treatment group Ⅰ[TO:(0.22 ±0.18)% vs.(0.66 ± 0.23)%;TS:(6.22 ±0.83)ms/RR interval(RRI)vs.(3.90 ±0.73)ms/RRI;sCD105:(1.65 ±0.43)mg/L vs.(2.92 ±0.50)mg/L;hs-CRP:(1.68 ±0.55)mg/L vs.(2.08±0.61)mg/L](P ＜0.01). Correlation analysis showed the levels of sCD105 and hs-CRP had significantly positive correlation with TO(P ＜ 0.01)and had negative correlation with TS(P ＜ 0.01).Conclusions The atorvastatin treatment in patients with ACS may stabilize coronary vascular endothelial cells and atherosclerotic plaque, and improve autonomic nerve function. Larger doses of atorvastatin may get more benefit.

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Clinical studies of bacillus of Calmette-Guerin polysaccharide nucleic acid adjunctive therapy in pulmonary tuberculosis

Wenfeng LIN ; Jin LI ; Qihuang CHEN

Chinese Journal of Postgraduates of Medicine.2011;34(7):11-13. doi:10.3760/cma.j.issn.1673-4904.2011.07.004

Objective To evaluate the effectiveness, the influence on cellular immune function and the side-effect of bacillus of Calmette-Guerin polysaccharide nucleic acid(BCG-PSN)combined with antituberculous chemotherapy in the treatment of pulmonary tuberculosis. Methods A total of 60 pulmonary tuberculosis patients were divided into treatment group(30 patients)and control group(30 patients)by random digits table. All patients accepted the same standard antituberculous chemotherapy, meanwhile patients in treatment group were injected with BCG-PSN. Observed and compared the clinical symptom,the size of the focas nidus,the change of toxic response and immunity. Results The symptoms were significantly relieved in both groups after treatment(P＜0.05), but it was significantly better in treatment group(P＜0.05), the effective rate and control rate in treatment group[36.7%(11/30),96.7%(29/30)]were significantly higher than those in control group[23.3%(7/30), 86.7%(26/30)](P ＜ 0.05). After treatment,the levels of CD3,CD4 and IL-2 were higher, and the level of CD8 was lower, but the treatment group improved significantly better than control group(P ＜ 0.05). The rate of leukopenia was lower in treatment group than that in control group[10.0%(3/30)vs. 33.3%(10/30),P ＜0.05]. As to the safety,no other toxicities were observed in the treatment group. Conclusions BCG-PSN combined with antituberculous chemotherapy in the treatment of pulmonary tuberculosis contributes to relieve the symptom, reduce size of the nidus, decrease leukopenia incidence and enhance the cell immunity. It is safe.

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Analysis of the relationship between electrocardiographic ST segment diversify and infarction of related artery and the site of occlusion in acute inferior myocardial infarction

Xiaohui LIU ; Guizhou TAO

Chinese Journal of Postgraduates of Medicine.2011;34(7):7-10. doi:10.3760/cma.j.issn.1673-4904.2011.07.003

Objective To predict the infarction of related artery(IRA)and the site of occlusion by analyzing the diversify of electrocardiographic ST segment and coronary angiography findings in acute inferior myocardial infarction. Methods Sixty-four patients with acute inferior myocardial infarction were divided into two groups by coronary angiography: right coronary artery(RCA)occlusion group(51 patients)and left circumflex coronary artery(LCX)occlusion group(13 patients). RCA occlusion group included proximal,middle and distal components occlusion, and LCX occlusion group included proximal and distal components occlusion. The cases of STⅢ elevation ＞ ST Ⅱ ,STaVL depression ＞ STⅠ ,STV1 depression,STV7-V9 and STV3R-V5R elevation were recorded and compared. Results The percentage of STⅢ elevation ＞ STⅡ, STaVL depression ＞STⅠ, STV1 no depression, STV7-V9 no elevation and STV3R-V5R elevation was significantly higher in RCA occlusion group than those in LCX occlusion group(P ＜ 0.01 or ＜ 0.05). The percentage of ST Ⅲ elevation ≤ ST Ⅱ, ST,VL depression ≤STⅠ ,STV1 depression,STV7-V9 elevation,STV3R-V5R no elevation was significantly higher in LCX occlusion group than those in RCA occlusion group(P ＜0.01 or ＜0.05). In RCA occlusion group:the sensitivity of STⅢ elevation ＞ STⅡ, STaVL depression ＞ STⅠ and STV1 no depression was 90.2%, 80.4% and 80.4%;the specificity of STⅢ elevation ＞ STⅢ and STaVL depression ＞ STⅠwas 84.6% and 84.6% ;the sensitivity of STV3R-V5R elevation was 51.0%, but its specificity was 100.0%. In LCX occlusion group: the sensitivity of STⅢ elevation ≤ ST Ⅲ and STaVL depression ≤ ST Ⅰ was 84.6% and 84.6%, and their specificity was 90.2% and 80.4%;the specificity of STV1 depression and STV7-V9 elevation was 80.4% and 78.4%; the sensitivity of STV3R-V5R no elevation was 100.0% ,and its specificity was 51.0%. In RCA occlusion group, the percentage of STV3R-V5Relevation was higher in proximal components occlusion than that in distal components occlusion[76.9%(10/13)vs. 27.3%(3/11),P=0.015]. Conclusions The IRA can be initially judged by analysis of the characteristics in the ST segment in Ⅰ,Ⅱ ,Ⅲ ,aVL,V1,V7-V9,V3R-V5R lead in acute inferior myocardial infarction. And the ST segment elevation in V3R-V5R is meaningful in the judgment of proximal and distal components occlusion in RCA.

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Research on the correlation between diabetic nephropathy and diabetic retinopathy

Baocheng CHANG ; Qian ZHAO ; Yinghai XU ; Qiumei SHAN ; Xinrong SONG ; Liming CHEN

Chinese Journal of Postgraduates of Medicine.2011;34(7):3-6. doi:10.3760/cma.j.issn.1673-4904.2011.07.002

Objective To investigate the clinical characteristics of diabetic retinopathy(DR)and diabetic nephropathy(DN)and their correlation. Methods All of 9237 hospitalized type 2 diabetes patients from January 2004 to June 2009 were collected. The prevalence and clinical of characteristics of DR and DN as well as their relationship were analyzed. Results The total prevalence of DR was 33.0%(3045/9237),and the prevalence of DR in the microalbuminuria, macroproteinuria and macroalbuminuria combined with renal dysfunction patients were 36.3%(588/1618),53.7%(1113/2074)and 70.7%(1206/1706)respectively.The prevalence of DN was 58.4%(5398/9237). Compared with that in the diabetes patients without DR, the levels of microalbumin and total protein in the urine were higher in the patients with moderate non-proliferative diabetic retinopathy(NPDR), serious NPDR and proliferative diabetic retinopathy(PDR), but the endogenous creatinine clearance rate was lower(P＜ 0.05). According to the non-conditional Logistic regression model,the risk factors of DR included diabetes duration,urinary protein,fibrinogen, C-reactive protein and peripheral neuropathy, and the risk factors of DN included diabetes duration, HbA1c, systolic blood pressure,urinary protein,low density lipoprotein and DR. Conclusions DR and DN are the chronic microvascular complications in the type 2 diabetes and have higher prevalence. There are good correlations between DR and DN.

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Clinical application research of gastric tube in radical operation for 26 patients with esophageal or cardial carcinoma

Yulong HAN

Chinese Journal of Postgraduates of Medicine.2011;34(8):21-23. doi:10.3760/cma.j.issn.1673-4904.2011.08.009

Objective To evaluate the clinical application of gastric tube in radical operation for patients with esophageal or cardial carcinoma. Methods From January 2007 to June 2010,50 patients with esophageal or cardial carcinoma were enrolled. Based on surgical methods, they were divided into the gastric tube group (26 cases) and the traditional way group (24 cases). Among the gastric tube group, 21 patients had esophageal carcinoma,and the other 5 patients had cardial carcinoma,and 1 patient was treated with anastomosis in the left neck, 11 patients with anastomosis in upper aortic arch,9 patients with anastomosis in lower aortic arch and 5 cardial carcinoma patients underwent radical resection. Among the traditional way group, 20 patients had esophageal carcinoma,and the other 4 patients had cstdial carcinoma, 1 patient wastreated with anastomosis in the left neck, 11 patients with anastomosis in upper aortic arch, 8 patients with anastomosis in lower aortic arch and 4 cardial carcinoma patients underwent radical resection. The rate of anastomotic leakage, operation time, and length of stay in hospital of the two groups were observed. Results All surgeries were successfully performed. There was no anastomotic leakage case in the two groups, while there were 3 cases pulmonary infection and 1 case death in the traditional way group. There was no statistical difference in operation time [(175 ± 11) min vs. (182±6) min, t = 1.556, P = 0.072] and length of stay in hospital [(16.8 ±9.8) d vs.(17.0 ± 11.3) d,t = 1.495,P= 0.068] between the gastric tube group and the traditional way group. Conclusion Gastric tube has good value in clinical application with fewer complications and without prolonging operation and hospitalization time, which can surely ameliorate quality of life.

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Clinical efficacy of bowel obstruction treated by octreotide

Changyan WANG

Chinese Journal of Postgraduates of Medicine.2011;34(8):19-21. doi:10.3760/cma.j.issn.1673-4904.2011.08.008

Objective To observe the clinical efficacy of octreotide for treatment of bowel obstruction. Methods Ninety-five cases of bowel obstruction treated from January 2007 to July 2010 were divided into study group (48 cases) and control group (47 cases) by random digits table. Patients in control group received the conventional therapy including fasting, gastrointestinal decompression, total parenteral nutrition, sufficient fluid infusion, water-electrolyte and acetic-alkali equilibrium maintenance and infection prevention, while patients in study group received octreotide 0.1 mg by subcutaneous injection on the base of above conventional therapy, the clinical symptomatic relief time, gastrointestinal decompression volume,anus exhaust time, hospitalization time and effective power of both groups were observed and compared.Results The clinical symptomatic relief time, gastrointestinal decompression volume, anus exhaust time and hospitalization time in study group were all significantly lower than those in control group, the differences was statistically significant (P ＜ 0.05); the effective power in study group was 97.9%(47/48),which was significantly higher than that in control group(87.2% ,41/47), the difference was statistically significant(P ＜0.05). There was no obvious adverse reactions occurred, the patients of treatment futility were therapied by surgery later. Conclusion Octreotide used to treat bowel obstruction has a reliable efficacy with low reverse reaction and deserves general application.

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Cause and management of difficult laparoscopic appendectomy

Yanghua LIU ; Youzhu LI ; Peizhong XIAN ; Meirong LI ; Chunan LIU ; Feipeng XU

Chinese Journal of Postgraduates of Medicine.2011;34(8):17-18. doi:10.3760/cma.j.issn.1673-4904.2011.08.007

Objective To study the cause and management of difficult laparoscopic appendectomy.Method A retrospective analysis of 102 difficult laparoscopic appendectomies was performed. Results The associating factors leading to operative difficulty were as follows:adhesion of peri-appendix in 44 cases,gangrene at root of appendix in 21 cases,special location of appendix in 17 cases,abdominal adhesion in 12 cases,obesity and inflatable intestine in 8 cases. Laparoscopic appendectomy was successfully performed in 96 cases(94.1%,96/102) ,and no intestinal leakage or massive hemorrahge occurred. Conclusions Adhesion of peri-appendix is the most common cause in difficult laparoscopic appendectomy,and gangrene at root of appendix is the most difficult one. Reasonable management for appendix stump contributes to successful operation.

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