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ObjectiveTo validate the feasibility and accuracy of right ventricular (RV) volume and systolic function with single cardiac cycle real-time three-dimensional (3D) echocardiography. MethodsThree-dimensional images of RV and left ventricle (LV) were obtained in 122 healthy adults by 3D matrix array transducer. The end systolic volume (ESV), end diastolic volume (EDV), stroke volume (SV) and ejection fraction (EF) were measured by RV analysis and LV analysis software. To validate the reliability of measurement of right ventricle by real-time three-dimensional echocardiography, the correlations of RV functional parameters and multiple parameters (such as age, gender and body surface area) were analyzed. And the correlation and difference between different modalities of left ventricle and right ventricle were compared.Results3D-RVEF was (55.66±13.97)%, 3D-RVEDV was (68.24±40.19) ml, 3D-RVESV was (30.09±19.14) ml and 3D-RVSV was (38.30±26.10) mL. RVSV and RVEF of normal men were larger than those of normal women, but no statistical difference were found [(40.15±26.15) mlvs (36.11±25.60) ml, (55.69±14.57)%vs (55.62±13.36)%, bothP>0.05]. RV related function parameters had no relevant correlation with age (P>0.05). Body surface area was weakly related to RVEDV, RVESV and RVSV (r=0.236, 0.247 and 0.178, allP<0.05). BSA had no correlation with RVEF. 3D-RVSV and 3D-RVEDV were weakly positively correlated with 3D-LVSV and 3D-LVEDV (r=0.215 and 0.201, bothP<0.05). 3D-RVEF and 3D-RVESV were not correlate with 3D-LVEF and 3D-LVESV.ConclusionThe single cardiac cycle real-time three-dimensional echocardiography is a simple and feasible method for assessment of right ventricular function and can quantify right ventricular contractive function precisely.
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Objective To discuss the efficacy and safety of sitagliptin combined with metformin in treatment of type 2 diabetes mellitus(T2DM).Methods One hundred patients with T2DM were divided into two groups by random digits table method with 50 cases each.The patients in study group were given phosphate sitagliptin (100 mg,day 1 oral) combined with metformin (500 mg,day 3 oral).The patients in control group were given repaglinide (1 mg,day 3 oral) combined with metformin (500 mg,day 3 oral).They were treated for 12 weeks and fasting plasma glucose(FPG),2 h postprandial blood glucose(2 h PG),glycosylated hemoglobin (HbA1c),fasting insulin (FINS),body mass index (BMI) and the incidence of hypoglycemic events were detected before and after treatment.Results After treatment,the level of FPG,2 h PG,HbA1c was significantly lower than that before treatment in two groups,and there was significant difference (P ＜ 0.01).The level of B MI after treatment was significantly decreased [(24.45 ± 2.13) kg/m2 vs.(25.46 ±2.62) kg/m2] and FINS was significantly increased [(13.36 ± 1.89) mU/L vs.(12.36 ± 1.80)mU/L] compared with that before treatment in study group (P ＜ 0.05 or ＜ 0.01).But the level of BMI and FINS had no significant difference before and after treatment in control group (P＞ 0.05).The incidence of hypoglycemic events had significant difference between study group and control group [0 vs.12％ (6/50)] (P ＜ 0.05).Conclusions Sitagliptin combined with metformin is safe and effective in treatment of type 2 diabetes mellitus,which is the preferred solution treatment.The risk of hypoglycaemia events is obviously reduced,also it can control and reduce weight and other advantages.
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Objective To analyze the change and clinical significance of blood lipid and high sensitive-C reactive protein (hs-CRP) in patients with subclinical hypothyroidism.Methods Fifty patients with subclinical hypothyroidism were selected as observation group,and 50 health people with the same gender and age were selected as control group.The blood lipid and hs-CRP levels in the two groups were measured and compared.Results The total cholesterol (TC),triacylglycerol (TG),and low density lipoprotein cholesterol (LDL-C) in observation group were significantly higher than those in control group [(5.20 ±0.84) mmol/L vs.(4.79 ±0.80) mmol/L,(2.21 ±0.97) mmol/L vs.(1.78 ±0.60) mmol/L,(3.25 ±0.65) mmol/L vs.(2.83 ±0.51) mmol/L],high density lipoprotein cholesterol (HDL-C) was significantly lower than that in control group [(1.18 ± 0.15) mmol/L vs.(1.28± 0.22) mmol/L],and there were statistical differences (P ＜ 0.05 or ＜ 0.01).The hs-CPR in observation group was significantly higher than that in control group [(4.2 ± 1.1) mg/L vs.(3.0 ± 0.8) mg/L],and there was statistical difference (P ＜0.01).Conclusions Subclinical hypothyroidism can cause increased TC,TG,LDL-C and hs-CRP and decreased HDL-C,which may accelerate atherosclerosis and cardiovascular disease.It is necessary to timely screen and treat the disease.
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Objective To investigate the application of evidence-based nursing in the patients with cerebrospinal fluid leakage (CSFL) after vertebrae surgery.Methods 60 cases of patients were randomly divided into the observation group and the control group (30 cases in each),the control group was given conventional nursing,the observation group used evidence-based nursing,which was established by referring to some data and literatures according to a series of related nursing problems,getting direct and indirect evidence,and through analysis and summarizing to set up the nursing project for implementation.The incidence of intracranial hypotension headache,hyponatremia,wound healing disorders,infection of intervertebral space were compared.Results In the observation group,incidence of postoperative intracranial hypotension symptoms,postoperative hyponatremia,the incidence of wound healing disorders was statistically different from that of the control group.The incidence of infection in two groups showed no significant difference.Conclusions Using evidence-based nursing can reduce a series of complications in patients with CSFL after cervical surgery,control infection effectively,improve patients' comfort and improve the quality of nursing.
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In recent years' many key medical colleges directly under Ministry of Public Health in our country have incorporated with comprehensive or multi-disciplinary universities.On this condition we must make good use of the advantages of the comprehensive universities in order to serve medical education development and train high-quality medical talents in humanism spirit.This article covers the following aspects: the necessity of strengthening medical students' humanism education, connotation of medical students' humanism education and ways as well as methods of enhancing medical students' humanism education.