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BACKGROUND: Coronary artery disease (CAD) risk in type Ⅱ diabetics is one of the hot topics in clinical research.OBJECTIVE: By using electron-beam tomography(EBT) technology, heart scans were performed to investigate coronary artery lesion in type Ⅱ diabetics and their CAD risks were evaluated as well.DESIGN: Comparative study based on type Ⅱ diabetics complicated with coronary artery lesion.SETTING: Gerontology department in a hospital affiliated to a military medical university of Chinese PLA.PARTICIPANTS: From January 2002 to June 2004, 93 inpatients between the ages of 36 and 78 in the Gerontology Department of Xijing Hospital, an affiliation to the Fourth Military Medical University of Chinese PLA, were selected(male 80, female 13) . Totally 25 of all the patients proved normal by physical examinations were set as normal control(male 22, female 3) group; other inpatients were divided into the abnormal blood glucose group and the coronary heart disease (CHD) group respectively according to their examination results. Of the 57 patients in the abnormal blood glucose group,49 were male and 8 were female. This group was divided into two subgroups:the impaired glucose tolerance group(IGT) containing 29 patients and the diabetes group containing 28 patients. In this group, 44 patients have had heart symptom of different extent. Of the 11 patients in the CHD group, 9 were male and 2 were female. Inclusion criteria: patients with type Ⅱ diabetes were defined by American Diabetes Association in 1979; patients with CHD were defined in the report of the Joint International Society and Federation of Cardiology/World Health Organization Task Force on the standardization of clinical nomenclature and criteria for diagnosis of ischemic heart disease in 1979, and they were all confirmed by coronary angiography. Exclusion criteeases.METHODS: Both plain EBT heart scanning and contrast-enhanced heart scanning were performed on the 93 patients to evaluate the occurrence of coronary artery calcification(CAC), the number of stenosed coronary arterie,and the number of soft plaques. Additionally, other examination results including blood glucose, blood HbA1c and blood lipid were also collected for comparison between the conditions of coronary artery and assessment of the CHD risk among groups.MAIN OUTCOME MEASUREMENTS: In all the groups, the occurrence of CAC, the number of stenosed coronary arteries and the number of plaques were compared, and the CHD risk was analyzed.RESULTS: The occurrence of coronary artery calcification was significantly increased in all the study groups as compared with the control group(x2 = 18.88, P < 0. 01 ). Increasing trend was also observed in the study groups when calculating the number of branches with coronary stenosis and plaques ( F = 10. 758, P < 0. 01; F = 9. 991, P < 0.01 ). CHD risk in diabetes was estimated to be 7. 514 (95% confidence interval, 1. 885 -63. 778).CONCLUSION: Coronary artery lesion can be easily observed in type Ⅱ diabetics,and high CHD risk is predicted in this population. Early diagnosis of CAD and early rehabilitation intervention in grade 2 are extremely important in improving the quality of life and reducing the disability ratio of type Ⅱ diabetics.Huang C, Gao JY, Wong XM, Li R, Yang AL, Zheng MW, Xue FB. Risk analysis of coronary artery disease in type Ⅱ diabetics.
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Objective To develop converting rule from international classification of disease (ICD) codes of trauma to abbreviated injury scale (AIS) values so as to provide clues for a simple and convenient trauma scoring way. Methods The corresponding set relations were made for ICD-9CM codes and AIS-90 codes with similar code meanings in the trauma diseases. Based on medical theories and knowledge, 8 indeces closely associated with injury severity were worked out for each ICD-9CM code of trauma diseases by using the database of discharge abstracts of trauma patients. Discriminant analysis was used to set up corresponding relations of ICD-9CM codes with AIS values. Results Seven indices were selected for discriminant function. Corresponding relations of all ICD-9CM codes of trauma diseases with AIS values was made through nonparametric discriminant method. Under deliberation and revision by several clinical experts on traumatology, the converting rule was established eventually. Consistency analysis between the sample's international classification of disease injury severity score (ICISS) values and injury severity score (ISS) values showed that ICISS values were closely correlated with 2-ICISS (Y=Ln), with correlation coefficient of 0.831 1 ( P
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Objective To develop a new comprehensive trauma score method based on international classification of diseases(ICD) and evaluate the effectiveness of its use in cerebral injured patients.Methods The model of the new trauma score method was constructed by referring to those of some certain comprehensive trauma score methods generally used around the world.Receiver operating characteristics(ROC) analysis was employed to evaluate the effectiveness of outcome prediction for 355 cerebral injured patients using the new developed trauma score method.Statistical comparisons were performed between the AUC for the new trauma score values and that of NISS values derived from two professional raters.Results The area under the curve(AUC) for the new trauma score values was as large as 0.925 4,whose 95% CI ranged from 0.863 4 to 0.987 5,and is statistically different from 0.5(P