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Objective To investigate the acute phase adverse effects and influencing factors of adverse effects of diphosphonate treatment in the elderly patients with primary osteoporosis.Methods A total of 208 patients [male 25 patients,female 183 patients,age 60 ～ 93 with a average of (75.51 ± 7.73) years] with primary osteoporosis were selected from 1 Jan 2012 to 30 Nov 2015,admitted to Department of Geriatrics.According to the serious condition of osteoporosis and willingness of patients,208 patients were divided into zoledronic acid treatment group,alendronate treatment group,and pamidronic acid group,and received corresponding diphosphonate treatment.All kinds of adverse reactions of diphosphonate in each treatment group were closely to be observed after administration of diphosphonate in 3 days and 7 days.Results The incidence rate of adverse reactions in the zoledronic acid treatment group (59/134,44.03％;60/134,44.78％) was obviously higher than that in the alendronate treatment group (1/57,1.75％;1/57,1.75％),and the pamidronic acid group (3/17,17.65％;3/17,17.65％) after treatment of diphosphonate in three and seven days (P ＜ 0.05).In different generations,the incidence rate of adverse reactions in the zoledronic acid group and the pamidronic acid group after treatment of diphosphonate in three and seven days was not statistically significant (P ＞ 0.05).There were three patients suffering from severe acute kidney injure (AKI) and three patients suffering from hypokalemia in the 134 patients treatment with zoledronic acid.Conclusions There are obvious differences in the incidence rate of acute phase adverse reactions in the osteoporosis patients who received different treatment policy (P ＜ 0.05).The safety issues in the kidney function and electrolyte abnormality (such as hypokalemia) should be paid much enough attention in the primary osteoporosis patients who receive zoledronic acid treatment.
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Objective To understand the use of antiplatelet drugs in patients with coronary heart disease( CHD) ,and to compare the effect of different anti platelet drugs on cardiovascular events in patients with CHD,and to provide clinical evidence for the optimization of anti platelet therapy?Methods One thousand and twenty?three cases patients with CHD who were treated in the First Hospital Affiliated to Chongqing Medical University from April 2010 to June 2014 were chosen?On the basis of conventional treatment,according to the different anti platelet program,the patents were divided into A group(703 cases),B group(211 cases) and C group(109 cases)?Group A was treated with aspirin and clopidogrel,B group was treated with clopidogrel,and C group was given aspirin therapy?Cardiovascular events( MACE) and bleeding events were observed at 1 month,6 months and 1 year after treatment in the 3 groups?Results After treatment for 1 month,6 months and 1 year,the incidence rates of MACE in group A were 9?1%( 64/703) ,16?6%( 117/703) and 28?4%( 200/703) ,in group B were 14?6%(31/211),25?5%(54/211) and 37?9%(80/211),in group C were 16?5%(18/109),29?4%( 32/109) and 34?0%( 37/109)?After treatment for 1 month,6 months and 1 year,the incidence rates of MACE in group A was significantly lower than group B and C(P0?05)?There were no significant differences in total incidence of deaths,the recurrence rate of myocardial infarction and stent restenosis rate among the three groups ( P>0?05 )?After treatment for 1 month,6 months,the incidence of angina in group A was lower significantly than that in group B and C( P0?05)?At 1 year follow?up,the incidence of gastrointestinal bleeding in group A was slightly higher than that in group B and group C ( 4?3% vs? 2?4% vs?3?7%) , but the difference was not statistically significant ( P>0?05 )?Conclusion In the CHD patients receiving aspirin and clopidogrel dual antiplatelet therapy,the incidence of MACE was lower than that in patients with aspirin or clopidogrel treatment alone, especially a reduction in the incidence of angina,and without increase of the risks in the gastrointestinal bleeding events,but the advantages above waning with treatment time extended to 1 year.
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Objective To explore the clinical manifestations,diagnosis,misdiagnosis and treatment of primary hyperparathyroidism.Methods The clinical data of 36 patients with primary hyperparathyroidism admitted into the First Affiliated Hospital of Chongqing Medical University from January 2009 to October 2014 were reviewed and analyzed retrospectively.Results The manifestations of primary hyperparathyroidism were various and atypical.Primary hyperparathyroidism was often misdiagnosed as other diseases by 25.0％ (9/36).Among the patients,the ratio of male to female was 1:1,and median age was 58 years old.Of all patients,there were 9 persons with joint pain,digestive system symptoms in 7 cases,cervical mass discovered in 6 cases(3 cases were found when B ultrasonic examination),urinary calculus in 5 cases,fatigue symptoms in 4 cases,osteoporosis and urinary calculus in 2 cases,1 case with fracture,2 cases without any symptoms.Their calcium and parathyroid hormone level were increased by various degree.The accuracy rates of level diagnosis of Color Doppler ultrasound combine with CT or 99Tcm-MIBI were improved obviously,85.2％ and 93.1％ respectively.Twenty-eight patients received surgical treatment and pathology examination confirmed the accurate pathological types after surgery.There were 23 cases of parathyroid adenoma,1 case parathyroid hyperplasia,1 case parathyroid carcinoma,2 cases of parathyroid adenoma with nodular goiter,parathyroid adenoma merged thyroid carcinoma in 1 case.Serum calcium and parathyroid hormone level declined obviously after operation.The other 8 patients received non-surgical treatment,7 cases were alleviated and 1 case died due to irreformable high blood calcium crisis.Conclusion There should be pay attention to recognize primary hyperparathyroidism,check the blood calcium,and about suspected cases should be performed as early as parathyroid tested,neck color Doppler ultrasound.Early surgical treatment can significantly improve the prognosis and quality of life.
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Based on the quality of students, we reasonably arranged thetraining course content and enhanced the training of clinical skills; and at the same time focused on teacher training of general practitioners to strengthen the training bases, so as to improve the overall construction of teaching effect, to adapt to the actual medical need of the community and improve community medical service level to achieve the purpose of general practitioners training.
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This experiment was carried out to analyze the time-frequency feature of rabbit cortical somatosensory evoked potential (SEP). Rabbit was narcotized and subjected to craniotomy. SEP was from sensory and motor cortex. Stimulation was continuing many times and signal was sampled at 3 800 Hz. The peak latency of each waveform was measured. Power spectrum of SEP was analyzed. The time-frequency feature of single-trial was compared with that of average SEP. It was found that the variability of single-trial SEP latency enlarges with time in a stimulation period. The spectrum of SEP includes three main frequency spectrum packages. The technique of summation makes a lot of signal aberration such as waveform confluence, new waveform emerging and after-discharging components dismissing.
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Animals , Female , Male , Rabbits , Cerebral Cortex , Physiology , Electric Stimulation , Evoked Potentials, Somatosensory , Physiology , Fourier Analysis , Signal Processing, Computer-AssistedABSTRACT
DNA was extracted from the peripheral venous blood of 338 subjects using BLOOD DNA MINI KIT. The 5 site SNP in 3 subtypes of Beta-AR were genotyped by PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) and allele-specific primer PCR techniques. The genotypes combination distribution of SNP at 5 sites in the 3 subtypes of Beta-AR were determined by clustering analysis technique. The natural combination distribution characteristics for SNP at 5 sites in the 3 subtypes of Beta-AR in 338 subjects were obtained. Sixty-seven combinations types were found. The preceding 5 combinations in the natural combination distribution of the SNP were: (1) The genotype combination of forty subjects was B1-AR S/S49+B1-AR R/R389+B2-AR R/G16+B2-AR Q/E27+B3-AR W/W64, its probability was 11.83%. (2) The genotype combination of thirty-three subjects was B1-AR S/S49+B1-AR R/R389+B2-AR R/G16+B2-AR Q/Q27+B3-AR W/W64, its probability was 9.76%. (3) The genotype combination of nineteen subjects was B1-AR S/S49+B1-AR R/G389+B2-AR R/G16+B2-AR Q/Q27+B3-AR W/W64, its probability was 5.62%. (4) The genotype combination of sixteen subjects was B1-AR S/S49+B1-AR R/G389+B2-AR R/G16+B2-AR Q/E27+B3-AR W/W64, its probability was 4.74%. (5) The genotype combination of thirteen subjects was B1-AR S/G49+B1-AR R/R389+B2-AR R/G16+B2-AR Q/E27+B3-AR W/W64, its probability was 3.85%. The obvious correlations exist among full sample and female or male subgroup, and between female and male subgroups.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Genotype , Polymerase Chain Reaction , Methods , Polymorphism, Single Nucleotide , Genetics , Receptors, Adrenergic, beta , Classification , Genetics , Receptors, Adrenergic, beta-1 , Genetics , Receptors, Adrenergic, beta-2 , Genetics , Receptors, Adrenergic, beta-3 , GeneticsABSTRACT
Objective:To find the clinical features and to supply the preventive and therapeutic methods.Methods:The death causes of the elderly in-patient in urban and outskirt hospitals between1989-1998 were surveyed and analyzed retrospectively.Results:Of the death causes in the elderly in-patients according to systems,respiratory systemic diseases ranked in the first,which accounted for 1.56%,and then the other death causes ranking in order were gastrointestinal disease,nerve system disease,cardiovascular disease,accidental and toxic damage etc.The death causes according to types ranked in order as follows,the first one was malignant tumor,its mortalityrate was 1.22% in the elderly in-patient group (of all malignant tumors,the mortality of primary lung cancer,liver cancer and gastric cancer was 0.40%,0.12% and 0.12% respectively).After that the death causes ranking in order were cerebral vascular disease,chronic bronchitis and emphysema,coronary heart disease,pulmonary heart disease,diabetes mellitus,hepatic cirrhosis,essential hypertension etc.Conclusion:It is of importance for the aged to take preventive measures as to do routine physical examination to detect and prevent risk factors of some diseases and change the improper living habits.
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Objective:To study genetype combination distribution and allele frequency distribution of NOS2 C-1173T and G-954C single nucleotide polymorphisms (SNP) of inducible nitric oxide synthase(NOS2) in the Chinese Han nationality population.Methods:Genomic DNA of leukocytes in venous blood was obtained from 565 Han Chinese people(female 251 and male 314).The NOS2 G-954C and NOS2 C-1173T SNPs were genotyped by nested allele-specific primer (NASP)PCR.Results:The genotype frequencies of CC,CT and TT were 66.73%,26.37% and 6.90% respectively in the NOS2 C-1173T SNP.C and T allele haplotype frequencies of NOS2 C-1173T SNP was 79.88% and 20.12% respectively.The genotype frequencies of NOS2 GG,GC and CC were 61.77%,37.88% and 0.35% respectively in the NOS2 G-954C SNP.G and C allele haplotype frequencies was 80.71% and 19.29% respectively in the NOS2 G-954C SNP.The preceding 5 combinations in the natural combination distribution of two sites of NOS2 SNP were found as follows:(1)The genotype combination of 233 subjects was NOS2 C-1173C+G-954G,its probability being 41.24%.(2)The genotype combination of 143 subjects was NOS2 C-1173C+G-954C,its probability being 25.31%.(3)The genotype combination of 89 subjects was NOS2 C-1173T+G-954G,the probability being 15.75%.(4)The genotype combination of 59 subjects was NOS2 C-1173T+G-954C,the probability being 10.44%.(5)The genotype combination of 27 subjects was NOS2 T-1173T+G-954G,the probability being 4.78%.Conclusion:This study shows the features of combination distribution and frequency distribuion of NOS2 SNPs and provides the basic laboratory data for the further study relationships among NOS2 SNPs,its physiological function and diseases.
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0.05).The comparison of the above HPS parameters showed that only APH was significantly lower than that in the group with TT allelic genotypes of NOS3 G894T(P