Study of the clinical value of medical history and clinical manifestation-based protocol for the diagnosis of spontaneous coronary artery dissection using intravascular ultrasound / 中华超声影像学杂志

Objective To investigate the feasibility and clinical value of medical history and clinical manifestation-based protocol(MHCMP) for the diagnosis of spontaneous coronary artery dissection(SCAD)using intravascular ultrasound (IVUS).Methods Based on the MHCMP designed in our centre,intraoperative sequential analysis was performed in patients with acute coronary syndrom and clinical tip of SCAD,SCAD and its classification were defined according to the result of IVUS.Results Of the 37 patients admitted with ACS at the Cardiology Service,29 patients had SCAD as the cause(78.4 ％).All the patients underwent coronary angiography and IVUS,of which 9 patiens were type I (24.3 ％),15 patients were type Ⅱ (40.5％) and 5 patients were type Ⅲ (13.5％).The left anterior descending artery was the most frequently affected (16 patients),followed by the the right coronary artery (7 patients),while 5 patients had dissection of the circumflex artery and 1 patient had dissection of the left main coronary artery.Type I (evident arterial wall stain):this was the pathognomonic angiographic appearance of SCAD with contrast dye staining of the arterial wall with multiple radiolucent lumens.Type Ⅱ (diffuse stenosis of varying severity):this angiographic appearance was not well appreciated and was often missed or misdiagnosed.SCAD commonly involved the mid to distal segments of coronary arteries,and could be so extensive that it reached the distal tip.There was an appreciable (often subtle) abrupt change in arterial caliber,with demarcation from normal diameter to diffuse narrowing.This diffuse and usually smooth narrowing could vary in severity from inconspicuous mild stenosis to complete occlusion.Type Ⅲ (mimic atherosclerosis):this appearance was the most challenging to differentiate from atherosclerosis and most likely to be misdiagnosed,while IVUS was helpful for the differential diagnosis.Conclusions MHCMP is able to screen out all kinds of SCAD and guide the treatment decisions making.

Curative Effect Observation on Yixin Tongmai Decoction in Prevention and Treatment of Restenosis after Coronary Stenting of Diabetes Mellitus Complicated with Coronary Heart Disease Cases / 世界科学技术-中医药现代化

This study was aimed to evaluate the efficacy and safety of Y ixin Tongmai Decoction in prevention and treatment of diabetes mellitus complicated with coronary heart disease ( CHD ) after coronary stenting restenosis . Sixty cases were randomly divided into the conventional western medicine treatment plus Y ixin Tongmai Decoction group ( treatment group ) and conventional treatment of western medicine group ( control group ) . Observation was given on the in-stent restenosis before treatment and one-year after treatment . And the traditional Chinese medicine ( TCM ) Syndrome Scale , changes of single symptom in TCM syndrome , effect of Y ixin Tongmai Decoction on blood glucose and other adverse reactions were also observed before and one-year after treatment . The results showed that in the curative effect evaluation , the restenosis rate of treatment group was 6 . 90%, and the restenosis rate of control group was 17 . 24%. There was significant difference be-tween two groups ( P < 0 . 05 ) . According to the standard of TCM syndrome curative effect , the total effective-ness in the treatment group was 86 . 21%, and that of the control group was 31 . 03%. And there was signifi-cant difference between two groups ( P < 0 . 05 ) . In the safety evaluation , there were no obvious abnormalities during safety detection in the clinical study of two groups. There was no influence on blood sugar levels. And no drug related adverse reactions occurred . It was concluded that Y ixin Tongmai Decoction can reduce coro-nary stent restenosis rate in diabetes complicated with CHD (chest pain) with the syndrome of qi deficiency and blood stasis , phlegm-turbid stasis . It can significantly improve the TCM syndrome and single symptom of patients with good safety .

Insight and inquiry for the corporate governance reform of public hospitals in Weifang / 中华医院管理杂志

An introduction to general guidelines and practices of reforming the corporate governance of public hospitals in Weifang,Shandong province.Such guidelines and practices include the following:set up a government hospital administration,and clarify the rights and responsibilities of public hospital owners; clarify the independent status of legal person of the hospital to revitalize it; improve the check and balance mechanism to ensure its effectiveness and order.Such a reform has streamlined the management framework of public hospitals,and mobilized incentives of both the director and the staff,further enhancing the public benefit characteristics of the hospitals and satisfying the patients.

Investigation and analysis of the perceived stigma among family members of people with schizophrenia / 中华护理杂志

Objectives To explore the perceived stigma among family members of people with schizophrenia and to identify the influential factors related to perceived stigma in socio-demographic characters of family members and patient characters.Methods Total 127 family members of people with schizophrenia in a psychiatric hospital in Beijing were surveyed by the Perceived Devaluation-Discrimination Scale developed by Link.Results The mean score of the perceived devaluation-discrimination scale is 2.60±0.44.It was significantly higher than the 2.5 midpoint(t=2.53,P<0.05).Family member's perceived stigma was significantly different between different groups of residence area,education level,occupation and family income (P<0.05).Perceived stigma were not affected by patient characters (P>0.05).Family members'education level was the influencing factors of stigma,and the R~2 Square is 0.213.Conclusions The family members of people with schizophrenia suffered from high stigma.Education level of family member may be one of the influential factors.