Objective In this study group of 180 patients randomized,single-blind divided into:BNP group and control group.Methods Through the continuous 2 years observing two groups of patients with cardiovascular endpoint events:any cardiovascular death,cardiovascular events in hospital(heart failure,acute coronary syndrome and cerebrovascular accident any need to increase the drug outside of the onset of decompensated heart failure)Results No difference in all-cause mortality between the two groups,the BNP group decreased significantly due to heart failure hospitalization rate(P0.05),BNP group lobbying uses the proportion of patients with heart failure drugs resistance was higher than that of the control group(P0.05),BNP group,the incidence of cerebrovascular accident was lower than that of the control group(P0.05),BNP ACS disease incidence was lower than that of the control group(P0.05).Conclusion Under the guide of BNP in elderly patients with chronic heart failure management model in terms of readmission for heart failure is better than that of the conventional management mode,and has certain advantages in prevention of ACS cerebrovascular accident,is worthy of reference for clinical.

Objective:To determine preliminarily the feasibility and a one-stop strategy of CT urography and angiography in one scanning acquisition using 4-slice MDCT. Materials and methods:Seventy-five consecutive patients (41 men and 34 women; mean age 52 years; age range, 22 to 86 years) without evident hydronephrosis who asked for CT urography (CTU) examination received the new technique of CTUA using by 4-MDCT. Twice-bolus protocol consisted of 50 mL of contrast material (300 mg per milliliter of iodine) immediately after urinating at 2~2.5 mL/sec at 0 seconds and 50 mL at 3.5~4 mL/sec at 20 minutes through the forearm vein. CT scanning (CTUA) started with one breath-hold 20 seconds after the second injection with 10 mm of slice thick, 0.75:1 of pitch and 15 mm/rot of speed. Five minutes after the second injection, CT scanning started again using the same parameters for routine CTU. After thin-slice reconstruction of 5 mm thick and 2.5 mm interval, all the images data were then transferred to an ADW 4.2 workstation to post-process by 3D VR software. Excellent rate of visualization of renal parenchyma, urinary tracts, and main arteries on CTUA and CTU images were reviewed and assessed independently first and interpreted agreeably by two experienced radiologists. Statistical analysis was performed using variance analysis (ANOVA) to evaluate the difference, and P 0.05 is considered statistically significant. Results:The technique success rate of CTUA was 100%, and excretory-corticomedullary phase source images were acquired, which the good rate of distinguishing the renal cortex from the medulla and calices was 100% (148/148), while the CTU source images were not well depicted the renal cortex, medulla and calicessimultaneously (P = 0.000). The good opacification of the renal calices, ureter, bladder, and the renal artery, the aorta and iliac artery was achieved in 95.94% (142/148), 94.59% (140/148), 95.95% (71/74), and 87.16% (129/148), 96% (72/75), 81.33% (122/150) of segments, respectively in CTUA, and 100% (148/148), 97.97% (145/148), 98.65% (73/74), 0%, 0%, 0% of segments, respectively in CTU. Urinary tracts were shown slightly better in CTU than in CTUA (P 0.05), but the arteries were shown significantly better in CTUA than in CTU (P = 0.000), and the CTUA could accurately reveal the tumor, stones, inflammation, prostatic hyperplasia, atherosclerosis and all kinds of deformities of urinary tract and vessels. Conclusion:It is technically adequate for a one-stop CTUA to achieve by using a single excretory-corticomedullary phase CT scanning after twice-bolus contrast injection with routine concentration and volume with once venepuncture. It three-dimensionally reveals renal parenchyma, urinary tract and main arteries simultaneously and the renal cortex, medulla and calices are also distinguished clearly.

<正>患者男,55岁。3天前因进食不洁出现脐周持续性隐痛,阵发性绞痛,予以山莨菪碱等对症治疗可缓解,伴恶心、呕吐2次,无腹泻、发热。血常规示白细胞、中性粒细胞明显升高。血、尿淀粉酶及尿常规正常。查体:急

研究发现,髋关节牵引可导致旋股内、外动脉尤其股骨头供养血管闭塞与血运障碍[1-3],为了观察持续牵引、闭塞这些血管对股骨头血循环的影响尤其会否发生股骨头坏死(osteonecrosis of the femoral head,ONFH),笔者进行了经皮经腔犬旋股内动脉内结扎术(percutaneous transluminal medial femoral circumfflex arterial ligation,PTMFCAL)的研究,结果报告如下。

Objective To observe the relationship between the level of serum uric ucid and the degree of hypertension. Methods The value of serum uric ueid was measured in 61 cases with essential hypertension (grade Ⅰ,Ⅱ,Ⅲ were 6,21 and 34 cases respectively)and in 53 in-patients without hypertension in the same period. Results Serum uric ueid levels,as well as the rate of hyperurieemia,in eases with essential hyperten- sion was higher than that in non-hypertension eases( P < 0. 05 ). Comparison with group non-hypertension, group grade Ⅰ and Ⅱ hypertension, group grade Ⅲ hypertension showed longer duration, higher levels of serum uric ueid( P <0.01 ). Conclusion The level of serum uric ueid and the rate of hyperuricemia in essential hyperten-sion increased significantly, and the higher of the degree, the longer of the duration, the more significant the in-creasing was.

Objective To analyze the correlation and mechanism between the level of serum uric acid and carotid artery atherosclerosis in patients with essential hypertension(EH).Methods A total of 61 patients with EH(divided into gradeⅠ,Ⅱ and Ⅲ)and 53 patients without hypertension were enrolled.The value of serum uric acid was measured and carotid ultrasound was performed.Results The mean value of serum uric acid in patients with or without EH was(339.3±121.3)μmmol/L and(295.1±89.8)μmmol/L,respectively(P0.05),and hypertension grade Ⅲ was significantly higher than that of grade Ⅰ and Ⅱ(P0.01).The detection rate of carotid atherosclerosis with ultrasound in cases with EH(52.46%)was higher than that in non-hypertension group(35.85%,P0.05).The rates of hyperuricemia and carotid atherosclerosis were not had statistical different among grade Ⅰ,Ⅱ and Ⅲ(P0.05).The rate of carotid atherosclerosis in group hypertension with hyperuricemia was higher than that either in group hypertension without HUA(P0.05)or in group non-hypertension with hyperuricemia(P0.05).Conclusion The patients with EH have high level of serum uric acid and will easily suffer hyperuricemia and carotid atherosclerosis.Hypertension with hyperuricemia increases the risk of carotid atherosclerosis.

Objective: To investigate the techniques of radioactive Iodine-125 seeds implantation for cancer interstitial brachytherapy and to determine the value and application of imageology. Methods: Fifty-five procedures of Iodine-125 seeds implantation were performed in 43 patients with 0.5 - 0.8 mCi seeds and intervals from 5 mm to 15 mm, which 7 of them guided by CT, 6 by small C-arm, 7 by endoscopy and 36 by surgery. Follow-up study by imaging were done for 159 which from 1 to 8 every case, and there were one to 612 days, mean 56 days, for the first imaging evaluation after seeds placement. Results: All procedures were once successful and the total therapeutic effect was 83.7% (36/43) without any serous complications. The period recovered from operation was 1day to 3 days and that of procedure guided by CT was all one day. The seed position was partially shifted in 3 cases which was detected by X-ray plain films. And the plain accurately determined seeds number, but distribution, in 38 cases, which needed to combine posteroanterior chest film with lateral one in 19 cases. Thirty-nine CT examinations showed satisfactorily seeds distribution but accurate seeds number, including all that implanting guided by CT and found seeds distribution outside of tumor in 32 ones. All of 84 CT examinations well depicted tumor change. Conclusion: Iodine-125 seeds implantation was safe and effective for cancer interstitial brachytherapy, imageology especially CT played important role in guiding during seeds implantation and follow-up studies.