Objective To evaluate the current situation in the diagnose and treatment of chronic cough in community medicine in Tangxia town of Dongguan city. Methods Questionnaires were completed in 18 public ser-vice stations of community health services (1 community health service center and 17 health service stations) in com-munity medicine in Tangxia town of Dongguan city. A total of 37 doctors were randomly recruited from the 18 public service stations of community health services, with 3 from the community health service center and 2 from each health service station. Results Only 5.4%(2/18) public service stations of community health services launched X-ray exam-ination, and no public service station of community health services can perform pulmonary function test. All the gener-al practitioners selected antibiotics and Chinese patent medicine as first choice drugs. No doctors expressed that they understood and carried out the directory of chronic cough, only 8.1%doctors expressed that they heard but not under-stand it. 94.6%doctors were not satisfied with the current diagnose and treatment of chronic cough, 81.1%of which believed that the main reason was the patients' economic status. Conclusion It is imperative to spread the experience treatment of chronic cough in public service stations of community health services.

Objective To observe the curative effect of tanshinone II A sodium sulfonate injection on acute cerebral infarction and the effect which to D-dimeric.Methods The treat group using tanshinone II A sodium sulfonate injection and the control group using troxerutin. And to compare the clinic curative effect between the two groups and the changes of D-dimeric content in serum after treatment. Results The total effective rate of treat group was 92.5% and the other was 80.0%(P0.05). The D-dimeric content in serum in the two groups were decreased obviously; it was more desereded obviously in the treat group than the control group(P<0.05).Conclusion The tanshinone II A sodium sulfonate injection which treat on acute cerebral infarction can advance blood supply to brain early recovery, improve microcirculation and degrade the D-dimeric content and promote patient recovered.

目的观察尤瑞克林治疗急性脑梗死的疗效及其对血清超敏C-反应蛋白(hs-CRP)的影响。方法将40例有溶栓禁忌证的轻-中度急性脑梗死患者随机分为2组,每组20例。治疗组给予尤瑞克林及常规治疗3周,对照组仅给予常规治疗。治疗前、后对2组患者进行神经功能缺损程度评定以判定临床疗效,并定期(第1、7、14、21天)测定治疗过程中血清hs-CRP含量,比较2组的临床疗效和治疗过程中患者血清中hs-CRP的含量变化。结果治疗组基本痊愈率(85.0%)、显效率(90.0%)及总有效率(95.0%)均显著高于对照组(P均<0.05)。在治疗过程中2组患者血清hs-CRP含量自第7天起均明显下降,且呈时间依赖性,各时间点治疗组较对照组下降更明显(P均<0.05)。结论尤瑞克林可明显降低轻-中度急性脑梗死患者的hs-CRP含量,改善神经功能缺损,促进患者康复。

Objective To analyze the clinical manifestation,diagnosis and misdiagnosisin formation of hepatolenticular degeneration,and to improve the diagnosis of this disease in the primary level hosipal.Methods A retrospective analysis of our hospital from 2005 to 2011 26 cases of patients with hepatolenticular degeneration,Analysis in the diagnosis of patients with clinical symptoms,signs,laboratory examination,imaging features and misdiagnosis.Results 26 patients were misdiagnosed as hepatitis in 11 cases,2 cases of liver cirrhosis,nephritis in 6 cases,7 cases of nervous and mental diseases.Conclusion Hepatolenticular degeneration is misdiagnosed easily,it is can doubt to be hepatolenticular degeneration with illegibility causative hepatopathy and neuropsychosis and nephrosis,it reminds us monitoring the changes of blood copper-protein and checking the K-F rings of cornea and investing the family history and detecting the related gene as soon as possible.

目的:探讨脑梗死超急性期血清泛素C 末端水解酶-1(ubiquitin C-terminal hydrolase-L1,UCH-L1)水平的变化及意义.方法:连续观察发病6 h 内表现为急性局灶性神经功能缺损的患者,分为超急性期脑梗死(hyperacute cerebral infarct,HCI)组(46 例)和短暂性脑缺血发作(transient ischemic attack,TIA)组(30例).用夹心ELISA 测定两组患者血清(发病6 h 内)UCH-L1 并进行比较.分析脑梗死超急性期血清UCH-L1水平与NIHSS 评分、脑梗死体积、mRS 评分的相关性.结果:HCI 组、TIA 组血清UCH-L1 水平分别为0.21(0.20)μg/L、0.13(0.07)μg/L,HCI 组血清UCH-L1 水平显著高于TIA 组(Z ＝ -4.047,P ＜ 0.001).HCI 组血清UCH-L1 水平与脑梗死体积[6.70(10.50)mL]呈正相关(r ＝ 0.751,P ＜ 0.001);与入院时NIHSS 评分[9(8)分](r ＝ 0.589,P ＜ 0.001)、入院7 d NIHSS 评分[7(8.25)分](r ＝ 0.563,P ＜ 0.001)正相关;与3 个月后mRS评分[2(3)分]正相关(r ＝ 0.554,P ＜ 0.001).Logistic 回归分析显示,UCH-L1 增高与高mRS 评分(发病3 个月后)独立相关(OR ＝ 3.275;95%CI:1.642 ～ 13.726;P:0.029).结论:脑梗死超急性期血清UCH-L1 水平可能预示了病情严重程度和预后.

Objective To evaluate the application value of ubiquitin C-terminal hydrolase-L1(UCH-L1) in early identification of acute ischemic cerebrovascular disease.Methods A total of 102 patients with the sudden appearance of focal neurological deficit within 6 from onset were observed in this prospective study and then they were divided into hyperacute cerebral infarction(HCI) group(except for lacunar infarction) 40 cases,lacunar infarction(LACI) group 32 cases and transient ischemic attack(TIA) group 30 cases.Serum UCH-L1 in three groups within 6 from onset was determined by ELISA.The value of serum UCH-L1 in diagnosing HCI was analyzed with receiver operating characteristic(ROC) curve.Results The level of serum UCH-L1 in HCI group,LACI group and TIA group were 0.24(0.21)μg/L,0.13(0.09)μg/L and 0.13(0.07)μg/L respectively.The level of serum UCH-L1 was significantly higher in HCI group than those in LACI and TIA groups(all P<0.001).The level of serum UCH-L1 in LACI group had no difference with the level of serum UCH-L1 in TIA group(P>0.05).The area under ROC curve for serum UCH-L1 in diagnosing HCI(except for LACI) was(0.793±0.047)(P<0.001,95%CI: 0.700~0.886),serum level of UCH-L1 was 0.17 μg/L on optimal cutoff.When level of serum UCH-L1 was over or equal to 0.17 μg/L,HCI was determined with 72.5% sensitivity,74.2% specificity,64.4% positive predict value and 80.7% negative predict value.Conclusion The detection of serum UCH-L1 level is helpful to the early identification of HCI,TIA and LACI.

Objective To evaluate the value of ubiquitin C-terminal hydrolase-L1(UCH-L1) in early differentiation of acute ischemic cerebrovascular disease.Methods Patients with sudden appearance of focal neurological deficit within 6 hour from onset were divided into hyperacute cerebral infarct(HCI) group(except for lacuna cerebra1infarct),lacuna cerebra1 infarct(LCI) group,transient ischemic attack(TIA) group.UCH-L1 in serum within 6 hour from onset was determined by ELISA.Results Level of serum UCH-L1 was significantly higher in HCI group than that in LCI group(P<0.001) and in TIA group(P<0.001).Level of serum UCH-L1 in LCI group had no difference with that in TIA group(P>0.05).Area under ROC curve for serum UCH-L1 to diagnose HCI was(0.793±0.047)(P<0.001).When serum UCH-L1 was over or equal to 0.17 μg/L,HCI was determined with 72.5% sensitivity,74.2% specificity.Conclusions Levels of serum UCH-L1 help to differentiate HCI(except for LCI) from TIAand LCI.