Objective To explore the value of urinary albumin/creatinine ratio (ACR) in coronary heart disease(CHD) compli-cating thyroid dysfunction and its correlation with the various detection indicators of thyroid function.Methods The results of uri-nary ACR and thyroid function detection in 863 patients with CHD in our hospital from November 2015 to August 2016 were col-lected.According to the standards of American National Kidney Foundation (NKF) and Food and Drug Administration(FDA) ,863 CHD patients were divided into the group A (ACR≤10.0 mg/g · Cr) ,B(10.0 mg/g · Cr< ACR≤30.0 mg/g · Cr) ,C (30.0 mg/g · Cr300 mg/g · Cr).According to the reference values of thyroid functional indica-tors ,these patients were divided into the thyroid function normal and abnormal groups.Results The ACR level was negatively cor-related with the FT3 level in 863 CHD patients(r= -0.297 ,P<0.05) ,and was positively related with the FT 4 level(r=0.172 , P<0.05).The abnormal rate of thyroid function had significantly statistical difference among four groups (χ2 =33.533 ,P<0.05). The abnormal rate of thyroid function had significantly statistical difference between the patients with ACR >10.0 mg/g · Cr and the patients with ACR ≤ 10.0 mg/g · Cr ,the difference was statistically significant (P< 0.05) ,its risk degree was 2.083. Conclusion ACR is likely to be a risk factor for CHD patients complicated with thyroid dysfunction.It is necessary to monitor the thyroid function when ACR level >10.0 mg/g · Cr in CHD patients.

Objective To investigate the reference interval of platelet‐related parameters including mean platelet volume (MPV) ,platelet distribution width (PDW) ,platelet hematocrit (PCT) .Methods Used Sysmex XN‐9000 assembly line and PEN‐TRA 120 hematology analyzer to analysis the venous blood cells for 3 415 cases of 16 to 90 years old physical examination personnel in Mianyang Central Hospital ,the platelet‐related parameters results of 2 718 standard healthy population by screening were statis‐tically analyzed .Results Platelet‐related parameters 95% reference interval (2 .5% -97 .5% ) of XN assembly line :M PV 9 .9-14 . 7 fL ,PDW 11 .2% -24 .3% ,PCT 0 .15% -0 .30% ;Platelet‐related parameters of 95% reference interval of PENTRA 120:MPV 8 .4-12 .7 fL ,PDW 13 .8% -24 .8% ,PCT 0 .12% -0 .26% ;comparison between the instruments :MPV ,PDW ,PCT results showed significant differences (P<0 .05);comparison between men and women :PCT test results of XN assembly line were differ‐ent (P<0 .05) ,MPV ,PDW ,PCT results of PENTRA 120 were different (P<0 .05);comparison between age groups :PCT result of all ages between men and women were different in XN assembly line (P<0 .05) ,in PENTRA 120 ,MPV ,PDW ,PCT results be‐tween ages were different in men (P<0 .05) ,PCT results between ages were different in women (P<0 .05) .Conclusion Each la‐boratory should establish the laboratory supporting biological reference interval of platelet‐related parameters based on different in‐struments ;in practical applications ,should set the reference interval for different gender or age .

Objective To evaluate the value of blood coagulation biomarkers in orthopaedic traumatic patients after surgery and analyze its diagnostic values for venous thrombosis embolism.Methods In thiscase control study, we consecutive enrolled 108 traumatic patients after surgery.54 patients have thrombosis and other 54 patients have no thrombosis.Blood was taken 3 -4 days after surgery.Routine coagulation screening test , FDP(fibrinogen/fibrin degradation products) , D dimer and new item such as TM( thrombomodulin) , TAT( thrombin-anti-thrombin complex) , t-PAIC( tissue-type plasminogen activator-plasminogen activator inhibitor complex),PIC(plasmin-anti-plasmin complex) were tested.The difference between groups of these biomarkers was compared, and then the receiver operation curve ( ROC) was drew to determine the diagnostic cut-off point and diagnostic performance.Results ALL blood coagulation biomarkers in orthopaedic traumatic patients after surgery were significantly increased.The group of patients with thrombosis have higher TM(9.04 ±2.06) IU/ml,t-PAIC(10.15 ±4.23) ng/ml, PIC(1.15 ±0.70)μg/ml, D dimer(5.31 ±5.10) ng/ml than group without thrombosis TM(7.50 ±1.70) IU/ml, t-PAIC (6.97 ±2.56)ng/ml, PIC(0.93 ±0.84)μg/ml,D dimer(2.35 ±2.12)ng/ml,and P=0.000 2,<0.000 1,<0.000 1,<0.000 1, respectively.However, TAT(4.79 ±4.32)ng/ml, (6.51 ±5.92)ng/ml, FDP (8.87 ±7.68 )μg/ml, ( 4.91 ±4.67 )μg/ml showed no difference between thrombosis groupand no thrombosis group, (P=0.212 3,0.050 8; respectively).The area under the ROC curve of TM, t-PAIC, PIC and D-dimer were 0.718 5,0.741 6,0.648 0,0.670 0, respectively; P values were <0.000 1,<0.000 1, 0.009 3,0.004 1, respectively; cut-off values were 11.15 IU/ml, 10.65 ng/ml, 1.36 μg/ml, 7.69 ng/ml, respectively;positive likelihood ratios were 9.00,11.29,3.66,14.60, respectively;specificity were 98.15%,96.23%, 90.20%, 97.96%, respectively; the diagnostic rates were 20.3%, 46.3%, 35.8%, 25.9%, respectively.Conclusions There were coagulation and fibrinolysis system activated in orthopaedic traumatic patients after surgery.TM, t-PAIC, PIC, D dimer were good biomarkers for the diagnosis of thrombosis after trauma surgery.TAT was not fit for screening thrombosis after surgery because of influence of anti-coagulation.

BACKGROUNDThoracic endovascular aortic repair (TEVAR) is an emerging treatment modality, which has been rapidly embraced by clinicians treating thoracic aortic disease. However, the clinical manifestations of systemic inflammatory response after TEVAR as post-implantation syndrome (PIS) resemble the perioperative infection. This study aimed to evaluate changes and diagnostic value of procalcitonin (PCT) and other traditional inflammatory markers for infections after TEVAR.

METHODSWe conducted a prospective clinical study that enrolled 162 consecutive aortic dissection cases, who underwent TEVAR in our institution between July 2011 and November 2012. The PCT, C-response protein (CRP), erythrocyte sedimentation rate (ESR) and blood routine examination were monitored before the operation and on days 1, 2, 3 and 5 after the operation. The diagnosis of infection was confirmed by the infection control committee with reference to Hospital Acquired Infection Diagnostic Criteria Assessment, released by the Ministry of Health of the People's Republic of China.

RESULTSPost endovascular repair of thoracic aorta, PCT changes significantly at different time points (χ(2) = 13.225, P = 0.021), without significant difference between the PIS group and the control group (0.24 ± 0.04 vs.0.26 ± 0.10, P = 0.804). PCT values were significantly higher in the first day after TEVAR than the preoperative levels (0.18 ± 0.03 vs. 0.11 ± 0.02, P < 0.001). Compared with PIS patients, the level of PCT, CRP, White blood cell (WBC) and neutrophil (NEU) in the infection patients elevated significantly (relatively χ(2) = 6.062, P = 0.048; χ(2) = 6.081, P = 0.048; χ(2) = 11.030, P = 0.004; χ(2) = 14.632, P = 0.001). According to the ROC analysis, the PCT levels in the first day after TEVAR (AUC = 0.785, P = 0.012) had better predictive values of infection than WBC, NEU CRP and ESR (AUC = 0.720, P = 0.040; AUC = 0.715, P = 0.045; AUC = 0.663, P = 0.274; AUC = 0.502, P = 0.991). The best predictive index was the changes of PCT between preoperative and postoperative (PCT), which possess AUC as 0.803 (P = 0.014). And PCT = 0.055 could be considered as an infection diagnosis cutoff value with a sensitivity of 83.3% and specificity 69.0%.

CONCLUSIONSPCT provides better diagnostic value of infection compared with other inflammatory markers. The potential applications of PCT in differential diagnosis of PIS and infection after percutaneous TEVAR deserve further studies.

Adult ; Aged ; Blood Sedimentation ; C-Reactive Protein ; metabolism ; Calcitonin ; metabolism ; Calcitonin Gene-Related Peptide ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Protein Precursors ; metabolism ; Vascular Surgical Procedures