Objective To evaluate the prognostic value of combing pre-procedural red cell distribution width(RDW)with serum uric acid(SUA)levels in patients with acute coronary syndrome(ACS)undergoing percutaneous coronary intervention(PCI).Meth-ods A total of 1 52 consecutive patients with ACS who underwent successful PCI within 12 hours after onset of symptom were en-rolled.RDW and SUA were determined within 12 hours before PCI.The patients were divided into 3 groups according to the cut-off values showed by receiver operating characteristic(ROC)curve:73 cases in group I,RDW<14.5% and SUA<402 μmol/L;50 cases in group Ⅱ,RDW< 14.5% and SUA≥ 402 μmol/L,RDW≥ 14.5% and SUA< 402 μmol/L;29 patients in group Ⅲ,RDW>14.5% and SUA>402 μmol/L.The pre-procedural RDW and SUA status associated with 30 days any cause mortality and major adverse combined cardiac events including revascularization,non-fatal recurrent myocardial infarction,secondary heart failure,rehos-pitalization and death were analyzed.Results Pre-procedural RDW and SUA level predicted 30 days cardiac mortality,RDW and SUA level correlated linearly(r=0.336,P =0.001).30 days major adverse combined cardiac events and any cause mortality were significantly different among the three groups(P =0.031,P =0.012).Conclusion Pre-procedural RDW≥ 14.5% and SUA≥402μmol/L indicates poor prognosis in ACS patients underwent successful PCI.Therefore the combination of RDW and SUA measure-ment should be taken into consideration for risk stratification to decide about the management strategies in ACS patients.

Cyclin D is the most closely relationship with tumor ,and it is currently known one of the sub-types of cyclins.CyclinD1,as a positive regulatory factor ,has an important role in the process of cell cycle ,espe-cially in cell proliferation and division .CyclinD1 is unusually up-regulated in lots of human cancers .CyclinD1 is a recently discovered protein which is highly expressed in the urinary tumors ,and its expression in tumors is asso-ciated with a more aggressive phenotype ,prognosis and recurrence .Therefore,the research of the target point to CyclinD1 in the urinary tumors may provide a new method for the therapy to urinary tumors .

Definiting the workflow and key link of the risk management in medical laboratory by FMEA.Identifying risk factors of the workflow and key link of blood coagulation test by the criteria for laboratory accreditation , such as ISO15189 recognition criteria and CAP laboratory accreditation inspection . Through the evaluation of the blood coagulation test , effective corrective actions and examining performance data periodically , the quality of the blood coagulation test can be improved continuously.

Objective To evaluate the utility of carbapenem inactivation method (CIM) in detecting carbapenemase-producing Acinetobacter baumannii.Methods A total of 121 strains of A. baumannii were identified and subjected to antimicrobial susceptibility testing by VITEK compact. Carbapenem inactivation method (CIM) was applied to detect the carbapenemase in the A. baumannii strains. The OXA-23 type carbapenemase-encoding genes were analyzed by common PCR method.Results Six-eight of the 121 strains showed resistance to imipenem and meropenem. PCR showed that 65 of the 68 strains carried OXA-23 gene. CIM was positive in 66 of the 68 strains. And 52 of the 121A. baumannii strains were susceptible to imipenem and meropenem. PCR showed that OXA-23 gene was negative in 49 of the 52 strains. CIM was negative in the 52 strains of non-carbapenemase-producing A. baumannii. Only one strain was resistant to imipenem but susceptible to meropenem. CIM was negative but QXA-23 was positive for this strain. The sensitivity and the specificity of CIM was 94.2% and 98.1% respectively in detecting carbapenemase-producing A. baumannii.Conclusions The results of CIM were consistent with the results obtained by PCR to detect the encoding gene of OXA-23. CIM is inexpensive, easier to operate and interpret than PCR method. CIM is applicable to detect OXA-23 type carbapenemase rapidly inA. baumannii.

OBJECTIVE: To investigate the effects of Radix notoginseng extracts drug-containing serum on the expressions of apoptosis-regulating proteins including Bax, bcl-2 and p21WAF1 in precancerous gastric cells. METHODS: The N-methyl-N'-nitro-N-nitroso-guanidine (MNNG) transformed eternalized human gastric mucosa epithelium GES-1 cell line (MC cell) was used in vitro as a model of gastric precancerous lesion. The medicated canine serum was prepared by feeding to the adult Beagle dog with Radix notoginseng extracts and obtaining the serum after 2-hour medication. MC cells were cultured with medicated canine serum (medicated serum group) or non-medicated canine serum (normal control group) for 72 hours. Expressions of Bax, bcl-2 and p21WAF1 proteins were detected by immunocytochemical assay and the average optical density of the cells was determined by an image analysis system. RESULTS: Compared with those of the normal control group, Bax and p21WAF1 expressions in medicated serum group were significantly enhanced (P<0.01), while the expression of bcl-2 was significantly reduced (P<0.01). CONCLUSION: Radix notoginseng extracts may inhibit the proliferation and promote the apoptosis of precancerous gastric cells through altering expressions of the bcl-2, Bax and p21WAF1 genes.

Objective:To explore the effects of scout scanning parameters (projection angle and tube potential) on image quality and radiation dose in chest CT and to provide guidance for the selection of scanning parameters in clinical practice.Methods:Different parameter combinations were selected to acquire the scout view of the anthropomorphic adult chest phantom. Fifteen scout views were obtained under parameter combinations of the projection angle (0/90/180 degrees), tube potential (70/80/100/120/140 kV) and tube current (25 mA). And then, chest spiral scans were performed according to the scout views. The other parameters were Assist kV, smart mA (maximum range), 80 mm detector width, 0.992∶1 pitch, 0.5 s rotation time, 330 mm scanning length, 5 mm thickness, NI (noise index) 10. The radiation dose modulation index (ASiR-V) was 30%, and the iterative level was 50%. Volume CT dose index (CTDI vol) and tube current at 4 body levels (pulmonary apex, trachea bifurcation, mammary level and diaphragmatic dome) were recorded. The thermoluminescent dosimeters (TLDs) were used to measure the organ dose of the breast glandular. Regions of interest (ROIs)were selected at the trachea bifurcation and diaphragmatic dome to calculate the contrast noise ratio (CNR). Results:The tube potential of the spiral scanning was automatically selected as 80 kV when the projection angle was 0 degree. The changing of the tube potential for the scout had little influence on the tube current at the four body levels, and the variation range was 0-2% (5/230). The tube potential in the spiral scanning was automatically selected as 100 kV when the projection angles were 90 and 180 degrees. The changing of the tube potential for the scout had a great influence on the tube current at the slice of trachea bifurcation and the variation range was from 14%(29/210)to 44%(93/210). According to the angle projection, there were statistical differences in CTDI vol( P< 0.017), organ dose of the breast glandular, and CNR at the slices of trachea bifurcation and at diaphragmatic dome ( F=13.027, 24.727, 10.630, P< 0.05). According to the tube potential in the scout scanning, there were no significant differences in CTDI vol, organ dose of the breast glandular and CNR at both levels ( P> 0.05). Conclusions:In chest CT, the influence of the projection angle in scout scanning on the image quality and radiation dose was more significant than that of the tube potential.

Objective To study the value and feasibility of temporary emergency bedside cardiac pacing. Method Two hundred patients with severe witnessed bradycardia were treated with temporary emergency cardiac pacing. We treated 130 patients with emergency bedside pacing and 70 patients with x-ray-guided pacing. Results Emergency bedside pacing was successful in 127 patients except three patients and no postoperative complications occurred. X-ray-guided pacing was successful in all 70 patients but three patients experienced complications: one deep venous thrombosis and two cardiac tamponades due to myocardial perforation. The pacing electrodes were more likely to be displaced in X-ray-guided pacing than in emergency bedside pacing (six cases versus three cases) . The door-to-operation time was 30-90 min for x-ray-guided cardiac pacing and 5-15 min for emergency bedside pacing. Needle-to-pacing times were similar for both procedures (3.5 ± 1.5 min for x-ray guided pacing versus 4± 2.5 min for bedside pacing). Conclusions Temporary emergency bedside cardiac pacing is a rapid, efficient and safe procedure for treating severe witnessed bradycardia. The technique is easily mastered and may prove lifesaving in an emergency.

OBJECTIVE: To study the apoptosis-promoting effect of the serum from Panax notoginseng extracts-fed dog on precancerous gastric cells by means of flow cytometry. METHODS: In the experiment, we adopted eternalized human gastric mucosa epithelium GES-1 cells transformed by N-methyl-N'-nitro-N-nitroso-guanidine (MNNG) (MC cells) as the model of precancerous lesions for study in vitro. We took the serum of a dog before and at two different points of time (2 and 6 hours) after feeding the dog with Panax notoginseng extracts for experiment. The MC cells were cultured in mediums with different concentrations of the medicated serum at 2- or 6-hour point of time for 72 hours. By means of flow cytometry, we examined the apoptosis-promoting effects of the serums on the MC cells. RESULTS: The medicated serums at these 2 points of time had significant effects in promoting MC cell apoptosis. The proportions of apoptotic cells in culture mediums with medicated serums had a significant increase as compared with those in culture mediums with non-medicated serums (serum obtained before administration of extracts to the dog) under the same conditions (P<0.05). The number of MC cells in G(0)/G(1)phase was decreased (P<0.05) and that in G(2)/M phase increased (P<0.05), while no consistent changes were observed in S phase. CONCLUSION: The medicated serums obtained at the two different points of time have significant apoptosis-promoting effects on MC cells. They decrease the number of MC cells in G(0)/G(1) phase and increase the number of MC cells in G(2)/M phase. This is probably responsible for the effects of Panax notoginseng extracts in inhibiting the proliferation of MC cells and promoting its apoptosis.

OBJECTIVE: Through cell cultivation, we studied the inhibiting effects of the serum of the dog fed with Panax notoginseng extracts on precancerous gastric cells, trying to find the best time points or periods when the extracts' function was the strongest after administration of the extracts to the dog. METHODS: The experiments adopted eternalized human gastric mucosa epithelium GES-1 cells and MC cells gained from GES-1 cells transformed by N-methyl-N'-nitro-N-nitroso-guanidine (MNNG) as the model of precancerous lesions for study in vitro. We took the serum of a dog before and at different points of time after feeding the dog with Panax notoginseng extracts for experiment. By means of MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay, we examined the inhibiting effects of the serum after culturing the GES-1 and MC cells for 72 hours with different concentration (8%, 4%, 2%) of medicated serum obtained from the dog at different points of time, so as to find that, at which points of time the medicated serum obtained, it would be the most effective. RESULTS: The results showed that the GES-1 and MC cells inhibition rates of medicated serum from the points of 2-hour and 6-hour were the highest, and the culture medium containing 8% of medicated serum from these two points had prominent inhibiting effects on both kinds of cells. The GES-1 cells inhibition rate in culture medium containing 8% of medicated serum from the point of 2-hour was 70.8% (P<0.01) and that of the MC cells was 45.3% (P<0.01). The GES-1 cells inhibition rate in culture medium containing 8% of medicated serum from the point of 6-hour was 88.5%(P<0.01) and that of the MC cells was 42.4% (P<0.01). CONCLUSION: The points of time with the strongest inhibiting effects are 2 hours and 6 hours after being fed with Panax notoginseng extracts. At these two points, the serum is most effective in inhibiting the proliferation of GES-1 and MC cells.

Objective To investigate the effects of dexmedetomidine on the inflammatory response during the aortic dissection perioperative period.Methods 53 patients with the type A aortic dissection who needed surgical treatment were randomly divided into the study group and the control group.Patients in the study group (group A) received dexmedetomidine (0.2-0.7 μg · kg-1 · h-1) while patients in the control group (group B) received morphine 0.2-0.6 mg/h to ease pain after they were admitted and continued to 48 h after the operation.The serum levels of TNF-α,MMPs,NE,NT-proBNP and CRP were measured in the patients at the time enrolled taking none of the two drugs(T0),before the operation(T1),immediately after the operation (T2) and 12 h (T3),24 h (T4),48 h (T5),72 h (T6) after the operation.MODS score and the length of stay in ICU were observed about the two groups of patients.Difference between the two groups was determined by the Student' s t-test.Single factor analysis of variance was used within the group.P ＜ 0.05 was considered statistically significant.Results Compared with the patients in group B,the MMPs levels in group A at 24、48 and 72 h after the operation were significantly lower.The patients in group A had lower levels of NT-proBNP and NE both at 48 h and 72 h after the operation.Lower levels of TNF-α and CRP were also found at 24 h and 48 h in this group.The MODS score at the fifth 、tenth and 15th day after the surgery were both significantly lower than that of the first day in patients of group A.Conclusion Dexmedetomidine can inhibit the inflammatory response during the aortic dissection perioperative period and can reduce the acute injury of organs caused by the excessive systemic inflammatory response.