Objective To evaluate the diagnostic value of procalcitonin (PCT) in patients with infection complicated by heart failure.Methods A total 2454 patients,which with simple heart failure,simple bacterial infection and bacterial infection complicated with heart failure,from Sun Yat-sen University affiliated zhongshan hospital were enrolled in this case-control study.244 heathly controls were aslo evaluated at the same time.The serum PCT levels in different groups were analyzed by Cobas E601.ROC curve was employed to compare the diagnostic values of PCT between simple heart failure group and infection complicated with heart failure group,and the cutoff value of PCT testing for infection complicated by different grades heart failure was determined.The difference between test groups was analyzed using Kruskal-Walis H method.Results PCT levels in simple heart failure group (3.46 ± 3.07) were significantly higher than those in control group (0.04 ± 0.03) (t =4.262,P ＜ 0.01).Besides,PCT levels in infection complicated by heart failure group(18.18 ± 10.33)were significantly higher than those in simple infection group(8.97 ± 6.20) (t =2.694,P ＜ 0.01).Although PCT could still be a biomarker for diagnosis of bacterial infection in patients with or without heart failure (areas under the ROC curve were 80％,82％,85％,88％,respectively),the positive predictive values of PCT were declined in line with the heart failure degree increasing [z(1,2) =-6.24,P＜0.01; z(l,3) =-4.35,P＜0.01; z(1,4) =-5.19,P＜0.01; z(2,3) =-5.33,P＜0.01;z(2,4) =-2.86,P＜0.05; z(3,4) =-2.46,P＜0.05].There are significant differences between areas under ROC curve [z(1,2) =-2.55,P ＜ 0.05 ; z(1,3) =-5.42,P ＜ 0.01; z(2,3) =-2.90,P ＜ 0.05],and the cutoff values of PCT to identify infection patients complicated with Ⅱ,Ⅲ,Ⅳ degrees heart failure were 0.086,0.192 and 0.657 μg/L,respectively.Conclusion PCT levels were increased in heart failure patients so we should pay more attention to the degree of heart failure and PCT level on patients which suffered both infection and heart failure.

Objective To evaluate the effects of clinical pathway combined with transitional care implemented by specialty nurses on patients with coronary heart disease after PCI (percutaneous coronary intervention) therapy. Methods Totally 124 patients after PCI were divided into the experimental group and the control group with random digit table. Patients in the control group received routine education and follow- up during hospitalization and discharge period. The experimental group received clinical pathway combined with transitional care implemented by specialty nurses based on routine education. The level of patients′knowledge, attitude, practice and risk factors were compared between the two groups 6 and 12 months after discharge. Results There were 55 patients in each group completed the research ultimately. The Coronary Heart Disease Knowledge Questionnaire in the experimental group scored (57.61 ±8.77), (81.27±6.88) and (88.47±6.10),while the control group scored (59.71±7.32),(68.61±7.12) and (76.85±7.70), after repeated measurement analysis of variance, F=74.71, 14.52, P<0.01. The scores of General Self- Efficacy Scale (GSES) and Coronary Artery Disease Self- Efficacy Scale (CSMS) between two groups at three time points showed statistical significance, F=5.40, 14.52, P<0.05 or 0.01. The risk factors of coronary heart disease such as total cholesterol, triacylglycerol, hemoglobin A1c, body mass index, systolic pressure and diastolic pressure were statistically different between two groups except for high density lipoprotein cholesterol and low density lipoprotein cholesterol, F=5.82, 20.32, 4.14, 4.15, 4.99, 7.15, P<0.05 or 0.01. Conclusions Clinical pathway combined with transitional care implemented by specialty nurses can improve the knowledge-attitude- practice level of patients, help to control the risk factors of coronary heart disease. It is an effective heart rehabilitation model for patients after PCI.

Objective To analyse the stress distribution of distal-extension removable partial dentures supported by mini implants. Methods The finite element analysis models of conventional removable partial dentures ( CRPD) and mini implants supported removable partial dentures (ISRPD) were established by modular denture model. The stress distribution of abutments and supporting tissues was compared by finite element analysis software Abaqus 6.5.Results Under vertical loading, the stress of abutment teeth, mucosa of edentulous region and alveolar bone of ISRPD model was lower than that of CRPD model. Under oblique loading, the stress of each part of CRPD model and alveolar bone of ISRPD model significantly increased, while that of abutment teeth and parodontium of ISPRD model decreased. Conclusion The distal-extension removable partial dentures supported by mini implants work well in protecting the abutments and supporting tissues.

Objective To analyse the stress distribution of precision attachment dentures used in distal-extension edentulous cases. Methods The finite element models of conventional removable partial dentures and precision attachment dentures were established by modular denture model, and the models of precision attachment dentures were established with 4┬4 as one abutment or 43┬34 as two abutments. The stress distribution of abutments and supporting tissues was compared by finite element analysis software Abaqus 6.5.Results Under vertical loading or oblique loading, the stress of abutments and supporting tissues from attachment dentures with two abutments was significantly lower than that from attachment dentures with one abutment. The stress of conventional removable partial dentures significantly increased under oblique loading. Conclusion It is reasonable for the design of attachment dentures with two abutments for mandibular distal-extension edentulous cases.

Objective To investigate the role of chemokine ligand 21 (CCL21) in the spinal cord in tibia bone cancer pain (BCP) in rats.Methods Forty adult female SD rats weighing 160-180 g were randomly divided into 5 groups (n=8 each):sham operation group (group Ⅰ ); sham operation + CCL21 neutralizing antibody group (groupⅡ); BCP group (group [); BCP + PBS group (group Ⅳ); BCP + control IgG group (groupⅤ)and BCP + CCL21 neutralizing antibody group (group Ⅵ).BCP was induced by inoculating Walker-256 mammary gland carcinoma cells into the rat tibia medullary cavity in groups Ⅲ-Ⅵ.PBS 15 μl,IgG 10 μg and CCL21 neutralizing antibody 10 μg were injected intrathecally (IT) at 14 days after intra-tibial injection of Walker-256 mammary gland cancer cells in groups Ⅳ- Ⅵ respectively.Mechanical withdrawal threshold to yon Frey filament stimulation (MWT) was measured at 1 day before (To,baseline) ; 7 and 14 d after Walker-256 cell injection (T1,T2)and at 0.5,1,2,4,8,12,24 and 48 h after intrathecal injection (T3-10 ).Results Intra-tibial injection of Walker-256 mammary gland cancer cells significantly decreased MWT as compared with the baseline values in administration of CCL21 neutralizing antibody at T5-8 as compared with MWT before intrathecal administration at T2 in group Ⅵ.MWT was significantly lower in groups Ⅲ- Ⅳ than in groups Ⅰ and Ⅱ.MWT was significantly higher at T5-8 in group Ⅵ than in groups Ⅲ - Ⅴ.Conclu]sion CCL21 in the spinal cord is involved in the maintenance of tibia BCP in rats.

BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) can be induced to differentiate into neuron-like cells in new environment after transplantation, and then to replace damaged cells for reconstructing neural circuit. OBJECTIVE: To establish the co-culture system between rat BMSCs and neural cells in vitro, and to study the influence of neural cells on the differentiation of BMSCs into neuron-like cells in the co-culture system. METHODS: The neural cells obtained from Wistar rat fetal brain tissue and BMSCs gained from rat thighbone were co-cultured in Transwell culture plate. The morphological changes of BMSCs were observed and the special markers of neural cells in BMSCs were examined by immunofluorescence on the fifth day of the co-culture. The results were compared with control group which where BMSCs were alone cultured. RESULTS AND CONCLUSION: BMSCs in the neural cells co-culture system extended, were radial, connected each other. Neuron specific enolase immunoreactions showed positive results, showing neuron-like cells. The positive ratio of neuron specific enolase-positive cells was (33.0±10.5)%. However, BMSCs in the control group did not express neuron morphological character. Immunofluorescence exhibited that cells were negative for neuron specific enolase. These indicate that microenvironment provided by neurons improves the differentiation of BMSCs into neuron-like cells.

Objective To compare the capabilities of NT-proBNP and BNP in diagnosis of heart failure when complicated with acute cerebral infarction.Methods EP15-A2 document,was employed to verify the precision and accuracy of NT-proBNP and BNP assays on chemiluminescence analyzer Cobas E601 and ADVIA Centaur respectively for 363 samples from patients with chronic heart failure,cerebral hemorrhage and acute cerebral infarction,cerebral infarction complicated with heart failure and normal controls were collected and analyzed by Cobas E601 and ADVIA Centaur,and then determined the changing trends of NT-proBNP and BNP.Moreover,ROC curve was employed in diagnostic value comparison of NT-proBNP and BNP in heart failure groups.Results Cobas E601 and ADVIA Centaur showed good repeatability and accuracy in the detection of NT-proBNP and BNP that both total non-precision were below 3.5％ and the deviations to calibrator were below 3.91％.The level of NT-proBNP an BNP didn't elevate in normal people and cerebral hemorrhage patients.However,they significant elevated in heart failure,acute cerebral infarction and cerebral infarction complicated with heart failure patients (P ＜ 0.01).Their levels were heart failure grade dependent.The levels of NT-proBNP in cerebral infarction complicated with grade Ⅰto Ⅲ heart failure patients were significantly higher than those in chronic heart failure patients,with same heart failure(P ＜ 0.05).However,compared to chronic heart failure patients,the level of BNP in cerebral infarction complicated with heart failure patients didn't elevate significantly until grade Ⅲ heart failure happened.Areas under the ROC curve (AUCs) of NT-proBNP and BNP were botb above 93％ in the diagnosis of chronic heart failure.But for patients who suffered cerebral infarction complicated with heart failure,the diagnostic value of NT-proBNP and BNP were decreased due to cerebral infarction interference.However,the ROC area of BNP was larger than that of NT-proBNP(P ＜ 0.05).Conclusion In the diagnosis of cerebral infarction complicated with heart failure,BNP could be a better choice to determine the degree of heart failure.

Objective:To understand the current situation of hospital violence medical students experienced during the internship period and their professional identity.Method:With the method of cluster sampling,a questionnaire survey was conducted among 500 medical students from a medical college in Ganzhou,to understand the characteristics of hospital violence and compare the difference between the medical students who experienced violence and those not.Results:The effective recovery rate of questionnaire was 90.8％,of which 61.4％ of medical students had witnessed hospital violence,8.1％ of students had experienced hospital violence;the hospital violence that medical students experienced were characterized by low frequency and emotional violence.The overall score of personal identity was (117.05 ± 19.65),was in a medium level.Among the comparison of personal identity between the medical students who had experienced violence and those not,there was a significant difference in occupational cognition dimension (P ＜ 0.01),but there was no significant difference in the total score and other four dimensions (P ＞ 0.05).Conclusion:We should pay attention to the current situation of hospital violence that students experienced and their professional attitude,carry out targeted training and psychological counseling to improve their ability to respond to hospital violence and enhance their professional identity.

Objective To develop an efficient and all-round management system of personnel information based on the standards of quality management in clinical laboratory.Methods ASP.NET and database technology were used to construct a web platform and develop the management modules of personnel information.Results The developed system consisted of 4 modules.The module of onestop management for personnel archives was realized,which could be viewed and self-maintained by individuals and auto-retrieved by the system.The module of job post for staff attendance record was realized by continuous,dynamic management and permanent retrievability of registered responsibilities.The module of training and examination could publish the information for staff to complete self-training within deadline and evaluated the training effects and competence by online tests,and granted appropriate authority to staff.The module of performance assessment could evaluate the performances of staff statically and dynamically by using objective indicators and review mechanism.After the application of the system,staff archives were updated in real time instead of once for year.The time for reviewing archives of staff reduced from fifteen minutes to one minute,the error incidents of staff reduced by 20％,workload for staff training and examination reduced by 60％,and the satisfaction degree of customers for staff increased from 93％ to 96.5％.Conclusion The developed management system could realize all-round standard management with high efficiency,so it should be more effective and cost-saving than traditional manners.The staffs would be willing to accept and cooperate with it.

Objective To research the establishment and application of real-time monitoring system of temperature-humidity in clinical laboratories.Methods The collection net for temperature-humidity data was set up using wireless temperature-humidity recorders and repeaters,and a management software which connected to LIS seamlessly was developed according to the management standard for temperature-humidity in clinical laboratories and the requirements for real-time monitoring.Results The real-time monitoring system sent the collected data of temperature-humidity as needed to repeaters by wireless signal and then transferred to host computer.As long as the data was out of the allowable range,the monitoring system could trigger alarm by sending message or E-mail to administrator who accessed the host through web browser to view the status of system,save attendance records,export data and generated reports.Conclusion The automatically monitoring for temperature-humidity of circumstances and instruments in the laboratories was achieved for 24-hours of every day by the developed system and met with the relevant requirements of real-time monitoring for temperature-humidity in clinical laboratories.