The morbidity and mortality of heart failure (HF) were gradually incrcased,around 2％-3％ of the population suffered from HF.As a biomarker,NT-proBNP has been shown to be widely used in the diagnosis of HF patients.NT-proBNP lever is affected by many factors,especially the age,age-specific NT-proBNP lever is very important in diagnosis of elderly HF patients.

Objective To investigate the therapeutic effect of island flap pedicled with dorsal cutaneous branches of digital inter-nal artery for severe thermos injury of fingers .Methods From May 2008 to May 2012 ,15 fingers in 12 cases with severe thermos injury were treated with island flap pedicled with dorsal cutaneous branches of digital internal artery .The defect size ranged from 1 .5 cm × 2 .0 cm to 2 .2 cm × 3 .0 cm ,4 fingers with anterograde flap repair ,11 fingers with retrograde flap repair .Results Partial necrosis happened at the distal end of 2 island flaps ,All the other flaps survived completely .The patients were followed up for 6-12 months with satisfactory cosmetic and functional results ,cicatricial contracture around the skin graft in 3 fingers ,The two-points discrimination distance was 9-11 mm in flaps .Conclusion These flaps have the advantages of an extended skin paddle and a versa-tile pivot point on the phalanx ,and they allow coverage of wide and distal defects .

Objective To study the advantages of rhytidectomy of W-shaped incisions combined with multiple suspension in temporal hair line. Methods 40 patients were divided into two groups: 16 cases in group A were treated by rhytidectomy of W-shaped incisions combined with multiple suspcnsion in temporal hair line;24 cases in group B were treatcd by traditional rhytidectomy. Results The inci-sions in group A, with an excellent repair under scar formation, healed well and some hairs on the timpo-ral hair line grew. Fishtail lines were obviously reduced, with nasolabial fold lifting the masseter area skin on parotid. Compared with group B, the difference was statistically significant (P<0.05). Conclusions This approach is simple but convenient, safe and efficient. Therefore, it is valuable and applicable clinical-ly.

Objective To compare the efficacy of transcervical resection(TCRC)and loop electrosurgical excision procedure(LEEP)for the treatment of cervical intraepithelial neoplasia grade I(CINⅠ).Methods A total of 231 CIN I patients were divided into two groups according to their patient number to receive TCRC or LEEP.The resected specimens were sent for pathological diagnosis and human papilloma virus(HPV)-16/18 test.Results No significant difference was found in the operation time[(14.1?2.2)min vs.(13.8?2.1)min],rates of wound infection and cervical stricture[1.7%(2/115)vs.1.7%(2/116)and 0.9%(1/115)vs.1.7%(2/116)],and rates of cure and recurrence [99.1%(107/108)vs.99.1%(108/109)and 0.9%(1/108)vs.0.9%(1/109)] between the TCRC and LEEP groups(t=1.060,P=0.290;?2=0.000,P=1.000;?2=0.000,P=1.000;?2=0.000,P=1.000;?2=0.000,P=1.000).In the TCRC group,the surgical wound was healed in(5.0?0.6)weeks,which was significantly shorter than that in the LEEP group[(5.2?0.7)weeks,t=-2.331,P=0.021].The patients who had severe endocervicitis in both the groups had similar rate of residual endocervicitis[16.7%(2/12)vs.53.8%(7/13),Fisher's test:P=0.097].In both the groups,one patient respectively showed residual lesion after the procedure,in whom HPV-16 and/or HPV-18 were detected.Conclusions Both TCRC and LEEP are effective for CINI.LEEP is easier to master than TCRC.Closed follow-up is essential of the with patients positive HPV-16 or-18.

Objective To compare the therapeutic effects of transcervical resection(TCRC) and loop electrical excision procedure(LEEP) for the treatment of moderate-to-severe chronic cervicitis.MethodsFrom January 2003 to July 2006,totally 520 patients with moderate-to-severe chronic cervicitis were randomly divided into two groups to receive TCRC or LEEP.ResultsThe intraoperative blood loss in the TCRC group was significantly less than that in the LEEP group [(4.2?1.3) ml vs(10.1?4.5) ml,t=-20.310,P=0.000].Whereas,no significantly differences were found in the drainage and bleeding time and cure rates between the two groups [(15.9? 3.7) d vs(16.2? 3.3) d,t=-0.976,P=0.330;and 95.2%(236/248) vs 93.2%(235/252),?2=0.832,P=0.362].ConclusionsBoth TCRC and LEEP are effective for chronic cervicitis.TCRC is superior to LEEP in the surgical outcomes;however the latter is easier to perform than TCRC.

Copeptin,the C-terminal portion of provasopressin,is a novel neurohormone of the arginine vasopressin (AVP)system,and is known to be co-released with AVP from hypothalamus.As a surrogate marker of the AVP system,copeptin has gradually replaced AVP in several clinical studies largely due to its structural and methodological advantages.Copeptin has been regarded as a marker of non-specific stress response.In recent years,copeptin attracts more and more attention especially in cardiovascular conditions (heart failure and acute coronary syndromes).The present review primarily focuses on copeptin detection,its general advantages,and its potential clinical value in a variety of cardiovascular conditions.

In order to increase the underachievement students’ score,we investigate their way of learning by questionnaire and interview. We find that learning motivation,learning style,learning time and thinking ability are the most important factors. So the underachievement students can be divided into four classes: learning motivation insufficiency, learning method incorrectness, learning time insufficiency and thinking ability insufficiency. And we raise some education strategies for each class.

Objective To investigate the effects of rhubarb combined with glutamine on repair of gut mucosal barrier injury after gastrointestinal surgery in rats. Methods Fifty male healthy Sprague-Dawley(SD)rats were randomly divided into five groups:control(C group),enteral nutrition(EN group),rhubarb with EN(R-EN group), glutamine with EN(G-EN group)and rhubarb combined with glutamine and EN(R-G-EN group)groups(each n=10). The rats of C group received no treatment and were fed normally. Cecectomy and gastrostomy were performed in EN,R-EN,G-EN and R-G-EN groups,and in 24 hours after surgery,they were interfered with the use of amoxicillin 50 mg/d and metronidazole 20 mg twice a day. From the first day after operation,each group was treated with the same prescription of enteral isocaloric and isonitrogenous nutrition for consecutive 7 days. Seven days later, under anaesthesia,laparotomy was performed,and a specimen of 1 cm intestinal segment was taken from the terminal 5 cm long ileum for all the groups;under the light microscope,the morphological examination of intestinal mucosal epithelial tight junctions(including villus height and mucosal thickness)was carried out. For each group,enzyme-linked immunosorbent assay(ELISA)was used to measure the levels of plasma citruline and D-lactate,and the serum concentration of TNF-αwas detected by utilizing double antibody ABC-ELISA. Results The levels of D-lactate and TNF-αin EN,R-EN,G-EN and R-G-EN groups were obviously higher than those in C group(all P<0.01). The level of plasma citruline(μmol/L:16.13±0.58 vs. 14.52±0.28)of R-G-EN group was remarkably higher than that in R-EN group(P<0.05),and its levels of serum D-lactate(mmol/L:3.12±0.56 vs. 3.62±0.52)and TNF-α(ng/L:2.82±0.62 vs. 3.54±0.49)were markedly lower than those of G-EN group(both P<0.05). The mucosal villus height(μm:126.50±6.31 vs. 175.67±11.91),mucosal thickness(μm:223.67±11.94 vs. 277.00±14.06)and the level of plasma citruline(μmol/L:13.25±0.36 vs. 15.67±0.55)in EN group were obviously lower than those of C group(all P<0.01);the above indexes of R-EN,G-EN and R-G-EN groups were higher than those of EN group (P<0.05 or P<0.01),but in the comparisons of the villus height and mucosal thickness among the three groups there were no statistical significant differences(all P>0.05). Conclusion The application of rhubarb combined with glutamine can protect gut mucosa,reduce the level of inflammatory reaction and elevate the level of plasma citruline, that is beneficial to the repair of gut mucosal barrier injury and its functional recovery after gastrointestinal surgery in rats.

【Objective】 To identify the main factor or factors w hich contribute to recurrent early spontaneous abortion for clinical diagnosis a nd treatment. 【Methods】 69 cases received the screening examination including inherent, endocrine, anatomical, infective, immunological and contamination hist ory poison metabolic factors, then analyses all factors. 【Results】 Analysing the single factor effecting th e recurrent early spontaneous abortion in the above 7 factors, we found the immun ological factor was 86.2%. Furthermore the immunological factor had significant difference in the various aged groups. 【Conclusion】 Immunological factor is a main factor in recurrent early spontaneous abortion. The immunological factor b ecomes significantly important as the times of spontaneous abortion increasing.

Objective To study the diagnosis and treatment of portal vein complications after orthotopic liver transplantation. Methods The clinical data of 173 patients receiving orthotopic liver transplantation in our hospital from 2002 to 2005 were retrospectively analyzed. Results The incidence of portal vein complications was 3.5% (6 cases). The incidence of portal vein stenosis was 1.2% and that of portal vein thrombosis was 2. 3%. Three cases had previously been treated for portal hypertension and three cases had had a history of portal vein thrombosis before liver transplantation. All the complicated patients recovered and were discharged after successful treatment. There was no complication related mortality. Conclusions A history of previous treatment for portal hypertension, portal vein thrombosis is a risk factor predisposing the patients to portal vein complications after orthotopic liver transplantation. Color Doppler sonography is a sensitive and specific method for monitoring the portal vein complications following orthotopic liver transplantation. The angiography of portal vein is essential for diagnosis of the complications. Thrombolysis treatment is unsatisfactory for advanced stage portal vein thrombosis. Balloon dilation and stenting are both a safe and effective management modality for simple portal vein stenosis.