Objective To explore the clinical effect of two different connecting tubes in hemodialysis combined with hemoperfusion. Methods A total of 25 patients were selected and divided into observation group and control group by self- control method. In the observation group, the hemodialysis combined with hemoperfusion was used 8 times, and the control group was treated with hemodialysis combined with hemoperfusion 8 times using conventional connecting tube. The time of the unloading of the perfusate and the amount of physiological saline required were compared between the two groups. There was no blood spillover during the unloading of the perfusate, the number of cases of allergic reaction during the treatment, and the coagulation of the dialyzer and the pipeline after the treatment. Results There was no allergic reaction in both groups. There was no significant difference between the two groups in the amount of saline needed to return blood (t=46.412, P=0.307). In the control group, there was 15 cases of blood spillover, while the observation group did not show blood spillover. There was significant difference between the two groups in unloading perfusion time(4.43±0.14)min vs. (3.02±0.11) min (t=10.784, P=0.003). The level Ⅰ and Ⅱ blood coagulation of dialyzer and pipeline was 12, 2 cases in the control group after the treatment and 5, 0 case in the observation group, no level Ⅲ blood coagulation cases, and there was a significant difference between the two groups (χ2=10.667, P<0.01). Conclusion In the hemodialysis combined with hemoperfusion therapy, multi-function group of the application effect is superior to conventional piping, is worthy of clinical application.

Objective To investigate the abnormal characteristics of electrocardiogram and its early diagnostic value in acute pulmonary embolism (PE) of different positions.Methods A total of 147 hospitalized patients of acute PE diagnosed by the pulmonary artery CT angiography (CTA) were enrolled in this study and divided into the following two groups:pulmonary trunk or main pulmonary artery (MPA) embolism (group A) and lobar artery or remote branch embolism (group B).ECG,D-dimer,BNP,cTnT were collected and determined,the varieties of abnormal ECG were counted.Then,the relationships between the severities of the PEs at different positions and the corresponding ECG abnormalities as well as the degree of right ventricular hypertrophy (RVH) were analyzed.Results There were significant differences in dyspnea,syncope,in-hospital mortality and the level of cTnT,BNP between the two groups (P ＜ 0.05).There were significant differences in the occurrence of SIQ Ⅲ T Ⅲ,right bundle branch block (RBBB),ST segment depression (STD) in leads Ⅲ and aVF,ST segment elevation (STE) in lead aVR,negative T waves (NTWs) in leads Ⅲ and aVF,STD in leads V1-V3/V6,and STE in leads V1-V3 in combination with STD in leads V4-V6 between the two groups (P ＜ 0.05).The proportion of RVH diagnosed via ECG has significantly different between the two groups.The result of correlation analysis showed that the incidence of pulmonary trunk or MPA embolism was significantly related to the number of ECG abnormalities (r =0.782,t =-7.086,P ＜ 0.05).Conclusions The number of abnormal ECGs increase and the RVH is more serious when PE occurring in pulmonary trunk as well as in the MPA,early recognition of electrocardiographic abnormalities is of greater value in the diagnosis of acute pulmonary trunk and MPA embolism.

The relationship between Ala/Ser polymorphism in 133 codon of exon 3 region of the RASSF1 gene and genetic susceptibility of lung cancer in Hubei province Han population was investigated by a case-control study. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was adopted to analyze the polymorphism of codon 133 of exon 3 in the RASSF1 gene of 100 pathologically diagnosed lung cancer patients, and 100 healthy controls. The relationship between different genotypes and the susceptibility of lung cancer was analyzed. Among 200 blood samples from Han people in Hubei Province, including 100 from lung cancer patients and 100 from healthy controls, the frequencies of Ala/Ala, Ala/Ser, Ser/Ser genotype of the RASSF1 in lung cancer patients were 83%, 16%, 1%, and those in healthy controls was 93%, 7%, 0% respectively, with the difference being statistically significant between two groups (P<0.05). The individuals with Ala/Ser genotype had higher risk of suffering from lung cancer, with an OR of 2.341, and 95% CI of 1.009-6.393 respectively. It was concluded that RASSF1Ala133Ser was a susceptible genetic factor of lung cancer. Ala/Ser genotype increased the risk of lung cancer.

Objective To explore the change in heme oxygenase-1 (HO-1) level in cerebrospinal fluid(CSF)and serum in patients with mild cognitive impairment(MCI),and the correlation between HO-1 and the rating scale,to provide a new marker for the diagnosis of MCI.Methods The HO-1 levels in CSF and serum in 45 MCI patients (MCI group) and 85 normal cases (control group) were analyzed with sensitive enzyme linked immunosorbent assays (ELISA).MMSE and MoCA scores were evaluated.Results The level of HO-1 was higher in MCI group than in control group both in CSF [(631.38±32.17)vs(480.75±17.98)ng/ L,P＜0.05],and in serum [(612.52±111.48)vs.(384.16±56.86)ng/ L,P＜0.05].The MCI and normal people HO-1 level had no significant difference between CSF group and serum group (P＞0.05).In MCI group,the levels of serum and CSF HO-1 had a positive correlation with MMSE scores (P＜0.05),but had no obvious correlation with MoCA scores (P＞0.05).In the normal group,the level of HO-1 was negatively related with MMSE scores in serum and CSF,and with MoCA scores in CSF (P＜0.05),but no obvious correlation in serum (P＞0.05).The levels of serum and CSF HO-1 had no obvious correlation with age in both groups (P＞0.05).Conclusions HO-1 concentration in both CSF and serum is significantly higher in MCI group than in normal group,and positively related with MMSE score.Thus the increase of HO-1concentration in both CSF and/or serum might be a new marker for the diagnosis of MCI.

Objective To investigate the influence of severity of obstructive sleep apnea hypopnea syndrome (OSAHS)on acute ST -segment elevation myocardial infarction (STEMI).Methods 86 STEMI patients were divided into two groups,STEMI with OSAHS(OSAHS group,n=38)and STEMI without OSAHS(control group,n=48).Clinical data about biochemical index,cardiac function index and the duration of STEMI onset were compared between OSAHS group and control group.Logistic statistic analysis was used to investigate the risk factors that influ-ence the circadian rhythm of onset in STEMI.Results A total of 86 patients met the inclusion criteria,they were divided into two groups,STEMI with OSAHS(OSAHS group,n=38)and STEMI without OSAHS(control group,n=48).The incidence rate of STEMI onset during 0600 am~1 159 am was significantly higher in OSAHS group compared to control group(20.8% vs.44.7%,χ2 =5.626,P=0.018).This variation was weaken in mild OSAHS group compared to moderate-severe OSAHS group(20.8% vs.31.3%,χ2 =0.726,P=0.394;20.8% vs.54.5%,χ2 =7.956,P=0.005).Multivariate logistic analysis showed that the severity of OSAHS was a risk factor to the STEMI onset during 0600 am~1159 am(OR=2.458,95%CI 1.110~5.439,P=0.027).Conclusion The severity of OSAHS significantly increases the STEMI onset during 0600 am~1 159 am.

Objective To observe the complications and mortality of hyponatremia in patients with acute exacerbation of chronic obstructive pulmonary disease.Methods The patients with acute exacerbation of chronic obstructive pulmonary disease were selected and divided into non -hyponatremia group(252 cases)and hyponatremia group(65 cases).The differences in the general status,serum ions,blood gas,APACHE Ⅱ score,complications dur-ing the hospitalization,using of ventilator and mortality between the two groups were compared,and drew the receiver operating characteristic(ROC)curve,to acquire higher serum sodium cut -off values.Results In the hyponatremia group,the body weight was (68.3 ±14.4)kg,BMI was (25.5 ±4.9)kg/m2 ,those in the non -hyponatremia group were (74.9 ±15.9)kg and (28.2 ±5.3)kg/m2 respectively,there were statistically significant differences(t =2.009,8.494,all P <0.05).The incidence rate of pneumonia in the hyponatremia group was 23.1%,which was higher than 13.1% in the non -hyponatremia group(χ2 =4.007,P =0.045).The hospital days of the hyponatremia group was (13.1 ±8.9)d,which was longer than (7.8 ±4.9)d of the non -hyponatremia group(t =15.638,P =0.000).The invasive ventilation days of the hyponatremia group was (1.1 ±0.4)d,which was longer than (0.9 ± 0.1)d of the non -hyponatremia group(t =2.885,P =0.004).The non invasive ventilation days of the hyponatremia group was (3.1 ±0.8)d,which was longer than (0.8 ±0.3)d of the non -hyponatremia group (t =2.984,P =0.003).The hospital mortality rate of the hyponatremia group was 12.3%,which was higher than 3.1% of the non -hyponatremia group(χ2 =7.189,P =0.007).The 90 -day mortality rate of the hyponatremia group was 29.2%, which was higher than 15.1% of the non -hyponatremia group(χ2 =7.017,P =0.008).When the serum sodium cut-off value was 128.8mmol/L by drawing ROC curve,the mortality rate in patients with lower than this value was 26.3%,while the mortality rate in patients with higher than the value was 3.7%.Conclusion Hyponatremia is related with the severity and prognosis of acute exacerbation of chronic obstructive pulmonary disease.It is most important to prevent and correct hyponatremia at early disease stage.

Purpose To investigate the application value in diagnosis of pleural effusion by cell block combined with immunohisto-chemistry. Methods 60 cases of pleural effusion were collected, and paraffin-embedded cell block was prepared and immunohisto-chemistry was used to detect the expression of CK7, TTF-1, E-cadherin, CEA and Calretinin. Results By use of cell block combined with immunohistochemistry, malignant detected rate was higher than that of the conventional centrifugal smear. There was statistical significance in the expression of CK7, TTF-1, E-cadherin, CEA and Calretinin between pleural effusion lung adenocarcinoma and reac-tive hyperplasia mesothelial cells (P<0. 05). CK7, TTF-1, E-cadherin and CEA were highly expressed in pleural effusion of lung ad-enocarcinoma cell. Calretinin was highly expressed in hyperplastic mesothelial cells. Conclusion Cell block and immunohistochemi-cal technique combination in the differential diagnosis of difficult pleural effusion has important clinical significance. It is worthy of popularization and further clinical application.

Objective To investigate the diagnostic value of serum brain natriuretic peptide(BNP)in chron-ic cor pulmonale of different period.Methods According to the inclusion criteria,we recruited 216 cases from heart and respiratory medicine(including outpatients and inpatients)of Qingyuan People 's Hosptial from April 2013 to December 2014.All the cases were divided into healthy control group(group A,n =48),cor pulmonale heart function compensatory period group(group B,n =43),cor pulmonale right heart failure group(group C,n =45),the simple left heart failure group(D group,n =40)and the whole heart failure group(group E,n =40).The serum BNP value,pul-monary function,echocardiography were detected.We compared the differences amomg them with correlation analysis, and drew the ROC curves to obtain the best cutoff point.Results The BNP value was higher in group C(495.44 ± 219.90)ng/L than group B[(182.44 ±69.71)ng/L,P <0.001],while the value was higher in group D(882.57 ± 288.56)ng/L and E(891.78 ±256.45)ng/L than group C(P <0.001).In cor pulmonale groups,BNP was positive-ly correlated with RV,RVOT,and PASP,negatively correlated with FEV1 ,and not correlated with LVEF %.In group D and E,BNP was negatively correlated with LVEF %.The best cutoff point of BNP was 285.3ng/L between cor pul-monale heart function compensatory period group(group B)and cor pulmonale right heart failure group(group C). The best cutoff point of BNP was 764.2ng/L between cor pulmonale right heart failure group(group C)and the whole heart failure group(group E).Conclusion There is certain correlation between serum BNP level and the progress of chronic cor pulmonale.Dynamic monitoring of serum BNP level in the judgement of treating cor pulmonale is of certain reference significance.

Objective To explore the influence of whole-course individualized nursing intervention on treatment compliance among intractable epilepsy children with ketogenic diet therapy.Methods 80 intractable epilepsy patients with ketogenic diet therapy were divided into the control group and the experimental group with 40 cases in each group.The routine nursing was given to the control group.On basis of routine nursing,whole-course individualized nursing intervention was given to the experimental group.The investigation was carried out before and after intervention in two groups by using self-designed questionnaire.The treatment compliance and therapeutic effect were compared between two groups.Results The treatment compliance and therapeutic effect were significantly alleviated in the experimental group compared with the control group in the third,sixth and twelfth months.Conclusions The whole-course individualized nursing intervention can improve the parental awareness of the disease,enhance their confidence and determination to adhere to the treatment,improve their treatment compliance,thereby improve the effect of treatment.

The relationship between Ala/Ser polymorphism in 133 codon of exon 3 region of the RASSF 1 gene and genetic susceptibility of lung cancer in Hubei province Han population was inves-tigated by a case-control study. Polymerase chain reaction-restriction fragment length polymorphisrr (PCR-RFLP) technique was adopted to analyze the polymorphism of codon 133 of exon 3 in the RASSF1 gene of 100 pathologically diagnosed lung cancer patients, and 100 healthy controls. The relationship between different genotypes and the susceptibility of lung cancer was analyzed. Among 200 blood samples from Han people in Hubei Province, including 100 from lung cancer patients and 100 from healthy controls, the frequencies of Ala/Ala, Ala/Ser, Ser/Ser genotype of the RASSF1 in lung cancer patients were 83%, 16%, 1%, and those in healthy controls was 93%, 7%, 0% respec-tively, with the difference being statistically significant between two groups (P<0.05). The individu-als with Ala/Ser genotype had higher risk of suffering from lung cancer, with an OR of 2.341, and 95% CI of 1.009-6.393 respectively. It was concluded that RASSFIAla133Ser was a susceptible ge-netic factor of lung cancer. Ala/Ser genotype increased the risk of lung cancer.