Objective To explore the value of combined application of qualitative detection of TB-DNA serum anti-PPD-IgG and acid-fast staining methods in the diagnosis of tuberculosis infection .Methods Totally 278 pulmonary tuberculosis patients and 121 non-pulmonary tuberculosis patients were collected from Qingyuan people′s hospital during the period from January 2013 to June 2015 .Tuberculosis in patients with TB-DNA qualitative and serum anti-PPD-IgG and acid-fast staining test results was analyzed . Sputum TB-DNA qualitative and serum anti-PPD-IgG detection and joint application of acid-fast staining in the diagnosis of tuber-culosis infection .Results Sensitivities of acid-fast staining ,TB-DNA and serum anti-PPD-IgG in the TB group were 32 .01% , 51 .44% and 48 .56% respectively .The detectable rate of combining TB-DNA with serum PPD-IgG was 67 .63% .The detectable rate of combining TB-DNA with acid-fast staining was 54 .68% .The detectable rate of combining serum anti-PPD-IgG with acid-fast combined rate was 57 .55% .The detectable rate of combining three assays improved to 68 .71% .Conclusion Serum anti-PPD-IgG detection in the diagnosis of tuberculosis is simple ,effective ,qualitative detection of acid-fast staining sensitivity better than TB-DNA ,but it had a poor specificity .Bacteriologic diagnosis are tuberculosis diagnostic gold standard,but the detectable rate for acid-fast bacilli is low .The qualitative of TB-DNA test had a better sensitivity and specificity than other two assay .Combining with three assays could increase detectable rate and improve diagnosis of tuberculosis disease .

The financial objective of the health non-operating state-owned assets(NSA) value-running is defined as non-profit, an empirical test is designed; the non-profit objective function and for-profit objective function is established and the impact of fix asset and staff cost on financial objective in multiple regression functions are compared.

Objective To investigate the clinical features and prognosis of adult dermatomyositis with gastrointestinal bleeding and perforation. Methods The clinical data of a adult dermatomyositis with gastrointestinal bleeding and perforation were retrospectively analyzed. And the clinical characteristics of this patient were analyzed, combined with 7 cases reported in the literature. Results Among the 8 cases, 6 cases were females and 2 cases were males, aged 18 to 63 years. The 5 cases had melena, 3 cases had hematemesis, 3 cases had hematochezia and 1 case had hemoptysis. The main treatment was glucocorticoids, immunosuppressive agent, intravenous immune globulin (IVIG), endoscopic hemostasis and angiographic embolization. Four of the 8 cases died. Conclusions Adult dermatomyositis with gastrointestinal bleeding and perforation is rare, but the condition is dangerous and the mortality is high. Dermatomyositis with early onset of abdominal pain, vomiting, melena should be alert to serious complications such as gastrointestinal bleeding and perforation.

Objective To evaluate the long-term prognostic capacity of the SYNTAX score Ⅱ(SxScore Ⅱ) and SYNTAX score (SxScore) in patients undergoing left main percutaneous coronary intervention (LM-PCI). Methods A total of 209 patients undergoing unprotected LM-PCI in the Cardiology Department of the Affiliated Hospital of PAP of Logistic College were prospectively collected. Follow up was carried out by telephone or outpatient or rehospitalization. The clinical endpoint focused on MACCE after PCI including composite death, nonfatal myocardial infarction, target vessel revascularization and stroke. The secondary endpoint included cardiac death and stent thrombosis. The SxScore and SxScoreⅡ were retrospectively calculated according to results of coronary angiography and clinical features of patients. Patients were stratified according to tertiles of low (≤22), intermediate (23-32), and high (≥33). The clinical data were comparedbetween three groups. The predictive ability of two scoring systems to MACCE after PCI was compared by COX regression evaluation. Results In 209 patients, 12 patients were lost to follow-up (5.7%), and the median follow-up was 30.2 months, 56 cases (28.4%) were observed to suffer from MACCE. The incidence rates of MACCE were 19.0%, 28.6%and 44.4%in SxScore low, intermediate and high groups respectively. The incidence rates of MACCE were 12.8%, 23.8%and 45.5%in SxScoreⅡlow, intermediate and high groups respectively. Single factor analysis showed that SxScore, SxScoreⅡ, age, diabetes and left ventricular ejection fraction (LVEF) were the independent predictors of MACCE. Multivariate analysis showed that SxScore and SxScoreⅡwere still risk independent predictors for MACCE. Conclusion Both SxScore and SxScoreⅡare independent risk predictors for MACCE in patients with unprotected left main coronary artery disease undergoing PCI treatment.

Objective To observe the clinical efficacy of Xuebijing injection ( XI) for the treatment of septic myocardial injury, and to study the possible therapeutic mechanism. Methods Thirty-nine qualified septic myocardial injury patients were randomly divided into XI group (N=24) and control group (N=15) . Both groups were treated with conventional therapy, including anti-inflammation treatment, transfusion for resuscitation, nutritional support, symptomatic and supportive treatment, and supportive treatment for keeping vital organ function. XI group was given intravenous drip of XI based on the conventional therapy. Before and after treatment, the peripheral blood concentrations of myocardial-specific isoenzyme of creatine kinase (CK-MB), cardiac troponin I (cTnI), brain natriuretic peptide ( BNP) and plasma calcitonin ( PCT) were detected, and the changes of electro-cardiogram ( ECG) were also observed. The mortality within 28 days was compared between XI group and the control group. Results ( 1) After treatment, cTnI, BNP and PCT concentrations in XI group were decreased significantly as compared with the control group, and there was statistical significance (P <0.05) . However, the decrease of CK-MB was not obvious in XI group ( P>0.05 compared with the control group) . ( 2) The difference of ECG was insignificant between the two groups after treatment ( P>0.05) . ( 3) The 28-day mortality was 8.33% in XI group, and was 13.33% in the control group, the difference being insignificant between the two groups (P>0.05) . (4) During the treatment, none case had adverse reaction. Conclusion XI can improve the myocardial injury, and relieve inflammation of septic myocardial injury patients.

Obstructive sleep apnea (OSA),the most common type of sleep disordered breathing was closely associated with the occurrence of ischemic stroke.It has been demonstrated that OSA is an independent risk factor for ischemic stroke.Its pathogenic mechanism includes atherosclerosis,coagulation abnormalities and cerebral hemodynamic changes caused by long-term periodic hypoxia hypoxemia and hypercapnia.The prognosis of ischemic stroke patients with OSA is poor.Therefore,it needs to be treated early to avoid further damage to brain tissue and reduce the mortality.

Objective To explore the measure to diminish the misdiagnosis of Budd-Chiari syndrome.Methods 46 cases of Budd-Chiari syndrome were analyzed.Results 33 cases had ever been misdiagnosed with average time of 5.3 years.One of the main clinical symptoms was the pathological process of lower limb(84.8%).Doppler color flow imaging examination showed positive rate of 100% in liver veins and inferior vena cava,,but none of the misdiagnosed cases received this examination.The viral marker test had a positive rate of only 4.3% that was not higher than that of general population.Conclusion Budd-Chiari syndrome has a variety of symptoms,so Doppler color flow imaging is considered an important means to diagnose this disease.

Cushing's syndrome is caused by the excessive secretion of cortisol from the adrenal cortex.Hypertension is one of the most distinguishing features of Cushing's syndrome,as it is present in about 80% of adult patients.The various pathogenetic mechanisms that have been proposed for the development of cortisol-induced hypertension in Cushing's syndrome and its management are discussed.

Objective To establish the method for content determination of total coumarins in Fructus Cnidii.Methods The content of the total coumarins was determined by UV spectrophotometry.Results The optimal detective wavelength was 320 nm for the total coumarins.Satisfactroy linear relationship with the absorbability was achieved when the mass concentration of osthole was within the range of 2～12 ?g/mL(r=0.999 5).The average recovery rate was 99.39%(RSD=2.67%,n=6).Conclusion The method is simple,accurate and sensitive,and it can be used for the quality control of Fructus cnidii and its preparation.

Objective To explore the examination methods about stability of carotid atherosclerotic plaque and evaluate the curative effect of medicine on carotid atherosclerosis.Methods 150 patients with carotid atherosclerotic plaque in acute stage ischemic stroke were divided into treatment group and control group at random.Stable or instable plaques were assessed and carotid artery intima-media thickness(IMT) were measured according to the characteristics of carotid atherosclerotic plaque on supersound imagin.The treatment in treatment group were different from that in control group.The therapeutic efficacy was observed respectively.Results After the treatment 1 month and 3 months,in treatment group carotid artery IMT decreaced more than that at accidence of treatment group and that of control group,the carotid atherosclerotic plaques stabilizese increasingly.Conclusion The stability of carotid atherosclerotic plaque may be evaluated through the ultrasound imagin.Statin and aspirin can lighten carotid atherosclerosis and stabilize the plaque.