Objective Investigate the postmortem stability of the six immunohistochemical markers of fibronectin(Fn),fibrinogen(Fg),C5 complement(C5), myoglobin(Mb), actin(HHF35)and desmin(Dm)for the postmortem diagnosis of myocardial infarction.Method The areas of depletion ofMb、HHF35 and Dm,and the positive reaction areas of Fn、Fg and C5 in the ischemic myocardium were studied with immunohistochemistry,image analysis technique and statistical system.The postmortem stability of the six immunohistochemical markers was compared.Results The specimens of normal myocardium kept at 4℃ for 1 to 2 days showed homogenous brown reactions for Dm, HHF35 and Mb; depletion of Dm, HHF35 and Mb became evident when these specimens were kept at 4℃ for 3 days postmortem, and the depletion area increased with the lapse of postmortem interval; the depletion area of Dm, HHF35 and Mb in ischemic myocardial tissues also increased with the lapse of postmortem interval;the positive reaction areas of Fg, C5 and Fn in ischemic myocardial tissues decreased with the lapse of postmortem interval.Fg became negative when the ischemic myocardium were kept at 4℃ for 2 weeks postmortem,C5 became negative when kept at 4℃ for 3 weeks postmortem,but Fn remained positive when kept at 4℃ for 4 weeks postmortem.No positive reactions for Fg,C5 and Fn could be found in normal myocardium when kept at 4℃ for different time intervals. The image analysis result showed that the positive reaction areas decreased with the lapse of postmortem interval. Conclusion The Dm and HHF35, Mb showed least postmortem stability, easily influenced by autolysis, only suitable for detection in fresh corpses(1to 2dayspostmortem) ;Fgislittlebitbetter,suitableforcorpsesat4℃ 1weekpostmortem ;C5isbet ter,suitableforcorpsesat 4℃ 2weekspostmortem ;Fnisthebestmarker ,suitableforcorpsesat 4℃ 4 weekspostmortem .

Objective To observe the clinical feasibility and effects of regional nerve blockade in patients with heart failure.Methods The study enrolled a total of 10 patients,age range from 55 to 75 years old(average 64?11 years old).The subject includes 8 males and 2 females,among which 6 cases were ischemic cardiomyopathy and 4 cases were dilated cardiomyopathy.All the patients met the criteria of NYHA class Ⅲ-Ⅳ heart function with heavy fluid load unresponsive to optimal medical therapy.Patients with diabetes and renal failure were ruled out from the study.After application of local anesthesia,15 mL of 0.25% Naropin was injected inside Gerota's fascia to achieve regional nerve blockade under CT guidance.Serum and urine electrolytes,neurohormones,renal clearance of sodium and 24-hour urine volume were recorded 24 h before and after the operation.Variartions in heart rate,blood pressure and symptons of dyspnea and edema were also under monitor.Results After nerve blockade,the 24-hour urine volume and renal sodium clearance increased obviously while the level of neurohormones decreased compared with that before operation.No obvious changes in heart rate and blood pressure were recorded and the symptons of heart failure were improved in the patients after operation. No complication was recorded in the study. Conclusion Regional nerve blockade may be a feasible,safe and effective treatment for congestive heart failure patients who do not respond well to the existing optimal medical therapy.

OBJECTIVE:To study the association between the reticulated platelets(RP) percentage and aspirin resistance(AR) with the percentage of reticulated platelets in whole blood representing the platelets turnover rate to illuminate the influence of platelets turnover rate on AR.METHODS:The RP percentage and arachidonic acid(AA) and adenosine diphosphate(ADP)-induced platelet aggregation in 80 patients after receiving aspirin(100 mg?day) for no less than 7 days were determined.The patients were divided into AR group,aspirin semi-resistance(ASR) group,and aspirin sensitive(AS) group,and the RP percentage in the three groups were compared.RESULTS:RP percentages in AR,ASR,and AS groups were(4.11?2.62)%,(2.23?1.79)%,and(2.18?1.24)%,respectively,showing signficant differneces between AR group and AS group(P0.05).CONCLUSION:Increased platelets turnover may induce AR,therefore,the patients with coronary artery disease should receive aspirn for multiple daily(antiplatelet therapy) or to take controlled release or sustained release aspirin.The safety and efficacy of these therapies should be confirmed in clinical trials.

Objective To investigate the incidence of fetal malnutrition( FM), its affected factors and their relationship with small - for gestational - age (SGA) fetus. Methods The intrauterinal growth of fetus was evaluated by the body weight of neonates and FM was detected by clinical assessment of nutritional status ( CANS ). Results ①33 out of 204 cases were found to be FM (16% ). FM in SGA group was significantly higher than that in AGA group ( 5.9% ) (x2 = 69.9, P ＜ 0. 01 ).② When ot = 0. 05, the body weight and head circumference of neonates, the education level of mothers were included into logistic regression model, and their regression coefficient were negative. Conclusion SGA was supposed to be two of the risk factors in developing FM. Fetus with low body weight, small head circumference and not - so - well educated mother were prone to suffer from FM.

Objective To understand the development situation of the purified protein derivative of tuberculin (PPD) test ,the prevalence of tuberculosis(TB) among the school students in Guangxi and the related influence factors of strong positive result in order to provide the basis for establishing the physical examination system of student TB in Guangxi .Methods The PPD test was conducted in the students participating in the survey firstly ,then the students with strong positive PPD test results and the TB sus-picious symptoms and the suspected TB cases were performed chest X-ray and sputum smear examination .The related factors in the students with strong positive PPD test results and non-strong positive PPD test results were comparatively analyzed .Results To-tally ,53 217 students received the PPD test with the positive rate of 5 .74% (3 055 cases) and the strong positive rate of 1 .46%(775 cases) .The detection rate of active TB was 0 .03% (15 cases) .The χ2 test and the Logistic regression analysis showed that the age group and the regional distribution were the influence factors of strong positive PPD test result (P<0 .05) .Conclusion The preliminary screening by the PPD test and then conducting chest X-ray and sputum smear examination are the effective method for find TB in school and the TB clinic .At the same time the TB screening should be strengthened in the schools in high epidemic areas of TB ,especially the college students .

Objective To investigate the relationships between serum osteocalcin levels of fasting plasma glucose(FPG),fasting serum insulin(FINS),insulin resistance,β-cell function as well as lipid metabolism in male traumatic patients.Methods A prospective cohort study was carried out in the Emergency Room of Shanghai Sixth People's Hospital from April to October of 2015.The male adult traumatic patients without traumatic brain injury,shock and the medical history such as the fractures,diabetes were enrolled as trauma group,and then patients' age,body mass index(BMI),injury severity score(ISS), admission time after trauma and fluid resuscitation volume before testing(FRVT) were recorded.A total of 80 heathly male adult subjects were enrolled from the physical examination center as control group with matched age and BMI.Comparison of biochemical characteristics were carried out between two groups, and relationships between serum osteocalcin levels and glycolipid metabolism in trauma group were analyzed.Insulin resistance and β-cell function were calculated by Homeostasis model assessment-insulin resistance(HOMA-IR)and Homeostasis model assessment of β-cell function(HOMA-β).Results A total of 102 male adult traumatic patients mostly subjected to traffic accident (56.9%) with FRVT (208.78±98.68)mL and ISS(9.30±3.67)were enrolled in trauma group.Serum OC levels,HOMA-β,total cholesterol(TC),high density lipoprotein(HDL-c)and low density lipoprotein(LDL-c) were lower,but FPG,FINS,C-peptide(C-P),HOMA-IR were higher compared with control group(P<0.05).Serum OC levels wer were negatively correlated with FPG and TC(P<0.05),and positively correlated with FINS,HOMA-IR,and HOMA-β(P<0.05),but there were no correlation of OC with FRVT and ISS.By multiple linear regression analysis after adjusting for age,BMI,FRVT and ISS,serum osteocalcin levels were significantly related to TC in traumatic patients (β=-0.812,P=0.024).Conclusion The glycolipid metabolism may be impacted by the serum level of osteocalcin after trauma.

Objective:To investigate the efficacy of the combined application of fluconazole and sodium bicarbonate in treatment of oral fungal infections among elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:A total of 360 elderly patients with AECOPD treated in the Emergency Ward of our hospital during July 1, 2018 and December 31, 2019, were included for observation. After admission, the oral mucosal lesions were observed every day, and fungal smear and fungal culture were performed immediately once signs of fungal infection appeared. Meanwhile, fluconazole was given with 300 mg. oral. qd., followed by 150 mg. oral. qd., and 2.5% sodium bicarbonate was given three times a day as gargle.Results:The prevalence of oral fungal infection was 8.3% among which candida infection accounted for 83.2%. The mean treatment time was 5.0 ± 0.3 days. Daily observation of the oral cavity, early detection and application of fluconazole combined with sodium bicarbonate had significantly clinical effect in elderly AECOPD patients with oral fungal infection, with an effective rate of 16.7%, and a cure rate of 83.3%. No toxic side effects on liver and kidney function were found during the treatment. Obvious efficacy was found in relieving clinical symptoms, and there was no increase in hospitalization costs and time.Conclusion:Early combination of fluconazole and sodium bicarbonate has a significant clinical effect on control of oral fungal infection in elderly patients with AECOPD.

Objective To design a wireless monitoring system which can obtain patients' multi-parameters (such as ECG, respiratory, blood pressure, SPO2, and heart rate). Methods The wireless communication system, based on CDMA, receives data through internet and analyses ECG by dealing and measuring signals. Results A wireless monitoring system is designed, which can analyse ECG, blood pressure, and respiratory. Doctors can give diagnostic suggestion based on the monitoring system's analyses and send it to patients by short messages. Conclusion This system can realize long -distance medical monitoring and report the diagnosis to patients timely.

Objective To develop a portable sleep monitoring system with low burden. Methods Information from signals related with sleep were used and dug. Electrodes from patients' body were reduced to decrease patient's physiological and psychological burden. Results Polysomnography(PSG) is the gold standard in detecting the Sleep Apnea Hypopnea Syndrome disease at present. While this method has its problems, such as complicated operation, large expenditure and big physiology and psychology burden for the patient. A sleep monitor system was introduced which has the advantages of convenience, practicality, small physiology and psychology burden for the patient. Conclusion The result indicates that this device is warmly welcomed by doctors and patients, and it is a new device for the diagnosis of the SAHS disease.

Objective To investigate the incidence and risk factors of deep vein thrombosis (DVT) in a cohort of Chinese patients with traumatic spinal cord injury (TSCI),and in addition,to evaluate the effect of injury types and concomitant injuries of other parts of body.Method Records of 143 casualties admitted to our institute for TSCI were analyzed retrospectively.Both lower extremities of all casualties were examined routinely with color Doppler ultrasonography (CDUS) before major surgical treatment.None of these casualties received any thromboprophylaxis before CDUS.Logistic regression was used to analyze risk factors of DVT.Results Of the 143 patients,32.2％ (n =46) suffered from DVT (proximal n =15,distal n =31).All casualties were diagnosed within one week after injury (mean 3.35 ± 1.65 days).Risk factors associated with DVT induced complete motor paralysis (odds ratio [OR] 5.05,95％ CI 1.70-14.90),concomitant fracture of lower extremities (OR 4.30,95％ CI 1.34-17.64),and lumbar vertebra injury (OR 4.29.95％ CI 1.50-10.83).Conclusions Clinically detectable DVT in TSCI are not uncommon in the Chinese population.Casualties with multiple risk factors may be benefited from early administration of thromboprophylaxis.