Objective To study the influencing factors which will lead to depression in patients undergoing orthopedic operation and put forward reasonable nursing countermeasures. Methods 198 patients with orthopaedic operation were investigated using the self-rating depression scale (SDS),social support rating scale (SSRS) and self-designed questionnaire.The influencing factors underwent Logistic regression analysis. Results 105 cases of patients with depression were found among 185 cases,accounting for 56.8％,and 70 cases(66.6％) with mild depression,30 cases(28.6％) with moderate depression,5 cases (4.8％) with severe depressive disorders.SDS score before operation was (37.59 ± 8.74),higher than (33.46 ± 8.55 ) of the national norm.Single factor and multiple factors Logistic regression analysis revealed that paying out-of-pocket for healthcare,worrying about poor prognosis,worrying about the diagnosis and treatment level,considering bad attitude of medical staff were main influencing factors for depression,while social support is a good way to protect patients against depression. Conclusions To cope with the serious depression of orthopedic patients,medical staff should take certain measures to improve patients' psychological quality,so as to achieve the purpose of improving their physical quality.

OBJECTIVE To compare the BacT/Alert FN with Botai SN anaerobic blood culture bottles for detection of commonly encountered anaerobes.METHODS Using these two types of anaerobic bottles to culture 5 commonly encountered anaerobes in automatic blood culturing system and BacT/Alert system,and then to analyze the results.RESULTS There were all 32 anaerobic bottles reported positive results by BacT/Alert FN bottles,and only 8 positive bottles were reported by Botai SN bottles.CONCLUSIONS The performance of the BacT/Alert FN is much better than Botai SN anaerobic blood culturing bottle when it is used to detect commonly encountered anaerobes.

Objective To investigate the association of restriction fragment length polymorphisms (RFLP) in p.S267F of SLC10A1 gene with clinical outcomes of hepatitis B virus (HBV) infection. Methods Clinical data of 1 268 patients with HBV infections admitted in Public Health Clinical Center Affiliated to Fudan University during July 2014 and February 2015 were collected.Polymerase chain reaction-restriction fragment length polymorphism ( PCR-RFLP) method was used to genotype the p .S267F of SLC10A1 gene in all patients, and the potential association between variants in p .S267F of SLC10A1 gene and the clinical outcomes of HBV infection was analyzed .Results Among 1 268 patients with HBV infections, 1 226 were of genotype CC, and 42 were of genotype CT, so the variation rate in p.S267F was 3.31%(42/1 268).Compared with patients with genotype CC , patients with genotype CT had a higher incidence of acute HBV infections (13.6%vs.28.6%,χ2 =19.819, P<0.05) and a lower incidence of HBV-related liver cirrhosis or hepatocellular carcinoma (13.9% vs.4.8%, χ2 =18.945, P <0.05). Conclusion RFLP in p.S267F of SLC10A1 gene may be associated with chronicity and aggravation of HBV infection, and genotype CT is possibly a protective factor .

Objective To identity the characteristic metabolites of platelets activation by Plasma metabolic Profiling in acute myocardium infarction ( AMI ) patients.Methods From August 2012 to February 2013, samples in three groups were collected at Tianjin Third Central hospital, including AMI group (25 clinically diagnosis myocardial infarction, 14 male, 11 female, average age 67 ±13 ) , control group(A) and simulation platelet activation group(B) (A and B group composed of 29 health volunteers, 11 male 18 female, average age 65 ±12 ) .After collagen platelet activation on B group, HPLC-LTQ Orbitrap XL MS platform was used to analyze the serum metabolic profiling in three groups respectively.Principal component analysis ( PCA) model and partial least squares-discriiminate analysis ( OPLS-DA) model were established to select characteristic metabolites in A and B group, and then tested in X group to find common ions.Results 20 characteristic metabolites were selected in A and B group.3 different lysophosphatidyl choline, sphingosine 1-phosphate, ethanol amine amides, sphingosine choline phosphate, thromboxane, 14-methyl hexadecanoic acid showed the same changing trend and were significant different between B group and AMI group.Conclusions Characteristic ions selected by metabolic profiling technology had significant distinguishing ability for AMI patients and health control.They may provide early diagnosis for AMI.

Objective To calculate the biological reference of plasma amino acid on L-8900 amino acid analyzer and to provide reference for clinical diagnosis with domestic reagents replacing original reagent .Methods By testing the original standards and the same batch of plasma (50 cases) ,we compared original reagents with domestic reagents for their performance (including resolution , repeatability ,accuracy ) .We tested the plasma free amino acids of 400 cases of healthy people using the domestic reagents to estab-lish biological reference interval of plasma amino acid ,and do correlation analysis between the amino acids level and liver function . Results (1)Domestic reagents showed high accuracy in the results of 5 consecutive detection of amino acids were high peak separa-tion and high peak retention time and high peak area .(2)Statistics derived biological reference interval of 19 amino acids and 10 kinds of amino acids had significant differences .(3)Correlation analysis showed that ALT and liver function were negatively corre-lated with threonine(P<0 .05) .GLU and valine ,isoleucine ,leucine were positively correlated(P<0 .05) .CHO and negatively cor-related with isoleucine(P<0 .05) .Conclusion Domestic agents can replace the original reagents ,on the basis ,the biological refer-ence intervals of plasma amino acids have great importance to clinical diagnosis and prognosis .

Objective To evaluate the clinical significance of the combined determination of serum procalcitonin (PCT),C reactive protein(CRP),prealbumin(PA)and white blood cell(WBC) in curative effect and prognosis of elderly patients with bacterial infection.Methods Serum PCT,CRP,PA and WBC levels and their dynamic changes of 70 patients with bacterial infection from intensive care unit(ICU)were measured.The patients with bacterial infection were classified into serious infection group and local infection group.And the comparison with virus infection group was made.Results The levels of PCT(18.00±3.20)μg/L and CRP(86.17±10.64)mg/L in serious infection group and local infection group[PCT(2.03±0.46)μg/L,CRP(50.24±7.45)mg/L] were increased.The contents of PA were reduced[(3.214±0.88)mg/L,(12.89± 1.03)mg/L].The levels of WBC were increased mildly[(8.89±1.23) × 109/L,(6.54±0.87) × 109/L].The differences were statistically significant between bacterial infection groups(serious infection group and local infection group) and virus infection group [PCT (0.21 ±0.06)μg/L,CRP (5.21 ±0.84) mg/L,PA (20.14 ±2.57)mg/L,WBC (5.30 ± 0.93) × 109/L] (P＜ 0.01).Serum PCT,CRP.PA and WBC showed significant differences between serious infection group and local infection group(P＜0.01).After antibiotic treatment,the levels of PCT (0.5 ± 0.08) μg/L,CRP (10.32 ± 1.65) mg/L and WBC (6.30± 0.91) × 109/L in bacterial infection group were reduced obviously and the concentration of PA (18.19±2.66)mg/L was elevated compared with before treatment [PCT(11.61±8.27)μg/L,CRP (71.80±20.09)mg/L,WBC(7.95± 1.59) × 109/L,PA(7.08±4.87)mg/L] (P＜0.01).Correlative analysis was performed between PCT and others indicators before and after antibiotic treatment in bacterial infection group and virus infection group.There was positive correlation between PCT and CRP,WBC before(r=0.586,0.445) and after treatment (r=0.688,0.463) in bacterial infection group.PCT and WBC(r=0.432) were positively correlated after treatment,while no correlation existed between PCT and others indexes in virus infection group(r＜0.306).When comparing sensitivity and specificity of PCT and CRP for diagnosis of bacterial infection disease,the sensitivity (95.7％) of PCT was similar to that of CRP.The specificity of PCT(86.7％) was remarkably higher than that of CRP(73.3％).Conclusions The combination of serum PCT,CRP.PA and WBC is valuable for early diagnosis of bacterial infection disease.Monitoring PCT level dynamically would assist an evaluation of curative effect and disease outcome of elderly patients.

Objectives This research explored the characteristics of changes in the serum metabolic profile of preeclampsia pregnancy(PE) to establish the disease distinguish model and screen characteristic metabolic markers with potential diagnostic value for preeclampsia.Methods From August 2014 to January 2016,samples in three groups were collected at Tianjin Third Central Hospital.Thirty-one clinically diagnosis patients with preeclampsia,25 normal pregnancy women and 29 healthy volunteers of childbearing age were enrolled.Ultraperformance liquid chromatography-mass spectrometry (UPLC-MS) was used to analyze serum metabolites of PE group (31 patients with preeclampsia),P group (25 normal pregnancy women) and Normal group (29 healthy volunteers of childbearing age).Nonparametric test analyzes were used to analyze the data and find the specific metabolites.Results This research established the principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) disease distinguish model for PE group,P group and Normal group.To distinguish PE group,P group and Normal group,15 characteristic metabolites were identified.Eight kinds of glycerol phospholipid (including 7 kinds of hemolysis phosphatidyl choline and 1 kind of lysophospholipids acid) and 1 kind of sphingomyelin in PE group were higher than that of normal pregnancy group.The difference had statistically significant(Z of the metabolites were 2.32,3.34,3.21,2.60,2.22,3.40,3.58,5.84,2.70 respectively,all P<0.05).1,25-Dihydroxyvitamin D3-26,23-lactone and 24-Oxo-1alpha,23,25-trihydroxyvitamin D3 in PE group were higher than that of P group and Normal group,which had a statistics difference (Z of the metabolites were 2.01,3.89,3.26,2.34 respectively,all P<0.05).Conclusions Metabolomics distinguish model has a good ability to distinguish PE group,P group and Normal group.Serum characteristic metabolites can successfully reflect the status of fat,calcium and phosphorus metabolism of preeclampsia patients and provide high value for prediction,diagnosis and treatment.

Objective To evaluate the serum metabolic profiling of acute myocardium infarction (AMI) patients,establish a disease distinguishing model and to select characteristic metabolites with potential clinical diagnostic value.Methods All 42 AMI patients and contemporaneous 35 healthy physical examination adults from May 2011 to March 2012 at the Third Central Hospital of Tianjin.UPLC-LTQ Orbitrap XL MS platform filter characteristics of metabolites.SPSS 17.0 was used for statistical analysis.ROC curve was established to assess the clinical diagnostic value of selected characteristic metabolites.Results PCA (R2X =75.6％,Q2 =39.7％) model and OPLS-DA (R2Y =97.8％,Q2 =97.0％) model were established and 19 ions were identified.Glycerophospholipids decreased in AMI group and sphingophospholipids increased in AMI group.The areas under the curve of all identified metabolites were greater than 0.8.Conclusion Metabolites selected in metabolic profiling analysis show outstanding ability in distinguishing AMI from health people and can be used as potential diagnostic biomarkers and benefit in further clinical study as novel drug targets

Objective Pleural effusion of patients with tuberculous pleurisy was analyzed by ultra high performance liquid chromatography-mass spectrometry (UPLC-MS).Orthogonal partial least squares discriminant analysis (OPLS-DA) model was established for searching and analyzing the potential metabolic biomarkers to provide new ideas for the early diagnosis of tuberculosis pleurisy.Methods Totally 166 cases of pleural samples were collected from November 2012 to September 2013 in Tianjin Haihe Hospital (tuberculosis pleurisy 83 cases,bacterial pleurisy 31 cases,lung cancer 30 cases and heart failure 22 cases)and metabonomics quantitative analysis was conducted.Quantitative analysis of metabolic methods was enrolled.Orthogonal partial least squares discriminant analysis (OPLS-DA) model was constructed by the pattern recognition method.Based on the OPLS-DA model,potential biomarkers was filtered preliminary by variable importance in the projection (VIP) and VIP confidence interval value.The specific metabolites were determined by applying non-parametric test(Kruskal-Wallis H test)by using SPSS 17.0,and potential metabolic biomarkers were screened.Results The prediction accuracy of OPLS-DA model was 100％ (38/38),which illustrated that the model could verify the tuberculous pleurisy group and the control group accurately.Based on the data of metabolites,46 potential metabolites were finally screened and 5 metabolites were identified with statistically significant differences (P ＜ 0.05).The data of tuberculosis pleurisy group showed a significant increase in 17a,20a-Dihydroxy cholesteryl,phospholipid [20∶4 (8Z,11Z,14z,17Z)] (1 188 670.00),tocotrienols (1 051 760.00) and phospholipid(O-18:0) (434 394.00) compared with the lung cancer group(735 615.00,336 815.00,324 563.00,193 055.00),bacterial pleurisy group (1 678 805.00,598 256.50,699 384.00,343 866.00),and heart failure group(535 842.00,253 503.00,234 503.00,130 185.00) (H =26.787,18.680,26.193,21.024,P ＜0.01),and a significant decrease in L-phenylalanine(245 976.00)compared with the lung cancer group(753 033.50),bacterial pleurisy group (357 278.00),and heart failure group(586 678.00) (H =13.635,P ＜ 0.01).Conclusions The OPLSDA model constructed on the basic of UPLC-MS technology platform can verify the tuberculous pleurisy group and the control group accurately,and the study provides new ideas and methods for identifying features of tuberculous pleurisy markers and early diagnosis.

Objectives To investigate the characteristics of changes in serum metabolic profile before and after resection of carcinoma tissues to establish a disease distinguishing model,to analyze the changing trend of characteristic metabolites,and to determine the molecular mechanism and potential clinical value of characteristic metabolic markers for HBV-related liver cancer.Methods Ultraperformance liquid chromatography-mass spectrometry (UPLC-MS) was used to analyze the serum metabolites of 15 patients with hepatocellular carcinoma (HCC) before and after partial hepatectomy and on 25 healthy volunteers.The pattern recognition method and nonparametric test analyzes were used to analyze the data and to identify the specific metabolites and their changes after resection of carcinoma tissues.Results We established the principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) disease distinguishing model for HCC patients before and after operation as against the healthy volunteers.To distinguish between the liver cancer group and the normal control group,27 characteristic metabolites were selected from the patients before and after resection of carcinoma tissues.Eight moved towards the normal control after resection of carcinoma tissues.This indicated that liver carcinoma was an important impacting factor for these metabolites.Finally,7 metabolites were identified,and these metabolites had high diagnostic value as shown on ROC curves.Conclusions Through serum metabolic profiling of patients before and after resection of carcinoma tissues,a high correlation between metabolism and hepatocellular carcinoma was found.Researches on endogenous metabolites and pathways in liver diseases will provide a better understanding of the molecular mechanisms and provide further directions for clinical diagnosis and treatment.