Objective:To observe the difference of results of treadmill exercise test (TET) between male smokers and non-smokers .Methods:A total of 200 men with long-term smoking ≥20 cigarette per day were screened from outpatients and treated as smoking group .Another 200 men with similar age ,who didn’ t smoke at all ,were regarded as non-smoking control group (control group) .There were no medical history for hypertension ,hyperlipidemia ,diabetes ,and were nega-tive for electrocardiography and color echocardiography (exclude left ventricular hypertrophy etc .organic heart disease) in two groups .TET results and incidence rate of acute myocardial infarction (AMI) within two years were compared between two groups .Results:Compared with control group ,there were significant rise in TET positive rate (37. 5% vs .57. 5% , P<0.001) and incidence rate of AMI (8.5% vs .17.5% ,P=0.007) within two years in smoking group .Conclusion:Risk of suffering from coronary artery disease is more high in smokers among men .

To observe the perioperative changes of erythrocyte (RBC) phosphofructokinase (PFK) activity and content of ATP and Mg~(2+) in patients undergoing open heart surgery. Method: Fifteen patients undergoing open heart surgery were admitted to this study. Arterial blood samples were collected for the measurements of PFK aczivity, contents of ATP and Mg~(2+) in RBC at 9 points: before anesthesia induction, spiliting sternum, the beginning of CPB.5 minutes after aorta occlusion, at the end of CPB, at the end of operation.on the lst,2nd and 3rd postoperative day. Result: Erythrocyte PFK activity had no marked change during anesthesia, but was decreased significantly on the 1st postoperative day compared with beseline (P

Objective To verify the reliability of TLD-based quality audit for radiotherapy dosimetry of medical electron accelerator in non-reference condition by monitoring the dose variations from electron beams with different field sizes and 45° wedge and the dose variations from photon beams with different field sizes and source-skin distance.Methods Both TLDs and finger ionization chambers were placed at a depth of 10 cm in water to measure the absorbed dose from photon beams,and also placed at the depth of maximum dose from electron beams under non-reference condition.TLDs were then mailed to National Institute for Radiological Protection,China CDC for further measurement.Results Among the 70 measuring points for photon beams,58 points showed the results with a relative error less than ± 7.0％ (IAEA's acceptable deviation:± 7.0％) between TLDs and finger ionization chambers measurements,and the percentage of qualified point numbers was 82.8％.After corrected by P,value,62 points were qualified and the percentage was up to 88.6％.All of the measuring points for electron beams,with the total number of 24,presented a relative error within ± 5.0％ (IAEA's acceptable deviation:± 5.0％) between TLDs and finger ioization cylindrical chambers measurements.Conclusions TLD-based quality audit is convenient for determining radiotherapy dosimetric parameters of electron beams in non-reference condition and can improve the accuracy of the measuring parameters in connection with finger chambers.For electron beams of 5 MeV ＜ E0 ＜ 10 MeV,the absorbed dose parameters measured by finger ionization chambers,combined with TLD audit,can help obtain the precise and reliable results.

Objective To study the efficacy of linezolid on gram positive bacterial infection in elderly patients and risk factors associated with thrombocytopenia.Methods A retrospective analysis of 50 elderly patients treated with intravenous linezolid for gram-positive bacterial infection from January 2008 to October 2010 was conducted.Clinical data and bacteriological responses were assessed.Efficacy of linezolid on infection and risk factors associated with thrombocytopenia in elderly patients were analyzed.Results The average duration of treatment was (13±2) d,the efficacy rate was 74 ％ and the bacteriological eradication rate was 69 ％ (18/26).Thrombocytopenia occurred in 24 patients during the treatment,and the average platelet count was significantly reduced compared with pretreatment[(146±87) 109/L vs.(239± 114) 109/L,t=3.888,P=0.000)].Thromhocytopenia was associated with the baseline platelet count and the mean time of linezolid treatment.Based on a Logistic regression analysis,the baseline platelet count ＜ 200 × 109/L was identified as the only significant risk factor for linezolid-associated thrombocytopenia in elderly patients (OR =0.244,95％CI:0.068-0.874,P=0.030).The mean platelet count was decreased significantly after 7 days of treatment,and decreased to the lowest value 1-2 days after the end of therapy.Conclusions Linezolid is effective and safe for the elderly with gram-positive bacterial infection,especially hospital acquired methicillin-resistant staphylococcus aureus infection.Linezolid has little effect on liver and renal function in elderly patients,but it can cause thrombocytopenia,which is associated with baseline platelet count and the mean time of linezolid treatment.Platelet counts should be monitored during treatment and measures should be taken to prevent hemorrhagic tendencies.

Objective To study the expression of eytokines in acute hemorrhage patients with systenlic in-flammatory response syndrome(SIRS)and multiple organ dysfunction syndrome(MODS).Methods Platelet acti-vation markers CD62p and cytokines in acute hemorrhage patients with SIRS and MODS were detected by using flow cytometry,and compared with that of control group.Results The expression of CD62p and cytokines(TNF-α and IL-6)in acute hemorrhage patients,with or without SIRS and MODS wag significantly higher than that in control group(P<0.01),and higher in MODS group than in SIRS group,and in MODS death group than in MODS survival group(P<0.01).Conclusion The activation of platelet and the over-expression of cytokines participate in the on-set and development of acute hemorrhage,SIRS and MODS,and were related with the severity of disease and progno-sis.

Objective To investigate the clonal relatedness of A.baumannii isolates from senile patients by conducting cross-sectional and longitudinal studies on antimicrobial susceptibility profiling and genomic diversity.Methods Cross-sectional study was done among the 170 non-repetitive A.baumannii isolates which were collected from senile patients during two years.Longitudinal study was conducted among 77 A.baumannii collected from 8 senile patients within longtime hospitalization.Results 75.3 ％ of the 170 isolates were non-susceptible to carbapenems,and the phenotype were XDR or MDR which spread evenly all over the senile wards.The isolates belonged to 36 pulsotypes determined by PFGE.Groups Ⅰ (contain119 isolates) were major epidemic strains,which were CRAB with XDR phenotype.In longitudinal study,comparison of pulsotypes was performed for each patient and all isolates were clustered into group Ⅰ except one isolate.All the 77 isolates were XDR.Conclusion Extensive drug-resistance of A.baumannii was a serious problem in the gerontal wards.Clone dissemina tion was the most important style of XDR strains spread.Horizontal infection control measures to interrupt person-to-person transmission should be reinforced to reduce the further spread of XDR A.baumannii.

Objective To study the mini-invasive surgical treatment for cholelithiasis disease in the primary hospital. Methods Laparoseope,duodenoscope and choledochoscope were combined to treat 293 cases with cholelith-iasis which included 2 cases cholecystolithisasis, 131 cases were cholecystolithiasis with secondary choledocholith,28 cases with primary choledocholith,39 cases with calculus of intrahepatic duct,93 cases with calculus of intrahepatic or extrahepatic duct. Results The program had minor trauma, mild suffering, and less operative complications,compared with traditional open operations. Conclusion The combined treatment of laparoscopy, duodenoscopy, choledochoscope and surgery for the cholelithiasis in the primary hospital is feasible, safe and effective.

Objective To verify the absorbed dose and two-dimensional dosimetry delivered by MLC-shaped IMRT photon beams using thermoluminescent dosimeters (TLDs) and radiochromic films.Methods Different types of medical linear accelerators at 7 third-grade first-class hospitals in Hubei were selected for this audit study.Besides TLDs and films,a small polystyrene phantom measuring 15 cm × 15 cm × 15 cm,supplied by the International Atomic Energy Agency (IAEA),was also used.The TPS dose calculation were performed with 6 MV X-ray beam and by delivering 6 Gy dose to the TLDs or films at 10 cm depth for 5 cm × 5 cm field size at 90 cm SSD.After irradiation,comparations were conducted of dose derivations between TPS-calculated values and TLD-or film-measured values.The two-dimensional dosimetry audit was carried out by using 30 cm × 30 cm homogeneous solid phantoms in which a 25 cm × 25 cm film was located at 5 cm depth.A single-filed profile generated by TPS was delivered to the film,and the film was measured.And then,two-dimensional dose distribution was analyzed using the film analysis system.Results The results suggested that the relative deviations of TLD and film to TPS dose was-8.5％ and-1.9％ for accelerator 1,5.4％ and 0.5％ for accelerator 7,respectively,whereas those for other accelerators were within ± 5％.The passing rates for two-dimensional dose distribution at all accelerators were all higher than 90％.Conclusions TLD and film quality audit for IMRT can be applied for a wide range of application in view of its simplicity,reliability and postal convenience.

OBJECTIVETo test whether folic acid offers protection of the brain tissue against acute cerebral infarction in rats.

METHODSSprague-Dawley rats were divided into control (n=8), pre-treatment (n=12) and treatment (n=16) groups, all having routine feed for 7 days. The rats in the control and treatment groups were given normal saline daily, and those in the pre-treatment group received folic acid suspension daily. All the rats were then subject to middle cerebral artery occlusion (MCAO) for 24 h followed by reperfusion. On and after the operation day, the rats in the control group were given normal saline and those in the other two groups were given folic acid suspension daily. Neural function deficiency was evaluated on a daily basis after the operation, and on day 6 after the operation, brain biopsy was performed for examination with TTC staining. Monocyte chemokine -1 (MCP-1) in both normal and infarct tissues was measured by ELISA.

RESULTSOn day 6 after the operation, the neural function deficiency scores of the control, pre-treatment and treatment groups were 4.56∓3.63, 2.94∓2.94 and 1.00∓1.00, and the percentages of the infarct area (to the whole brain area) were (44.23∓10.06)%, (20.64∓6.78)% and (14.61∓13.51)%, respectively. The contents of MCP-1 in the infarct area of the brain tissues were 168.58∓107.21 ng/L, 152.91∓64.78 ng/L, and 97.74∓46.19 ng/L in the 3 groups, respectively.

CONCLUSIONFolic acid can protect brain tissue against acute cerebral infarction in rats.

Animals ; Cerebral Infarction ; drug therapy ; Female ; Folic Acid ; therapeutic use ; Infarction, Middle Cerebral Artery ; drug therapy ; Neuroprotective Agents ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; prevention & control ; Thrombolytic Therapy

Objective:To examine the significance of serum Endocan levels in evaluating the severity of disease and predicting the prognosis for elderly patients with multiple organ dysfunction syndrome(MODS).Methods:Seventy-five elderly patients from the Department of Geriatric ICU at the First Affiliated Hospital of Nanjing Medical University were selected and divided into two groups: the non-MODS group and the MODS group.This division was based on the levels of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)scores and MODS scores within 24 hours of admission.Additionally, 40 elderly individuals undergoing physical examination were included as a control group.Venous blood samples were collected from all participants to detect the levels of Endocan using ELISA.The patients were further categorized into the survival group and the death group based on their clinical outcome within 28 days.The Endocan levels in all groups were compared, and receiver operating characteristic(ROC)curves were generated to assess the value of Endocan in determining the severity of the disease and predicting prognosis in elderly MODS patients.Results:The levels of Endocan were found to be higher in the MODS group compared to the non-MODS and control groups[(622.3±149.2)ng/L vs.(433.1±189.7)ng/L, P<0.001]. Furthermore, patients with higher APACHE Ⅱ and MODS scores exhibited higher levels of Endocan.The area under the ROC curve(AUC)for Endocan, MODS score, and Endocan+ MODS score were 0.791, 0.806, and 0.820, respectively( P>0.05). Similarly, the AUC for Endocan, APACHE Ⅱ score, and Endocan+ APACHE Ⅱ score were 0.763, 0.799, and 0.803, respectively( P>0.05). Interestingly, the survival group had lower levels of Endocan compared to the death group[(444.6±193.6)ng/L vs.(618.2±149.5)ng/L, P<0.001]. Conclusions:Endocan can be utilized as a noteworthy indicator, which is associated with the seriousness of illness and the prognosis for elderly patients with multiple organ dysfunction syndrome(MODS).