Objective: To investigate the diagnostic value of combined examination of copeptin and high sensitivity cardiac troponin T (hs-cTnT) in patients at the early stage of acute myocardial infarction (AMI) . Methods: A total of 272 patients were enrolled in this study, all of them suffered from chest pain and admitted within 4 hours. The patients were divided into 4 groups according to coronary artery angiography (CAG) results. Control group, the patients with normal CAG,n=64, UAP group (unstable angina pectoris),n=50, STEMI group,n=82, NSTEMI group,n=76. All patients received in-hospital observation, plasma levels of copeptin and hs-cTnT were examined at admission and at 6 hours after the chest pain respectively. Results: Within 4 hours of chest pain, combined examination of copeptin and hs-cTnT had the higher sensitivity for diagnosing AMI than a single detection of hs-cTnT with the cut-off point of hs-cTnT ≤ 14ng/L and Copeptin < 14pmol/L. In NSTEMI group, the AUC (area under curve) for combined examination was 0.97 (95% CI 0.88-0.99), AUC for single hs-cTnT detection was 0.75 (95% CI 0.62-0.87),P<0.05. In STEMI group, the AUC for combined examination was 0.97 (95% CI 0.88-0.99), AUC for single hs-cTnT detection was 0.74 (95% CI 0.60-0.88),P< 0.05. The AUC for combined examination of copeptin and hs-cTnT in diagnosing early AMI was 0.912 (95% CI 0.812-0.961) which was higher than single detection of hs-cTnT, AUC 0.851 (95% CI 0.713-0.936), Z=2.553,P<0.05. Conclusion: Combined examination of copeptin and hs-cTnT had the higher sensitivity and accuracy for diagnosing the patients at the early stage of AMI, it may help the risk stratiifcation of chest pain which is valuable in clinical practice.

Objective To investigate the change of tear film function in patients with seasonal allergic conjunctivitis (SAC) between acute exacerbation and non-onset phase.Methods This was a prospective controlled study.Functional assessment of tear film was performed in 30 eyes of 15 patients with SAC (SAC group) between acute exacerbation and non-onset phase and 15 healthy controls (control group).The tear film function included tear film break-up-time (BUT),Schirmer I test (SIt) and tear film interferometer imager measurement.Results BUT was significantly decreased in SAC group on acuteexacerbation compared with that on non-onset phase and control group [(6.97 ± 1.56) s vs.(11.27 ± 1.39),(12.00 ± 1.11) s],and there was significant difference (U =20.50,P =0.000;U =1.00,P =0.000).Moreover,BUT in SAC group on non-onset phase was similar as control group(U =322.00,P ＞ 0.05).There was no significant difference in SIt among SAC group on acute exacerbation and non-onset phase and control group(P ＞ 0.05).In tear film interferometer imager measurement,80.0％(24/30) was Ⅰ-Ⅱ grade,20.0％(6/30) was Ⅲ grade in control group,20.0％(6/30) was Ⅰ-Ⅱ grade,80.0％(24/30) was Ⅲ-Ⅴ grade in SAC group on acute exacerbation,60.0％(18/30) was I-Ⅱ grade,40.0％(12/30) was Ⅲ-Ⅴ grade in SAC group on non-onset phase,and there was significant difference between SAC group on acute exacerbaiion and SAC group on non-onset phase,control group (x2 =19.27,P =0.000; x2 =8.40,P =0.004),and there was no significant difference between SAC group on non-onset phase and control group (x2 =1.98,P＞0.05).Conclusion SAC can cause the instability of tear film during the acute exacerbation,whereas this instability can be recovered within the non-onset phase of S A C,which is close to the normal control

Objective To evaluate the effects of percutaneous transhepatic variceal obliteration in the treatment of acute bleeding from gastroesophageal varices in patients with severe cirrhosis.Methods 19 patients with Child C cirrhosis suffered from active bleeding from gastroesphageal varices. Emergency procechures of percutaneous transhepatic variceal obliteration were performed in all 19 patients. Results Successful catheterization and obliteration of the varices in all of the 19 cases. Active bleeding were controlled in 18 cases with only one failure and TIPSS was performed. During a follow up peroiod ranging from one to 12 months, 14 cases bled recurrently during 3 to 12 months. 15 cases died within the follow up period. 4 cases were alive. Severe complication of intraperitoneal bleeding occurred in 1 case, and laparotomy was performed. Conclusions Percutaneous transhepatic variceal obliteration is effective in controlling acute bleeding from gastroesophageal varices in patients with Child C cirrhosis. It could be used as the first choice treatment method for emergency when TIPSS is contraindicated.

Objective To investigate technique methods of dense emolization of intracranial aneurysms, factors resulting incomplete embolization. Methods 58 patients with intracranial aneurysms, using different embolization technique treated narrow and wide aneurysms with GDC. Dense emolization rate of aneurysms was elevated. Results dense emolization 50 aneurysms (86.2%), 95% in 3 aneurysms (5.2%), 90% in 3 aneurysms (5.2%), 80% in 2 aneurysms (3.4%). All embolizated aneurysms showed no enlarging recurrence or rebleeding.Conclusions Dense embolization of intracranial aneurysms should try to obtain.

OBJECTIVE To investigate the distribution and drug resistance of nosocomial infection pathogens in ICU from 2005 to 2008.METHODS Antimicrobial susceptibility test of 850 clinical isolates were carried out by means of K-B method.RESULTS Among 850 isolates,Gram-negative bacilli,Gram-positive cocci and fungi accounted for 68.9%,15.8% and 15.3%,respectively.ESBLs-producing strains accounted for 50% and 55.4% in E.coli and Klebsiella spp.MRS was detected in 82.7% of Staphylococcus.Imipenem and meropenem were the most active agents against strains of Enterobacteriaceae,Acinetobacter spp and Pseudomonas aeruginosa.No VRE or VRS strains were detected.CONCLUSIONS Gram-negative bacilli are the most frequent organisms in ICU.It is necessary to conduct drug resistance supervision of nosocomial infection pathogens in ICU and take measures to control nosocomial infection spread.

Objective:To explore the directed forgetting ability of elder people to disease/death-related words under the conditions of the neutral and negative emotion.Methods:Thirty-six elder people and thirty-seven young people were included in this study.The directed forgetting effects to disease/death-related words were compared by using item-method directed forgetting paradigm under the neutral and negative emotional conditions.Results:Under the neutral and negative emotion conditions,higher recognition of to-be-remembered (TBR) than to-be-forgotten (TBF) words in elder group and younger group (Ps ＜ 0.05).The elder group showed the weaker effect of directed forgetting than younger group[neutral emotion:(0.4 ± 0.1) vs.(0.6 ± 0.1);negative emotion:(0.3 ± 0.1) vs.(0.7 ± 0.04),Ps ＜ 0.05].Under the negative emotion condition,elder people showed stronger effect of directed forgetting for sensitive words compared with control words[(0.4 ± 0.1) vs.(0.1 ± 0.1),P ＜ 0.001].Conclusion:The results suggest that the directed forgetting ability of elderly is weaker than that of young individuals,the ability of non-sensitive words than that with sensitive words,and the directed forgetting effect of elder people tonon-sensitive words in negative emotion is weaker than that in neutral emotion.

AIM:To investigate whether ginsenoside Rg1 attenuates high-fat diet ( HFD)-induced non-alcoho-lic fatty liver disease ( NAFLD) by improving β-oxidation.METHODS: SD rats ( n=60) were randomly divided into control group ( CON ) , HFD group, low-dose, medium-dose and high-dose ginsenoside Rg1 groups ( LDG, MDG and HDG) and positive drug ( sodium ursodeoxycholate) treatment group ( PDT) .High-fat diet was given for 8 weeks to suc-cessfully establish an NAFLD model.The animals were treated with the appropriate medications for 4 weeks and 8 weeks af-ter modeling, and sacrificed to collect the liver tissues for observing the pathologic changes with HE staining and for detec-ting liver functions and lipid levels.The expression of hepatic acyl-CoA synthetase 1 (CoASH1), carnitine acyltransferase I (CATI) and acyl-CoA oxidase 1 (ACOX1) at mRNA and protein levels was determined by RT-PCR and Western blot-ting.RESULTS:After 4-week treatment, the fatty infiltration of the liver tissues in PDT group, LDG group and MDG group was not attenuated except HDG group.After 8 weeks of treatment, a small number of fat particles was observed in PDT group and LDG group, while no infiltration of lipid droplet was found in MDG group and HDG group.Compared with HFD group, the levels of AST, ALT, AKP, TC, TG and LDL-C were significantly decreased after 4-week treatment in PDT group, LDG group, MDG group and HDG group (P<0.05), these indexes were further reduced after 8-week treatment. After 4-week treatment, HDL-C was significantly increased in the 4 treatment groups and almost restored to the level of CON group after 8-week treatment.The levels of CoASH1, CACTI and ACOX1 in the liver tissue of the 4 treatment groups were significantly increased after 4-week treatment (P<0.05) and much improved after 8-week treatment, and those in MDG group and HDG group were better than those in PDT group (P<0.05).CONCLUSION:Ginsenoside Rg1 regulatesβ-oxidation-related enzymes to improve the fat metabolism, thus playing a therapeutic role in liver injury in the rats with NAFLD.

Objective To explore the efficacy of microvascular decompression (MVD)on trigeminal neuralgia and the anatomical characteristics of the responsible blood vessels.Methods The clinical data of 25patients with idiopathic trigemine neuralgia(ITN) undergoing MVD were analyzed retrospectively.The origins of the responsible blood vessels and sites of compression at the trigeminal root were observed and determined.Meanwhile,the anatomical characteristics of the responsible blood vessels and the efficacy of MVD were investigated.Results The offending vessels which were responsible for ITN were identified at root exit zone (REZ) in 21 cases (84％).The most common responsible vessel was the superior cerebellar artery in 13 cases (52％),followed by anterior inferior cerebellar artery in 6 cases (24％).Seventy six percent of the offending vessels were arteries and 8％ were rock vein.No vascular compression but evident increase in the thickness of arachnoid mater covered by the trigeminal nerve was observed in 4 cases ( 16％ ).All patients were relieved for the acute pain and the overall cure rate was 96％.Conclusion MVD is a safe,microinvasive and effective surgical modality for ITN.The key for better outcomes and less complications of MVD is to improve microsurgical techniques and deal with all the involved vessels.

Objective To investigate the characteristics of medicine taking,the type and ratio of long-term medication and treatment satisfaction in patients with gastroesophageal reflux disease (GERD),to analyze the effects of GERD combined with functional bowel disease (FBD) on the treatment satisfaction,and to compare the changes of type of medication and treatment satisfaction in patients with GERD in recent years.Methods From April to June in 2011,the questionnaire survey was conducted in gastroenterology clinic of People's Hospital of Peking University.The incidence of typical GERD symptoms was investigated by a validated reflux disease questionnaire (RDQ),the score between one and five was considered there might be reflux symptoms and the score over 12 was diagnosed as GERD.FBD was diagnosed according to Rome Ⅲ criteria.The information of GERD related medication taking within one year before the survey,long-term medication taking (≥ 1 year)and the treatment satisfaction of patients whose RDQ score over zero was recorded and compared with the data collected in the same method in 2004.The chi-square test was performed for data statistical analyses with SPSS 17.0 software.Results Among 1074 patients who completed questionnaire survey in 2011,the percentage of patients with reflux symptoms was 32.7％ (351/1074),the percentage of diagnosed GERD was 10.0％ (107/1074),and GERD combined with FBD was 25.2％ (27/107) of GERD.A total of 304 cases (86.6％) of patients with reflux symptoms had information of medication taking; 78.0％ (237/304) of whom had taken GERD related medication within one year before the survey.The rate of GERD related medication taking especially proton pump inhibitor (PPI) and antiacid medication taking increased along with RDQ score (x2 =24.2,13.1 and 18.2,all P＜0.05).A total of 104 cases of GERD patients had information of medication taking; 88.5 ％ (92/104) GERD patients had taken GERD related medication within one year before the survey,52.9％ (55/104) GERD patients had taken PPI medication,30.8％ (32/104) needed long-term medication and 20.2％ (21/104) needed longterm PPI treatment.There was no significant difference in treatment satisfaction between different RDQ score ranges (x2 =3.3,P＞0.05).Among GERD patients who appraised the effects of treatment,the percentage of satisfied,acceptable and not satified with the treatment was 37.1％(26/70),48.6％ (34/70)and 14.3％(10/70),respectively.There was no significant difference in treatment satisfation between GERD with and without FBD (x2 =3.1,P＞0.05).In 2011,the rates of medication taking (88.5％,92/104) and PPI taking (52.9％,55/104) in GERD patients significantly increased compared with those in 2004 (57.3％,98/171; 7.6％,13/171,x2 =29.4,71.4,both P＜0.05).The percentage of treatment satisfaction in 2011(37.1％,26/70) increased compared with that in 2004(25.7％,18/70,x2 =12.8,P＜0.01).Conclusions Some of patients with GERD symptoms need long-term medication,especially PPI treatment.In recent years,the rate of medication taking in GERD patients increased in outpatients department,PPI taking significantly increased and the treatment satisfaction also increased.Maybe the treatment satisfaction is not affected by GERD combined with FBD.

ObjectiveTo study the expression and clinical significance of osteopontin in nasopharyngeal carcinoma tissues.MethodsOsteopontin expression was determined in nasopharyngeal carcinoma tissues in 44 cases and normal mucosa tissues in 25 cases by immunohistochemical staining.The relationship between osteopontin expression and pathological features of nasopharyngeal car(e)inoma was analyzed.ResultsThe positive expression rate of osteopontin in nasopharyngeal carcinoma tissues was significantly higher than that in normal tissues and the positive staining area was larger [77.27％(34/44) vs.8.00％(2/25),(60.24 ± 17.51 )％ vs.(1.32 ± 0.48)％ ](P＜0.05).The positive expression of osteopontin was correlated with clinical staging and lymph node metastasis(P ＜ 0.05),while had no relationship with pathological staging(P＞ 0.05).ConclusionsThere is a close correlation between expression of osteopontin and tumor cell invasion and metastasis.Over-expression of osteopontin may be one of the important factors contributing to the invasion and migration of nasopharyngeal carcinoma.