Objective To investigate the correlation of serum ereatine kinase iseenzyme-MB (CK-MB) and recent cardiac events(30 days, 180 days) and late cardiac events (360 days) in patients with acute coronary syndrome (ACS). Methods Serum creatine kinase (CK) and CK-MB in 168 patients with ACS were measured, and these patients were divided into four groups according to the levels of CK and CK-MB. The occurrence of cardiac events analysis of CK and CK-MB was followed up for 30, 180 and 360 days and the relationship between the occurrence of cardiac events and the levels of CK and CK-MB were studied. Results There was statistical correlation between increased CK-MB and abnormal ECG Q wave, ST segment change (P< 0.05), 168 patients had followed up 30, 180 and 360 days, in which cardiac events happened in 57 common patients (64 examples), 27 examples (16.1%) happened in the recent cardiac event, and 37 examples(22.0%) happened in the late cardiac event. The cardiac event and CK-MB elevation had statistical correlation (P<0.05). Conclusion ACS patients with increased CK-MB levels prompt a poor prognosis, and could be an independent indicator of recent and late cardiac events in patients with ACS.

Objective To investigate the accuracy and efficiency of hand-held echocardiography (VSCAN) used by intensivist for the diagnosis and treatment decisions in emergency consultation for patients getting worse at risk of life-threatening setting in non-ICU ward.Methods A prospective study in acutely deteriorated patients needed the intensivist for emergency consultation in general wards was carried out.The consultation process was executed as follows:(1) The intensivist established an initial diagnosis based on medical history,physical examination and laboratory findings,and assessed the hemodynamics and the cause of acute respiratory failure and cardiac arrest according the documented information.The data recorded as control group (Pre-VSCAN) for comparison with the later available data in subsequent analysis.(2) Problem-based ultrasound examination was performed with VSCAN.For patients suffered cardiac arrest,the FEEL protocol was used to find the potential cause of cardiac arrest such as pericardial tamponade and massive pulmonary embolism screened.For the other patients,a simplified eFATE or BLUE-plus protocols were used based on clinical requirement.With the findings of ultrasound examination the intensivist established an final diagnosis and identified the hemodynamics and the lung pathologies.The consultation advice was then provided to the attending doctors of the patient.The intensivist kept the records of echo results,final diagnosis and consultation advice as data of study group data (Post-VSCAN).The response of the treatment and outcome were followed up.Two attending ICU doctors analyzed these data and judged the correctness of Pre-VSCAN and Post-VSCAN based on the response to treatment and the outcome.Results Ninety patients were finally included in statistical analysis.Sixteen (17.8％) cases,40 (44.4％) cases,29 (32.2％) cases and 5 (5.6％) were consulted for acute circulation dysfunction,acute respiratory failure,both reasons and cardiac arrest,respectively.Compared to pre-VSCAN,VSCAN verification can significantly improve the accuracy of the diagnosis (81.1％ vs.58.9％,P =0.001),assessment of hemodynamics (78.3％ vs.52.2％,P =0.009) and can find more accurate judgment of acute respiratory failure (71.0％ vs.43.5％,P =0.001).Conclusion The hand-held echocardiography used by intensivist is valuable for the diagnosis and the assessment of cardiopulmonary status in case of request for emergency consultation in general wards.

Experience-oriented teaching approach was introduced into the bilingual course of medical imaging in order to improve the teaching effect.This approach was performed through English literature translation activities and scene-teaching.Meanwhile it points out that this approach has particular advantages in stimulating students' interest and initiative in study.

Objective Comparative evaluation of flow cytometric immunophenotyping in the diagnosis and differentiation of lymphadenopathy,lymphoma and reactive lymphoid hyperplasia. Methods Ninty-nine fine-needle aspiration specimens from patients with tentative clinical lymphoprofierative disorders were consecutively analyzed by both cytology and flow cytometry with histology results as the gold standard. The three color antibodies including CD3,CD3,CD4,CD5,CD10,CD19,CD20,CD23,CD45,K,λ,FMC7 and CD34 were used for cell composition evaluation and cells with abnormal phenotype. Lymphoma cases were classified according to new WHO classification and subtypes were categorized by immunophenotypic analysis. The results from flow cytometry and cytology were compared. Results By cytological study, 40 of 99 cases were diagnosed with lymphoma, 29 cases were diagnosed with metastatic carcinoma, and 30 cases were diagnosed with reactive lymphoid hyperplasia, necrosis or tuberculosis. Among them, 2 non-Hodgkin lymphoma(NHL) cases were misdiagnosed as reactive lymphoid hyperplasia by cytology. Biopsy was performed in 18 cases of NHL including 16 B-NHL and 2 T-NHL By flow cytometry study, 35 of 99 eases were diagnosed with lymphoma, including 4 cases of lymphoblast lymphoma, 1 case of T-cell lymphoma, and 30 eases of other B-NHL For those 30 cases of B-NHL, 28 cases showed monoclonal light chain expression, and k: λ orλ: k atios exceed 3: 1, and B-cell proportion was (73. 2±27. 2)%. Twenty-six cases could be sub-classified by immunophenotyped. Among 16 histologically confirmed B-NHL cases, only 2 cases diagnosed with follicular lymphoma showed discrepancy with flow cytometry results. In all cases diagnosed with reactive lymphoid hyperplasia and metastasis carcinoma , no abnormal lymphocytes can be found, and k: λ or k: λ ratios were less than 3: 1. Conclusions Fine-needle aspiration analysis with flow eytometrie immunophenotyping can be helpful in diagnosis and differential diagnosis as well as sub-classification of NHL

Objective: To investigate the influence of depression symtoms and related occupational stress on workers in chip manufacturing industry. Methods: By using cluster sampling method, 2 251workers in electronic manufacturing industry were selected as study subjects in July-December 2016. The simple Occupational Stress Questionnnaire and The Chinese version of Effort-reword imbalance questionnaire (ERI) Questionnnaire were used to investigate and evaluate their job demand-control-support questionnaire (JDC) and ERI Occupational stress stiuation respctively. Depression symptoms were measured by the depression module of the patient health questionnaire (PHQ-9) . Results: Among the 2 251 workers, 77.03% workers were found high level of depression symptom.486 workers were the highest level depression.1 248 workers were the higher level depression. The scores of depression symptoms in the related influceing factors JDC and ERI occupational stress were different (P<0.05) . The multivariate logistic analysis results indicated the main positve factors of depression were above college degree, more than 1 years of working age and high input (P<0.05) . The main protective factors of depression were non migrant workers and high return (P<0.05) . Conclusion The rate of depression of workers is relatively higher in chip manufacturing factory. Enterprises should pay special attention to workers who were above college degree, more than 1 years of working age and high input, ERI occupational stress.

Objective: To observe the effect of overexpression of miRNA200a (miR-200a) recombinant lentivirus on the expression of Wnt/β-catenin signaling pathway in mouse lung epithelial cell line MLE-12 induced by silica (SiO₂) . Methods: The mice were divided into SiO₂ control group (SiO₂) , virus control group (SiO₂+Lv-NC) group and overexpressing miR-200a virus group (SiO₂+Lv-miR-200a). The expression of β-catenin, MMP2, MMP9, TCF-4 and Cyclin D1 mRNA and protein were detected by realtime-PCR and western blot after incubating cells for 18 h stimulating at the final concentration of 200 μg/ml of SiO₂. Results: The expression of miR-200a in MLE-12 cells of SiO₂+Lv-miR-200 a group was significantly higher than that in SiO₂ group and SiO₂+Lv-NC group. The mRNA and protein expression of β-catenin, MMP2, MMP9, TCF-4 and Cyclin D1 in MLE-12 cells of SiO₂+Lv-miR-200a group were significantly lower than those in SiO₂ group and SiO₂+Lv-NC group (P<0.05) . Conclusion Overexpression of miR-200a can inhibit the expression of related genes of Wnt/β-catenin signaling pathway in silica-induced mouse lung epithelial cells.

Objective To provide epidemiological data as a reference for the coming research and clinical practice by analyzing the problem based critical care ultrasound (CCUS) examination database in Department of Critical Care Medicine,West China Hospital, Sichuan University. Methods A retrospective study of the database was performed. The clinical problems prompting the CCUS examination were classified, the ultrasonnic findings representing the pathophysiological changes were collected and gathered into categories, and the pathophysiological etiology for each classification of clinical problems was stated after referring to the clinical information. Results In the 135 cases with a mean age of (51±18) years, 386 times of problems based examinations were performed (2.85 times per patient). The problems prompting the examinations were acute circulatory dysfunction (271 times, 70.2%), acute respiratory dysfunction (34 times, 8.8%), acute circulatory dysfunction combined with acute respiratory dysfunction (76 times, 19.7%), and suspected diaphragm disorder and others (5 times, 1.2%). In the 347 times of examination for acute circulatory dysfunction, the pathophysiological changes discovered by the CCUS examination included hypovolemia (55 times, 15.9%), hypervolemia (85 times, 24.5%), decreased systemic vascular resistance index (22 times, 6.3%), and increased right ventricular (RV) afterload (15 times, 4.3%). In the 246 times of examination for cardiac dysfunction, the underlying etiology detected included left ventricular (LV) systolic dysfunction (31 times, 12.6%), LV diastolic dysfunction (108 times, 43.9%), LV systolic dysfunction associated with diastolic dysfunction (49 times, 19.9%), RV dysfunction (23 times, 9.4%), and whole heart failure (35 times, 14.2%). Acute respiratory disorders was identified 110 times in total, which consisted of lung consolidation (40 times, 36.4%), diffuse ultrasonic interstitial syndrome (DIS; 27 times, 24.5%), consolidation associated with DIS (18 times, 16.4%), focal interstitial syndrome (17 times, 14.6%), and others (9 times, 8.2%). Causes of deterioration of the cases were cardiogenic pulmonary edema, diastolic dysfunction, RV failure, acute valve insult or chronic valve insufficiency and so on. Conclusions The main problems prompting the CCUS examinations are acute circulatory dysfunction and acute respiratory dysfunction. CCUS examination can provide physicians with valuable information on the full picture of the pathophysiology characteristics of hemodynamics and lung pathology to help diagnose the causes of the deterioration and guide clinical treatment.

Objective:The Capital′s Funds for Health Improvement and Research (referred to as ″CFH″), established to address clinical medical issues, have been operating for over a decade. This study aims to comprehensively evaluate the achievements of this fund and provide empirical support and recommendations for optimizing the operational model of the clinical research fund.Methods:An online questionnaire was used to investigate the following aspects of CFH: subject area, the person in charge, derived projects, theses, patents, transformation of results, and popularization and promotion.Results:A total of 745 projects were collected through the online survey, and after rechecking for outliers, 720 completed projects were ultimately included. The top three disciplinary domains, in terms of the number of completed projects, were oncology, cardiovascular diseases, and neurological disorders. The age distribution of project leaders exhibited a left-skewed pattern, with a median age of 45 years. 319 (44%) received support from other related projects subsequently. 95% of the projects resulted in paper publication. 211 (29%) projects applied for patents and copyrights, with 141 projects being granted patent authorization. 78 (11%) projects successfully achieved technology transfer, with transfer and licensing being the most common modes. 156 (22%) projects disseminated their outputs, often targeting secondary hospitals and community health institutions.Conclusions:CFH aligns with local needs, and the outputs are substantial. In the future, consideration can be given to establishing an evaluation mechanism, increasing efforts to promote high-quality outputs, strengthening the organizational model set by the project guidelines, and further improving the rolling support mechanism.

OBJECTIVE: To explore the feasibility and the value of Bayes analysis in clinical decision-making for solitary pulmonary nodules (SPNs). METHODS: We collected 352 consecutive SPN patients (malignancy, n=135; benignity, n=217) retrospectively to form the training set. Utilizing Bayes analysis, the prior odds of malignant SPNs and the likelihood ratios of clinical and CT findings were derived from the training set, which were then used to calculate the probability of malignancy in each SPN. Bayes analysis was also tested prospectively for its diagnostic validation and precision of predictive probability on the test set of 132 SPN patients (malignancy, n=61; benignity, n=71), and compared with the performance of physicians using routine judgment. The actual results of patients diagnosis were analyzed according to the scale of calculated malignant probability in SPNs. RESULTS: The sensitivity, specificity, and accuracy of Bayes analysis for the training samples were 88.9%, 93.1%, and 91.5%, respectively. In the test set, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of Bayes analysis were 88.5%, 85.9%, 87.1%, 84.4%, and 89.7%, respectively. The accuracy of Bayes analysis had no statistically significant difference with that of senior physician A (80.3%, chi2=2.37, P=0.122) and B (79.5%, chi2=3.12, P=0.076), and was higher than that of junior physician C (74.2%, chi2=7.05, P=0.012) and D (74.2%, chi2=6.56, P=0.009); The Brier score was 0.099, 0.140, 0.137,0.154, and 0.179 for Bayes analysis,senior physician A, senior physician B, junior physician C, and junior physician D, respectively. Excluding the solitary metastasis (n=11) misclassified, the false negative rate of Bayes analysis was 1.0% (5/484) for SPNs with <20% estimated probability of malignancy. CONCLUSION Bayes analysis is accurate in qualitative diagnosis, precise in forecasting the malignant probability, and has low false negative rate for SPNs. It is feasible to use Bayes analysis for the management of SPNs.
Adenocarcinoma ; diagnosis ; Adult ; Aged ; Aged, 80 and over ; Bayes Theorem ; Decision Making ; Diagnosis, Differential ; Feasibility Studies ; Female ; Humans ; Lung Neoplasms ; diagnosis ; Male ; Middle Aged ; Solitary Pulmonary Nodule ; diagnosis ; Tomography, X-Ray Computed ; Tuberculoma ; diagnosis ; Tuberculosis, Pulmonary ; diagnosis

Objective: To analyze the characteristics and influencing factors of new occupational diseases in Tianjin from 2008 to 2017, and to provide scientific basis for the formulation of prevention and control measures for occupational diseases in Tianjin. Methods: In 2018, data on the new occupational disease in Tianjin from 2008 to 2017 were collected from the China Disease Prevention and Control Information System. Statistical analysis was performed on the basic situation, the nature of the company, and the distribution of the industry. Results: A total of 5201 cases of occupational diseases were reported in Tianjin from 2008 to 2017, mainly including pneumoconiosis (92.37%) , followed by occupational poisoning (2.88%) , and the third occupational ENT disease (2.31%) . The male cases were higher than females, with a median age of 56 years and a median of 20 years of service. The most reported area was Hedong District (26.86%) . The economic type and scale of the cases belonged to state-owned large and medium-sized enterprises. The industry is mainly composed of non-metallic mineral products, and there are significant differences in the composition ratios of its economic type (χ²=19240.00, P<0.01) , enterprise size (χ²=3883.00, P<0.01) and industry (χ²=52050.00, P<0.01) . Conclusion Pneumoconiosis, occupational poisoning and occupational ENT diseases are the key prevention and control occupational diseases in Tianjin city. It is necessary to strengthen the prevention and control of occupational diseases in large and medium-sized state-owned enterprises, and to respond to occupational disease hazards in such key industries as the manufacturing industry so as to protect the health of occupational groups.