Objective To investigate the value of N-termind pro-B-type natriuretic peptide(NT-pro-BNP)in differential diagnosis of dyspnea in emergency department, and to investigate the rapid diagnosis cutoff of dyspnea due to acute congestive heart failure. Methods Ninety. one cases of dyspnea in emergency department recruited from January to June ,2008 were divided into two groups: acute cardiac dyspnea group and none acute cardiac dyspnea group. To evaluate the value of different parameters in differential diagnosis of dyspnea in emergency department and analysis the area under the receiver-operating characteristic of different parameters for the diagnosis of acute cardiac dyspnea. To achieve the best cutoff of different parameters for the diagnosis of dyspnea due to acute congestive heart failure finally. Results Among two groups, NT-pro-BNP (acute cardiac dyspnea vs. none acute cardiac dyspnea,6203.50 ng/L vs. 1410.00 ng/L,P ＜ 0.01), Troponin Ⅰ (acute cardiac dyspnea vs. none acute cardiac dyspnea,0.12 μg/L vs. 0.03 μg/L,P ＜0.01) ,left ventricular ejection fraction(acute cardiac dyspnea vs. none acute cardiac dyspnea,46.25% vs. 65.60%, P ＜ 0.01), left atrial diameter (acute cardiac dyspnea vs. none acute cardiac dyspnea,42.75 mm vs. 36.00 mm,P ＜0.01) had significant difference. NT-pro-BNP at cutoff of ≥3715 ng/L was highly sensitive and specific for the diagnosis of acute cardiac dyspnea. Receiver-operating characteristic analyses demonstrated that NT-pro-BNP and left ventricular ejection fraction was the best diagnostic indices of acute cardiac dyspnea. The area under the receiver-operating characteristic curve of Nt-pro-BNP was 0.828 ± 0.045 (P ＜ 0.01),and left ventricular ejection fraction was 0.829 ± 0.049 (P ＜ 0.01). Correlation analysis showed that NT-pro-BNP was correlated with left ventricular ejection fraction (P ＜ 0.01). The combined test of NT-pro-BNP and left ventricular ejection fraction was performed. Specificity increased to 96.50%, total consistent rate increased to 83.50% ,positive predictive value increased to 91.30%, positive likelihood ratio 17.60, faulse diagnostic rate decreased to 3.50%. Conclusions NT-pro-BNP examination in emergency department was helpful to rapid differential diagnosis of dyspnea. It helped to differentiate the patients with acute congestive heart failure and none acute congestive heart failure causes of dyspnea.

Objectives: To investigate the effect of butyrate, the by-products of diet fiber fermented in colon, on the apoptosis of human colon cancer cell and its mechanism for colon cancer prevention. Methods: The subculture of human colon cancer cell line SW1116 was cultured in medium without or with different concentration of butyrate(2、3、4、7 and 10 mmol/L). The cell proliferation rate and apoptosis were measured by MTT and flow cytometer or electro-microscopy respectively after 6、24、48 and 72 cultivation. Results: By the increasing of butyrate concentration and cell culture time, the proliferation of SW1116 cell was inhibited gradually with a highest rate of 59.19% during the study period. The percent of G 1 cell was increased gradually whereas the percent of S cell was decreased. The apoptosis rate of SW1116 was increased gradually with a highest rate of 30.62% at the same time. The ultrastructure of SW1116 cell was changed after butyrate was added to culture medium. Conclusions: Butyrate could not only inhibit the proliferation of colon cancer cell line but also induce it apoptosis.

Objectives:To assess the nutritional status of retired residents in a community by mininutritional assessment(MNA) combined with anthropometry. Methods:MNA questionnaire and anthropometric parameters including waistline,hipline,height,weight,body mass index(BMI),midarm circumference,triceps skinfold(TSF) and midarm muscle circumference were performed in 115 retired residents. Results:①24 (20.9%) residents had MNA scores less than 23.5,which meaned malnutrition or at risk of malnutrition.②According to each single index,namely waistline, waist hip ratio and BMI,incidence of obesity was 53.9%,61.7% and 65.2% respectively.③According to each single index,that is,midarm circumference,TSF and midarm muscle circumference,prevalence of moderate or severe malnutrition was 1.7%,19.1% and 2.2%respectively.④There lied a significant correlation between MNA score and several anthropometric parameters. Conclusions:①Both overnutrition and undernutrition can be manifested in retired home residents,for whom nutritional intervene should be enhanced.②MNA questionnaire can be well used in Chinese.

Objectives:To investigate the nutritional status of the maintenance hemodialysis(MHD) patients. Methods:The dietary investigation, anthropometry and biochemical tests were conducted in 46 MHD patients,including weight,triceps skinfold(TSF), arm muscle circumference(AMC), serum total protein(TP), albumin(Alb), prealbumin(PA), transferrin(TF) and ideal weight rate(IBW%).Then nutritional status was evaluated. Results:①The energy intake of most MHD patients was lower than 125.4 kJ/(kg?d) and the mean protein intake was nearly 1.0 g/(kg?d).②According to each single index,the incidence of malnutrition was:39.13% by IBW%, 71.74% by TSF, 58.70% by AMC, 30.43 % by Alb and 82.61% by TF respectively.Only 6.52% patients had all normal paremeters. Conclusions:Malnutrition incidence of MHD patients was as high as 93.48% in our study. The regular nutritional assessment and the nutritional advice are very important for the better clinical outcome in the MHD patients.

Objective To investigate the effects of preemptive analgesia with parecoxib sodium on postoperative analgesia and delirium after nerve injury-free surgery for fracture of thoracic and lumbar vertebrae and to promote the postoperative rehabilitation of the patients. Method 80 patients meeting the criteria were selected. and randomly divided into observation group and control group.40 patients each group. The observation group used parecoxib sodium for preemptive analgesia. while the control group used sufentanil. and the analgesia effects and the incidences of delirium were observed. Results The differences in operative time and intra-operative blood loss between the patients of the two groups were statistically insignificant. In 2 h. 6 h. 12 h.24 h and 48 h after the surgery.the VAS score and the accumulative time of intravenous self-controlled analgesia pump being pressed of the observation group were significantly lower than those of the control group. and the differences were statistically significant (P<0.05). The first time for the patients of the observation group to press the intravenous self-controlled analgesia pump is (3.84±0.62) h after the surgery, is significantly later than that of the control group (1.05±0.47)h.and the difference is statistically significant (P<0.05). The incidence of delirium in 7 days after the surgery in the patients of the observation group was 10.00%. and is significantly lower than that of the control group (25.00%) (P<0.05). Conclusion Using parecoxib sodium for preemptive analgesia before nerve injury-free surgery for fracture of thoracic and lumbar vertebrae can elevate the postoperative analgesia effects of the patients.decrease the incidence of postoperative delirium, and is highly safe and consequently worthy of clinical application.

Objective: To investigate the mechanism of butyrate,which is the by-products of diet fiber fermented in colon and induce the apoptosis of human colon cancer cell. Methods: The subculture of human colon cancer cell line SW1116 was cultured in medium with different concentration of butyrate(0、2 、3 、4、7 and 10 mmol/L).The mRNA and proteins of bcl-2 or bax in cell lines were detected respectively by RT-PCR and Western Blotting while the concentration of p53 protein and the activity of caspase-3 was detected by flow cytometer and fluorescent quantitative assay respectively after 6、24、48 and 72h cultivation.Results: There was no expression of bcl-2 mRNA and its protein in SW1116 cell during the study periods but the expression of bax mRNA and its protein,the p53 protein concentration and the caspase-3 activity increased gradually when the butyrate concentration was increased and the cultivation time was prolonged. Conclusion: By up-regulating the expression of bax mRNA and its protein,butyrate induce the apoptosis of colon cancer cell on a p53 dependent way.

Objective To investigate the clinical therapeutic effects of different surgical treatments on cervical spondylotic my-elopathy and the occurrence of postoperative complications .Methods 65 patients with cervical spondylotic myelopathy admitted in our department between January 2010 and January 2013 were retrospectively analyzed ;and among them ,31 underwent anterior cer-vical discectomy and fusion(ACDF) and 34 underwent anterior cervical corpectomy and fusion (ACCF);the general surgical condi-tions ,JOA scores and functional grades of Nurick ,incidences of dysphagia and so on in the patients of the two groups were investi-gated .Results The operative time and intra-operative blood loss of the patients of the ACDF group were better than those of the ACCF group[(88 .70 ± 9 .03)min ,(125 .46 ± 12 .62)min ,(94 .26 ± 10 .34)mL ,(133 .98 ± 12 .09)mL] ,and the differences were sta-tistically significant(P<0 .05) .The postoperative lengths of stay of the two groups were similar ,and the differences in preoperative and postoperative JOA scores and functional grade of Nurick of the two groups were statistically insignificant (P>0 .05);but the differences between the preoperative and postoperative JOA scores and functional grade of Nurick in 6 months after the surgeries and those before the surgeries of the same groups were statistically significant (P<0 .05) .At the same observation time points ,the incidences of dysphagia and the thicknesses of soft tissue before the cervical vertebra in the operated segment of the observation group were all lower than those of the control group ,and the differences were statistically significant (P<0 .05);in the patients of either group ,no loosening ,translocation or non-fusion of the bone graft was observed .Conclusion The two surgeries in treatment of cervical spondylotic myelopathy van both obtain satisfying clinical therapeutic effects ,but ACDF has a lower incidence of postop-erative complications ,and doctors should choose a suitable surgery based on the actual conditions .

BACKGROUND: Studies have shown that osteoporosis often leads to a failure in pedicle screw fixation. Considering that the use of ordinary pedicle screw fixation cannot achieve a strong and stable fixation of the osteoporotic vertebra,special measures to strengthen the internal fixation is indispensable.OBJECTIVE: To evaluate the effect of bone cement augmentation combined with expandable pedicle screw fixation on the fixation strength of osteoporotic thoracolumbar vertebrae.METHODS: Twenty osteoporotic thoracolumbar vertebral specimens were randomly divided into four groups: conventional pedicle screw group implanted with normal pedicle screw, and the other three groups implanted with expandable pedicle screw. Bone cement augmentation with polymethylmethacrylate (PMMA) and calcium sulfate was done in the PMMA group and calcium sulfate group, respectively, followed by expandable pedicle screw implantation. No bone cement was used in the expandable pedicle screw group. The maximum axial pull-out strength and yield energy absorption value of the unilateral pedicle were detected, and the maximum removal torque of the contralateral pedicle was determined. Bone cement leakage after augmentation was observed.RESULTS AND CONCLUSION: Compared with the conventional pedicle screw group, the other three groups showed a significant increase in the maximum pull-out strength, maximum removal torque and yield energy absorption values (P < 0.05). Moreover, these parameters were significantly higher in the PMMA and calcium sulfate groups than the expandable pedicle screw group and conventional pedicle screw group (P < 0.05), but there was no significant difference between the PMMA and calcium sulfate groups (P > 0.05). No leakage of bone cement was found in all the groups. To conclude, the combined use of expandable pedicle screw and can significantly enhance the stability of the osteoporotic thoracolumbar vertebrae, and the PMMA and calcium sulfate cements have similar effects.

Objective To explore efficacy of laparoscopic radical operation for gastric cancer and analyze its influence on immune function.Methods 86 patients with gastric cancer were ran-domly divided into observation group and control group,43 cases in each group.The control group received conventional open type gastric cancer treatment,while observation group received laparo-scopic radical gastrectomy treatment.Blood loss,the first exhaust time,ambulation time,the fre-quency of use of pain medications,first feeding time and length of stay were compared,and immune function after 10 days of treatment(CD3,CD4,CD8,CD4 /CD8 levels and the percentage of NK cells)as well as the incidence rate of postoperative complications were compared.Results Intraop-erative blood loss,the first exhaust time,ambulation time,the frequency of pain medications,first feeding time and hospital stay in the observation group were significantly better than the control group (P <0.05 ).10 days after treatment,CD3,CD4,CD8,CD4 /CD8 levels in both groups sig-nificantly reduced,and of which in the observation group were significantly better than the control group (P <0.05).There was no significant difference of complications between two groups (P <0.05).Conclusion Laparoscopic radical operation for gastric cancer can significantly improve post-operative recovery,reduce incidence of complications and cause less influence on immune function, so it is worthy of clinical application.

Objective To explore efficacy of laparoscopic radical operation for gastric cancer and analyze its influence on immune function.Methods 86 patients with gastric cancer were ran-domly divided into observation group and control group,43 cases in each group.The control group received conventional open type gastric cancer treatment,while observation group received laparo-scopic radical gastrectomy treatment.Blood loss,the first exhaust time,ambulation time,the fre-quency of use of pain medications,first feeding time and length of stay were compared,and immune function after 10 days of treatment(CD3,CD4,CD8,CD4 /CD8 levels and the percentage of NK cells)as well as the incidence rate of postoperative complications were compared.Results Intraop-erative blood loss,the first exhaust time,ambulation time,the frequency of pain medications,first feeding time and hospital stay in the observation group were significantly better than the control group (P <0.05 ).10 days after treatment,CD3,CD4,CD8,CD4 /CD8 levels in both groups sig-nificantly reduced,and of which in the observation group were significantly better than the control group (P <0.05).There was no significant difference of complications between two groups (P <0.05).Conclusion Laparoscopic radical operation for gastric cancer can significantly improve post-operative recovery,reduce incidence of complications and cause less influence on immune function, so it is worthy of clinical application.