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.

AIM: To examine the 2′,5′-oligoadenylate synthetase activity and the peritoneal pathological changes when using commercially dialysates in order to reveal effects of the peritoneal dialysate biocompatibility on the immune function and morphological changes. METHODS: (1) CAPD animal models were made using dialysates. (2) Dynamic measurements of 2′,5′-oligoadenylate synthetase activity were made by paper chromatography. (3)The pathological changes of the peritoneal mesothelial cells were examined by light microscope. RESULTS: 2′,5′-oligoadenylate synthetase activities in both experimental (dialysis solution groups) and control group were increased and the mesothelial cell began to exfoliate and become thicker with the infiltration of inflammatory cells at different degrees in the experimental groups, while in the Baxter group, no active inflammation was observed. When the peritoneal dialysis stopped, activity of 2′,5′-oligoadenylate synthetase began to be normal in control group and continued to decline in experimental groups.CONCLUSION: Prolonged immune suppression existed with long-term peritoneal dialysis, causing pathological changes of the peritoneum at certain degrees. Different dialysis solutions resulted in different degrees of immuno-supression and peritoneal damages, which was relevant to the biological compatibility of the peritoneal dialysate.

Objective To analyze inducing factors of acute left heart failure(AHF) of emergency case.Methods According to different age and gender,the inducing factors of AHF of 211 patients were retrospectively analyzed.Results Infection(42.99%) was the most important inducing factors of AHF in all the four age-groups,but as for patients elder 80,the arrhythmias was also play an important part in inducing factors of AHF.The difference of inducing factors was found among the four age-groups.but the difference of inducing factors was not found between the two gender-groups. Conclusion Since the most important inducing factors of AHF of emergency case was infection,anti-infectives is important for preventing and controlling AHF.

Objective To observe the level of circulating CD31 +/CD42b-endothelial microparticles in patients with ST-elevated myocardial infarction (STEMI),and discuss the correlation between CD31 +/CD42b-and traditional myocardial injury index.Methods A total of 22 healthy subjects and 44 patients with angiographically confirmed coronary atherosclerotic lesions collected from January 2010 to December 2010 were studied prospectively.The patients were divided into SAP (stable angina pectoris,Canadian Cardiovascular Society,CCS Ⅱ to Ⅲ ) group (n =22) and STEMI group (n =22).The level of circulating CD31 +/CD42b-endothelial microparticles was detected by flow cytometric device after admission; creatine kinase (CK) and its isoenzymes (CK-MB) were detected by using biochemical analyzer; C-reactive protein was determined by a highly sensitive latex-enhanced turbidimetric immunoassay with a low detection limit of 0.25 mg/dl (IMMAGE,Beckman Coulter; Reagent from Orion Diagn Co.Ltd.,Vantaa,Finland).Cardiac troponin I was measured by chemiluminescence immunoassay (ACCESS2 from Beckman Coulter).In 22 STEMI patients,blood sample was taken not only after admission but subsequently at 4-hour intervals during the first 48 hours.Peak levels of myocardial enzymes after injury ( creatine kinase,CK; creatine kinase MB isoenzyme,CK-MB; c troponins I,cTnI) and high sensitive C reactive protein (hs-CRP) values were determined.The correlation between circulating level of CD31 +/CD42b(-) and peak levels of myocardial biomarkers after injury were analyzed.Results The endothelial micro-particles were significantly higher in STEMI patients than those in either SAP group or normal group ( P ＜ 0.01 ),whereas there was no difference between the latter two groups.In STEMI patients studied in these cross sectional study,circulating CD31 +/CD42b-microparticles were positively correlated with peak level of myocardial biomarkers after injury.Moreover,the correlations between myocardial biomarkers after injury ( CK,CK-MB,cTnl and hs-CRP) and circulating CD31 +/CD42b-microparticles were r =0.489,P =0.021; r =0.501,P=0.018; r=0.491,P=0.02; r=0.612,P=0.002.Conclusions The level of circulating blood CD31 +/CD42b-endothelial micro-particle was expected to become a predictive marker in STEMI.

Objective To explore the effect of weightlessness simulation on processing speed of mental rotation of males in 72 h head-down tilt,in order to further reveal human performance changes caused by weightlessness.Methods During 72 h weightlessness simulation (9 am day 1 to 9 pm day 4,head-down tilt started from 9 pm day 1),16 male subjects were processed speed of rotation data byhand picture mental rotation (test 8 times),using self cross-references design,and the variation of processing speed of mental rotation by duration was analyzed.Results The linear regression analysis showed,the reaction time of each time point for each subject as the independent variable,the angle of rotation as the dependent variable,with the extension of simulated weightlessness time.The intercept(constant term of the regression equation),indicating the processing speed of non-rotation,were gradually increased with HDT time,but didn(t) reached significantly difference (F(3,14) =0.551,P =0.650) ;the slope(Regression coefficient of the regression equation),indicating the processing speed of rotation.were gradually increased with HDT time,and reached the significantly difference (F(3,14) =4.338,P =0.009).The value of intercept and slope was like upside-down U in three days,and reached the highest value at day 2.Conclusion Weightlessness simulation have affection on the speed of mental rotation,especially on the rotation speed.

Objective To evaluate the ability of matrix-assisted laser desorption/ionization time-offlight mass spectrometry (MALDI-TOF MS) in identifying species of Acinetobacter calcoaceticus-Acinetobacter baumannii complex,and investigate the species distribution of Acinetobacter calcoaceticus-Acinetobacter baumannii complex isolated in our hospital.Methods A total of 502 nonduplicate clinical isolates of Acinetobacter calcoaceticus-Acinetobacter baumannii complex were retrospectively collected from the second affiliated hospital of Zhejiang University between January 2012 and July 2012.All strains were re-identified by MALDI-TOF MS and were also verified by sequence analysis of 16S-23S rRNA gene spacer region.Results Among all the 502 strains of Acinetobacter calcoaceticus-Acinetobacter baumannii complex,identificaion results provided by MALDI-TOF MS were A.baumannii (431,85.9％),A.pittii (68,13.5％),A.calcoaceticus (3,0.6％).Sequence analysis of 16S-23S rRNA gene spacer region was used to identify all the 502 strains:403 (80.3％) were identified as A.baumannii,68 (13.5％) as A.pittii,28 (5.6％) as A.nosocomialis and 3 (0.6％) as A.calcoaceticus.MALDI-TOF MS correctly identified all the strains but erroneously identified all 28 strains of A.nosocomialis as A.baumannii,compared with sequence analysis of 16S-23S rRNA gene spacer region.Conclusions MALDI-TOF MS can be used as a fast,simple,reliable and excellently reproducible method to identify members of Acinetobacter calcoaceticus-Acinetobacter baumannii complex at low costs.MALDI-TOF MS is expected to be an ideal technique for routine clinical microbiology testing in the future.

Objective To explore the time course of response inhibition function in juvenile delin-quents with antisocial personality characteristics.Methods The healthy control group ( n=21),juvenile delinquents with antisocial personality characteristics ( CD +AP ) ( n=18) and juvenile delinquents ( CD) ( n=18) were selected in current study by recording the event-related potentials in a Go/Nogo task.N2 and P3 components of event-related potentials were analyzed.Results Behavioral results showed that Nogo cor-rection rate of control group ((93.13±2.71)%) were significantly higher than CD group ((87.51±2.82)%, P<0.01) and CD +AP group((85.63±2.45)%, P<0.01).In CD+AP group,the amplitude of the N2nogo ( (-1.82±1.64)μV) was significantly lower than control group ( (-6.36±2.93)μV, P<0.01) ,and the am-plitude of the P3nogo ((5.52±2.79)μV) was significantly decreased than healthy control ((11.26±4.92)μV, P<0.01).In CD group,the amplitude of P3nogo ((5.20±3.17)μV) was significantly reduced than healthy control ((11.26±4.92)μV, P<0.01).Conclusion N2nogo and N2d are associated with the early phases of response inhibition and reflected response conflict.P3nogo and P3d are associated with the late phases of response inhibition and monitored inhibitory control.These data suggest that CD+AP participants exhibited im-paired response conflict and inhibitory control.This may be associated with persistent antisocial behavior.

Objective To investigate the CT findings of cardiac rhabdomyoma in childhood. Methods Five children with cardiac rhabdomyoma confirmed by operation was retrospectively analysed. Enhanced electron beam CT (EBCT) was performed in 4 children and enhanced 64-slice helical CT (MSCT) scan was performed in 1 infant. Three dimensional reconstruction was applied for the full display of the lesions based on the transverse section images. Results ( 1 ) Multiple masses or nodules originated from atrioventricular septum were observed in 4 children including 1 nodule from the anterior walls of the left and right ventricles. A mass was derived from the mitral valve in 1 infant (2) The CT value of the lesions after enhancement ranged from 80 to 180 HU and was similar to neighbouring left ventricular myocardium. (3) The ventricular outlet obstruction was found in 3 children including 1 infant with pericardial effusion and pulmonary inflamation of the right lower lobe. Conclusion The rhabdomyoma should be considered first when masses or nodules originated from atrioventricular septum and with the enhancement similar to neigbouring left ventricular myocardium in children.

Objective This study was to analyze the early and long-term effect of completion pneumonectomy.Methods Retrospective analysis was made on the patients who underwent completion pneummonectomy in Shanghai Chest Hospital.Results There were totally 56 cases patients underwent completion pneumonectomy during January 2003 to July 2013.Among them,45 patients received CCP,and other 11 patients received RCP.CCP refers to the complete removal of lung tissue remaining after an initial ipsilateral partial pulmonary resection.RCP refers to the complete removal of residual lung due to the severe complications after pneumonectomy.The mortality and morbidity rate of CCP were 4.4％ and 33.3％ respectively.In the case of CCP,the incidence of benign lesions is significantly higher than the incidence of malignant tumor(80.0％ vs 27.5％,P =0.04).The mortality and morbidity rate of RCP were 27.3％ and 90.9％ respectively.In the case of RCP,higher postoperative mortality often occurs in aged patients (P =0.046) and patients with preoperatie mechanical ventilation (P =0.03).Overall five-year survival rate for patients with benign lesions was 80％,and for malignant lung cancer patients,the number was 30％.Survival time differs according to the TNM staging(a median of 60.0 months,35.0 months,10.0 months,stage Ⅰ,stage Ⅱ,stage Ⅲ,P ＜0.01),and survival rate was higher when the time interval(between the initial pulmonary resection and the completion pneumonectomy) ＞ 2 years(a median of 60.0 months,18.0 months,P ＜ 0.01).Conclusion Completion pneumonectomy is a high-risk surgery,especially RCP.Advanced age and preoperative mechanical ventilation are associated with higher postoperative mortality rate for RCP.As for CCP,higher postoperative risk exists in patients with benign lesions,but the survival rate is also higher.In patients with malignant lung tumor,survival rate is higher when the time interval (between the initial pulmonary resection and the completion pneumonectomy) ＞2 year.

Objective To explore the relationship between schizotypal personality proneness and intelligence .Methods 1905 subjects were tested by Chinese Soldier Personality Questionnaire(CSPQ).According to the results of CSPQ,the subjects were divided into high-risk subjects and normal ones.The Words Reasoning Test, the Arithmetic Reasoning Test and the Assembling Test were used to evaluate the intelligence,and the scores of these tests were compared between the two groups.Correlation coefficient between schizotypal personality proneness and intelligence was calculated.Results The scores of the Words Reasoning Test,the Arithmetic Reasoning Test and the Assembling Test in high-risk subjects were significantly lower than those in normal ones((87.83±18.42)VS(101.37±13.48),P<0.01;(91.74±14.26)vs(101.65±14.62),P<0.01;(87.70±18.82)VS (101.73±14.26),P<0.01).Schizotypal personality proneness was significantly correlated with the scores of intelligence(r=-0.39,P<0.01).Conclusion Lower intelligence level is found in the group with schizotypal personality proneness.Intelligence is correlated with schizotypal personality proneness.