Objective To detect the loss of cardiac troponin T (CTnT) in human myocardial infarction. Methods Loss of cardiac troponin T in human myocardial infarction was detected by immunohistochemical LSAB method. Results Obvious depletion of CTnT was observed in cases died from myocardial infarction,and by the computer image analysis, the mean CTnT-depleting area in myocardial infarction group was significantly different from that in the control group(P

Experimental acute myocardial ischemia model of dog was established, and the postmortem stability of fibronectin for the diagnosis of mycardial infarction was studied with immunohistochemistry and image analysis technique. The results showed that the positive reaction areas of fibronectin in ischemic myocardial tissues decreased along with the prolongation of postmortem interval, but positive reaction of fibronectin could still be found in ischemic myocardia kept for 4 weeks postmortem. No positive reaction for fibronectin could be found in normal myocardia when kept for different times. So fibronectin is a quite stable marker for the postmortem diagnosis of myocardial infarction, and is of practical value in the forensic practice.

For the purpose of establishment of a diagnostic method of mild viral myocarditis,an experimental mild viral myocarditis model was induced in Balb/c murine by coxsackie virus B 3.The cardiac tissue secfion were stained by LSAB-immunohistochemical method with anti fibronectin(Fn) antibody. The results demonstrated that the Fn deposition was found in the myocardium of mice with myocarditis and the mild degeneration of cardiomyocytes could be identified by Fn LSAB immunohistochemical staining.It is suggested that the Fn deposition in the myocardium tissue is one of the reliable marks of myocardium inflammation.

Experimental acute myocardial ischemia model of rat was established, and the changes of C5 complement in the ischemic myocardia were studied with immunohistochemistry and image analysis technique. The results showed that the positive reaction of C5 could be observed in ischemic myocardia at 15 min after ischemia, and the positive reaction area increased along with the prolongation of the ischemic period. It is concluded that the positive reaction of C5 in cardiomyocytes is a quite sensitive marker of early myocardial ischaemia.The immunohistochemical detection of C5 in cardiomyocytes will be a meaningful tool for the postmortem diagnosis of early myocardial ischaemia.

In order to explore the value of fibronectin (Fn) in the postmortem diagnosis of myocardial infarction.The changes of Fn staining in normal, infarcted and other non infarcted myocardial injuries resulted from myocarditis, mechanical asphyxia, electrocution, hemorrhagic shock, cardiac contusion and organophosphate poisoning were studied with immunohistochemistry and image analysis system. The results showed that positive Fn staining could only be observed in groups of myocardial infarction and myocarditis, but could not be found in groups of mechanical asphyxia, electrocution, hemorrhagic shock, cardiac contusion, organophosphate poisoning. It is indicated that positive reaction of Fn could be affected only by myocarditis, so it is quite specific for the diagnosis of myocardial infarction.

Objective To investigate the CT characteristics of retroperitoneal extra-adrenal paraganglioma(PGL).Methods CT findings of 11 patients with pathologically confirmed retroperitoneal extra-adrenal PGL were analyzed retrospectively,and the relevant literature was reviewed.All patients received plain CT as well as contrast-enhancement CT scan.Results All of the 11 tumors were located in the retroperitoneal space around large blood vessels,including 2 functional and 9 unfunctional extra-adrenal paragangliomas.Eight of 11 cases were benign tumors which presented as round or oval masses with sharp margins,separated from surrounding structures clearly;while the rest 3 cases,which with indistinct edge,even more with the invasion of surrounding structures (renal artery,renal venous and pancreas),were confirmed to be malignant.Most of the tumors were heterogeneous on plain CT.It was common to see intratumoral necrosis or cystic degeneration in the tumors (9 cases),while hemorrhage or calcification was uncommon,which was found in 3 and 2 cases,respectively.Homogeneous intensity was only observed in 2 masses with diameter less than 4 cm.On contrast-enhanced CT image, the solid part of the tumors presented continuously significant enhancement.Dilated feeding artery was found in or around the masses (8 cases) in artery phase.Conclusion There are certain characteristics of retroperitoneal extra-adrenal paraganglioma on CT scanning, which are helpful for preoperative diagnosis and treatment of this disease.

Objective To explore the blood pressure variability (BPV) in pediatric patients undergoing maintenance hemodialysis (MHD) and to assess the factors associated with pre-dialysis BPV (pre-HD BPV).Methods The pediatric patients who undergone regular dialysis for more than twelve months from Oct 2005 to Oct 2011 in hemo dialysis center of Guizhou Provincial People's Hospital were divided into high pre-HD BPV group and low pre-HD BPV group.Baseline characteristics,biochemical indexes and cardiac function parameters measured by echocardiography were collected in both groups and multiple linear regression analysis was performed.Results Pediatric patients in high pre-HD BPV group demonstrated significantly higher inter-dialytic weight growth rate (IDWG),pre-dialysis systolic blood pressure and average amount of dehydration than those in low pre-HD BPV group (P ＜ 0.05),while significantly lower hemoglobin and albumin levels than those in low pre-HD BPV group (P ＜ 0.05).Comparison among laboratory indicators,serum phosphorus and parathyroid hormone demonstrated significant difference between groups (P ＜ 0.05).For all pediatric patients,pre-HD BPV was positively correlated with IDWG (β=0.165),pre-dialysis systolicblood pressure (β=0.259),and iPTH (β=0.187),while negatively correlated with hemoglobin level (β=-0.199).Conclusions Increasing IDWG,higher pre-dialysis systolic blood pressure,anemia and secondary hyperparathyroidism influence BPV in pediatric patients on MHD.

We describe the case of a 79-year-old male presented with sudden onset of abdominal pain and mild breathlessness, and complicated acute progressive anemia with haemoglobin which declined from 120 g/L to 70 g/L within five days. An urgent computed tomography an-giography showed acute thoracic aortic dissection, DeBakey type IIIb, a dissecting aneurysm in the proximal descending thoracic aorta start-ing immediately after the origin of the left subclavian artery and extending distally below the renal arteries with evidence of rupture into the right pleural cavity for massive pleural effusion. Plasma D-dimer, brain natriuretic peptide and C reactive protein level were elevated. Our case showed that D-dimer can be used as a‘rule-out’ test in patients with suspected aortic dissection. A raised BNP may exert a protective role through anti-inflammatory endothelial actions in the systemic circulation.

Objective The present study was designed to investigate the risk factors affecting bleeding during percutaneous nephrolithotomy. Methods The records of 218 patients with percutaneous nephrolithotomy procedure by a single surgeon were retrospectively reviewed.The mean age was 48 years ( range,19 -70).One hundred and forty six patients had staghore stones,and 7 patients had previous open or percutaneous nephrolithotomy histories.Forty-one patients had concomitant diabetes mellitus,and 89 cases had hypertension.The following factors including age,sex,BMI,diabetes status,hypertension status,stone type,calix of puncture,previous open or percutaneous nephrolithotomy history,number of accesses,size of accesses,operative time,and surgeon experience were analyzed.Univariate analysis and multivariate step regression analysis were used for statistical assessment. Results 207 procedures were successfully performed,and 11 patients failed because of difficulty to establish the accesses.Single-tract was used in 176 cases and multiple-tract was used in 31 cases.163 cases were performed via a 18 F access and 44 cases via a 24 F access.The mean operative time was 78.4 min.The overall blood transfusion rate was 7.7％,and stone type ( P =0.034),diabetes ( P =0.030),number of accesses ( P =0.019 ),size of accesses ( P =0.008) and operative time (P =0.001 ) were the risk factors affecting blood transfusion requirement.The average hemoglobin (Hb) drop after percutaneous nephrolithotomy procedures was 11.2 g/L,and stone type ( P ＜ 0.001 ),diabetes ( P =0.015 ),number of accesses ( P =0.016),size of accesses ( P ＜ 0.001 ) and operative time ( P ＜ 0.001 ) were the risk factors affecting Hb drop.The following covariates including Hb drop:age,sex,BMI,previous open or percutaneous nephrolithotomy history,hypertension status,calix of puncture and surgeon experience were not risk factors affecting blood transfusion requirement and Hb drop.Multivariate stepwise regression analysis showed that diabetes ( OR =1.75 ),stone type ( OR =1.92),number of accesses ( OR =2.45 ),size of accesses ( OR =1.32) and operative time ( OR =1.66) significantly increased risk of bleeding. Conclusions Stone type,diabetes,number of accesses,size of accesses and operative time were the risk factors affecting blood loss during percutaneous nephrolithotomy.

Objective: To explore the prevalence of body weight control behaviors (BWCB) among middle school students in Jiangsu province. Methods: The database was established part from the surveillance of adolescent common disease and health related factors in Jiangsu province in 2017 and analysis were carried out to describe the prevalence rates of four basic BWCB and their comorbidity. Results: Among 18 855 investigators, 75.8% middle school students reported having taken at least one kind of BWCB within 30 days before investigation, the report rates of BWCB of middle school students among male and female were 77.3% and 74.3%(P<0.01), showed decreasing tendency from grade 1 of junior middle school to grade 3 of senior middle school (Kendall’s tau-c=-0.10, P<0.01), those of malnutrition, normal body weight, overweight and obesity were 57.2%, 72.8%, 83.8%, 86.7% respectively and showed increasing tendency(Kendall’s tau-c=0.13, P<0.01). Reported rate of Changing diet structure, physical exercise, reducing diet and taking slimming drug prevalence were 58.7%, 61.0%, 17.9%, 2.6%, orderly. There are 15 combinations of BWCB based on those 4 kinds of behavior. In the highest five types list ,changing diet structure & physical exercise (35.2%) was the most common type, and followed by physical exercise(13.0%), Changing diet structure(9.2%), Changing diet structure & physical exercise & reducing diet(8.6%), Changing diet structure & physical exercise & reducing diet(3.4%), others 6.5%. The proportions of top five kinds of BWCB among middle school students taken BWCB were 46.4%, 17.1%, 12.2%, 11.3%, 4.5%, respectively, accounting for 91.5%. The probabilities of different types of BWCB were similar between urban and town(χ2=9.13, P=0.10), different among sex(χ2=351.17, P<0.01), districts(χ2=140.20, P<0.01), school type and nutrition status(χ2=343.95, 309.62, P<0.01). Conclusion Some overweight or obesity students report on control body weight, while some report taking medicine and reducing diet behavior. Health education on healthy body weight should be implemented for middle school students to cultivate healthy body image so as to keep healthy body weight.