Objective To investigate the evaluation value of blood lactic acid dynamic monitoring and APACHE Ⅱ score in trhe prognosis of sepsis.Methods The blood lactic acid level,lactic acid clearance rate,shock and MODS occurrence rate and mortality in 76 patients with sepsis in ICU of our hospital from January to October 2015 were statistically analyzed.Various indexes and prognosis were performed the multi-variable Logistic regression analysis.Results The APACHEⅡ scores,shock and MODS occurrence rate and mortality in the lactic acid elevation group were higher than those in the lactic acid normal group,the difference was statistically significant(P<0.05).In grouping according to the lactic acid peak value,the observation indexes had no statistical difference among 3 groups(P>0.05);in grouping according to 6 h lactic acid clearance rate,except APACHEⅡscore,the other observation indexes in the high clearance rate group were significantly lower than those in the low clearance rate group,the difference was statistically significant (P<0.05).The lactic acid level at admission,lactic acid peak value,6 h lactic acid clearance rate and APACHEⅡscore in the survival group were significantly better than those in the death group,the difference was statistically significant(P<0.05).In 3 groups according to APACHEⅡ score,the lactic acid peak value,shock,MODS occurrence rate and mortality rate had statistically significant differences among 3 groups (P<0.05).The lactic acid level at admission,6 h lactic acid clearance rate and APACHEⅡscore were the independent risk factors in the patients with sepsis.Conclusion The lactic acid level at admission,6 h lactic acid clearance rate and APACHEⅡ score were the independent risk factors in the patients with sepsis.

Objective To evaluate the clinical parameter, diagnosis and operative mode of parathyroid tumor. Methods The clinical symptoms, examination methods and the mode of operation in 15 operated patients with parathyroid tumor from May 1979 to October 2001 were retrospectively analyzed. Results 15 patients with parathyroid tumors, including 10 adenomas, 3 carcinoma and 2 cysts, all revealed the symptom of hyperparathyroidism except 2 cases of cyst. The accuracy of B-US and CT in preoperative diagnosis on location was 86 7% and 91 7% respectively, and their accuracy in preoperative diagnosis on quality was 26 7% and 75 0% respectively. All patients were treated by surgery. Among them, 12 patients were cured, 1 died, and 2 relapsed. Conclusion If a patient has the symptoms of bone pain, nephrolith and the mass in neck, we should consider whether he suffers from parathyroid tumor. B-US is the first choice in preoperative diagnosis on tumor location, and CT was the good examination method for tumor location also. The diagnosis on tumor quality dependeds on pathological examination mostly. Surgery remains to be the most important. The only unilateral exploration for the benign parathyroid tumor is performed and the operative range of parathyroid carcinoma should include both the mass and thyroid.

Using method of orthogonal design we observed that low K+,high Ca2+ & low Mg2+ in perfusate produced the peak incidence of reperf-usion-indaced ventricular fibrillation & introduction of K+ & Ca2+ significantly affected the incidence & pnset of it, The appropriate prop-ortion of K+, ea2+ & Mg2+ in perfusate is the important effecting factor of reperfusion-induced arrhythmias in Langendorff heart of rats.

m-Nisoldipine ( m-Nis ) , isobutyl methyl 1 , 4-dihydro - 2, 6-dimethyl-4-( 3-nitrophenyl )-3 , 5-pyridine dicarboxylate, is a new calcium antagonist. Its effects on hemodynamics and regional blood flow as well as the distribution of cardiac output were evaluated in comparison with Nis with radio-biomicrospheres in conscious rabbits. ( 1 ) m-Nis ( 1 ?g/kg ? min-1 ? 10 min, iv ) increased cardiac output and cardiac index significantly (P0.05) ; ( 2 ) m-Nis increased stroke volume and left ventricular systolic work ( per beat ) while Nis slightly increased the former and decreased the later, and these differences were statistically significant (P

Objective To study the diagnosis and indications of operation of thyroiditis associated with thyroid cancer(TTATC). Methods The clinical data of 16 patients with TTATC were analysed retrospectively. Results All 16 patients were treated surgically, including subacute thyroditis with thyroid cancer in 4 patients, Hashimoto's disease with thyroid cancer in 12. The carcinoma of thyroid were composed of 12 papillary, 3 follicular, and 1 mixed papillary follicular cancer. The 16 patients were followed up for 2 months 9 years, showing they were all alive and healthy. Conclusions In order to avoid delaying the treatment of thyroid cancer, the following thyroiditis with thyroid nodule should be operated earlier: (1) The nodule in thyroditis didn't alter to smaller and shows a tendency to be enlarge after systematic drug therapy. (2) the cold nodule is of cold character in SPECT but solid in ultrasound.

Objective To make soluble expression of Plasmodium falciparum (FCC1/HN) glutamate dehydrogenase(GDH) in Escherichia coli, purification and immunocompetence identification of the recombinant non-fusion GDH. Methods The GDH gene was cloned into prokaryotic expression vector pET23(a) to form recombinant expression vector pET23(a)/GDH. pET23(a)/GDH was transformed into E.coli BL21(DE3). Induced by IPTG(isopropyl-beta D-thiogalactoside), GDH was highly expressed in the supernatant after sonication. The soluble recombinant GDH was purified by Source-Q and Source-S chromatography. Enzyme-linked immunosorbent assay and Western blotting were carried out to identify the immunocompetence of the purified product. Results SDS-PAGE analysis showed that the soluble GDH protein accounted for approximately 15% of the total bacterial protein. By two-step ion-exchange chromatography, the purity of GDH reached more than 90% and the GDH possessed high antigenicity. Conclusion The soluble expression of GDH results in an integral three-dimensional structure epitope with high biological activity.

Objective PCT and sTREM-1 combined with APACHE Ⅱ score for assessing diagnosis of sepsis and prognostic value.Methods The clinical data for related patients who had hospitalized between January and October 2015 were collected by prospective study methods.According to China guidelines for treatment of severe sepsis/septic shock (2014).The patients were divided into SIRS group,sepsis group,severe sepsis group,septic shock group,and control group.Results Levels of CRP and sTREM-1 were significantly higher in total sepsis group and subgroups than in SIRS group and control group,with a statistical difference (P ＜ 0.05);but there were no significant differences among he subgroups.Lactic acid level differed statistically between both total sepsis group and its subgroups and both control group and SIRS group,so did level of lactic acid between the other groups and septic shock group (P ＜ 0.05).PCT was significantly higher in total sepsis group and its subgroups than in the control group and SIRS group,so did it in septic shock and severe sepsis group than in sepsis group.PCT level was significantly higher in septic shock than in severe sepsis (P ＜ 0.05).APACHE Ⅱ scores were markedly in total sepsis group and its subgroups than in SIRS group and the control group;and it differed statistically between septic shock group and sepsis group (P ＜ 0.05).According to the ROC curve analysis,the area under the curve was 0.935,0.877,0.816,and 0.856 for PCT,sTREM-1,APACHE Ⅱ,CRP,and lactic acid,respectively.Conclusions Detection of serum PCT and sTREM-1 combined with APACHE Ⅱ score can be used to assess diagnosis of sepsis and prognostic value,which has more benefit to the diagnosis and treatment of sepsis.

Objective To study the clinical value of sTREM-1, PCT, CRP in sepsis. Methods A prospective study was conducted and clinical data of related patients from January to October 2015 were collected. Thirty-nine cases of sepsis patients , 15 patients with SIRS and 12 normal controls were detected by ELISA then the prognostic value of sTREM-1, PCT, CRP was determined in sepsis. Results In sepsis and SIRS group, sTREM-1 and PCT level were significantly higher than those in control group (P < 0.05); CRP only in sepsis group and control group was statistically significant (P < 0.05). In sepsis group, sTREM-1,PCT and CRP were significantly higher than those in SIRS group (P < 0.05). The ROC curve analysis indicated that sTREM-1,PCT and CRP for SIRS and non SIRS area under the curve was 0.914,0.887 and 0.831 respectively. Conclusion sTREM-1 is a good indicator for early diagnosis of sepsis, and it has high sensitivity and specificity.

Objective To investigate the left atrium (LA) function and structure changes in the paroxysmal atrial fibrillation (AF) patients after catheter ablation using tissue Doppler imaging. Methods After complete pul-monary vein, radiofrequency ablation guided by Ensite NavX System, LA systolic function and LA diameter, volume, mean mitral gradient and mitral annulus early and advanced diastolic peak velocity were assessed in 32 cases of par-oxysmal AF patients,which were compared with age-matched controls before and after 24 hours, 1 week, 1 month) AF ablation. Results AF did not occur again in 32 AF paroxysmal patients after isolation. LA diameter and volume in AF groups before ablation were larger than controls(P<0.01), which were also larger 24 hours after ablation than before (P>0.05 ), but LA volume was larger than before (P<0.05), and decreased in I week after ablation (P< 0.05), but had no significant difference compared with controls in 1 month(P>0.05 ) ;mitral annulus advanced di-astolic peak velocity decreased in AF groups before ablation (P<0.01 )and was lower than that 24 hours after cathe-ter ablation (P<0.05 ), but increased after 1 week (P<0.05 or P <0.01 ), and had no significance after 1 month. Conclusion Catheter ablation is the effective way to manage AF because LA is distended and atrial systolic func-tion is reduced within 24 hours after procedure, then gradually increased in a week and will nearly recover to that be-fore procedure in a month, which may be correlated with LA repair, implicating that postprocedural thromboembollc risk and procedure injury should be taken into consideration.

Cardiomyopathy, Hypertrophic ; Humans ; Pulmonary Edema