Objective To evaluate the application value of the blood culture combined with the detection of serum procalcitonin and C-reactive protein(CRP)in diagnosing infectious fever patients.Methods The PCT and CRP detection results on the blood sampling day in 126 cases of fever with positive blood culture and 123 cases of fever with negative blood culture in the emergency department were retrospectively analyzed,and the two sets of data were compared and statistically analyzed by the SPSS 16.0 soft-ware.Results The positive rates of CRP and PCT in 126 cases of positive blood culture were 100% and 100%,the detection values were 26.9-256.8 and 0.25-98.6,the positive rates of CRP and PCT in 123 cases of negative blood culture 95.5% and 15.4% re-spectively,the detection values were 1 .2-126.8 and 0.02-0.98.The PCT and CRP detection values in the positive blood culture group were significantly higher than those in the negative blood culture group,the difference was statistically significant(P <0.01). Conclusion PCT and CRP can be served as the monitoring indicators for blood bacterial infections,the blood culture combined with PCT and CRP detection has the guidance significance for early diagnosing bacterial infection.

Objective To investigate the role of nucleotide-binding oligomerization domain-containing protein 1 (NOD1) in inducing insulin resistance in differentiated human adipocytes.Methods Human preadipocytes obtained via liposuction were induced to differentiate into mature adipocytes.iE-DAP,a specific ligand for NOD1,was administered to human adipocytes in culture.NF-κB transcriptional activity and proinflammatory cytokines production were determined by luciferase assay and enzyme-linked immunosorbent assay.Glucose uptake in adipocytes was measured by 2-deoxy-D-[3 H] glucose uptake (P＜0.05).The expression of phosphatidylinositol-3-kinase p85 (PI-3K p85),insulin receptor substrate-1 (IRS-1) and Akt phosphorylations were detected by Western blotting.Results NF-κB transcriptional activity and cytokines such as interleukin (IL)-6,IL-8,and monocyte chemotactic protein 1 secretion were markedly increased after stimulation with iE-DAP (P＜0.05 or P＜0.01).Insulin-induced glucose uptake was decreased with the activation of NOD1 in a dose-and time-dependent fashion.NOD1 activation weakened insulin signal transduction as being revealed by increasing IRS-1 Ser307phosphorylation,reducing protein expression of PI-3K p85,and attenuating insulin-induced phosphorylation of Akt on Ser473 and Thr308in human adipocytes.Conclusion These results indicate that NOD1 activation induces inflammatory response and insulin resistance via IRS-1/PI3-K/Akt signaling pathway in human adipocytes.

Objective To investigate the effect of intracoronary application of tirofiban on coronary slow flow patients with acute myocardial infarction during primary percutaneous coronary intervention (PPC1).Method It was a retrospective analysis of 187 patients with acute myocardial infarction treated with PPCI in the emergency department of Beijing Anzhen Hospital enrolled in this study from January,2008 through January,2011.The patients divided into 2 groups in terms of intra-coronary administration of tirofiban (tirofiban group) and intra-coronary use of nitroglycerol (control group).Data were statistically analyzed by using SPSS 13.0 software.Categorical variables were analyzed using x2 test and continuous variables were compared by t test.Results Between two groups,there were no differences in preoperative systolic pressure (P =0.245),the rate of TIMI flow 3 (P =0.568) after PPCI and ST segment resolution (P =0.824),LVEF (P =0.275) and in-hospital mortality (P =0.502).Compared with tirofiban group,the systolic pressure was lower and the rate of using intra-aortic counter-pulsation was higher in control group.Although the incidence of slight bleeding in the control group was lower than that in the tirofiban group,no severe bleeding was observed in both groups.Conclusions The effect of intracoronary use of tirofiban was similar to that of nitroglycerol in terms of improving slow flow of coronary artery.It could safely and effectively reduce the incidence of the coronary slow flow in the patients after PPCI,but it produced a little impact on systolic pressure.It may be a better method of choice for AMI patient with low blood pressure.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Isocitrate Dehydrogenase ; genetics ; Leukemia, Myeloid, Acute ; genetics ; Male ; Mutation ; Nuclear Proteins ; genetics ; Prognosis ; Treatment Outcome

Objective To evaluate the occurrence rate and agents of the bacterial contamination of bandage contact lenses after photorefractive keratectomy(PRK) .Methods In a prospective study ,50 patients (100 eyes) underwent PRK .Conjunctival sac se‐creta were placed onto chocolate agar before PRK .All patients accepted bandage contact lenses and anti‐inflammatory drug therapy . Contact lenses and conjunctival sac secreta were placed onto chocolate agar after PRK .Corrected visual acuity ,intraocular pressure and corneal thickness were compared in the 2 groups .Results Among 100 pieces of cornea contact lens ,3 pieces (3% ) were tested positive for bacteria detection and bacteria were staphylococcus epidermis .All conjunctival sac secreta of preoperative and postoper‐ative were not detected bacteria ,postoperative eye infection was not found .Between the positive and negative groups ,tear secretion , may be related to cultivate positive correlation .Conclusion Bacterial contamination is possible when using bandage contact lenses after PRK ,specially for patients with less tear secretion .

The development of printing ink is a challenge for binder jetting 3D printed preparations, which directly determines the quality of the printed product. This study adopted a 2³ full-factor Design of Experiment (DoE) with three central points to optimize the printing ink composition of levetiracetam 3D printed dispersible tablet based on the concept of Quality by Design. Firstly, using polyvinyl pyrrolidone K30, glycerin and polysorbate 20 as independent variables based on 40% (v/v) isopropanol aqueous solution, and weight variation, hardness, friability and dispersion uniformity of the printed tablets were used as dependent variables. Then obtained the design space of the printing ink prescription by DoE model analysis, and the response optimizer was used to obtain the optimal printing ink prescription: isopropanol aqueous solution containing 0.1% (w/w) polyvinyl pyrrolidone K30 and 4.0% (w/w) glycerin. The jetting mechanism and wettability of the printing ink were analyzed, and different strengths of personalized 3D printed tablets were prepared and characterized, which verified the rationality of the printing ink formulation. This study provided a reference for the development of printing ink for binder jetting 3D printed preparations.

Objective To investigate the status of clinical nurses' professional self-concept and analyze its influencing factors. Methods A total of 572 clinic nurses were investigated by using Professional Self-concept of Nurses Instrument. Results Indicators including married status, education background, age, nursing experiences, professional title and position were influencing factors of professional self-concept.Conclusions Clinical nurses below 30 years old or under 10 years nursing experiences or lower professional title or no position or single should emphasize on professional self-concept.

Objective To observe the serum B-type natriuretic peptide(BNP)changes in patients with acute coronary syndrome during percutaneous coronary intervention(PCI).Method The serum BNP level was determined and the heart function was assessed in 236 consecutive patients with acute coronary syndrome(ACS) admitted to CCU and in 54 normal normal suvjects as control from January 2005 to December 2006 in Tongji Hospital.The ACS patients were further divided into various subgroups according to the involved arteries and performance of PCI.Serum BNP,hypersensitive c respose protein(HsCRP)level,amd heart comstitution and function were analyzed.Results The serum BNP and HsCRP level were significantly increased in patients with ACS [(332.06?483.17)ng/L and(31.06?52.15)mg/L]more than those in normal subjects [(81.44?195.55)ng/L and(11.15?20.78)mg/L,respectively,P

Objective To study the influence of sex on the prognosis in acute ST elevated myocardial in- farction(STEMI)patients after primary percutaneous coronary intervention(PCI).Methods :The risk factors, coronary angiography and prognosis in 478 males and 101 females with STEMl were compared.Results:Mortality of STEMI was significantly different in different age groups(P<0.01).The attack of the STEMI in women was 10 vears later than that of men(P<0.01),especially in those women whose age was over 71 years oId.The complica- tion ratio of hypertension and type 2 mellitus diabetes was higher in female patients than that in male(P<0.01). More multi-vessel lesions were found in female patients than those in male(P<0.01).The incidence of in-hospital mortality,pseudoaneurysm,haematoma Was significantly higher in females than in males(P<0.05.P<0.01).Con- clusions The in-hospital mortalitv and puncture complications in STEMI female patients treated with primary PCI are higher than male patients.

Objective To find the factors lowering the rate of effective thrombus aspiration in patients with STsegment elevation acute myocardial infarction (STEMI) treated with primary percutaneous coronary intervention(PCI). Method From January to December 2008 , a total of 226 AMI patients from Beijing Anzhen Hospital,treated with primary PCI to aspirate the thrombus from the infracted coronary artery via a cannula, were enrolled in a single center retrospective study. The criterion of successful thrombectomy (device success) was defined as the coronary blood flow of involved vessel after PCI resumed to greater than TIMI grade 1. One hundred seventy-eight patients were assigned to effective thrombus aspiration group, and 48 patients without improvement in coronary blood flow of involved vessel after PCI to control group. Data collected after PCI including the normalization of the elevated ST segment,the use of direct stent, ratio of no-flow/slow flow, intra-coronary administration of Tirofiban and the rate of thrombolysis in myocardial infarction (TIMI) flow grade 3 were analyzed with logistic analysis soas to find out the factors affecting the efficacy of thrombus aspiration. Results There were no significant differences in data before PCI between two groups ( P ＞0.05). Compared with the control group, the factors studied such as smoke, diabetes, the rate of pre-PCI TIMI flow grade 0,the post-PCI ratio of no-reflow/slow flow,and the intra-coronary administration of Tirofiban were fewer significantly in the effective thrombus aspiration group. And the rate of post-PCI TIMI flow grade 3, and the rate of direct stent were higher in the effective thrombus aspiration group. Logistic analysis showed that smoke ( OR = 1.551,95%CI: 1.018 ～ 2. 154, P = 0.012), diabetes ( OR = 1. 132,95%CI:0.276 ～ 3.562, P =0.044), and pre-PCI TIMI flow grade 0 OR = 0.544,95%CI:0.368 ～ 1.911,P = 0.035) were independent factors of effective thrombus aspiration. Conclusions Effective thrombus aspiration may improved the coronary blood flow to TIMI flow grade 3 after PCI and reduce the impaiment of myocardial perfusion, and the factors affecting the efficacy of thrombus aspiration should be paid more attention to and should be minimized to achieve the better clinical outcomes.