Objective To investigate the early diagnostic value of high‐sensitivity C‐reactive protein(hs‐CRP) ,D‐dimer and cTnI in ACS .Methods All the 83 blood samples of patients with chest pain in the emergency department of our hospital were enrolled in the study ,and 30 healthy people were recruited as the control group .According to the final clinical diagnosis ,29 patients were grouped into non‐ischemic chest pain(NICP) group and 54 patients were grouped into ACS group .Venous blood samples were col‐lected and the concentrations of serum hs‐CRP ,cTnI ,plasma D‐dimer were measured .The diagnostic value of the 3 indicators and their combined test for ACS was evaluated by using the receiver operating characteristic(ROC) curve and Youden index .Results The levels of hs‐CRP ,cTnI and D‐dimer in ACS group were significantly higher than those of the control group and the NICP group (P<0 .05) .The levels of hs‐CRP and D‐dimer in ACS group were significantly higher than those of the NICP group(P<0 .05) . ROC showed that the area under urve of hs‐CRP ,D‐dimer and cTnI were 0 .564 ,0 .631 and 0 .639 respectively .The sensitivity ,spe‐cificity and accuracy of the combined detection of hs‐CRP ,cTnI and D‐dimer were 88 .1% ,58 .7% ,53 .2% respectively . Conclusion To some extent ,the levels of hs‐CRP ,cTnI and D‐dimer all could be used as indicators in the diagnosis of ACS .But combined detection of hs‐CRP ,cTnI and D‐dimer could improve the sensitivity and specificity ,and had value to guide clinical diagno‐sis of ACS in the early stage .

Objective To evaluate the effectiveness of using anti‐cyclic citrullinated peptide (anti‐CCP) antibody or rheumatoid factor(RF) as the single laboratory parameter for rheumatoid arthritis(RA) diagnosis ,versus to using the two parameters in com‐bination .Methods A total of 56 cases of patients with RA were enrolled into RA group ,other 34 cases of patients with out RA were enrolled into non‐RA group .Levels of anti‐CCP antibody and RF were detected by using electro‐chemiluminescence immunoas‐say(ECLIA)and compared between the two groups .And the diagnostic efficacy of single and combined detection of anti‐CCP anti‐body and RF were evaluated .Results The levels of anti‐CCP antibody and RF in the RA group were higher than those in the non‐RA group ,had statistically significant differences(P<0 .05) .In diagnosis of RA ,the areas under receiver operating characteristic (ROC)curve of anti‐CCP antibody and RF were 0 .925 and 0 .822 respectively .The sensitivity and specificity of anti‐CCP antibody were both higher than those of RF .Compared with single detection of anti‐CCP antibody ,there was no significant increase of sensi‐tivity in using anti‐CCP antibody/RF ,whereas the specificity dropped significantly .Combined detection of anti‐CCP antibody and RF ,compared with single detection of anti‐CCP antibody ,had significantly lower sensitivity ,but no significant changes were found in specificity .Conclusion Single detection of anti‐CCP antibody is more effective than RF for diagnosing RA ,while combined detec‐tion of anti‐CCP antibody and RF could not significantly improve the specificity and sensitivity .It is suggested to only use anti‐CCP antibody for diagnosis of RA .

Objective To study the preparation of Fructus perrillae oil nanoemulsion and its quality evaluation. Methods The formulations of Fructus Perrillae oil nanoemulsion were optimized by drawing the pseudoternary phase diagrams and investigating the form, viscosity, particle size distribution, stability, conductance, and refractiratio. Results The optimal formulation was composed of wheat oil and cremophor RH40, electron microscopy presented Fructus Perrillae oil nanoemulsion as small spherical drops, viscosity was (5.49?0.02)/mm2?s-1, conductance was 316/ms-1, refractiratio was (1.124?0.002 50), and mean diameter of particle was (50.3?1.1) nm.The average recovery determined by GC was 98.9%, its mean RSD was 0.88%. Conclusion The solubility and stability of Fructus Perrillae oil are promoted by nanoemulsion with better produncibility. It is a favorable medical matrix.

Objective To investigate the prognostic significance of serum lactate level and lactate clearance rate for critical illness patients.Methods Two hundred and eighty-six patients with hyperlactacidemia were investigated by analyzing the clinical data,laboratory data and outcomes.Comparison of mortality rate and APACHE Ⅱ score between different stratified levels of serum lactate was carried out.The blood pH,HCO3-,BE,and Lac were compared between survivors and non-survivors in terms of in-hospital death in seven days after admission.The above variables of blood gas analysis were studied in patients with severe hyperlactacidemia as well as the different lactate clearance rates and APACHE Ⅱ scores were compared between survivors and non-survivors.The mortality rates and APACHE Ⅱ scores were compared between high and low lactate-clearance rate groups.Results The mortality rates of different stratified levels of serum lactate (≥2,＜4 mmol/L; ≥4,＜ 10mmol/L; ≥ 10 mmoL/L) were 14.04％,46.67％,78.79％,respectively.As the serum level of lactate increased,the decompensation rate of pH,APACHE Ⅱ score and mortality rate increased consequently.Compared with non-survivors,survivors had a higher lactate clearance rate (P ＜ 0.01),and lower APACHE Ⅱ score (P ＜ 0.01).The high-clearance group had lower mortality rate and 6-hour APACHE Ⅱ score compared with the low-clearance group (P ＜ 0.01),but the initiate levels of serum lactate and APACHE Ⅱ scores were not noticeably different between the two groups (P ＞ 0.05).Serum lactate level had a significant positive relationship with APACHE Ⅱ score (r =0.868,P ＜ 0.01),but lactate clearance rate had a significant reverse relationship with APACHE Ⅱ score (r =-0.823,P ＜ 0.01).Conclusions Both serum lactate levels and early lactate clearance rate had high prognostic value for critical illness patients,and in combination with changes in APACHE Ⅱ score,they could guide clinical treatment and give precise evaluation of the prognosis.

Objective To explore the correlation of the reversely increased results of 75g oral glucose tolerance test (OGTT) during pregnancy to the pregnancy outcome, so as to provide a reliable theoretical basis of the early intervention for the pregnant women with high plasma glucose.Methods The clinical data of 461 cases were retrospectively analyzed. Patients were chosen from the pregnant women undergoing routine antenatal examination in our hospital during 2014. According to the results of 75g OGTT, 226 patients were analyzed as the observation group, in whom the level of postprandial 2-hour plasma glucose was higher than that of postprandial 1-hour plasma glucose. Meanwhile 235 pregnant women with or without gestational diabetes mellitus (GDM) were randomly selected as the control group.Results The levels of fasting plasma glucose and 1-hour postprandial plasma glucose were lower, but those of 2-hour postprandial plasma glucose was higher in observation group than in control group (P<0.01). No statistical difference existed between the two groups (P>0.05) in the incidences of polyhydramnios, oligohydramnios, fetal growth restriction (FGR), premature labor (PTL), pregnancy induced hypertension (PIH), complicated with premature rupture of membrane (PROM), intrauterine fetal death (IUFD) and non scar uterus cesarean section rate (CSR). Compared with the observation group, the rates of neonatal dysplasia and neonatal asphyxia and the newborn transfer rate were lower in the control group, of which the newborn transfer rate was statistically different (P<0.01).Conclusions There might be a delayed plasma glucose metabolism in the patients with reversely increased result of 75g OGTT during pregnancy, which may affect the long-term prognosis of the newborn. Therefore, more attention should be paid to such patients with reversely increased result of 75g OGTT.

In patient with primary biliary cirrhosis,the metabolism of calcium and vitamin D could be affected and osteomalacia and secondary hyperparathyroidism might occurr.Besides,hypoalbuminemia may mask the real level of serum calcium and thus lead to misdiagnosis of coexisting parathyroid adenoma.Therefore,a rare case of parathyroid adenoma associated with primary biliary cirrhosis was herewith presented to call attention to the effect of hypoalbuminemia on serum calcium.

A total of 101 honey samples that originated from 20 different unifloral honey and other multifloral honey samples were collected from China.FT-NIR spectrometer were applied to determinate the content of fructose and glucose of honey with two different modes: transflectance (800-2500 nm, 2 mm optical path length) and transmittance (800-1370 nm, 20 mm optical path length).It was found that the prediction accuracy of fructose and glucose had significant difference with the two modes.In order to analyze the reason of this difference, support vector machine (SVM) was used to analyze the non-linear information, and genetic algorithm (GA) was used to analyze the characteristic wavelengths.The result indicated that the detection difference of fructose and glucose was originated from their different characteristic wavelengths.Through the optimization of detection method, it was found that for the determination of glucose, short wavelength and long optical path length should be used, on the other side, the whole wavelength region and short wavelength, with selecting the characteristic wavelength to avoid the disturb of water can also be used.For the determination of fructose, whole wavelength region and short optical path length should be used.Linear regression methods such as PLSR could obtain good results, and non-linear methods such as SVM did not improve the model performance.

Objective To explore the expression of the nerve growth factor receptors p75 (p75NGFR) in human bladder carcinoma samples, and the effects of hypoxia on the expression of p75NGFR in human bladder cancer ceils. Methods The expression of p75NGFR in 107 bladder cancer and lymph node specimens were immunohistochemically investigated. The expression of p75NGFR in bladder cancer cell line (T24) was assessed by immunocytochemistry, and reverse tran-scription-PCR in the Normoxic Condition (air, 5%CO2) and in hypoxia condition(10%O2, 5%CO2, 85%N2). Results p75NGFR expressed in 46 of 107(43.0%) tumor samples. There was no signifi-cant correlation between p75NGFR and the factors such as gender, age, extent of the tumors, and pathologic grading(P0.05), p75NGFR was expressed in examined cell line T24, and also expressed in 5 of 24 bladder tumors in metastasized lymph node specimens. Hypoxia markedly down-regulated the expression of p75NGFR of T24 cell line at third day. Conclusions It is suggested that p75NGFR is expressed less in lymph node metastasis. Hypoxia markedly inhibited expression of p75NGFR of T24 cell lines.

Objective To report our experience of retroperitoneal laparoscopic extravascular stent placement for nutcracker syndrome.Methods The clinical data of 12 nutcracker syndrome patients (10 males and 2 females;mean age 26 years) who underwent retroperitoneal laparoscopic extravascular stent placement from March 2014 to Febuary 2016 were retrospectively reviewed.The main symptoms were gross hematuria in 8 patients(one with proteinuria)and flank pain was noted in 1 patient.Three male patients had left-sided secondary varicoceles.Ultrasonography and computed tomography showed the left renal vein clamped by the superior mesenteric artery and the aorta.The anteroposterior diameter of the left renal vein in the renal hilum was three-fold than the aortomesenteric area,and the peak velocity ratio of the aortomesenteric area was much faster than the renal hilum.Twelve patients underwent laparoscopic extravascular stent placement under general anesthesia.The preaortic fibrous tissue between the aorta and the superior mesenteric artery was released intraoperatively.Renal vein became fiat when the superior mesenteric artery was elevated.The 6-8 cm extravascular stent was set on the surface of the renal vein to prevent the compression.Results Stenting was successfully accomplished in all 12 patients.Mean operative time was 62 min (50-125 min),estimated blood loss was 35 ml(20-100 ml),and the hospital stay after operation was 8 days (6-12 days).Three patients had a transient orthostatic intolerance,and they were cured by conservative treatment.With a mean follow up of 14 months (5-30 months),symptoms of hematuria and flank pain resolved in 7/8 and 1/1,respectively.Varicoceles were cured in all three patients.One case got partial relief because of recurrent hematuria due to excessive exercise.Ultrasonography showed that extravascular stent was in the right place,and the angle between abdominal aorta and superior mesenteric artery became normal.The inner diameter of left renal vein was decreased,and the narrow segment was diminished in diameter meanwhile the blood outflow was smooth.Conclusions Retroperitoneal laparoscopic extravascular stent placement in the renal vein is a safe and effective approach for nutcracker syndrome.

Parathyroid adenoma is the main cause of primary hyperparathyroidism and often associated with thyroid nodular goiter.Thyrothymic thyroid rest belong to the ectopic thyroids which are classified into 4 grades according to the state of their connection with the proper neck thyroid gland.Thyrothymic thyroid remnant can also develop into nodular goiter and may be difficult to be distinguished from parathyroid adenoma.We present herewith the diagnosis and treatment of a rare case of parathyroid adenoma accompanied by thyrothymic thyroid remnant nodular goiter in order to remind clinicians of the attention to the thyrothymic thyroid remnant disease.