ObjectiveTo assess the significance of serum cysteine proteinase inhibitor C (Cys-C) and β2 microglobulin (β2MG) concentrations in the diagnosis and prognosis of sepsis-induced acute kidney injury.Methods Two hundred and fifty patients presenting to the Emergency Department of Beijing Chaoyang Hospital from October 2008 to October 2009 with sepsis were assessed.Serum creatinine (SCr),β2MG and Cys-C concentrations and Acute Physiology and Chronic Health Evaluation Ⅱ ( APACHE Ⅱ ) scores were determined when the septic patients presented to the hospital. The 28-day mortality was recorded.The study patients were retrospectively divided into acute kidney injury ( n =63 ) and no acute kidney injury groups (n =187 ).The predictive accuracies of Cys-C and β2MG for acute kidney injury were analyzed by plotting a relative operating characteristic (ROC) curve.The Spearman interclass correlation method was used to analyze the correlation between Cys-C concentration and APACHE Ⅱ score in sepsisinduced acute kidney injury.ResultsCys-C and β2 MG concentrations were significantly greater in the acute than in the no acute kidney injury group [ ( 1189 ± 214) μg/L vs.(678 ± 118) μg/L,P =0.007 ; (3705 ±599)μg/L vs.(2365 ±446) μg/L,P =0.004,respectively].SCr concentrations and APACHE Ⅱ scores were significantly greater in the acute than in the no acute kidney injury group [ (145 ±49) vs.(73 ±25),P=0.013,(19 ±4) vs.(13 ±4),P=0.016].There was a significant correlation between Cys-C concentration and APACHEII score in the acute kidney injury group (P ＜0.01).The 28-day mortality was significantly greater in the acute than in the no acute kidney injury group.The areas under the ROC curve for Cys-C and β2MG concentrations were 0.909 ( OR =1.006,95％ CI =1.002 - 1.009) and 0.82 ( OR =1.001,95％ CI =1.000 -1.001),respectively.ConclusionsMonitoring of Cys-C and β2MG concentrations can effectively predict the occurrence of acute kidney injury in septic patients.Cys-C concentration is a more accurate predictor of this diagnosis than β2MG concentration.An increasing Cys-C concentration is an indicator of poor prognosis.

Objective To evaluate acoustic effects of laryngeal microsurgery on vocal polyp, vocal cyst and vocal leuko- plakia. Methods 300 cases in vocal fold diseases were measured acoustically pre - and post - microsurgery. Results After openation, jitter, shimmer and NNE decreased statistically in vocal polyp and vocal cyst patients, and did not improve in vocal leukoplakia patients. Whether or not the surgery was done, F0 of all patients did not change Conclusion Laryngeal microsurgery had definite effect on clearing benign focus. After surgery, vocal functioin improved in vocal polyp and cyst patients, and in vocal leukoplakia, there was no improvement in such a short time as one week.

ObjectiveThe difference of Cys-C ( serum cysteine proteinase inhibitor C) among sepsis group,systemic inflammatory response syndrome (SIRS) group,and non -SIRS group were explored in this study.The significance of mortality and the relationship between Cys-C and acute physiology and chronic health evaluation (APACHE)Ⅱ score were under discussed. Methods After excluding the individual whose survival less than 24 hours,two hundred and fifty patients sought medical care in the emergency department of Beijing Chaoyang Hospital of the Capital Medical University were selected as samples from October 2008 to October 2009.They were classified into three groups:SIRS group ( n =121 ),non-SIRS group (n =74) and sepsis group ( n =55 ).The serum Cys-C level and APACHE Ⅱ score were determined for each patient.The positive detection rate of Cys-C ( ＞ 830 ng/ml) was calculated and then a 28-day mortality was recorded according to this study result.The positive detection rate and 28-day mortality were also compared with chi-square test.The prognostic values of Cys-C,APACHE Ⅱ score for the 28-daymortality were evaluated by logistic regression analysis.Results There was significant change observed between sepsis group and non-SIRS group (41.38％ vs. 13.57％,P =0.007 ) for the positive detection rate of Cys-C,as well as that between SIRS group and non-SIRS group ( 32.79％ vs. 13.57％,P =0.005).However,a contrary result was obtained when compared sepsis group with SIRS group (41.38％ vs.32.79％,P =0.346) ).Significant difference was noticed in the 28-day mortality of the patients from sepsis group and SIRS group in comparison to those of non-SIRS group (41.6％ vs. 17.2％,P ＜ 0.01 ;36.91％ vs. 17.2％,P ＜ 0.05).Cys-C level in patient with sepsis indicated a positive correlation to APACHE Ⅱ score ( P ＜0.0001 ).ConclusionsThe positive rate of Cys-C in SIRS group and septic group were significantly higher than that of non-SIRS patients,and this is an index for poor prognosis in sepsis patients.

[Objective]To explore the result of total hip arthroplasty(THA) performed in patients with osteoarthritis secondary to developmental dysplasia of the hip(DDH) and the degree of hip dysplasia on the treatment result. [Method]Forty-seven cases(55 hips) with osteoarthritis secondary to DDH were treated with THA.According to the classification of Crowe,23 hips were in classⅠ,19 in classⅡand 13 in class Ⅲ/Ⅳ.Before operation,the morphological changes of acetabula and femurs were evaluated with helical CT.During the operation,the acetabula were reconstructed at the level of real acetabula,the femoral canal was carefully enlarged and the small and straight femoral protheses were employed.The Harris hip score was conducted in each patients preoperatively and postoperatively.[Result]The Harris hip score in class Ⅰ,Ⅱand Ⅲ/Ⅳ were from 50.7?7.6,44.9?6.2 and 41.1?8.2 preoperative to 90.6?3.7,87.3?4.5 and 82.7?7.3 postoperative,respectively.There was significant difference between them(P

To study the effect of unilateral vocal cord paralysis on vocal vibration, EGG parameters of 46 patients were analysed. EGG of most patients were abnormal, CQ decreasing while CI, CQP and CIP increasing. The incidence of normal EGG in patients whose vocal cord located in the middle was higher than that in the para - middle. Inversely, the incidence of abnormal EGG - CQ of the former was lower than that of the latter. EGG of the group in the intermediate was abnormal. The position of paralyzed vocal cord had no effect on CI,CQP and CIP. EGG reflects the characteristics of per vibratory cycle, and is a potential technique to study the irregular vocal vibration.

Objective To study the effects of Electroglottography(EGG) on screening vocal fold disorders.Methods 134 cases of glottal carcinoma and 167 benign vocal diseases and 62 healthy volunteers were measured. EGG waveform and variables were analyzed to investigate the sensitivity and specificity of EGG measurement.Results Compared with healthy people, the majority of EGG waveform and variables of vocal fold disorders were abnormal. The differences were significant statistically either between healthy people and vocal fold disorders or between benign vocal diseases and malignancy. In benign vocal diseases, the differences of EGG waveform and variables among vocal polyp and cyst and leukoplakia were insignificant statistically, and nor were the differences among various clinical T stages in glottal carcinoma.Conclusion EGG measurement is sensitive to screen vocal fold disorders, and is specific to distinguish benign and malignant diseases, but it couldn not be used to identify the types or clinical stage of the diseases.

Objective To investigate the changes of serum inflammatory factors and blood glucose in patients with systemic inflammatory response syndrome (SIRS) . Methods Seventy eight SIRS patients were divided into survival subgroup (n =37) and fatal subgroup ( n = 41), 35 non-SIRS patients were designated as control group. Thirty eight out 76 patients whose blood glucose was higher than 6. 1 mmol/L were randomly selected for intensive insulin therapy. Serum IL-6, IL-10, IL-13, TNF-α and blood glucose were measured; HLA-DR expression on monocytes was detected. Results Serum IL-6, TNF-αand blood glucose levels were (80±8) vs. (42±7)×10~3μg/L, (52±20) vs. (17±6) ×10~3μg/L and (11.9±1.1)vs.(6.5±1.5)mmoL/L in SIRS vs.non-SIRS group respectively(all P＜0.05);those were(108±21)vs.(66±22)×10~3μg/L,(28±8)vs.(16±9)×10~3μg/L,(14.4±2.1)vs.(7.0±1.0)mmol/L in fatal vs.survival group,respectively(all P＜0.05).The changes of IL-10,IL-13 and HLA-DR expression intensity of monocyte showed a reverse trend.The intensive insulin therapy reversed the above tendency and reduced the fatality rate.Conclusions Blood glucose levels are corrected with serum cytokines in SIRS patients and reflex the immune status and disease prognosis.Intensive insulin therapy can improve the prognosis of SIRS patients.

Objective: To assess the effect of Compound Danshen(CD) Injection (Radix Salviae Militiorrhizae) in the treatment of hypertensive cerebral hemorrhage (HCH). Methods : Sixty-three cases (aged 56～78, 61.9 years on average) with HCH were randomly divided into three groups: (CD+Deproteinized Calf-blood Extractives (DCE) group and Reptilase+DCE group as the treated groups, DCE group as the control group) to observe the outcome of the clinical treatment, hematoma absorbability and changes of ADP-platelet agglutination rate (Pag) and prothrombin time (PT). Results : The rate of the good result (GR) and moderate disability (MD) in CD group was 83.34% with the method of Glasgow outcome score (GOS), others were 47.61% and 61.11% ,respectively. they have significant difference, P

Objective To investigate influence of nutritional status on prognosis in patients with systemic inflammatory response syndrome (SIRS). Methods Retrospective analysis for clinical data of 533 patients who hospitalized at the Internal Medicine Department of Beijing Social Welfare Hospital and the Emergency Department of Chaoyang Hospital, Beijing during 2005 to 2010 were performed. All the patients were divided into SIRS (323 cases) and non-SIRS (210 cases) groups based on diagnostic criteria of SIRS and pyemia, and groups of the survival (431 cases) and the dead ( 102 cases) based on their end outcomes.Patients of SIRS were further divided into sub-groups of pyemia (287 cases) and non-pyemia (36 cases)based on their infection status. The Acute Physiology and Chronic Health Evaluation Ⅱ ( APACHE Ⅱ ),serum levels of prealbumin ( PAB), albumin ( ALB), total cholesterol (CHOL) and C-creative protein (CRP) were measured for all the patients on the 1st, 3rd, 7th days after admission, before discharge and prior to death, respectively. Results Scores of APACHE Ⅱ were significantly higher in SIRS and the dead groups than those in non-SIRS and the survival groups (P ＜0. 05 ). Serum level of albumin was significantly lower in SIRS and the dead groups than that in non-SIRS and the survival groups on the 7th day after admission (SIRS vs. non-SIRS: F=9.812, P=0.035; the dead vs. the survival: F =45.285, P=0. 003). Change in serum level of prealbumin was the same as the level of albumin, with significant difference between various groups since the 3rd day after admission ( P ＜ 0. 05 ). Significant time effects could be found in the dead and survival groups (for the dead group: F = 19. 188, P = 0. 000; and for the survival group: F = 47. 250, P ＜ 0. 01 ). Multiple regression analysis showed that serum levels of prealbumin and total cholesterol correlated with scores of APACHE Ⅱ[with a regression formula of scores of APACHE Ⅱ = 52.032-21.407 PAB-8.971 CHOL (R2 =0.801, F=48.016, P =0.023)]. Logistic regression analysis showed that low level of prealbumin and high scores of APACHE Ⅱ both were predictors for survival of SIRS patients, with an overall accuracy of 77. 1 percent, 73.5 percent for survival and 79. 5 percent for death prediction. Conclusions Severe malnutrition can be found in patients with SIRS and serum level of prealbumin can be used to evaluate their nutritional status and severity of the disease. High scores of APACHE Ⅱ combined with low serum level of prealbumin can predict prognosis of the patients.

Objective To summarize the outcomes and clinical experience of orthotopic heart transplantations in Shanghai Zhongshan Hospital.Methods From May 2000 through October 2005,141 patients,101 males and 40 females,diagnosed as having dilated cardiomyopathy in 118,hypertrophic cardiomyopathy in 2,restrictive cardiomyopathy in 2,end-stage ischemic heart disease in 9, primary malignant cardiac tumor in 4,valvular heart disease in 3 and others in 3,underwent orthotopic heart(transplantations) at our center.The operative procedures included 120 bicaval anastomotic cardiac transplantations,19 conventional Stanford orthotopic cardiac transplantations and 2 total heart transplantations.The immunosuppressive therapy strategies included Cyclosporine A or tacrolimus,corticosteroids and mycophenolate mofetil.For the latest 28 patients,induction therapy with Daclizumab was applied.Results There were 3 operative deaths with an operative survival of 97.9 %.During the follow-up from 1 month to 65 months,the actuarial survival rate was 90.8 % after 1 year,84.6 % after 3 year and 81.4 % after 5 year.Acute rejection,infections,graft failure and metastasis of primary cardiac tumor were the main causes of death in the 1st postoperative year,while acute rejection and graft coronary vasculopathy were the leading causes of death thereafter.Postoperative complications included acute rejection,infections,renal dysfunction and graft failure.Conclusions Orthotopic heart transplantation was proved to be a reliable choice for endstage heart disease with excellent outcomes.More attention should be paid to surveillance and management of acute rejection, infections and graft coronary vasculopathy in the long-term follow-up.