Breast Neoplasms ; pathology ; Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; Neoplasms ; pathology ; Nose Neoplasms ; secondary ; Skin Neoplasms ; secondary

Objective To explore the clinical value of combined detection of antiperinuclear fac-tor (APF) ,anti-RA keratin antibody (AKA) and anticyclic citrullinated peptide antibody (anti-CCP) in diagnosis and differential diagnosis of rheumatoid arthritis (RA). Methods Totally 119 RA pa-tients,101 non-RA rheumatisants and 39 healthy controls were enrolled in the study. Enzyme linked immunosorbent assay (ELISA) was applied to quantitately detecting anti-CCP antibody; immunofluo-rescence method was applied to quantitately determining AKA and APF. Then the quadruple tabular form was used to calculate the sensitivity and specificity. Results In RA group,the sensitivity of APF, AKA and anti-CCP antibody was 48.8% ,32.3% and 83.5% respectively; the specificity was 92. 2%, 93. 1% and 94.1 % respectively. Conclusion Three autoantibodies,including APF,AKA and anti-CCP antibody have high specificity in early diagnosis of RA. Combined detection of the three antibodies con-tributes to diagnosis and differential diagnosis of rheumatoid arthritis (RA).

Health management is developing very fast as a new subject.The ethical problem in which there is rare in reports.Discussion about the ethical problems appears in health management and health examination,such as privacy protection,sex morality,excess service,healthy morality,humanities concern,cooperation between each section and so on,has a important actual significance.

Objective To evaluate the clinical value of cardiac troponin I(cTnI) in the diagnosis of myocardial ischemic injury.Methods Twenty patients were randomly divided into two groups: group I (cold crystalloid cardioplegia, n=10) and group Ⅱ (cold blood cardioplegia, n=10). The central venous blood samples were taken at various times during perioperation to measure the serum levels of cTnI,CK MB and CK . Myocardial samples were obtained 10 min before aorta clamping and 30 min after aotra unclamping, to observe myocardial ultrastructure .Results cTnI,CK and CK MB levels were normal before operation, increased markablely following aotra unclamping ,reached the peak 1 h after aorta unclamping to 24 h after operation, and decreased progressively to be normal in two groups. The serum cTnI level was significantly lower in group Ⅱ than that in group Ⅰ 24 h and 48 h after operation. The serum CK MB activity was lower in group Ⅱ than that in group Ⅰ 1 h after aorta unclamping. There was positive significant correlation between aorta cross clamping time and cTnI peak level.Conclusions cTnI can be used to evaluate the degree of myocardial injury and myocardial protective effect in open heart surgery during CPB. As indicators for reflecting the myocardial injury, the sensitivity and specificity of cTnI are more valuable than those of myocardial enzymes.

Evaluation methods of chronic sinusitis ( Visual Analogue Score and Lund-Kennedy Score) were recom-mended by the 2009 Chinese Medical Association otolaryngology head and neck surgery to nasal Science Group,and retrospective analysis of the functional endoscopic sinus surgery for noninvasive fungal sinusitis treatment effect of 143 patients. VAS of preoperative was 5.8±1.0,postoperative score was 3.9±1.0, 2.4±0.9 after 3 months,6 months, respectively (P<0.01). Lund-Kennedy Score of preoperative was 7.7±2.1, postoperative score was 3.7±1.9, 1.6±1.4 after 3 months,6 months respectively (P<0.01).

Objective To investigate the role of problem-based learning (PBL) in the improve-ment of students' comprehensive ability in experimental classes of fundamental nursing. Methods A total of 172 nursing students were randomly divided into the experimental group (n=76) and the control group (n=96), they received PBL and traditional education, respectively.The teaching effect was compared using X2 tesL Results The experimental group was better than the control group in comprehensive a-bility such as communication skills, operant skills, coping skills, health education, appearance and at-titude. Conclusions PBL can promote the nursing students to understand the comprehensive information of special problems, and improve their skills of resolving practical problems and autonomic learning.

Objective　To evaluate the diagnositic value of exercise stress echocardiography (ESE) in patients with pacemaker-dependnet.Methods　Forty-six patients remained pacemaker dependent with a fixed heart rate throughout ESE and coronary angiographic studies.Results　Thirty-four of 46 patients completed the ESE. Coronary artery disease was confirmed in 28 of 34 who had coronary angiograms. ESE had a sensitivity of 75% and specificity of 83% in pacemaker-dependent patients.Conclusions　ESE has preserved diagnostic utility in pacemaker dependent patients with absolute chronotropic incompetence.

Adult ; Air Pollutants, Occupational ; analysis ; poisoning ; Arsenic Poisoning ; complications ; Causality ; Female ; Humans ; Male ; Maximum Allowable Concentration ; Purpura, Thrombotic Thrombocytopenic ; epidemiology ; Young Adult

Hyperhomocysteinemia is an independent risk factor for arterial and venous obstructive vascular di-seases. Raised plasma homocysteine concentrations are caused by genetic and non-genetic factors. The pathogenic mechanism is not clear. It may be associated with endothelium dysfunction, abnormal lipid metabolism, hypertrophy of intima media, increased platelet aggregation and several clotting factors interfered, etc. The metabolism and pathogenic mechanism of homocysteine are reviewed in this article, which provides theoretical foundation for the treatement of hyperhomocysteinemia.

To evaluate the effects of diltiazem hydrochloride (D) and verapamil (V) on hypertensive left ventricular (LV) diastolic function, the measurement of pulsed Doppler transmittal inflow was performed in 44 patients (22 cases in each group) before, and at 3 h and 7 h after single large dose. Sixteen patients of D group and 11 of V group received routine dose for one month. The Doppler diastolic function indexes included EDC EV/AV, EA/TA AA/TA and 1/3 FFd. The result showed that blood pressure was reduced to the same level in two groups, but improvement of LV diastolic function was more significant in D group. It is concluded that two calcium antagonists can improvement of LV diastolic function after single large dose, but improvement of LV diastolic function is not completely related to reduction of Hood pressure. After one month, since D can reduce Wood pressure and improve mycardial ischemia more markedly than V, and the negative inotropic effect is lower than V, D is superior to V in improving LV diastolie function