Objective To investigate the changes of serum N-terminal proBNP (NT-proBNP) ,carbohydrate antigen 125(CA-125) and high sensitive CRP(Hs-CRP) levels in patients with chronic heart failure(CHF) ,to evaluate the severity of CHF using the three markers alone or in combination .Methods A total of 62 patients with CHF(CHF group) from our hospital were select-ed .Among them ,13 cases were in NYHA class Ⅱ ,27 cases were in class Ⅲ and 22 cases were in class Ⅳ .The control group in-cluded 54 patients without CHF .Serum levels of NT-proBNP ,CA-125 and Hs-CRP were detected in CHF group and control group . The left ventricular ejection fraction(LVEF) were detected by echocardiography .Results The serum levels of NT-proBNP ,CA-125 and Hs-CRP of CHF group before treatment were significantly higher than those of control group (P<0 .01) ,and the serum levels increased with the degree of severity of heart failure .There were statistically significant difference among patients in NYHA classⅡ ,class Ⅲ and class Ⅳ (P< 0 .01) .There was a high correlation between NT-proBNP ,CA-125 and LVEF (NT-proBNP vs . LVEF ,r=0 .934 ,P<0 .01 ;CA-125 vs .LVEF ,r=0 .878 ,P<0 .01) ,a low correlation between Hs-CRP and LVEF(r=0 .437 ,P<0 .05) .Compared with the single marker detection ,the combined detection of NT-proBNP ,CA-125 and Hs-CRP increased the AUC .Conclusion The combined detection of NT-proBNP ,CA-125 and Hs-CRP can increase the value of the observed severity of heart failure .

Under the background that the job division and complication of the laboratory instrument are highly improved, It puts forward the new demand for the use and maintenance of the laboratory instrument. Nowadays, for the lack of training, Many staff in medical laboratory can not correctly use and maintain the instrument in their rotation to various departments. The problems are solved by the following ways: making an appropriate staff rotation plan, ensuring all operations were carried out strictly according to the instrument guide book, establishing the holder appointment system and individual responsibility system, ensuring the reports were sent out by the new rotating personnel independently only after strict training and qualified examination. Through these methods, the accuracy of the equipment and the quality of testing have greatly increased.

Objective To analyze the clinical outcome of definitive perineal urethrostomy for the treatment of complex adult anterior urethral strictures.Methods From June 2012 to February 2018,28 patients who underwent the definitive perineal urethrostomy for a complex anterior urethral stricture were retrospectively reviewed.The mean age of the patients was 62.3 (range 34 to 77) years and stricture etiology was lichen sclerosus in 46.4％ (13/28) of the cases,iatrogenic stricture after transurethral resection of the prostate in 35.7％ (10/28),failed hypospadias repair in 10.7％ (3/28),infection 3.6％ (1/28)and idiopathic etiology 3.6％ (1/28).The mean stricture length was 9.6 (range 4.5 to 16.0) cm and the stricture length ＜5 cm in 7.1％ (2/28) of the cases,5-10 cm in 35.7％ (10/28) and ＞ 10 cm in 57.1％ (16/28).0f28 patients 21 (75％) underwent prior urethral dilation,4 (14.3％) underwent direct vision internal urethrotomy (DVIU) and 17 (60.7％) underwent urethroplasty.Among the medical history of interest,hypertension was observed in 17 patients (60.7％),chronic ischemic heart disease in 11 patients (39.3％),diabetes mellitus in 9 patients (32.1％) and chronic obstructive pulmonary disease (COPD) in 9 patients (32.1％).All patients completed the perineal urethrostomy with inverted U-shaped perineal skin flap.The patient was placed in a normal lithotomy position and an inverted U-shaped perineal incision was made.We can get an inverted U-shaped perineal skin flap after dissecting along the bulbospongiosus muscle.The bulbar urethra was opened along the ventral surface and the margins of the spongiosum tissue were closed with perineal skin flap.We analyzed the clinical characteristics of the patients,the outcome of the technique and investigated the satisfaction rates of the patients by outpatient follow-up or telephone interview.Surgical success was defined as functional voiding without the need for further procedures.Results The perioperative complications included 3 cases of urinary tract infection,1 case of bleeding and 1 case of wound dehiscence.Mean follow-up length was 27.2 (range 6.0 to 64.0)months.Of 28 cases 26 (92.9％) were successful and the mean maximum urinary flow rate was 26.5 (range 17.0 to 40.0) ml/s.Postoperatively,2 cases of urethrostomy strictures were found in 2 months and 4 months,respectively.They required periodic outpatient dilation and the younger one was in the waiting list for revision of the perineostomy and the older one refused the revision.Of 28 patients 24 (85.7％) were satisfied with the results obtained with surgery,15 were very satisfied,9 cases satisfied and 4 cases dissatisfied.Conclusions The successful rate of the definitive perineal urethrostomy for the complex adult anterior urethral strictures was high and patients were satisfied with the outcome of the surgery.The definitive perineal urthrostomy is a well-tolerated treatment option for patients with complex anterior urethral strictures,especially for those aged and with extensive comorbidities.