Objective To explore diagnostic value of the serum and urine procalcitonin (PCT) detecting in the urinary system infection.Methods The serum and urine PCT levels in 45 urinary system infection patients with clear pathological diagnosis (exclude other system infections) who were outpatiented or hospitalized in the People's Hospital of Zhongshan between March and November 2016 (including 21 cases of upper urinary tract infection and 24 cases of lower urinary tract infection) and 35 healthy adults who went through physical examinations at the hospital during the same period,were measured using electrochemiluminescence immunoassay (ECLIA) on Cobase 601 Immunoassay Analyzer and analyzed to compare the differences of PCT levels in the three groups.Results The urine PCT level in upper urinary tract infection group was 0.243± 0.123 ng/ml.It was significantly lower than lower urinary tract infection group (0.486±0.232 ng/ml,t=4.11,P=0.000) and control group (0.454± 0.253 ng/ml,t=3.96,P=0.000).The serum PCT level in upper urinary tract infection group was 0.062±0.014 ng/ml.It was obviously higher than that in lower urinary tract infection group (0.043±0.020 ng/ml,t=3.56,P=0.01) and control group (0.032±0.013 ng/ml,t=7.38,P=0.000).In all groups,the urine PCT levels were significantly higher than their serum PCT levels (t =9.48,9.12,6.79,P＜ 0.01),and significant differences were observed in them.The sensitivity,specificity,positive predictive value and negative predictive value of serum PCT for diagnosing upper urinary tract infections were 81.5％,84.2％,80.6％ and 85.6％ respectively,and the urine PCT were 86.4％,80.7％,88.4 ％ and 83.1 ％ respectively.Conclusion Detection of serum and urine PCT has important accessory diagnostic value for identifying upper and lower urinary tract infections.

Objective To compare efficacy, time consumed and complications among cricothyroid membrane puncture guided tracheostomy ( CMPGT ) , surgical tracheostomy ( ST ) , surgical cricothyroidotomy ( SC) , and percutaneous tracheostomy using Griggs'guide wire dilating forceps ( GWDF) for the establishment of airway in urgent need of medical attention.Methods Twenty miniature swine were randomly ( random number) divided into four groups.The procedures of CMPGT, ST, SC and GWDF were carried out when patients'SpO2 ( oxygen saturation of blood ) declined to 80% by suspension of oxygen supply after general anesthesia. Procedure performed time, ventilation resumed time, SpO2 and electrocardiograph ( ECG) and arterial blood gases ( ABG) analysis including SaO2 , PaO2 , PaCO2 , blood pH, and heart rate, blood pressure were recorded.Fiberoptic bronchoscope was used to assess any damage to the tracheal wall.Complications were noted and scored in a two-month follow-up period.Results Airways were successfully established in all swine.The times consumed for SC, GWDF, CMPGT, and ST were (86 ±12) s, (165 ±63) s, (174 ±34) s, and (519 ±128) s, respectively, however a shorter time for ventilation resumed was found in CMPGT procedure (23 ±4) s, P<0.01.ECG showed that SpO2 and T-wave decreased and Q-T shortened after oxygen suspension and recovered to normal level rapidly after ventilation.There were significant differences in ECG and ABG between pre-and post-operative periods ( P<0.05) in all groups.Minimal intra-operative bleeding was found in two swine of each group.In ST group, moderate intra-operative bleeding was encountered in three swine.Three pigs were suffered from hypotension owing to prolonged hypoxemia.There was minimal postoperative bleeding occurred in one swine, thus leading to stoma infection.In SC group, moderate intra-operative bleeding was noticed in one swine. One miniature swine had slight injury at laryngeal cartilage resulting in difficult decannulation happened in one swine.and moderate tracheal wall injury occurred in one swine of GWDF group.The complication scores of CMPGT, GWDF, SC and ST were 3, 5, 9, and 19, respectively.Conclusions A shorter time for ventilation resumed with fewer complications was found in the procedure of CMPGT than that in the other methods.This animal study suggested that CMPGT was a time-saving and secure technique for emergency surgical airway establishment which has been practiced in human being as well.Key words:Surgical airway establishment, Cricothyroidotomy, Tracheostomy, Percutaneous dilational tracheostomy.

ObjectiveTo evaluate analytical performance of NT-proBNP on Electro-Chemiluminescence Immunoassay system.MethodsThe precision,accuracy,limit of blank ( LoB ),limit of detection (LoD),functional sensitivity (FS),analytical measure range (AMR),maximal dilution rate,clinical reportable range(CRR) and the analytical anti-interference ability of NT-proBNP were evaluated according to EP documents issued by CLSI and related references.The analytical performance data were compared to quality standards declared by the manusfacturers.According to CLSI C28-A2,80 healthy volunteers,aged from 18 to 74, were chosen and divided into 4 groups on average for biological reference intervals verification.Results The within-run CV and total CV were 1.1％ -2.2％and 1.5％ -2.9％ respectively.The deviations from controls distributed by National Center for Clinical Laboratory and affiliated calibrators were 2.7％ -5.9％ and 2.7％ -7.5％,respectively.The results of LoB,LoD and FS were 2.5,7.8 and 8.8 pg/ml,respectively.AMR was 8 -35 126 pg/ml,and the most suitable dilution rate was 1∶ 2,so the CRR was 9 -70 252 pg/ml.428 μmol/L bilirubin,2 g/L haematoglobin and 2 200 FIU chyle didn't interfere with the NT-proBNP assay.Moreover,almost all the data from different age groups were in the range of biological reference intervals declared by the manusfacturers, except one test data (167 pg/ml).Conclusions The analyticalperformance of NT-proBNP analyzed on Roche Cobas E601electrochemiluminescence immunoassay systemisconsistentwiththestandarlswhichmanufacturershas proclaimed.The establishment of LoD,FS,maximal dilution and CRR for NT-proBNP assay could provide the quality assurance for clinical use and the biological reference intervals declared by manusfacturers could meet the clinical needs.

Objective To evaluate the effect of extensive resection and immediate reconstruction based on classification of abdominal wall defects for patients with abdominal wall neoplasms.Methods From Jan 1999 to May 2016,112 patients with abdominal wall neoplasms were treated with extensive resection,including Type Ⅰ (n =20),Type Ⅱ (n =45) and Type Ⅲ (n =47).Immediate abdominal wall reconstruction comprised primary sutures or free skin graft for Type I defects,component separation (CST) with or without a prosthetic or biological mesh reinforcement for Type Ⅱ defects and pedicled or vascularized myocutaneous flap with or without a prosthetic or biological mesh or prosthetic + biological mesh with or without CST for Type Ⅲ defects.Results The average follow up was 76.86 ± 21.22 months,3 patients developed flap necrosis,9 patients suffered from wound infection.Local recurrence was observed in 20 patients,35 patients developed distant metastasis.Conclusions The optimal strategy based on the abdominal wall defect classification for immediate reconstruction of huge abdominal wall defects is safe and effective after resection of abdominal wall neoplasms.

Purpose To investigate the feasibility to diagnose and evaluate the vulnerability of the atherosclerotic plaque through contrast-enhanced ultrasonography. Materials and Methods Thirty-four patients with carotid atherosclerosis were enrolled in the study to take contrast-enhanced ultrasonography and were observed on whether the plaque was enhanced and the features of its enhancement. The peak intensity (PI), time to peak (TTP), and density echo (DE) were calculated according to the time-intensity curve with QLAB software. Results The ratio of enhanced malacoplakia and the mixed plaque showed no difference (χ2=0.847, P>0.05). The percentages of enhanced plaque distributed on the base, tail and the shoulder were 70.0%, 23.3% and 6.7%, respectively with significant difference (χ2=29.100, P<0.001); the distribution ratio of enhanced plaque from high to low were as follows: the plaque on the shoulder > the plaque on the base> the plaque on the tail. It was positively correlated between enhanced plaque and its distribution (r=0.404, P<0.01). The TTP of the ROI between the malacoplakias and the mixed plaques showed no difference (t=0.479, P>0.05). The PI and DE of the ROI in the malacoplakia and the mixed plaques were analyzed by the time-intensity curve and the differences proved to be statistically significant (t=7.497 and 12.224, P<0.05). Conclusion Contrast-enhanced ultrasonography could present the neovessels in the atherosclerotic plaque, which is helpful in evaluating the vulnerability of atherosclerotic plaque.

Objective To investigate the prevalence,awareness,treatment and control rate of hypertension among Dongxiang population of Dongxiang county in Gansu province,and analyze risk factors of hypertension in this population.Methods A total of 1 879 Dongxiang residents of Dongxiang county in Gansu province aged 18 years and over were selected in one town and eight villages by random cluster method from April to June in 2014.All subjects were interviewed and physical examination including blood pressure measurement was performed.Multivariate logistic regression analysis was used to analyze the risk factors of hypertension.Results Prevalence of hypertension in this population was 21.4％ (402/1 879).Prevalence of hypertension increased with aging and was 7.9％ (35/441) in 18-39 years old people,and 20.2％ (151/749) in 40-59 years old people,and 31.3 ％ (216/689) in ≥ 60 years old people (P ＜ 0.01).There were no gender (male vs.female) difference in prevalence of hypertension in 18-39 years old group (8.0％ (20/249) vs.7.8％ (15/192),P ＞ 0.05) and 40-59 years old group (19.8％ (78/393) vs.20.5％ (73/356),P ＞ 0.05),while the prevalence of hypertension was significantly higher in male than in female(34.2％ (123/360) vs.28.3％ (93/329),P ＜ 0.01) in ≥ 60 years old group.Prevalence of hypertension was also significantly higher in rural area residents than in county town residents (23.4％ (255/1 090) vs.18.6％ (147/789),P ＜ 0.01).The rates of awareness,treatment and control of hypertension in this population were 24.4％ (98/402),14.7％ (59/402) and 5.0％ (20/402),respectively.Rates of awareness (22.7％ (58/255) vs.27.2％ (40/147),P ＜ 0.01),treatment (13.3％ (34/255) vs.17.0％ (25/147),P ＜ 0.05) and control (3.9％ (10/255) vs.6.8％ (10/147),P ＜ 0.05)were significantly lower in rural area residents than in county residents.Multivariate logistic regression analysis showed that age,family history of hypertension,high body mass index,less physical activity and more static state were risk factors of hypertension in this population (P ＜ 0.05 or 0.01).Conclusions Prevalence of hypertension is high and awareness,treatment and control rates of hypertension are low in adult residents of Dongxiang county in Gansu province.Hypertension prevention focusing on risk factors control and treatment strategies should be enhanced in this population.

Objective To investigate the application value of single detection and combined detection of 4 kinds of inflammatory indicators of procalcitonin (PCT ) ,high sensitivity C-reactive protein(hs-CRP) ,interleu-kin-6(IL-6) and white blood cell(WBC) in diagnosing type 2 diabetes mellitus(T2DM) bloodstream by analy-zing the levels of peripheral blood PCT ,hs-CRP ,IL-6 and WBC in the T2DM bloodstream infection group and T2DM non-bloodstream infection group .Methods The clinical data in 85 patients with T2DM bloodstream in-fection (T2DM bloodstream infection group ) and contemporaneous 80 cases of T2DM non-bloodstream infec-tion(T2DM non-bloodstream infection group) in this hospital from January 2013 to July 2016 were retrospec-tively analyzed .The levels of various inflammatory indicators in peripheral blood were analyzed .The receiver operating characteristic(ROC) curve of various inflammatory indicators was drawn ,the area under the curve (AUC) and the best cut-off value were calculated .The detection schemes included 24 kinds of schemes such as the single indicator ,2-indicator ,3-indicator and 4-indicator .Results The levels of PCT ,hs-CRP ,IL-6 and WBC in the T2DM bloodstream infection group were significantly higher than those in the T 2DM non-blood-stream infection group ,the difference was statistically significant (P<0 .05) .AUC of PCT ,hs-CRP ,IL-6 and WBC were 0 .909 ,0 .818 ,0 .838 and 0 .760 respectively ,with best cut-off values of 0 .493 ng/mL ,11 .19 ng/mL ,40 .95 pg/mL and 11 .87 × 109/L respectively .The Youden index of PCT was highest (0 .65) and the ac-curacy of IL-6 was highest (83 .33％ ) in the single indicator detection scheme .The Youden index and accuracy of the scheme of PCT/hs-CRP and PCT+hs-CRP+IL-6 were highest in the combined detection scheme .Con-clusion PCT detection has the prominent value in the assisted diagnosis of T 2DM bloodstream infection .Inthe combined detection scheme ,PCT/hs-CRP and PCT+hs-CRP+IL-6 have the highest value in the assisted diagnosis in T2DM bloodstream infection .