Objective To investigate the prognostic value of HbA1c and hs-CRP in patients with acute coronary syndrome . Methods A total of 141 patients diagnosed as acute coronary syndrome from August 2009 to August 2011 in this hospital were col-lected .According to the levels of HbA1c and hs-CRP ,patients were divided into the following four groups :the high HbA1c and hs-CRP group ,the high HbA1c group ,the high hs-CRP group ,the low HbA1c and hs-CRP group(control group) .After receiving standard treatment and being discharged from hospital ,all patients were followed up every two month until death or the end of the study .Clinical data from all patients were statistically analyzed .Results Compared with the control group ,the cumulative survival of the high HbA1c group was much lower in 2 years(P<0 .05) and the difference between the two groups was not significant 2 years later(P>0 .05) .However ,the cumulative survival in high HbA1c and high hs-CRP group and the high hs-CRP group were significantly lower than the control group through the whole follow-up time .A Cox regression modal with HbA1c and hs-CRP as the covariates established and the formula was :h(t ,x)=h0(t) exp(0 .092 × HbA1c+ 0 .610 × hs-CRP)(χ2 =10 .326 ,P<0 .01) . The value of HbA1c and hs-CRP were associated with increased risk of mortality [RR 1 .971 ,95% CI(1 .245 -2 .539) ,P<0 .05 and RR 3 .398 ,95% CI(2 .879-3 .917) ,P<0 .05 ,respectively] .The specificity and sensitivity of that modal was 75% and 83 .6% , respectively .The Kappa value was 0 .446 .Conclusion The combined detection of HbA1c and hs-CRP level can predict the progno-sis of patients with acute coronary syndromes .

Objective To establish a HPLC method to detect the propofol concentration of plasma in children undergoing cardiopulmonary bypass. Methods RP-HPLC with fluorescence detector was used in the study. Plasma samples were precipitated by the thymol-methanol solution, and centrifugated. 20?l of supernatant fluid was injected for analysis and separated by Dikma Diamonsil C18 column. The mobile phase was composed of acetonitril:water =56:44(V/V), flo rate was 1.0ml/min. Fluorescence detective wave lengths were ?ex= 276nm, ?em=312nm. HPLC machine was Agilent1100 series. Main column was Diamonsil C18(150?4.6nm,5um),guard column was Phenomenex Security(4mm?3mm). Results There was a good linear relationship within the range of 0.02～8.0mg/L(r=0.9993, n =9),the limit of detection was 5?g/L,average recovery was 96.99%,intra RSD(relative standard deviation )was between0.810% and 5.73%,inter RSD was between 0.932% and 7.337%. Conclusions The method is sensitive, simple, rapid, good linear relationship and precise. The experiment can be used for determination of propofol concentration in child undergoing cardiopulmonary bypass.

Objective To explore the clinical epidemiological characteristics of gastrointestinal stromal tumor (GIST). Methods By using the clinical epidemiological study methods, the clinical epidemiological characteristics of GIST in Shanxi province from 2000 to 2005 were investigated and analyzed. Results A total of 181 cases of GIST was found from January 2000 to December 2005. The new cases increased every year, and all of them belonged to the Han nationality. There was no statistical significance between the two sexes. The ages were between 18 to 80 years, and the median age was 57 years. The disease incidence increased along with the increase of age. More cases were found in Taiyuan, Changzhi and Jinzhong city, and most of them lived in the downtown area. GIST may occur in any part of the digestive tract, and the predilection sites were stomach, small intestine, colon, rectum and esophagus. 76.83 % of them were in the gastrointestinal tract, the other 23.17 % were not. The commonest symptoms and physical signs were dysphagia, nausea, vomiting, abdominalgia, abdominal distension, abdominal mass and magersucht. As to the histological types, 70.30 % were spindle cell type, 12.10 % were epithelial cell type, and 17.60 % were mixed cell type. As to the karyokinesis, 49.50 %≤5, 36.30 % was 6~10, and 14.30 %≥10. The immunological expression was as follows: CD117 was 80.20 %, CD34 was 67 %, and no positive expression was found on MCK. Conclusions GIST is a rare tumor, and was sporadic in the populations. The clinical incidence of GIST showed a tendency of gradual increase.

The examinations of blood and bone marrow in 125 patients with visceral leishmaniasis revealed that seven routine parameters of the blood samples were below the lower limit of normal in most cases and 64.8% of the cases showed complications with iron deficiency anemia(IDA) and cell maturation disorders.Therefore, iron deficiency anemia and significant reduction of blood components can be used as indicators on the severity of Leishmania infection.

The essence of training for clinical postgraduates is comprehensive capacity,including clinical and scientific research capacity,and the demand for the former is relatively higher than the latter. By means of discussion on the source and the educational system for postgraduates,we try to train clinical anesthesiology postgraduates with high diathesis and meet the needs of clinical anesthesia.

Clinical practice is an important teaching stage for interns of anesthesiology in medical universities.We discuss advantages and disadvantages for different teaching modes in the course of clinical practice,aiming at choosing a better one to optimize practice quality and bringing up graduates with high diathesis.

[Objective]Postoperative analgesia with the use of parenteral opoids or epidural analgesia can be associated with troublesome side effects.Good perioperative analgesia facilitates rehabilitation,improves patient satisfaction,and may reduce the hospital stay.We investigated the analgesic effect of locally injected drugs around a total knee prosthesis.[Method]Thirty-eight patients undergoing total knee arthroplasty were randomized either to reveive a periarticuiar intraoperative injection containing bupicaine,morphine,epinephrine,hydrocordisone or to reveive no injection.We compared the PCA consumption at the some time point after tatal knee arthroplasty.Visual analog scores for pain,preoperation and postoperation,6 weeks after operation were collected.[Result]The patients who had received the injection used significantly less patient-controlled analgesia over the first 24 hours after the surgery.They had lower visual analog scores for pain 24 hours and 48 hours after operation.No cardiac or central nervous system toxicity was observed.[Conclusion]The perioperative analgesia protocol improved patient satisfaction,pain control and minimizes side effects after total kneearthroplasty.

Objective: To investigate the influencing factors of nosocomial infections among patients undergoing radiotherapy, so as to provide insights into nosocomial infection control among radiotherapy patients. Methods: The malignant tumor patients receiving radiotherapy in Yiwu Central Hospital from 2019 to 2020 were selected. Their demographic features, radiotherapy and nosocomial infections were collected through the eletronic medical records. The factors affecting nosocomial infections were identified among radiotherapy patients using a multivariable logistic regression model. Results: Totally 553 malignant tumor patients receiving radiotherapy were enrolled, including 268 men ( 48.46% ) and with a mean age of ( 60.31±13.66 ) years. The mean duration of hospital stay was ( 28.67±14.32 ) days, and the mean radiotherapy cycle was ( 3.63±1.89 ) weeks. A total of 46 patients were detected with nosocomial infections, with prevalence of 8.32%. The top three sites with the highest prevalence of nosocomial infections included the lower respiratory tract ( 14 cases, 30.43% ), oral cavity ( 10 cases, 21.74 ) and urinary tract ( 8 cases, 17.39% ), and 42 bacterial strains were isolated, with Gram-negative bacteria as the predominant strains ( 25 strains, 59.52% ). Multivariable logistic regression analysis showed that radiotherapy cycle of 4 weeks and longer ( OR=3.857, 95%CI: 1.896-7.846 ), radiotherapy exposure ( OR=3.254, 95%CI: 1.561-6.783 ), arteriovenous catheterization ( OR=2.165, 95%CI: 1.144-4.098 ), urinary tract intubation ( OR=6.028, 95%CI: 1.841-19.734 ) and poor nutritional status ( OR=3.933, 95%CI: 1.493-10.360 ) were associated with nosocomial infections among radiotherapy patients. Conclusion Radiotherapy cycle, exposure to radiotherapy, arteriovenous catheterization, urinary tract intubation and poor nutritional status are factors affecting nosocomial infections among radiotherapy patients.

ObjectiveTo investigate the efficacy of mountain-burning fire acupunctureat point Yongquan(KI1)in treating spinal cord injury.MethodThirty patients with spinal cord injury were randomly allocated to observation and control groups, 15 cases each. The control group received modern rehabilitation therapy and the observationgroup, mountain-burning fire acupuncture at point Yongquan plus exercise rehabilitation therapy.ResultThe total efficacy rate was 93.3% in the observation group and 73.3% in the control group. The total efficacy rate increased significantly in the observation group and was significantly higher than in the control group(P<0.05).ConclusionMountain-burning fire acupuncture at point Yongquan has a marked therapeutic effect on spinal cord injury and effectively improves urinary and fecal voiding, sexual and limb motor functions in the patients.

Objective To observe the appearances of decussation of superior cerebellar peduncle (SCP) on MR diffusion tensor imaging (DTI) with different parameters of scanning and reconstruction. Methods Twenty healthy volunteers were examined on Siemens 3.0T MR DTI (b=0, 1000 s/mm~2), post processing were made in Siemens Leonardo workstation using Siemens Standar 6 dirs software to reconstruct the white matter fibers with different fractional anisotropy (FA) threshold value (0.04-0.20), angle threshold value (20°-89°) and voxel size (1.2 mm×1.2 mm×3.0 mm-1.6 mm×1.6 mm×5.0 mm). Results Crossing fiber was presented each voxel group on diffusion tensor tractography (DTT). The types of crossing fiber in the small voxel were more than those of big voxel image obviously. Reduced along with the FA threshold value, the number of crossing fiber increased gradually. After the peak value (FA=0.08), the number of crossing fiber reduced along with the FA threshold value reduced gradually. Increased along with the angle threshold value, the number of crossing fiber increased gradually. The number of crossing fiber reduced along with the angle threshold value increased gradually after the peak value (the angle threshold value＝80°). There were 5 kinds of MR fiber tracking appearances at the level of decussation of SCP on DTT. The fiber crossed to the opposited red nucleus in anterior-posterior style, superior-inferior style and single main bundle fiber. Kissing fiber and missing fiber sign was shouw in all subjects, which mainly located in the center of the decussation. Conclusion DTT FACT can show the descussation of SCP in most health subjects with five typical appearance. The descussation of SCP has the obvious appearances, may be causing by individual difference. For the crossing fiber of SCP, voxel size 1.2 mm×1.2 mm×3.0 mm, FA 0.08 and the angle 80° are recommended.