The morbidity and mortality of heart failure (HF) were gradually incrcased,around 2％-3％ of the population suffered from HF.As a biomarker,NT-proBNP has been shown to be widely used in the diagnosis of HF patients.NT-proBNP lever is affected by many factors,especially the age,age-specific NT-proBNP lever is very important in diagnosis of elderly HF patients.

Copeptin,the C-terminal portion of provasopressin,is a novel neurohormone of the arginine vasopressin (AVP)system,and is known to be co-released with AVP from hypothalamus.As a surrogate marker of the AVP system,copeptin has gradually replaced AVP in several clinical studies largely due to its structural and methodological advantages.Copeptin has been regarded as a marker of non-specific stress response.In recent years,copeptin attracts more and more attention especially in cardiovascular conditions (heart failure and acute coronary syndromes).The present review primarily focuses on copeptin detection,its general advantages,and its potential clinical value in a variety of cardiovascular conditions.

Objective To investigate the therapeutic effect of island flap pedicled with dorsal cutaneous branches of digital inter-nal artery for severe thermos injury of fingers .Methods From May 2008 to May 2012 ,15 fingers in 12 cases with severe thermos injury were treated with island flap pedicled with dorsal cutaneous branches of digital internal artery .The defect size ranged from 1 .5 cm × 2 .0 cm to 2 .2 cm × 3 .0 cm ,4 fingers with anterograde flap repair ,11 fingers with retrograde flap repair .Results Partial necrosis happened at the distal end of 2 island flaps ,All the other flaps survived completely .The patients were followed up for 6-12 months with satisfactory cosmetic and functional results ,cicatricial contracture around the skin graft in 3 fingers ,The two-points discrimination distance was 9-11 mm in flaps .Conclusion These flaps have the advantages of an extended skin paddle and a versa-tile pivot point on the phalanx ,and they allow coverage of wide and distal defects .

Objective To compare the efficacy of transcervical resection(TCRC)and loop electrosurgical excision procedure(LEEP)for the treatment of cervical intraepithelial neoplasia grade I(CINⅠ).Methods A total of 231 CIN I patients were divided into two groups according to their patient number to receive TCRC or LEEP.The resected specimens were sent for pathological diagnosis and human papilloma virus(HPV)-16/18 test.Results No significant difference was found in the operation time[(14.1?2.2)min vs.(13.8?2.1)min],rates of wound infection and cervical stricture[1.7%(2/115)vs.1.7%(2/116)and 0.9%(1/115)vs.1.7%(2/116)],and rates of cure and recurrence [99.1%(107/108)vs.99.1%(108/109)and 0.9%(1/108)vs.0.9%(1/109)] between the TCRC and LEEP groups(t=1.060,P=0.290;?2=0.000,P=1.000;?2=0.000,P=1.000;?2=0.000,P=1.000;?2=0.000,P=1.000).In the TCRC group,the surgical wound was healed in(5.0?0.6)weeks,which was significantly shorter than that in the LEEP group[(5.2?0.7)weeks,t=-2.331,P=0.021].The patients who had severe endocervicitis in both the groups had similar rate of residual endocervicitis[16.7%(2/12)vs.53.8%(7/13),Fisher's test:P=0.097].In both the groups,one patient respectively showed residual lesion after the procedure,in whom HPV-16 and/or HPV-18 were detected.Conclusions Both TCRC and LEEP are effective for CINI.LEEP is easier to master than TCRC.Closed follow-up is essential of the with patients positive HPV-16 or-18.

Objective To study the advantages of rhytidectomy of W-shaped incisions combined with multiple suspension in temporal hair line. Methods 40 patients were divided into two groups: 16 cases in group A were treated by rhytidectomy of W-shaped incisions combined with multiple suspcnsion in temporal hair line;24 cases in group B were treatcd by traditional rhytidectomy. Results The inci-sions in group A, with an excellent repair under scar formation, healed well and some hairs on the timpo-ral hair line grew. Fishtail lines were obviously reduced, with nasolabial fold lifting the masseter area skin on parotid. Compared with group B, the difference was statistically significant (P<0.05). Conclusions This approach is simple but convenient, safe and efficient. Therefore, it is valuable and applicable clinical-ly.

Objective To compare the therapeutic effects of transcervical resection(TCRC) and loop electrical excision procedure(LEEP) for the treatment of moderate-to-severe chronic cervicitis.MethodsFrom January 2003 to July 2006,totally 520 patients with moderate-to-severe chronic cervicitis were randomly divided into two groups to receive TCRC or LEEP.ResultsThe intraoperative blood loss in the TCRC group was significantly less than that in the LEEP group [(4.2?1.3) ml vs(10.1?4.5) ml,t=-20.310,P=0.000].Whereas,no significantly differences were found in the drainage and bleeding time and cure rates between the two groups [(15.9? 3.7) d vs(16.2? 3.3) d,t=-0.976,P=0.330;and 95.2%(236/248) vs 93.2%(235/252),?2=0.832,P=0.362].ConclusionsBoth TCRC and LEEP are effective for chronic cervicitis.TCRC is superior to LEEP in the surgical outcomes;however the latter is easier to perform than TCRC.

In order to increase the underachievement students’ score,we investigate their way of learning by questionnaire and interview. We find that learning motivation,learning style,learning time and thinking ability are the most important factors. So the underachievement students can be divided into four classes: learning motivation insufficiency, learning method incorrectness, learning time insufficiency and thinking ability insufficiency. And we raise some education strategies for each class.

Objective To evaluate the association of body weight with brachial-ankle pulse wave velocity (baPWV) in females.Methods A total of 2 921 residents (≥20 years old) were selected by the stratified cluster random sampling method from March to December 2011.Arterial stiffness was assessed by baPWV.Multivariate logistic regression analysis was used to evaluate the effect of body mass index (BMI) on arteriosclerosis.The predictive value of BMI to evaluate arteriosclerosis was analyzed by using receiver operation characteristic (ROC) curve.Results The prevalence of arteriosclerosis was significantly increased in overweight/obese residents (P＜0.01).BMI was positively correlated with baPWV (r=0.310,P＜0.01).The prevalence of increased arterial stiffness in individuals≥65 years older was higher than that in people of 20-40 or 41-64 years old (x2 values were 677.30 and 347.26,respectively; both P＜0.01).For females of 20-40 or 41-46 years old,the prevalences of increased arterial stiffness in overweight and obese groups were higher than those in normal body weight group (both P＜0.01).In univariate analysis,age,resting heart rate,systolic blood pressure (SBP) and diastolic blood pressure (DBP) were correlated with arteriosclerosis (all P＜0.01).The odds ratio for the prevalence of arteriosclerosis in overweight women was 2.017 (95％ confidence interval (CI):1.637-2.486,P＜0.01) and that in obese women was 2.759 (95％ CI:1.964-3.876,P＜0.01) after adjustment for age,resting heart rate and blood pressure.The area under the ROC curve was 0.693 (95％ CI:0.671-0.715,P＜0.01) to evaluate arteriosclerosis in females and the optimal cut-off point for BMI was 23.42 kg/m2.Conclusions For females,overweight and obesity may be risk factors of arteriosclerosis.The optimal cut-off point for BMI to evaluate arteriosclerosis in women could be 23.42 kg/m2.

Objective To evaluate the surgical outcome of cystic vestibular schwannoma patients with fluid-level imaging by MRI.Methods Forty-five patients of cystic vestibular schwannoma were enrolled and divided into fluid-level (n =24) group and non-fluid-level (n =21) group by MRI.The incidence of peritumoral adhesion,incidence of complete tumor removal and postoperative facial nerve function of the two groups were recorded.Results The incidence of peritumoral adhesion in fluid-level and non-fluid-level group were 70.8％ (17/24) and 28.6％ (6/21),and the difference was significant (x2 =8.010,P ＜ 0.05).The incidence of complete tumor removal were 45.8％ (11/24) and 76.2％ (16/21) in fluid-level and non-fluid-level group,which showed significant differences between groups (x2 =4.30 ; P ＜ 0.05).Patients of House-Brackmann grade Ⅰ-Ⅲ in fluid-level group at discharge and one year after operation,were 62.5％ (15/24) and 50.0％ (8/16),and 81.0％ (17/21) and 83.3％ (15/18) in non-fluid-level group.The was significant difference at one year after operation (P ＜ 0.05) in terms of patients of House-Brackmann grade Ⅰ-Ⅲ.Conclusion The cystic vestibular schwannoma patients with fluid level have more frequency to adhere to surrounding neurovascular structures and less favorable surgical outcome.These findings may be useful in predicting surgical outcome and making surgical strategy preoperatively.

Objective To investigate the effects of rhubarb combined with glutamine on repair of gut mucosal barrier injury after gastrointestinal surgery in rats. Methods Fifty male healthy Sprague-Dawley(SD)rats were randomly divided into five groups:control(C group),enteral nutrition(EN group),rhubarb with EN(R-EN group), glutamine with EN(G-EN group)and rhubarb combined with glutamine and EN(R-G-EN group)groups(each n=10). The rats of C group received no treatment and were fed normally. Cecectomy and gastrostomy were performed in EN,R-EN,G-EN and R-G-EN groups,and in 24 hours after surgery,they were interfered with the use of amoxicillin 50 mg/d and metronidazole 20 mg twice a day. From the first day after operation,each group was treated with the same prescription of enteral isocaloric and isonitrogenous nutrition for consecutive 7 days. Seven days later, under anaesthesia,laparotomy was performed,and a specimen of 1 cm intestinal segment was taken from the terminal 5 cm long ileum for all the groups;under the light microscope,the morphological examination of intestinal mucosal epithelial tight junctions(including villus height and mucosal thickness)was carried out. For each group,enzyme-linked immunosorbent assay(ELISA)was used to measure the levels of plasma citruline and D-lactate,and the serum concentration of TNF-αwas detected by utilizing double antibody ABC-ELISA. Results The levels of D-lactate and TNF-αin EN,R-EN,G-EN and R-G-EN groups were obviously higher than those in C group(all P<0.01). The level of plasma citruline(μmol/L:16.13±0.58 vs. 14.52±0.28)of R-G-EN group was remarkably higher than that in R-EN group(P<0.05),and its levels of serum D-lactate(mmol/L:3.12±0.56 vs. 3.62±0.52)and TNF-α(ng/L:2.82±0.62 vs. 3.54±0.49)were markedly lower than those of G-EN group(both P<0.05). The mucosal villus height(μm:126.50±6.31 vs. 175.67±11.91),mucosal thickness(μm:223.67±11.94 vs. 277.00±14.06)and the level of plasma citruline(μmol/L:13.25±0.36 vs. 15.67±0.55)in EN group were obviously lower than those of C group(all P<0.01);the above indexes of R-EN,G-EN and R-G-EN groups were higher than those of EN group (P<0.05 or P<0.01),but in the comparisons of the villus height and mucosal thickness among the three groups there were no statistical significant differences(all P>0.05). Conclusion The application of rhubarb combined with glutamine can protect gut mucosa,reduce the level of inflammatory reaction and elevate the level of plasma citruline, that is beneficial to the repair of gut mucosal barrier injury and its functional recovery after gastrointestinal surgery in rats.