Objective To establish an appropriate cut-off value of high sensitivity cardiac troponin T (hs-cTnT) and optimal combination measurement in the early diagnosis of acute myocardial infarction (AMI).Methods This research is a prospective study.342 patients admitted to emergency department with chest pain,43 patients with renal failure,40 patients with pneumonia and 18 premature with patent ductus arteriosus were involved from June 2012 to June 2013 in Peking University Third Hospital.The plasma hs-TnT,NT-proBNP,cardiac troponin Ⅰ (cTnI),CK-MB and copeptin were measured.The distribution of hs-cTnT among associated diseases was analyzed,the diagnostic performance of hs-cTnT and the role of combination hs-cTnT with NT-proBNP,CK-MB and copeptin were evaluated by receiver operating characteristic (ROC) curve.The statistical method was used to calculate the Sensitivity,specificity,negative predictive value and positive predictive value of hs-cTnT in the diagnosis of AMI.Results As compared to patients with STEMI(median 0.52 μg/L,range 0.037-7.610 μg/L),hs-cTnT was lower in the patients with Non-STEMI(median 0.127 5 μg/L,range 0.021-4.260 μg/L).However,the levels of hs-TnT in other diseases were also increased increased in varyng degrees (Chi-square =76.432,P ＜ 0.05)The areas under the curve (AUC) for hs-cTnT and cTnI in the diagnosis of AMI were 0.862 (95％ CI:0.729-0.928) and 0.748 (95％ CI0.666-0.818) respectively (Z =2.713,P ＜ 0.05).Taking 0.014μg/L and 0.035 μg/L as cut-off value of hs-TNT,the sensitivities were 100％ vs 95.1％,the specificities were 44.4％ vs 65.7％.The combination of hs-cTnT,NT-proBNP,CK-MB resulted in a increase in AUC (0.915,95％ CI:0.838-0.964) (Z =2.147,P ＜ 0.05) and the combination of hs-cTnT and copeptin resulted in a increase in AUC 0.921 (95％ CI:0.820-0.975) (Z =2.589,P ＜ 0.05).Conclusion With the cut-off value of 0.035 μg/L for diagnosis of AMI was appropriate,and the combination measurement can improve the accuracy of early diagnosis of AMI.

Objective To explore factors related to the development of segmental instabilities in lumbar spine. Methods Fifty-seven patients with lumbar segment instabilities at L 4～5 were selected as illness group, 22 patients with facetectomy at L 4～5 as post-operation control group, and 19 healthy subjects as normal control. X-ray plain films were taken in sagittal,flexion and extension positions. Computed tomographic scans were taken to define the axial morphology of the facet joint. Magnetic resonance scans were taken to describe disc degeneration of 36 patients in illness group. Results The facet joint was oriented sagittally in the forward translation patients in flexion. The disc degeneration was slight in the rotational instability patients. The patients with total facetectomy exited forward translation in flexion. Conclusion A more sagittally oriented facet and disc degeneration are associated with forward translation in flexion and may be the cause of degenerative spondylolisthesis, whereas ligament failure is associated with rotational instability.

The symbiotic bacterium exists in the intestines of entomopathogenic nematodes and is a potential biological agent.Systematic classification of these bacteria is scarce in China.In this paper,seven strains of symbiotic bacteria from local entomopathogenic nematodes were identified by both observation of mor-phology,physiological,biochemical characteristics and sequence analysis of 16S rDNA fragments.

OBJECTIVE To strengthen the management of earthquake victims with nosocomial infection,in order to prevent and control the multidrug-resistance transmission,and the nosocomial infection outbreak. METHODS All 77 earthquake victims were under real-time monitoring. RESULTS Of 77 cases,53 were infected (69.74%). From 83 samples,83 pathogenic bacteria were isolated. The Gram-positive cocci were 19 (meticillin-resistant Staphylococcus aureus 3,Meticillin-resistant S. epidermidis 7),58 were Gram-negative bacilli (Acinetobacter baumannii 21,multi-drug resistant strains 10,ESBLs positive Escherichia coli 10,Pseudomonas aeruginosa 9) and the fungi were 6 strains,The resistance rates of Gram-positive cocci to penicillin,ampicillin/sulbactam and cefazolin were 89.47%,68.42% and 89.47%; the resistance rates of Gram-negative bacillis to imipenem,cefoperazone/sulbactam,piperacillin/tazobactam,azithromycin,tobramycin,and cefoxitin were 37.93%,60.34%,48.83%,98.28%,98.28% and 70.69%,respectively. CONCLUSIONS Under the situation of higher infection rate and a serious drug resistance in earthquake area,there are no multidrug-resistance transmissionm and the spread of nosocomiol infection outbreak happened in hospital due to strictly enforced prevention meassures and access real-time monitoring and management,

Objective To evaluate the effectiveness of the treatment of slight and moderate benign prostatic hyperplasia(BPH)with large doses of cemilton by urodynamie test.Methods A systematic review of using large doses of cernihon only for 80 patients with BPH with 7 grade ＜ International Prostate Symptom Score(IPSS)≤20 grade.All cases with cemilton had been administered in a dosage of 750 mg,three times a day for one year.All were respectively given IPSS,postvoiding residual urine(PVR),maximum flow rate(Qmax)and pressure-flow(A-G)test in order to assess the effectiveness at pre-treatment and 3,6,12 months after treatment.Results All patients had followed up for(1.2±1.6)years,additionally 26 of those were removed and others had received complete follow-up.Before the treatment IPSS was(20.5±4.5)grade,PVR was(42.5±8.2)ml,Qmax was(10.2±2.3)ml/s,A-G was 56.5±12.8,PQmax was (54.8±13.7)mm Hg(1 mm Hg = 0.133 kPa),and 12 months later,IPSS was(11.0±3.3)grade,PVR was (15.9±7.4)ml,Qmax was(15.7±2.5)ml/s,A-G was 49.2±13.6,PQmax was(43.6±14.9)mm Hg.There were significantly difference between pre-treatment and post-treatment data of the urodynamics(P ＜ 0.05).Conclusions The effectiveness of the treatment of slight and moderate benign prostatic hyperplasia with large doses of cemihon are relatively satisfactory.Main post-treatment urodynamic parameters obviously improves than that of the pre-treatment.

Objective To evaluate the effectiveness of the treatment of high risk benign prostatic hyperplasia (BPH) with transrectal high-intensity focused ultrasound (TR-HIFU) by urodynamic test. Methods One hundred and thirty patients with BPH, most of who suffering with diabetes mellitus,cardio-cerebrovascular disease, respiratory disease. All patients were given the operation with Sonablate-500 high-intensity focused ultrasound (HIFU). International prostate symptom score (IPSS), quality of life (QOL), maximum urinary flow rate (Qmax), post void residual urine volume (PVR), pressure-flow tests (A-G) were employed for the evaluation of curatives effect on preoperation, 30th and 90th day after the treatment. Results The duration of the TR-HIFU prostate ablation treatment was 15-85 rain. One hundred and seven patients after treatment were followed up for 3 months. Compared the effect before treatment with that after treatment, IPSS improved from (27.0 ±11.5) scores to (8.5±1.4) scores, Qmax increased from (5.7±2.3) ml/s to (14.1±4.2) ml/s, PVR decreased from (118.5±78.0) ml to (30.0±15.0) mI,A-G parameters reduced from 62.4±19.3 to 25.6±13.0 and urine volume (VV) increased from (85.8 + 42.0) ml to (194.0±52.0) ml. The parameters all altered obviously (P < 0.05). Conclusions TR-HIFU appears highly attractive as a new optional, safe and efficacious and minimally invasive treatment for the high risk BPH. Main post-operative urodynamie parameters are more obviously improved than those of the preoperation.

Objective To determine the clinical value of MRCP for peroperative evaluation of donor biliary system in living donor liver transplantation (LDLT). Methods A total of 60 living donors for the LDLT were enrolled in this study. Of the 60 donors with a mean age of 32.2 (19-60), 50were male and 10 female. MRCP was performed before and cholangiography was done during the right lobectomy in these donors. The results of MRCP were compared with those of cholangiography to determine the value of MRCP for typing the biliary system in the donors. Results The preoperative MRCP showed that 40 donors were of type Ⅰ biliary tract, 12 of type Ⅱ , 5 of type Ⅲ and 3 of other types. The intraoperative cholangiography showed that the accordance rate of MRCP was 97.4%,91% and 89% for type Ⅰ , type Ⅱ and other types, respectively. The overall rate of accuracy of MRCP was 95% (57/60). Conlusion MRCP can show types of biliary tract in living donors for liver transplantation to provide evidence for plan of surgery.

Objective To analyze videourodynamic characteristics of female bladder outlet obstruction (BOO). Methods Retrospective analysis of videourodynamic characteristics were performed in 42 women with BOO. On the basis of the videourodynamic findings, women with BOO were categorized into five groups: bladder neck obstruction, middle urethra (urethral sphincter) obstruction, distal urethra obstruction, external orifice of urethra obstruction, high-grade pelvic organ prolapse. Data of five groups were compared in Qmax, maximum cystometric capacity, Pdet at Qmax, residual urine, detrusor instability and hydronephrosis. Data of all patients were analyzed by SPSS13 statistical software, measurement data by t-test and enumeration data by x2-test. Results Five groups had not significant deviation in the maximum cystometric capacity. however patients with bladder neck obstruction had significant deviation with others in Pdet at Qmax (78. 0 ± 23. 6)cm H2O, residual urine (120. 6±115.2)ml, Qmax (7.0±2.3)ml/s (P<0.05). There was significant deviation between middle urethra (urethral sphincter) obstruction(76.9%)and others in detrusor instability(P<0. 05). In all patients with hydronephrosis, bladder neck obstruction(57. 1 %) had significant deviation with others (P<0. 05). Conclusions Videourodynamic tests could assess lower urinary tract function, and may guide clinic management. The bladder neck obstruction was most serious and harmful to upper urinary tract.

Objective To investigate the current status of healthcare-associated infection (HAI),community-associated infection(CAD,and antimierobial use in hospitalized patients in medical institutions of Guizhou Province.Methods In September 2014,infection status of hospitalized patients in 174 second level hospitals and above in Guizhou Province were performed cross-sectional survey.Results A total of 68 419 patients were surveyed,the actual survey rate was 99.65％.1 581 patients developed 1 684 cases of HAI,HAI prevalence rate and HAI case prevalence rate were 2.31％ and 2.46％ respectively,18 571 patients developed 19 191 cases of HAI,CAI prevalence rate and CAI case prevalence rate were 27.14％ and 28.05％ respectively;patients in general intensive care unit(ICU) and pediatric department(non-neonatal group) had the highest HAI and CAI prevalence rates respectively.Constituent ratios of HAI and CAI sites was significantly different(x2 =17 325.44,P＜0.01);Escherichia coli was the main pathogen causing HAI and CAI.Utilization rate of antimicrobial agents on the survey day was 39.82 ％,ICU (80.47 ％) and pediatric department (76.67 ％) were the highest.Therapeutic antimicrobial use accounted for 67.48 ％ (n =18 386),single antimicrobial use accounted for 79.55 ％ (n =21 672).Pathogenic detection rate of specimens from patients receiving therapeutic antimicrobial agents was 31.76％.Conclusion This survey is helpful for understanding the high risk departments and sites of HAI and CAI in Guizhou Province,as well as pathogenic detection rate of specimens from patients receiving therapeutic antimicrobial agents,which provides basis for further prevention and control of HAI.

Objective To evaluate the short-term and mid-to-long-term clinical effectiveness of endovascular isolation technique with covered-stent in treating Stanford type B aortic dissection. Methods A total of 183 patients with Stanford type B aortic dissection, who were admitted to authors’ hospital during the period from January 2005 to December 2013 to receive endovascular isolation treatment with covered-stent under general anaethesia, were enrolled in this study. The clinical data, including post-operative symptoms, complications, retention time in ICU, hospitalization days, 30-day mortality, etc. were retrospectively analyzed. After discharged from hospital, the patients were followed up to check the situation, position and shape of the stent, the diameter of dissection false lumen, the internal leakage, etc. The survival rate and the quality of life were determined. Results Endovascular isolation procedure with covered-stent was successfully accomplished in all the 183 cases. The retention time in ICU was (3.08 ± 1.93) days, the mean hospitalization time was (3.08 ± 1.93) days, and the 30-day mortality was 1.09%. After discharged from hospital, the patients were followed up regularly, and no collapse or displacement of stent was observed, and the stent remained in its normal shape. No recurrence of dissection, rupture or reversal tear was observed. No long existing internal leakage could be detected. During the follow-up period 4 patients died, among them three died from cerebral infarction and one died of natural death. The 5-year survival rate was 97.82% and the patient’s quality of life did not become apparently worse. Conclusion For the treatment of Stanford type B aortic dissection, endovascular isolation therapy with covered-stent has excellent short-term effect and stable mid-to-long-term result.