Objective To evaluate the roles of B-type natriuretic peptide (BNP) in predicting the severity of community-acquired pneumonia (CAP) by studying the correlation between them.Methods A total of 202 patients with CAP admitted from December 2011 to December 2012 were enrolled in this study.All these patients were checked with laboratory tests for BNP level,C-reactive protein (CRP),white blood cell count (WBC) as well as other markers needed for obtaining pneumonia severity index (PSI).The differences in BNP levels,CRP levels,and WBC were compared among different degrees of pneumonia severity,and the correlation between BNP levels and PSI was investigated by a linear correlation analysis.The patients enrolled were divided into a high-risk group (defined as Ⅳ-Ⅴ grade of PSI) and a low-risk group (defined as Ⅰ-Ⅲgrade of PSI).Meanwhile,they were also divided into a survivor group and a non-survivor group according to outcomes.BNP levels between the two groups were compared,and a receiver operating characteristic (ROC) curve analysis was performed on the BNP levels versus PSI.Results BNP levels increased with CAP severity (r =0.782,P ＜0.01).The mean level of BNP (263.2 ± 119.6) pg/mLof patients in the high-risk group was significantly higher than that of patients (71.5 ± 54.3) pg/mL in the low-risk group (P ＜ 0.01).The patients in the non-survivor group had significantly higher BNP levels compared to the survivor group [(343.86 ± 125.49) vs.(183.00 ±121.71) pg/mL,P ＜ 0.01].In addition,there were positive correlations between BNP levels and PSI (r =0.782,P＜0.001),between BNP levels and CRP levels (r =0.560,P＜0.01),and between BNP levels and WBC (r =0.513,P＜0.001).The BNP level had a high accuracy in predicting the severity of CAP (AUC =0.952).The optimal cut-off point of BNP level for distinguishing high-risk from low-risk patients was 125.0 pg/mL,with a semitivity of 0.891 and a specificity of 0.946.Moreover,BNP level had a definite accuracy in predicting mortality (AUC =0.823).Its optimal cut-off point for predicting death was 299.0 pg/mL,with a sensitivity of 0.675 and a specificity of 0.816; its negative predictive cut-off value was 0.926,and positive predictive value was 0.426.Conclusions BNP level is positively correlated with the severity of CAP.The patient with BNP level above 125.0 pg/mL should be hospitalized immediately and patients with BNP level higher than 299.0 pg/mL are at the high risk of death.Therefore,BNP is a useful biomarker for evaluating the severity of patients with CAP.

Objective To explore the cost of healthcare-associated infection (HAI)management in a tertiary first-class hospital,provide data support for cost-effectiveness and cost-benefit analysis of HAI management,and provide scientific evidence for the rational allocation of hospital resources.Methods Micro-costing study was used to calcu-late the direct cost of the department of HAI management by collecting the quantity and unit price of each item. Results The total cost of HAI management in this hospital in 2013 were about ￥870 000,including human cost￥790 000,depreciated fixed assets ￥34 501 ,low-value consumption goods ￥3 800,publicity and training￥33 600,office consumables ￥5 208;average cost were ￥12.16 per person and ￥529.69 per bed.Conclusion Human cost is the main cost in HAI management in this hospital.

Objective To explore the change of serum concentrations of apolipoprotein A5(APOA5),and the relationship with levels of adiponectin and fasting insulin(FINS)in patients with coronary heart disease(CHD).Methods Blood lipids,the serum concentrations of APOA5,adiponectin and insulin were examined in 95 individuals,who were divided into two groups:51 patients with CHD and 44 healthy individuals.Results The concentrations of APOA5 and adiponectin in CHD patients were significantly lower than the healthy individuals[(230.06?115.8)?g/L and(3.03?1.85)?g/L vs(324.43?151.79)?g/L and(4.12?2.48)?g/L respectively,all P

BACKGROUND: Although pneumonia severity index (PSI) is widely used to evaluate the severity of community-acquired pneumonia (CAP), the calculation of PSI is very complicated. The present study aimed to evaluate the role of B-type natriuretic peptide (BNP) in predicting the severity of CAP. METHODS: For 202 patients with CAP admitted to the emergency department, BNP levels, cardiac load indexes, inflammatory indexes including C-reactive protein (CRP), white blood cell count (WBC), and PSI were detected. The correlation between the indexes and PSI was investigated. BNP levels for survivor and non-survivor groups were compared, and a receiver operating characteristic (ROC) curve analysis was performed on the BNP levels versus PSI. RESULTS: The BNP levels increased with CAP severity (r=0.782, P<0.001). The BNP levels of the high-risk group (PSI classes Ⅳ and Ⅴ) were significantly higher than those of the low-risk group (PSI classes Ⅰ–Ⅲ) (P<0.001). The BNP levels were significantly higher in the non-survivor group than in the survivor group (P<0.001). In addition, there were positive correlations between BNP levels and PSI scores (r=0.782, P<0.001). The BNP level was highly accurate in predicting the severity of CAP (AUC=0.952). The optimal cut-off point of BNP level for distinguishing high-risk patients from low-risk ones was 125.0 pg/mL, with a sensitivity of 0.891 and a specificity of 0.946. Moreover, BNP level was accurate in predicting mortality (AUC=0.823). Its optimal cut-off point for predicting death was 299.0 pg/mL, with a sensitivity of 0.675 and a specificity of 0.816. Its negative predictive cut-off value was 0.926, and the positive predictive cut-off value was 0.426. CONCLUSION: BNP level is positively correlated with the severity of CAP, and may be used as a biomarker for evaluating the severity of CAP.

Objective To explore the incidence and distribution features of neonatal phenylketonuria(PKU) and congenital hypothyroidism(CH) in Lianyungang area.Methods The heel blood samples dried on filter paper was collected from newborns after 72 hours.As the screening indicators,PKU was detected through serum phenylalanine concentration(Phe) detection by Guthrie′s bacterial inhibition assay and CH was detected through serum thyroid stimulating hormone(TSH) levels detection by time-resolved fluorometry(TRFIA) or enzyme linked immunosorbent assay(ELISA).Results Sixty-four children with CH were diagnosed and the rate of CH was 1∶2423,41 patients were examined by thyroid gland nuclein kinescope picture,among which there were 23 patients whose thyroid glands were unusal.These patients lived in 45 towns(streets),which had no difference between men and women,city and country side.A couple of twins were screened for CH;15 cases of PKU was detected with an incidence of 1∶10 339.These patients′ parents were neither consanguineous marriage nor dominance hereditary family history.Their physical and mental development were similar to the same age children after interventive treatment.Conclusions The distribution of CH and PKU is diffuse in Lianyungang.Neonatal screening is the only valid means to find patients with CH and PKU.

Antineoplastic Agents/therapeutic use* ; Gastrointestinal Stromal Tumors/drug therapy* ; Humans ; Liver ; Liver Neoplasms/drug therapy* ; Lung ; Naphthyridines/therapeutic use* ; Urea/analogs & derivatives*

As one of the major geriatric syndromes,frailty exerts adverse effects on life expectancy and quality of life of the elderly.Because of its importance,a number of methods and tools have been introduced for the assessment of frailty.Malnutrition,as an independent risk factor,interacts with frailty and is involved in its progression.This article reviews recent studies on frailty and malnutrition.

Objective To obtain highly purified botulinum neurotoxin A light chain(BoNT-ALC) protein in E.coli by genetic engineering and multi-step purifications, and identify its metalloproteases activity.Methods The full-length of BoNT-ALC was cloned from BoNT A by PCR and inserted into plasmid pET-22b.Then pET-22b-ALC was transformed into E.coli BL21( DE3) strains and induced by IPTG.The protein was purified by Ni-NTA sepharose,anion exchange column and gel filtration.The enzymatic activity of the protein was identified by SNAP-25.Results and Conclusion A highly purified and homogeneous protein is obtained, which shows good enzymatic activity.

objective To explore the mechanism of Naotaitong granule on ischemic apoplexy by observing the effect of Naotaitong granule on ischemic apoplexy model. Methods128 rats were randomly divided into sham operation group, console group, experimental group and control group. Ischemic apoplexy model were established in all the animals. Different disposal was given to different group. In the 7 d、 10 d、 14 d、21 d and 28 d after drug administration, immunohistochemistry were used to evaluate the expression of Slit2 and VEGF. In addition, behavior alteration and HE staining were applied to evaluate the variation of brain tissue neuron. ResultsAll the animals revealed hemiplegia and cerebral tissue softened after successfully establishing apoplexy model. The morphology of experimental group and control group was improved after drug administration with softened focus obviously reduced. Longa grade of console group in the 7 d、 10 d、 14 d、 21 d and 28 d was (2.92±0.20)、 (2.58±0.20)、 (2.25±0.27)、 (1.83±0.26) and (1.42±0.20) respectively. Longa grade of Naotaitong group in the 7 d、 10 d、 14 d、 21 d and 28 d was (1.92±0.20)、 (1.50±0.32)、 (1.25±0.27)、(0.83 ±0.26) and (0.50±0.00) respectively. Longa grade of control group in the 7 d、 10 d、 14 d、 21 d and 28 d was (2.33±0.41)、 (2.00±0.45)、 (1.75±0.27)、 (1.33±0.41) and (0.92±0.38) respectively. Longa grade of both control and Naotaitong group had statistics significance compared with the console group (P＜0.01) .Conclusion Naotaitong granule may improve anoxemia in rats brain and protect brain tissue.

Objective To evaluate the clinical efficacy of 3D DCE MRA(three dimensional dynamic contrast-enhanced MR angiography)in patients of preoperation of liver transplantion.Methods 8 cases of potential liver transplant recipients suffering from severe liver disease underwent MRI and 3D DCE MRA, accessed the images synthetically. All of them had DUS examination, 4 cases received liver transplantation successfully.Results Satisfactory angiography images were obtained in all cases, the grade Ⅱ～Ⅲ branches of the hepatic artery, the grade Ⅱ～Ⅴ branches of the portal vein and gradeⅡ branches of the hepatic vein could clearly be visualized. Gastric-oesophageal varices were found in 3 cases of cirrhosis, compression and displacment of hepatic artery and portal vein were shown in one case of polycystic liver.Conclusion 3D DCE MRA is an efficiency, noninvasive technique, it offers great help in evaluating pre-operative vasculature of liver transplantation.