Objective:To research the application value of coronary CT angiography(CTA) detection for epicardial adipose tissue(EAT) and pericardial adipose tissue(PAT) in the diagnosis of coronary stent restenosis.Method:Selected 68 cases coronary atherosclerotic stenosis patients who were treated by coronary stent from June 2012 to June 2013 in hospital. All patients were detected after the operation of CTA within 3 years and they were divided into two groups (coronary stent restenosis positive group included 29 cases, negative group included 39 cases). To analyze the relationship between EAT and PAT through the statistical method and analyze the application value of EAT and PAT in the diagnosis of coronary stent restenosis based on calcification score image measurement of EAT and PAT volume.Results: Correlation analysis results showed there was correlation between EAT volume and PAT volume (r=0.859,P<0.05); through compared CAG and the diagnostic results of coronary artery stent restenosis by EAT and PAT, the sensitivity was 82.87%, specificity was 84.62%, CCTA positive predictive value was 80.00%, negative predictive value was 86.84% and diagnostic accuracy was 83.82% of the stent patency which was evaluated by CAG. The consistency evaluation marker Kappa was 0.554. The analysis of patients with coronary stent restenosis showed that there was significant correlation between Gensini score of coronary stent restenosis and EAT and PAT(P<0.05).Conclusion:There was significant correlation between EAT volume and PAT volume, and they can be used to evaluate the sensitivity and specificity of coronary stent operation restenosis and the results were higher. Besides, its clinical diagnostic value was similar with CAG.

Sepsis has relatively high morbidity and mortality in patients at intensive care unit (ICU). With the study of sepsis having continued to develop in recent years, the defects existing in this research have unceasingly exposed. Because the lack of design process of international standardized clinical randomized controlled trials (RCT) for septic patients, the situation of incomplete data record exists in these clinical studies, that may further affect the interpretation of the research results, therefore it is in urgent need to have an international standardized RCT design process for septic patients.

OBJECTIVE:To establish a method for preparation and quality control of compound dexamethasone liniment.METHODS:The compound dexamethasone liniment were prepared with dexamethasone acetate and vitamin E,the contents were determined by HPLC.RESULTS:The calibration curves of dexamethasone acetate and vitamin E were linear in the range of2～40?g/ml and80～800?g/ml respectively,and their average recoveries were100.5%(RSD=0.82%)and98.6%(RSD=0.59%)respectively.CONCLUSION:The preparation is reasonable in formula,simple and accurate in quality control.

Objective To evaluate the value of imaging examination and diagnosis of airway foreign body in children. Methods 218 of airway foreign bodies confirmed by bronchoscopy were retrospectively analyzed in terms of clinical and imaging data. Results 218 patients included 140 males and 78 females. Their ages ranged 6 months to 12 years(mean,19.2 months). All patients had conventional radiographs on frontal chest films,neck lateral films and fluoroscopy. 34 cases underwent 64-slice spiral chest CT examination. According to the location of the foreign bodies,29 cases were in throat and subglottic,55 cases in trachea and 134 cases in bronchus(79 cas-es in the right,55 cases in the left). According to the character of the foreign bodies,5 cases were metal,29 cas-es in bone,93 cases in peanuts,59 cases in seeds,22 cases in fruits and vegetables and 10 cases in others respec-tively. Thirty-fourcases showed a direct sign of the foreign body and 177 cases showed the indirect signs. 34 cases on CT examination directly were showed foreign body in the tracheal bronchi. The diagnostic accuracy of CT exami-nation was 100%. Conclusions X-ray photograph and fluoroscopy were the first choice for aspiratory foreign bod-ies in children. CT examination is an important supplementary method when conventional X-ray examination is neg-ative.

Human colostrum and milk collected at different times during the first six months of lactation from 301 subjects were tested for the levels of SIgA, IgM, IgG, C3, C4, lactoferrin and lysozyme by the technique of radial immunodiffusion. These kinds of immunoglobulins in colostrum and milk were detected, however the SIgA was highest among immunoglobulins in colostrum, which acounted for 89.8%.The average level of SigA on the first day of postpartum was 3152.5 mg/dl and exceeded those in the serum by 13-fold. It was suggested that breast-feeding may be crucial for the newborns before their mucosal immune system has been established. The average levels of C3 and C4 on the first day of postpartum were 99.7mg/dl and 65.9mg/dl respectively, reaching the normal serum level. Lactoferrin was as high as 1228.7mg/dl in the colostrum of the first day of lactation. The concentration of lysozyme was 944.2ug/ml on the first day of postpartum, which was about 429 times higher than that of cow milk. Using Holder pasteurization (62.5℃, 30 minutes), the SIgA and lysozyme activity of the milk could be reduced by 29.7% and 8.3% respectively, but a lot of anti-infective factors still remained in milk. So pasteurization may be useful for the sterilization of stored human milk.

Objective To investigate the distribution and antimicrobial resistance of gram-negative bacilli isolated from wound specimens of orthopedic patients,and provide reference for the rational use of antimicrobial agents. Methods 682 isolates of gram-negative bacilli were collected from orthopedic department in a comprehensive hospi-tal between January 2011 and December 2013, antimicrobial susceptibility testing results were analyzed. Results The main gram-negative bacilli isolated from wound specimens of orthopedic patients were Pseudomonas aeruginosa (P .aeruginosa)(16.72%),Escherichia coli (E.coli)(15.40%),and Enterobacter cloacae (E.cloa-cae)(12.76%).The detection rates of extended-spectrum beta-lactamase-producing E.coli and Klebsialla pneu-moniae (K .pneumoniae)were 54.29%(57/105)and 31 .43% (22/70)respectively,and mainly distributed in the trauma orthopedic department,accounting for 49.12% and 45.45% respectively.The susceptibility rates of E.coli, K .pneumoniae ,and E.cloacae to meropenem and imipenem were all 100.00%.The susceptibility rates of E.coli and K .pneumoniae to amikacin,piperacillin-tazobactam and amoxicillin/clavulanic acid were all >80%.Suscepti-bility rate of E.cloacae to most antimicrobial agents were 71 .26% -100.00% except for piperacillin(64.37%). Susceptibility rates of P .aeruginosa to most antimicrobial agents were >85% except for cefepime (78.95%)and aztreonam (65.79%).Conclusion Gram-negative bacilli are the most common pathogens in wound infection of or-thopedics patients.In order to use antimicrobial agents rationally and improve clinical treatment effect,it is impor-tant to realize the distribution of pathogens and antimicrobial resistance.

Objective To investigate the clinical significance of homocysteine(Hcy) and glycated hemoglobin (HbA1c) in patients with diabetic retinopathy.Methods From March 2013 to February 2015,a total of 168 patients with diabetes from Beijing Jishuitern Hospital were divided into diabetic retinopathy group (76 cases,32 male,44 female,average age 62.97 ± 12.46) and non-diabetic retinopathy group (92 cases,46male,46 female,average age 58.14 ± 13.71),and 65 cases of healthy subjects (46male,46 female,average age 60.24 ± 10.85) were enrolled as normal control group as well.Hcy and HbA1c were detected in all groups.Multiple independent samples nonparametric tests were used to compare the difference between groups.The concentrations of Hcy and HbA1c between DR group and NDR group were analysised by ROC curve analysis.Result The Hcy levels in normal control group,NDR group and DR group were 7.00 (4.55-10.50) μmol/L,12.45 (10.30-15.10) μmol/L,20.10 (16.63-25.68) μmol/L respectively.The HbA1c levels in normal control group,NDR group and DR group were 5.30 (5.00-5.70) ％,6.80 (5.83-8.03) ％,7.25 (6.50-8.60) ％ respectively.There was no significant difference in Hay and HbA1c levels between groups (P ＜ 0.01);Compared with non-diabetic retinopathy group,levels of Hcy,HbA1c in diabetic retinopathy group were obviously higher;The optimal diagnostic cut-off values of Hcy was 14.35 μmol/L,at this cut-off value,the sensitivity was 96.05％,specificity was 68.48％;The optimal diagnostic cut-off values of HbA1c was 6.05％,at this cut-off value,the sensitivity was 98.68％,specificity was31.25％.Conclusion Patients with Diabetic retinopathy might have hyperhomocystinemia,and detection of Hcy may contribute to the early diagnosis of diabetic retinopathy.

Objective To explore the influence of autologous blood salvage on the gastric intramucosal pH(pHi)in operation for orthopedic patients.Methods 40 patients nnderwent orthopedic surgery were randomly divided into two groups(n=20 each).Salvage group received autologous blood transfusion.The pHi was measured by a nasogastric tube air carbon dioxide tension instrument.The blood samples were collected before operation(T0),1 h after operation(T1),2h after operation(T2)and the end of surgery(T3)for the measurement of pHi.The volume of blood recovery,erythrocyte suspension and plasma were counted.Results The volume of erythrocyte suspension and plasma were significantly higher in control group than in salvage group during operation(P＜0.05).There was no obviously different in blood gas indexes in the two groups(P＞0.05).The phi was significantly higher in salvage group[(7.381±0.023),(7.386±0.025)]than those in control group[(7.361±0.022),(7.375±0.024)]at T2 and T3(all P＜0.05).Conclusion Autologous blood salvage could recover loss blood in time,and make pHi decline,and maintain effective circulation,and significantly improved visceral microcirculatory perfusion and oxygenation in patients under went orthopedic surgery.

Objective To investigate the effects of continuous stellate ganglion block (SGB) on serum thyroid hormone and cortisol levels in patients with severe brain injury.Methods Eighty ASA Ⅱ or Ⅲ patients with severe brain injury aged 22-61 yr undergoing emergency craniotomy were randomly divided into 2 groups ( n = 40 each): control group (group C) received routine treatment only and continuous SGB group (group SGB) received continuous SGB with 0.2% ropivacaine besides routine treatment. SGB was performed on the operated side after induction of general anesthesia and tracheal intubation. An epidural catheter was placed. A bolus of 0.2% ropivacaine 7 ml was followed by continuous infusion of 0.2% ropivacaine at a rate of 2 ml/h. Continuous SGB was maintained for 48 h. Successful SGB was confirmed by increase in skin temperature by ≥1.5℃ behind earlobe on the operated side.Venous blood samples were obtained at 30 min before and 3 and 7 day after operation for determination of serum thyroid stimulating hormone (TSH), triiodothyronine (T3) ,thyroxine (T4) , reverse triiodothyronine(rT3) and cortisol concentrations. Glasgow prognosis score was used to evaluate the clinical results at 3 months after operation. Results Serum T4 , rT3 , TSH and cortisol concentrations were significantly lower while the serum T3 concentration was higher in the SGB group than in group C at 3 and 7 d after operation. The clinical results were significant better in SGB group than in group C according to Glasgow prognosis scores at 3 months after operation. Conclusion Continuous SGB can inhibit the stress response, and improve hypothalamus-pituitary-thyroid gland axis function and is helpful to patient's recovery from injury.