Objective To evaluate the diagnostic value of rapid ELISA method in detecting D‐dimer combined with cardiac tro‐ponin I (cTnI) for early exclusion of acute myocardial infarction (AMI) .Methods The samples from 178 consecutive patients with chest pain and suspected AMI were tested for cTnI and D‐dimer on admission;then cTnI was also tested at 6 h after admission . AMI was definitely diagnosed by echocardiography combined with angiography .The cTnI cut‐off for diagnosing AMI was 0 .11μg/L (accounting for 10% of total CV lowest level) .Results AMI was diagnosed in 40 cases(22 .4% ) .The negative prediction value (NPV) on admission was 87 .9% for single cTnI and increased to 98 .4% at 6 h after admission .The cut‐off for single D‐dimer on admission was 200 ng/mL FEU and its NPV was 87 .9% .No false negative was observed when both cTnI and D‐dimer were nega‐tive on admission .Conclusion The combination detection of cTnI and D‐dimer has the potential to be used as an early exclusion di‐agnosis of suspected AMI in the patients with chest pain at arriving in the emergency department ,thus shorten the patient′s hospi‐tal duration and save costs .

Antibiotics being currently the most extensively used medicine in clinical practice and abuse of them being prevalent, it is thus necessary to monitor in an effective and systematic manner the rational use of them. Based on the existing database and network of hospital information system, a monitoring system for the rational use of antibiotics was successfully developed using the development tool of PowerBuild. This functionally powerful and easy-to-use system, which provides comprehensive and reliable information, improved work efficiency and managerial level by automatically monitoring many chief indicators of antibiotic usage, including dosage, resistance, combination with other drugs, course, pathway, usage during the perioperative period, usage for preventive purposes, therapeutic effect, and the ratio of hospital infection occurrence resulting from the use of antibiotics under different circumstances.

Primary biliary cholangitis (PBC)is a commonly seen cholestatic liver disease.Currently,ursodeoxy-cholic acid (UDCA)is the only drug approved for the effective treatment of PBC.However,up to 40% of PBC patients had poor response to UDCA.Farnesoid X receptor (FXR)can inhibit the synthesis of bile acid,regulating the transport of bile acid and playing a role in anti-hepatic fibrosis.This article reviewed the role of FXR in treatment of PBC.

Objective: Executive dysfunction is a typical characteristic of vascular cognitive impairment(VCI),with subcortical ischemia as its pathological basis.The aim of this study was to investigate the characteristics of event-related potential of visual-spatial working memory based on ischemic white matter lesions,and offer more electrophysiological evidence for the evaluation of VCI.Methods: We included in this study 24 patients with ischemic white matter lesions(13 mild and 11 severe cases) and 12 elderly healthy controls,and induced event-related potentials(ERP) of visual-spatial working memory from the delayed matching-to-sample task in all the participants.Results: Three waves were identified: N330,P420 and late negative component. On the two-ball-load,the N330 amplitude in the middle frontal,right frontal and occipital lobe was significantly smaller in the mild and severe lesion groups(P

Objective To study the role of transforming growth factor-?1(TGF-?1) and bone morphogenetic protein 2 (BMP2) in the ankylosing spondylitis, and to evaluate whether synovial levels of TGF-?1/ BMP2 mRNA and TGF-?1/BMP2 protein expression correlate with disease activity and macroscopic observation during arthroscopy. Metheds TGF-?1/BMP2 mRNA and protein were detected by in situ hybridization and immunohistochemistry.The vascular morphology of synovial membrane was assessed for vascular morphology, tortuous vessels, straight vessels, vascular density, synovial hypertrophy, by 2 blinded observers and Reece's method using a validated VAS methods. They were significantly higher in AS than that in RA in different synovial regions. Results TGF-?1 mRNA and TGF-?1 expression were significantly higher in early AS than that in early RA in perivascular region and sublining interstitial tissue. BMP2 mRNA and BMP2 expression were significantly higher in AS than that in RA in different synovial regions.No significant relation was found between TGF-?1/BMP2 expression and CRP/ESR/platelet count in early AS. A positive relation was found between the TGF-?1 and synovial hypertrophy in synovium lining layer region, and between TGF-?1 and straight vessels,vascular density in perivascular region, and between BMP2 and synovial hypertrophy in sublining region in early AS. Conclusion Expression of TGF-?1 mRNA and TGF-?1 protein is higher in AS synovial tissue than that in RA. BMP2 mRNA and BMP2 expression are significantly higher in AS than that in RA.

Air Pollution ; analysis ; Barium ; analysis ; chemistry ; Solubility ; Spectrophotometry, Atomic ; methods ; Workplace

OBJECTIVETo explore the clinical effects of internal fixation with lag screws plus an anti-sliding plate for the treatment of Hoffa fractures of the lateral femoral condyle.

METHODSFrom May 2006 to May 2014, 17 patients with Hoffa fractures of the lateral femoral condyle were treated with lag screws plus an anti-sliding plate. There were 13 males and 4 females, ranging in age from 27 to 59 years, with a mean of 32.5 years. All the fractures were fresh and closed fractures. According to the Letenneur's classification, 8 cases were type I, 4 cases were type II, 5 cases were type III. All the patients had no injuries of the cruciate ligament and the another part of the knee. Operative incision and fracture healing time were observed, knee joint function was evaluated by Letenneur system and HSS standard.

RESULTSThe patients were followed up from 10 to 24 months with a mean of 14.6 months. All incisions achieved primary healing, and no internal fixation breakage, malunion, femoral candyle necrosis, deep vein thrombosis of lower extremity were found. Fracture healing time was from 4 to 9 months with an average of 4.7 months. According to Letenneur's functional assessment, 10 patients got an excellent results, 4 good, 3 fair. Total HSS score was 91.1 +/- 4.7 on average,15 cases obtained excellent results, 2 good.

CONCLUSIONInternal fixation with lag screws and an anti-sliding plate can result in excellent effects for Hoffa fractures of the lateral femoral condyle. The key to a successful surgery is an anatomic reduction and rigid fixation of the fracture.

Adult ; Bone Plates ; Bone Screws ; Female ; Femoral Fractures ; physiopathology ; surgery ; Femur ; injuries ; surgery ; Fracture Fixation, Internal ; Fracture Healing ; Fractures, Closed ; physiopathology ; surgery ; Humans ; Ligaments, Articular ; surgery ; Male ; Middle Aged

Objective To investigate the ch an ges of gastric intramucosal pH (pHi) during orthotopic liver transplantation (OL T) without venovenous bypasss. Methods Twenty patients (14 males and 6 females) aged (46.7 ?4.6) years, undergoing orthotopic liver transplantation without venovenous byp asss, were included in this study. A gastric tube technique was used to draw gas tric juice 3～5 mL to determine pHi and PiCO 2 before OLT, at 20 min preanhep atic phase, 30 min anhepatic phase, 30 min new hepatic phase and at 2 h and 2 4 h after operation. The arterial blood samples collected taken for the measure ments of PaCO 2, PO 2, pH, BE and HCO 3- at the same time point s as above. pHi was calculated through Henderson-Hasselbach equation. Results The gastric intraumucosal pH (pHi) was decreased significant ly at the time points of 30 min anhepatic phase and 30 min new hepatic phase c ompared with before operation (P

Objective To improve the understanding of severe anaphylactic reactions to infliximab retreatment. Methods Delayed hypersensitivity to infliximab in two patients with ankylosing spondylitis who had previously received infliximab and resumed after discontinuation over 4 years were reported and the related literatures were reviewed. Results Two patients ( 1 male, 1 female ) who were diagnosised with ankylosing spondylitis for more than 10 years, both individuals had received infliximab treatment during a clinical trial approximately 4-5 years prior to further therapy. On day 6 after subsequent infusion, one patient had pruritic skin rash covering her whole body, followed by flustered, dyspnea, hypotension and anaphylactic shock, she was successfully treated with epinephrine and glucocorticoid. Another patient experienced a skin rash and itching 9 days after reinfusion, he was successfully treated with antihistaminics.Conclusion A distant infliximab retreatment is associated with high rates of reinfusion reactions, including fever, urticaria, myalgia, arthralgia,even hypotension, dyspnea, laryngeal edema and anaphylactic shock.We recommend careful monitoring of those patients who receive infliximab retreatment, particularly after a lengthy interval.

Objective To evaluate the effects of endogenous NO on the chemosensitivity of human breast cancer cell. Methods MCF-7 cells were cultured as monolayer, incubated with cytokine IL-1β. The pro-duction of NO was detected by NO assay. The expression of iNOS protein was measured by Western blotting. Establishing control group and experimental group, the chemosensitivity of MCF-7 cells incubated by L-NMMA and L-Arg to ADM and 5-Fu was studied by MTT assay. Results There was a positive correlation of dose-dependence between NO production and IL-1β concentration. MCF-7 cells expressed plenty of iNOS by induetion of IL-1β. There was no significant difference on iNOS whether L-NMMA and L-Arg existed or not. Incubating MCF-7 cells with 0. 5 μmol/L or 1 μmol/L ADM, the survival rate of experiment group was remarkablely decreased(P < 0.05) ; L-NMMA significantly increased survival rate of experiment group(P < O. 05) ; L-Arg decreased survival rate of experiment group(P < 0.05). Conclusion The induction of IL-113 in MCF-7 cells can increase the production of endogenous NO, which increases MCF-7 cells' sensitivity to chemotherapy.