Objective: To evaluate the clinical effects of troponin alone and troponin combining copeptin in early diagnosis of Non-ST segment elevation myocardial infarction (NSTEMI) by meta-analysis. Methods: We searched Medline, EMBASE, Cochrane, Pubmed, CNKI and Wanfang database (1995-01 to 2015-10) for the publications of troponin alone and troponin combining copeptin in early diagnosis of NSTEMI. Based on inclusion and exclusion criteria, we screened the literatures and evaluated their quality by QUADAS items. Manager 5.2 and Meta-DiSc 1.4 software were used to study the pooled sensitivity and speciifcity for troponin alone and troponin combining copeptin in NSTEMI early diagnosis, and to calculate the summary receiver operating characteristic curve (SROC) with the area under curve (AUC). Results: There were 11 articles including 1 Chinese article enrolled. For NSTEMI diagnosis, compared with troponin alone, troponin combining copeptin showed the higher sensitivity (90% vs 75%), but lower speciifcity (60% vs 87%). For SROC, both AUC were > 0.7, while the AUC of troponin combining copeptin was even lower (0.805 vs 0.891). Conclusion: Combination of troponin and copeptin had the better sensitivity for NSTEMI early diagnosis, although it with lower speciifcity while increased copeptin level might suggest the patients associated with other clinical conditions such as heart failure or stroke which were important in clinical practice.

Objective To investigate the clinical significance of the ST segment changing in treadmill exercise test positive for the diagnosis of coronary heart disease. Methods 133 patients (hospitalized from January 2014 to January 2015) with the ST segment depression≥0.1 mm in treadmill exercise test were retrospectively analyzed. Patients were divided into the observation group and the control group according to the coronary angiography (the dividing line is artery stenosis is more than 50% or not ). ST-segment depression margin and recovery time of the two groups were compared. ST-segment depression margin and recovery time of patients with different vascular lesion number were also analyzed. Results In 133 cases, 79 cases of coronary angiography were positive(59.4%). Positive rate of ST segment recovery time(> 90 s) was 76.9% in. The maximal ST-segment depression margin and recovery time in the observation group were more than the control group, the difference was statistically significant (P<0.05). Compared with the maximal ST segment depression margin in single-vessel stenosis group , the difference in the double-vessel and multi-vessel stenosis group was not statistically significant(P > 0.05). But in terms of ST-segment recovery time, the double-vessel and multivessel stenosis group were higher than the single-vessel stenosis group , and the difference was statistically significant (P< 0.05). Conclusion Clinically, patients with TET positive combined the ST segment depression and ST-segment recovery time are important hints for the diagnosis of coronary artery disease , and is worthy of promotion.

Objective To establish a distraction osteogenesis SD rat model for exploring the effect of total flavonoids from Rhizoma Drynariae on the quality of rat bone formation in the process of distraction osteogenesis from the perspective of tomography.Methods Twenty-four rats were randomly divided into experimental group and control group after successful modeling,and were respectively given intragastric administration with total flavonoids from Rhizoma Drynariae(in dose of 77.125 mg/kg) and saline for 8 weeks.Seven days after operation,the tibias of all the rats were given distraction at the speed of 0.2 mm for 20 days.Eight weeks after the operation,X-ray examination for all the rats was performed,and then the rats were killed for obtaining the tibia samples for Micro-CT scanning.The differences of X-ray Lane-Sandhu scores,the bone mineral density and bone mineral content were compared between the two groups.Results The X-ray Lane-Sandhu scores,the bone mineral density and bone mineral contents showed by Micro-CT scanning in the experimental group were higher than those in the control group,and the differences were statistically significant (P ＜ 0.05).Conclusion The total flavonoids from Rhizoma Drynariae can improve the quality of bone formation in the process of distraction osteogenesis in rats.

Objective To evaluate the impact of cigarette excise tax up-regulation on the retail price of cigarettes in 2015.Methods Nominal and real price of selected cigarette varieties were calculated with data from Tobacco Retail Price Monitoring Project,which was conducted in 10 cities of China from 2013 to 2015.The trend of the cigarette prices changing was analyzed with annual data.Results A total of 352 varieties of cigarettes were surveyed during the three years.The nominal price of these cigarettes did not change significantly from 2013 to 2014.Compared with nominal price of 2014,the price of 286 varieties increased and the price of 10 most popular varieties increased from 0.6％ to 7.4％ after cigarette excise tax increased,but the actual prices had both rise and fall compared with 2013.Conclusions Cigarette excise tax raise in 2015 had influence on the retail price of cigarettes.But the increase in retail price was very limited,if factors including inflation and purchasing power are taken into consideration.Therefore,the influence of 2015 cigarette excise tax raise on tobacco control needs further evaluation.

Objective To exam the exposure status to tobacco advertisement and promotion programs in Chinese middle school students.Methods Stratified multi-stage cluster sampling was used to select participated grade 7-9 middle school students in 31 provinces (n=155 117).A self-administrated questionnaire was used in which questions related to behavior on tobacco use,exposure to second-hand smoking (SHS),access to tobacco products and prices,tobacco control advocacy,exposure to tobacco advertisement,and promotion as well as attitude and knowledge towards tobacco,etc.Data was weighted and analyzed,using the complex survey module of SAS 9.3 software.Results In the past 30 days,48.5％ of the students had a chance to see advertisement or promotion programs on tobacco.Tobacco advertisement or promotion were most frequently seen on TV (21.3 ％) among students,followed by outdoor billboard (20.1％),at the stands for sale (17.5％),and Internet (15.6％).In addition,4.6％ of the students reported having kept the items related to brand logos of tobacco products; 2.0％ reported having been offered a free tobacco product by tobacco company representatives; 69.7％ reported having seen scenes related to smoking on TV/videos/movie screens.Twenty five point two percent of the student smokers reported buying individual sticks at last purchase.Among those students who had never been exposed to tobacco,the ones who had been exposed to tobacco advertisement and promotion programs reported that they were more likely to feel smoking attractive than those who had not.They also reported that if a cigarette was offered by friends,they might try to smoke within the next 12 months,feeling that smoking would make him/her comfortable,and finally to feel that they might enjoy smoking (P＜0.000 1).Conclusion Adolescents had been heavily exposed to tobacco advertisement and promotion programs in China.Students who had been exposed to tobacco advertisement or promotions were more likely to express positive attitude to tobacco use.It is urgent to make amendments to China's Advertising Law to completely prohibit tobacco advertisement,promotion and sponsorship programs,to keep the young people away from tobacco.

Objective: To investigate the ethical decision-making process of breaking confidentiality when counselors dealing with self-inflicted injury and suicide issues in college situation. Methods: A semi-structural interview was addressed to 10 counselors from 7 college counseling centers in Beijing, among whom with (10 ± 8) years of experience on average in this field. Content analysis method was used to transcription of the interviewing data. Results: Totally 8 counselors had received ethical training more or less, and attached great importance to ethical codes. There were still some conflicts between school regulations and confidentiality rules in 7 university counseling centers. Different counselors varied greatly in decision-making on breaking confidentiality when facing college students' self-inflicted injury and suicide. Faced with conflicts between college demands and confidentiality principles, counselors could take the professional standpoint and consider more of the interests of students. Conclusion: The decision-making process on self-inflicted injury and suicide confidentiality breakthrough needs to be standardized. College's attention and support to the counseling work should be strengthen and enhance ethical awareness.

OBJECTIVETo study the correlation between IDH1 mutation, MGMT expression, clinicopathologic features and post-radiotherapy prognosis in patients with astrocytoma.

METHODSDetection of IDH1 mutation and MGMT expression was carried out in 48 cases of astrocytoma (WHO grade II to III) by EnVision method with immunohistochemical staining. Follow-up data, including treatment response and overall survival time, were analyzed.

RESULTSThe rates of IDH1 mutation and MGMT expression in astrocytomas were 62.7% (30/48) and 47.9% (23/48), respectively. There was a negative correlation between IDH1 mutation and MGMT expression (r = -0.641, P < 0.01). The age of patients with IDH1 mutation was younger at disease onset. The IDH1 mutation rate in patients with WHO grade II astrocytoma was higher than that in patients with WHO grade III tumor (P < 0.05). The age at onset was an independent factor affecting the expression of mutant IDH1. After radiotherapy, patients with IDH1 mutation+/MGMT- tumor carried a longer overall survival time than patients with IDH1 mutation-/MGMT+ tumor (P < 0.05).

CONCLUSIONSThere is a correlation between IDH1 mutation and MGMT expression in WHO grade II to III astrocytoma. Age at onset is an independent factor affecting the expression of mutant IDH1. Tumors with IDH1+/MGMT- pattern show better response to radiotherapy than tumors with IDH1-/MGMT+ pattern. Detection of IDH1 mutation and MGMT protein expression can provide some guidance in choice of treatment modalities in patients with astrocytoma.

Adult ; Age Factors ; Age of Onset ; Aged ; Astrocytoma ; genetics ; metabolism ; mortality ; pathology ; radiotherapy ; Brain Neoplasms ; genetics ; metabolism ; mortality ; pathology ; radiotherapy ; DNA Modification Methylases ; metabolism ; DNA Repair Enzymes ; metabolism ; Female ; Humans ; Isocitrate Dehydrogenase ; genetics ; Male ; Middle Aged ; Mutant Proteins ; genetics ; Mutation ; Prognosis ; Tumor Suppressor Proteins ; metabolism