Objective:To design real-time transmission system for pre-hospital emergency electrocardiogram(ECG) so as to provide specialty and accurate diagnostic analysis about ECG before patient achieved at hospital and to shorten the waiting time for diagnosis and treatment after they achieved at hospital.Methods: 4G network and virtual private dial-up network(VPDN) were used to real-time transmit ECG data of patient from ambulance to hospital so as to doctors of ECG department and emergency room can analyze the detecting reporter, choose plan of emergency guidance and prepare operation and treatment for patientsaccording to the received ECG data in time.Results: The situations of emergency patients have been grasped and been primarily confirmed before they achieved hospital, therefore, the doctors could made relative preparation for fast and specially treating patients after they once achieved hospital.Conclusion: The real-time transmission system of pre-hospital emergency ECG can remedy the shortage of technical strength of pre-hospital emergency team, and shorten the treating time of emergency patients, and increase the success rate of rescue.

Objective To investigate the clinical characteristics and treatment method of pulmonary metastasis of transitional cell carcinoma of urinary tract.Methods The clinical data of 18 patients with pulmonary metastasis of transitional cell carcinoma of the urinary tract,who were admitted to the Second Hospital of Tianjin Medical University from July 2005 to March 2009 were analyzed.Results The primary sites of transitional cell carcinoma of these 18 patients were renal pelvis(8 cases),ureter(6 cases) and bladder(4 cases).Multiple metastases to both lungs were found in 14 cases,the chest X-ray showed dense nodular shadows in different size diffused in both lungs,and CT examination revealed the same picture.All the 14 patients were treated with systemic chemotherapy,and 13 of them underwent surgical operation after the discovery of local recurrence in their bladders.Isolated lung metastasis was found in 4 cases,in whom chest X-ray showed isolated dense nodular shadow in the lung,and CT examination revealed soft tissue shadows adjacent to the chest wall.All the 4 patients were treated with implantation of radioactive pellets and systemic chemotherapy,and one of them underwent surgical operation after the discovery of a local recurrence in the bladder.Follow-up was conducted for 6-36 months.Two patients died in 6-12 months,14 died in 12-24 months,and 2 survived for longer than 24 months.Conclusions The incidence of pulmonary metastasis of transitional cell carcinoma of urinary tract is low.Chest radiograph and CT are the main diagnostic means.Systemic chemotherapy should be used as the main treatment for diffuse pulmonary metastasis,radioactive pellet implantation and systemic chemotherapy should be used for a localized isolated pulmonary metastasis,and surgical operation should be done for the patient with local recurrence in the bladder.

Objective To study the effect of PIM-1 gene silence by RNA interference (RNAi) on the growth of human prostate cancer xenograft tumor in nude mice. Methods The xenograft tumor model of human prostate cancer was established by injecting PC-3 cells in armpits of 12 nude mice. After modeling, the nude mice were randomly divided into three groups: interference plasmid group (injecting with RNAi recombinant plasmid), empty plasmid group and negative control group (liposome every), 4 mice in each group. Mice were injected every 2 days for 5 times. The tumor volumes of xenografts were measured during experiment, and the curve of tumor growth was drawn accordingly. The quality of tumor was measured, and the inhibitory rate of tumor was calculated at the end of the experiments. The expression levels of PIM-1, c-MYC mRNA and protein in xenograft tumors were detected by real-time PCR and Western blot assay, respectively. Furthermore, immunohistochemistry staining was used to verify the expression of PIM-1. Results The xenograft tumor model of human prostate cancer was established successfully. The volume of tumor was significantly decreased 6 days after the injection treatment in interference plasmid group than that of empty plasmid group and negative control group. The effect of suppressing tumor growth was remarkable. The expression levels of PIM-1 mRNA and protein were down-regulated significantly in interference plasmid group than those of other two groups. The immunohistochemical staining of PIM-1 showed the same changes. There was no significant difference in c-MYC protein level between the three groups. But interestingly, the c-MYC mRNA level was significantly decreased in interference plasmid group than that of other two groups. Conclusion The silence of PIM-1 gene by RNAi recombinant plasmid can result a significant growth suppression of the human prostate cancer xenograft tumors in nude mice. The expression of c-MYC gene is down-regulated at translation level in the therapeutic group concomitantly. PIM-1 may be a promising target of gene therapy for prostate cancer.

Objective To investigate the diagnostic value of acridine orange fluorescene(AO-F) in bladder cancers. Methods One thousand and sixteen bladder cancer patients were reviewed retro-spectively. The positive-rates of AO-F in different stages, grades, size, quantity, position of tumors, hematuria and treatment ways were evaluated. Results The total positive rate of AO-F was 78.05 % (793/1016). The positive-rate was 74.69% (611/818) in superficial stage and 91.92% (182/198) in invasive bladder cancer, 67.24% (351/522) in grade Ⅰ and Ⅱ , 90. 37% (413/457) in grade Ⅲ. The percentage of positive AO-F was 80.30% (750/934) in patients with hematuria, 52.44% (43/82) in patients without hematuria. The percentage was 79.87% (710/889) when the tumor size was more than 2 cm, 65.35% (83/127) when size less than 2 cm. 83.07% (363/437) sample was positive in multiple tumors, 74.27% (430/579) in single tumor. The percentage was 77.21% (105/136) in tumors involving trigone or neck of bladder, 78.07% (687/880) in tumors without involving these re-gions. There was 69.68% (393/564) in treatment with TURBt, 87.87% (268/305) in partial resec-tion, 91.74% (100/109) in total resection. A good association was observed between stage, grade, hematuria appearance, tumor size, quantity of carcinoma, treatment way and AO-F positive-rate, and a linear correlation was present between grade, stage and positive cytology. There was no significant association between position of the tumor and AO-F positive-rate. Conclusions The function of AO-F is significant in diagnosis of bladder cancer.

To construct a library of mouse single chain variable fragment (scFv) antibody against ofloxacin using phage display and recombinant antibody technique, specific anti-ofloxacin scFv was screened and 3D structure was homology modeling. Total RNA was extracted from hybridoma cell of ofloxacin mAb, and was used to amplify VH and VL gene by RT-PCR using random primer. Then they were linked by a DNA linker encoding (G1y4 Ser) 3 as VH-linker-VL sequence forming scFv by SOE(splicing by overlap extension) PCR. These fragments were inserted into phage T7 after double digestion and transformed with host bacteria BLT5403. 3 ×105 pfu / ml single chain antibody phage libraries were successfully constructed. Four positive phage scFv clones were screened by direct competitive ELISA after four times of enriched procedure in the order of adsorption-elution-amplificatio, 3D structure of specific scFv was homology modeling finally. This research lays a foundation for further massive expression of anti-ofloxacin scFv.

OBJECTIVETo systematically evaluate prostate health index (PHI) in predicting the results of prostate biopsy in the diagnosis of prostate cancer.

METHODSWe retrieved the literature relevant to the value of PHI in predicting prostate cancer at prostate biopsy published from the inception to February 2014 in the databanks of PubMed (1966 - 2014), CNKI (1982 - 2014), VIP (1989 - 2014), and Cochrane Library (1999 - 2014). According to the inclusion and exclusion criteria and retrieval strategies, we extracted the data, evaluated the quality of the included literature, and performed meta-analysis using the Meta-Disc 1.4 software.

RESULTSTotally, 64 articles were identified, of which 52 were excluded and 12 included with 1 430 cases of prostate cancer and 2 159 normal or BPH controls. There was heterogeneity among the included studies. Based on the random effect model, in predicting the results of prostate biopsy in the diagnosis of prostate cancer, serum PHI exhibited a pooled sensitivity of 55.1% (95% CI: 0.525 - 0.577), a pooled specificity of 71.5% (95% CI: 0.695 - 0.734), a positive likelihood ratio (P-LR) of 2.379 (95% CI: 1.922 - 2.943), a negative likelihood ratio (N-LR) of 0.515 (95% CI: 0.428 - 0.619), a diagnosis odds ratio (DOR) of 5.268 (95% CI: 3.870 - 7.170), a summary receiver operating characteristic curve--area under the curve (SROC AUC) of 0.7578, and a Q * index of 0.6999.

CONCLUSIONSerum PHI plays a role of auxiliary diagnosis in detecting prostate cancer and can be used in the prediction of the results of prostate biopsy.

Aged ; Biopsy, Needle ; Humans ; Male ; Middle Aged ; Prostate ; pathology ; Prostatic Neoplasms ; diagnosis ; pathology

PURPOSE: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines for chronic obstructive pulmonary disease (COPD) uses the post-bronchodilator spirometry for diagnosis and severity staging. We evaluated differences in the severity classification of COPD, based on pre- and post-bronchodilator spirometry. MATERIALS AND METHODS: From 2000 to 2004, 207 COPD patients who underwent spirometry before and after inhalation of 400 microg of fenoterol were analyzed. A responder to the bronchodilator test (BDT) was defined by the American Thoracic Society (ATS) as an increase in forced expiratory volume in one second (FEV1) or forced vital capacity > or = 12% and > or = 200 mL, and by the European Respiratory Society (ERS) as an increase in FEV1 > or = 10% of the predicted value. COPD severity was classified according to the 2008 GOLD guidelines. RESULTS: For the entire study population, the FEV1 increased by 11.8 +/- 12.5% of baseline after BDT and 41.1% and 27.1% of subjects were classified as responders using the ATS and ERS criteria, respectively. Based on pre-BDT spirometry, 55, 85, 58, and 9 patients were classified as Stage I-IV COPD, respectively. Sixty-seven (32.4%) patients changed severity staging after BDT, including 20.0%, 28.2%, 44.8%, and 66.7% of pre-BDT patients Stages I through IV, respectively. More ATS or ERS BDT-responders had a change in severity staging than non-responders (52.9% vs. 18.9% and 62.5% vs. 21.2%, both p < 0.001). CONCLUSION: Our data suggest that the severity staging of COPD using pre-BDT spirometry might lead to significant differences as compared to staging, based on post-BDT spirometry, as recommended by the current GOLD guidelines.
Bronchodilator Agents/*diagnostic use ; Fenoterol/diagnostic use ; Forced Expiratory Volume/drug effects ; Humans ; Practice Guidelines as Topic ; Prognosis ; Pulmonary Disease, Chronic Obstructive/*diagnosis ; Spirometry/methods

The prevalence of asthma and allergic disease has increased worldwide over the last few decades. Many common environmental factors are associated with this increase. Several theories have been proposed to account for this trend, especially those concerning the impact of environmental toxicants. The development of the immune system, particularly in the prenatal period, has far-reaching consequences for health during early childhood, and throughout adult life. One underlying mechanism for the increased levels of allergic responses, secondary to exposure, appears to be an imbalance in the T-helper function caused by exposure to the toxicants. Exposure to environmental endocrine-disrupting chemicals can result in dramatic changes in cytokine production, the activity of the immune system, the overall Th1 and Th2 balance, and in mediators of type 1 hypersensitivity mediators, such as IgE. Passive exposure to tobacco smoke is a common risk factor for wheezing and asthma in children. People living in urban areas and close to roads with a high volume of traffic, and high levels of diesel exhaust fumes, have the highest exposure to environmental compounds, and these people are strongly linked with type 1 hypersensitivity disorders and enhanced Th2 responses. These data are consistent with epidemiological research that has consistently detected increased incidences of allergies and asthma in people living in these locations. During recent decades more than 100,000 new chemicals have been used in common consumer products and are released into the everyday environment. Therefore, in this review, we discuss the environmental effects on allergies of indoor and outside exposure.
Adult ; Asthma ; Child ; Humans ; Hypersensitivity ; Immune System ; Immunoglobulin E ; Incidence ; Inflammation* ; Prevalence ; Respiratory Sounds ; Risk Factors ; Smoke ; Smoking ; Tobacco ; Vehicle Emissions

Objective: To analyze the basic thyroid hormone level on long term prognosis and peri-operative recovery in patients after heart transplantation (HT) at the terminal stage of heart failure (HF).
Methods: A total of 270 consecutive patients who received HT at the terminal stage of HF in our hospital from 2009-09 to 2014-07 were retrospectively studied. According to serum levels of thyroid stimulating hormone (TSH), the patients were divided into 3 groups: TSH < 0.55 mIU/L group, TSH (0.55-2.5) mIU/L group and TSH > 2.5 mIU/L group. The peri-operative recovery condition and long term prognosis were observed and compared among 3 groups.
Result: The average age of patients was at (44.58 ± 13.30) years including 228 (84.4%) male and 42 (15.6%) female. The average post-operative follow-up period was (31.88 ± 17.48) months with 100% follow-up rate. There were 41.8% of patients with hypothyroidism, and 46 (17.0%) patients with low T3 syndrome, 56 (20.7%) with subclinical hypothyroidism and 11 (4.1%) with clinical hypothyroidism. The ratio of low level thyroid hormone in HT patients was much higher than general population. For peri-operative recovery, the ICU stay time and mechanical ventilation time were similar among 3 groups,P>0.05, while TSH (0.55-2.50) mIU/L group had the shortest times and TSH > 2.50 mIU/L group had longest times. For long term prognosis, no matter uni-/multi- aviate regression analysis or Kaplan-Meier surviving curve all suggested that TSH > 2.50 mIU/L was the independent risk factor inlfuencing the prognosis of HT patients at the terminal stage of HF. Upon TSH increasing, the patients would have worse prognosis accordingly.
Conclusion: Serum level of TSH > 2.50 mIU/L was the independent risk factor in HT patients at the terminal stage of HF.

Objective To investigate the feasibility of modified rapid Carba NP test for the detection of carbapenemase,and analyze the differences between the modified method and Carba NP test.Methods A total of 264 strains of gram-negative bacillus,including 164 carbapenem-resistant strains and 100 sensitive strains,were collected,and their carbapenemase were detected by Carba NP test and the modified rapid Carba NP test,respectively.The differences between the two tests were evaluated based on PCR as a reference.Results Among 164 carbapenem-resistant strains,carbapenemase gene was detected in 144 strains by PCR.The carbapenemase gene was negative in 100 sensitive strains.Among 164 carbapenem-resistant strains,135 were positive for the Carba NP test,while 130 for the modified rapid Carba NP test.One hundred of sensitive strains were negative for the two Carba NP tests.Compared with the results of PCR,the sensitivity,specificity and Kappa value of the Carba NP test were 91.7％ (132/144),97.5％ (117/120) and 0.886,respectively,while those of the modified rapid Carba NP test were 89.6％ (129/144),99.2％ (119/120) and 0.879,respectively.There was no significant difference in the positive rates between Carba NP test and the modified rapid Carba NP test (x2 =1.45,P ＞ 0.05).Conclusion The modified rapid Carba NP test which has high consistency with the PCR method,is faster and cheaper than the Carba NP test,and may be applied to epidemiologic survey and the early monitoring of nosocomial infections.