Medical wastes are highly risky as infectious substances or hazardous chemical substances, if out of control, will cause serious environmental pollution and spread of diseases, directly jeopardizing human health. In consideration of such hazards of medical wastes, Chinese laws have made strict regulations on their management, which however fall short in terms of their rigorousness. In the era to build a resource-saving and environment-friendly society, it is imperative to establish and improve an effective mechanism for the regulation of medical wastes, to further improve China's legal system of medical waste management and to upgrade the law enforcement on it.

Dyslipidemia is a well-established risk factor for atherosclerosis. Treating dyslipidemia in elderly patients requires specific knowledge and understanding of common dyslipidemias and the relative safety of various pharmacologic agents in the presence of possible multiple comorbidities. Lifestyle modification remains the first step in the treatment of dyslipidemia; however, it can be difficult to sustain and achieve acceptable compliance in the elderly and it is best used in combination with drug therapy. Statins are widely accepted as the first-line therapy. Several recent studies have demonstrated that statins are safe and effective in the elderly. However, it is important to note that there is very limited data regarding the effects of dyslipidemia treatment on morbidity and mortality in patients over 85 years of age. In summary, the clinicians must recognize that the presence of dyslipidemia in the elderly poses substantial risk of coronary events and stroke. The available evidence has demonstrated that in most elderly patients who are at increased risk for cardiovascular morbidity and mortality, treatment of dyslipidemia with appropriate therapy reduces the risk, and when used carefully with close monitoring for safety, the treatment is generally well tolerated. With increasing life expectancy, it is critical for physicians to recognize the importance of detection and treatment of dyslipidemia in the elderly.

Objective To measure the concentrations of antibodies against outer membrane protein P6 and its T-and B-combined antigenic epitopes of nontypeable Haemophilus influenzae ( NTHi) in children and adults of different ages and to evaluate the differences among different subjects for further investigation on NTHi multiple antigenic peptide vaccine .Methods A prokaryotic expression system was established to ex-press the recombinant outer membrane protein P 6 of NTHi.The expressed protein was purified by using Ni-NTA affinity chromatography .T-and B-cell epitopes in protein P6 were predicted with Epitope prediction software 1.0 and ANTIGENIC program and were used to synthesize T-and B-combined antigenic epitopes .A total of 605 subjects aged from 1 day to 103 years old were recruited from October 2013 to March 2014 .Ser-um concentrations of antibodies against protein P 6 and its T-and B-combined antigenic epitopes were meas-ured by using ELISA .Mann-Whitney U test was used to analyze the differences between groups .Pearson product-moment correlation coefficient was used for correlation analysis .Results Four T-and B-combined antigenic epitopes including P 6-2, P6-61, P6-95 and P6-122 were predicted and synthesized .The levels of antibodies against NTHi P6 and P6-2, P6-61, P6-95 and P6-122 were significant lower in the <1 months group than those in the 1-6 months group (all P<0.001) and 7 months-3 years group (all P<0.001).Three groups including 7 months-3 years group , 4-6 years group and 7-14 years group showed significant differ-ences regarding to the antibodies levels , among the 7 months-3 years group showed the highest levels , fol-lowed by the 4-6 years group and the 7-14 years group.However, no significant difference was found be-tween other adjacent groups .Concentrations of antibodies against P 6-2, P6-61, P6-95 and P6-122 were pos-itively correlated with the level of antibody against P 6 (P<0.0001).Conclusion The distribution of anti-bodies against T-and B-combined antigenic epitopes in P6 was highly in accord with those against P6, which indicated good immunogenicity of those epitopes .The highest antibodies levels were found in subjects aged 7 months to 3 years old , which might correlate with the high risk of NTHi infection at that stage .

Objective To investigate the correlation between microembolic signal (MES) and immune inflammation in patients with acute ischemic stroke. Methods The consecutive patients with acute ischemic stroke were enroled. According to the results of MES, they were divided into either a positive group or a negative group. The Immune inflammatory indexes, demographics, and baseline clinical data in both groups were compared. Multivariate logistic regression analysis was used to analyze the independent influencing factors of MES in acute ischemic stroke. Results A total of 237 patients were enroled, including 52 in the MES positive group and 185 in the MES negative group. There were significant differences in the levels of triglyceride (2. 130 ± 0. 933 mmol/L vs. 1. 811 ± 0. 962 mmol/L; t = 2. 126, P = 0. 035), plasma fibrinogen (2. 946 ± 0. 255 g/L vs. 2. 833 ± 0. 322 g/L; t = 2. 332, P = 0. 021 ), Lp-PLA2 level ( 288. 265 ± 27. 855 μg/L vs. 261. 652 ± 29. 961 μg/L; t = 2. 897, P = 0. 004 ), as wel as the proportions of CD4 + CD25high Treg (8. 695% ± 1. 461% vs. 9. 445% ± 1. 397% ; t = 3. 386, P = 0. 001), artery stenosis ≥70% (21. 15% vs. 5. 41% ; χ2 = 10. 592, P = 0. 001 ) and smal arterial occlusive stroke (9. 62% vs. 23. 24% ; χ2 = 4.667, P = 0. 031) between the MES positive group and the MES negative group. Multivariate logistic regression analysis showed that the increased plasma fibrinogen level (odds ratio [OR] 3. 257, 95%confidence interval [CI] 1. 124 - 9. 438; P = 0. 030), artery stenosis ≥ 70% (OR 3. 585, 95% CI 1. 394 -9. 219; P = 0. 008), and the decreased ratio of Treg (OR 3. 801, 95% CI 1. 190 - 12. 148; P = 0. 024) were the independent risk factors for positive MES, and smal arterial occlusive stroke was its independent protective factor (OR 0. 244, 95% CI 0. 072 - 0. 829; P = 0. 024). Conclusions MES may be associated with immune inflammation. The relationship between stroke and immune inflammation should be taken seriously.

OBJECTIVETo investigate the diagnosis, treatment and prognosis of adult prostatic sarcoma.

METHODSThe records of 7 patients with prostate sarcoma were reviewed in the light of clinical manifestation, laboratory examination, therapeutic methods and histological subtypes. Several clinicopathological variables were assessed for prognostic significance.

RESULTSOf the 7 cases, 3 were leiomyosarcoma, 3 rhabdomyosarcoma and the other malignant neurilemoma. Most patients presented urinary obstruction, and the diagnosis of prostate sarcoma was established with ultrasound guided biopsy. Histological subtypes were related to the rate of survival. Two patients received radical cystoprostatectomy and died 13 and 21 months respectively after operation. Two cases underwent total pelvic exenteration, followed by chemotherapy and/or radiotherapy and still alive 15 months after operation. The other 3 received only chemotherapy and/or radiotherapy and died 7 months on average after diagnosis.

CONCLUSIONThe long-term survival rate for adults with prostate sarcoma is low. Early diagnosis and complete surgical resection offer patients the best chance for survival. Long-term surveillance is necessary for the early detection of recurrence.

Adult ; Aged ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prognosis ; Prostatic Neoplasms ; diagnosis ; pathology ; therapy ; Retrospective Studies ; Sarcoma ; diagnosis ; pathology ; therapy

Objective To evaluate the value of simultaneous amplification and testing method for diagnosing in patients with pulmonary tuberculosis.Methods Total of 277 sputum samples were detected by SAT,Lowenstein-Jensen (L-J) culture and Ziehl-neelsen staining.Chi-square test was used to compare and analysis the statistical difference in positive detection rates.The sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of SAT for early diagnosing and judging curative effect were calculated respectively when the clinical diagnosis and L-J culture used as its reference standard.Results The positive detection rates of the three methods for detecting Mycobacterium tuberculosis from the 277 sputum samples were 47.3％ (131/277),30.3％ (84/277),29.6％ (82/277),there was a significant difference between SAT and L-J culture(x2 =16.8,P ＜ 0.05)and Ziehl-neelsen(X2 =18.3,P ＜ 0.05)by chi-square test.Before treatment was commenced,using clinical diagnosis as its reference,the sensitivity,specificity,PPV and NPV of SAT were 59.0％ (95/161),97.4％ (37/38)、99.0％ (95/96) and 35.9％ (37/103) ; After intensive treatment was over,taking culture as its standard,the results were 11/11,64.2％ (43/67),31.4％ (11/35),100％ (43/43).Conclusions SAT can be useful for early diagnosis of clinically suspicious TB case,it has a more sensitive detecting values of SAT for living bacilli and a shorter test period,which implied it can help judging the response to anti-TB treatment.

Objective To study the effect of interferon-gamma release assays (IGRAs) adenosine deaminase activity test (ADA) and tuberculosis antibody test (TB-ab) in diagnosis of tuberculous pleurisy.Materials Sixty-three patients with pleurisy were tested for IGRAs,ADA and tuberculosis antibody.Samples of blood were tested.IGRAs,ADA and tuberculosis antibody were diagnosed according to manufacturer' s instructions.Results Either of the method could detect several patients with tuberculous pleurisy.Tuberculosis antibody showed lowest sensitivity and specificity.In our experiments,ADA test only detected 58.14％ of patients,although specificity can be high.We detected highest percentage of tuberculous pleurisy (79.07％) in blood IGRAs,with a specificity of 70％.Conclusion Blood IGRAs are more effective than blood ADA and tuberculosis antibody test,and it is recommend that IGRAs should be used in diagnosis of tuberculous pleurisy.