Objective To explore the value of combined application of qualitative detection of TB-DNA serum anti-PPD-IgG and acid-fast staining methods in the diagnosis of tuberculosis infection .Methods Totally 278 pulmonary tuberculosis patients and 121 non-pulmonary tuberculosis patients were collected from Qingyuan people′s hospital during the period from January 2013 to June 2015 .Tuberculosis in patients with TB-DNA qualitative and serum anti-PPD-IgG and acid-fast staining test results was analyzed . Sputum TB-DNA qualitative and serum anti-PPD-IgG detection and joint application of acid-fast staining in the diagnosis of tuber-culosis infection .Results Sensitivities of acid-fast staining ,TB-DNA and serum anti-PPD-IgG in the TB group were 32 .01% , 51 .44% and 48 .56% respectively .The detectable rate of combining TB-DNA with serum PPD-IgG was 67 .63% .The detectable rate of combining TB-DNA with acid-fast staining was 54 .68% .The detectable rate of combining serum anti-PPD-IgG with acid-fast combined rate was 57 .55% .The detectable rate of combining three assays improved to 68 .71% .Conclusion Serum anti-PPD-IgG detection in the diagnosis of tuberculosis is simple ,effective ,qualitative detection of acid-fast staining sensitivity better than TB-DNA ,but it had a poor specificity .Bacteriologic diagnosis are tuberculosis diagnostic gold standard,but the detectable rate for acid-fast bacilli is low .The qualitative of TB-DNA test had a better sensitivity and specificity than other two assay .Combining with three assays could increase detectable rate and improve diagnosis of tuberculosis disease .

The financial objective of the health non-operating state-owned assets(NSA) value-running is defined as non-profit, an empirical test is designed; the non-profit objective function and for-profit objective function is established and the impact of fix asset and staff cost on financial objective in multiple regression functions are compared.

Objective To investigate the clinical features and prognosis of adult dermatomyositis with gastrointestinal bleeding and perforation. Methods The clinical data of a adult dermatomyositis with gastrointestinal bleeding and perforation were retrospectively analyzed. And the clinical characteristics of this patient were analyzed, combined with 7 cases reported in the literature. Results Among the 8 cases, 6 cases were females and 2 cases were males, aged 18 to 63 years. The 5 cases had melena, 3 cases had hematemesis, 3 cases had hematochezia and 1 case had hemoptysis. The main treatment was glucocorticoids, immunosuppressive agent, intravenous immune globulin (IVIG), endoscopic hemostasis and angiographic embolization. Four of the 8 cases died. Conclusions Adult dermatomyositis with gastrointestinal bleeding and perforation is rare, but the condition is dangerous and the mortality is high. Dermatomyositis with early onset of abdominal pain, vomiting, melena should be alert to serious complications such as gastrointestinal bleeding and perforation.

Epigenesis, Genetic ; Epigenomics ; Humans

Obstructive sleep apnea (OSA),the most common type of sleep disordered breathing was closely associated with the occurrence of ischemic stroke.It has been demonstrated that OSA is an independent risk factor for ischemic stroke.Its pathogenic mechanism includes atherosclerosis,coagulation abnormalities and cerebral hemodynamic changes caused by long-term periodic hypoxia hypoxemia and hypercapnia.The prognosis of ischemic stroke patients with OSA is poor.Therefore,it needs to be treated early to avoid further damage to brain tissue and reduce the mortality.

Objective To evaluate the change of left ventricular(LV) function by real-time three dimensional echocardiography(RT-3DE) and to explore the clinical value of change of serum adiponectin level in patients with metabolic syndrome (MS).Methods One hundred and twenty patients were divided into MS group and control group according to the diagnostic standard of the nternational Diabetes Federation.Transthorasic 2D ultrasound and RT-3DE examination were performed in all study objects, and serum adiponectin levels were measured.Results Parameter index [including Tmsv16-SD, Tmsv12-SD,Tmsv16- Dif, Tmsv12-Dif, Tmsv16-SD (％), Tmsv 12-SD (％), Tmsv16-Dif (％), Tmsv12-Dif (％)] of 17segment time to minimal systolic volume in MS group was more than that in control group (all P ＜0.05).Some regional systolic index of LV and serum adiponectin level were less than that in control group (all P ＜0.05).Compared with the control group, E/E' was lower (P ＜ 0.05).There were significant relations between serum adiponectin level and E/A of mitral valves, E'/A' of mitral annulus and E/E'(r = 0.368,0.493,and -0.347 respectively, P ＜0.05).Conclusions RT-3DE can rapidly evaluate LV systolic and diastolic synchrony in MS patients.E/E' show an excellent correlation with serum adiponectin level,and it may be a new promising method for routine evaluation of LV diastolic function.

BACKGROUND:Neurotrophic factors have been conformed to have the effects of promoting the survival, differentiation and axonal regeneration of the injured neurons, so that the structural integrity of the injured spinal cord can be reserved as much as possible.OBJECTIVE: To observe the effects of nerve growth factor (NGF) on the neural regeneration and motor function following spinal cord injury in rats.DESIGN: A randomized controlled observation.SETTING: Department of Neurology, Union Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: Thirty healthy adult male Wistar rats of common degree, were provided by the Experimental Animal Center, Tongji Medical College of Huazhong University of Science and Technology.METHODS:The experiment was carried out in the Department of Neurology, Union Hospital of Tongji Medical College,Huazhong University of Science and Technology. The 30 rats were randomly divided into NGF-treated group (n=15) and control group (n=15). ① T8 spinal injury was induced by the improved Allen method. ③ The improved Rivlin method (namely, slope test) was used to assess the motor function following spinal cord injury in rats before model establishment and at 3 days, 1, 2 and 3 weeks after treatment respectively. ④ At 2 days and 3 weeks postoperatively, 7 rats in the NGF-treated group and 8 rats in the control group were selated and the cross-sectional tissue(0.5 cm) of the injured spinal cord was removed, fixed in neutral formalin, dehydrated, and embedded with paraffin, and then cut into 5 μm sections.MAIN OUTCOME MEASURES:① The results of the slope test before model establishment and at 3 days,1, 2 and 3weeks after treatment respectively; ② Axonal count in white matter at 2 days and 3 weeks after model establishment.RESULTS:① The scores of slope test after spinal cord injury at 1, 2 and 3 weeks postoperatively in the NGF-treated group were obviously higher than those in the control group [(45.2±3.2), (51.2±3.8), (53.4±4.6)°; (45.2±3.2), (51.2±3.8),(53.4±4.6)°, P ＜ 0.05].② At 3 weeks after treatment, a few dispersal and heterogeneous NGF200 spots were observed in the white matter of rats in the control group, but there were plentiful and symmetrical NGF200 spots in the NGF-treated group. The axonal count in white matter at 3 weeks following spinal cord injury in the NGF-treated group was obviously higher than that in the control group (363.6±34.2, 187.5±32.1, P＜ 0.05).CONCLUSION:NGF can promote the neural regeneration following spinal cord injury to a certain extent, and help to im prove the functional recovery.

Many studies have confirmed that thyroid hormone (TH) and mitochondria have protective effects on myocardium. The partial subtype of sirtuins (SIRTs) can also be able to protect myocardium by mitochondria, which includes improving ischemia reperfusion injury, improving the pathological cardiac hypertrophy and improvement of heart failure. SIRTs can achieve the protective effect for myocardium mainly through inhibiting mitochondrial permeability transition pore and mitochondrial membrane permeabilization, maintaining balance of regulation of mitochondrial morphology, promoting mitochondrial biogenesis, maintaining the function of autophagy of impaired mitochondria. At the same time, there is an interaction between TH and SIRTs. At present, the role of mitochondria has become more and more concerned in apoptosis and necrosis and its protective effect on cells. This review summarized the protective effect of SIRTs on myocardium through mitochondrial and the influence of the interaction between SIRTs and TH on myocardial protection of mitochondrial.

[Summary] Glucose homeostasis is precisely regulated by glucagon of pancreaticαcell and insulin ofβcell secretion.Diabetes is a chronic disease characterized by insulin deficiency or insulin resistance (IR). Absolute or relative excess of glucagon secretion may play an important role in the development of diabetes.Previously more studies on the functions of islet βcells were reported,but less on islet αcells. There are a variety of factors involved in the regulation of glucagon secretion,such as nutrients,endocrine hormones and neurotransmitters. High fasting and postprandial blood glucose in patients with diabetes are associated with increased glucagon.Isletαcell dysfunction is closely related to the development of diabetes and the ability of responding to hypoglycemia.Further studies of α cell function and its role on the development of diabetes could provide insight into the treatment of diabetes.

Objective To evaluate the long-term prognostic capacity of the SYNTAX score Ⅱ(SxScore Ⅱ) and SYNTAX score (SxScore) in patients undergoing left main percutaneous coronary intervention (LM-PCI). Methods A total of 209 patients undergoing unprotected LM-PCI in the Cardiology Department of the Affiliated Hospital of PAP of Logistic College were prospectively collected. Follow up was carried out by telephone or outpatient or rehospitalization. The clinical endpoint focused on MACCE after PCI including composite death, nonfatal myocardial infarction, target vessel revascularization and stroke. The secondary endpoint included cardiac death and stent thrombosis. The SxScore and SxScoreⅡ were retrospectively calculated according to results of coronary angiography and clinical features of patients. Patients were stratified according to tertiles of low (≤22), intermediate (23-32), and high (≥33). The clinical data were comparedbetween three groups. The predictive ability of two scoring systems to MACCE after PCI was compared by COX regression evaluation. Results In 209 patients, 12 patients were lost to follow-up (5.7%), and the median follow-up was 30.2 months, 56 cases (28.4%) were observed to suffer from MACCE. The incidence rates of MACCE were 19.0%, 28.6%and 44.4%in SxScore low, intermediate and high groups respectively. The incidence rates of MACCE were 12.8%, 23.8%and 45.5%in SxScoreⅡlow, intermediate and high groups respectively. Single factor analysis showed that SxScore, SxScoreⅡ, age, diabetes and left ventricular ejection fraction (LVEF) were the independent predictors of MACCE. Multivariate analysis showed that SxScore and SxScoreⅡwere still risk independent predictors for MACCE. Conclusion Both SxScore and SxScoreⅡare independent risk predictors for MACCE in patients with unprotected left main coronary artery disease undergoing PCI treatment.