Experimental results showed Zn(Ⅱ)-ammonium thiocyanate-hexadocyltrimethylammonium bromide complex was floated in the presence of sodium chloride. There fore Zn(Ⅱ) could be completely separated from Fe(Ⅲ), Co(Ⅱ),Ni(Ⅱ), Mn(ⅡD, Al(Ⅲ) by floation. The method is non-toxic, simple, rapid and economical.

Objective To explore the risk factors of no reflow phenomenon on post-percutaneous coronary intervention(PCI) in patients with acute myocardial infarction (AMI).Methods The clinical data of 268 patients with AMI who performed emergency PCI were collected and divided into normal group(normal flow) and no-reflow group (no flow).The risk factors of predicting the occurrence of no reflow phenomenon were screened by univariate and multivariate analysis.Results Thirty-two cases (11.9％) of 268 patients had flow occurrence and 236 cases(88.1％) were with no flow occurrence.There were significantly statistical differences between the two groups in terms of angina pectoris history before infarction,white blood cell count (WBC),history of oral of stains,administration of 600 mg of plavix before the operation,creatinine kinase,MB isoenzyme (CK-MB),C-reactive protein (CRP),Low density lipoprotein(LDL),time of coronary artery perfusion,numbers of balloons used during PCI and Killip ≥ grade 2 (all P ＜ 0.05).The multivariate logistic regression model analysis displayed that Killip ≥ grade 2 (odds ratio (OR) =1.237,95％ confidence interval (95％ CI) 1.049 -2.264,P=0.021),history of oral of stains(OR=2.355,95％CI 1.547-3.438,P＜0.001),WBC ≥ 12× 109/L (OR =4.139,95％ CI 2.273-8.451,P＜0.001),no administration of 600 mg of plavix before the procedure (OR =2.645,95％CI 1.628-5.246,P＞0.005) and no angina pectoris history before infarction(OR=1.413,95％CI 1.150-2.426,P＜0.001) were independent risk factors regarding of causing no reflow phenomenon.Conclusion The factors including Killip ≥ grade 2,history of oral of stains,WBC ≥ 12× 109/L,no administration of 600 mg of plavix before theoperation and no angina pectoris history before infarction were independent risk factors in terms of causing no reflow phenomenon.

Objective To observe the effects of insulin pump therapy on type 1 diabetes mellitus children with diabetic keto or diabetic ketoa-cidosis(DK/DKA).Methods Forty-three children with DK/DKA were randomly divided into treatment group(n=26)and control group(n=17).The patients in treatment group were treated with insulin pump,control group were received small amount insulin injravenous injection.The changs of blood sugar,urine ketone bodies,incidence of hypoglycemia and length of stay were observed.Results 1.The effect of decreasing sugar was the same between two groups.2.There was no hypoglycemia events in treatment group.But 2 cases in control group had hypoglycemia.3.There was significant difference of length of stay between two groups(P

Objective To study the practicality and repeatability of B-mode ultrasonography on diagnosis and score of carotid atherosclerosis. Methods Ninety-nine B-mode ultrasonography pictures of carotid atherosclerosis were obtained from field investigation. According to the established standard(normal scored as 0, other scored as 1 - 7 by the severity), the 99 pictures were diagnosed and scored once together by three trained inexperienced members of the research team. Ten days later, these pictures were diagnosed and scored respectively, by the three members.The diagnostic results were analyzed with statistical methods to test the feasibility and repeatability of this set of diagnostic and scoring system. Results The joint diagnostic results by the three group members were regard as standard with scores 0 in 27 cases, 1 in 27 cases, 2 in 10 cases, 3 in 4 cases, 4 in 13 cases, 5 in 8 cases, 6 in 6 cases, and 7 in 4 cases. Independent diagnostic results by member A was 0 in 29 cases, 1 in 24 cases, 2 in 11 cases, 3 in 2 cases, 4 in 12 cases, 5 in 11 cases, 6 in 6 cases, and 7 in 4 cases. Independent diagnostic results by member B was 0 in 29 cases, 1 in 22 cases, 2 in 14 cases, 3 in 4 cases, 4 in 13 cases, 5 in 5 cases, 6 in 8 cases, and 7 in 4 cases. Independent diagnostic results by member C was 0 in 28 cases, 1 in 25 cases, 2 in 8 cases, 3 in 5 cases, 4 in 14 cases, 5 in 10 cases, 6 in 4 cases, and 7 in 5 cases. Comparison of the 4 diagnostic scores, the difference was not statistically significant(F = 0.019, P ＞ 0.05). Joint diagnostic results of the three members were compared with the standard and correlation coefficient were 0.977,0.987,0.932, respectively(all P ＜ 0.01 ). The correlation coefficient of diagnostic results of each member were 0.969,0.935,0.928, respectively (all P ＜0.01 ). Diagnostic results of each member were consistent with the standard and the compliance rate were 88.9% (88/99) ,90.9%(90/99) and 86.9%(86/99), respectively. Conclusions B-mode ultrasonography is a non-injure method for diagnosis of carotid atherosclerosis in epidemiology investigation. The method is easy to grasp and has a good repeatability.

Objective To study relationships between myocardial injury and the levels of serum complement C3, C4 and C5b-9 in patients with acute coronary syndrome (ACS). Methods A retrospectively analysis was conducted. 170 ACS patients [including 110 cases of ST-segment elevation myocardial infarction (STEMI) and 60 cases of non-ST-segment elevation acute coronary syndrome (NSTE-ACS)] with ischemic chest pain or chest discomfort onset within the prior 12 hours admitted to the cardiology department of Tianjin Union Medicine Center from January 2014 to July 2016 were enrolled. Thirty-six healthy cases were enrolled as control during the same time. The levels of serum complement C3, C4 and C5b-9 on 1, 3 and 7 days after admission and myocardial function indicators were analyzed. Major adverse cardiovascular events (MACE) and readmission rate were analyzed after 1 year follow-up. The correlation between serum complement levels and myocardial function indicators was analyzed by Pearson correlation analysis. Results ① The levels of serum C3, C4 and C5b-9 on the first day in NSTE-ACS group and STEMI group were significantly higher than control group [C3 (g/L): 1.04±0.33, 1.26±0.35 vs. 0.39±0.21, C4 (g/L): 0.31±0.14, 0.33±0.10 vs. 0.19±0.07, C5b-9 (g/L): 575.46±197.26, 659.26±160.77 vs. 501.40±141.51, all P < 0.05]. There were no changes of serum C3, C4 in NSTE-ACS group, but C5b-9 decreased after a peak (g/L: 700.63±218.42) at 3 days. Serum complements in STEMI group reached peak on the third day [C3 (g/L): 1.37±0.33, C4 (g/L): 0.42±0.12, C5b-9 (g/L): 754.72±136.22]. The levels of serum C4 and C5b-9 in STEMI group were higher than NSTE-ACS group on the third and seventh day. ② The levels of troponin T (TnT), creatine kinase-MB (CK-MB), solution intercellular adhesion molecule-1 (sICAM-1), global registry of acute coronary events (GRACE) scores and percutaneous coronary intervention (PCI) numbers in STEMI group were significantly higher than those in the NSTE-ACS group, which were as opposite as left ventricular ejection fraction (LVEF). However, there were no significant differences in levels of serum N-terminal pro-brain nitric peptide (NT-proBNP), Fibrinogen (Fib), readmission rate and incidence of MACE between STEMI and NSTE-ACS groups. ③ According to GRACE, patients with ACS were divided into low risk group (≤ 108 scores, 26 cases), intermediate risk group (109-140 scores, 61 cases) and highest group (> 140 scores, 83 cases). TnT and sICAM-1 in intermediate risk group were significantly increased as compared with low risk group. Levels of TnT, sICAM-1, C3, C4 and C5b-9 in the highest group were significantly higher than the low and intermediate risk groups, however the lowest LVEF was found in the highest group. ④ It was shown by Pearson correlation analyses that levels of serum C3, C4, C5b-9 were positively correlated with TnT (r value was 0.481, 0.367, 0.292, respectively, all P <0.01), sICAM-1 (r value was 0.298, 0.249, 0.365, respectively, all P < 0.01), but negatively correlated with LVEF (r value was -0.384, -0.260, -0.200, respectively, all P < 0.01). In addition sICAM-1 positively correlated with TnT (r = 0.536, P = 0.000), but negatively correlated with LVEF (r = -0.341, P = 0.001). Conclusions Serum complements activation was found in the acute phase of ACS patients. Serum complement C3, C4 and C5b-9 are involved in the process of myocardial injury, and may reflect severity of myocardial injury and cardiac dysfunction.

Diabetes mellitus is a worldwide public health problem,which is a serious threat to human health.WHO released the global diabetes report shows Chinese incidence of type 2 diabetes was explosive growth in the past few decades,but public awareness of diabetes is generally inadequate,especially at the grassroots level.Therefore,it is imperative to regulate the basic level of diabetes diagnosis and treatment.As one of the basic measures of diabetes treatment in our country,education and management of diabetes' foundation is weak,mainly for the lack of national basic medical and health institutions,dull form of education and lack of target,shortages of specialized diabetes staff.So in order to safeguards the success of primary diabetes education and management and improve the prevention of primary diabetes,it is necessary to establish a sound mechanism of reward system,make full use of various payment platform,strengthen the basic management of diabetes monitoring information construction and carry out the Internet education measures.This article reviews the current situation of education and management of primary diabetes.

Objective To investigate the guidance of a new classification on the treatment methods selection for cystic dilation of bile duct (CDBD).Methods The clinical data of 213 patients with CDBD who received treatment according to the Todani 2003 classification at the Peking Union medical College Hospital from September 1968 to July 2013 were retrospectively analyzed.The CDBD was reclassified with a new classification proposed by Dong Jiahong et al,and the guidance of the new classification on the treatment methods selection for CDBD was analyzed.Patients were followed up via out-patient examination and telephone interview till August 2013.Results Of the 213 patients,139 were with Todani type Ⅰ CDBD (type C CDBD of the new classification) ; 3 were with Todani type Ⅱ CDBD (type C1 CDBD of the new classification) ; 1 was with Todani type Ⅲ CDBD (type E CDBD of the new classification); 52 were with Todani type Ⅳa CDBD (35 with type D1 and 17 with type D2 CDBD of the new classification) ; 1 was with Todani type Ⅳb CDBD (type C CDBD of the new classification) ; 8 were with Todani typeⅤ-Ⅰ CDBD (type B CDBD of the new classification) ; 9 were with Todani type Ⅴ-Ⅱ CDBD (type A CDBD of the new classification).Eighteen patients did not receive the surgical treatment.Of the 195 patients who received surgical treatment,patients with type C and D CDBD of the new classification took a large proportion.Patients with type C CDBD of the new classification received cystectomy,biliary cyst resection,Rouxen-Y cholangiojejunostomy or internal drainage.Patients with type D CDBD of the new classification received extrahepatic biliary cyst resection,Roux-en-Y cholangiojejunostomy.Patients with severe intrahepatic disease and with type D1 CDBD of the new classification received concomitant left hemihepatectomy or pancreaticoduodenectomy.Patients with type A1 CDBD of the new classification received right hemihepatectomy.Patients with type A2 CDBD of the new classification were cured by conservative treatment after split liver transplantation.Patients with type B1 CDBD of the new classification received left hemihepatectomy and Roux-en-Y cholangiojejunostomy.Patients with type B2 CDBD of the new classification received bile duct stone extraction.There was 1 patient with type E CDBD,and partial resection of the CDBD ± bile duct reconstruction was carried out.Pancreatic fistula,biliary fistula,reflux cholangitis,cholangitis and anastomotic stricture were detected on 74 patients,and they were cured by conservative treatment or lithotomy.A total of 187 patients were followed up with the median time of 85 months (range,1-432 months).One hundred of seventy-five patients recovered well,and 12 patients with canceration of the bile duct died of tumor metastasis at postoperative 1-282 months.Conclusion This new classification simplifies the typing of extrahepatic bile duct dilation,refines the typing of intrahepatic bile duct dilation,and has better guidance for surgical treatment.

Objective To understand the genetic characterization of HA1 gene of influenza A H3N2 viruses circulated in recent years in Hebei.Methods Viral RNAs of 25 H3N2 strains were extracted and amplified by Reverse Transcription Polymerase Chain Reaction (RT-PCR).The products of PCR were purified and sequenced,and the sequences were analyzed though biometic software.Results Several amino acid substitutions located in antigenic sites or receptor binding sites were found more in the isolates than the current vaccine virus or the isolates from previous year.Amino acid substitution was found in 3,140,142,144,145,158,159,189,192,193,198,204,225,226 and 227 positions in the isolates during 2003-2008,more amino acid substitutions took place in antigenic determinant A,B and receptor binding site (RBS).New phylogenetic branches appeared continuously during 2003-2008.The H3N2 strains of the same year almost clustered in the same group on the phylogenetic tree.Conclusions Amino acid substitutions continuously occurred in the HA1 genes in influenza A H3N2 viruses isolated in Hebei from 2003 to 2008,it is meaningful to pay close attention to the HA1 variation in order to prevent and control influenza.