Objective To evaluate the clinical significance of QT dispersion (QTd),QTcd in dilated cardiomyopathy(DCM).Methods QTd and QTcd on simultaneous recording 12 lead ECG in 60 DCM cases were measured and compared with 60 healthy subjects.Results QTd and QTcd in DCM group were remarkably higher than those in control group (P

Human epidermal growth factor receptor 2 (HER-2/neu) is an important prognostic predictor and the key predictor of anti-HER-2 therapy of breast cancer. Accurate testing of HER-2 status for breast cancer patients is important in clinical practice. As of this writing, the American Society of Clinical Oncology and the College of American Pathologists recommend three methods for HER-2 detection, namely, immunohistochemistry, fluorescence in situ hybridization, and bright-field in situ hybridization. The abovementioned methods have their own advantages and disadvantages. New methods, such as multiplex ligation-dependent probe amplification, quantitative reverse transcription polymerase chain reaction, and RNA in situ hybridization, are currently applied to detect HER-2 status. New technologies not only make up for the shortcomings of routine methods but also have unique benefits that can meet the demands for HER-2 testing of some breast cancer patients. Thus, these methods are promising for clinical applications and can improve clinical diagnosis and treatment. The characteristics, advantages, and drawbacks of these technologies are introduced and reviewed in this paper.

1727 arterial blood gas samples of 341 cases of acyanotic congenitla heart diseases,79 cases of cyanotic congenital heart diseases and 88 cases of acquired heart diseases during cardio-pulmonary bypass surgery were analyzed.It was found that there were various degrees of acid-base disorders right before the bypass was on.During the speration,acid-base imbalance was aggravated because of anesthesia,fluid infusion,hypothermia,surgical manipulation,etc.Respiratory alkalosis was most common to occur,and metabolic acidosis was the secodn.After the cessation of bypass,acid-base disorders could be significantly alleviated or imporved.So it is belived that it is very important to monitor the changes of blood gases and acid-base balance and to manage timely the complications during cardiopulmonary bypass.Fluid infusion,administration of agents to improve the microcirculation.and replacement of alkaline electrolytes are helpful to maintain acid-base balance.

Objective To observe the changes in contents of ? 1 Microglobulin (? 1 M) in urine after exposure to acceleration of different speeds(+Gz) in order to provide scientific indications for efficient protection for pilots under high +Gz acceleration and efficient flight health service support. Methods Six healthy men were subjected to the following experiments: ①pressurized anti G suit (KH X); ②pressure breathing for +Gz (PBG); ③pressurized anti G suit and PBG and AGSM (up to +9Gz for 10 s). Urine samples were collected before, immediately after, 30 minutes and 24 hour after the exposures for the determination of ? 1 microgolbulin (? 1 M). Results It was found that ①The G tolerances of subjects under 3 conditions were (6 25?0 52) G/10s, (8 17?0 26) G/10s, 6 5G/30s, and 9 00 G/10s, respectively. ②30 minutes after each series of exposure, the contents of ? 1 M in urine samples were increased ( P

Objective To evaluate the specificity of Architect chemiluminescence immunoassay ( CLIA) for diagnosis of syphilis in the clinical screening test.Methods 65 774 syphilis specific antibody results in the Beijing Tongren Hospital were retrospectively analyzed.In this study, Architect CLIA for diagnosis of syphilis was used as a screening test for the pre-operative patients from August 2011 to July 2012.All the repeatedly reactive samples were tested by the tolulized red unheated serum test ( TRUST) and Treponema pallidum particle agglutination ( TPPA) assay.Samples with with discordant results were verified by western blot ( WB) Finally, all the results were statistically analyzed by software SPSS 17.0.Results Among 65 774 samples, 940 (1.43%) were found to be repeatedly reactive using the Architect CLIA.Of these sera, 330 ( 35.11%) were reactive and 610 ( 64.89%) were nonreactive by TRUST.Because a TRUST titer of 1:1was not always sufficient to confirm a TPPA reactive result, all the samples with CLIA reactive results were finally performed by TPPA assays.The results showed that 843 ( 89.68%) were positive and 97 (10.32%) were negative.After arbitrated by the WB, out of 97 TPPA negative sera, 18 (18.56%) were positive;7(7.22%) were indeterminate and 72(74.23%) were negative.Conclusions The specificity of Architect CLIA for diagnosis of syphilis was 99.89%.The results showed that confirmation by TPPA on sera with screening test for syphilis by Architect CLIA effectively decreased the false-positive results and could be suitable for a routine supplementary for syphilis.However, if necessary, the WB should be further utilized.

Objective To assess the safety and effect of intraoperative cell salvage (ICS) during cesarean section.Methods This was a case-control study in which 60 gravidas who received ICS (ICS group) and 60 gravidas who received allogenic transfusion (control group) during caesarean section in Obstetrics and Gynecology Hospital of Fudan University during January 2014 to December 2016 were enrolled.Subjects in the two groups were matched in age,gestational age,gestational complications (placenta increta,placenta previa,scarred uterine,leiomyomas and anemia) and hemorrhagic volume during cesarean section.Several indicators including complications of transfusion,postoperative recovery,expense of transfusion,as well as the complete blood count and body temperature before and after operation were compared between the two groups.T,rank-sum or Chi-square test was used for statistical analysis.Results (1) No significant difference in age,gestational age,twin gestation,complications,preoperative body temperature,or the volume of hemorrhage or transfusion was observed between the two groups (all P＞0.05).(2) The autotransfusion volume was 385 (161-583) ml in the ICS group.Fifteen cases (20.0％) in the ICS group also received additional transfusions of leukocyte-reduced red blood cell (RBC) suspension,fresh frozen plasma and cryoprecipitate and two cases (3.3％) received additional transfusions of leukocyte reduced RBC suspension and fresh frozen plasma.The two groups showed no significant difference in the cost of transfusion or per-capita transfusion volume of fresh frozen plasma or cryoprecipitate.However,the transfusion volume of leukocyte-reduced RBC suspension was lower in the ICS group as compared with that in the control group [M(P25-P75),1.9 (1.5-4.5) vs 4.1 (2.8-6.2) U,Z=-2.800,P=0.005].(3) There was no significant difference in complete blood count or coagulation function between the two groups before the operation.White blood cell (WBC) counts in the two groups were elevated following operation.Postoperative WBC count in the control group was higher than that in the ICS group,while the levels of RBC and hemoglobin were lower than those in the ICS group following operation (all P＜0.05).(4) No amniotic fluid embolism was reported in the two groups.Only one case of rash was reported in the ICS group,which was fewer than the transfusion reactions occurred in the control group [1.7％ (1/60) vs 13.3％ (8/60),x2=5.886,P=0.016].(5) The two groups showed no significant difference in preoperative temperature,the highest temperature within three days after operation or incision healing.Compared with the patients in the control group,those in the ICS group had shorter hospital stay [(4.7± 1.1) vs (6.3 ±1.8) d,t=3.341,P＜0.05].Conclusion ICS is a safe and effective measure for gravidas at higher risk of hemorrhage during cesarean section.

Objective　To find out the morbidity and main pathogens of ventilator-associated pneumonia(VAP) in PICU.Methods　44 VAP cases were reviewed.Results　44 VAP cases were diagnosed and analyzed from 1998, 2 to 2001,1,the morbidity of VAP was 69.8%.The predominant pathogen was Pseudomonas aeruginosa.Conclusion　It has reference value in consideri ng the possible pathogens of pneumonia.

Adolescent ; Adult ; Burns, Chemical ; Eye Burns ; Fisheries ; Humans ; Hydrogen Sulfide ; Middle Aged ; Occupational Injuries ; Young Adult

Objective To analyze thyroid papillary carcinoma (PTMC) neck lymph node metastasis (LNM) related factors,and further to explore the diagnostic value of ultrasonography in LNM.Methods A retrospective analysis of 384 cases of patients with PTMC confirmed by pathology and ultrasonic data were performed,according to the presence of cervical lymph node metastasis,they were divided into transfer group (116 cases) and nontransfer group (268 cases).Analysis was made to summarize the clinical and sonographic features of the two groups.Chi-square test and the multi-factor Logistic regression analysis were used to study the risk factors.Results ①The single factor analysis of sonographic features showed that the factors of gender (X 2 = 3.893,P = 0.048),age (P = 0.001),tumor diameter (P = 0.008), boundary(X 2 =6.327,P =0.012),acoustic halo (X2 = 15.562,P =0.001),and place (X 2 =9.441 ,P =0.024) were statistical different between the two groups;②Multiariable Logistic regression analysis showed that:patient age,tumor diameter,and acoustic halo were independent risk factors for PTMC neck lymph node metastasis,if Logistic model was used to predict the probability P =0.50 as a threshold,its accuracy was 74.2%,and the area under the ROC curve was 0.744.Conclusions Patients with age ≤ 45 years, tumor diameter ≥ 0.7 cm,located in the lower pole,boundary with uneven acoustic halo,were prone to LNM,and easy to Ⅵ area,suggest preventive cleaning lymph node in central region.

Objective To establish a real-time quantitative reverse-transcription PCR ( qRT-PCR) method for detection of hepatitis E virus ( HEV) of different genotypes based on standard HEV DNA plasmid in order to promote its application in clinical laboratory. Methods Specific primers and probe of HEV were designed based on the conserved open reading frame 3 (ORF3) regions. HEV DNA plasmids were construc-ted and 10-fold serial dilutions of the plasmids were prepared and used as standards to establish one-step qRT-PCR. The established method was compared with HEV antigen, antibody and RT-nPCR assays. Some positive samples were sequenced and analyzed by evolutionary tree. Results The one-step qRT-PCR meth-od for HEV detection in serum or feces samples was successfully establish. It could reach a sensitivity of 25 copies/test and 77. 8% of its results were consistent with those by HEV antigen assay. Nine patients were infected with HEV of genotypes 4a, 4d or 4n as indicated by evolutionary tree. Conclusion The HEV qRT-PCR method based on its standard plasmid is successfully established, which paves the way for commercial-ization of clinical applications.