Objective To study the influence of procalcitonin (PCT)on the prognosis in the patients with acute coronary syn-drome(ACS)to provide the basis for clinic treatment.Methods 210 cases of ACS treated in our hospital from May 2013 to May 2014 were selected and divided into the group A (n=121),B (n=49)and C (n=40)according to their PCT levels,the group A:PCT≤0.05 ng/mL,the group B:0.05

New oral anticoagulants,including direct thrombin inhibitors and factor Xa inhibitors.They have overcome several shortcomings of warfarin.The efficacy of preventing stroke and systemic embolism is superior to or not inferior to warfarin in patients with non-valvular atrial fibrilhtion,and they can decrease the risk of bleeding (especially intracranial hemorrhage).However,no agent can efficiently reverse its anticoagulant effect now.This article reviews the pharmacological characteristics,clinical efficacy,complications,and its management of the commonly used new oral anticoagulants at present.

Objective To study the clinical application oflaparoscopic-assisted operation to colorectal neoplasms. Methods 28 cases of colorectal neoplasms underwent laparoscopic surgery from July 1997 to November 2000. The mean age was 65.3 years old(33～89)years.3 cases underwent right hemicolectomy.1 case of sigmoid colon adenoma was given partial colectomy. Sigmoid-rectal anterior resection was conducted in 21 cases. 3 cases underwent abdominal peritonieal resection. Results 5 cases were converted to open laparotomy.The mean operative time was 178(150～300)min for 23 cases given laparoscopic surgery with 135(30～1000)ml of average intraoperative bleeding. Neither postoperative complications nor intraoperative deaths occurred.1 case of low portion rectal cancer showed abdominal metastasis 12 months after surgery.Neither port site nor incision metastasis happened. Conclusions Laparoscopic assisted surgery has the advantages of less surgical trauma,less gastrointestinal interference and quicker recovery. Under the circumstances of radical resection and selected candidate,laparoscopic assisted surgery can be applied to colorectal neoplasms.

Objective To discuss the illness mechanism and the reason of defective energy of the stomach and intestines with acute panereatitis.Method 43 cases of acute pancreatitis was studied which had the stomach and intestinal insufficiency to determine lesion degree of the stomach and intestines acording to the change of abdomen signs.Results The data found that the patient of light acute pancreatitis had light abdominal distention,cirumscribed abdominal tenderness and rebounding pain,weaken gurgling sound;most advanced acute pancreatitis had severe abdominal distention,abdominal tenderness and rebounding pain,almost no gurgling sound.Conclusion Abdominal sign could be a indicator to determine patient's condition of acute pancreatitis and a standard to diagnose acute pancreatitis.

Aim: To set a suitable route for efficient expression and purification of recombinant hyaluronan syn-thase from Pasteurella multocida (rPmH AS). Methods: Coding sequences were cloned and expressed in Esche-richia coli strain of BL-21( DE3). Then rPmHAS was purified through a simple Ni-affinity chromatography and identified by hyaluronic acid binding protein ( HABP) based ELISA assay. Results: High yield expression of functional rPmHAS exceeding the highest production reported hitherto was achieved, and the purity of rPmHAS was as high as 90%. Conclusion: In this study, an optimized system of the expression, purification and identifica-tion route for large scale preparation of rPmHAS was established, which will be helpful for accelerating further study of PmHAS and facilitating fine researches on peculiar hyaluronic acid with special properties.

Objective To study the epidemic characters and tendency of HIV/AIDS (Human immunodeficiency virus/ Acquired immunodeficiency syndrome) from serologic check results.Methods 36 021 specimens of suspected clinical cases and routine cases before surgery in Xinjiang Urumqi Uiger Municipal People's Hospital were detected from 2001—2004. At first, these cases werescreened by ELISA(Enzyme-linked immunoadsordent assay) , then ascertained by desease-control center and AIDS surveillance systems through WB , HIV RNA were estimated by the application of RT-PCR , CD cell were counted with flow cytometry.Result Prevalence figures have risen sharply from 1999—2001 and increased steadily since 2002 , the positive rates of anti-HIV were 0.714%(259 cases) . 38 percents cases were female (97/259), female ratio had the increasing trend and 3 cases were found as intrauterine infection . 80% cases were adolescent(16 year old to 35 year old) , 85.6% cases were Uiger minority , 94% and 67.7% cases were drug abuse through vein and non-occupation respectively.83.3% and 8.69% cases were found in north and south of Xinjiang respectively.The positive rates of virus nucleic acid were 50% , in which 76%(19/25) were 104~105 cop/ml. CD4,CD8,CD4/CD8 were all abnormal,CD4/CD8 ratio decreased to 96%,The number of CD4 cells was remarkably reduced 56%; while CD8 cells was significantly rised 60%;Inpatients increased gradually. Among them , 80% cases were dead due to infection , 16.7% surgical cases were fracture spontaneously.Conclusion The serologic detection of anti- HIV , HIV RNA , CD cell counts had confirmed AIDS episode later ; The progress was more rapidly;infectious rate of female was increased and followed intrauterine infection in Xinjiang.The numbers of episode and death were in growth stage , antivirus therapy were imperative.

Objective To explore the relationship between the vegetation and space distribution of Oncomelania snails in Poyang Lake region,so as to get better understanding of the habitats of Oncomelania snails by using remote sensing technology.Methods The marshlands close to schistosomiasis endemic villages in Poyang Lake region were selected,and the traditional methods were used to investigate the situation of vegetation and Oncomelania snails.The longitude and latitude of investigation spots were recorded by GPS,and the field survey data were vectored by using ArcGIS software.The geometric calibration and unsupervised classification were made on TM satellite images of low-flow period of spring by using PCI 9.0.And then,the relationship between space distribution of snail habitats and vegetation was analyzed through superposing the filed data and satellite images.Results The vegetation in marshlands of Poyang Lake region can be differentiated as three types,in which the single dominant vegetation area was mainly breeding place of Oncomelania snails,and wet vegetation type and hybrid weed type were snail seldom breeding areas.Conclusions The distribution roles of vegetation in marshland are closely related to the habitats of snails,presenting a flaky and bandy distribution.The habitats of Oncomelania snails can be quickly understood by remote sensing technology.

Objective To study the practicability of measurement of abdominal wall tension (AWT) for noninvasive monitoring of intra-abdominal pressure in ICU patients.Methods Patients with indwelling urethral catheter admitted to ICU from April 2011 to March 2013 were enrolled for a prospective study.Exclusion criteria were patients with muscular relaxants,abdominal operation in three months,acute peritonitis,abdominal mass,acute injury of urinary bladder,acute cystitis,neurogenic bladder,intrapelvis hematoma,and pelvic fracture.The AWT (N/mm) and urinary bladder pressure (UBP) (mm Hg) of all patients were measured.Statistical analysis was performed by SPSS 13.0 statistical software.The correlation of AWT and UBP were analyzed using linear regression analysis.The effects of respiration and body position on AWT were analyzed using the Paired-samples t test,and the effects of gender and body mass index (BMI) on basic level of AWT (IAP ＜ 12 mm Hg) were analyzed using the One-way ANOVA.Results A total of 51 patients were recruited in study.A significantly linear correlation between AWT and UBP were observed (R =0.986,P ＜ 0.01),the regression equation was Y =1.369 + 9.57X (P ＜ 0.01).Under the supine-flat positioning,the intra-abdominal pressures at the end of inspiration and the end of expiration were (1.65 ± 0.52) N/mm and (1.45 ± 0.54) N/mm,respectively,and under body straight up 30° supine positioning,the intra-abdominal pressures at the end of inspiration and the end of expiration were (1.25 ± 0.30) N/mm and (1.07 ± 0.35) N/mm,respectively.There were significant differences in intra-abdominal pressure between different respiratory phases and body positions (P ＜ 0.01).Basic levels of AWT in male and female were (1.09 ± 0.29) N/mm and (1.01 ± 0.34) N/mm.The basic levels of AWT in patients with BMI ＜ 18.5,18.5 ≤ BMI ≤25 and BMI ＞ 25 were (0.91 ± 0.30) N/mm,(1.02 ±0.35) N/mm and (1.16 ±0.28) N/mm respectively,but gender and BMI had no significant effects on basic level of AWT (P =0.457 and 0.313,respectively).Conclusions There was a significantly linear correlation between AWT and UBP,and respiratory phase and body position had significant effects on AWT,but gender and BMI had no significant impacts on basic level of AWT.AWT could be served as a simple,easy,and accurate method to monitor the IAP in critical ill patients.

Objective To improve overall value of healthcare industry through setting up critical inpatient medical services strategic plan.Methods Identify major objectives which the local government expects to achieve through strategic map; Standardize inpatient output and assign weight to each group through diagonosis related groups; Translate the objectives of strategic map and result of diagnosis related group to Balanced Score-card; Finally build up strategic map and according action plans.ResultsPreliminarily established 16 objectives、23 measures and 13 tasks in four perspectives including customer,internal work flow,learning and growing and finance.ConclusionThe strategy map and the balanced score-card can help implement full strategic plan of regional inpatient medical services; DRGs is a core management tool of patient-centred service output management; Balanced Score-card is able to realize continuous improvement of Beijing inpatient medical services from macro to micro persoetive.

In order to provide quality rehabilitation care for patients in the hierarchical medical service system,a joint rehabilitation team of general practitioner and specialists from secondary and tertiary hospital was formed in Shanghai Xujiahui Community Health Service Center,and the community rehabilitation has been implemented with "integrated general-specialty" model.This article introduces the characteristics,structure,service contents and advantages of the "integrated general-specialty" rehabilitation service mode,also presents suggestions for solving the existing problems of the mode.