Objective To explore the significance of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) for the death risk evaluation in elderly patients with chronic disease in five years.Methods A total of 765 elderly patients with chronic disease[136 patients with coronary heart disease (CHD),76 patients with hypertension disease (HD),86 patients with chronic obstructive pulmonary disease (COPD),75 patients with Type 2 diabetic mellitus (T2DM),76 patients with cerebral infarction (CI),73 patients with coronary heart disease combined with hypertension,71 patients with coronary heart disease combined with chronic obstructive pulmonary disease,61 patients with coronary heart disease combined with diabetic,51 patients with coronary heart disease combined with cerebral infarction,and 60 patients with three comorbidity] were classified into the survival group (312 cases) and the death group (453 cases) according to disease prognosis.The serum NT-proBNP levels of 88 healthy controls and 765 elderly patients with chronic disease were determined by bi-directional lateral flow immunoassay.The death events were followed up and observed for an average of 5 years.The results were analyzed statistically.Results The serum NT-proBNP levels in the death group with various diseases were significantly higher than the survival group (P ＜0.01),the patient's age and the proportion of male in the death group and the survival group had no significant difference (P ＞ 0.05).The serum NT-proBNP levels,the patient's age and the Proportion of male in the death group with various elderly chronic diseases had no statistical significance (P ＞ 0.05).The serum NT-proBNP levels in the death group with various elderly chronic diseases had no statistical significance (P ＞ 0.05),and were significantly higher than the survival group (P ＜ 0.01).The patient's age and the proportion of male in the death group and the survival group had no significant difference (P ＞ 0.05).The serum NT-proBNP levels in the death group in the different periods had statistical significance (P ＜ 0.01),and were significantly higher than the survival group and healthy control group (P ＜ 0.01).The more shorter of the survival time was,the higher the serum NT-proBNP 1eve was.The serum NT-proBNP levels were negatively correlated with the survival time of the patients (r =-0.378,P =0.000).The receiver operator characteristic (ROC) curve indicated that the optimal cut-off values of serum NT-proBNP levels for the death risk evaluation in elder patients with chronic disease were 1 499.50 ng/L.Kaplan-Meier survival curve showed that the survival rates of serum NT-proBNP levels had significant difference (P ＜0.01).The higher the serum NT-proBNP level was,the more shorter of the Survival rates were.Conclusions The levels of serum NT-proBNP have an important prognostic value in the death risk evaluation in elderly patients with various chronic disease.It is an independent risk factor for the death occurred in eiderly patients with chronic disease.The levels of serum NT-proBNP are closely correlated with the survival rates and survival time of elderly patients,It can be used as a monitoring indicator of the elderly patients with chronic disease in risk stratification.

Objective To establish a HPLC method for determination of the content of catechin in Songling- Xuemaikang capsules. Methods The analysis was performed on Alltima C18 column (250 mm × 4.6 mm, 5 μm) with mobile phase consisting of methanol (A) -l% Acetic Acid (B) for gradient elution. The flow rate was 1 ml/min and the column temperature was 25 ℃. Results The results showed that catechin was well separated with the good linearity in 0.00756-0.05040 μg/μl. The average recovery of catechin was 100.147%. Conclusions The method could be applied to determine catechin in Songling-Xuemaikang capsules, which would make sure the quality control of capsules.

[Abstract] Objective To evaluate the effect of Mycobacterium tuberculosis Direct Assay (MTD) for rapid detecting Mycobacterium tuberculosis rRNA and Multi-locus PCR for M.bovis BCG strain typing in patients with suspected extra-pulmonary tuberculosis.Methods From June 2010 to December 2011,47 children and 75 adult patients with suspected extra-pulmonary tuberculosis in Shanghai public health clinical center were recruited.Also 48 non-tuberculosis patients were taken as a negative control.Clinical specimens from these patients were collected.Acid fast stain,solid culture,liquid culture,and MTD were used to detect all clinical specimens simultaneously.Screen tuberculosis strains of the culture isolates by MPT64 antigen assay and use Multi-locus PCR for the BCG strain genotyping of the isolates without MPT64 antigen.SPSS16.0 was used to analyse the results.Results The sensitivity for acid fast stain,solid culture,liquid culture and MTD test was 10.7％ (13/122),11.5％ (14/122),16.4％ (20/122) and 37.7％ (46/122),respectively.And the specificity of MTD was 100.0％.Six clinical isolates from children were identified as BCG by Multi-locus PCR typing,the same with chemical tests.Conclusions The MTD assay and the MGIT960 liquid culture are effective and reliable method for diagnosing extra-pulmonary tuberculosis.And Multi-locus PCR can be assisted for the early diagnosis of extra-pulmonary tuberculosis patients with suspected BCG infection.

Objective To establish the rapid pathogen identification method for HIV and Mycobac-terium tuberculosis (Mtb)co-infection and the assay for the drug susceptibility. Methods Geneprobe and 16S rDNA sequencing were used to differentiate mycobacterium species and modified microscopic observation drug susceptibility (MODS) was used for the drug susceptibility test. The above assays were compared with acid-fast smear, L-J culture and proportional drug susceptibility tests. Results (1) Thirty-four mycobacte-rial isolates were obtained from 112 samples collected from 68 HIV patients. Among these isolates, the strain species were determined by Geneprobe and 16S rDNA sequencing as the followings: 21 Mtb complex, 10 NTM including 5 M.avium complex, 2 M.gordonae, 2 M.kansasii, 1 M.colombiense, and 3 co-infection. (2) The sensitivity of Mtb to rifampicin, ethambutol, isoniazid and streptomycin were 100%, 100%, 76.2%, 90.5% respectively, while the sensitivity of NTM to rifampicin, ethambutol, isoniazid and strepto-mycin were 40%, 60%, 0%, 30% respectively. There is no significant statistic difference between the two methods, MODS and the reference standard, for the drug susceptibility test. (3) Six to eight weeks are nee-ded for the identification of the species of mycobacteria and the drug susceptibility test by using traditional method. In this study, 5-14 d, 6-15 d and 10-14 d are needed for Geneprobe, 16S rDNA sequencing, and MODS respectively. The time for the testing has been dramatically shortened. Conclusion The identifica-tion of mycobacterial species and the drug susceptibility test using clinical samples could be completed within 15 days by using combined Geneprobe, 16S rDNA sequencing and modified MODS. This combined method can be used for the pathogen identification and drug resistant test in HIV patients who are co-infected by my-cobacteria.

Eighteen patients with early cancer and precancerous lesions of esophagogastric junction underwent multiband mucosectomy (MBM) in Yangzhou First People's Hospital from January 2013 to February 2014.The clinicopathological data of patients were analyzed retrospectively and the short-term efficacy and safety of MBM were evaluated.Operations were successful in all 18 cases.The mean operative time was 35.8 min.Intraoperative bleeding occurred in 3 cases and successfully managed by endoscopic hemostasis.Small perforation occurred in 1 patient and was closed by metal clips.Pathological examination showed mucosal cancer in 5 cases,high-grade intraepithelial neoplasia in 8 cases and low-grade intraepithelial neoplasia in 5 cases.No relapse of cancer was found during follow-up.Results indicate that MBM is an effective and safe method in treatment of early cancer and precancerous lesions in the esophagogastric junction.

OBJECTIVETo explore the effect of Danshensu on the lipid metabolism of hyperlipidemic rats.

METHODSixty clean male SD rats were selected. Twelve of them were selected in the basic control group and fed with common foods, and the remaining rats were fed with the high-fat feeds. After the successful modeling, they were randomly divided into the high-fat control group and low dose (10 mg x kg(-1) x d(-1)), medium dose (20 mg x kg(-1) x d(-1)) and high dose (40 mg x kg(-1) x d(-1)) Danshensu (dissolved in saline) groups. Both of the two groups were abdominally injected with the same volume of normal saline once a day for consecutively 30 days. The serum TG, TC, HDL-C and liver ACC1, FAS, HMGR, CPT-I mRNA expressions were detected.

RESULT AND CONCLUSIONDanshensu could inhibit the LDL-C level, timely clear redundant cholesterol and effectively regulate the lipid metablism of hyperlipidemic rats by reducing the TC content, decrease the fatty acid by reducing the FAS mRNA expression, and reduce the synthesis levels of endogenous cholesterol by inhibit the HMGR mRNA expression.

Animals ; Hyperlipidemias ; drug therapy ; metabolism ; Lactates ; pharmacology ; Lipid Metabolism ; drug effects ; Male ; Rats ; Rats, Sprague-Dawley

ObjectiveTo explore the safety and efficacy of endoscopic dilatation combined with submucosal injection of triamcinolone acetonide in treatment of benign esophageal stricture.MethodsThe patients of benign esophageal stricture proved by biopsy were randomly divided into three groups.Group A were treated by expansion only,group B were injected with triamcinolone acetonide submucosal combined with expansion,and we treated group C by another injection a week later on the basis of treatment in group B.A 12 months' follow-up was conducted,the dysphagia score,the cure rate.time to sustained symptom relief,re-expansion time interval and adverse reactions were recorded.ResultsSome patients experienced chest pain and regurgitation after the procedure and all improved by corresponding managements.No complications including massive bleeding,infection,perforation or local tissue atrophy were observed.The dysphagia scores in 3 groups after the procedure were all improved ( P ＜ 0.05 ),and no significant difference was noticed between 3 groups (P ＞ 0.05 ).At the end of the follow-up,the duration of dysphagia remission and the interval between 2 consecutive dilatation in Group A were 14.4 ± 3.2 weeks and 18.2 ± 3.7 weeks,respectively,which were significant shorter than those in Group B ( 19.3 ±3.9 weeks and 24.6 ±4.2 weeks,respectively) and those in Group C (20.2 ±4.2 weeks and 26.1 ±4.5 weeks,respectively),while there was no difference between Groups B and C.The cure rate in Group C (43.5％,10/23) was significantly higher than that of Group A (29.2％,7/24) or Group B (27.3％,6/22),while there was no difference between Groups A and B.ConclusionEndoscopic dilatation combined with submucosal injection of triamcinolone acetonide is safe and may improve the symptoms of dysphagia and delay the re-stenosis for patients with benign esophageal stricture,meanwhile,multi-frequency treatment may improve the cure rate.

BACKGROUND:Mimics software is a three-dimensional (3D) image processing and editing tool based on CT scan data. Mimics software can rebuild the data and images gotten in CT, MRI and ultrasound scans into 3D images and display on the computer screen so as to help clinicians understand the type of fracture and the relationship of the 3D structure of the surrounding tissue and to provide a great help in the development of orthopedics operation. OBJECTIVE:To explore the application effect of Mimics software 3D reconstruction on perioperative period of Pilon fracture. METHODS:This study selected 61 cases of Pilon fracture, who received the surgery in the Zhongshan City Xiaolan People’s Hospital from September 2008 to September 2013, as research objects. They were randomly divided into 3D group and control group in accordance with the time of admission. Al patients underwent anterioposterior and lateral X-ray film examination and multi-slice spiral CT scan. Patients in the control group received internal fixation according to above examination results. Patients of the 3D group, on the base of those of the control group, were subjected to internal fixation after three-dimensional entity reconstruction by using Mimics V 10.0 software. Operation time and functional curative effect in the postoperative folow-up were compared between the two groups. RESULTS AND CONCLUSION:The operation time was significantly less in the 3D group than in the control group (P < 0.05). The number of patients with excelent 6-month functional curative effect was more, and the number of patients with poor effect was less in the 3D group than in the control group. The 6-month functional curative effect was better in the 3D group than in the control group (P < 0.05). These results showed that the application of Mimics software 3D reconstruction to the perioperative period of Pilon fractures can give comprehensive assessment of the situation of fracture, optimize and improve the preoperative plan and reduce the risk of surgery, and promote the successful completion of internal fixation.

Objective To analyze the pathologically confirmed pulmonary Actinomycosis in the 11 patients in focusing on clinical features and mis-diagnostic reasons so as to improve physicians' awareness of this rare disease and reduce the misdiagnosis.Methods We retrospectively reviewed the medical records of 11 cases with pathologically confirmed pulmonary Actinomycosis during January 2003-August 2015.The clinical data and main causes of misdiagnosis in these cases were collected and analyzed.Results The study included 11 patients with a mean age of(53.0 ± 11.6.0)years.Among the 11 cases,8 (72.7 ％) patients had complications,6 (54.5 ％) were current or ex-smokers.Main clinical manifestations of 11 cases were cough(11/11,100.0 ％),sputum(11/11,100.0 ％),hemoptysis (7/11,63.6％),chest pain(6/11,54.5％)and fever(3/11,27.3％).Ten patients presented with one lobe of lung lesions,including 4 patients in the lower lobe and 3 in the upper lobe of the left lung,2 in the upper lobe and 1 in the lower lobe of the right lung.While,the remained one case presented with lesion locating in right main bronchus.Iconography often presented as pulmonary mass shadow,consolidation shadow,spicule sign,lobulation sign,hilar and/or mediastinal lymphadenopathy and pleural effusion.Vacuolar lesions were observed in some of the focuses.Flexible bronchoscopy was performed in 8 (72.7％)patients.Among them,7 patients showed mucosal swelling and congestion,luminal occlusion with purulence secretion,2 cases with polypoid neoplasm.Initial misdiagnosis rate were 100％ (11/11),among which 7 cases were misdiagnosed as lung cancer,2 cases as fungus infection,and 1 case as pulmonary tuberculosis and 1 case as pneumonia,respectively.All patients were definitely diagnosed by biopsy finding an evidence of hyphae of Actinomycosis in lung tissue specimens.The definitive diagnosis was made by CT-guided percutaneous lung biopsy in 4 cases,by transbronchial lung biopsy (TBLB)in 5 cases and by thoracotomy or video-assisted thoracoscopic surgery(VATS) in 1 case respectively.Actinomycosis in most patients was cured with high-dose penicillin administration over a prolonged period.Conclusions The diagnosis of pulmonary Actinomycosis remains challenging via its non-specific clinical symptoms and iconography features,and the presence of comorbidity may further increase the difficulty and complexity of diagnosis,leading to delaying-or mistaking-diagnosis.Obtaining positively pathological specimens is diagnostic key.Transbronchial lung biopsy through a bronchoscope and CT-guided percutaneous needle biopsy are the priority methods.

Objective To investigate the expression and clinical significance of neutrophil S100A8/A9 in induced sputum in children with bronchial asthma. Methods A total of 108 cases of bronchial asthma patients in the FourthAffiliated Hospital of Nanchang University were involved in the study form October 2014 to October 2015. According to the severity of the disease, the patients were divided into mild group (n=40), moderate group (n=36) and severe group (n=32). Twenty health children were taken as control group at the same period. All the patients were treated with budesonide aerosol for three months, and the control group was received aerosol inhalation for normal saline (NS). The ratio of forced expiratory volume in one second and forced vital capacity (FEV1/FVC, FEV1%) were used to evaluate the pulmonary function in two groups. The asthma control questionnaire (AcQ-5) score was used to estimate the asthma control effects. The expression level of neutrophil S100A8/A9 mRNA in induced sputum was detected by real-time PCR. The correlation of S100A8/A9 mRNA, AcQ-5 score and FEV1%was analyzed. Results Before the treatment, the FEV1%decreased, while the AcQ-5 score and express level of S100A8/A9 mRNA significantly increased with the severity of disease (all P<0.01). Three months after treatment, asthma was completely controlled in 60 patients, partial controlled in 31 cases and uncontrolled in 17 cases. With the improvement of the therapeutic efficacy, the FEV1%significantly decreased, while the express level of S100A8/A9 mRNA significantly increased (all P < 0.01). The express level of S100A8/A9 mRNA in induced sputum neutrophils was negatively correlated with FEV1%(r=-0.327 and-0.406 respectively, P<0.05), which was positively correlated with ACQ-5 score (r=0.704 and 0.817, P<0.05). Conclusion The level of S100A8/A9 expression in induced sputum neutrophil is positively correlated with the severity of asthma, which can be used as clinical indicators of the severity and the efficacy of asthma.