Objective To explore the perioperative antithrombotic strategy in percutaneous coronary intervention(PCI)for the patients with coronary heart disease(CHD)who were treated with long-term warfarin anticoagulation,and to evaluate the safety of the strategy and short-term efficacy.Methods The clinical data of 76 patients were analyzed,who underwent coronary stenting while treated with long-term warfarin anticoagulation.All of them had unstable angina.The reasons of requiring warfarin anticoagulation were cardiac valve replacement [51(67.1%)],pulmonary embolism within half a year [6(7.9%)],and sustained atrial fibrillation at high risk of stroke [19(25.0%)].Warfarin was withdrawn and low molecular weight heparin(LMWH)was administered as alternative anti-thrombus drugs before PCI.PCI was performed when international normalized ratio(INR)went less than or equal to 1.3.LMWH was administered combined with low dose aspirin(100mg/d)and clopidogrel(75mg/d)post PCI,while warfarin was resumed too.When INR arrived at 1.8,LMWH was withdrawn.Warfarin was administered in a dose adjusted to achieve the target INR of 1.8 to 2.3.Clopidogrel was withdrawn 1 month later.Aspirin(75-100mg/d)was continued,and then warfarin was resumed to the dose before PCI.The data of the incidence of ischemic events,major adverse cardiac events(MACE),subacute instent thrombus(SAT),and hemorrhage events during hospital period were analyzed.Results The incidence of hemorrhage events was 5.3%(4/76),one of them was secondary hemorrhage events.The rate of MACE was 1.3%(1/76).No main hemorrhage events and SAT occurred during hospitalization related to regulating antithrombotic strategy.Conclusions As alternatives of warfarin,LMWH is taken before PCI,and then the low dose of aspirin,clopidogrel,LMWH and warfarin are admitted in a short period after PCI,the dosage of warfarin should be accurately adjusted according INR post PCI,and then the LMWH is taken out of service timely,such a strategy is safe and efficient in peri-percutaneous coronary intervention for the patients with CHD who were treated with maintaining warfarin anticoagulation.

Objective To explore the adjustment of interleukin II combining lifein for CD+4 T lymphocyte, Th1 and Th2 of patients with malignant tumor. Methods CD+4 T lymphocyte were measured by flow cytometer. Th1 lymphocyte and Th2 lymphocyte were measured by ELISA. Thirty- eight patients with malignant tumor were enrolled in the study. Interleukin II were administered at the dose of 500 000 U, i.h Qd, from day 1 to day 5. Lifein were administered at the dose of 10mg/d, i.m Qd, from day 6 to day 21 or form day 6 to day 27. The count of CD+4 T lymphocyte, Th1 lymphocyte and Th2 lymphocyte were studied before treatment, 2 weeks and 1 month after treatment. Conduct ANOYA using SPSS software. Results The expression of CD+4 T lymphocyte in patients as with increase tendency. The counts of Th1 lymphocyte, Th2 lymphocyte and Th1/Th2 were not significantly different after treatment. Conclusions The dose of this treatment could enhance the count of CD+4 T, but it could not adjust the count of Th1 lymphocyte, Th2 lymphocyte. The target of treatment about interleukin II combining lifein for patients with malignant tumor is CD+4 T lymphocyte's other subsets.

Objective To compare the detection performance of the modified serum test (TRUST) method and the traditional method in syphilis screening.Methods A series of TRUST high titer syphilis serum was diluted,and the positive rate of each method was calculated by using the improved method and the traditional method.Comparison of two detection methods of C50,C5 ～ C95 interval,as well as the accuracy of the density curve,and the consistency of the two methods were compared,and diagnostic performance were compared.Results The improved method of C50 was less than the traditional method of C50,and the improved method of C5 ～ C95 range was narrower than the traditional method,compared with the traditional method.The improved method of the non precision density curve was steeper than the traditional method,and the two confidence interval of the consistency degree of the 95％ methods was 73.4％ to 95.8％.The diagnostic sensitivity (SEN),diagnostic specificity (SPE),positive predictive value (PPV),negative predictive value (NPV) and diagnostic efficiency(DF) of the improved method were 64.29 ％,99.1％,85.71％,97.05 ％ and 96.39 ％,respectively.The SEN,SPE,PPV,NPV and DF of the traditional methods were 3.75 ％,98.49 ％,75 ％,96.18 ％ and 95 ％,respectively.The improved method was superior to the traditional methods in the two aspects of SEN and PPV (x2 =8.25,10.03,all P＜0.05),with the statistically significant difference.The improved method was slightly higher than the traditional method in SPE,NPV and DF (x2 =2.39,3.45,4.03,all P＞0.05),with the no statistically significant difference.Conclusion The precision,diagnostic sensitivity and diagnostic specificity of the improved method was higher than that of the traditional method,and it can be applied to the detection of large batch samples with the aid of the full automatic enzyme immunoassay instrument.The improved method can be used to replace the traditional method for syphilis screening.

Objective To evaluate the diagnostic value of H-FABP for early detection of acute myocardial infarction(AMI). Methods Serum H-FABP of 126 healthy individuals and 53 AMI patients were measured by self developed ELISA. MYO, cTnI and CK-MB, traditional biochemistry diagnostic markers were estimated at the same time. The dynamic movement of these myocardial indicators for AMI patients, and their diagnostic sensitivity and specificity in the earlier period of AMI onset was analyzed. Results The plasma concentration of H-FABP began to increase at (1.84?0.64) h after AMI onset, earlier than CK-MB and cTnI. The time-concentration dynamic curves of H-FABP was similar to that of MYO and moved to left in comparison with both CK-MB and cTnI. The sensitivity and specificity of H-FABP at 2 h after AMI were 76.47% and 80.41%, and 89.16% and 91.26% at 4 h, respectively;. Conclusions H-FABP is more sensitive and specific in the early diagnosis of AMI within 2 hours and at 4 hours after symptom onset. It is hoped that H-FABP become an important myocardial marker for both early diagnosis and elimination diagnosis of AMI.

Objective To test the reliability and validity of the rating scale of social function deficit due to mental disorders (SSFD-MD). Methods 1003 cases with mental disability evaluation were tested by SSFDMD. At sametime, 100 cases of 1003 cases were test-retested and back to back tested by two examiners. 300 cases of 1003 cases also were tested by social disability screening schedule( SDSS),scale of social function for psychosis inpatients(SSPI),global assessment function(GAF) ,the brief psychiatric rating scale(BPRS) ,WH0 disability assessment scale Ⅱ (WHO-DASⅡ ), adult rating scale of mentally disabled ( ARSMD) and rating scale for extrapyramidal side effects (RSESE). Results ①The Cronbach's α coefficients of the total score and all dimensions of SSFD-MD were more than 0.90. The test-retest reliability ranged from 0.67～0. 83 ,and the scorer reliability were 0. 87～0.97. ②The correlations between item scores ranged from 0.46 ～0.74(P＜0.01). The correlations between the factor scores and the total scores ranged from 0.73～0.87(P＜0.01). To extract five full-scale principal components after orthogonal rotation to maximize variance,the cumulative total variance explained was 82.25%.There were highly correlations between SSFD-MD and SDSS.SSPI and GAF,respectively ( r = 0. 71,0.72 and 0. 78). There were moderate correlations between SSFD-MD and BPRS WHO-DAS II ARSMD,respectively(0.62,0. 50 and 0.46). There was a low correlations between SSFD-MD and RSESE ( r = 0.22) ,but all correlations were significant(P＜0.01). Conclusion SSFD-MD has acceptable psychometrics properties on reliability and validity.

Purpose: Models for predicting perforation during endoscopic resection (ER) of gastric submucosal tumors (SMTs) originating from the muscularis propria (MP) are rare. Therefore, this study was conducted to determine important parameters in endoscopic ultrasonography (EUS) images to predict perforation and to build predictive models. Methods: Consecutive patients with gastric SMTs originating from the MP who received ER from May 1, 2013 to January 15, 2021 were retrospectively reviewed. They were classified into case and control groups based on the presence of perforation. Logistic multivariate analysis was used to identify potential variables and build predictive models (models 1 and 2: with and without information on tumor pathology, respectively). Results: In total, 199 EUS procedures (194 patients) were finally chosen, with 99 procedures in the case group and 100 in the control group. The ratio of the inner distance to the outer distance (I/O ratio) was significantly larger in the case group than in the control group (median ratio, 2.20 vs. 1.53; P<0.001). Multivariate analysis showed that age (odds ratio [OR], 1.036 in model 1; OR, 1.046 in model 2), the I/O ratio (OR, 2.731 in model 1; OR, 2.372 in model 2), and the pathology of the tumors (OR, 10.977 for gastrointestinal stromal tumors; OR, 15.051 for others in model 1) were risk factors for perforation. The two models to predict perforation had areas under the curve of 0.836 (model 1) and 0.755 (model 2). Conclusion EUS was useful in predicting perforation in ER for gastric SMTs originating from the MP. Two predictive models were developed.

Objective To explore the application value of respiratory syncytial virus RNA (RSV-RNA) and respiratory syncytial virus IgM (RSV-IgM) antibody in the diagnosis of children with respiratory infection .Methods From September 2015 to April 2017 ,56 cases of respiratory syncytial virus infection were selected ,and the specimens of pharyngeal secretions were collected ,and RSV-RNA was detected ,in addition ,fasting venous blood was taken from children ,and the RSV-IgM antibody was detected .The positive rate of detection and correlation with age and time of onset were statistically analyzed .Results The positive rates of RSV-RNA and RSV-IgM were 89 .29% and 32 .14% ,respectively .The detection rate of RSV-RNA was significantly higher than that of RSV-IgM ,and the difference was statistically significant (P<0 .05) .The two groups ,≤6 months and from >6 months to 1 year old ,the detection rates of RSV-RNA in children was higher than RSV-IgM (P<0 .05) ,and the detection rate of RSV-RNA in chil-dren with ≤7 days of onset was higher than that of RSV-IgM (P<0 .05) .Conclusion The detection of children with RSV infec-tion ,which the detection of RNA has higher accuracy than IgM ,especially for children ≤1 year old ,the onset time is shorter(≤7 days) ,plays an important guiding role for early diagnosis .

Background/Aims: We investigated the dynamics of serum HBV pre-genomic RNA (pgRNA) and hepatitis B core-related antigen (HBcrAg) in patients receiving nucleos(t)ide analogues (NAs) and their predictability for favourable suppression of serum hepatitis B surface antigen (HBsAg). Methods: Serum viral biomarkers were measured at baseline, weeks 4, 12, 24, 36, and 48 of treatment. Patients were followed up thereafter and serum HBsAg level was measured at end of follow-up (EOFU). Favourable HBsAg response (FHR) was defined as ≤100 IU/mL or HBsAg seroclearance upon EOFU. Results: Twenty-eight hepatitis B e antigen (HBeAg)-positive and 36 HBeAg-negative patients (median, 38.2 years old; 71.9% male) were recruited with median follow-up duration of 17.1 years (interquartile range, 12.8–18.2). For the entire cohort, 22/64 (34.4%) achieved FHR. For HBeAg-positive patients, serum HBV pgRNA decline at week 4 was significantly greater for patients with FHR compared to non-FHR (5.49 vs. 4.32 log copies/mL, respectively; P=0.016). The area under the receiver-operating-characteristic curve (AUROC) for week 4 HBV pgRNA reduction to predict FHR in HBeAg-positive patients was 0.825 (95% confidence interval [CI], 0.661–0.989). For HBeAg-negative patients, instead of increase in serum HBcrAg in non-FHR patients, FHR patients had median reduction in HBcrAg at week 4 (increment of 1.75 vs. reduction of 2.98 log U/mL; P=0.023). The AUROC for week 4 change of HBcrAg to predict FHR in HBeAg-negative patients was 0.789 (95% CI, 0.596–0.982). Conclusions Early on-treatment changes of serum HBV pgRNA and HBcrAg at 4 weeks predict HBsAg seroclearance or ≤100 IU/mL in NA-treated CHB patients upon long-term FU.

OBJECTIVE To investigate the inhibitory effect and mechanism of lead(Pb2+)on γ-amino-butyric acid(GABA)A receptor-mediated currents(IGABA)and GABAergic synaptic transmission in rat cortical neurons.METHODS ①The cortical neurons from 0 d Sprague Dawley(SD)rats were cultured for experiments.The cultured cells(7-14 d)were recorded using the patch-clamp technique to analyze the effects of Pb2+ at different concentrations(1,5,10,50 and 100 μmol·L-1)on IGABA induced by GABA 100 μmol·L-1.② The effects of Pb2+ 50 μmol·L-1 on IGABA induced by GABA at different concentrations(1,10,50,100,500 and 100 μmol·L-1)were detected.③Brain slices(350 μm)were prepared from SD rats(15-19 d).The spontaneous inhibitory post-synaptic currents(sIPSCs),miniature inhibitory post-synaptic currents(mIPSCs)and current injection-induced action potential(AP)were recorded to detect the effects of Pb2+ 10 μmol·L-1 on the amplitude and frequency of sIPSCs and mIPSCs,and the frequency of AP.RESULTS ①Pb2+ inhibited IGABA in a concentration-dependent manner,and IC50 was(68±20)μmol·L-1.②Pb2+ also suppressed the maximum current induced by GABA(P<0.01),with a significant increase of the GABA′s EC50 from(20±6)μmol·L-1 to(87±39)μmol·L-1,indicating that Pb2+ might inhibit IGABA in a non-competitive mechanism.③Pb2+ 10 μmol·L-1 inhibited the frequency(P<0.01)rather than the ampli-tude of sIPSCs reversibly,but had no effect on eigher the frequency or amplitude of mIPSCs.In addi-tion,Pb2+ decreased the frequency of evoked AP by current injection(P<0.01)and reduced the overall excitability of rat cortical neurons.CONCLUSION Pb2+ can significantly inhibit IGABA in primary cultured neurons.In the brain slice experiment,Pb2+ may affect sIPSCs frequency by inhibiting the AP of cortical neurons,suggesting that there are different intrinsic mechanisms through which Pb2+ inhibits both IGABA in primary cultured neurons and the frequency of sIPSCs in brain slice neurons,which points to the complexity of the mechanism of Pb2+ poisoning.