Objective: To investigate the diagnostic value of combined examination of copeptin and high sensitivity cardiac troponin T (hs-cTnT) in patients at the early stage of acute myocardial infarction (AMI) . Methods: A total of 272 patients were enrolled in this study, all of them suffered from chest pain and admitted within 4 hours. The patients were divided into 4 groups according to coronary artery angiography (CAG) results. Control group, the patients with normal CAG,n=64, UAP group (unstable angina pectoris),n=50, STEMI group,n=82, NSTEMI group,n=76. All patients received in-hospital observation, plasma levels of copeptin and hs-cTnT were examined at admission and at 6 hours after the chest pain respectively. Results: Within 4 hours of chest pain, combined examination of copeptin and hs-cTnT had the higher sensitivity for diagnosing AMI than a single detection of hs-cTnT with the cut-off point of hs-cTnT ≤ 14ng/L and Copeptin < 14pmol/L. In NSTEMI group, the AUC (area under curve) for combined examination was 0.97 (95% CI 0.88-0.99), AUC for single hs-cTnT detection was 0.75 (95% CI 0.62-0.87),P<0.05. In STEMI group, the AUC for combined examination was 0.97 (95% CI 0.88-0.99), AUC for single hs-cTnT detection was 0.74 (95% CI 0.60-0.88),P< 0.05. The AUC for combined examination of copeptin and hs-cTnT in diagnosing early AMI was 0.912 (95% CI 0.812-0.961) which was higher than single detection of hs-cTnT, AUC 0.851 (95% CI 0.713-0.936), Z=2.553,P<0.05. Conclusion: Combined examination of copeptin and hs-cTnT had the higher sensitivity and accuracy for diagnosing the patients at the early stage of AMI, it may help the risk stratiifcation of chest pain which is valuable in clinical practice.

Objective To evaluate the effects of percutaneous transhepatic variceal obliteration in the treatment of acute bleeding from gastroesophageal varices in patients with severe cirrhosis.Methods 19 patients with Child C cirrhosis suffered from active bleeding from gastroesphageal varices. Emergency procechures of percutaneous transhepatic variceal obliteration were performed in all 19 patients. Results Successful catheterization and obliteration of the varices in all of the 19 cases. Active bleeding were controlled in 18 cases with only one failure and TIPSS was performed. During a follow up peroiod ranging from one to 12 months, 14 cases bled recurrently during 3 to 12 months. 15 cases died within the follow up period. 4 cases were alive. Severe complication of intraperitoneal bleeding occurred in 1 case, and laparotomy was performed. Conclusions Percutaneous transhepatic variceal obliteration is effective in controlling acute bleeding from gastroesophageal varices in patients with Child C cirrhosis. It could be used as the first choice treatment method for emergency when TIPSS is contraindicated.

Objective To investigate technique methods of dense emolization of intracranial aneurysms, factors resulting incomplete embolization. Methods 58 patients with intracranial aneurysms, using different embolization technique treated narrow and wide aneurysms with GDC. Dense emolization rate of aneurysms was elevated. Results dense emolization 50 aneurysms (86.2%), 95% in 3 aneurysms (5.2%), 90% in 3 aneurysms (5.2%), 80% in 2 aneurysms (3.4%). All embolizated aneurysms showed no enlarging recurrence or rebleeding.Conclusions Dense embolization of intracranial aneurysms should try to obtain.

Objective To investigate the change of tear film function in patients with seasonal allergic conjunctivitis (SAC) between acute exacerbation and non-onset phase.Methods This was a prospective controlled study.Functional assessment of tear film was performed in 30 eyes of 15 patients with SAC (SAC group) between acute exacerbation and non-onset phase and 15 healthy controls (control group).The tear film function included tear film break-up-time (BUT),Schirmer I test (SIt) and tear film interferometer imager measurement.Results BUT was significantly decreased in SAC group on acuteexacerbation compared with that on non-onset phase and control group [(6.97 ± 1.56) s vs.(11.27 ± 1.39),(12.00 ± 1.11) s],and there was significant difference (U =20.50,P =0.000;U =1.00,P =0.000).Moreover,BUT in SAC group on non-onset phase was similar as control group(U =322.00,P ＞ 0.05).There was no significant difference in SIt among SAC group on acute exacerbation and non-onset phase and control group(P ＞ 0.05).In tear film interferometer imager measurement,80.0％(24/30) was Ⅰ-Ⅱ grade,20.0％(6/30) was Ⅲ grade in control group,20.0％(6/30) was Ⅰ-Ⅱ grade,80.0％(24/30) was Ⅲ-Ⅴ grade in SAC group on acute exacerbation,60.0％(18/30) was I-Ⅱ grade,40.0％(12/30) was Ⅲ-Ⅴ grade in SAC group on non-onset phase,and there was significant difference between SAC group on acute exacerbaiion and SAC group on non-onset phase,control group (x2 =19.27,P =0.000; x2 =8.40,P =0.004),and there was no significant difference between SAC group on non-onset phase and control group (x2 =1.98,P＞0.05).Conclusion SAC can cause the instability of tear film during the acute exacerbation,whereas this instability can be recovered within the non-onset phase of S A C,which is close to the normal control

OBJECTIVE To investigate the distribution and drug resistance of nosocomial infection pathogens in ICU from 2005 to 2008.METHODS Antimicrobial susceptibility test of 850 clinical isolates were carried out by means of K-B method.RESULTS Among 850 isolates,Gram-negative bacilli,Gram-positive cocci and fungi accounted for 68.9%,15.8% and 15.3%,respectively.ESBLs-producing strains accounted for 50% and 55.4% in E.coli and Klebsiella spp.MRS was detected in 82.7% of Staphylococcus.Imipenem and meropenem were the most active agents against strains of Enterobacteriaceae,Acinetobacter spp and Pseudomonas aeruginosa.No VRE or VRS strains were detected.CONCLUSIONS Gram-negative bacilli are the most frequent organisms in ICU.It is necessary to conduct drug resistance supervision of nosocomial infection pathogens in ICU and take measures to control nosocomial infection spread.

Objective:To explore the directed forgetting ability of elder people to disease/death-related words under the conditions of the neutral and negative emotion.Methods:Thirty-six elder people and thirty-seven young people were included in this study.The directed forgetting effects to disease/death-related words were compared by using item-method directed forgetting paradigm under the neutral and negative emotional conditions.Results:Under the neutral and negative emotion conditions,higher recognition of to-be-remembered (TBR) than to-be-forgotten (TBF) words in elder group and younger group (Ps ＜ 0.05).The elder group showed the weaker effect of directed forgetting than younger group[neutral emotion:(0.4 ± 0.1) vs.(0.6 ± 0.1);negative emotion:(0.3 ± 0.1) vs.(0.7 ± 0.04),Ps ＜ 0.05].Under the negative emotion condition,elder people showed stronger effect of directed forgetting for sensitive words compared with control words[(0.4 ± 0.1) vs.(0.1 ± 0.1),P ＜ 0.001].Conclusion:The results suggest that the directed forgetting ability of elderly is weaker than that of young individuals,the ability of non-sensitive words than that with sensitive words,and the directed forgetting effect of elder people tonon-sensitive words in negative emotion is weaker than that in neutral emotion.

AIM:To investigate whether ginsenoside Rg1 attenuates high-fat diet ( HFD)-induced non-alcoho-lic fatty liver disease ( NAFLD) by improving β-oxidation.METHODS: SD rats ( n=60) were randomly divided into control group ( CON ) , HFD group, low-dose, medium-dose and high-dose ginsenoside Rg1 groups ( LDG, MDG and HDG) and positive drug ( sodium ursodeoxycholate) treatment group ( PDT) .High-fat diet was given for 8 weeks to suc-cessfully establish an NAFLD model.The animals were treated with the appropriate medications for 4 weeks and 8 weeks af-ter modeling, and sacrificed to collect the liver tissues for observing the pathologic changes with HE staining and for detec-ting liver functions and lipid levels.The expression of hepatic acyl-CoA synthetase 1 (CoASH1), carnitine acyltransferase I (CATI) and acyl-CoA oxidase 1 (ACOX1) at mRNA and protein levels was determined by RT-PCR and Western blot-ting.RESULTS:After 4-week treatment, the fatty infiltration of the liver tissues in PDT group, LDG group and MDG group was not attenuated except HDG group.After 8 weeks of treatment, a small number of fat particles was observed in PDT group and LDG group, while no infiltration of lipid droplet was found in MDG group and HDG group.Compared with HFD group, the levels of AST, ALT, AKP, TC, TG and LDL-C were significantly decreased after 4-week treatment in PDT group, LDG group, MDG group and HDG group (P<0.05), these indexes were further reduced after 8-week treatment. After 4-week treatment, HDL-C was significantly increased in the 4 treatment groups and almost restored to the level of CON group after 8-week treatment.The levels of CoASH1, CACTI and ACOX1 in the liver tissue of the 4 treatment groups were significantly increased after 4-week treatment (P<0.05) and much improved after 8-week treatment, and those in MDG group and HDG group were better than those in PDT group (P<0.05).CONCLUSION:Ginsenoside Rg1 regulatesβ-oxidation-related enzymes to improve the fat metabolism, thus playing a therapeutic role in liver injury in the rats with NAFLD.

Purpose To detect the expression of NKX2. 2 protein in gastrointestinal, pancreatic and esophageal neuroendocrine tumors and the correlation between the expression of NKX2. 2 and the clinicopathologic parameters. Methods 41 cases of gastrointestinal, pancreatic and esophageal neuroendocrine tumors were collected. The expression of NKX2. 2, Syn and CgA in neuroendocrine tumor samples were checked by using immunohistochemical staining. Results The positive expression of NKX2. 2 protein was localized in the nucleus. NKX2. 2 protein showed positive staining in neuroendocrine tumors of the seven original sites. In the four cases of normal pancreatic islet cells also showed strongly diffuse positive nuclear staining. The positive rates of NKX2. 2, Syn and CgA protein in the small intestine, rectum, pancreatic neuroendocrine tumors were 100%, 100% and 46. 7%, respectively. The positive rates of NKX2. 2 in foregut, midgut and hindgut were 30% and 87% (χ2 = 11. 09, P=0. 001). Positive NKX2. 2 protein expression was not associated with gender, age group, grade, tumor size and lymph node metastasis. Conclusion NKX2. 2, as a new type of neuroendo-crine markers, is obviously superior to CgA in the diagnosis of neuroendocrine tumors in the small bowel, rectum and pancreas. NKX2. 2, Syn and CgA, a panel approach may be beneficial to enhance diagnostic accuracy of the neuroendocrine tumors.

Objective To prepare the supersaturation self-emulsifying drug delivery system(S-SEDDS) containing silymarin and to evaluate its basic properties.Methods With the time of self-emulsifying,the consequence of color visual examination and particle size as parameters,the optimum formulations of silymarin SSEDDS were screened by solubility test,compatibility tests and pseudo ternary phase diagrams.The silymarin concentration was determined by HPLC.The in vitro dissolution characteristics of silymarin S-SEDDS were investigated with silymarin SEDDS as control.Results The optimum silymarin S-SEDDS was composed of medium chain triglycerides(MCT) 40%,Cremophor RH40(ethoxylated hydrogenatedcastor oil) 48%,Labrasol 12%.The time of self-emulsifying was less than 3 min,the average particle diameter was 49.6 nm,the adding amount of hydroxypropyl methylcellulose(HPMC) was 50 mg/g,and the average content of silymarin was 39.3 mg/g.The in vitro dissolution test of silymarin S-SEDDS showed that the presence of a small amount of cellulosic polymer effectively sustained a metastable supersaturated state by retarding precipitation kinetics.Conclusion The designed formulation of silymarin S-SEDDS is reasonable and provides a strong foundation for further development of new preparations.

Objective To summarize the application of endovascular treatment of the acute ruptured intracranial aneurysms with the new Trufill detachable coil system.Methods Thirty five patients with the acute ruptured intracranial aneurysms were treated with DCS or DCS Orbit within 72 hours. Results All 35 cases were successful with compact embolization in 29 aneurysms,95% in 3 aneurysms,90% in 2 aneurysms,80% in 1 anearysm.One case hemorrhaged during operation and 1 case had thrombosis after operation,but with good prognosis of both.One case died of pneurmonia.Thirty cases achieved clinic follow-up 1 to 15 months after operation with only one rebleeing.Sixteen cases achieved DSA follow-up 3 to 12 months after the operation.Partial recurrence of the occluded aneurysm was shown in 1 case.Conclusions Trufill DCS or DCS Orbit is a safe,reliable and effective therapy for the endovascular treatment of intracraranial aneurysms.