Objective To investigate the value of N-termind pro-B-type natriuretic peptide(NT-pro-BNP)in differential diagnosis of dyspnea in emergency department, and to investigate the rapid diagnosis cutoff of dyspnea due to acute congestive heart failure. Methods Ninety. one cases of dyspnea in emergency department recruited from January to June ,2008 were divided into two groups: acute cardiac dyspnea group and none acute cardiac dyspnea group. To evaluate the value of different parameters in differential diagnosis of dyspnea in emergency department and analysis the area under the receiver-operating characteristic of different parameters for the diagnosis of acute cardiac dyspnea. To achieve the best cutoff of different parameters for the diagnosis of dyspnea due to acute congestive heart failure finally. Results Among two groups, NT-pro-BNP (acute cardiac dyspnea vs. none acute cardiac dyspnea,6203.50 ng/L vs. 1410.00 ng/L,P ＜ 0.01), Troponin Ⅰ (acute cardiac dyspnea vs. none acute cardiac dyspnea,0.12 μg/L vs. 0.03 μg/L,P ＜0.01) ,left ventricular ejection fraction(acute cardiac dyspnea vs. none acute cardiac dyspnea,46.25% vs. 65.60%, P ＜ 0.01), left atrial diameter (acute cardiac dyspnea vs. none acute cardiac dyspnea,42.75 mm vs. 36.00 mm,P ＜0.01) had significant difference. NT-pro-BNP at cutoff of ≥3715 ng/L was highly sensitive and specific for the diagnosis of acute cardiac dyspnea. Receiver-operating characteristic analyses demonstrated that NT-pro-BNP and left ventricular ejection fraction was the best diagnostic indices of acute cardiac dyspnea. The area under the receiver-operating characteristic curve of Nt-pro-BNP was 0.828 ± 0.045 (P ＜ 0.01),and left ventricular ejection fraction was 0.829 ± 0.049 (P ＜ 0.01). Correlation analysis showed that NT-pro-BNP was correlated with left ventricular ejection fraction (P ＜ 0.01). The combined test of NT-pro-BNP and left ventricular ejection fraction was performed. Specificity increased to 96.50%, total consistent rate increased to 83.50% ,positive predictive value increased to 91.30%, positive likelihood ratio 17.60, faulse diagnostic rate decreased to 3.50%. Conclusions NT-pro-BNP examination in emergency department was helpful to rapid differential diagnosis of dyspnea. It helped to differentiate the patients with acute congestive heart failure and none acute congestive heart failure causes of dyspnea.

Objective:To explore the drug application in the postoperative chemotherapy for the patients with non-small cell lung cancer. Methods:The chemotherapy regimens, drug utilization and adverse drug reactions in the non-small cell lung cancer patients received postoperative chemotherapy in 2012 were statistically analyzed in a retrospective study. Results:Totally 8 kinds of chemother-apy regimens were used in 156 cases. The NC( vinorelbine + carboplatin) regimen was used most frequently and the PC( pemetrexed+ carboplatin) regimen was with the highest expense. Proton pump inhibitors, recombinant human erythropoietin and lentinan were the top three in the adjuvant drugs used in the treatment. Conclusion:It is necessary to further standardize the postoperative chemo-therapy for non-small cell lung cancer patients. Thoracic surgeons along with pharmacists should strengthen the drug use monitoring during the whole treatment process to promote the rational drug use.

Objective To analyze inducing factors of acute left heart failure(AHF) of emergency case.Methods According to different age and gender,the inducing factors of AHF of 211 patients were retrospectively analyzed.Results Infection(42.99%) was the most important inducing factors of AHF in all the four age-groups,but as for patients elder 80,the arrhythmias was also play an important part in inducing factors of AHF.The difference of inducing factors was found among the four age-groups.but the difference of inducing factors was not found between the two gender-groups. Conclusion Since the most important inducing factors of AHF of emergency case was infection,anti-infectives is important for preventing and controlling AHF.

BACKGROUND: Chinese medicine Gukang prescription has a clear effect on clinical treatment of osteoporosis, but the therapeutic pathway is stil unclear.
OBJECTIVE:To investigate the effects of Chinese medicine Gukang on the expression of receptor activator of nuclear factor kappa B ligand and osteoprotegerin by regulating core binding factor alpha 1 expression to control the growth and development of osteoblasts.
METHODS:Sprague-Dawley neonatal rats within 24 hours after delivery were used for the separation and culture of osteoblasts. Adult Sprague-Dawley rats were used to prepare drug-containing serum, and then divided into two groups randomly:normal control group and Gukang group. Rats in the normal control and Gukang groups were intragastrical y administrated with extract of Gukang prescription and normal saline based on rat’s body surface area, for 1 consecutive week. Two hours after the last administration, blood samples were taken from the heart. Then the serum was col ected. Osteoblasts at passage 3 were confirmed with alkaline phosphatase assay and digested. After counting and planting, al osteoblasts were divided into two groups and treated with col ected
serum for 72 hours. Proliferative rate of osteoblasts was detected by using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide test. Secretion of alkaline phosphatase was detected by using enzyme linked immunosorbent assay and corrected with the corresponding absorbance value. mRNA expression of core binding factor alpha 1, receptor activator of nuclear factor kappa B ligand and osteoprotegerin were detected by using reverse
transcription-PCR in al groups.
RESULTS AND CONCLUSION:mRNA expression of osteoprotegerin and core binding factor alpha 1 in the Gukang group was significantly higher than that in the normal control group, but protein and mRNA expression of receptor
activator of nuclear factor kappa B ligand were dramatical y lower in the Gukang group compared with the normal control group (P<0.01). These findings indicate that Chinese medicine Gukang prescription can modulate the expression of
core binding factor alpha 1, thereby adjusting the expression of receptor activator of nuclear factor kappa B ligand and osteoprotegerin, which may be one of the mechanisms underlying Gukang treatment for osteoporosis.

Objective To evaluate the relationship and bias of the Stago-CT and CA1500 automatic coagulation analyzer.Meth-ods The relationship and bias of PT,APTT,INR,FIB,TT,DD examined by the Stago-CT and CA1500 automatic coagulation ana-lyzer by using NCCLS EP9-A2.Results For the six items(PT,APTT,INR,FIB,TT,DD)the r2 were 0.996 9,0.969 1,0.967 7, 0.955 8,0.972 6,0.949 6,respectively,and the bias were 2.9,0.88,5.22,1.16,3.48,20.3.Conclusion The five items (PT, APTT,INR,FIB,TT)at a good relationship(r2 >0.95)by the Stago-CT and CA1500 automatic coagulation analyzer except for the DD(r2 =0.949 6);The bias of the five items(PT,APTT,INR,FIB,TT)were within in the United States of demanding that a third of the clinical laboratory of CLIA 88′bias,except for the DD.

Objective To investigate the efficacy of dual plating internal fixation with olecranon osteotomy approach for the emergency surgery of complex distal humeral fractures (intereondylar and supracondylar fracture).Methods Forty-seven cases of complex distal humeral fractures were treated with emergency surgery from May 2002 to May 2007.The dual plating internal fLxation was implemented with olecranon osteotomy approach in a posteubital slight arc shaped median incision.Early postoperative rehabilitation was necessary.Results The follow-up period differed from 5 to 50 months,averaged 18 months.All fractures healed in 3-6 months after surgery.The Cassebaum scoring system was used for the assessment of cubital joint function,36 cases were excellent,4 cases were good,5 cases were common,and 2 cases were bad.The excellent and good rate was 85.1%.Conclusions For complex distal humeral fractures,dual plating internal fixation emergency surgery with olecranon osteotomy approach ensures the early postoperative rehabilitation of the cubital joint and the maximum possible functional recovery.It shows the efficacy is satisfactory.

Objective This study was to analyze the early and long-term effect of completion pneumonectomy.Methods Retrospective analysis was made on the patients who underwent completion pneummonectomy in Shanghai Chest Hospital.Results There were totally 56 cases patients underwent completion pneumonectomy during January 2003 to July 2013.Among them,45 patients received CCP,and other 11 patients received RCP.CCP refers to the complete removal of lung tissue remaining after an initial ipsilateral partial pulmonary resection.RCP refers to the complete removal of residual lung due to the severe complications after pneumonectomy.The mortality and morbidity rate of CCP were 4.4％ and 33.3％ respectively.In the case of CCP,the incidence of benign lesions is significantly higher than the incidence of malignant tumor(80.0％ vs 27.5％,P =0.04).The mortality and morbidity rate of RCP were 27.3％ and 90.9％ respectively.In the case of RCP,higher postoperative mortality often occurs in aged patients (P =0.046) and patients with preoperatie mechanical ventilation (P =0.03).Overall five-year survival rate for patients with benign lesions was 80％,and for malignant lung cancer patients,the number was 30％.Survival time differs according to the TNM staging(a median of 60.0 months,35.0 months,10.0 months,stage Ⅰ,stage Ⅱ,stage Ⅲ,P ＜0.01),and survival rate was higher when the time interval(between the initial pulmonary resection and the completion pneumonectomy) ＞ 2 years(a median of 60.0 months,18.0 months,P ＜ 0.01).Conclusion Completion pneumonectomy is a high-risk surgery,especially RCP.Advanced age and preoperative mechanical ventilation are associated with higher postoperative mortality rate for RCP.As for CCP,higher postoperative risk exists in patients with benign lesions,but the survival rate is also higher.In patients with malignant lung tumor,survival rate is higher when the time interval (between the initial pulmonary resection and the completion pneumonectomy) ＞2 year.

Gastroesophageal reflux disease is a series of intraesophageal and/or extraesophageal symptoms caused by the reflux of gastric contents into the esophagus because of abnormal structure and function of gastroesophageal junction. Acid suppression therapy is the preferred treatment, but most patients with gastroesophageal reflux disease have poor symptom control or excessive dose for drug control, resulting in low quality of life. With the renewal of endoscopic equipment, endoscopic adjuvant therapy is attracting the attention of clinical physicians and patients owing to minimal trauma, rapid recovery, obvious symptom control, and few complications. This paper reviews endoscopic adjuvant therapy.

Deep brain stimulation is widely used for treatment of neuropsychiatric diseases, showing its unique advantages in the treatment of central nervous diseases, such as epilepsy, Parkinson's disease, essential tremor, drug-refractory psychiatric diseases, drug-refractory pain, improvement of arousal and cognitive functions, and addiction diseases. After more than 30 years of clinical research, animal experiments and material research, the scopes and modes of DBS use have been fully developed, and important progress has been made in seeking better stimulation targets and modes. The complexity and individuality of the disease lead to differences in the response of each patient to DBS treatment, so it is necessary to further clarify its mechanism of action and explore better therapeutic targets and parameters to meet higher clinical requirements. This paper reviews the clinical application of DBS as follows.

In the research field of bone tissue engineering, the interaction of osteoblast and substrate is pivotal and the adhesion of osteoblast to biomaterials is the basic condition. Firstly, osteoblast must adhere to biomaterials, then it can migrate, proliferate and differentiate. This paper introduces the proteins relating to the adhesion of osteoblast and the influences of relating surface character and modification of biomaterials on the adhesion ability of osteoblast. These could serve as basic data and useful reference for the development of bone tissue engineering and tissue engineering scaffold materials.
Biocompatible Materials ; chemistry ; Bone Regeneration ; Cell Adhesion ; Cell Differentiation ; Cell Proliferation ; Humans ; Osteoblasts ; cytology ; Surface Properties ; Tissue Engineering ; methods ; Tissue Scaffolds ; chemistry