Patients with nonvalvular atrial fibrillation are the high-risk population of ischemic stroke.Anticoagulation therapy is mainly used to prevent the occurrence of stroke in clinical practice.However,there are some difficulties in the conventional administration of oral anticoagulant warfarin because of some restrictions.There are a number of novel oral anticoagulants with promising data for the prevention of stroke in nonvalvular atrial fibrillation,such as direct thrombin inhibitor and coagulant factor X a inhibitor.

The vulnerable carotid atherosclerosis plaque is an important risk factor for ischemic stroke.However,there are no objective diagnostic criteria for the vulnerability of carotid atherosclerosis plaque in clinical practice now.This article reviews the progress in the diagnosis of vulnerable plaque from the aspects of ultrasound,CT,MRL cerebral angiography,and biochemical indexes.

Objective To investigate the clinical features of early postoperative inflammtory small bowel obstruction,and discuss its diagnosis,treatment and preventive measures.Methods The clinical data of 68 cases of early postoperative inflammatory small bowel obstruction were analyzed retrospectively.Results Within the 68 cases,65 cases were cured by non-operative treatment including gastrointestinal decompression,anti-inflammatory drugs,somatostatin,total parenteral nutrition(TPN) and traditional Chinese medicine.The mean time from the onset of symptoms to the recovery of bowel function was 14 days.Three cases were cured by transferring to operation.One case of them was transferred to operation for strangulated intestinal obstruction during the period of conservative treatment.One case underwent oper.ion because the patient didn t recover after 4 weeks expectant treatment.One case underwent operation for the impatience with the conservative treatment of both the doctors and the patient.Conclusion Non-operative therapy should be the first choice for the treatment of early postoperative inflammatory small bowel obstruction,and its therapeutical effect was well-accepted.

Objective To explore the relation between thyroid nodular and thyroid calcification .Methods The clinical data of 430 cases with nodular goiter admitted from January 2011 to December 2013 were reviewed.All cases were performed ultrasonography and pathologic examination .Results Of 430 cases,there was thyroid carcinoma in 49 cases(11.4%),including microcalcification in 30 cases(61.2%) and macrocalcification in 3 cases(6.1%);benign lesion in 381 cases(88.6%),including microcalcification in 24 cases(6.3%) and macrocalcification in 39 cases(10.2%).The difference was remarkable (P=0.000).There was remarkable difference in malignant calci-fied nodules ratio between the patients with microcalcification and macrocalcification (55.6%vs 7.1%,P=0.000), between the patients aged 45 years below and above(48.8%vs 22.6%,P=0.007),between the patients with solita-ry and multiple nodules(45.0%vs 16.7%,P=0.005).But there was no statistic difference in malignant calcified nodules ratio between the male and female groups (24.2% vs.39.7%,P=0.130).Conclusion Microcalcification is a highly specific sign to predict thyroid carcinoma in ultrasonography exam .Positive intervention will be performed immediately when calcification appears in thyroid nodules .

0.05). There was statistically significant difference in morbidity rate between the groups (2.1% vs 9.3%, P=0.037). Conclusions: Percutaneous and surgical treatment of pyogenic liver abscesses are both effective, nevertheless percutaneous drainage carries lower morbidity and should be the first-line treatment.

Objective To explore the effect of separate management of income and expenditure (SMIE) on standard community healthcare services. Methods Health management records of 137 community health service ( CHS) institutions in Beijing during 2006 and 2009 were retrospectively analyzed. Paired t test was used to compare annual healthcare services at urban and rural areas before or after SMIE was adopted. Results The standard community healthcare services was reduced from 1 081 965. 53 to 971 793. 98 at urban areas and from 157 492. 23 to 149 305. 25 at rural areas (P >0. 05). Urban healthcare center-based standard services was decreased from 59. 94% to 52. 14% (P < 0. 05 ); while out-hospital services were increased from 13. 50% to 18. 88% (P<0. 05). In urban areas,standard services for women healthcare, chronic disease profiling, health education and information management were significantly increased (I <0. 05). However,Temporary observation and endemic disease prevention and treatment were the main job of rural healthcare. Conclusions SMIE in CHS institutions could accommodate to the need of health management, supporting policies should be further improved.

Objective To investigate the causes and treatment of familial neurohypophyseal diabetes insipidus with hydronephrosis.Methods A retrospective analysis was conducted in 6 cases (5 males and 1 female,aged 11 to 53 years) of familial neurohypophyseal diabetes insipidus with hydronephrosis treated in our institute from June 2009 to December 2010.All cases had polydipsia and polyuria since their childhood.The daily output of urine ranged from 5,290 to 15,040 ml.The urine specific gravity was less than 1.005.The water deprivation and vasopressin injection test showed positive results,and MRI showed that the shape and size of pituitary gland were in normal range.Ultrasound and IVU showed that all cases had hydronephrosis.Five adult cases were administered with Desmopressin 0.2 mg three times a day,and 1 juvenile patient given half dosage of Desmopressin as in adult.The case No.1 underwent percutaneous nephrostomy and bilateral ureteral reimplantation.Case No.2 received urethral catheterization for 5 days and Tamsulosin.Three cases with urinary tract infection were given antibiotics on the base of urine culture and antibiotic sensitivity test results.Follow-up was undertaken every 3 mon for the duration of 18-36 mon.Results In 6 cases,polydipsia and polyuria were significantly improved after the treatment.Daily urine output dropped to 6000 ml in 5 adult cases and decreased to 2000 ml in the juvenile case.The flank sore of case No.1 was relieved after percutaneous nephrostomy,and hydronephrosis improved 6 mon after bilateral ureteral reimplantation.The residual urine volume of case No.2 was reduced to 40 ml,and no recurrence was observed after anti-infection therapy.During the follow-up,6 cases showed relieved hydronephrosis and no recurrent infection.Conclusions It is of important to reduce the urine volume for the treatment of familial neurohypophyseal diabetes insipidus with hydronephrosis.Early diagnosis and treatment of the diseases is crucial for the improvement of renal function.

Objective: To investigate the diagnostic value of serum SCC, NSE, CEA, and CYFRA21-1 for lung cancer patients.Methods" The levels of SCC, NSE, CEA, and CYFRA21-1 were detected by electrochemoluminescence immuno-assay in 132 lung cancer patients, 48 patients with benign lung diseases and 92 healthy people.Results: The levels of NSE, CEA, and CYFRA21-1 in patients with lung cancer were higher than those in patients with benign lung diseases and in.normal controls.The level of SCC in patients with lung cancer was higher than that in normal controls.The levels of CEA and CYFRA21-1 in patients with benign lung disease were higher than those in normal controls.Patients with adenocarci-noma had the highest level of GEA and patients with small cell lung cancer had the highest level of NSE.Patients with squamous cell carcinoma had the highest levels of SCC and CYFRA21-1.The sensitivity sequence of the tumor markers in lung cancer was: NSE>CEA>CYFRA21-1>SCC.CEA showed the highest sensitivity of about 58.8% in adenocarcinoma.CYFRA21-1 showed the highest sensitivity of about 71.4% in squamous cell carcinoma.NSE showed the highest sensitivi-ty of about 50% in small cell lung cancer.ROC curves showed that the under-curve area of NSE, CEA, and CYFRA21-1was 0.928±0.034, 0.957±0.026, and 0.964±0.023, respectively.The combination of NSE, CEA, and CYFRA21-1 presented with the highest sensitivity (75.6%) and good specificity (90.7%) for the diagnosis of lung cancer.The combination of SCC, NSE, and CEA detection presented with the highest sensitivity (73.5%) for the diagnosis of adenocarcinoma.The combina-tion of NSE, CEA, and CYFRA21-1 showed the highest sensitivity (87.5%) for the diagnosis of squamous call carcinoma.The combination of SCC, NSE, and CYFRA2.1-1 showed the highest sensitivity (75.0%) for the diagnosis of small cell lung cancer.Conclusion: The assay of SCC, NSE, CEA and CYFRA21-1 is useful for the diagnosis of lung cancer and the ex-pression of the four tumor markers is closely correlated with pathological types.The suitable combination of tumor markers is helpful for differential diagnosis of lung cencar.

wearable microfluidics have wide applications in medical, sports and military field. with the help of wearable microfluidics, through the direct physical contact between the chip and skin, the pH, glucose, lactate, sodium/potassium, calcium and heavy metal in the body fluid can be detected from sweat, tear and saliva without puncture for blood. And these information are of great importance for the monitoring of vital signs and disease diagnosis. This paper introduced the most recent development and applications of the wearable microfluidics in the body fluid testing and drug delivery. The up-to-date research development for the drug delivery using wearable microfluidics was also briefly introduced in this article. The forecast of the emerging trend for wearable microfluidics and discussion of potential technique barriers was also provided at the end of this article.

Objective To explore the potential pathogenesis of Yersinia pestis and provide new clues for vaccine development through comparative proteomic analysis of wild-type and pCD1 cured strain of Yersinia pestis 201.Methods Differentially expressed proteins at 26℃ and 37℃ were separated and identified using two-dimensional electrophoresis coupled with mass spectrometry .Results A total of 24 differently expressed proteins were successfully identified from the samples of bacteria grown at 26℃ and 25 proteins at 37℃.Among these, 7 proteins were encoded by pCD 1 plasmid. Conclusion Through comparative proteomic research, we have found that the abundance of several proteins can be dramatically changed when the large plasmid pCD 1 is missing,suggesting that the plasmid can regulate the expression of many genes located in the chromosome .