Objective To evaluate the prognosis capacity of the Primary Angioplasty in Myocardial Infarction (PAMI) risk score for 6 months mortality in the clinical patients with ST segment elevation myocardial infarction treated with primary percutaneous coronary intervention (PCI), in addition to asses the incremental value of EF and multivessel disease for risk stratification. Methods Six clinical variables and their relative value of score derived from PAMI risk scoring system were used to determine individual's risk score. The patients with STEMI were evaluated during the in-hospital period and followed-up for a mean of (10.34?3.24) months for mortality. The p values were calculated using a Kruskal-Wallis H test for categorical variables when appropriate; otherwise Independent-samples test was used. Logistic regression examined the discriminant accuracy of the PAMI risk score to predict death and assessed the incremental value of the EF and multivessel disease. Results A 88.8% of patients (183 patients) finished the follow up of 6 months. The overall in-hospital mortality rate was 4.4%, 30-day mortality rate was 6% and 6 months mortality rate was 9.3%. Eighty-eight patients scored 0-2 points, 54 patients scored 3-5 points, 17 patients scored 6-8 points and 24 patients scored ≥9 points. The 6 months mortality were 1.1%,3.7%, 17.6% and 41.7% respectively. Logistic regression analysis indicated that multivessel disease is a risk factor (OR 10.189) and EF is a protected factor (OR 0.849) for 6 months mortality after PCI. Multivessel disease and EF provided incremental information over that provided by the PAMI risk score. Conclusion The PAMI risk score can be applied in early stage after PCI for mortality risk assessment for patients with STEMI. EF and multivessel disease also convey important prognostic information and should be included in risk stratification after STEMI.

Objective To investigate the image quality and diagnostic accuracy using 64-slice spiral computed tomography (64-CTA) scanner in patients with suspected coronary artery disease. Methods Sixty eight patients with chest pain or post PTCA underwent CT coronary angiography (CTA) and selected coronary angiography (SCA). The SCA results were served as "gold standard" to evaluate the diagnostic accuracy of CTA, while the sensitivity, positive predictive value (PPV) and negative predictive value (NPV) were calculated, respectively. Results 64-slice spiral CT could clearly demonstrate the coronary arterial trunk and branchs with stenosis, calcifications abnormal orifise origination and bridge vascular disease; especially with high accuracy in revealing calcification and even with quantification. The sensitivity, specificity, PPV and NPV of the degree of stenosis more than 75% for coronary artery segments evaluated by CTA were significantly higher than those of the degree of stenosis less than 50% for coronary artery segments(P

Objective:To evaluate the clinical value of 64-slice spiral coronary CT angiography(CTA)in diagnosis of in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)in patients with coronary artery disease.Methods:CTA was used to reconstruct and analyze the 345 segments(each stent was divided into three segments:proximal,middle and distal)of 115 stents in 60 patients with coronary heart disease after PCI.The results of selective coronary angiography(SCA)were taken as the golden standard to evaluate the sensitivity and specificity of CTA in diagnosis of ISR after PCI.Results:CTA clearly showed the location and length of the stents,the stenosis at stent and the characteristics of restenosis plaques.Thirty-nine in-stent restenosis lesions were found by CTA,including 8 calcified lesions and 31 non-calcified lesions.There were 25 lesions at the proximal end of the stent,7 at the middle and 7 at the distal end.Forty-two lesions were found by CTA,including 9 calcified lesions and 33 non-calcified lesions,with 26 at the proximal end,8 at the middle and 8 at the distal end.CTA correctly diagnosed 36 segments,missed 6,and misdiagnosed 3.The sensitivity,specificity,PPV,NPV and accuracy of CTA were 85.71%,99.01%,92.31%,98.04% and 97.39%,respectively.CTA had the highest sensitivity and specificity for diagnosis of the proximal ISR,being 96.15% and 100%,respectively.Proximal stent restenosis accounted for 64.10% of the total.Conclusion:CTA can clearly demonstrate the in-stent restenosis and has a high accuracy in diagnosing restenosis after PCI.CTA is a safe,simple and reliable noninvasive diagnostic method for diagnosis of in-stent restenosis after PCI.

Objective To understand the blood lipidcondition of perimenopausal women ,control and standard-reaching situ-ation of dyslipidemi.MethodSix hundred and forty inpatientaged 45-55 yearold (including 400 femaleand 200 males) ad-mitted in the Jiangbei People′Hospital from January 2000 to January 2014 and 200 femaleaged ove60 yearwere selected .TG , TLDL-,HDL-,complicating disease,control of blood pressure and blood lipid,and the lipid-regulating drugapplication situ-ation were recorded .ResultThe prevalence rate of dyslipidemiin perimenopausal women wa23 .40% .The blood lipidcontrol standard-reaching rate wa40 .80% ;the average levelof TG ,LDL-and Tin the perimenopausal women were highethan those in the men of the same age ,while the average level of HDL-walowethan thain the men of the same age .The prevalence rate of dyslipidemiwahighethan thain the men .The average lipid level in the femaleaged ove60 yearwere highethan thaof the perimenopausal women .Conclusion The lipid level of perimenopausal women ihighethan thain the men athe same age . The prevalence rate of dyslipidemiilowethan thain the femaleaged ove60 year,and the control standard-reaching rate is lower.

Objective To study the validity of a new material, to verify the influence of gender and age differences on normal school children, and give advice to establishing the norms of mean nasalance for normal school children.Methods The mean nasalance of 190 school children in Shanghai was obtained by reading the new, old material and the vowel /a/,/o/,/e/,/i/,/u/, and /ü/, the mean nasalance was analyzed for the standard deviations.The gender and age score differences were compared.Results The new material was more stable than the old.In the test of /i/ and/ü/and the nasal material, the girls'' MNS was higher than the boys''.In testing the vowels /a/,/o/,/e/,/i/,/u/, and /ü/and the new material, there were differences in different ages.Conclusion The validity of new material is more stable than the old.The MNS of the normal children in Shanghai show that it is higher for the girls than the boys, and also higher for the older children than for the younger.

Objective To determine the proper dosage of fentanyl for open heart surgery performed under cardiopulmonary bypass (CPB) without aortic cross-clamping and cardioplegia.Methods Twenty-seven ASA Ⅰ -H patients (10 male, 17 female) with fairly good cardiac function (NYHA Ⅰ - Ⅱ) scheduled for surgical repair of atrioseptal defect ( ASD) or ventricular septal defect (VSD) or mitral valve replacement (MVR) were studied. Age ranged from 18 to 44 years and body weight from 35 to 58 kg. The patients were randomly divided into three fentanyl dosage groups: group Ⅰ 10?kg ; group II 30 ?g kg-1 and group Ⅲ 50 ?g kg-1. Premedication consisted of intramuscular pethidine 1-2 mg kg-1 and scopolamine 0.05-0.06 mg kg-1 . Anesthesia was induced with midazolam 0.2 mg kg-1 and fentanyl 5 ?g kg-1 . Tracheal intubation was facilitated with vecuronium 0.15 mg g-1 . The patients were mechanically ventilated (Vr 8-10 ml kg-1 ,F 10-12 bpm,FiO2 100% ). The rest of the total dose of fentanyl (5 ?g kg-1 in group I , 25 ?g kg-1 in group II , 45 ?g kg-1 in group III) was infused after induction of anesthesia until the initiation of CPB, supplemented with inhalation of 0.6 % isoflurane. During CPB propofol was infused at 5 mg kg-1 h-1 . after discontinuation of CPB, again 0.6% isoflurane was inhaled until the end of surgery. Vecuronium 0.05 mg kg was given every 25-30 min during operation. EGG, HR, BP, CVP, SpO2, PET CO2 and body temperature (naso-pharyngeal and rectal) were continuously monitored during operation. Arterial blood samples were obtained before anesthesia (T0), 5 min after tracheal intubation (T, ) , immediately after thoracotomy (T2) , immediately before CPB (T3), 15 min after CPB was initiated (T4) , 10 min after termination of CPB (T5) and 5 min after chest was closed (T6) for blood gas analyses and determination of blood electrolytes and acid-base balance and blood concentrations of glucose, ACTH, angiotensin Ⅱ (A- Ⅱ ) and cortisol. Time of emergence from anesthesia and extubation were recorded.Results The demographic data, including age and body weight, CPB time and duration of surgery were comparable among the three groups. There were no significant changes in SpO2 , PETCO2 , body temperature, blood gases and electrolytes during operation in the three groups. MAP decreased significantly during CPB. The blood glucose, ACTH, A- Ⅱ and cortisol concentrations increased significantly during and after CPB as compared with the preanesthetic baseline (T0 ) ( P

Objective:To explore the predictive factors for adverse clinical outcomes in critically ill adult patients with autoimmune encephalitis by analyzing their clinical characteristics and prognosis.Methods:Clinical data of patients diagnosed with " confirmed" or " possible" autoimmune encephalitis who were hospitalized in the intensive care unit (ICU) of the Department of Neurology at the Second Xiangya Hospital of Central South University from January 2015 to December 2023 were retrospectively collected. The neurological function of patients at 3, 6, and 12 months of onset was followed up, and the modified Rankin Scale (mRS) at 12 months was used as an evaluation index for clinical prognosis; Further analysis was conducted on the relationship between clinical features, auxiliary examinations, and prognosis.Results:The 12-month survival rate of critically ill adult patients with autoimmune encephalitis in our center was 90.7%(117/129), and the 6-month poor prognosis rate was 28.7%(37/129). Univariate logistic regression analysis found that age of onset ( P<0.01), presence of tumors ( P<0.01), mechanical ventilation ( P<0.01), Glasgow Coma Scale (GCS) at ICU admission ( P<0.01), Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score ( P<0.01), cerebrospinal fluid glucose ( P<0.01), cerebrospinal fluid protein level ( P=0.02), epileptic waves in electroencephalography (EEG) ( P=0.03), use of glucocorticoids ( P=0.04), and time interval between initiation of intravenous immunoglobulin (IVIG) and onset ( P=0.04) were associated with prognosis. The results of multiple logistic regression analysis showed that mechanical ventilation [ P=0.01, area under the curve (AUC)=0.72)], APACHE Ⅱ score ( P=0.04, AUC=0.68), cerebrospinal fluid protein content ( P=0.04, AUC=0.65), and the time interval between initiation of IVIG and onset ( P=0.02, AUC=0.64) were independent predictive factors for the prognosis of adult critical autoimmune encephalitis. The prognostic prediction model for adult critical autoimmune encephalitis established by combining these four indicators has a higher AUC (0.85). Conclusions:Mechanical ventilation, APACHE Ⅱ score, cerebrospinal fluid protein level, and the time interval between initiation of IVIG and onset are predictive factors for poor clinical outcomes in critically ill autoimmune encephalitis in adults; The prognostic prediction model for adult critical autoimmune encephalitis established by combining these four indicators can identify patients with poor prognosis early, which is beneficial for early comprehensive management and intervention treatment to improve patient prognosis.

Dystonia is a movement disorder characterized by involuntary abnormal movements or postures due to sustained or intermittent muscle contractions. In recent years, rapid progress has been achieved in the genetics of this disease, leading to an in-depth understanding of common genes and phenotypes related to dystonia. GNAO1 is one of the genes closely associated with dystonia. GNAO1 gene, nevertheless, remains largely unknown to most clinicians. This article reviews the molecular genetic features, clinical characteristics, and therapeutic strategies of GNAO1 gene-associated dystonia, thereby increasing the knowledge of clinicians about GNAO1 gene-associated dystonia and preventing underdiagnosis and misdiagnosis in clinical practice.

Objective To investigate the exposure level of radioactive hazard factors and the health management of radiation workers in non-medical radiation institutions (excluding military institutions) in Jinan, China through radioactive hazard factor monitoring, to identify the weak links, and to provide a scientific basis for future work priorities. Methods According to the monitoring plan formulated by Jinan Municipal Health Commission, the task undertaking institutions at all levels in Jinan investigated the types of radioactive hazard factors, detection, training, and health monitoring of 101 non-medical radiation institutions in Jinan. In addition, the workplace radiation levels were detected in 25 institutions of 6 types of monitoring objects, including industrial flaw detection, non-medical accelerator, non-sealed radioactive material workplace, nuclear instrument, baggage detector, and others. Results The investigation objects included institutions engaged in industrial flaw detection, nuclear instrument, luggage detector, non-medical accelerator, non-sealed source workplace, and others. Of these institutions, 91.84% were equipped with radiation protection detectors, 92.86% were equipped with personal dose alarm, 97.73% were equipped with personal protective equipment, 94.36% performed radiation protection training, 92.69% employed radiation workers with certificates, 95.77% performed personal dose detection, 94.83% performed occupational health examination, and 100.00% were qualified for radiation protection detection in workplace. Conclusion There is still a gap between the radiation protection status of non-medical institutions in Jinan and the national regulations and standards, so it is necessary to further strengthen supervision and law enforcement and make greater efforts in training and publicity.

Background::Non-smokers account for a large proportion of lung cancer patients, especially in Asia, but the attention paid to them is limited compared with smokers. In non-smokers, males display a risk for lung cancer incidence distinct from the females—even after excluding the influence of smoking; but the knowledge regarding the factors causing the difference is sparse. Based on a large multicenter prospective cancer screening cohort in China, we aimed to elucidate the interpretable sex differences caused by known factors and provide clues for primary and secondary prevention.Methods::Risk factors including demographic characteristics, lifestyle factors, family history of cancer, and baseline comorbidity were obtained from 796,283 Chinese non-smoking participants by the baseline risk assessment completed in 2013 to 2018. Cox regression analysis was performed to assess the sex difference in the risk of lung cancer, and the hazard ratios (HRs) that were adjusted for different known factors were calculated and compared to determine the proportion of excess risk and to explain the existing risk factors.Results::With a median follow-up of 4.80 years, 3351 subjects who were diagnosed with lung cancer were selected in the analysis. The lung cancer risk of males was significantly higher than that of females; the HRs in all male non-smokers were 1.29 (95% confidence interval [CI]: 1.20-1.38) after adjusting for the age and 1.38 (95% CI: 1.28-1.50) after adjusting for all factors, which suggested that known factors could not explain the sex difference in the risk of lung cancer in non-smokers. Known factors were 7% (|1.29-1.38|/1.29) more harmful in women than in men. For adenocarcinoma, women showed excess risk higher than men, contrary to squamous cell carcinoma; after adjusting for all factors, 47% ([1.30-1.16]/[1.30-1]) and 4% ([7.02-6.75]/[7.02-1])) of the excess risk was explainable in adenocarcinoma and squamous cell carcinoma. The main causes of gender differences in lung cancer risk were lifestyle factors, baseline comorbidity, and family history.Conclusions::Significant gender differences in the risk of lung cancer were discovered in China non-smokers. Existing risk factors did not explain the excess lung cancer risk of all non-smoking men, and the internal causes for the excess risk still need to be explored; most known risk factors were more harmful to non-smoking women; further exploring the causes of the sex difference would help to improve the prevention and screening programs and protect the non-smoking males from lung cancers.