Objective To explore the value of combined application of qualitative detection of TB-DNA serum anti-PPD-IgG and acid-fast staining methods in the diagnosis of tuberculosis infection .Methods Totally 278 pulmonary tuberculosis patients and 121 non-pulmonary tuberculosis patients were collected from Qingyuan people′s hospital during the period from January 2013 to June 2015 .Tuberculosis in patients with TB-DNA qualitative and serum anti-PPD-IgG and acid-fast staining test results was analyzed . Sputum TB-DNA qualitative and serum anti-PPD-IgG detection and joint application of acid-fast staining in the diagnosis of tuber-culosis infection .Results Sensitivities of acid-fast staining ,TB-DNA and serum anti-PPD-IgG in the TB group were 32 .01% , 51 .44% and 48 .56% respectively .The detectable rate of combining TB-DNA with serum PPD-IgG was 67 .63% .The detectable rate of combining TB-DNA with acid-fast staining was 54 .68% .The detectable rate of combining serum anti-PPD-IgG with acid-fast combined rate was 57 .55% .The detectable rate of combining three assays improved to 68 .71% .Conclusion Serum anti-PPD-IgG detection in the diagnosis of tuberculosis is simple ,effective ,qualitative detection of acid-fast staining sensitivity better than TB-DNA ,but it had a poor specificity .Bacteriologic diagnosis are tuberculosis diagnostic gold standard,but the detectable rate for acid-fast bacilli is low .The qualitative of TB-DNA test had a better sensitivity and specificity than other two assay .Combining with three assays could increase detectable rate and improve diagnosis of tuberculosis disease .

The financial objective of the health non-operating state-owned assets(NSA) value-running is defined as non-profit, an empirical test is designed; the non-profit objective function and for-profit objective function is established and the impact of fix asset and staff cost on financial objective in multiple regression functions are compared.

Objective To investigate the clinical features and prognosis of adult dermatomyositis with gastrointestinal bleeding and perforation. Methods The clinical data of a adult dermatomyositis with gastrointestinal bleeding and perforation were retrospectively analyzed. And the clinical characteristics of this patient were analyzed, combined with 7 cases reported in the literature. Results Among the 8 cases, 6 cases were females and 2 cases were males, aged 18 to 63 years. The 5 cases had melena, 3 cases had hematemesis, 3 cases had hematochezia and 1 case had hemoptysis. The main treatment was glucocorticoids, immunosuppressive agent, intravenous immune globulin (IVIG), endoscopic hemostasis and angiographic embolization. Four of the 8 cases died. Conclusions Adult dermatomyositis with gastrointestinal bleeding and perforation is rare, but the condition is dangerous and the mortality is high. Dermatomyositis with early onset of abdominal pain, vomiting, melena should be alert to serious complications such as gastrointestinal bleeding and perforation.

Objective To evaluate the change of left ventricular(LV) function by real-time three dimensional echocardiography(RT-3DE) and to explore the clinical value of change of serum adiponectin level in patients with metabolic syndrome (MS).Methods One hundred and twenty patients were divided into MS group and control group according to the diagnostic standard of the nternational Diabetes Federation.Transthorasic 2D ultrasound and RT-3DE examination were performed in all study objects, and serum adiponectin levels were measured.Results Parameter index [including Tmsv16-SD, Tmsv12-SD,Tmsv16- Dif, Tmsv12-Dif, Tmsv16-SD (％), Tmsv 12-SD (％), Tmsv16-Dif (％), Tmsv12-Dif (％)] of 17segment time to minimal systolic volume in MS group was more than that in control group (all P ＜0.05).Some regional systolic index of LV and serum adiponectin level were less than that in control group (all P ＜0.05).Compared with the control group, E/E' was lower (P ＜ 0.05).There were significant relations between serum adiponectin level and E/A of mitral valves, E'/A' of mitral annulus and E/E'(r = 0.368,0.493,and -0.347 respectively, P ＜0.05).Conclusions RT-3DE can rapidly evaluate LV systolic and diastolic synchrony in MS patients.E/E' show an excellent correlation with serum adiponectin level,and it may be a new promising method for routine evaluation of LV diastolic function.

Objective To explore the curative effects,prognostic factors,and adverse reactions of different treatment modalities of chemotherapy in patients with non-small cell lung cancer (NSCLC).Methods151 NSCLC patients were randomly assigned into 3 groups to undergo concurrent chemoradiotherapy ( n = 43 ) ,sequential chemo-radiotherapy ( n = 49 ) ,or pure chemotherapy (n = 59).The clinical data were analyzed.ResultsThe short-term effective rates of the concurrent and sequential chemo-radiotherapy groups were 81.4% and 73.5% respectively with no significantly difference between them,but both significantly higher than that of the pure chemotherapy group ( 39.0% ,both P ＜ 0.05 ).The mortality of the concurrent cherno-radiation group was 53.5% ,significantly lower than those of the sequential chemo-radiotherapy and pure chemotherapy groups (67.3% and 67.8% respectively,both P ＜0.05).The median survival time of the concurrent chemo-radiotherapy group was 26 months,significantly longer than those of the sequential chemo-radiotherapy and pure chemotherapy groups ( 12 and 11 months respectively,both P ＜ 0.05).The l-year survival rates of the 3 groups were 80.2% ,47.1%,and 45.6%.The 2-year survival rates were 58.2% ,38.5% ,and 24.4% ,and the 3-year survival rates were 32.7% ,27.5% ,and 0,respectively.The white blood cell decrease rates of the grades Ⅲ～Ⅳ of the concurrent chemo-radiotherapy group were significantly higher than those of the other 2 groups (both P ＜0.05 ).There were no significant differences in the rates of radiation esophagitis and radiation pneumonitis between the concurrent and sequential chemo-radiotherapy groups.Age,performance status score,clinical staging,and treatment modality were the 4 influencing factors in the prognosis of NSCLC ( all P ＜ 0.05 ).Conclusion Relatively safe with tolerable adverse reactions,concurrent chemo-radiotherapy is superior to sequential chemo-radiotherapy,particularly to pure chemotherapy,in increase of median survival time and survival rate in treatment of NSCLC.Age,PS,clinical staging and therapy method are independent indicators influencing the prognosis.

BACKGROUND:Neurotrophic factors have been conformed to have the effects of promoting the survival, differentiation and axonal regeneration of the injured neurons, so that the structural integrity of the injured spinal cord can be reserved as much as possible.OBJECTIVE: To observe the effects of nerve growth factor (NGF) on the neural regeneration and motor function following spinal cord injury in rats.DESIGN: A randomized controlled observation.SETTING: Department of Neurology, Union Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: Thirty healthy adult male Wistar rats of common degree, were provided by the Experimental Animal Center, Tongji Medical College of Huazhong University of Science and Technology.METHODS:The experiment was carried out in the Department of Neurology, Union Hospital of Tongji Medical College,Huazhong University of Science and Technology. The 30 rats were randomly divided into NGF-treated group (n=15) and control group (n=15). ① T8 spinal injury was induced by the improved Allen method. ③ The improved Rivlin method (namely, slope test) was used to assess the motor function following spinal cord injury in rats before model establishment and at 3 days, 1, 2 and 3 weeks after treatment respectively. ④ At 2 days and 3 weeks postoperatively, 7 rats in the NGF-treated group and 8 rats in the control group were selated and the cross-sectional tissue(0.5 cm) of the injured spinal cord was removed, fixed in neutral formalin, dehydrated, and embedded with paraffin, and then cut into 5 μm sections.MAIN OUTCOME MEASURES:① The results of the slope test before model establishment and at 3 days,1, 2 and 3weeks after treatment respectively; ② Axonal count in white matter at 2 days and 3 weeks after model establishment.RESULTS:① The scores of slope test after spinal cord injury at 1, 2 and 3 weeks postoperatively in the NGF-treated group were obviously higher than those in the control group [(45.2±3.2), (51.2±3.8), (53.4±4.6)°; (45.2±3.2), (51.2±3.8),(53.4±4.6)°, P ＜ 0.05].② At 3 weeks after treatment, a few dispersal and heterogeneous NGF200 spots were observed in the white matter of rats in the control group, but there were plentiful and symmetrical NGF200 spots in the NGF-treated group. The axonal count in white matter at 3 weeks following spinal cord injury in the NGF-treated group was obviously higher than that in the control group (363.6±34.2, 187.5±32.1, P＜ 0.05).CONCLUSION:NGF can promote the neural regeneration following spinal cord injury to a certain extent, and help to im prove the functional recovery.

Many studies have confirmed that thyroid hormone (TH) and mitochondria have protective effects on myocardium. The partial subtype of sirtuins (SIRTs) can also be able to protect myocardium by mitochondria, which includes improving ischemia reperfusion injury, improving the pathological cardiac hypertrophy and improvement of heart failure. SIRTs can achieve the protective effect for myocardium mainly through inhibiting mitochondrial permeability transition pore and mitochondrial membrane permeabilization, maintaining balance of regulation of mitochondrial morphology, promoting mitochondrial biogenesis, maintaining the function of autophagy of impaired mitochondria. At the same time, there is an interaction between TH and SIRTs. At present, the role of mitochondria has become more and more concerned in apoptosis and necrosis and its protective effect on cells. This review summarized the protective effect of SIRTs on myocardium through mitochondrial and the influence of the interaction between SIRTs and TH on myocardial protection of mitochondrial.

Objective To evaluate the long-term prognostic capacity of the SYNTAX score Ⅱ(SxScore Ⅱ) and SYNTAX score (SxScore) in patients undergoing left main percutaneous coronary intervention (LM-PCI). Methods A total of 209 patients undergoing unprotected LM-PCI in the Cardiology Department of the Affiliated Hospital of PAP of Logistic College were prospectively collected. Follow up was carried out by telephone or outpatient or rehospitalization. The clinical endpoint focused on MACCE after PCI including composite death, nonfatal myocardial infarction, target vessel revascularization and stroke. The secondary endpoint included cardiac death and stent thrombosis. The SxScore and SxScoreⅡ were retrospectively calculated according to results of coronary angiography and clinical features of patients. Patients were stratified according to tertiles of low (≤22), intermediate (23-32), and high (≥33). The clinical data were comparedbetween three groups. The predictive ability of two scoring systems to MACCE after PCI was compared by COX regression evaluation. Results In 209 patients, 12 patients were lost to follow-up (5.7%), and the median follow-up was 30.2 months, 56 cases (28.4%) were observed to suffer from MACCE. The incidence rates of MACCE were 19.0%, 28.6%and 44.4%in SxScore low, intermediate and high groups respectively. The incidence rates of MACCE were 12.8%, 23.8%and 45.5%in SxScoreⅡlow, intermediate and high groups respectively. Single factor analysis showed that SxScore, SxScoreⅡ, age, diabetes and left ventricular ejection fraction (LVEF) were the independent predictors of MACCE. Multivariate analysis showed that SxScore and SxScoreⅡwere still risk independent predictors for MACCE. Conclusion Both SxScore and SxScoreⅡare independent risk predictors for MACCE in patients with unprotected left main coronary artery disease undergoing PCI treatment.

OBJECTIVE: To assess the efficacy and safety of compound azintamide and trimebutine maleate in the treatment of functional dyspepsia (FD) in elderly patients. METHODS: 48 elderly patients with FD up to Rome Ⅲ were randomly divided into two groups. Treatment group were given 200 mg trimebutine maleate tid at 15 min before meal and 2 pieces of compound azintamide tid after meal for 4 weeks (n=23). Control group were given 200 mg trimebutine maleate tid for 4 weeks (n=25). Questionnaire survey was applied to detect the index of dyspeptic symptoms and drug toxity before and after treatment. RESULTS: The patients with FD in two groups were matched well in respect of age, sex and index of dyspeptic symptoms. Routine therapy was achieved and adverse reaction wasn’t found. Curative efficacy and symptom score in treatment group were significantly better than in control group after 4 weeks of treatment, such as poor appetite, abdominal distension, early satiety, belching , except upper abdominal pain and burning sensation (P

OBJECTIVE To study the clinical manifestation and relationship of the pathologic type,clinical treatment and the prognosis of head and neck rhabdomyosarcoma. METHODS The clinical data of 28 cases with head and neck rhabdomyosarcoma were reviewed retrospectively. RESULTS Among these 28 cases, 10 cases were treated surgically accompanying with postoperative chemotherapy and radiotherapy, 6 cases were treated with operation and chemotherapy, 2 cases were treated with operation and radiotherapy, 2 cases were treated with radiotherapy and chemotherapy, 4 cases were treated with chemotherapy only, 2 cases were treated with radiotherapy only, and 2 cases were treated with palliative operation. The 3-year and 5-year total survival rates were 57.14 % and 28.57 % respectively.Two cases who were embryonal type in pathology and at stage Ⅰand treated with extensive dissection accompanied with chemotherapy survived more than 10 years. Among 8 cases survived more 5 years, 6 cases were embryonal type, one case was alveolar type, one case was pleomorphic type. CONCLUSION The combined treatment strategy can improve the survival rate of the patients.