Objective To explore the causes of the special cases showing the EKG changes of cardiac infarction. Methods To analyse the causes of 30 special cases showing the EKG changes of cardiac infarction between 2000 and 2004. Results Among 30 special cases there were 11 cases of viral myocarditis( 36. 7 % ), 7 cases of acute pancreatitis(23.3% ) ,6 cases of hypertrophic obstructive cardiomyopathy(20% ) ,4 cases of bile-cyst and heart syn-drome(13. 3% ) and 2 cases of pulmonary embolism(6. 7% ). Conclusions There are many causes showing the EKG changes of cardiac infarction. It isn't the typical symptom of the cardiac infarction. It should be combined with the clinic and be distinguished timely and exactly in order to avoid the misdiagnosis.

Objective To investigate the relativity mechanism and clinical significance between the ST-T changes in electrocardiogram and cerebral apoplexy. Methods 2160 electrocardiogram materids of brain patients in our hospital for medical treatment were analyzed retrospectively. The clinical materials of 98 cases(contrast group) who had no obvious changes and 80 cases(observe group) who had obvious changes of ST-T in ECG were compared. Results 1327 cases of electrocardiographic presented abnormality of 2160, which accounted for 56. 97% of the unusual electrocardiogram. Compared with the contrast group, the incidence of hypertension, coronary heart disease, respiratory failure. electrolyte distur-rbances,beart expanding and mayn rinds of electrocardraphic abnormality was higher(P

Objective To establish normal reference interval for four items of blood coagulation on ACL‐TOP Automatic coagu‐lation analyzer .Methods The fasting anti‐coagulation blood samples were collected from 1 268 inpatients and people conducted physical examination ,all subjects without liver disease ,history of blood disease and coagulation disfunction .The prothrombin time (PT) ,activated partical prothrombin time(APTT) ,thrombin time(TT) and serum levels of fibrinogen(FIB) were determined by u‐sing ACL‐TOP automatic coagulation analyzer which was producted by America IL company .And data of determination results were used to establish the normal reference intervals of indexes in this laboratory .Results The precision and accuracy of this analy‐zer was good .There were differences of normal reference intervals between which established in this laboratory and which provided by the manufacturer .Conclusion Each laboratory should establish its own normal reference interval ,not blindly refer to reference interval provided by regents manual .

Objective To evaluate the change of elasticity of rabbit liver following portal inflow vessels occlusion using acoustic radiation force impulse (ARFI). Methods Twelve Japanese white big ear rabbits were used to establish total hepatic vascular exclusion animal models by occluding the portal inflow vessels. The elasticity of rabbits' right liver was detected during the stages of baseline(T0), 5 min(T1),20min(T2) ,30min (T3)after occluding the portal inflow vessels using ARFI respectively. The elasticity of rabbit liver, levels of serum's aspartate aminotransferase (AST), alanine aminotransferase (ALT) and historical results of hepatic tissue during different stage were compared. Results Shear wave velocity(Vs)of rabbits' right livers in T2 was significantly higher than that in T0 ( P ＜0.05) and Vs of rabbits' right livers in T3 was significantly higher than that in T2 ( P ＜0.05). No significant differences of serum's AST,ALT levels between T2 and T0 were found,while the Vs of rabbit live in T2 was slightly higher than that in T0 (P＞0.05), serum's AST, ALT levels in T3 were significantly higher than that in T2 ( P ＜0.05).Historical changes of liver ischemia and injury were observed in T2 and T3 with light microscopy. Conclusions The liver ischemia and injury severity can be accurately and objectively evaluated using ARFI.

Objective:To explore the clinical significance of standardized screening for diagnosis and treatment of early gastric cancer in Qinghai Province.Methods:Opportunistic early gastric cancer screening was conducted in outpatients of Digestive Department, Physical Examination Center and inpatients of Qinghai Provincial People′s Hospital from January 2016 to December 2020, according to the optimal cut-off values of serum pepsinogen (PG)Ⅰ, PGⅠ/PGⅡ ratio (PGR) and serum gastrin 17 (G17) obtained from the previous screening study of gastric cancer and precancerous diseases in different areas of Qinghai Province. At the same time, the standardized early gastric cancer screening program was applied in 10 municipal (county-level) hospitals in Qinghai Province. The detection rate, early diagnosis rate and endoscopic treatment rate of early gastric cancer in Qinghai Provincial People′s Hospital and the above 10 hospitals in the past five years were analyzed respectively.Results:In the five years, the total detection rate, early diagnosis rate and endoscopic treatment rate of early gastric cancer in Qinghai Provincial People′s Hospital were 0.214% (407/190 178), 17.54% (407/2 321) and 81.82% (333/407), respectively. The above indices in 10 other hospitals were 0.085% (264/309 217), 12.94% (264/2 040) and 37.12% (98/264), respectively. The overall detection rate of early gastric cancer was higher than 0.024% reported previously.Conclusion:The standardized early gastric cancer screening program can not only improve the diagnosis rate of early gastric cancer in Qinghai Province, but also save medical resources. It is an economical, efficient and feasible program, suitable for the highin-cidence area of gastric cancer in Qinghai Province.

Objective To explore the imaging characteristics and make the differential diagnosis of intraspinal extramedullary epidural lesions. Methods 23 cases with intraspinal extramedullary epidural lesions confirmed by puncture or surgical pathology were selected for retrospective analysis of the lesion morphology,MRI signs and the relationship between the lesion and surrounding tissues.Results Intraspinal extramedullary epidural lesions were more often located at thoracic spinal canal.The shapes of lesions were always various.The malignant tumors were irregular.It could damage the adjacent bone and grew surrounding the spinal cord.Leaping growth and multiple vertebral involvements could be seen in metastasis.The complex components of lesions were related to heterogeneous signal intensity on MRI,which could be presented with hypoGto hyperGintense on T1 WI and T2 WI.The angiolipoma showed hypoGto hyperGintense on T1 WI,and the hyperGintense signal could be suppressed with fatGsuppressed sequence.Meningioma tended to present with homogeneous signal on both T1 WI and T2 WI, with dural tail on contrast MRI.All of the lesions were moderately or significantly enhanced on contrast MRI.Conclusion Intraspinal extramedullary epidural lesions include a wide range of lesions,and the components of lesions are very complex.Among them,the distinctive MRI characteristics include the lesions containing fat and vascular components,besides malignant lesions invading adjacent tissues.Comprehensive analysis of the shape and signal of lesions,as well as the relationship between lesions,and surrounding structures is very helpful in differential diagnosis of intraspinal extramedullary epidural lesions.

Objective:To investigate the safety and effectiveness of endoscopic cold snare resection of small colorectal polyps and prophylactic hemostatic clip.Methods:A total of 260 patients diagnosed as having small colorectal polyps in Qinghai Provincial People's Hospital from January 2021 to March 2022 were randomly assigned to cold snare polypectomy (CSP) group (receiving CSP), CSP+hemostatic clip group (receiving CSP+prophylactic hemostatic clip), hot snare polypectomy (HSP) group, and HSP +hemostatic clip group (receiving HSP+prophylactic hemostatic clip). Each group had 65 cases. The treatment, incidence of bleeding, and other complications were compared.Results:There was no significant difference in the basic characteristics of patients or polyps among the four groups ( P>0.05). Immediate intraoperative bleeding occurred in 5 cases (7.69%), 4 cases (6.15%), 3 cases (4.62%), and 3 cases (4.62%) in the four groups respectively with no significant difference ( χ2=0.778, P=0.855), while only 1 delayed postoperative bleeding was observed in HSP group with no significant difference among the four groups ( χ2=3.012, P=0.390). The incidence of postoperative abdominal pain was the highest in the HSP group ( n=7, 10.77%) significantly different from those of the CSP group ( n=1, 1.54%) and the CSP+hemostatic clip group ( n=1, 1.54%) ( P<0.05). Polypectomy time of single polyp in CSP group was the shortest (2.18±1.07 min) , followed by HSP group (2.83±0.82 min), then CSP+hemostatic clip group (3.15±1.16 min), with HSP+hemostatic clip group (4.88±1.85 min) being the longest ( F=50.397, P<0.001). Conclusion:It is suggested to use CSP for small colorectal polyps. If there is no risk of bleeding or perforation during the operation, it is not necessary to use prophylactic hemostatic clips.

Hepatocellular carcinoma(HCC)is the fourth leading cause of cancer-related death,following lung cancer,colorectal cancer and gastric cancer.Chemoresistance is currently the major challenge in clinical treatment of HCC patients,and it is also the primary cause of the poor prognosis and high recurrence rate of patients.There are multiple factors and complex mechanisms in the occurrence of HCC drug resistance.Recent research has shown that non-coding RNA(ncRNA)is closely related to HCC chemoresistance.By regulating the expression of target genes and protein translation,ncRNA affects the occurrence,metastasis,and prognosis of HCC and is expected to become a therapeutic biomarker and potential drug therapeutic target for HCC.Therefore,this study reviews several common ncRNAs,including long non-coding RNAs(LncRNAs),miRNAs and transferRNA(tRNAs),in the molecular mechanisms and research progress of HCC chemoresistance,providing new ideas for solving the problem of HCC chemoresistance.

In this study,the current status for breast diseases in a region with high-incidence of cervical cancer were epidemiologically investigated.From March to August,2009,17618 women,from Wufeng area of Hubei province,China,were recruited to screen breast diseases by using breast infrared diagnostic apparatus.Other diagnostic methods,such as B-mode ultrasound,X-ray mammography,needle biopsy and pathological examination were,if necessary,used to further confirm the diagnosis.The screening showed that 5990 of 17618 cases (34.00％) had breast diseases,5843 (33.16％) had mammary gland hyperplasia,48 (0.27％) had breast fibroadenoma,ll (0.06％) had breast carcinoma,and 88 (0.50％) had other breast diseases.The peak morbidity of breast cancer was found in the women aged 50-0 ages.The morbidity of breast cancer was significantly increased in women elder than or equal to 50 years old (n=8,0.157％) in comparison with that in the subjects younger than 50 years old (n=3,0.024％) (u=2.327,P＜0.05).It was shown that the occurrence of breast diseases was concentrated in women aged 20-40 years,while the total morbidity reached its peak at the age of 30 years and then decreased sharply after age of 40.Compared with the patients elder than or equal to 40 years old (n=3289,27.46％),the morbidity rate of breast diseases was significantly increased in women less than 40 years old (2648 cases,47.18％; P＜0.001).However,there was no significant difference in the morbidity of breast diseases between the age group of 20-29 years and that of 30-39 years (P=0.453),and both of them were high.There was no significant association between the morbidity of breast diseases and cervical cancer.Since the morbidity of breast diseases was higher among young women,more attention should be paid to the screening of breast diseases among young women for early diagnosis.

Objective To monitor the antifungal resistance of clinical isolates of Candida spp.in the East China region.Methods MALDI-TOF MS or molecular methods were used to re-identify the strains collected from January 2018 to December 2022.Antifungal susceptibility testing was performed using the broth microdilution method.The susceptibility test results were interpreted according to the breakpoints of 2022 Clinical and Laboratory Standards Institute(CLSI)documents M27 M44s-Ed3 and M57s-Ed4.Results A total of 3 026 strains of Candida were collected,65.33％of which were isolated from sterile body sites,mainly from blood(38.86％)and pleural effusion/ascites(10.21％).The predominant species of Candida were Candida albicans(44.51％),followed by Candida parapsilosis complex(19.46％),Candida tropicalis(13.98％),Candida glabrata(10.34％),and other Candida species(0.79％).Candida albicans showed overall high susceptibility rates to the 10 antifungal drugs tested(the lowest rate being 93.62％).Only 2.97％of the strains showed dose-dependent susceptibility(SDD)to fluconazole.Candida parapsilosis complex had a SDD rate of 2.61％and a resistance rate of 9.42％to fluconazole,and susceptibility rates above 90％to other drugs.Candida glabrata had a SDD rate of 92.01％and a resistance rate of 7.99％to fluconazole,resistance rates of 32.27％and 48.24％to posaconazole and voriconazole non-wild-type strains(NWT),respectively,and susceptibility rates above 90％to other drugs.Candida tropicalis had resistance rates of 29.55％and 26.24％to fluconazole and voriconazole,respectively,resistance rates of 76.60％and 21.99％to posaconazole and echinocandins non-wild-type strains(NWT),and a resistance rate of 2.36％to echinocandins.Conclusions The prevalence and species distribution of Candida spp.in the East China region are consistent with previous domestic and international reports.Candida glabrata exhibits certain degree of resistance to fluconazole,while Candida tropicalis demonstrates higher resistance to triazole drugs.Additionally,echinocandins resistance has emerged in Candida albicans,Candida glabrata,Candida tropicalis,and Candida parapsilosis.