Objective To explore the clinical value of clara cell protein 16 (Cc 16) in the early diagnosis of ARDS in critically ill patients.Methods A total of 55 critically ill patients admitted between March 2013 and December 2013 in the Intensive Care Unit were enrolled for study.The inclusion criteria were as follows:sepsis,pneumonia,multiple injuries,patients after emergency or elective operation and non-cardiogenic diseases,whereas the exclusion criteria were cardiogenic pulmonary edema,age ≤ 18 years or≥80 years and disease course prolonged over one week.The level of serum Cc16 was detected with enzyme linked immunosorbent assay (ELISA).In addition,data of other biochemical examinations,the Acute Physiology and Chronic Health Evaluation (APACHE]Ⅱ) score and the relevant medical data were documented.The patients were divided into ARDS groups and non-ARDS groups based on clinical data met Berlin definition.Results The sensitivity and specificity of serum Cc16 for diagnosis of ARDS were 92％ and 80％,respectively with the area under the curve being 0.92,which were better than those of APACHE Ⅱ score,D-dimer,C-reactive protein,N-terminal pro-brain natriuretic peptide and serum albumin detected by the means of receiver operating characteristic curve,and cut off value was 20.62 ng/L.The bivariate analysis showed there was negative correlation between Cc16 and oxagenation index in ARDS patients and the Pearson correlation coefficient of serum Cc16 with oxygenation index was r =-0.342 (P =0.04).The results of one-way analysis of variance showed difference in level of Cc16 between subgroups (F =15.76,P =0.005 17).The level of Ccl6 in severe ARDS group was (64.18 ± 12.95) ng/L which was higher than that in mild ARDS group (35.87 ± 11.28) ng/L (P =0.001 14),and in moderate ARDS group (38.66 ± 20.14) ng/L (P =0.004 9),and in non-ARDS group (16.72 ± 8.74) ng/L (P =0.000 32).There was no statistically significant difference in Cc16 level between mild ARDS group and moderate ARDS group (P =0.682).The level of serum Ccl6 did not correlate with type or days of respiratory ventilation support,28-day survival rate or 120-hour survival rate and days of ICU stay and hospital stay.Conclusions The diagnostic value of serum Cc16 is very high in determining the presence and severity of ARDS in addition to the Berlin criteria in critically ill patients accurately assessing degree of lung injury.

The model of Doppler signal was constructed at first,then the design of wall filter and AR Models of unneeded filtering clutter were analyzed and various filter that can suppress wall signal were mainly analyzed and their capability were compared simply in this paper.

急性肠套叠是2岁以下小儿常见的一种急腹症,诊断治疗不及时、不正确会导致肠坏死、肠穿孔及腹膜炎等严重并发症,有时甚至危及患儿生命.多数学者[1-3]认为发病时间在24 h之内、一般状态良好、没有腹膜炎及肠坏死征象时,最佳治疗方法为空气灌肠复位法.但是如果空气灌肠整复失败,患儿就需要进行外科手术治疗.所以,提高空气灌肠整复的成功率极为重要.

目的:评价尿流动力学检查在BPH病人术前诊治中的意义.方法:对38例BPH患者术前进行尿流动力学检测;根据检测结果选择不同方法进行治疗,其中行前列腺切除术30例,膀胱造瘘术2例,保守治疗6例.结果:38例中有32例存在膀胱出口梗阻,逼尿肌功能严重低下或无力6例,逼尿肌功能不稳定16例,逼尿肌反射亢进1例;术后3个月复查,38例均取得满意疗效.结论:BPH病人术前尿流动力学检测可以明确膀胱出口有无梗阻、逼尿肌顺应性和收缩功能,这对于合理选择术式以提高疗效有重要的临床意义.