ObjectiveTo observe the changes in plasma interleukin-33 (IL-33) in patients with sepsis and its regularity, the association between IL-33 and the infection, and the significance of IL-33 in predicting the prognosis of sepsis.Methods A prospective single-center single-blind clinical study was conducted. Forty patients with sepsis in intensive care unit (ICU) of Shengjing Hospital of China Medical University from May 2012 to January 2013 were enrolled. The patients were divided into general sepsis, severe sepsis and septic shock groups according to the severity of systemic infection and presence of organ dysfunction. The sepsis patients were again divided into 28-day death group and survival group. Ten healthy volunteers and 11 patients with systemic inflammatory response syndrome (SIRS) were enrolled as healthy control and SIRS groups. The levels of procalcitonin (PCT), IL-33, IL-6, IL-1β, tumor necrosis factor-α (TNF-α), and IL-33 receptor sST2 were determined with enzyme linked immunosorbent assay (ELISA) within 3 hours, and 24 hours and 5 days after enrollment to ICU. The acute physiology and chronic health evaluationⅡ (APACHEⅡ) score was calculated. The clinical outcome, length of stay in ICU, and duration of mechanical ventilation were recorded. The relationship between IL-33 and each parameter was analyzed by Spearman analysis. Receiver operating characteristic (ROC) curve was drawn to evaluate IL-33 in predicting the outcome of sepsis.Results Plasma IL-33 in sepsis patients within 3 hours after admission was significantly increased compared with that of the healthy controls and SIRS group (ng/L: 15.43±7.22 vs. 0.67±0.24, 1.25±1.09, bothP< 0.01). Compared with SIRS group, PCT in sepsis group was significantly increased [μg/L: 52.23 (19.69, 73.37) vs. 1.22 (0.69, 3.73),Z = -2.447,P< 0.001]. With exacerbation of illness, APACHEⅡ score, the values of PCT and IL-33 were gradually increased in general sepsis, severe sepsis and septic shock groups, while the length of stay in ICU and the duration of mechanical ventilation were gradually prolonged (P< 0.05 orP< 0.01). The concentration of IL-33 (ng/L) of sepsis patients admitted to ICU within 3 hours, and 24 hours and 5 days of the illness was 15.43±7.22, 11.82±6.16, 5.55±2.25, respectively (F = 4.823,P = 0.004). There was a positive correction between IL-33 within 3 hours after ICU admission and APACHEⅡ score (r = 0.351,P = 0.031), PCT (r = 0.412,P = 0.005), IL-6 (r = 0.535,P = 0.030), IL-1β (r = 0.674,P = 0.030), TNF-α (r = 0.250,P= 0.030), sST2 (r = 0.620,P< 0.001), and length of stay in ICU (r = 0.296,P = 0.013), duration of mechanical ventilation (r = 0.385,P = 0.011). Decreased plasma IL-33 level could be found in the survivors (n = 37,F = 7.798,P< 0.01), and its level in non-survivors (n = 3) was increased (F = 37.283,P> 0.05). The area under the ROC curve (AUC) of IL-33 and PCT in ROC curve were 0.821, 0.829. When the cut-off value of IL-33 was 13.79 ng/L, the sensitivity was 74.2%, the specificity was 79.6%; when the cut-off value of PCT was 4.70μg/L, the sensitivity was 87.5%, and the specificity was 81.4%.Conclusions The concentration of IL-33 3 hours after ICU admission was obviously increased in sepsis patients, and it was positively correlated with PCT, therefore it is valuable in the diagnosis of the infection. In addition plasma IL-33 is related to the severity of sepsis. Its trend of change is valuable in predicting the outcome and in distinguishing sepsis from SIRS.

OBJECTIVE:To compare antidiuretic activity of Ootheca Mantidis before and after processing,and to explore the best medicinal part and mechanism of Ootheca Mantidis. METHODS:96 rats were randomly divided into blank group,model group,positive group,Ootheca Mantidis group,Ootheca Mantidis stir-fried with salt group,steamed Ootheca Mantidis group, crude product eggs and egg shell groups,processed product eggs and egg shell groups,with 8 rats in each group,12 groups in to-tal. Except blank group,other groups were given adenine 250 mg/kg,ig,for 4 weeks to induce kidney-yang and diuresis model. From third week,Ootheca Mantidis crude drug group and processed Ootheca Mantidis group were all given relevant medicine 0.11 g(crude drug)/ml i.g,and crude product eggs and egg shell groups and processed product eggs and egg shell groups were given rel-evant medicine,ig,once a day,by mass ratio of eggs to egg shell(cude drug 1∶2.4,salt stir-fried product 1∶1.7,steamed prod-uct 1∶2.1)for consecutive 4 weeks. The urinary volume,body weight,renal index and the serum contents of ADH and ALD were all determined. RESULTS:Compared with blank group,body weight and serum content of ADH and ALD decreased in model group,while renal index and urinary volume increased(P<0.05). After 4 weeks of treatment,compared with model group,body weight and serum content of ADH increased in Ootheca Mantidis groups,while urinary volume and renal index decreased (P<0.05);serum content of ALD increased in treatment groups;there was statistical significance in the serum content of ALD in those groups except Ootheca Mantidis group,Ootheca Mantidis stir-fried with salt group and steamed Ootheca Mantidis group (P<0.05);except for ALD,those index were in descending order of steamed Ootheca Mantidis group>Ootheca Mantidis stir-fried with salt group>Ootheca Mantidis group,and steamed Ootheca Mantidis shell group had best exchange. CONCLUSIONS:The an-tidiuretic activity of Ootheca Mantidis has been enhanced after processing. The egg shell of steamed Ootheca Mantidis is main me-dicinal part. To increase the serum content of ADH might be one of the main mechanism of arresting polyuria.

Objective To compare the effect of minimally invasive hematoma the quenching aspiration and hematoma evacuation in the treatment of hypertensive basal ganglia brain hemorrhage.Methods 92 patients with hypertensive cerebral basal ganglia hemorrhage underwent surgical treatment were randomly divided into two groups:minimally invasive quenching suction group of 46 patients,craniotomy group of 46 patients.The mortality,complications and activities of daily living(ADL) postoperative three months were observed.Results The mortality rate of the minimally invasive quenching suck group was lower than that of the craniotomy group (8.7％ vs 21.7％,P ＜ 0.05).The postoperative rebleeding and the incidence rate of complications such as lung infections in the minimally invasive quenching suction group were lower than those of the craniotomy group(all P ＜ 0.05).ADL score 3 months postoperatively of the minimally invasive quenching suction group was higher than that of the craniotomy group [(85.53 ± 13.47) points vs (56.12 ± 11.72) points,P ＜ 0.05].Conclusion Minimally invasive hematoma the quenched aspiration in treatment of hypertensive basal ganglia brain bleeding trauma can reduce the mortality,reduce the occurrence of postoperative complications,increase quality of life in patients,has better efficacy for treatment of hypertensive intracerebral hemorrhage.

Middle ear cancer is a rare malignant tumor of middle ear and mastoid region. Most of middle ear cancer is squamous cell carcinoma in pathology. The major symptoms of middle ear cancer are also common findings in patients with chronic otitis media, so it is quite difficult to make an early diagnosis. Clinical diagnosis most depends on the image examination and pathological examination. There are various treatment strategies in international medical circles. Operation combined with radiotherapy is primary treatment modality used in most cases. Middle ear cancer generally has a poor prognosis.

Medullary thyroid carcinoma(MTC), which includes sporadic type and hereditary type, is a kind of malignant tumor in thyroid parafollicular cells. MTC is the common clinical character of the multiple en-docrine neoplasia type 2 (MEN 2), including MEN 2A and MEN 2B, and familial medullary thyroid carcinoma(FMTC). The RET gene encodes a receptor tyrosine kinase, its mutations and polymorphisms can induce acti-vation of the BET tyrosine kinase domain via different signal pathways resulting the genesis of MTC. RET has been used as a target for MTC molecular therapy. However, a clinically useful therapeutic option for treating pa-tients with RET-associated cancer is still not available.

Objective To analyze the curative effect and safety of the estrogen as an adjunctive treatment of senile vaginitis.Methods 100 patients with senile vaginitis in our hospital from June 2011 to September 2012 were divided into observation group (n =50) and control group (n =50).Observation group was given estrogen plus metronidazole and control group was given metronidazole only.Results 45 cases were cured and 4 cases had effective treatment in observation group,and 21 cases were cured and 17 cases had effective treatment in control group.The efficacy rate was 98.0％ (49 cases)in observation group versus 76.0％(38 cases) in control group (x2=11.50,P＜0.01).After the treatment,the recurrence rate was 6.1％ (3 cases)and 26.3 ％ (10 cases)in observation and control groups respectively (x2 =10.66,P＜0.05).After treatment,vaginal health scores,symptom scores of vaginitis,and vaginal PH were significantly higher in the observation group than in the control group (all P＜0.05).In addition,the improvements of signs and symptoms were significantly better in the observation group than in the control group (all P＜0.05).However,there was no significant difference in adverse reaction rate between the two groups (P＞ 0.05).Conclusions Estrogen as an adjunctive treatment of senile vaginitis has better curative effect and safety.It is worthy of generalization in clinical medicine.

Objective To investigate the effect of combined use of acupuncture and medicine on T cell subgroups in ulcerative colitis patients. Methods Sixty-four patients with ulcerative colitis were randomly allocated to treatment and control groups, 32 cases each. The treatment group received acupuncture plus medication and the control group, medication alone. After two months of treatment, changes in T cell subgroups were observed in the two groups and the clinical therapeutic effects were compared between the two groups. Results The total efficacy rate was 87.5% in the treatment group and 75.5% in the control group; there was a statistically significant difference between the two groups (P<0.05). There were statistically significant pre-/post-treatment differences in CD3, CD4 and CD4/CD8 in the treatment group (P<0.05). There were statistically significant post-treatment differences in T cell subgroup indices (CD3, CD4 and CD4/CD8) between the treatment and control groups (P<0.05). Conclusions Combined use of acupuncture and medicine is an effective way to treat ulcerative colitis. It can regulate the numbers of CD3 and CD4 and improve bodily immunologic function in the patients.

Taking Shengjing Hospital of China Medical University as an example, informatization management measures are applied to outpatient surgical nursing process, including one-card-through outpatient information diagnosis and treatment model, cell-phone APP clinical message diagnosis and treatment model, electronic queuing system, sub-period and multi-channel reserved registration, medical material receiving, online reporting of the repair work, so as to optimize nursing service process, increase effective treatment time, improve efficiency and quality of nursing service.

Objective To investigate the level and influencing factors of self-efficacy for peritoneal dialysis patients. Methods A total of 110 peritoneal dialysis patients were recruited and investigated with a self-designed scale, Self-efficacy for managing Chronic Disease 6-Item Scale, Social Support Assessment Scale, Family APGAR Index and Hospital Anxiety and Depression Scale. Results The score of the self-efficacy was (6.87±2.06) points. Multiple regression analysis showed that anxiety and depression, social support and family function were influencing factors of the self-efficacy, which could explain 44.9% of the variance. Conclusions Improving the self-efficacy of peritoneal dialysis patients can enhance self-care agency and rehabilitation efficacy.

Objective To investigate the effect of moxifloxacin and levofloxacin on the treatment of urinary tract infection and the incidence of adverse reactions.Methods 92 cases of patients with urinary tract infection from January 2015 to September 2016 in Hangzhou cancer hospital were selected and randomly divided into group A and group B with 46 cases in each group.Group A were treated with moxifloxacin treatment,group B were treated with levofloxacin in the treatment,compared with the treatment of two groups of patients.Results The clinical effective rate and clinical cure rate of group A were significantly higher than those of group B,the difference was statistically significant(P<0.05),there was no significant difference in the incidence of adverse reactions and bacterial clearance between the two groups.The incidence of adverse reactions in group A was 10.87％,drug cost was 275.47 yuan,the cost effectiveness ratio of 3.17,the incidence of adverse reactions in group B was 13.04％,drug cost was 45.50 yuan,cost-effectiveness ratio of 0.59,there was no significant difference in the incidence of adverse reactions between the two groups; the cost of drug and cost-effectiveness of group A was significantly better than group B,the difference was statistically significant(P<0.05).Conclusion Moxifloxacin is more effective in the treatment of urinary tract infections,but levofloxacin has lower drug costs.