ObjectiveTo explore the early diagnostic value of pro-adrenomedullin (pro-ADM) in sepsis. Methods A prospective study was conducted. Eighty-two patients with acute infection admitted to Department of Emergency of Shanxi Medical University Second Hospital from April 2013 to March 2014 were enrolled. According to the diagnostic criteria of sepsis, the patients with acute infection were divided into ordinary infection group [infection without systemic inflammatory response syndrome (SIRS),n = 25] and sepsis group (infection combined with SIRS, n = 57). According to degree of severity of sepsis, the latter group was subdivided into three subgroups: sepsis group (n = 22), severe sepsis group (n = 27) and septic shock group (n = 8). Twenty-four healthy persons were included to serve as healthy control group. The venous blood from all the research objects in hospital was collected within 24 hours. The levels of pro-ADM and procalcitonin ( PCT ) were determined by enzyme linked immunosorbent assay (ELISA), and acute physiology and chronic health evaluationⅡ (APACHEⅡ) score was recorded. The relationship between pro-ADM and PCT and also APACHEⅡ score was analyzed with Pearson correlation analysis. The receiver-operating characteristic curve (ROC) of pro-ADM and PCT were used to evaluate the diagnostic acuity of sepsis.Results The plasma levels of pro-ADM, PCT and APACHEⅡ score in sepsis group were significantly higher than those in ordinary infection group and healthy control group [pro-ADM (ng/L): 66.69±1.73 vs. 53.43±2.70, 45.87±1.43; PCT (ng/L):1 336.49±40.26 vs. 1 083.09±47.99, 959.04±37.53; APACHEⅡ score: 14.60±0.81 vs. 8.10±1.14, 3.00±1.15,allP< 0.01]. With the aggravation of sepsis, the levels of pro-ADM, PCT and APACHEⅡ score were gradually increased, and there were significant differences among sepsis, severe sepsis, and septic shock groups [pro-ADM (ng/L): 64.91±2.50, 73.56±2.80, 84.67±4.52; PCT (ng/L): 1 152.65±48.62, 1 233.93±63.06, 1 475.71±109.93;APACHEⅡ score: 12.91±1.15, 14.55±1.14, 19.37±2.40,P< 0.05 orP< 0.01]. Pearson correlation analysis results showed that the level of pro-ADM was positively related with PCT (r = 0.473,P = 0.006), and it was also positively correlated with APACHEⅡ score (r = 0.707,P = 0.008). ROC curve analysis showed that area under the ROC curve (AUC) of pro-ADM for diagnosis of sepsis was 0.823 (P = 0.003). When the cutoff value was 59.40 ng/L, the sensitivity was 80.7%, the specificity was 68.0%, the positive predictive value was 85.2%, and the negative predictive value was 60.7%. AUC of the PCT for diagnosis of sepsis was 0.653 (P = 0.043). When the cutoff value was 1 194.67 ng/L, the sensitivity was 68.4%, the specificity was 64.0%, the positive predictive value was 81.8%, and the negative predictive value was 44.7%. It was proved that the pro-ADM had a higher diagnostic value for sepsis than PCT.Conclusion The plasma levels of pro-ADM can be used as an early indicator in diagnosis and severity evaluation and prognosis in patients with sepsis .

Objective To explore the value of neopterin (Np) in early diagnosis and risk stratification of sepsis.Methods A total of 82 patients admitted to the emergency department from April 2013 to February 2014 were enrolled in the study.They were divided into two groups:sepsis-free group (n =8) and sepsis group (n =74).Patients' APACHE Ⅱ scores were calculated within 24 hours after admission,and then their plasma levels of Np and procalcitonin (PCT) were detected and analysis was carried out to find the correlation between plasma levels of Np,PCT and acute physiology and chronic health evaluation Ⅱ score (APACHE Ⅱ score) in two groups.And 74 patients in sepsis group were further divided into three subgroups according to their APACHE Ⅱ score:Ⅰ subgroup (score ＜ 15,n =27),Ⅱ subgroup (score 15 to 24,n =32),and Ⅲ subgroup (score ＞ 25 or more,n =15).The differences in plasma Np and PCT levels were compared among three subgroups and correlation analysis of Np levels with PCT levels and APACHE Ⅱ scores was carried out.Results The plasma levels of Np,PCT and APACHE Ⅱ scores in sepsis group were higher than those in sepsis-free group (P ＜ 0.05).In sepsis group,the plasma levels of Np and PCT were gradually increased with the increasing severity of sepsis (P ＜ 0.05);In sepsis group,the plasma levels of Np,PCT and APACHE Ⅱ scores were positively correlated (P ＜0.01).The area under receiver operating characteristic curve (ROC) of Np was O.79 and the area under ROC of PCT was 0.75,both of which had high diagnostic accuracy.Conclusions Neopterin has greatly useful value in early diagnosis and risk stratification of sepsis.

Objective To explore the causes of death of patients with cerebral hemorrhage of hypertension in recent 6 years and the countermeasure of decrease death rate.Methods The clinical data,different kinds of treatment and curative effects of the patients of two groups,admitted in recent six years,with cerebral hemorrhage of hypertension was refrospectively analysied.Results Of 157 cases of cerebral hemorrhage of hypertension in group A,there were 69 cases died(44%).Of 158 cases of cerebral hemorrhage of hypertension in group B,there were 48 cases died(30.4%).Death rate between the two of group had significant difference(P

Objective To investigate the prevalence rate of non-obese fatty liver disease and its influencing factors, and to provide a reference for the prevention and treatment of fatty liver disease. Methods A total of 23 545 individuals who underwent physical examination in Karamay Central Hospital from January to December 2015 and had complete data of abdominal ultrasound, body mass index (BMI), age, and sex were screened out to analyze the prevalence rate of fatty liver disease, and 7484 individuals with normal BMI who had complete data of triglyceride (TG), fasting blood glucose, and alanine aminotransferase (ALT) were further screened out to perform a multivariate analysis. The t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between groups. A multivariate logistic regression analysis was performed to investigate independent influencing factors for non-obese fatty liver disease. Results In 2015, the prevalence rate of fatty liver disease was 30.2% (7116/23 545) among the individuals who underwent physical examination in Karamay Central Hospital. A stratified analysis based on BMI showed that the individuals with emaciation, normal BMI, overweight, and obesity had a prevalence rate of 0.8% (6/706), 9.3% (919/9899), 38.4% (3404/8870), and 68.5% (2787/4070), respectively (all P < 0.05), and male individuals had a significantly higher prevalence rate of fatty liver disease than female individuals (all P < 0.05). Among the 919 patients with non-obese fatty liver disease, young, middle-aged, and elderly patients accounted for 40.7% (374/919), 46.1% (424/919), and 13.2% (121/919), respectively. For the individuals with normal BMI, there was no significant difference in the prevalence rate of fatty liver disease between middle-aged and elderly individuals (14.5% vs 16.8%, P > 0.05), while both of them had a significantly higher prevalence rate than the young individuals (14.5%/16.8% vs 6.0%, P < 0.05). Young and middle-aged male individuals had a significantly higher prevalence rate of fatty liver disease than their female counterparts ( χ 2 =99.40 and 43.29, both P < 0.001), while the elderly male individuals had a significantly lower prevalence rate than their female counterparts ( χ 2 =9.81, P =0.002). For the individuals with normal BMI, the individuals with normal TG had a prevalence rate of fatty liver disease of 5.0% (311/6273), while those with elevated TG had a prevalence rate of 26.8% (325/1211), with a significant difference between the two groups ( χ 2 =624.90, P < 0.001). The multivariate logistic regression analysis showed that age, BMI, ALT, fasting blood glucose, TG, and serum uric acid level were independent influencing factors for fatty liver disease in individuals with normal BMI (all P < 0.001). Conclusion There is a relatively high prevalence rate of non-obese fatty liver disease among individuals undergoing physical examination in Karamay Central Hospital, and 61.5% of the patients with non-obese fatty liver disease have glucose or lipid metabolic disorders. Serum TG level may be used as a simple and effective screening index for non-obese fatty liver disease.