Sepsis is one of the main cause of patients' death. Lung is the most vulnerable target organ during sepsis, and sepsis patients are often complicated with acute respiratory distress syndrome (ARDS), of which the main mechanism is vascular leakage caused by cytoskeleton rearrangement and cell-to-cell connection changes. IQ-guanosine triphosphatease-activating protein 1 (IQGAP1) has become the key component of cytoskeleton dynamics regulation in recent years. At present, the relationship between IQGAP1 and ARDS induced by sepsis is not yet clear. In this article, we will review the mechanism of the interaction between IQGAP1 and pathogenic microorganisms, changes of pulmonary micro vascular barrier function and cyto-skeleton at the molecular level.

Objective To observe the clinical effect of holmium laser for the treatment of ureteral calculi under ureteroscope .Methods In 205 cases of ureteral calculi with ureteroscopic holmium laser treatment ,the stone expulsion rate,complication,gravel rate were analyzed.Results Operation time was (65.3 ±18.4)min,hospitaliza-tion time was (5.6 ±2.7) d,the success rate of operation was 95.1%(195/205),incidence of complications (hemorrhage in 1 cases,perforation in 2 cases,20 patients with fever) was 11.2%,3 cases of calculi moved to pel-vis,indwelling double J tube in operation ,postoperative ESWL,after 2weeks ~3months stone completely lithagogue rate was 98.4%(192/195).7 cases converted to open operation .After operation 3 cases of ureteral calculi and 5 cases of renal pelvis stones were in postoperative ESWL ( extracorporeal shock wave lithotripsy ) , which was completely discharged and cure .Conclusion There are some advantages of ureteroscopic holmium laser lithotripsy for ureteral calculi with high success rate,the stone expulsion rate high,fewer complications,less trauma,safe and reliable.

ObjectiveTo assess the value of legs passively lifted as an indicator of fluid responsiveness in mechanically ventilated patients with severe sepsis.Methods Twenty-eight mechanically ventilated patients with severe sepsis admitted from May 2010 to May 2011 for volume resuscitation were collected.Patients with non-sinus rhythm or arrhythmia and parturients were excluded. Variation of hemodynamics of the patients in a semi-recumbent position,after passive leg raising (PLR) and after volume expansion (500 ml 6％ hydroxyethyl starch infusion within 30 mins) was studied by using the technique of pulse indicator continuous cardiac output (PiCCO) system.The volume resuscitation were resulted into two groups,responder and non-responder,as per △SVI (stroke volume index) over 15％.HR,arterial systoicblood pressure (ABPs),arterial diastolic blood pressure (ABPd),mean arterial blood pressure (ABPm),mean central venous pressure (CVPm) and cardiac index (CI) were compared between two groups.The changes of ABPs,ABPm,CVPm and SVI after PLR and after fluid resuscitation werc compared with those before PLR and fluid resuscitation.The ROC curve was drawn to evaluate the value of △SVI and △CVPm in predicting volume responsiveness. SPSS 17.0 software was used for statistic analysis. ResultsOf 28 patients,8 were responders and 10 were non-responders.In responders after PLR,some hemodynamic variables including ABPs,ABPm and CVPm were significantly increased [(100.1 ± 18.1) vs.(115.9 ±13.1),P=0.005; (68.1±12.4) vs.(77.8±13.0),P=0.03and(7.2±3.4) vs.(10.1±4.1),P=0.03,respectively ].After PLR,the area under curve (AUC) of the ROC curve of △SVI and △CVPm to predict the responsiveness after fluid resuscitation were 0.897 ± 0.059 (95 ％ CI 0.762-1.000) and 0.819±0.081 (95％CI 0.661-0.977),respectively.When the cut-off levels of △SVI and △CVPm were 10.5％ and 12.7％,the sensitivities were 72.2％ and 72.2％,the specificities were 90％ and 80％.Conclusions Changes in △SVI and △CVPm induced by passive leg raising are accurate indices for predicting fluid responsiveness in mechanically ventilated patients with severe sepsis.

Objective To investigate the expression and significance of fragile histidine triad(FHIT) gene in the cholangiocarcinoma cell line QBC939.Methods The eukaryotic expression vector was transfected into QBC939,real-time RT-PCR was used to detect the change of FHIT expression,and direct counting method under microscope was used to detect the change in the biological behavior of cells.Results After transfection,the expression of FHIT mRNA increased by 2.53-fold,but the cell clones were significantly less [(11.2?1.3) vs.(10.5?1.1) vs.(6.3?1.0),P

Objective: To observe the liver function changes and to analyze the risk factors in patients at peri-operative period of cardiopulmonary bypass surgery.
Methods: A total of 108 patients with cardiopulmonary bypass surgery were observed for their liver function at prior and 1, 2, 3, 6 days post-operation, the related risk factors for lever damage were studied by uni- and multivariate regression analysis.
Results: Compared with pre-operative indexes,① at 1, 2, 3 and 6 days post-operation, aspartate aminotransferase (AST), direct bilirubin (DBIL) were increased, serum albumin (ALB), cholinesterase (CHE) were decreased, and at 1, 2, 3 days post-operation, total bilirubin (TBIL) was increased, at 1, 2, 3 days post-operation, alkaline phosphatase (ALP) was decreased, while it increased at 6 days post-operation, allP<0.05;② glutamyl endopeptidase (GGT) was decreased at 1, 2 days post-operation, while it increased at 6 days post-operation,P<0.05;③glutamate pyruvate transaminase (GPT) was increased at 6 days after operation,P<0.05. Univariate regression analysis indicated that cardiothoracic ratio ≥ 0.56 (P<0.05, OR=2.900, 95% CI: 1.206~6.976), cardiopulmonary bypass time (P<0.05, OR=1.042, 95%CI: 1.017~1.068), aortic clamping time (P<0.05, OR=1.041, 95% CI: 1.012~1.070) and lactic acid level at 1 day after operation (P<0.05, OR=1.518, 95% CI: 1.182-1.948) were related to post-operative damage of liver function. Multivariate regression analysis presented that cardiopulmonary bypass time (P<0.05, OR=1.033, 95% CI: 1.007-1.059) and lactic acid level at 1 day after operation (P<0.05, OR=1.340, 95% CI: 1.028-1.745) were the independent risk factors for post-operative damage of liver function.
Conclusion: Multiterm of liver function could be damaged at the early stage after cardiopulmonary bypass surgery; cardiopulmonary bypass time and lactic acid level at 1 day after operation were the independent risk factors for peri-operative damage of liver function in relevant patients.

Objective To evaluate the clinical value of the immunochemistry staining of thyroid transcription factor-1 (TTF-1), cytokeratin7 (CK7), P63, and cytokeratin5/6 (CK5/6) in the bronchoscop-ic forceps biopsy specimen in the differential diagnosis of non-small cell lung cancers.Methods Totally 143 cases of non-small cell lung cancers from Department of Respiratory and Department of Oncology from Nov 2012 to Jan 2014 were diagnosed with pathological examinations of the bronchoscopic forceps biospy.The sen-sitivity and specificity of TTF-1, CK7, P63, and CK5/6 of forceps biopsy at the diagnosis of lung adenocarci-noma and squamous cell carcinoma were calculated.Results The expressions of TTF-1 and CK7 in the pul-monary adenocarcinomas were higher than the pulmonary squamous cell cancer ( P <0.01).The diagnosis sensitivity and specificity of TTF-1 in the pulmonary adenocarcinoma were 85.1%(63/74) and 98.6%(68/69), respectively.The diagnosis sensitivity and specificity of CK7 in the pulmonary adenocarcinoma were 82.4%(61/74) and 91.3%(63/69), respectively.The diagnosis sensitivity and specificity of P63 in the pulmonary squamous cell cancer were 97.1% ( 67/69 ) and 89.2% ( 66/74 ) , respectively.The diagnosis sensitivity and specificity of CK5/6 in the pulmonary squamous cell cancer were 79.7%(55/69) and 89.2%(66/74), respectively.The combined expression of CK7(+)/TTF-1(+) in the pulmonary adenocarcinoma was higher than the pulmonary squamous cell cancer ( P <0.01).The combined expression of P63(+)/CK5/6(+) in the pulmonary squamous cell cancer was higher than the pulmonary adenocarcinoma ( P <0.01).Conclusions The combination use of the immunochemistry staining of TTF-1, CK7, P63, and CK5/6 helps to differentiate lung adenocarcinoma and squamous cell cancer.

Objective:To investigate the recent and forward effects of different operation patterns on recurrent calculus of intrahepatic duct.Methods:A analysis was made on previous history and operation patterns,distribution,effect and follow-up visit in 76 reoperation patients with recrudescent hepatolith between Jan,2000 and Feb,2008 in Affiliated Provincial Hospital of Anhui Medical University,retrospectively.The situation after operation was confirmed as the short-term curative effects and the follow-up results as long-term curative effects.Results:The average hospital stay was 10.4 days and the incidence rate of postoperative complications was 14.5%.The follow-up which lasted from 8 months to 8 years showed that the average recurernce rate was 38.2%.Besides,the rate of joint-type operation was lower than single-type operation (P

Objective To study the role of plasma B type natriuretic peptide(BNP)concentration in the diagnosis and predicting prognosis of patients with heart failure(HF).Methods Plasma BNP concentration was measured with immunofluorescenee assay in 90 patients with dyspnea.Left ventricular ejection fraction(LVEF)and pulmonary capillary wedge pressure(PCWP)were determined by eehoeardiography and Swan-Ganz catheter respectively in these patients at the same time.The gradation of HF was based on the criteria of cardiac function classification setted by New York Heart Association(NYHA).The HF patients were classified into 2 groups according to BNP concentration measured just before the discharge:patients with BNP＜400 ng/L and BNP≥400 ng/L.The re-admisslon rate within 30 days because of the HF between the two groups was compared.Results Plasma BNP levels were higher in the patients with left heart failure than those in the non-heart failure patients[(569?222)ng/L vs.(52?10)ng/L,P＜0.01],and BNP levels were increased in accordance with the severity of HF.The sensitivity,specificity,and negative predictive values of plasma BNP levels≥100 ng/L for predicting HF were 94.7%,91.7% and 96.7%,respectively.Plasma BNP levels were positively related to PCWP(r=0.55,P＜0.01),and negatively related to LVEF(r=-0.62,P＜0.01).There was no significant difference of plasma BNP levels between patients with different causes of HF.The re-admission rate within 30 days after discharge was notably high if the plasma BNP concentrations were over 400 ng/L.Conclusion Plasma BNP concentration can be regarded as a valuable marker for diagnosis and predicting prognosis of patients with HF.

Burns, Inhalation ; complications ; Humans ; Male ; Middle Aged ; Nitric Acid ; adverse effects ; Pulmonary Edema ; chemically induced ; therapy