Objective To investigate the clinical significance of plasma presepsin levels in patients with sepsis. Methods 92 patients who were admitted to the ICU of the affiliated hospital of Jiangsu University from October 2011 to March 2013 and 30 age-matched healthy controls were enrolled in this study. The patients were divided into three groups: sepsis, SIRS, and control. Plasma presepsin and serum procalcitonin (PCT) were measured, APACHEⅡscore were calculated at enrollment, and ROC curve was used to analyze the performance index for the diagnosis of sepsis. Results Serum levels of presepsin, PCT and APACHEⅡscore were significantly higher in the death group than in the SIRS group and the control group (P<0.01). Serum levels of presepsin and PCT were higher in the sepsis group than in the SIRS group and the control group (P<0.05). There was no significant statistical difference between the SIRS group and the sepsis group in the APACHEⅡ score (detailed in table 1). Level of plasma presepsin was significantly correlated with serum PCT (r = 0.82); plasma presepsin level was related with the APACHEⅡ score (r = 0.69). The area under the curve (AUC) of presepsin was 0.908 (95%CI 0.848~0.967), greater than the AUC of PCT 0.862 (95%CI 0.787~0.937). The cutoff value of presepsin for discrimination of bacterial and nonbacterial infectious diseases was determined to be 629 pg/mL, of which the clinical sensitivity and specificity were 68.6% and 90%, respectively; when the cutoff value of PCT was 1.98 ng/mL, the clinical sensitivity and specificity were 92%and 65%. Conclusions Level of presepsin increases in patients with sepsis, and an elevated presepsin may suggest the severity of sepsis.

Aim To study the preparation of α-cobro-toxin-loaded poly ( lactide-co-glycolide ) microspheres and their analgesic effect. Method The microspheres were prepared by modified water-in-oil-in-oil ( w/o/o ) emulsion solvent evaporation method. A tail flick assay was used to evaluate the analgesic activity of the micro-spheres after nasal administration. Result The micro-spheres with high entrapment efficiency ( >80%) and average diameter of about 25 μm could be prepared by modified water-in-oil-in-oil ( w/o/o ) emulsion solvent evaporation method. A tail flick assy showed the evi-dence for their analgesic effect. Conclusion When Chinese cobraneurotoxin is loaded into microsphere and then the microsphere is administered through nasal cav-ity, its analgesic effect is enhanced significantly.

Objective To evaluate the relation between cystatin C and the presence and severity of asymptomatic coronary artery disease in metabolic syndrome(MetS).Methods A total of 201 asymptomatic MetS patients with normal renal function were per-formed the coronary angiograph and the detection of serum Cystatin C level and other risk factors for atherosclerosis.Results Ser-um cystatin C level in the MetS patients with asymptomatic coronary artery disease were significantly higher than those in the pa-tients without coronary artery disease,moreover the more severe of the disease,the higher the cyctatin C,which was independently associated with other risk factors for atherosclerosis.Conclusion Serum cystatin C level can been used as the index for the presence and severity of asymptomatic coronary artery disease in Mets with normal kidney function.

Objective To explore the mechanisms of recovery from aphasia by using speech-activated single photon emission computed tomography(SPECT)brain imaging.Methods The SPECT brain imaging of 7 aphasic patients caused by various brain disorders were performed while they were at rest and performing oral reading,respec- tively,with an one-day interval.A semi-quantitative analysis of regional cerebral blood flow(rCBF)was conducted using region of interesting(ROI).The change of rCBF before and after reading was calculated and compared to ana- lyze the role of both hemispheres in the recovery from aphasia.Results It was found that the activation pattern of brain region was associated with the speech performance of the patients.The activated brain regions were mainly loca- ted at the left hemisphere in 5 patients whose reading capacity was relatively better,and mainly at the right hemi- sphere in the other 2 patients who had poor performance in reading.Conclusion After a focal lesion of the left hemisphere,the recovery of speech function might be mainly attributed to the repair of the damaged left hemisphere language network.When the left-hemispheric centers were permanently impaired,the brain would recruit some right- hemisphere regions for speech processing,but this strategy was less effective than the repair of the original speech-rel- evant network.

Objective To evaluate the value of high-frequency echocardiography in assessing Bax gene transfer influence on survival of heterotopic cardiac allograft in rats.Methods Thirty rat models of heterotopic heart transplantation were established.Group A received heart transplantation only; Group B received cyclosporin (CsA) after operatiom Group C received ultrasound targeted microbubble destruction (UTMD) combined with Bax-shRNA.All rats were tested by high-frequency echocardiography at day 1,3,6 after transplantation.The ultrasound parameters included left ventricular internal dimension diastole (LVIDd),left ventricular internal dimension systole(LVIDs),left ventricular ejection fraction(LVEF),left ventricular thickness (LVT),left ventricular thickening (LVTR) and so on.The pathologic examinations were carried out on five rats at day 6 after echocardiography exam.The other rats in each group were observed for the survival time of cardiac allograft.Results ①The left ventricular long axis view and the apical four chamber view could be displayed clearly by high-frequency echocardiography.②The survival time of allografts in group C was (16.21 ± 5.01)d,which was longer than that in group B [(11.14 ± 1.72)d,P ＜ 0.05] and group A [(7.26 ± 1.50)d,P ＜0.01].③LVT index got higher after transfection.At day 6,LVEF of group A was lower than group B and C markedly(P ＜0.05) while no significant difference was found between group B and C(P ＞0.05).At day 3 and 6,LVT of group A and B were higher than group C (P ＜0.05) while LVTR was lower(P ＜0.05).Conclusions The Bax gene transfer influence on survival of heterotopic cardiac allograft in rats could be evaluated accurately by high-frequency echocardiography which could assess cardiac structure and function.LVT and LVTR can be considered as early evaluation indexes for its high sensitivity over LVEF.

AlM: To investigate the refractive status of the preschool children in Xiantao, Hubei Province in order to find out the abnormal refraction error beyond the physiological range.
METHODS: ln this cross - sectional study, we investigated preschool children in kindergartens and the scattered ones were 12 716 ( 25 432 eyes ) ranging from 6mo ~ 6 years old. 1 581 children ( 3 162 eyes ) were diagnosed ametropia by Suresight refractive screening instrument, which were confirmed again after mydriasis optometry.
RESULTS: The incidence rate of ametropia in preschool children in Xiantao was 12. 4%, and statistics showed no significant difference between boys and girls (P>0. 05), but had differences of morbility rate among each age group (P<0. 05). With age increasing morbility rate of the refractive error decreased. The simple hyperopia and the compound hyperopia astigmatism were dominant in all refraction error. Professional ophthalmologists diagnosed amblyopia in 261 children (522 eyes), which was 16. 5%, among 1581 abnormal refractive children (3 162 eyes) screened out by Suresight refractive screening instrument.
CONCLUSlON: The incidence rate of ametropia decreases with age increasing in the preschool children from 6mo~6 years old, which imply preschool children should have mydriasis optometry in order to find out amblyopia and other congenital eye disease.

Objective:To evaluate the clinical efficacy between preparation porcelain veneer(PPV)and no-preparation porcelain veneer(NPPV).Methods:44 patients with 97 PPVs and 23 patients with 57 NPPVs were followed up for 3 years.Mental tension, postoperative dentin sensitivity and satisfaction of the patients,survival rate of the veneers,sulcus bleeding index(SBI)of preopera-tive and postoperative 3 years were evaluated.A comparative analysis was taken to examine the clinical indicators of 2 groups accord-ing to the modified CDA /Ryge criteria.Results:Survival rates of PPVs and NPPVs were 96.91 % and 96.49%(P >0.05),satisfac-tion rates of the 2 group patients were 95.45% and 95.65%(P >0.05),respectively.Mental tension and the postoperative dentin sensitivity of patients in PPV group was higher than those in NPPV group.Preoperative and postoperative SBI were not statistically dif-ferent between the 2 groups(P >0.05).Marginal adaptation in PPV group was better than that in NPPV group.Color matching, Porcelain surface and Marginal stain were not statistically different between 2 groups.Conclusion:Preparation porcelain veneers and no-preparation porcelain veneers both are effective in clinical application.

Objective To investigate the influencing factors of hemorrhagic transformation in non-thrombolysis patients after acute cerebral infarction. Methods According to Chengdu Stroke Registry Project,2598 consecutive patients with acute cerebral infarction admitted to the Department of Neurology,West China Hospital within 1 week of attack from January 2010 to December 2013 were enrolled prospectively. The patients were divided into a hemorrhagic transformation group and a non-hemorrhagic transformation group according to whether they had hemorrhagic transformation or not. As for patients with hemorrhagic transformation,they were divided into a symptomatic hemorrhagic transformation (SHT)group and an asymptomatic hemorrhagic transformation (ASHT)group according to whether they had aggravation of symptom and sign. The baseline data of all patients were collected and compared between the groups. The P<0. 1 variables of the univariate analysis result were enrolled in multivariate logistic regression analysis in order to identify the independent influencing factor of hemorrhagic transformation. Results In 2598 patients,249 (9. 6%)had hemorrhagic transformation,28 of them (1. 1%)were SHT and 221 (8. 5%)were ASHT. There were significant differences in male,hypertension,dyslipidemia,atrial fibrillation,drinking and smoking ratio,blood glucose,cholesterol,low density lipoprotein cholesterol, National Institutes of Health Stroke Scale (NHISS)scores,and the trial of Org 1072 in acute stroke treatment (TOAST)classification between the HT group and the non-HT group (all P<0. 05). There were no significant difference in the related influencing factors between the SHT group and the ASHT group (all P>0. 05). The results of multivariate logistic regression analysis showed that dyslipidemia (OR,0. 588, 95%CI 0. 374-0. 924,P=0. 021)was negatively correlated with hemorrhagic transformation. Atrial fibrillation (OR,3. 188,95%CI 2. 159-4. 707,P<0. 001),blood glucose (OR,1. 081,95%CI 1. 044-1. 119,P<0.001),and NHISS score (OR,1. 305,95%CI 1. 170-1. 455,P<0. 001)were positively correlated with hemorrhagic transformation. In TOAST classification,relative to the large atherosclerotic stroke,the small artery occlusive cerebral infarction was negatively correlated with hemorrhagic transformation (OR,0. 315, 95%CI 0. 167-0. 596,P<0. 001). After removing the influencing factor of atrial fibrillation,compared with the large artery atherosclerotic stroke,cardioembolism stroke was positively correlated with hemorrhagic transformation (OR,2. 823,95%CI 1. 946-4. 095,P<0. 001). Conclusion Dyslipidemia,atrial fibrillation,blood glucose,NHISS score and TOAST classification were independently associated with hemorrhagic transformation in non-thrombolysis patients after acute cerebral infarction.

The progress in integrative medicine (IM) of coronary heart disease (CHD) in 2013 was summarized in this paper. Gratifying progress has taken place both in clinical studies and basic research of IM on CHD during 2013. We got some innovation in Chinese medical etiologies and pathogeneses of CHD. We also got some improvement in researches on Chinese medical syndromes in various fields. Many clinical studies have proved Chinese medicine and pharmacy is playing a role in preventing and improving CHD patients. In-depth basic researches on preventing and treating CHD by IM are gradually undergoing. Acting targets and mechanism are further clarified. Besides, we also pointed out the developing tendency of CHD researches and the current deficiency in CHD researches, hoping to provide reference for further studies in this field.
Coronary Disease ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Integrative Medicine

Objective To investigate the expression of NF-k B and c-myc in keratinocytes of HPV infected condyloma acuminata (CA) lesions.Methods Fifty cases of HPV 6/11 positive CA were diagnosed by in situ hybridization.The expression and distribution of NF-k B and c-myc were detected by immunohistochemistry technique (EnVision) with CA lesions and 25 normal human skins (foreskins). Results②The expression of NF-k B and c-myc was significantly higher in keratinocytes of CA lesions than those of normal controls (P＜0.01 ).NF-k B was mainly expressed in spinous layers of CA lesions, and most positive signals located significantly in the cytoplasm.C-myc was mainly expressed in the whole epidermis or in spinous and basal layers in CA lesions,and positive signals located in the nuclei.②There was a positive correlation between the expression of NF-k B and c-myc in CA lesions (r=0.89,P＜0.01).Conclusions The study demonstrates that the expression of both NF-k B and c-myc is significant- ly higher in HPV 6/11 positive CA than in normal skin.The data suggest that transcriptional factor NF-k B and c-myc may play a role in the regulation of proliferation of HPV 6/11 infected cells.