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.

Actinomyces ; growth & development ; Coinfection ; Humans ; Maxillary Sinus ; Maxillary Sinusitis ; diagnosis ; microbiology

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.

In the past few decades, accumulated experimental and clinical evidences suggest that cyclic guanosine monophos-phate (cGMP) plays an important role in atheroselerosis. Vasodilator-stimulated phosphoprotein (VASP), a major downstream compo-nent of the cGMP signaling cascade, is an actin-binding protein which regulates cell adhesion, morphology change, cell motility and cell proliferation. It has shown that VASP is associated with many factors influencing atherosclerosis, and it plays an important role in the genesis and development of atherosclerosis. The relationships between the occurrence of atherosclerosis and risk factors for athero-sclerosis such as hypertension, hyperglycaemia and hyperlipidemia are reviewed in this article.

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 examine the expression of podocalyxin protein in glomerular podocytes by long-term high glucose exposure in vitro and in vivo.Methods:Immunohistochemical staining and computer image analysis were applied to detect the expression of podocalyxin protein in glomeruli from db/db mice and Wt mice.The effects of high glucose on the expression of podocalyxin protein were analized by Western blotting.The activation of MAPKS signaling pathway(ERK,p38 and JNK)by high glucose was also examined.Results:The expressions of podocalyxin protein in db/db mice were obviously less than that in Wt mice[(0.18?0.07)vs(0.25?0.05),P

Objective To exzaminate its efficacy of appendectomy with small incision and sum up its virtues ,indications and technologies.Methods To analysize the clinical datas of 118 patients admissioned in Hangzhou first people’s hospital from July in 2001 to Dec.2006 retrospectively. Results 113 cases cured ,2 cases complicated with incision infectionh ,2 with fat fludify,1 with chronic diarrhea for bacterium maladjustment,1 with appendicity cancer proved by pathology. Conclusions Appendectomy with small incision compared with traditional operation has little complications ,no serious pain ,intestinal function recovery rapidly ,hospital stay shorter and incision close up well.simple appendicitis and most of suppurate appendicitis may be prefer to conside.

Objective To sum up and investigate the experience in diagnosis and therapeutic procedure for Hashimoto's disease(HD).Methods Clinical datas of 57 patients who were diagnosed clinically as HD admitted to First People's Hospital of Hangzhou from Jan 1996 to Dec 2006 were collected and analyzed.Results 50 females and 7 males,aged 12 to 68 years(average of 43.6 years).Rate of male to female is 1∶14,HD was coexistent with 10.5%(6/5 7)of thyoidgland malignant tumor 19.3%(11/57)of adenoma,14.0%(8/57)of hyperthyroidism,21.1%(11/57)of other systemtic autoimmunity disease and 8.8%(5/57)other rare disease 33.3%(19/57)of them were performed raical operation.The misdiagnosis rate was 21.1%(12/57)and missed diagnosis rate was 22.8%(13/57),The clinical feature of HD for diagnosis and surgical management procedure have been discussed.Conclusions It is emphasized that patients who suspected highly of having HD should be examinated by comprehensive methods,including B-us,lightly color on scintillation scintigraphy,elevation of antimicrosomiauxi and antithyoglobuline,FNAB,operative exploration and biopsy would be helpful.We suggest that the diagnosis of HD may be taken some routinely comprehensive procedure.To date,consecutive therapy and occationly some patients when the disease in coexistence,who ought to be operated correspondingly.

Objective To observe the clinical results of abdominal cavity chemotherapy by tube for the patients with stomach cancer ascities.Methods Fourteen patients with advanced stomach cancer ascities were treated by combination of abdominal chemotherapy and intervention chemotherapy from June in 2001 to June in 2006.Results Four patients alleviated completely,6 partly alleviated,2 mildly alleviated,1 stability,1 in progress.The total effective rate is 85.7%.Conclusions Abdominal chemotherapy is simple,the curative effect is accurate,but should choose suitable belly cavity detain tube,taking strict precautions against slip of chemotherapeutic drugs,the period is tight to observe.the poisonous reaction is also observed and should be handled in time,support therapy should be strengthened.