Objective To dynamic monitoring the changes of serum cortisol,adrenocorticotropic hormone (ACTH) in children with sepsis and servere sepsis,and to assess it's relationship with clinical features.Methods Thirty children with sepsis were enrolled in this study from Sep 2010 to Jan 2011 in our hospital,and were divided into severe sepsis group (n =10) and sepsis group (n =20).The serum cortisol and ACTH were analysed in acute and recovery period respectively in both two groups,and compared with 10 non-sepsis children as control group.Results In the acute period,the level of serum cortisol in severe sepsis group [ (33.97 ±6.83) μg/ml ] was significantly higher than those in sepsis group [ (26.30 ± 10.43) μg/ml]and control group [ ( 19.06 ± 6.91 ) μg/ml ] ( P ＜ 0.01 ) ; the level of serum ACTH in severe sepsis group [ (25.47 ± 9.41 ) pg/ml ] was significantly higher than those in sepsis group [ ( 15.52 ± 5.85 ) pg/ml ] and control group [ (9.16 ± 3.02 ) pg/ml ] ( P ＜ 0.01 ).Conclusion Stress response exists in the early period of sepsis,and the levels of serum cortisol and ACTH are increased significantly.The levels of serum cortisol and ACTH are positive correlation with the severity of diseases,and they could be used as serious index and a marker for evaluating prognosis in children with sepsis.

BACKGROUND:Different sources of stem cells have different molecular characteristics and growth characteristics;therefore, there are some differences in therapeutic mechanisms and effects. OBJECTIVE:To compare mesenchymal stem cells growth characteristics form two sources. METHODS:Mesenchymal stem cells from the umbilical cord and the embryonic liver were isolated and cultured. Passage 5 cells were used to observe the cellmorphology, calculate the doubling time of cellpopulation-doubling time, identify surface markers and determine the differentiation capacity. Mesenchymal stem cells from the umbilical cord were subcultured to passages 10 and 15, and cellcurves were drawn and population doubling time was calculated. RESULTS AND CONCLUSION:Mesenchymal stem cells from these two sources in logarithmic phase were fusiform and grew spiral y with osteogenic, adipogenic, and chondrogenic capacities. The growth curves of cells were both S-shaped. At passage 5, the doubling time was (34.37±0.31) hours for embryonic liver-derived mesenchymal stem cells and (35.63±0.38) hours for umbilical cord-derived mesenchymal stem cells, and there was no significant difference (P>0.05). However, the population doubling time of passages 10 and 15 umbilical cord-derived mesenchymal stem cells was (52.6±0.53) and (53.27±0.92) hours, respectively, which was significantly difference from that of passage 5 cells (P<0.05). The cellmorphology and growth curve from two sources are basical y the same. Embryonic liver-derived stem cells are smal er and proliferate faster than umbilical cord-derived mesenchymal stem cells, but no statistical difference is found between the two types.

Objective To investigate the expression and clinicopathological significance of metastasis-associated 1 (MTA1), matrix metalloproteinase-9 (MMP-9) and vascular endothelial growth factor-C (VEGF-C) in a gastric adenocarcinoma.Methods The expressions of MTA1, MMP-9, and VEGF-C were detected with immunohistochemical method in 120 cases of gastric adenocarcinoma tissues and 30 cases of normal gastric tissues.Results The positive percentage of MTA1, MMP-9, and VEGF-C proteins in gastric adenocarcinomas was 76.7％ , 71.7％ , and 64.2％ , respectively, which was significantly higher than that (33.3％, 36.7％, and 30.0％) in normal gastric mucosa tissues (P ＜0.05).The expressions of MTA1, MMP-9, and VEGF-C were significantly higher in gastric carcinoma invasion serous membrane, lymph node metastasis, clinical Ⅲ ～ than that in non-invasion serous membrane, non-lymph node metastasis, and clinical Ⅰ ～ Ⅱ (P ＜ 0.05).The expression of MTA1 had significantly positive correlation with that of MMP-9 (P ＜ 0.05) and VEGF-C (P ＜ 0.05) in gastric adenocarcinomas.Conclusions The expressions of MTA1, MMP-9, and VEGF-C were higher in gastric adenocarcinomas than normal gastric mucosa tissues.They may play an important role in the invasion and metastasis of gastric carcinomas.MTA1 may promote infiltration, invasion, and lymph node metastasis of gastric carcinoma through regulation of the expressions of MMP-9 and VEGF-C.The combined detection of MTA1, MMP-9, and VEGF-C expressions has important value to judge the grade malignance of gastric adenocarcinomas.

Objective To investigate the correlation between the use density of antibiotic and antifungal drugs and the positive rate of aspergillus in our hospital from 2009 to 2013,in order to provide a scientific basis for rational use of antibiotic and antifungal drugs. Methods The use density of carbapenems,two third-generation cephalosporins,and antifungal drugs,and the positive rate of aspergillus in our hospital from 2009 to 2013 were studied retrospectively. Their correlation was analyzed using SPSS software. Results There was significantly positive correlation between the use density of imipenem and that of fluconazole (r=0.913,P<0.05).The use density of biapenem was positively correlated with that of voriconazole (r=0.915,P<0.05).The use density of biapenem and that of voriconazole was positively correlated with positive rate of aspergillus,respectively ( r=0.918,r=0.955,both P<0.05).The other antibiotic and antifungal drugs were not significantly correlated to the positive rate of aspergillus.

AIM:To determine the optimal extraction of effective component from Swertia chirayita(Roxb.ex Flemi) Karsten in Tibet. METHODS: HPLC method was used to determine the yield rate and mango glucoside content,the preference extract methods,extraction solvents and extraction method of Swertia chirayita(Roxb.ex Flemi) Karsten were chose by parallel comparative method. RESULTS: 75% ethanol was used to extract medicine materials by Percolate,the flow rate was 4 mL/min/kg,collecting 6 times liquor after percolate. CONCLUSION: The extraction method is simple and convenient,furthermore the extract stability is good too.

Objective To investigate the protective effect of hydrogen sulfide (H2S) on chronic unpredictable mild stress (CUMS)-induced damage in hippocampus of rats and explore potential mechanisms.Methods 40 SD rats were divided into four groups,including controI,CUMS,CUMS co-treated with NaHS (1.68 mg/kg×14 d,ip) and CUMS co-treated with NaHS (5.6 mg/kg×14 d,ip) groups.After treatment with CUMS for 4 weeks,arrangement and morphology of hippocampal neuron were examined by HE staining,apoptosis of hippocampal neurons were measured by Tunel assay.Klotho expression was detected by ELISA.Meanwhile,the generation of H2S in the hippocampus was measured by spectrophotometry and the neurogenesis of hippocampus was detected by Brdu staining.Results The arrangement and morphology of CA3 hippocampal cells were disturbed and the neurogenesis in hippocampal DG region were inhibited in the CUMS group compared with control group.Moreover,the CUMS rats showed increased loss of hippocampal neurons (1.151±0.041,P＜0.01),and the expression of klotho(0.910±0.032) and generation of H2S((0.445± 0.025)nmol · mg-1 · min-1) in CUMS rats were decreased in contrast to the control((0.621±0.019) nmol · mg-1 · min-1,P＜0.05).The sparse neuron and inhibited neurogenesis by CUMS in hippocampus of rats were improved by NaHS administration,and the loss of hippocampal neurons in CUMS + 1.68 mg/kg NaHS (1.032±0.023) or CUMS +5.60 mg/kg NaHS(1.045±0.038) were decreased in contrast to the CUMS rats(P＜0.01).Compared with CUMS group,the expression of klotho in CUMS + 1.68 mg/kg NaHS group (1.045±0.021)or CUMS +5.6 mg/kg NaHS group(1.046±0.076) was up-regulated(P＜0.05) and the generation of H2S in CUMS + 1.68 mg/kg NaHS group((0.582±0.008) nmol · mg-1 · min-1) or CUMS +5.6mg/kg NaHS group ((0.585 ±0.029) nmol · mg-1 · min-1) was increased (all P＜0.05).Conclusion H2S can antagonize the neural injury-induced by chronic stress probably by upregulating the expression of klotho protein,facilitating the production of H2S and promoting neurogenesis in hippocampus.

BACKGROUND:Studies have reported that taurine has a certain therapeutic effect on the disease of various systems, such as nervous system, cardiovascular system, immune system and digestive system. The liver is the main place, also the important target organ, of taurine metabolism. Therefore, the relationship between taurine and hepatopathy has become a hot topic in recent years. OBJECTIVE:To investigate the influence of taurine on superoxide dismutase and malondialdehyde expression in the liver tissue of rat models of liver fibrosis induced by carbon tetrachloride. METHODS:Thirty male C57B/L rats of SPF grade were randomly and evenly divided into blank control, model and taurine groups. Rats in the blank control group were intraperitonealy injected with 100% peanut oil of 1 mL/kg, twice a week, in total 10 weeks. Rats in the model group were intraperitonealy injected with peanut oil of 1 mL/kg containing 20% carbon tetrachloride, twice a week, in total 10 weeks. Rats in the taurine group were intraperitonealy injected with peanut oil of 1mL/kg containing 20% carbon tetrachloride, twice a week, in total 10 weeks, and were intragastricaly administered taurine of 500 mg/kg per day starting from the 3rd week til the 10th week. RESULTS AND CONCLUSION:Compared with the blank control group, the serum levels of hyaluronic acid, laminin, typeⅢ procolagen, typeⅣ colagen, alanine aminotransferase, aspartate aminotransferase were significantly increased (P < 0.05), the level of superoxide dismutase in the liver tissue was lowered (P < 0.05), the level of malondialdehyde in liver tissue was significantly increased (P < 0.05), and liver index was increased (P < 0.05) in the model group. Pathological examination showed that there were necrosis of liver cels, fat vacuoles, fibrous tissue hyperplasia and inflammatory cel infiltration in the rats of the model group. Compared with the model group, the serum levels of hyaluronic acid, laminin, typeⅢ procolagen, typeⅣ colagen, alanine aminotransferase, aspartate aminotransferase were significantly lowered (P < 0.05), the level of superoxide dismutase in the liver tissue was significantly increased (P < 0.05), the level of malondialdehyde in the liver tissue was significantly lowered (P < 0.05), and liver index was significantly decreased (P < 0.05) in the taurine group. Pathological examination showed that there were no inflammatory cel infiltration, fat vacuoles, and fibrous tissue deposition in the liver tissue. The results indicate that taurine can decrease the contents of superoxide dismutase and malondialdehyde, and relieve the degree of liver fibrosis induced by carbon tetrachloridevia exerting its antioxidative effects.

Objective:To analyze the clinical characteristics that affect the early outcomes of the elderly patients with transient ischemic attack(TIA) and provide the guidance for the prediction of disease recurrence.Methods:From January 2016 to December 2019, 315 TIA patients over 60 years old based on the time-clinical definition who were admitted to the department of neurology in Beijing Shijitan Hospital were divided into recurrence cerebrovascular events group(RCVEs group) and non-recurrence cerebrovascular events group(non-RCVEs group) according to the recurrence at 1 month after onset. The clinical characteristics of the two groups were compared by Logsitic regression analysis.Results:There were 29 cases in the RCVEs group and 286 cases in the non-RCVEs group. Compared to the non-RCVEs group, patients in RCVEs group were more likely have higher prevalence of hypertension history(14/15, 83/203), moderate or severe intracranial artery stenosis(21/8, 132/154), carotid stenosis(22/7, 107/179), DWI positive, motor symptoms, carotid artery stenting and higher times of TIA episodes(2(2, 3), 2(1, 2)), fasting blood glucose and glycosylated hemoglobin levels(8.86(8.17, 9.56)mmol/L, 5.82(5.27, 6.33)mmol/L). Logistic regression analysis showed that patients in RCVEs group had a DWI positive( B=1.634, OR=5.124, 95% CI: 2.898-9.059, P=0.000) and higher prevalence of moderate to severe stenosis of carotid artery( B=0.572, OR=1.773, 95% CI: 1.050-2.993, P=0.032). Conclusion:DWI positive and moderate to severe carotid stenosis may influence the early poor prognosis in patients with TIA.

Objective To investigate the association between the obstructive sleep apnea-hypopnea syndrome(OSAHS) in hypertension and insulin.Methods A total of 521 patients were divided into 4 groups according to apnea-hypopnea index and OSAHS degrees.The control group ( group Ⅰ ),mild OSAHS group ( group Ⅱ ),moderate OSAHS group ( group Ⅲ ) and severe OSAHS group ( group Ⅳ ) had 89 patients,194 patients,118 patients and 120 patients respectively.Results The BMI[( 30.4 ± 3.8 )kg/m2],apnea-hypopnea index ( AHI,3.8 ± 0.1 ),Fasting insulin (FIns)[(3.08 ± 0.26 ) mU/L]and insulin resistance ( 2.43 ± 0.27 ) of patients in severe OSAHS group were significantly higher than that of in the control,mild OSAHS group and moderate OSAHS group ( P ＜ 0.01 ).The levels of saturation of minimum oxygen from skin of patients in severe OSAHS group was significantly lower ( MSpO2 ) than in that of the control,mild OSAHS group and moderate OSAHS group.Multiple linear regression analysis showed that fasting plasma insulin and insulin resistance was positive correlation with apnea-hypopnea index,while they also negatively associated with saturation of minimum oxygen.Conclusions FIns and insulin resistance strongly associate with AHI and levels of saturation of minimum oxygen from skin.Hypertensive patients with OSAHS have more chances to suffer with insulin resistance.

Objective To evaluate the satisfaction and current situation of advanced health assessment course for postgraduates. So that it can provide the evidence for the development of teaching reform. Methods Facilitating the convenient sampling of 69 nursing master′s degree authorized schools in China. And a further survey using self-designed questionnaires was conducted in the teacher who in charge of this course and 73 postgraduates in 17 schools offering Advanced Health Assessment. The data were analyzed using reliability, validity, frequency and percentage. Results There were 45 schools responded effectively, of which only 17 schools set up this course. There were no uniform norms of the teaching materials, hours and credits. 73 postgraduates were satisfied with the teaching methods, training practical abilities, meeting academic development needs, practicality, and commonality of the advanced health assessment course. However, 54.8％ of the students said the course is too difficult to handle. Conclusion All the schools should pay more attention to Advanced Health Assessment Course and improve the professional level of postgraduates.