Objective To explore the therapeutic value of hemoperfusion combined with daytime high capacity hemofiltration in the treatment of severe acute pancreatitis.Methods The clinical data of 25 patients with severe acute pancreatitis treated by hemoperfusion combined with daytime high capacity hemofiltration(the observation group) were retrospectively analyzed,and compared with 30 severe acute pancreatitis patients without blood purification treatment(the control group).Results After the treatment,the biochemical indicator of the observation group was improved obviously compared with pre-treatment.Of the observation group,the hospital slaying time was shorter [(21.6±12.3) d vs(30.8±15.6) d],and the cure rate was higher(72％ vs 40％),and the death rate was lower (16％ vs 30％),compared with the control group(all P ＜ 0.05),but the treatment costs had no difference between the two groups.Conclusion Patients with severe acute pancreatitis on the basis of conventional treatment should conduct as early as possible hemoperfusion combined with daytime high capacity hemofiltration,and it could improve the success rate of the rescue and shorthen the length of hospital stay,and its curative effect was accurate.

Purpose　The aim is to investigate the hemostatic and protective effect of fibrin sealant(FS) on liver trauma in rats.Methods　On the surface of cracked wound(type Ⅰ) and resected wound(type Ⅱ)，spraying of FS or thrombin or direct suturation, was used receptively. Natural hemostasis was used as control.During postoperation the hemostatic time and the state of wound healing on 1st, 4th, 7th,14th, 50th day were observed.Results　Compared with the natural hemostasis,the hemostatical time of the FS group was shorter 86.0%(P＜0.01)in liver trauma type Ⅰ and 79.0%(P＜0.01)in liver trauma type Ⅱ.Compared with the thrombin group,the hemostatical time of the FS group was shorten 45.0%(P＜0.01)in liver trauma type Ⅰ and 84.0%(P＜0.05) in liver trauma type Ⅱ.The wound surface of FS group was healed faster than that of other groups.Conclusion　FS was an effective hemostatic and healing-promoter on liver trauma of rats.

Objective To evaluate the role of phosphatase and tensin homologue deleted on chromosome 10 (PTEN) in diabetes mellitus-induced reduction of hypoxic postconditioning (HPO)-induced protection of cardiomyocytes and the relationship with glycogen synthase kinase-3β (GSK-3β)-mediated mitochondrial apoptotic pathway.Methods H9c2 cells incubated in high-glucose (30 mmol/L) medium for 24 h were divided into 6 groups (n =5 each) using a random number table:normoxia group (group N),hypoxia-reoxygenation (H/R) group,group HPO,PTEN gene silencing normoxia group (group P-N),PTEN gene silencing H/R group (group P-H/R),and PTEN gene silencing HPO group (group P-HPO).H9c2 cells were exposed to 95％ N2-5％ CO2 for 4 h followed by 2 h reoxygenation with 90％ O2-10％ CO2.HPO was induced by 3 cycles of 5 min reoxygenation followed by 5 min hypoxia before reoxygenation.At the end of reoxygenation,the level of lactate dehydrogenase (LDH) in the supernatant was detected by enzyme-linked immunosorbent assay,the changes in mitochondrial membrane potential (MMP were assessed by JC-1 fluorescence assay,the cell apoptosis was detected by AnnexinV-FITC/PI flow cytometry,and the expression of PTEN and phosphorylated GSK-3β (p-GSK-3β) was determined by Western blot.The JC-1 monomer/polymer ratio and apoptosis rate were calculated.Results Compared with group N,the amount of LDH released,JC-1 monomer/polymer ratio and apoptosis rate were significantly increased,and the expression of PTEN was up-regulated in H/R and HPO groups (P＜0.05).There was no significant difference in the parameters mentioned above between group H/R and group HPO (P＞0.05).Compared with group HPO,the amount of LDH released,JC-1 monomer/polymer ratio and apoptosis rate were significantly decreased,PTEN expression was down-regulated,and the expression of p-GSK-3β was up-regulated in group P-HPO (P＜0.05).Compared with group N,the expression of PTEN was significantly down-regulated,and no significant changes were found in the other parameters mentioned above in group P-N (P＞0.05).Compared with group H/R,the expression of PTEN was significantly down-regulated,and no significant changes were found in the other parameters mentioned above in group P-H/R (P＞0.05).Conclusion PTEN is involved in diabetes mellitus-induced reduction of HPO-induced protection of cardiomyocytes,and the mechanism is associated with PTEN-induced activation of GSK-3β-modulated mitochondrial apoptotic pathway.

Objective To explore the expression and diagnostic value of serum microRNA-574-3p (miR-574-3p) in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).Methods A total of 90 patients with HBV-related HCC,40 patients with HBV-related liver cirrhosis (LC) and 50 healthy controls were recruited.The expression levels of serum miR-574-3p,α-fetoprotein (AFP) and α-Lfucosidase (AFU) of all subjects were determined.The difference of serum miR-574-3p level between groups was compared.The relation between serum miR-574-3p level of HCC patients and its clinical pathological characteristics was analyzed.The t-test was performed.The relationship between serum miR-574-3p level of HCC patients and AFP,AFU was analyzed by Spearman correlation analysis.The diagnostic efficacy of them as diagnostic markers was evaluated by receiver operating characteristic curves (ROC) and the area under the curve (AUC)(95％ CI (confidence interval)).Results The relative quantity expression of serum miR-574-3p of HCC group,LC group and healthy group was 2.152(1.654,3.061),1.292 (0.984,1.666) and 1.018 (0.750,1.726),respectively.The expression level of serum miR-574-3p of HCC group was significantly higher than those of LC group and healthy control group,and the differences were statistically significant (t=2.726 and 2.845,both P＜0.01).The expression level of serum miR-574-3p of HCC patients was significantly different in tumors with different degree of differentiation (t=2.262,P=0.039),different stage (t=2.354,P=0.025) and different HBV DNA concentrations (t=2.771,P＜0.01).There was no correlation between serum miR-574-3p level and AFP (r2 =0.076,P=0.505),AFU (r2 =0.082,P=0.422) in HCC patients.When compared HCC group with LC group,AUC of serum miR-574-3p of was 0.823 and 95％ CI was 0.750 to 0.897.When compared HCC group with healthy control group,AUC of serum miR-574-3p was 0.840 and 95％CI was 0.769 to 0.910.Conclusions The expression level of serum miR-574-3p of HCC patients is significantly higher than those of LC patients and healthy controls.Serum miR-574-3p may be an important biomarker in the diagnosis of HCC.

Objective To assess the clinical value of endoscopic uhrasonography(EUS)combined with the mini-probe endoscopic uhrasonography(MPUS)in determing tumor invasion depth and lymph node metastases of early superficial esophageal cancer.Methods One hundred and twenty-four superficial esophageal cancer lesions of 121 patients were staged by EUS combined with MPUS,and the results were finally compared with pathological findings of surgical specimens or samples obtained by mucosal resection.Results The diagnostic accuracy of EUS in T staging of superficial esophageal cancer was 82.3%(102/124).The total ratio of lymph node metastases was 5.0%(6/121),with no node metastases in carcinoma in situ,1.3%(1/28)in mucosal carcinoma,11.6%(5/43)in submucosal carcinoma.Conclusion EUS combined with MPUS is accurate in staging of the superficial carcinoma,which can help the choice of therapeutic strategies.

Objective To analyze the influencing factors of peritoneal dialysis associated peritonitis(PDAP)and the distribution characteristics of pathogenic bacteria.Methods The clinical data of 257 patients who underwent peritoneal dialysis(PD)and regular follow-up in Meizhou People's Hospital from January 2012 to October 2022 were retrospectively analyzed.According to the occurrence of PDAP,the patients were divided into the PDAP group(n=102)and the non-PDAP group(n=155).The exhaled liquid(5-10 mL)was extracted with a sterile syringe,and the pathogen was identified by blood culture method.General data such as gender,age,primary disease,education level,whether complicated with hypertension/diabetes/cardiovascular diseases,whether keeping pets or poultry,body mass index(BMI)and dialysis duration were collected.Fasting elbow venous blood was drawn in the morning of the next day after diagnosis,the levels of hemoglobin(Hb),albumin(ALB),serum potassium,serum phosphorus,and serum calcium were detected.The estimated glomerular filtration rate(eGFR)and urea clearance index(UCI)were recorded.Multivariate logistic regression was used to analyze the risk factors of PDAP in PD patients.Results There were 217 cases of PDAP in 102 patients with PDAP,and 124 cases(57.14％)were positive for pathogen culture.A total of 127 pathogenic bacteria were isolated,including 84 Gram-positive strains(66.14％),39 Gram-negative strains(30.71％)and 4 Fungi strains(3.15％).Among the 84 strains of Gram-positive bacteria,there were 25 strains of staphylococcus epidermidis(29.76％),17 strains of staphylococcus aureus(20.24％),12 strains of staphylo-coccus haemolyticus(14.29％),8 strains of staphylococcus warneri(9.52％),10 strains of streptococcus salivarius(11.90％),5 strains of streptococcus sanguis(5.95％),and 7 other strains(8.33％).Among the 39 strains of Gram-nega-tive bacteria,there were 20 strains of escherichia coli(51.28％),6 strains of pseudomonas aeruginosa(15.38％),6 strains of acinetobacter baumannii(15.38％),5 strains of klebsiella pneumoniae(12.82％),and 2 strains of enterobacter cloacae(5.13％).Among the 4 strains of Fungi,there were 3 strains of near-smooth candida(75.00％)and 1 strain of candida glabrata(25.00％).There was no significant difference in gender,age,primary disease,education level,BMI,and the propor-tion of comorbidities with hypertension,diabetes and cardiovascular diseases between the PDAP and non-PDAP groups(P＞0.05).The proportion of patients keeping pets or poultry in the PDAP group was higher than that in the non-PDAP group,and the dialysis duration was longer than that in the non-PDAP group(P＜0.05).There was no significant difference in serum phosphorus,serum calcium,eGFR and UCI between the PDAP and non-PDAP groups(P＞0.05).The levels of Hb,ALB and serum potassium in the PDAP group were significantly lower than those in the non-PDAP group(P＜0.05).Logistic regression analysis showed that keeping pets or poultry and long dialysis duration were risk factors for PDAP in PD patients(P＜0.05).High Hb and ALB levels were protective factors for PDAP in PD patients(P＜0.05).There was no correlation between serum potassium and PDAP in PD patients(P＞0.05).Conclusion Gram-positive bacteria are the main pathogenic bacteria of PDAP,among which staphylococcus epidermidis is the predominant one.Keeping pets or poultry and long dialysis duration are risk factors for PDAP,while high Hb and ALB levels are protective factors for PDAP in PD patients.

Objective To evaluate the efficacy of endoscopic ultrasound guided fine-needle aspiration (EUS-FNA) in diagnosis of enlarged mediastinal lymph nodes (LNs), mediastinal occupying lesion of unknown origin, as well as in N-staging for lung cancer. Methods EUS-FNA was performed via esophagus with a 22-gange needle in 61 patients, followed by pathological and cytological examinations. Results The positive diagnosis rate of EUS-FNA was 93.4% (57/61), and the cytological and pathological diagnostic accuracy were 85.2% (52/61) and 83.6% (51/61), respectively. Of 61 patients, 26 were suspected as having lung cancer with mediastinal lymph nodes metastasis, but the bronchoscopy failed to confirm the diag-nosis. EUS-FNA diagnosed lung cancer in 21 and benign lesion in 5. Of 22 patients with mediastinal occupying lesions of unknown origin, 19 (86.4%) were diagnosed by EUS-FNA. Of 7 patients with malignant tumor history and enlarged mediastinal lymph nodes, EUS-FNA confirmed mediastinal metastasis in 6 (85.7%). Six cases of lung cancer with suspected mediastinal lymph nodes metastasis were confirmed by EUS-FNA and the corresponding therapy regimen was modified. No complications related to EUS-FNA procedure occurred. Conclusion EUS-FNA is a safe and effective method for diagnosis of enlarged medistinal LNs, mediastinal lesion of unkown origin and N-stage of lung cancer.

Objective:To compare serum procalcitonin and fibrinogen degradation product levels between type 2 diabetes mellitus patients with Escherichia coli bloodstream and urinary tract infections. Methods:The clinical data of 82 type 2 diabetes mellitus patients with Escherichia coli infections who received treatment between December 2014 and December 2019 in the First Affiliated Hospital of Datong University (The Fifth People's Hospital of Datong) were retrospectively analyzed. These patients were assigned to bloodstream infection ( n = 40) and urinary tract infection ( n = 42) according to the way of Escherichia coli infection. Serum procalcitonin and fibrinogen degradation product levels, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, C-reactive protein, white blood cell count, D-Dimer level, antithrombin III activity, and electrolytes were determined and compared between the two groups. Correlation between procalcitonin and other variables was analyzed. Multiple linear regression analysis was performed with procalcitonin level as a dependent variable and other relevant indexes as independent variables. Results:Body temperature, white blood cell count, neutrophil count, monocyte count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, procalcitonin level, C-reactive protein level, fibrinogen degradation product level, and D-Dimer level in the bloodstream injection group were (39.49 ± 0.64) ℃, (14.92 ± 11.78) × 10 9/L, (13.39 ± 11.60) × 10 9/L, (0.72 ± 0.36) ×10 9/L, (14.86 ± 10.52), (199.15 ± 160.69), (22.81 ± 17.86) μg/L, (133.44 ± 63.63) mg/L, (49.71 ± 41.44) mg/L, (16.56 ± 12.20) mg/L, respectively, which were significantly higher than those in the urinary tract infection group [(37.12 ± 1.20) ℃, (9.04 ± 3.95) × 10 9/L, (6.25 ± 4.02) × 10 9/L, (0.42 ± 0.29) × 10 9/L, (3.67 ± 3.34), (120.01 ± 44.08), (4.46 ± 8.69) μg/L, (39.22 ± 22.16) mg/L, (3.81 ± 3.41) mg/L, (0.84 ± 0.75) mg/L), t = 7.356, 2.578, 3.162, 2.958, 5.538, 2.591, 2.810, 4.825, 2.902, 2.375, all P < 0.05]. Platelet count, lymphocyte count, blood sodium level and antithrombin Ⅲ activity in the bloodstream infection group were (167.50 ± 104.93) × 10 9/L, (1.06 ± 0.58) × 10 9/L, (130.89 ± 6.50) mmol/L, (57.88 ± 16.28)% , which were significantly lower than those in the urinary tract infection group [(239.40 ± 82.52)× 10 9/L, (2.14 ± 0.71) × 10 9/L, (138.46 ± 5.96) mmol/L, (90.11 ± 8.90)%, t = -2.853, -6.313, -4.046, -7.350, all P < 0.05]. Correlation analysis revealed that serum procalcitonin level was positively correlated with body temperature ( r = 0.387), white blood cell count ( r = 0.355), neutrophil count ( r = 0.368), C-reactive protein ( r = 0.605), fibrinogen degradation product level ( r = 0.616), D-Dimer level ( r = 0.486) (all P < 0.05), and it was negatively correlated with sodium level ( r = -0.319) and antithrombin Ⅲ activity ( r = -0.465) (both P < 0.05). Multiple linear regression analysis results revealed that fibrinogen degradation product level and body temperature were greatly correlated with procalcitonin level. Conclusion:Inflammatory indicators procalcitonin level, body temperature, white blood cell count, neutrophil count, C-reactive protein, fibrinogen degradation product level and D-Dimer level were remarkably higher in type 2 diabetes mellitus patients with Escherichia coli bloodstream infection than those in type 2 diabetes mellitus patients with Escherichia coli urinary tract infection. Procalcitonin level was greatly correlated with body temperature and fibrinogen degradation product level.