Objective To select valuable biomarkers for diagnosis and predicting outcome of sepsis-related acute respiratory distress syndrome(ARDS) from D-dimmer (DD),yon Willebrand factor (vWF),platelet (PLT),N terminal-pro brain natriuretic peptide (NT-ProBNP),interleukin-6 (IL-6),interleukin-8 (IL-8) and surfactant protein D (SP-D).Methods A total of 48 sepsis accompanied with ARDS patients and 40 sepsis patients were prospectively studied with comparison.The clinical characteristics of all the patients were recorded in detail.The blood samples were obtained within 24 hours of ICU admission.The concentration or activity of the seven biomarkers was quantitatively assayed and the results were recorded.To select the most valuable biomarkers as clinical indices,diagnosis model and death predictive model were constructed by Logistic regression.Results Among the seven candidate biomarkers,SP-D,vWF and IL-8 showed the most value.Their area under the receiver operator characteristic curve (ROC) were 0.758 (P ＜ 0.01),0.783 (P ＜ 0.01) and 0.747 (P ＜ 0.01) respectively,and raised to 0.847 (P ＜ 0.001) when the three biomarkers were combined.IL-8,age greater than or equal to 60 years and APACHE Ⅱ score greater than or equal to 20 were related to ARDS death with 12.138(lnIL-8)(P=0.022),6.157(P=0.040) and7.415(P=0.014) of OR values respectively.Conclusion SP-D,vWF,IL-8 should be valuable for early prediction of sepsis-induced ARDS and the diagnostic accuracy raised through combined utilization.IL-8 may be predictable for prognosis of sepsis related ARDS and the comprehensive evaluation combining clinical indices with IL-8 should be suggested in clinical practice.

Objective:To observe the clinical efficacy of acupuncture plus moxibustion at Ciliao (BL 32) for primary dysmenorrhea (PD) due to cold-dampness. Methods:A total of 58 cases with PD due to cold-dampness were randomly allocated into an observation group (n=29) and a control group (n=29). Patients in the observation group were treated with acupuncture and suspended moxibustion at Ciliao (BL 32), whereas patients in the control group were treated with routine acupuncture alone. After three courses of treatment, the clinical efficacy was evaluated and compared between the two groups. Results:After treatment, the symptom scores were significantly reduced in both groups (P<0.05), but there were no significant between-group differences in clinical efficacy and symptom scores (P>0.05). Conclusion: With fewer points and less pain, acupuncture-moxibustion at Ciliao (BL 32) can obtain similar effect as routine acupuncture therapy for PD due to cold-dampness.

Objective To analyze and summarize the treatment strategies for unstable angina with no-reflow phenomenon after PTCA during early percutaneous interventional procedures.Methods A total of 32 cases with unstable angina were divided into two groups:one group with drug therapy and the other group with drug therapy and thrombus aspiration catheter.The patients were chosen when there was no-reflow phenomenon after PTCA during early percutaneous interventional procedures and their clinical data were compared and analyzed.Blood flow TIMI grade,myocardial perfusion grade (MBG),TIMI myocardial perfusion (TMP) grade and other indexes were observed and recorded.Results The general conditions had no statistical difference between two groups.Compared with the drug therapy group,the proportion of patients with TIMI,MBG and TMP grade 3 was higher in aspiration and drug therapy group (89％ VS 71％ P＜0.05).Conclusion Drug therapy and thrombus aspiration catheter in treatment helps to improve myocardial perfusion level for unstable angina with no no-reflow phenomenon after PTCA during early percutaneous interventional procedures.

Objective To evaluate the diagnosis and surgical treatment of parathyroid carcinoma (PTC). Methods Clinical data of 8 PTC cases were analyzed retrospectively. Results PTC accounted for 5. 7% of patients with primary hyperparathyroidism (PHPT) in our hospital. There were 4 men and 4 women. Male patients had younger mean onset age compared with female patients. The disease history of PTC was shorter than PHPT of benign causes. Six patients were admitted for acute hypercalcemia. Seven patients complained of palpable neck mass. Calcium level was 3.75?0.34 mmol/L,and PTH level was 1429.47?841.75 pg/ml. Frozen section established diagnosis in only one case. Four patients underwent radical en bloc resection. Other 4 cases received routine simple parathyroidectomy, 3 patients developed recurrence in 12 - 18 months postoperatively. Conclusions Acute hypercalcemia is common in PTC. Frozen biopsy diagnosis is not satisfactory. An initial en bloc resection of tumor and adjacent structures contributes most to the prognosis.

A patient with severe hypoglycemia due to insulin-like growth factor ( IGF)-IIsecreted by a giant solitary fibrous tumor of the pleura ( SFTP) was investigated through comprehensively reviewing his medical history and clinical records. The patient had severe hypoglycemia accompanied with significantly decreased serum insulin level. A solitary fibrous tumor of the pleura was found, and right pneumonectomy removed this giant tumor. Two years after the operation, the patient was fit and well with no further hypoglycemia episodes. Non-islet-cell tumor hypoglycemia should be considered in patients who have hypoglycemia episodes accompanied with significantly decreased serum insulin level.

Objective To investigate clinical effect of combined laparoscopic and endoscopic submucosal resection for the gastric antrum-body tumors originated from the muscularis propria.Methods A total of 8 patients with gastric antrum-body tumors originated from the muscularis propria were treated by combined laparoscopic and endoscopic submucosal resection from Jan 2013 to Apr 2014.All patients were diagnosed as having gastric antrum-body tumors originated from the muscularis propria by preoperative endoscopic ultrasonography.Endoscopy showed that the surface mucosa of tumors were normal in all patients.Tumors were found in the gastric antrum-body front wall in 4 cases,and in the back wall in 2 cases,and in the lesser omental bursa in 1 case,and in the greater omental bursa in 1 case.The tumors size was from 1.5 to 3.5 cm,averaging (2.4 ± 0.7) cm.The therapeutic procedure included three phases.The lesion was first exposed with laparoscopy.Then,the fluid was injected into the submucosa in the part of tumor by endoscopy.Finally the tumor was resected by laparoscopy.These patients were followed up and analyzed retrospectively.Results Combined laparoscopic and endoscopic submucosal resection was successfully performed in all patients.All tumors were resected completely.Sever bleeding,infection or death were not found in any patients.Postoperative pathology and immunohistochemistry staining confirmed 6 stromal tumors and 2 neurofibroma.All patients were followed up for 6 months,and there was no recurrent case.Gastric mucosa and function were normal in all patients.Conclusion Combined laparoscopic and endoscopic submucosal resection is a simple,safe and effective method for gastric antrum-body tumors originated from the muscularis propria,and leads to little complication.

Objective To investigate the protective and therapeutic effect of chalcone ketones compound(code:L2H17,hereinafter referred to as L2)on mice infected with influenza A virus.Methods BALB/c mice were randomly divided into six groups:normal group,model group,positive drug-treated group,L2 treated groups (3 different concentrations).The mice were adapted for 72 hours,before a model was established by intranasal infection.Mice in each group were given medicine by i.g once daily for 6 days starting 24 h before virus challenge.Survival was observed daily for 14 days.The mortality,median survival time,rate of death protection and rate of prolonging life were determined to observe the therapeutic effect of chalcone(L2) against influenza virus infection.The whole lungs were taken under aseptic conditions on days 3 and 5 post-infection to calculat lung indexes and lung index inhibition.The left lung was fixed with 4% formaldehyde for pathological biopsy,the right lung was soaked in RNAstore to detect lung tissue viral load,and the double antibody sandwich ELISA method was used to detect the expression of inflammatory cytokines IL-6 and TNF-α in order to observe the therapeutic effect of L2 on viral pneumonia caused by influenza virus infection.Results Compared with the model group,the L2 80 mg/kg treatment group exhibited significant increases in median survival time(11 d),the rate of death protection (50%),and the rate of prolonging life(24.1%)but a moderate 50% decrease in mortality.In addition,the lung index decreased significantly both on d 3 and 5 after virus infection (P<0.05).The pathological results also improved significantly.The L2 80 mg/kg dose group had a significantly lower viral load of lung tissue on d 3 and 5 post-infection(P<0.05).Compared with model group,the expression of inflammatory factor IL-6 became lower to different degrees.Conclusion L2 has a protective effect on mice infected with influenza virus by reducing the degree of pathological changes of pneumonia caused by influenza viruses.

Primary pigmented nodular adrenal disease (PPNAD) is a kind of autosomal dominant inherited disease. Patient in the study presented with Cushing's syndrome, and clinical and pathological diagnosis of PPNAD was confirmed. It is now confirmed that there are two relevant genes and their mutations may lead to PPNAD. This study showed no mutations in the patient, surpecting if there would be an alternative mechanism or a new gene in playing the role.