Objective To investigate clinical value of gelsoin level for evaluating severity and prognosis in patients with critical illness. Methods Forty-eight patients with critical illness admitted to the Emergency Intensive Care Unit of Beijing Hospital during February to December 2008 were enrolled in this study, with 23 survivors and 25 deaths. Serum level of gelsolin was measured for 31 of them at least twice during their hospital stay, and for other 17 only once at their admission. They all were evaluated with acute physiology and chronic health evaluation Ⅱ ( APACHE Ⅱ ) scores within 24 hours after admission. In addition, serum level of gelsolin was measured for another 307 healthy adults as controls. Results Initial level of gelsolin was significantly lower in 48 patients at critically ill than that in controls [(24 ± 11) mg/L vs. (192 ±39) mg/L, P < 0. 01]. There was significant difference in initial level of gelsolin between surviving group (23 cases) and death group (25 cases) [(28 ± 10) mg/L vs. (21 ±12) mg/L, P = 0. 033]. Fatality of patients at critically ill increased as their level of gelsolin at 22 mg/L or less, with a predicting accuracy of 74. 19% , as well as decreasing trend of their gelsolin levels in continuously minitoring, with a predicting accuracy of 70. 97%. Predicting accuracy of APACHE Ⅱ scores of 30 or more was 67.74%. However, predicting accuracy would reach 93.55% as final level of gelsolin and its decreasing trend combined with APACHE Ⅱ scores in prognostic assessment for critically ill patients. Conclusions Severity of patients at critically ill can be predicted by their gelsolin level, especially in continuously monitoring, which is an indicator better than APACHE Ⅱ scores. Combination of gelsolin level with APACHE Ⅱ scores shows a more accurate prognostic assessment for critically ill patients.

Objective To study the reasons of minicholecystectomy complications.Methods 25 cases of minicholecystectomy complications among 1532 cases that have had an operation of minicholecystectomy were reviewed and the reasons resulting in those complication were analysed.Results In the 25 cases of minicholecystectomy complications,there is a bile duct injury in 5 cases,bleeding of gallbladder in 3,cardia guts reflection in 4,leakage of bile in 2,infection of incisional wound in 6,missed diagnosis gastric cancer in 1,missed diagnosis carcinoma of gallbladder in 2,microcholecyst in 2.Conclusion The major causes of the minicholecystectomy complications are minimal incision,worse exposure,minimal space operation and superdrag.

Objective To evaluate the value of gelsolin for the prognosis of patients with severe sepsis.Methods 50 patients in the emergency intensive care unit of Beijing hospital from January 2015 to July 2015,were determined white blood cell count (WBC),C-reactive protein (CRP),procalcitonin (PCT),gelsolin at admission,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score were estimated within 24 hours.According to the 28 days of survival outcome,50 patients were divided into two groups:survival group and death group.The significant difference of these factors was compared.Binary logistic regression analysis was applied for screening independent risk factors for the prediction of death.The receiver operating characteristic (ROC) curve was applied for the evaluation and comparison about prognosis ability.Results 31 patients were in the survival group,19 patients in the death group.The gelsolin [(21.43±10.54) vs.(13.31±8.54),P=0.007] andAPACHE Ⅱ score [(19.2±6.86) vs.(24.6 ± 8.9),P =0.021] in two groups had significance difference.Binary logistic regression analysis indicated that the gelsolin and APACHE Ⅱ score were independent risk factors of predicting death.The area under of ROC curve (AUC) of the gelsolin was 0.745 (95％ CI:0.599-0.851,P =0.004) and the APACHE Ⅱ score was 0.699 (95％ CI:0.537-0.862,P =0.019).Both prognosis ability were equivalent.To combine the tow factors,the accuracy of predition was 90％ and has better complementarity.Conclusions the gelsolin could assess the severity of patients with severe sepsis and predict the prognosis more accurately.

Objective To analyze the expressions of astrocyte elevated gene-1 (AEG-1 )and Beclin-1 (BECN-1 )in papillary thyroid carcinoma (PTC)and their clinical significances.Methods Thirty patients with PTC who were performed total thyroidectomy in the General Hospital Affiliated to Tianjin Medical University from October 201 5 to May 201 6 were collected.All patients were diagnosed with unilateral PTC.The tumor tissues were taken from the patients′ipsilateral thyroids,and 30 cases of normal tissues were taken from the patients′contralateral normal thyroids.The expressions of AEG-1 and BECN-1 in PTC tissues were detected by reverse transcription-poly-merase chain reaction (RT-PCR).The relationships between the expression status and clinicopathologic features were analyzed.Results The positive expression levels [M(QR )]of AEG-1 in PTC and the normal tissues were 0.626 1 (0.741 4)and 0.049 8 (0.01 1 8)respectively,with a significant difference (Z=-4.488,P=0.000). The positive expression levels of BECN-1 in PTC and the normal tissues were 0.067 9 (0.1 98 1 )and 0.785 7 (0.361 7)respectively,with a significant difference (Z=-5.441 ,P=0.000).In PTC,the expressions of AEG-1 and BECN-1 were related to TNMstaging (Z=-3.980,P=0.000;Z=-2.265,P=0.023)and lymphatic metas-tasis (Z=-3.1 90,P=0.001;Z=-2.640,P=0.008),but they were not related to age (Z=-1 .203,P=0.229;Z=-1 .1 62,P=0.245),gender (Z=-1 .222,P=0.222;Z=-0.453,P=0.651 )and tumor size (Z=-1 .496,P=0.1 35;Z=-1 .1 66,P=0.244).The expression of AEG-1 was negatively correlated with that of BECN-1 (r=-0.343,P=0.007).Conclusion The expression of AEG-1 in PTC is higher than that in normal tissues and the expression of BECN-1 in PTC is lower than that in normal tissues,and the expressions of AEG-1 and BECN-1 are related to TNM staging and lymphatic metastasis,which are expected to become prognostic indicators.

Objective In order to understand the mechanisms beyond lipid regulation of 3 hydroxy 3 methyl glutaryl coenzyme A(HMG CoA) reductase inhibitors in anti atherosclerosis, we observed the influence of pravastatin on the pathogenesis of atherosclerotic lesions and the expression of intercellular adhesion molecule (ICAM) 1 in aortic wall of the apoE deficient mice. Methods Pravastatin(10 mg?kg?d -1 ) was fed to 10 , 20 , and 30 week old male apoE deficient mice respectively for 4 weeks. The atherosclerotic plaque size and the ratio of plaque area to aortic luminal area (PA/LA) were determined by histochemical staining and analyzed quantitatively. The expression of ICAM 1 in aortic wall of apoE deficient mice was detected by immunohistochemistry and Western blotting. Results Compared with controls, pravastatin delayed the plaque formation in apoE deficient mice 〔(161 786 1?38 041 2) ?m 2 vs (99 127 9?13 600 3) ?m 2, P

OBJECTIVE:To investigate the perioperative use of antibacterials in patients undergoing C-sect.METHODS:The medical records of 753 cases between Oct.2005 and Mar.2007 were reviewed retrospectively.RESULTS:All the patients(100.00%)undergoing C-sect received antibacterials by iv gtt during perioperative period,and 99.07% were given at 0.5h before operation.Among all the antibacterials,73.31% were benzylpenicillin sodium.86.85% of the patients had a course of treatment of 2～3 days;93.36% of the antibacterials were used in single kind.As for the preventive medication outcome,the effective rate totaled 99.20%(694 CR+ 53 PR).CONCLUSION:The perioperative use of antibacterials in patients undergoing C-sect was rational on the whole.The antibacteirals were more often used singly for a course of 2 to 3 days.The low grade kind with low toxicity and cheap price is the preferred preventive medication for patients undergoing C-sect.

BACKGROUND:In recent years, studies have shown that mesenchymal stem cells can secrete various growth factors, and has certain application prospect in the treatment of liver fibrosis.
OBJECTIVE:To explore the different sources of mesenchymal stem cells in the treatment of liver fibrosis in rats. METHODS:Fifty Sprague-Dawley rats were given intraperitoneal injection of carbon tetrachloride to construct the model of liver fibrosis. Another 10 normal Sprague-Dawley rats were used as normal controls. Model rats were randomly divided into five groups, 10 rats in each group, including model control group, normal saline group, bone marrow mesenchymal stem cellgroup, umbilical cord mesenchymal stem cellgroup, and umbilical cord blood mesenchymal stem cellgroup. After 8 weeks of modeling, different sources of mesenchymal stem cells at a density of 2×106 were injected via tail vein into model rats. After 12 weeks, the rats were kil ed, and serum alanine aminotransferase, aspartate aminotransferase and albumin levels were detected as wel as the expression of type I col agen and glial fibril ary acidic protein in liver tissue was detected by fluorescence quantitative PCR method.
RESULTS AND CONCLUSION:We have successful y established the SD rat model of hepatic fibrosis. Bone marrow mesenchymal stem cells aggravated hepatic fibrosis, umbilical cord blood and umbilical cord mesenchymal stem cells could reduce the level of hepatic fibrosis in rats. Umbilical cord mesenchymal stem cells had the most obvious effect that significantly reduced expressions of alanine aminotransferase, aspartate aminotransferase and type I col agen and glial fibril ary acidic protein. The results showed different sources of mesenchymal stem cells have different effects on rat fibrosis. Bone marrow mesenchymal stem cells aggravate hepatic fibrosis, and umbilical cord and umbilical cord blood stem cells can al eviate hepatic fibrosis in rats.

Objective To explore the impact of cardio cerebral vascular diseases (CVD) on life expectancy among residents in Shandong Province,develop effective preventive measures for the high-risk population and provide guidance for the health care resource allocation.Methods Based on the death monitoring data of the disease in Shandong Province in 2012,we calculated the crude mortality and standardized the mortality rate of the disease.We designed life tables with all causes of death and with eliminating causes of CVD death and analysed life expectancy with and without them examined.Results In 2012,crude mortality rate of CVD was 320.16/100 000 (SMR 252.85/100 000) in Shandong Province.The death rate of CVD was of 46.30％ of all deaths reported by monitoring system.The mortality rate of CVD in male and female were 332.99/100 000 and 307.02/100 000,respectively.The mortality rate of CVD in rural and urban areas were 341.84/100 000 and 267.28/100 000,respectively.The mortality of CVD increased with age and growed rapidly after the age of 60.Life expectancy of urban and rural areas was 79.20 years and 78.14 years,respectively.After eliminating causes of CVD death,life expectancy for eliminating causes of CVD death in urban and rural areas increased 8.51 years and 10.02 years,respectively.Life expectancy for eliminating causes of CVD death in male and female increased 8.02 years and 11.10 years,respectively.Conclusions Life expectancy of urban and rural areas,the male and female for eliminating causes of CVD death than that of all causes of death were greatly extended.Reducing the death caused by CVD to increase health life expectancy have important public health significance.

Specific to the existing problems of uneven distribution of resources in the medical industry,especially the shortage of grass-root high-quality medical resources,the paper introduces the construction objective,overall architecture and construction contents of regional medical collaboration,and normalizes the medical service process through informationalized technological means,in order to promote standardized construction of the regional medical information system and information interconnection and intercommunication.

Objective: To investigate the prevalence of overweight and obesity and relation of body mass index (BMI) to body fat percentage and waist circumference in Chinese healthy adults. Methods: 1005 healthy adults were divided into five groups by BMI,which was made by WHO's recent classification of BMI for Asian adults. Anthropometric measurements (waist and hip circumference , skinfold thickness and ratio of waist and hip circumference) and bioelectrical impedance analysis (BIA) were done in subjects. Results: The prevalence of overweight and obesity classⅠin males were significantly higher than in females. The prevalence of obesity classⅡwas lower both in males and in females. Females had higher percent body fat than males measured by BIA and by skinfold thickness measurements. BMI was significantly correlated with waist circumference in all age groups. Waist circumference was more than 80 cm in overweight females, and more than 90 cm in obesity classⅠin males. Conclusion: The age of overweight and obesity in males was younger than in females. The body fat in females was higher than in males. BMI cut off points for obesity diagnosis are over estimated much more than BIA and skinfold thickness measurements for percent body fat in adults. It should be noted that age, sex and physical activity need to be considered besides BMI when obesity is diagnosed.