Objective:To explore the relationship between serum and cerebrospinal fluid levels of progranulin (PGRN) and prognosis in children with purulent meningitis (PM).Methods:Sixty children with PM (PM group) and 60 children without central nervous system infection (suspected central nervous system infection, or having indications for lumbar puncture; control group) in Zhuji People′s Hospital of Zhejiang Province from January 2014 to December 2018 were selected. The serum and cerebrospinal fluid PGRN, C-reactive protein (CRP) and procalcitonin (PCT) levels were detected. The correlation was analyzed by Pearson method; the receiver operating characteristic (ROC) curve was drawn, and the prognostic value of serum and cerebrospinal fluid PGRN were evaluated.Results:The serum and cerebrospinal fluid PGRN, CRP and PCT in PM group were significantly higher than those in control group, serum: (42.61 ± 4.79) ng/L vs. (26.13 ± 4.26) ng/L, (58.46 ± 3.74) mg/L vs. (1.34 ± 0.37) mg/L, (7.48 ± 0.24) μg/L vs. (0.31 ± 0.06) μg/L; cerebrospinal fluid: (3.52 ± 0.43) ng/L vs. (1.47 ± 0.36) ng/L, (23.06 ± 0.67) mg/L vs. (2.17 ± 0.45) mg/L, (4.13 ± 0.25) μg/L vs. (0.18 ± 0.07) μg/L, and there were statistical differences ( P<0.01). The correlation analysis result showed that serum and cerebrospinal fluid PGRN were positively correlated with CRP and PCT in children with PM (serum: r = 0.517 and 0.546, P<0.01; cerebrospinal fluid: r = 0.541 and 0.528, P<0.01). Among the 60 children with PM, 44 had good prognosis and 16 had poor prognosis. The serum and cerebrospinal fluid PGRN, CRP and PCT in children with poor prognosis were significantly higher than those in children with good prognosis, serum: (48.78 ± 4.65) ng/L vs. (34.15 ± 5.12) ng/L, (67.15 ± 3.84) mg/L vs. (47.02 ± 4.23) mg/L, (8.46 ± 0.35) μg/L vs. (6.23 ± 0.31) μg/L; cerebrospinal fluid: (3.93 ± 0.49) ng/L vs. (3.12 ± 0.37) ng/L, (27.62 ± 0.74) mg/L vs. (18.53 ± 0.81) mg/L, (4.97 ± 0.28) μg/L vs. (3.24 ± 0.31) μg/L, and there were statistical differences ( P<0.01). ROC curve analysis result showed that the area under curve of serum and cerebrospinal fluid PGRN for assessing the prognosis of children with PM was 0.821 (95% CI 0.818 to 0.824) and 0.913 (95% CI 0.910 to 0.916), with a sensitivity of 81.23% and 89.46%, and a specificity of 72.34% and 79.58%, cut-off value of PGRN was 41.53 and 3.54 ng/L. Conclusions:Serum and cerebrospinal fluid PGRN levels in children with PM are significantly increased, which are closely related to the prognosis of children with PM, and are potential indicators for evaluating the prognosis of PM.

Polycyclic aromatic hydrocarbons(PAHs) is a class of organic pollutants widely distributed in various environmental medium,and human exposure can occur by many routes (inhalation,ingestion,and skin contact),regardless of the source. PAHs can seriously impact human health and environment due to their high toxicity,stability. Studies on the toxicity of PAHs have involved in many fields,such as genotoxicity,hepatotoxicity,developmental toxicity,carcinogenesis and so on. The development of studies on genotoxicity of PAHs was reviewed in this paper,including DNA damage,chromosome damage and genetic susceptibility.

Acute pancreatitis,a multiple system disease was associated with distant organs injury such as the liver,lung and kidney,etc.Acute renal failure is one of the major death causes in severe acute pancreatitis.Renal injury in acute pancreatitis and its pathogenesis was reviewed to further understand the mechanisms of systemic inflammatory response and multiple organ failure

Objective To observe the influence of preoperative regional chemotherpy on colon cancer cell cycle.Methods30 colorectal cancer patients received intraarterial chemotherapy 10 days before the radical resection.The expression of p16 and Rb protein was examined by immunohistochemistry.Result was compared with the control group.Results Labeling index (LI) of p16 protein was (35?19)% in treatment group, while in control group L1 was (16?8)%,( P

Objective To study the safety of tilt table test (TTT) in elderly patients. Methods Among the 785 subjects examined for TTT, 110 were elders with an average age of( 65?4) years, ranging from 60 to 82. Out of the 110 elder subjects, 39 syncope patients were due to unknown reasons, 13 due to heart or brain diseases and 58 were non syncope subjects. We conducted base tilt table test (BTTT) in all patients and additional isoproterenol tilt table test (ITTT) in 18 patients. The BTTT protocol included 60～80 degrees upright tilt for 25 minutes and the ITTT protocol included isoproterenol infusion at 2-4 ?g/min for 10 minutes. Results 13 out of 39 patients with unknown reasons had a positive BTTT and 6 out of 10 patients had a positive ITTT, respectively; Among the 31 out of 110 positive TTT patients, 17 (54.8%) showed a vasodepressor response, 4 (12.9%) a cardioinhibitory response and 10 (32.3%) mixed response. Serious abnormal responses were not observed. Conclusions (1) TTT is a safe and effective method for diagnosing the vasovagal syncope (VVS) in elderly patients; (2) Because of its safety, BTTT could be chosen for identifying the VVS in the elderly heart or brain disease patients complicated with syncope.

Objective To clone and express hypervariable region 1 (HVR1) fragments of different genotypes of HCV strains from different cities of China.Then detect the reactivity of the expressed HVR1 fusion proteins with sera of chronic he-patitis C patients to analyzing it's signification in clinical utilization. Methods HVR1 genes of four HCV strains (genotype 1b and 2a) were amplified from pGEMT-E2 plasmids and cloned into pQE40 vectors, respectively to construct four recombinant prokaryotic expression plasmids which expressed HVR1 as fusion proteins with DHFR in Escherichia coli strain TG1. Then we used the purified DHFR-HVR1 proteins to detect the anti-HVR1 antibodies in 70 serum samples of chronic hepatitis C patients. Results Four DHFR- HVR1 fusion proteins were successfully expressed in E.coli (320～ 800 ?g fusion proteins per 100 ml culture). Each fusion protein (SH1b, BJ1b, SD1b and SD2a) reacted with 72.8%(51/70), 60%(42/70), 48.6%(34/70), and 58.6%(41/30) of the anti-HCV positive patients' sera, respectively by ELISA. 57% (4/7) of the non responders' sera taken before therapy reacted with all four HVR1 fusion proteins, while only 15.3% (2/13) of the sera from responders reacted with all of them. The A values of sera from IFN therapy responders were significantly higher than non responders (P

Objective To study the distribution of glycosylated hemoglobin A1c (HbA1c) levels in Xiamen,and to investigate the relationship among HbA1c level and gender and age.Methods This was a cross-sectional study.10 487 cases of physical examination individuals in Zhongshan hospital from January 2013 to April 2014 were recruited.HbA1c was measured by ARKRAY HA-8180 automatic glycosylated hemoglobin analyzer (Japan).All data were collected for analyzing the HbA1c levels in different sex and age groups,exploring the rule between HbA1c and age,and comparing the different diagnostic criteria of diabetes mellitus(DM).Differences between the two groups were compared using the Independent Samples T Test.The measurement data of multiple group were compared with single factor analysis of variance (One way ANOVA),and the comparison between two groups was performed with LSD T test.Correlation between different variables was analyzed by Pearson correlation and linear regression.Results Focused on all the 10 487 cases and 9 436 cases with HbA1c ＜ 6.5％ physical examination population,the levels of HbA1c were positively correlated with age,the linear regression equations were HbA1c (％) =0.021 2 × age (years) + 4.811 9 (r =0.348 9,P=0.000) and HbA1c(％) =0.010 9 × age (years) + 5.0944 (r=0.4257,P =0.000)respectively; HbA1c levels in male physical examination population were significantly higher than those in females (P ＜ 0.001),moreover,in different gender groups,HbA1c level had gradually risen with increasing age.Patients at risk for diabetes (prediabetes,39.60％) diagnosed by the criteria of 2010 American Diabetes Association (ADA) were 2.55 times more than those diagnosed by the criteria of international expert committee (15.55％).Conclusions The HbA1c level is related to age and gender in Xiamen city.It is necessary to establish different reference intervals and DM diagnostic cut-off point.The criteria of 2010 ADA can identify more high-risk DM individuals,with is especially suitable for the physical examination screening.

ObjectiveDiabetes is an independent risk factor for coronary artery bypasss grafting(CABG). Off pump coronary artery bypasss (OPCAB) experience in 251 cases was reviewed to determine whether diabetes wou ld be applicable in OPCAB procedures.MethodsConsecutive 251 patients underwent OPCAB over 12 month period. This study included 71 diebetic patients (DM group) and 180 nondiabetic patients (NDM group). Preoperative v ariables were compared between the two groups by univariate analysis.R esultsNo differences were found regarding the length of stay in cardio intensive care unit [DM group(2.4?0.3)d; NDM group (2.4?0.3) d;P=0. 386], and sternal complication (DM group: 5.7%;NDM group: 3.9%;P=0.511) . In hospital complications were as follows: death rate(DM group: 2.8%; NDM gr oup: 1.1%; P=0.680); stroke (DM group: 2 8%; NDM group: 1 7%; P=0 623 ); hemofiltratioin renal failure (DM group: 2.8%; NDM group: 0.5%; P=0.194); myocardial infarction(DM group: 0%; NDM group: 0.5%;P=1.000); blood using were more frequent in DM group comparied with NDM group (P=0.111). ConclusionOPCAB in diabetic patients is as safe as in non diabetic patients.

Objective: Endoscopic measurement mainly depends on visual estimation or open biopsy forceps,which have been proved lacking in accuracy due to the image barrel distortion caused by wide-angle lens in endoscope.This study aimed to validate a new concept of "virtual internal standard" proposed by ourselves and develop a new method for endoscopic measurement based on the concept.Methods: We photographed planar grid graphs printed with standard calibrations with an electronic endoscope at different object distances,obtained the information on the virtual internal standard from each photo at the corresponding object distance,and analyzed the digital characteristics of the barrel distortion photos,including the size of the visual field,the image compression ratio,and the credible area for measurement with the virtual internal standard.Based on the analyses,the method of endoscopic measurement by the virtual internal standard was established and experiments both in vivo and in vitro were conducted.Results: The ratio of the object distance to the visual field was 1 ∶ 2 when the former was between 10 mm and 40 mm.Calculation of the compression ratio showed that the credible area of measurement in the central area was 10 mm at the object distance of 10-15 mm,20 mm at 20-30 mm,and 30 mm at 30-50 mm.The credible area of measurement on various planes accounted for 2/5 to 3/5 of the total image width.There was a tendency of double-curve change in the arrangement of pixel values of the central grids on different planes.The differences between the pixel values per centimeter became slight at the object distance of 35-50 mm.Conclusion: Endoscopic measurement by the virtual internal standard is a objective,accurate,simple and practical method.

Objective To investigate the effects of alprostadil on expression of proinflammatory cytokines in patients with severe acute pancreatitis (SAP) and evaluate the clinical efficacy.Methods Seventy-three SAP patients were collected from January 2014 to May 2016,and then were randomly divided into control group (n=37) and experimental group (n=36).On the basis of routine treatment,the experimental group patient was given alprostadil at a dose of 15μg/d.The expression of C-reactive protein (CRP),white blood cell (WBC) count,amylase,alanine aminotransferase (ALT),aspartate aminotransferase (AST),creatinine,serum proinflammatory cytokine tumor necrosis factor alpha (TNF-α),interleukin-1 beta (IL-1[β),interleukin-6 (IL-6) were detected in serum on the 1st,3rd and 7th day.Results The biochemical indexes and expression ofproinflammatory cytokines were significantly increased in the two groups on the 1st day,and decreased gradually,with a significant difference between the time points (P＜0.05),but the between-group difference was not significant (P＞0.05).These indexes were decreased significantly with the passage of time and there were significant differences between the two groups at the 3rd and 7th day (P＜0.05).Conclusion Alprostadil can effectively reduce the severity of early inflammatory reaction in SAP patients,and has important significance for improving the prognosis.