Objective To study the variation and prognostic value of serum heparin-binding protein (HBP),a potent inducer of vascular leakage in septic shock.Methods A total of 82 sepsis patients admitted to central ICU from August 2011 to July 2012 were enrolled in the prospective study.Eighty-two sepsis patients were divided into septic shock group (group A,n =39) and sepsis without shock group (group B,n =43).At the same time,another 30 shock patients without sepsis were enrolled as group C and 35 patients without sepsis and shock were enrolled as group D.Blood samples obtained within 24 hours after enrollment,and the concentrations of HBP were measured by ELISA and lactate by electrode method.Comparisons of HBP,lactate and APACHE Ⅱ score between groups were carried out by Studers't test,and the early prognostic value in septic shock and mortality was studied by receiver operating characteristic (ROC) curve.Results Patients in group A (t =3.862,P＜0.001) and group B(t =5.193,P＜ 0.001) both had higher HBP level than patients in group D.HBP level in group A patients was also higher than that of group B (t =3.270,P =0.002).Septic shock patients (group A) had higher HBP than patients of group C (t =3.029,P =0.004).The area under curve (AUC) of HBP predicting septic shock patients was 0.834,with sensitivity 0.795,specificity 0.795.The AUC of HBP predicting 28-day mortality of all enrolled patients was was 0.680,and the AUC of predicting 28-day mortality of sepsis patients was 0.784.Conclusions HBP levels were increased in septic patients,especially in septic shock patients.HBP is a better predictor than traditional predictors like lactate and APACHE Ⅱ score for predicting septic shock.HBP is a good and specific evaluation marker for predicting septic shock and the mortality of sepsis patients.The measurement of HBP during the early stage of disease presents valuable information about diagnosis and treatment.

BACKGROUND:Studies have shown that dental pulp cells can differentiate into odontoblastic like cells under certain stimulations, which is regulated by several signal pathways network. OBJECTIVE:To summarize the research progress of stimulating molecules and underlying molecular mechanisms of dental pulp cells’ odontoblastic differentiation. METHODS:A computer-based online search of CNKI and Wanfang databases was undertaken for the related Chinese articles dated from January 1998 to July 2014 with the keywords of“dental pulp cells”and“odontoblastic differentiation”in Chinese. Meanwhile, PubMed database was searched for the related English articles dated from January 1998 to July 2014 with the same keywords in English. Those with unrelated research subjects, or repetitive studies were excluded. Final y, 63 articles were reviewed. RESULTS AND CONCLUSION:Various stimuli, including bone morphogenetic protein,β-glycerophosphate and ascorbic acid, can stimulate dental pulp cells differentiation into odontoblastic like cells under certain conditions regulated by several signal pathways network. But odontoblastic differentiation is a complex process, and further research into stimulating molecules and underlying molecular mechanisms of dental pulp cells’ odontoblastic differentiation is significantly important for clinical applications of dental regenerative therapy.

Poststroke depression (PSD) is the most common neurological and psychiatric complications after stroke.A large number of studies have showed that PSD is the result of a variety of mechanisms on the basis of stroke.This article reviews the pathophysiology mechanisms of PSD.

Objective To investigate the role of correcting anemia in improving the heart function of chronic heart failure(CHF) with anemia. Methods Sixty-six CHF patients with anemia were randomly assigned to two groups. Thirty cases in the control group received routine treatment including digitalis, diuretics, vasodilator,ACEI or β-blocker,and 36 cases in the observe group received the above routine treatment and EPO,chalybeate and transferring hematid. Results Clinical efficiency ratio and total efficiency ratio were higher in the observe group (63. 9% ,91.7%) than in the control group(33.3% ,56. 7%) (χ2 =6. 73 and 10.91 ,P ＜0.01). After treatment for 3 months,Hb concentration, LVEF, LVDD, LEDV and LESV in the observe group were (125.0 ± 4. 0) g/L,(49.6±8.0)%,(4.9 ±0.7) cm,(130.1 ±24.0) ml and (72.5 ±32.0) ml respectively,which were all significantly improved than those in the control group [(80.0 ± 7.0) g/L, (34. 7 ± 10.0) %, (6. 0 ± 0.4) cm,(148. 3 ± 30.8) ml and (79. 7 ± 25. 0) ml] (P ＜ 0.01). Conclusions Correcting anemia is a safe and effective method in improveing the heart functionin CHF patients with anemia.

Objective To investigate the effects of cadmium on bone loss in ovariectomized rats. Methods Female Sprague-Dawley rats, aged 6 months, were divided to 5 groups, i.e. sham operation group (sh) , control group (ovariectomy 0 mg/L Cd), low dose group (ovariectomy+50 mg/L Cd), medium dose group (ovariectomy+100 mg/L Cd), high dose group (ovariectomy+200 mg/L Cd). Cadmium was administrated via drinking water. After 24- week exposure, the following indices were measured, bone mineral density (BMD) at the femurs necks, serum estradiol, urinary and blood cadmium, urinary ? 2-MG, bone calcium and cadmium, and calcium contents in feces and urine. Results Estradiol and BMD significantly declined in the ovariectomized rats. Cadmium administration aggravated the declines of BMD in a dose-effect pattern. Urinary ? 2-MG, the excretions of calcium in feces and urine were significantly higher in cadmium-exposed groups in a dose-effects pattern. And bone calcium was also significantly lower in the group exposed to 200 mg/L cadmium than in the control group. Conclusion It is indicated that cadmium could increase bone loss and decrease BMD in ovariectomized rats by increasing the excretions of calcium in feces and urine.

Objective To study the role of heparin-binding protein (HBP) in sepsis-associated acute respiratory distress syndrome (ARDS),and to evaluate the prognostic value of HBP in ARDS.Method Sixty seven sepsis patients were enrolled in the prospective study.According to whether present ARDS,patients were divided into two groups:ARDS group and non-ARDS group.Blood samples were obtained within 2 hours after patients were diagnosed with sepsis.We measured the level of interleukin-6,interleukin8 and HBP by ELISA,counted the number of polymorphonuclear neutrophils (PMN),and calculated Acute Physiology and Chronic Health Evaluation Ⅱ score.We compared interleukin-6,interleukin-8,PMN and HBP between two groups by Student's t test.Correlation analysis was studied between HBP and other indicators by Spearman rank correlation coefficient.We also studied the early prognostic value on sepsisassociated ARDS by establishing receiver operating characteristic (ROC) curve.Results Interleukin-6 (t=4.25,P＜0.01),interleukin-8 (t=10.10,P＜0.01),PMN (t=3.47,P=0.0009) and HBP (t =0.0225,P =2.336,all showed significant difference between ARDS group and non-ARDS group.Interleukin-6 (r=0.535,P=0.002),interleukin-8 (r=0.419,P=0.017) and PMN (r=0.419,P =0.017) all had positive correlation with HBP.The area under curve (AUC) of HBP predicting ARDS was 0.796.Conclusions HBP level elevated in sepsis-associated ARDS patients and were correlated with interleuki-6,interleuki-8 and PMN.HBP show a high value on predicting emergence of sepsis-associated ARDS.HBP may play an important role in sepsis-associated ARDS pathological process.From this study we can conclude one of possible ARDS pathogenesis:inflammatory mediators,such as interleuki-6,interleuki8,activate PMN.Subseqoently PMN releases HBP.Then HBP resolts in vascolar leakage,which is one of the basic ARDS pathology.

Objective To investigate the apoptosis of renal tubule epithelium after cardiopulmonary resuscitation(CPR)in rats and its possible mechanism.Methods Cardiac arrest was induced by asphyxiation(succinylcholine)and ice-cold 0.5 mol/l KCL in rats,and resuscitation started at 5 minutes after arrest.Forty-eight male SD rats were randomly divided into 6 groups:sham(control group);after cardiopulmonary resuscitation rats were allowed to reperfuse spontaneously for 3 hours,6 hours,12 hours,24 hours and 48 hours(n=8,per group).The apoptosis of renal tubule epithelium was assessed by TUNEL.Fas and Bcl-2 protein expression were observed using immunocytochemistry in every group.Results The apoptosis of renal tubule epithelium was singnificantly increased at 3 hours after resuscitation and peaked at 24 hours(P

Objective To study the relationship between the washout speed in the contrast-enhanced ultrasound (CEUS) and the differentiation grading in pathology in patients with hypervascular hepatocellular carcinoma (HCC).Methods Totally 271 patients who underwent complete resection for hypervascular HCC from April 2009 to December 2014 at Nanchong Central Hospital were included in this study.CEUS examinations were perfomred in all patients 2-3 days before liver resection.A timer on the ultrasound screen displayed the time elapsed since the saline flush was used to determine time to washout.The washout rate were categorized into four levels based on enhancement in portal venous phase and delayed phase.The differentiation grade and the washout speed were compared using Kruskal-Wallis test.Results All 271 (100％) lesions were arterially enhanced with different washout rate.Washout speed 1 was found in 19 patients (7.0％),while speed 2 in 157 patients (57.9％),speed 3 in 65 (24.0％),and speed 4 in 30,respectively.The washout speed had a significant correlation with the differentiation (x2=179.8238,P ＜ 0.001).The faster washout speed,the higher differentiated.Washout speed 1 could distinghuish well-differentiated from the poor and moderately differentiated tumor.The sensitivity and specificity of preoperative washout speed 1 to identify well histologic grade were 98.0％ and 77.8％,the positive predictive value and negative predictive value were 96.0％ and 48.8％,and the positive likelihood ratio and negative likelihood ratiowere were 1.9 and 0.01.Washout speed 4 could distinghuish poor differentiated from well and moderately differentiated tumor The sensitivity and specificity of preoperative washout speed 4 to identify poor histologic grade were 24.3％ and 97.0％,the positive predictive value and the negative predictive value were 65.3％ and 61.3％,and the positive likelihood ratio and negative likelihood ratiowere were 3.2 and 0.7.Conculsions Washout speed can reflect the degree of differentiation roughly.Washout speed can effectively diagnose the well-differentiated HCC,but it is difficult for moderate and poor differentiated HCC.

BACKGROUND:It is stil disputed about the treatment of subacromial impingement syndrome at present, arthroscopic subacromial decompression or open subacromial decompression. OBJECTIVE:To assess the clinical therapeutic effects of arthroscopic subacromial decompressionversus open subacromial decompression in the treatment of subacromial impingement syndrome. METHODS:Controled trials on arthroscopic subacromial decompressionversus open acromioplasty in the treatment of subacromial impingement syndrome were colected in different databases through computer search. There was no limitation for language, randomized controled trials or blinded studies. At last, the meta-analysis was conducted by using RevMan5.0 software. RESULTS AND CONCLUSION:Four randomized controled trials and six non-randomized controled trials were included in this study, involving 583 patients with subacromial impingement syndrome. The results of meta-analysis prompted that as to the hospital inpatient days and time until return to work, the group of arthroscopic subacromial decompression was shorter than open subacromial decompression. However, as to the postoperative shoulder functional scores, the operative time, patient’s satisfaction, and the rate of excelent and good results of postoperative UCLAs, there were no significant statistical differences between two groups. Due to the certain limitations and deficiencies of the quantity and quality in the included trials, there must stil need large-sample, multi-centered, high-quality randomized controled trials to confirm these results.

Objective To provide reference for exploring the senile chronic disease health management new model by apply‐ing the chronic disease health management model into the practice of home‐based care service center in community .Methods The chronic disease health management team was established and the management platform of home‐based care service centers in com‐munity was applied to implement the chronic disease health management service .The senile chronic disease management and service situation were compared between before and after implementing chronic disease health management ,and the difference of service be‐tween the home‐based care service center and community health service center after implementing the chronic disease health man‐agement was compared as well .Results The service content implementation in the home‐based care service center was significantly improved after senile chronic disease health management (P<0 .01) ,and the chronic disease management satisfaction was increased by 39 .66% .Meanwhile ,the management rate and control rate of chronic diseases in the community home‐based care service center were superior to those in the community health service center (P<0 .01) .Conclusion Applying the chronic disease health manage‐ment model into the platform of the home‐based care service center can provide more comprehensive ,specific and efficient chronic disease health management service ,w hich provides a new model of senile chronic disease management application .