Sepsis is a complex systemic inflammatory response syndrome caused by infection.Sepsis can deteriorate to severe sepsis,septic shock,and multiple organ dysfunction syndrome.Due to the use of antimicrobial agents,fluid resuscitation and the developments of all kinds of support life,the treatment of sepsis has greatly improved over the past years.However,the mortality rates of sepsis still remain high.Rapid,accurate and early diagnosis of sepsis is a key factor to lower the high mortality rate of sepsis.Recently,it has been found that some biomarkers are closely associated with early diagnosis of sepsis and are helpful for the treatment.These biomarkers for early diagnosis include presepsin(sCD14-subtype),neutrophil CD64,soluble triggering receptor expressed on myeloid cells-1 (sTREM-1),soluble CD163,microRNAs,copeptin,and so on.Examining these biomarkers alone or in combination will bring new opportunities for the early diagnosis of sepsis,and hopefully provide new ideas for the treatment of sepsis.This article reviews the progress on the current emerging biomarkers for early diagnosis of sepsis.

Staphylococcus aureus continues to be a major pathogen in both community and healthcare associated infections.The pathogenicity of staphylococcus aureus is a complex process involving a variety of extracellular and cell wall components that are coordinately expressed during different stages of infection.Accessory gene regulator (agr)-mediated quorum sensing plays a major role in staphylococcal pathogenesis.However,agr dysfunction strains exist extensively in staphylococcus aureus clinical isolates.This review will mainly focus on the influence of agr dysfunction on staphylococcus aureus biofilm formation,clinical course and outcome of infectious diseases,and antibiotic resistance.

Diabetes-related macular exudation is a common fundus change associated with diabetes mellitus,charactered by hard exudates of macular area.It is one of main causes of lowing vision in diabetic patients.The incidence of diabetes-related macular exudation is increasing recent years,and therefore the diabetic maculopathy is also a matter of urgent concern.Domestic and international studies suggested that many systemic factors,such as blood glucose level,blood pressure,hypertension,higher blood lipid,inflammatory factors and genetic predisposition,exert impacts in the pathogenesis and development of diabetic retinopathy.However,whether the hard exudates of macular area also is associated with systemic factors mentioned above is unclear up to now.Since the hard exudates of diabetic maculopathy may leads to permanent loss of visual function,it is very important for us to find the effective prevent and managing approaches.This paper aimed to review the progress in this field and summarize the relevant risk factors that must be strictly controlled.

Objective To discuss the safety management of hemodialysis equipment for safe and effective treatment to patients.Methods The management methods were summarized in aspects of the installation,utilization and maintenance of hemodialysis equipment.Results The hemodialysis patients received the safe and effective treatment through the strict management and the standardized system.Conclusion The standardized management can not only reduce the unnecessary failures of the equipment,and prolong the service life,but also increase the utilization rate of the equipment,and provide the best,safest and most satisfactory treatment for patients.

In critically ill patients,evoked potential(EP) testing is an important tool for measuring neurologic function,signal transmission,and secondary processing of sensory information in real time.EP potential measures conduction along the peripheral and central sensory pathways with longer-latency potentials representing more complex thalamocortical and intracortical processing.In critically ill patients with limited neurologic exams,EP provides a window into brain function and the potential for recovery of consciousness.Brainstem auditory EP and cortical event-related potentials are most commonly used in ICU.The primary indications for EP in critically ill patients are prognostication in anoxic-ischemic or traumatic coma,monitoring for neurologic improvement or decline,and confirmation of brain death.Historically,EP has been regarded as a negative prognostic test,that is,the absence of cortical potentials are associated with poor outcomes while the presence cortical potentials are prognostically indeterminate.In recent studies,the presence of middle-latency and long-latency potentials as well as the amplitude of cortical potentials is more specific for good outcomes.Event-related potentials,particularly mismatch negativity of complex auditory patterns,is emerging as an important positive prognostic test in patients under comatose.In infants,other than anoxic-ischemic or traumatic brain injury,brainstem auditory is also widely used in premature baby,bilirubin encephalopathy and detection of possible hearing loss.

Sclerosing cholangitis includes a spectrum of chronic, variably progressive cholestatic liver disease characterized by inflammation, fibrosis and stricture of the intrahepatic and extrahepatic bile ducts. Sclerosing cholangitis can be divided into primary sclerosing cholangitis of unidentified etiology and secondary sclerosing cholangitis caused by various identifiable etiologies, including immunoglobulin G4-related sclerosing cholangitis, recurrent pyogenic cholangitis, ischemic cholangitis, acquired immunodeficiency syndromerelated cholangitis and eosinophilic cholangitis. In this article, we describe the imaging findings of the various spectrums of sclerosing cholangitis with anemphasis on a systemic approach in differential diagnosis. It is very important for magnetic resonance cholangiography and endoscopic cholangiography in imaging diagnosis and differential diagnosis of sclerosing cholangitis. We also discuss the clinical significance and therapeutic options for treating sclerosing cholangitis.

The liver specific contrast agent gadolinium ethoxybenzyldiethylenetriaminepe ntaacetic acid (Gd-EOB-DTPA) is routinely used in clinical magnetic resonance imaging. It combines assessment of tissue perfusion during the vascular phase with hepatocyte specific imaging during the hepatobiliary phase. This combination of imaging properties has been shown to provide excellent results in the detection and differentiation of liver lesions. The enhancement characteristics of Gd-EOB-DTPA in hepatocellular carcinoma, regenerative nodules and degenerated nodules were summarized in this review. Liver cell specific contrast agent can further improve the diagnostic ability.

Objective To investigate the 2-year retention rates and tolerability of levetiracetam (LEV), Lamotrigine(LTG), and Oxcarbazepine(OXC) in pediatric patients with epilepsy.Methods 310 pediatric patients with epilepsy were included in this study: LEV (n=145), LTG (n=101), and OXC (n=64). The clinical efficacy, first discontinuation time and discontinuation reasons were recorded and compared. The retention rates at 12, 24, 52 and 104 weeks were evaluated. Results At the two-year follow up:Clinical efficacy didn't significantly differ among the three groups (P = 0.190); The 2-year retention rates for LEV, LTG, and OXC, were 68.28%, 72.28%, and 48.44%, respectively (P = 0.002). LEV and LTG had equivalent retention rates, whereas OXC retention was significantly inferior to the LEV and LTG retention (P<0.05). The common reasons for drug discontinuation were adverse effects (47.66%) and lack of efficacy (42.10%), while the rate of adverse effects leading to drug withdrawal of OXC (66.77%) was higher than that of LEV (36.96%, P = 0.003) and LTG (42.86%, P = 0.023). Conclusion These results suggested that LEV, LTG and OXC had similar clinical efficacy. LEV and LTG had comparable retention profiles and long-term tolerability in the 2-year treatment, while OXC therapy seemed to be relatively less useful. If there are no specific contradictions, pediatric patients with epilepsy could be better receiving LEV and LTG antiepileptic treatment.

Objective:To investigate the correlation of ABCB1 polymorphisms and the synergistic effect of Wuzhi capsules on ta-crolimus. Methods:The ABCB11236C>T(rs1128503), ABCB12677G>T/A(rs2032582) and ABCB13435C>T(rs1045642) genotypes were determined by restriction fragment length polymorphism ( RFLP) analysis. The whole blood levels of tacrolimus in renal transplant recipients were measured by chemiluminescent microparticle immunoassay. Analysis of covariance ( ANCOVA) was per-formed to determine the difference of tacrolimus C0/D among the various groups. Results: Whether co-administeration of Wuzhi cap-sules and tacrolimus or not, tacrolimus C0/D of ABCB11236C>T, ABCB12677G>T/A and ABCB13435C>T genotype and haplo-type was without significant difference. Conclusion:When combined with Wuzhi capsules, ABCB11236C>T, ABCB12677G>T/A and ABCB13435C>T mutation is not associated with tacrolimus C0/D.

Objectives To provide outline for the Research & Development department of hospitals making research strategy by analyzing the quantity of publications and their cited status for the top 20 hospitals in SCI and MEDLINE, and the top 100 hospitals in domestic publications in 2008. Methods The number of publications and their cited times for the first 20 hospitals in SCI and MEDLINE, and the top 100hospitals in domestic publications in 2008 were analyzed with bibliometric analysis. Results Compared with 2007, the increased number and ratio of publications in SCI and MEDLINE for the top 20 hospitals were 1050, 51.19% and 658, 15.04%, respectively; for top 100 hospitals, the average decreased number of domestic publications was 2.08, and the number of cited publications was increased 202.52 and the increased ratio was 13.51%. Conclusions The SCI publications from top 20 hospitals increase sharply, the increase of the MEDLINE articles from the top 20 hospitals is slowly. The negative growth is showed in the number of domestic articles for the top 100 hospitals. In addition, the increase of cited articles is slowly and disproportion.