Objective To investigate the changes of plasma microRNA-223(miR-223) and HMGB-1 in pediatric sepsis patients.Methods There were 49 children with sepsis enrolled in the study (sepsis group),severe sepsis group (n=25) and general group (n=24). Meanwhile, 50 healthy children (normal control group) were selected as control group. The expression levels of plasma miR-223and HMGB-1 (high mobility group box 1) were detected. The predictive values of miR-223and HMGB-1 in plasma of children with sepsis were evaluated by receiver operatingcharacteristic (ROC) curve.Results The plasma miR-223 and HMGB-1 expression levels in severe sepsis group and general group were up-regulated compared with those in the normal control group (F=63.02, 76.32,P<0.05). The area under ROC curve of miR-223,HMGB-1 predicting sepsis were 0.904 (95%CI 0.821-0.998), 0.748 (95%CI: 0.625-0.903). There was positive correlation between miR-223 and HMGB-1 (r=3.532, P<0.05). Conclusions The expression levels of plasma miR-223 in children with sepsis are signiifcantly up-regulated, which can be used as early diagnostic markers to relfect the severity of inlfammation in some degree.

Experimental autoimmune encephalomyelitis ( EAE ) is a classic animal model for multiple sclerosis . After more than 2 centuries of development , EAE can be established in mice , monkeys and rats ,etc.Some animals can be immunized by different immune antigens which have different features in sensibility and clinical characteristics .In this pa-per, we will review the development of EAE , discuss the characteristics of EAE models produced by immunization of differ-ent animals with different antigens .In summary, we explore the development of animal models of EAE .

Objective: To establish a method for the determination of cyasterone in Shenshixiao capsules. Methods: Using an HPLC method, the column was an Agilent C18 (250 mm × 4. 6 mm,5 μm) column, the mobile phase was methanol-water with gradient elution. The detection wavelength was 243nm, the flow rate was 1. 0 ml·min-1 ,and the temperature of column was room temperature. Results:The linear relationship of cyasterone was good within the concentration range of 0. 025-0. 247 μg(r=0. 999 6), the average recovery was 99. 4%, and RSD was 0. 76%. Conclusion:The method is rapid, simple and accurate, and can be used in the quality control of the preparation.

AIM: To establish the quality control standard for Compound Dingfengzhitong Capsule (Radix Notoginseng, Radix Saposhnikoviae, Radix Angelicae Dahuricae). METHODS: Radix Saposhnikoviae, Radix Angelicae Dahuricae in capsule were identified by TLC, and the content of ginsenoside R g1 was determined by HPLC. RESULTS: Radix Saposhnikoviae, Radix Angelicae Dahuricae could be identified by TLC. The Ginsenoside R g1 showed a good linear relationship at a range of 0.5286?g～26.43?g, r=0.9999(n=6) , the average recovery was 99.94%, and RSD was 1.34%( n =9). CONCLUSION: The method is accurate with the good reproducibility and can be used for the quality control of Compound Dingfengzhitong Capsules.

Objective To construct the competency model of excellent and common clinical medicine undergraduates according to the competency theory . Methods Literature search was used to screen competency model. Behavioral event interview was used to interview 32 excellent clinical experts. Open questionnaire survey was conducted to 100 clinical medical undergraduates. We compiled the primary competency dictionary based on the above results. To determine the final competency dictionary, Delphi method of 50 experts was used to determine the final competency dictionary. According to the competency dictionary, a questionnaire survey was made to test the excellent and ordinary undergraduate students. Results The 38 features of behavioral event interview and 42 features of open questionnaire survey were combined to 51 features, which were used as the first round of expert questionnaire. Two rounds of expert consultation reached a high degree of coordination. 4 first level indicators: knowledge and skills, social role+values+service characteristics, self-concept and consciousness, personality quality and motivation and 36 features were established as final compentency model. 80 excellent clinical medical undergraduates got score of 143.65 ±23.53, while 100 ordinary undergraduates got score of 133.55 ±35.31 (t=2.29,P=0.023), which indicated the competency model could distinguish excellent and ordinary clinical under-graduates . Conclusion This competency model of clinical undergraduate students is reliable and practical, which can be used in future clinical undergraduate training and evaluation.

Objective To evaluate the value of acoustic radiation force impulse (ARFI) elastography in assessment of nonalcoholic fatty liver disease (NAFLD) and hepatic fibrosis in rats.Methods Models with various degrees of NAFLD severity were conducted in 110 rats by feeding high fat emulsion.The right liver lobe of rat models were processed and embedded in a fabricated gelatin solution to measure the shear wave velocity (SWV) by ARFI.And the other liver lobes were used for histologic assessment.Based on NAFLD activity score (NAS),the final pathologic NAFLD diagnosis were considered as normal group (NAS=0),simple steatosis (SS) group (1≤NAS≤2),borderline (3≤NAS≤4) group and nonalcoholic steatohepatitis (NASH) group (NAS≥5).The diagnostic accuracy of the SWV parameters in evaluating NAFLD severity and fibrosis stages was studied using ROC curves.Results The difference of SWV values among normal group,SS group,borderline group and NASH group was statistically significant (F=31.53,P＜0.001).Taking SWV≥ 2.54 m/s as the diagnostic standard to differentiate normal rats from rats with SS,and SWV≥2.90 m/s to differentiate SS from NASH in rats,the area under ROC curve (AUC) was 0.922 (95％CI [0.871,0.973],P＜0.001) and 0.882 (95％ CI [0.807,0.956],P＜0.001) respectively.The sensitivity and specificity were 93.5 ％ and 100 ％ for differentiating normal and SS groups,83.3 ％ and 84.2 ％ for differentiating SS and NASH groups.Taking SWV≥3.48 m/s as cutoff to predict fibrosis (≥F2 stage),the AUC was 0.963 (95％CI [0.909,1.000],P＜0.001),the sensitivity was 92.9％ and the specificity was 97.6％.Taking SWV≥3.61 m/s as cutoff to predict severe fibrosis (≥F3 stage),the AUC was 0.997 (95％CI [0.990,1.000],P＜0.001),sensitivity was 100％ and specificity was 98.9％.The same high validity was maintained as in the prediction of cirrhosis (F4 stage) with the cutoff as SWV≥4.50 m/s,and the AUC was 0.993 (95％CI [0.982,1.000],P＜0.001),the sensitivity was 100 ％ and the specificity was 96.8％.Conclusion ARFI elastography is a promising method for differentiating the different severity of NAFLD and staging the degree of hepatic fibrosis with NAFLD in rat models.

Background:Chronic atrophic gastritis(CAG)is a common disease of digestive system and is a precancerous lesion of the intestinal type gastric cancer. Serum pepsinogens(PGs)and gastrin 17(G17)are biological markers of gastric mucosal lesions,which have a prominent role in diagnosis of CAG and screening of early gastric cancer. Aims:To study the correlation of serum PGs and G17 with age in patients with CAG. Methods:A total of 582 CAG patients admitted from Jan. 2016 to Sep. 2017 at the Baoding First Central Hospital were enrolled. The levels of serum PGⅠ,PGⅡ and G17 were determined by ELISA,and the PGⅠ/ PGⅡ ratio(PGR)was calculated. The correlations of these indices with the clinical data of CAG patients were analyzed. Results:The levels of serum PGⅠ and PGⅡ were increased with age(P<0.01),and the levels of PGR and G17 were decreased with age(P <0.05). Spearman rank correlation coefficient analysis showed that the levels of PGⅠ and PGⅡ were positively correlated with age(rs=0.374,P<0.01;rs=0.559, P<0.01),and the levels of PGR and G17 were negatively correlated with age(rs= -0.649,P<0.01;rs= -0.141, P<0.05). Conclusions:The levels of serum PGⅠ,PGⅡand G17 in patients with CAG were correlated with age. When serum PGs and G17 are used as serological indicators for diagnosis of CAG and screening of early gastric cancer,the impact of age on these indices should be taken into account.

ObjectiveTo explore the risk factors of stroke， and to provide reference for the prevention and health management of stroke. MethodsFrom February 2022 to March 2022， four community residents over 60 years old with stroke in Shanghai were randomly selected as the case group （n=100）， and non-stroke residents were selected as the control group （n=100）. The survey was in the form of questionnaires to record and compare the age， body mass index （BMI）， blood lipids， blood pressure-related indicators， family history of other diseases， living habits， mood and sleep conditions of all subjects. The value of predicting the incidence of stroke among the elderly in Shanghai community was analyzed by receiver operating characteristic （ROC）， and the influencing factors of stroke were analyzed by logistic model. ResultsBMI， hypertension， heart disease， diabetes， transient ischemic attack （TIA）， dyslipidemia， family history of stroke， smoking， lack of exercise or only light physical labor， SBP， DBP， TG levels were significantly higher in the case group （P<0.05）. The level of HDL-C was significantly lower than that in the control group （P<0.05）. BMI， SBP， DBP， TG， HDL-C predicted the incidence of stroke by ROC analysis （P<0.05）. Logistic regression analysis showed that BMI≥23.820 kg·m^-2， heart disease， diabetes， TIA， dyslipidemia， family history of stroke， smoking， lack of exercise or only light physical labor， SBP≥139.535 mmHg， DBP≥89.605 mmHg， TG≥1.565 mmol·L^-1 and HDL-C≤1.105 mmol·L^-1 were risk factors for stroke （P<0.05）. ConclusionPhysical health status including blood lipids and blood pressure， family history of certain diseases， and living habits could be important risk factors for stroke in the elderly in Shanghai community. Preventive intervention measures for the above factors have important clinical significance.

Objective: To explore the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection who received entecavir alone or in combination with anluohuaxianwan for 78 weeks. Methods: Patients with chronic HBV infection were randomly treated with entecavir alone or in combination with anluohuaxian for 78 weeks. Ishak fibrosis score was used for blind interpretation of liver biopsy specimens. The improvement in liver fibrosis condition before and after the treatment was compared. Student's t test and non-parametric test (Mann-Whitney U-Test and Kruskal-Wallis test) were used to analyze the measurement data. The categorical variables were analyzed by Chi-square test method and Spearman’s rank correlation coefficient was used to test bivariate associations. Results: Liver fibrosis improvement rate after 78 weeks of treatment was 36.53% (80/219) and the progression rate was 23.29% (51/219). The improvement of liver fibrosis was associated to the degree of baseline fibrosis and treatment methods (P < 0.05). The improvement rate of hepatic fibrosis in patients treated with anluohuaxianwan combined with entecavir at baseline F < 3 (54.74%, 52/95) was significantly higher than that in patients treated only with entecavir (33.33%, 16/48), P = 0.016 and the progression rate of hepatic fibrosis (13.68%, 13/95) was lower than that in patients treated alone (18.75%, 9/48), P = 0.466. In patients with baseline F < 3, the proportion of patients with improved and stable liver fibrosis in the combined treatment group (68.1%, 32/47) was higher than that in the treatment group alone (51.7%, 15/29). Conclusion Combined anluohuaxianwan and entecavir treatment can significantly improve the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection. Furthermore, it has the tendency to improve the stability rate and reduce the rate of progression of liver fibrosis.