Lactate acid is an attractive biomarker reflecting microcirculatory dysfunction and tissue hypoxia.Surviving Sepsis Campaign in 2012 recommend lactate acid as one of the practical biomarkers representingtissue hypoxiato guide management of patients of septic shock.The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) in 2016 updated septic shock clinical criteria as a vasopressor requirement to maintain a mean arterial pressure of 65mmHg(1mmHg=0.133kPa) or greater and serum lactate acid level greater than 2mmol/L(>18mg/dl) in the absence of hypovolemia.Lactate acid ≥4mmol/L is often associated with poor clinical outcomes in septic shock patients.Lactate-guided therapy is becoming increasingly important in guiding the resuscitation and the use of vasoactive agents of septic shock.Lactate clearance and early lactate area are valuable indicators to predict the prognosis in patients with septic shock.

Objective To understand the serum adiponectin levels in normal subjects and type 2 diabetes patients with macrovascular complications, to investigate the correlation between adipnectin and macrovascular complications in type 2 diabetes patients. Methods One hundred and two normal subjects, 116 type 2 diabetes patients and 123 type 2 diabetic patients with macrovascular complications were recruited in the current study. The serum adiponectin levels among three groups were compared, and the factors affecting the serum adiponectin were investigated. Results ①The serum adiponectin level was significantly lower in type 2 diabetic patients (8. 62 ± 2. 97) mg/L than that in normal subjects (10. 03 ± 4.41) mg/L, and was the lowest in type 2 diabetic patients with macrovascular complications(6. 17 ± 2. 55) mg/L(P < 0.05). ②Serum adiponetin level was negatively correlated with BMI,WHR,HOMA-IR,fasting insulin level, HbAlC and TG(r = -0.492, -0. 581, -0. 813, -0. 754, -0.619, -0.387, P<0.05). ③In a general multivariate regression, HOMA-IR fasting insulin and HbAlc.were negatively correlated with serum adipnectin level (r = - 0. 828, - 0. 769, - 0. 631, P < 0. 01). Conclusions The serum adiponectin level in type 2 diabetic patients is significantly decreased and even more in type 2 diabetic patients with macrovascular complications. These results suggest that lower serum adiponectin level is related to macrovascular complications in type 2 diabetic patients and maybe plays an important role in atherosclerosis in type 2 diabetic patients.

Objective To explore the correlation of adipnectin with T2DM and its macrovascular complications. Methods The levels of serum adiponectin, plasma glucose, serum lipids, and fasting insulin were measured in normal subjects, type 2 diabetic patients and type 2 diabetic patients with macrovascular complications. Results (1) The serum adiponectin level was significantly lower in type 2 diabetic patients than in normal subjects, and was the lowest in type 2 diabetic patients with macrovascular complications. (2) Serum adiponetin level was negatively correlated with BMI,HOMA-IR, HbA_1c,TG and fasting insulin level. Conclusions The results suggest that lower serum adiponectin level may be related to macrovascular complications in type 2 diabetic patients.

Objective To explore the anti-cancer function of old drugs from the perspective of the concept of Chinese herbal nature combination, and provide method and a new thinking style for the new function discovery from old drugs under the guidance of the theory of traditional Chinese medicine (TCM). Methods Using lung cancer with qi and yin deficiency as the example, the therapeutic principles of TCM anti-lung cancer treatment were analyzed and Chinese herbal nature combination patterns (CHNCP) for cancer treatment were extracted based on the relationship between function and Chinese herbal nature combination. The chemical medicines were re-screened with the cancer CHNCP and the candidates were identified. Results The therapeutic principle of TCM anti-lung cancer treatment is invigorating qi and nourishing yin. Fifteen chemical medicines were identified as the anti-cancer candidates, including 2 anti-cancer drugs being used in clinics and 4 drugs having the anti-cancer activity. Conclusion The method for finding the anti-cancer function of old drugs based on the Chinese herbal nature combination is feasiable, which provide new clues for application of old drugs.

It is significant for theory and application to study on marine microbial exopolysaccharides with differential structures and activities endowed by the specific marine environment.The recent progress of the research on the structures and bioactivities of marine microbial ex- opolysaccharides was reviewed,and the prospect of the research and development of the marine microbial exopolysaecharides was also expec- ted.

Antibodies ; immunology ; Antibody Formation ; Complement C4b ; immunology ; pharmacology ; Diagnosis ; Graft Rejection ; diagnosis ; immunology ; Humans ; Kidney Transplantation ; immunology ; Peptide Fragments ; immunology ; pharmacology ; Transplantation, Homologous ; immunology

Objective To discuss the feasibility,indications,surgical techniques,and outcome con- cerning the application of less invasive stabilization system (LISS) for complex proximal femoral fractures.Methods We treated 12 complex proximal femoral fractures using femoral LISS reversely from June 2005 to May 2006. They were five complex intertrochanteric fractures and seven subtrochanteric ones.By AO classification,two were type 31-A2.2,two type 31-A2.3,one type 31-A3.3,one type 32-A3.1,three type 32-B1.1,one type 32-B2.1, and two type 32-B3.I.The patients were treated with closed or indirect reduction and fixation with percutaneous LISS plate reversely.Results There were no major postoperative complications in this study.The mean operation time was 65 minutes (range,50 to 90 minutes),the mean intra-operative blood loss was 142 milliliters (range,50 to 400 milliliters),and the mean postoperative hospital stay was 9.3 days (range,6 to 15 days).All patients had a clinical follow-up;the mean follow-up time was 7.2 months (range,3 to 14 months).Ten cases healed clinically three months postoperatively,one periprosthetic fracture healed four months and one pathological fracture healed six months after operation.At the final radiographic follow-up,no collapse,varus deformity,cutting-out,hardware failure,or avascular necrosis was found.Conclusions Femoral LISS used reversely can provide secure fixation for proximal femoral fractures biomechanically and anatomically.It is also easy and safe.It is particularly suitable for old patients with intertrochanteric fractures complicated with disorders of internal organs and severe osteoporosis or patients with complex proximal femoral fractures.It is important to be skillful in indirect reduction and positioning of guide wire into hole A,and to avoid immediate weight-bearing postoperatively.

Partial pancreatectomy was performed in a female patient with islet cell nodular hyperplasia, who repeatedly suffered from hypokalemia and hypoglycemia without diarrhea.After surgical operation,her symptoms were relieved.

Objective To investigate the effect of Dureping injection (DRP) on IL-4, IFN-? mRNA and CD40L protein expression of FM1 infected mice with virus pneumonia, and explore the mechanism of antiviral effect. Methods ICR mice were divided into 7 groups:DRP1, DRP2, DRP3, SHL, Ribavirin, sham and model group. The mice were sacrificed on the 7th after infected, and the lung index was calculated. Then, IFN-?mRNA and IL-10 mRNA in the lung tissue was measured with RT-PCR, CD40L protein in the lung tissue was measured with Western-blot. Results The lung index of mice in model group was significantly higher than sham group (P0.05). Conclusion DRP in vivo could down-regulate the lung index, inhibit the transcription IL-4 mRNA, enhance the transcription of IFN-? and inhibit the expression of CD40L protein in lung of FM1 infected mice.

Objective To assess the efficacy of different types of thymectomy for the treatment of myasthenia gravis(MG).Methods A retrospective analysis on 269 cases of MG,who were treated in our hospital from 1991 to 2006 by transsternal thymectomy(January 1991 to May 2002,n=161),thoracoscopic thymectomy(February 2002 to July 2005,n=67),or video-assisted thoracoscopic extended thymectomy(VATET,February 2005 to November 2006,n=41).Results The mean operation time of the transsternal group was significantly shorter than that in the other groups [transsternal group vs thoracoscopic and VATET groups:(97.5?17.5)min vs(130.3?31.5)min(q=12.991,P