Objective:To explore the value of using risk-stratifcation of mergency department suspected sepsis score(REDS) score in the prognosis of patients with sepsis.Methods:The clinical data of sepsis patients hospitalized in Huangshan Shoukang hospital from January 2018 to February 2020 were collected for retrospective case-control study.The REDS, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and mortality in emergency department(MEDS) of all cases were calculated.To evaluate the value of REDS in prognosis of patients with sepsis by comparing REDS with APACHEⅡ and MEDS.Results:Finally 103 patients were enrolled in the study, including 65 males (63.11%) and 38 females (36.89%); the age ranged from 42 to 93 years old, the median (quartile) was 74 (65, 82) years old; 72 patients (69.91%) survived (survival group), 31 patients (30.09%) died (death group). There were significant differences between survival group and death group in REDS((5.28±2.10) score vs.(7.87±2.53) score), MEDS score ((6.64±3.32) score vs.(9.06±3.3) score), APACHE Ⅱ score ((18.96±6.72) score vs.(21.87±6.15) score) (t value were5.404, 3.381 and 2.067, respectively; P value were<0.001, 0.001 and 0.041, respectively). Youden index was biggest(0.381), when REDS was 7.5.The area under the receiver operating characteristic curve was 0.777 (95% CI: 0.678-0.876, P<0.001). When APACHE Ⅱ score was 19.5, Youden index was the largest (0.177), and the area under the ROC of APACHEⅡwas 0.614(95% CI: 0.499-0.729, P=0.068). When the MEDS score was 10.5, Youden index was the largest (0.341), and the area under the receiver operating characteristic curve was 0.696 (95% CI: 0.590-0.802, P=0.002). The area under the curve of working characteristics of the subjects with red score was larger than that of APACHE Ⅱ score ( Z=1.987, P=0.046). Conclusion:REDS has a good effect in judging the condition and prognosis of patients with sepsis, which is equivalent to MEDS score, but better than APACHEⅡ.

Objective To investigate the efficacy of nedaplati docetaxel combined with radiotherapy on patients with locally advanced cervical cancer.Methods The clinical data of 99 cases with pathologically diagnosed advanced cervical cancer from Jun.2013 to jul.2014 in the Matemal and Child Health Care Hospital of Tangshan were recorded.The patients were randomly divided into the control group (45 cases only with radiotherapy) and the observation group(54 cases with nedaplati and docetaxel beside radiotherapy).Results The effective rate in observation group was 90.74％,higher than control group (71.11％,x2 =6.358,P =0.017).There were significant incidence of bone marrow suppression renal dysfunction and gastrointestinal both in two groups,but can endure.There was no significant difference in term of side effect in two groups (P ＞0.05).Conclusion The therapy of nedaplati and docetaxel combined with radiotherapy has better effect for patients with advanced cervical cancer and without significantly increasing side effect.

Objective To investigate the correlation of the S100B level with cardiac function and chronic heart failure.Methods A total of 80 elderly chronic heart failure (CHF) patients who accepted treatments in our hospital from March 2012 to December 2013 were recruited,and 80 subjects undergoing health examinations served as the control group.The New York Heart Association (NYHA) functional classification in the experimental group was determined.Serum levels of S100B and NT-proBNP,left ventricular end diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) were compared between the groups,and the correlation of the S100B level with NT proBNP,LVEF and the NYHA functional classification were analyzed.Results The serum S100B level was increased in the experimental group as compared with the control group [(91.4 ±31.9) pg/L vs.(74.9±26.0) pg/L,t=1.980,P=0.000].The serum NT-proBNP level was higher,LVEDD was longer,and LVEF was lower in the experimental group than in the control group (all P＜0.01).The serum S100B level was positively correlated with NT-proBNP (r=0.309,P=0.003) and the NYHA functional classification (r=0.508,P=0.001),and negatively correlated with the LVEF (r=-0.192,P=0.004).Conclusions The serum S100B level is increased in patients with CHF and negatively correlated with cardiac function,suggesting that the S100B protein may serve as a valuable tool for the diagnosis and assessment of CHF.However,more studies are needed to provide more evidence.

Objective To investigate one year survival rate and life quality of patients with non-small cell lung cancer(NSCLC)treated by different arms.Methods One hundred and seventy-nine cases NSCLC patients from January 2013 to December 2014 were selected from the Third Hospital of Tanshan and followed-up,including 57 cases with surgical treatment,70 cases with the use of Navelbine plus cisplatin,52 cases with dendritic cells(DC)and cytokine induced killer cells(CIK)immune based therapy(DC/CIK)treatment.After one year period of radiotherapy and chemotherapy,the SF-36 questionnaire was used to investigate the quality of life of the surviving patients,and the quality of life was assessed from three aspects of the physiological,psychological and social functions.To quantify the quality of life score,the 100 percentage grading system was adopted,logistic regression analysis was used to adjust the influence of age and gender on survival rate,and the data were analyzed by SAS 9.2 statistical software package.Results One hundred and seventy-nine subjects were included in this study,by the end of follow-up on December 2015,there were 119 cases survived,the survival rate was 66.5％(119/179).Survival rate of surgical operation group,DC/CIK group and chemotherapy group orderly decreased(82.5％(47/57),76.9％(40/52)and 45.7％(32/70),P＜0.01).After adjusting age and gender impact,multiple logistic regression model showed that DC/CIK group survival rate was 3.96 times higher than the pure chemotherapy group(95％CI=1.78-8.80),surgical operation group was 5.58 times higher than simple chemotherapy group(95％CI=2.44-12.79).There were no significant differences between DC/CIK group and surgical operation group on physical disease,health status,emotional intelligence,mental health and social function,no significant difference(P＞0.05),but the chemotherapy group was lower(P＜0.05);physiological function in the chemotherapy group,operation group and DC/CIK group showed an increasing trend(P＜0.05).Conclusion The one year survival rate of NSCLC patients treated by different arms is 66.5％,and the life quality of patients with biological immune therapy method is better.

Objective: To investigate the effect of interleukin-8 (IL-8) on survival and apoptosis of hypoxic human umbilical vein endothelial cells (HUVECs) with its mechanisms.
Methods: Hypoxic HUVECs were induced by CoCl2. HUVECs were cultured with different concentrations of CoCl2 or IL-8 and the survival rates of HUVECs were examined. Normal or hypoxic HUVECs were incubated with IL-8 or simultaneously incubated with anti-IL-8 or Akt inhibitor LY294002 for 48h. The HUVECs survival rate was detected by MTT method, apoptosis rate was measured by Annexin V-FITC/PI method, the protein expressions of Caspase-3, phosphorylated Akt (pAkt) and GSK-3βser9 (pGSK-3βser9) were evaluated by Western blot analysis.
Results: By 12 h incubation with low concentration of CoCl2 (50, 100 μmol/L), HUVECs proliferation were improved, P<0.01; while by 24h and 48 h incubation with high concentration of CoCl2 (200, 400 μmol/L) HUVECs survival were decreased. By 48h and 72h incubation with IL-8 at (10, 50, 100 ng/ml), the hypoxia induced cell apoptosis was decreased and the survival was increased,P<0.01. IL-8 at 10 ng/ml may obviously inhibit the normal and hypoxic HUVECs apoptosis, down-regulate caspase-3 and up-regulate pAkt and pGSK-3βser9 expressions in HUVECs,P<0.01, while the above effects could be reversed by LY294002 and anti-IL-8,P<0.01.
Conclusion: IL-8 could down-regulate caspase-3 and up-regulate pAkt and pGSK-3βser9 expressions in HUVECs and therefore, inhibit the apoptosis and improve the survival of hypoxic HUVECs.

Objective To study the clonal heterogeneity in differentiation potential of immortalized mesenchymal stem cells in vitro and in rive.Methods The monoclonal cell lines were performed with limiting dilution cloning,and were induced to adipocytic,asteogenic and neuronal differentiation in vitro.After transplanted the monoclonal cell lines into SCID mice,the xenotransplants were removed and evaluated by immunohistochemistry.Results From the parental HMSC-TERT,32 single-cell derived clones were established,of which the differentiation properties varied considerably in vitro.The cells grow in different plating densities during expansion in culture:HMSC-TERT-2 expressed more strongly in LCA,GFAP and vimemin;HMSC-TERT-C19 expressed more strongly in keratinose than HMSC-TERT-2,HMSC-IERT-20,and MSC-H;HMSC-TERT-C2 expressed more strongly in actin than HMSC-TERT-2.Conclusions The HMSC-TERT monoclone cells are heterogeneity in differentiation petential in vitro and in vivo,suggesting that standard in vitro culture and in vivo inoculate procedure phy an important role in the clinical application of stem cells.

Objective To analyze the changes of leptin and adiponectin levels in serum of patients with diabetic retinopathy and investigate their chnical significance in diabetic retinopathy (DR).Methods One hundred and twenty-one patients with type 2 diabetes mellitus as the case group who hospitalized from Nov.2012 to Nov.2013.Among the patients,41 cases of non-DR,40 cases of nonproliferative-DR,40 cases of proliferativeDR.Forty healthy were served as the control group.The levels of leptin and adiponectin in serum were detected by Enzyme-Linked Immuno Sorbent Assay (ELISA).Results The overall levels of leptin in case group was (15.25 ± 4.70) μg/L,significantly higher than the control group ((6.15 ± 1.70) μg/L; t =-11.696,P ＜0.01)).The level of adiponectin in case group was (7.39 ± 1.92) mg/L,lower than the control group ((11.10 ± 1.46) mg/L; t =11.216,P ＜ 0.01).Moreover,the levels of leptin increased successively from (10.91 ±1.21) μg/L in NDR,(15.22 ±3.75) μg/ L in NPDR and (20.50 ±3.70) μg/L in PDR.While,the adiponectin levels decreased from (9.61 ± 1.35) mg/L in NDR,(7.11 ± 1.18) mg/L in NPDR and (5.34 ± 1.36) mg/L in PDR respectively.And the differences between the groups were significant(F =149,542,291,550;P ＜0.05).The levels of leptin and adiponectin in serum showed a negative correlation (r =-0.662,P ＜0.01).Condusion Levels of leptin and adiponectin in serum associate with DR,and both of them might be the important indexes for the prediction and curative effect evaluation of DR.

Objective To evaluate the postoperative quality of life of donors in living donor renal transplantation patients.Methods One hundred and seventeen donors were involved in present study from 2006-2008.A crosssectional survey was performed with questionnaire research to all the donors who received living donor nephrectomy during this period.The questionnaire included sociodemographic characteristics,surgical complications,economic status,donors awareness status,family support,the health care,social welfare and daily exercise after surgery.The Chinese version of SF-36 was used as the measurement of quality of life.The statistic analyze include T test,analysis of variance and stepwise regression analysis.Results The donors' mental health status was better than the healthy population (P ＜ 0.05).The difference of quality of life and scores of other dimensions compared with the healthy population was not statistically significant (P ＞ 0.05).In univariate analysis,four kinds of fields such as age,education level,economic status and physical exercise were associated with quality of life.In further multivariate analysis,with exclusion of the interaction between various factors,the main factors for postoperative quality of life are the cultural,economic status and physical activity (P ＜ 0.05).Conclusions Social and psychological factor should be concerned in donor's preoperative screening.Good social psychological background,the necessary psychological intervention and postoperative follow-up maybe play an important role to improve the postoperative quality of life in living donor renal transplantation.

Objective To investigate the infection following the lymphocytes deleted agent (ATG) and IL-2 receptor antagonists (Basilixinab and Daclizumab)-based induction therapy after renal trausplantation.Methods A retrospective analysis was carried out on 701 kidney transplant recipients between Jan. 1,2005 to Dec.31,2010.According to exclusive and inclusive criteria,finally 549 patients were evaluated,including 429 patients treated with ATG (ATG group) and 120 patients with anti-CD25 monoclonal antibodies (monoclonal antibodies group; 86 patients with Basiliximab,and 34 patients with Daclizumab).The incidence of acute rejection,infection rate,infection time,hospital stay,severe infection rate and mortality were analyzed.After operation,the patients received an immunosuppression therapy including Tacrolimus (cyclosporine A),Mycophenolate-Mofetil and prednisone to present rejection. Part of the patients were treated with ganciclovir and sulfamethoxazole sulfadiazine and trimethoprim for infection prevention.Results The acute rejection rate in ATG group and monoclonal antibodies group was 15.9％ (68/429) and 10.0％ (12/120),and there was no statistically significant difference (P＞0.05).The infection rate in ATG group was 11.9％ (51/429),including 13.7％ (7/51) with severe infection,and mortality was 7.8％(4/51).The infection rate was 15.0％ (18/120) in monoclonal antibodies group,including 11.1％ (2/18) with severe infection,and mortality was 5.6％ (1/18).There was no statistically significnat difference in infection rate,severe infection rate and mortality between two groups (P＞0.05).The hospital stay in ATG group and monoclonal antibodies group was 25.8 days and 19.1 days respectively (P＜0.05).Dead cases had not received regular anti-infection treatment,and the patients age was over 50 years.Conclusion The infection risk and mortality between these two induction therapies are identical,but hn comparison to the patients using ATG,the infection of patients using anti-CD25 monoclonal antibodies is easier to control.Anti-infection prophylaxis is important to reduce infection rate and decrease infectious mortality.

objective To evaluate the influence of HLA matching and new immunosuppressants on pre-venting acute rejection of renal allograft in sensitized recipients. Methods 751 recipients underwent renal transplantation were enrolled in this study including 46 sensitized recipients (study group) with PRA be-tween 10%-90% and 705 non-sensitized recipients (control group) with PRA less than 10% pretransplant. All patients in the study group received induction course (ATG 100 mg/d, 5-7 d) plus triple-immunosup-pressive therapy including FK506 + MMF + steroid. The rate of acute rejection and delayed graft function after renal transplantation was analyzed. The influence of HLA matching on preventing acute rejection was al-so evaluated. Results The acute rejection rate in the study group and control group was 30.43% and 19. 57%, respectively, (P < 0.05). The rate of delayed graft function was 60.86% in the study group, signifi-cantly higher than that of the control group (11.87%). There was no statistically difference of one-year pa-tient / graft survival rotes between the two groups. The average serum creatinin levels at one-year posttrans-plantation were similar between the two groups (130 mmol/dl in the study group and 125 mmol/di in the control group). The average loci of HLA matching in the study group (4.2) was significantly higher than that in the control group (2.8). The acute rejection rate in the study group was significantly higher when lo-ci of HLA mismatch ranging from 2-4 compared with loci of HLA mismatch less than 2. The acute rejection rate was significantly higher in the highly sensitized recipients (PRA ranging from 50% -90% pretmnsplant) than that in the less sensitized (PRA ranging from 10% to 20% pretransplant) in the study group. Patients with higher PRA level posttransplantation were prone to developing acute rejection. Conclusion HLA matching and new immunosuppressants can reduce the incidence of acute rejection in sensitized recipi-ents and increase the survival rate of patients and allografts.