ObjectiveTo observe the changes in plasma interleukin-33 (IL-33) in patients with sepsis and its regularity, the association between IL-33 and the infection, and the significance of IL-33 in predicting the prognosis of sepsis.Methods A prospective single-center single-blind clinical study was conducted. Forty patients with sepsis in intensive care unit (ICU) of Shengjing Hospital of China Medical University from May 2012 to January 2013 were enrolled. The patients were divided into general sepsis, severe sepsis and septic shock groups according to the severity of systemic infection and presence of organ dysfunction. The sepsis patients were again divided into 28-day death group and survival group. Ten healthy volunteers and 11 patients with systemic inflammatory response syndrome (SIRS) were enrolled as healthy control and SIRS groups. The levels of procalcitonin (PCT), IL-33, IL-6, IL-1β, tumor necrosis factor-α (TNF-α), and IL-33 receptor sST2 were determined with enzyme linked immunosorbent assay (ELISA) within 3 hours, and 24 hours and 5 days after enrollment to ICU. The acute physiology and chronic health evaluationⅡ (APACHEⅡ) score was calculated. The clinical outcome, length of stay in ICU, and duration of mechanical ventilation were recorded. The relationship between IL-33 and each parameter was analyzed by Spearman analysis. Receiver operating characteristic (ROC) curve was drawn to evaluate IL-33 in predicting the outcome of sepsis.Results Plasma IL-33 in sepsis patients within 3 hours after admission was significantly increased compared with that of the healthy controls and SIRS group (ng/L: 15.43±7.22 vs. 0.67±0.24, 1.25±1.09, bothP< 0.01). Compared with SIRS group, PCT in sepsis group was significantly increased [μg/L: 52.23 (19.69, 73.37) vs. 1.22 (0.69, 3.73),Z = -2.447,P< 0.001]. With exacerbation of illness, APACHEⅡ score, the values of PCT and IL-33 were gradually increased in general sepsis, severe sepsis and septic shock groups, while the length of stay in ICU and the duration of mechanical ventilation were gradually prolonged (P< 0.05 orP< 0.01). The concentration of IL-33 (ng/L) of sepsis patients admitted to ICU within 3 hours, and 24 hours and 5 days of the illness was 15.43±7.22, 11.82±6.16, 5.55±2.25, respectively (F = 4.823,P = 0.004). There was a positive correction between IL-33 within 3 hours after ICU admission and APACHEⅡ score (r = 0.351,P = 0.031), PCT (r = 0.412,P = 0.005), IL-6 (r = 0.535,P = 0.030), IL-1β (r = 0.674,P = 0.030), TNF-α (r = 0.250,P= 0.030), sST2 (r = 0.620,P< 0.001), and length of stay in ICU (r = 0.296,P = 0.013), duration of mechanical ventilation (r = 0.385,P = 0.011). Decreased plasma IL-33 level could be found in the survivors (n = 37,F = 7.798,P< 0.01), and its level in non-survivors (n = 3) was increased (F = 37.283,P> 0.05). The area under the ROC curve (AUC) of IL-33 and PCT in ROC curve were 0.821, 0.829. When the cut-off value of IL-33 was 13.79 ng/L, the sensitivity was 74.2%, the specificity was 79.6%; when the cut-off value of PCT was 4.70μg/L, the sensitivity was 87.5%, and the specificity was 81.4%.Conclusions The concentration of IL-33 3 hours after ICU admission was obviously increased in sepsis patients, and it was positively correlated with PCT, therefore it is valuable in the diagnosis of the infection. In addition plasma IL-33 is related to the severity of sepsis. Its trend of change is valuable in predicting the outcome and in distinguishing sepsis from SIRS.

OBJECTIVE:To compare antidiuretic activity of Ootheca Mantidis before and after processing,and to explore the best medicinal part and mechanism of Ootheca Mantidis. METHODS:96 rats were randomly divided into blank group,model group,positive group,Ootheca Mantidis group,Ootheca Mantidis stir-fried with salt group,steamed Ootheca Mantidis group, crude product eggs and egg shell groups,processed product eggs and egg shell groups,with 8 rats in each group,12 groups in to-tal. Except blank group,other groups were given adenine 250 mg/kg,ig,for 4 weeks to induce kidney-yang and diuresis model. From third week,Ootheca Mantidis crude drug group and processed Ootheca Mantidis group were all given relevant medicine 0.11 g(crude drug)/ml i.g,and crude product eggs and egg shell groups and processed product eggs and egg shell groups were given rel-evant medicine,ig,once a day,by mass ratio of eggs to egg shell(cude drug 1∶2.4,salt stir-fried product 1∶1.7,steamed prod-uct 1∶2.1)for consecutive 4 weeks. The urinary volume,body weight,renal index and the serum contents of ADH and ALD were all determined. RESULTS:Compared with blank group,body weight and serum content of ADH and ALD decreased in model group,while renal index and urinary volume increased(P<0.05). After 4 weeks of treatment,compared with model group,body weight and serum content of ADH increased in Ootheca Mantidis groups,while urinary volume and renal index decreased (P<0.05);serum content of ALD increased in treatment groups;there was statistical significance in the serum content of ALD in those groups except Ootheca Mantidis group,Ootheca Mantidis stir-fried with salt group and steamed Ootheca Mantidis group (P<0.05);except for ALD,those index were in descending order of steamed Ootheca Mantidis group>Ootheca Mantidis stir-fried with salt group>Ootheca Mantidis group,and steamed Ootheca Mantidis shell group had best exchange. CONCLUSIONS:The an-tidiuretic activity of Ootheca Mantidis has been enhanced after processing. The egg shell of steamed Ootheca Mantidis is main me-dicinal part. To increase the serum content of ADH might be one of the main mechanism of arresting polyuria.

Diagnostic Tests, Routine ; Humans ; Liver Cirrhosis ; diagnosis

Objective To investigate the therapeutic effect and nursing ways of pulmonary surfactant in premature babies with respiratory distress syndrome. Methods From July 2008 to January 2011,63 cases of premature babies with respiratory distress syndrome were admitted to our department, pulmonary surfactant was dripped through trachea into these patients, the treatment effect after medication was observed. Results Among these premature babies, one case died of respiratory failure, one case died from pulmonary hemorrhage, sixty-one cases were cured, the cure rate was 96.8%. After treatment, the arterial blood pH, partial pressure of oxygen(PaO2) and oxygen saturation(SaO2) of the 61 patients was significantly higher than before treatment, the arterial blood partial pressure of carbon dioxide (PaCO2)、 total carbon dioxide (TCO2)、actual bicarbonate (AB)was significantly lower than before treatment. Conclusions Pulmonary surfactant combined with appropriate nursing ways is able to cure premature babies with respiratory distress syndrome effectively.

Hero is a new range finder which can shows results on its liquid crystal screen automatical- ly.It was made on the basis on the principle of L (length)-V (voltage) transformation.A/D controlling display and driving circuit.Its resolving power is 0.01 mm,repetition error 0.06 mm.Therefore,it is exquisite,accurate,function-stable and practical.

Twenty-five cases of hyperextensive injuries to the cervical spine seen between Aug 1975 and 1884 were analyzed with regard to the clinical patterns of neurological damage and the reentgenogra-phic features of skeletal and soft-tissue injuries. Acute central cord syndrome was presented in sixteen cases, and in four cases who had a partial cord injuries, two of them had a typical Brown-Se'quard syndrome. The patients had an anterior cord syndrome; three had serious cord injuries, one of them died of myocardial failure on the fourth day after injury. In this series, a hyperextensive mechanism of cervical spine may gave rise to different types of spinal cord injury, but central cord syndrome was most frequently encountered. Conservative treatment was generally used, and the results of treatment were satisfactory in most cases. Diagnosis of hyperextension injuries and the relationship between cervical spine and cord injury were discussed.

Riboswitches are cis-acting domains located in mRNA sequences that could regulate gene expression by sensing small molecules without employing protein. Most known riboswitches in bacteria have naturally evolved to bind essential metabolite ligands and are involved in the regulation of critical genes that are responsible for the biosynthesis or transport of the cognate ligand. The riboswitch-mediated gene expression could be repressed by metabolite analogs, which caused bacterial growth inhibition or even death. A number of leading compounds targeting riboswitches have been discovered. A promising avenue for the development of new class of riboswitch-based antibiotics has been opened. Herein we reviewed the current findings of riboswitches that served as targets for antibacterial drug development and the underlying mechanisms. The development of high-throughput methods and rational drug design for riboswitch-specific drug discovery are relevant challenges are discussed. summarized.

A major hurdle that humbles the modernization of traditional Chinese herbal medicine (CHM) is the inconsistency of chemical composition, which is inevitable due to the natural origins of CHM. Here I propose a concept of a new category of drugs, named "post-absorption/metabolism multicompound drug (PAMD)" that will meet every standard of modern pharmaceuticals, yet maintain the fundamental principle of traditional Chinese medicine, which is an integrative therapeutic approach through multiple mechanisms by a cocktail of various herbs. The PAMD concept is based on the fact that the most of chemical ingredients in an orally taken CHM remedy may never enter the blood stream owing to the poor gastrointestinal absorption. Only a few original ingredients or, most likely, a few metabolites of those absorbed ingredients are found in the blood or target organs. The compounds after the absorption/metabolic process are the only ones responsible for pharmacological functions of the remedy. Given the limited number of species, those compounds, once isolated and tested for their pharmacological activity, can be formulated with designed ratios to form new drugs that should theoretically possess an equivalent or better therapeutic efficacy than the original CHM remedy. Strategies of developing PAMDs and possible difficulties are also discussed.

Medullary thyroid carcinoma(MTC), which includes sporadic type and hereditary type, is a kind of malignant tumor in thyroid parafollicular cells. MTC is the common clinical character of the multiple en-docrine neoplasia type 2 (MEN 2), including MEN 2A and MEN 2B, and familial medullary thyroid carcinoma(FMTC). The RET gene encodes a receptor tyrosine kinase, its mutations and polymorphisms can induce acti-vation of the BET tyrosine kinase domain via different signal pathways resulting the genesis of MTC. RET has been used as a target for MTC molecular therapy. However, a clinically useful therapeutic option for treating pa-tients with RET-associated cancer is still not available.

Objective:To explore the effectiveness of methadone combined with buprenorphine on the alleviation of heroin withdrawal symptoms. Methods: One hundred and twenty patients with heroin dependence were randomly divided into two groups , namely the methadone combined buprenorphine treatment group (n=60)and the methadone alone treatment group (n=60). Rating scales were employed to assess the treatment outcomes. Results: Compared with patients in the methadone alone treatment group, patients in the combined treatment group reported fewer withdrawal symptoms, especially in first four days. They also subjectively considered the combined treatment as more acceptable. This effect was more pronounced in patients with relatively high levels of initial withdrawal symptoms. Conclusion: Methadone with buprenorphine was proved to be a favourable combination treatment in terms of reducing withdrawal symptoms, as well as improving the short-term detoxification success rate, especially in patients with severe heroin withdrawal symptoms.