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.

Objective To explore the clinical value of diagnos is value of the dynamic EEG monitoring (AEEG) (24-hour EEG monitoring) in epilepsy diagnosis. Methods 252 cases of clinically diagnosed as epilepsy were received AEEG monitoring, interictal awake and sleep EEG epileptiform discharge detection rates were compared. Results Of 252 cases epileptiform discharges were detected in 191 cases. appear separately in the awake period in 17 cases,sleep alone in 80 cases,both awake and sleep there were 94 cases, 111 cases were found in a sober period(accounting for 58. 1%) ,sleep period was found in 174 cases(91.1%) ,the difference was statistically significant(P ＜0. 01). Epileptiform discharges were seen mainly in NREM sleep Ⅰ -Phase Ⅱ. Conclusion Epileptiform discharges during sleep was significantly higher than those detected in the awakening period, AEEG contribute to the diagnosis of epilepsy,seizures can not be excluded on clinical and conventional EEG in patients without positive findings,can be AEEG monitoring.

With the advances of medical management and surgical techniques during cardiopulmonary bypass,children with congenital heart disease are increasingly surviving to adulthood.Research into their neurodevelopmental outcomes in the past 20 years had revealed sobering realizations about the adverse impact on the quality of life of these surgical survivors.A multitude of factors contribute to the incidence and severity of neurodevelopmental abnormalities and can be separated into preoperative,intraoperative,and postoperative events,in addition to genetic contributions and socioeconomic factors.This article highlight some of current understanding of these protean factors.Understanding should lead to modification of current techniques and management strategies,all with the ultimate goal of improving patients' quality of life.

In order to provide some more scientific and practical advice and tactics for acupuncture in prevention of migraine in clinic, a computer-based information search was conducted in MEDLINE database, and the current reports of clinical trials were summarized and a comparison of Western and Chinese research designs was made. The significant role of acupuncture for prevention of migraine has not been applied in wide range in China until the present day. However, it has been paid great attention in Western countries. This situation might be related to the differences of efficacy assessment of acupuncture between China and Western countries; meanwhile, in the past traditional acupuncturists put much stress on the therapeutic approaches for acute attacks of headache but less on prevention. It is necessary for Chinese doctors to learn from research method in the West and emphasize more on acupuncture for preventing migraine and conduct high-level clinical trials as well. The author recommends that Chinese doctors should select acupuncture points mainly according to meridian syndrome differentiation and apply long term intermittent interventions.

Objective To evaluate the clinical effect of intracavitary microwave hyperthermia combined with radiotherapy for advanced cervical cancer. Methods 66 patients were randomized into two groups:33 pa-tients treated by radiotherapy plus hyperthermia ( H + R group) ,33 patients treated by radiotherapy alone ( Rgroup). Radiotherapies of both groups were alike:a midplane dose of 30 Gy to the whole pelvis and 20 Gy to the parametrical areas were given by using 8 MV-X rays, combined with 42 Gy with 192Ir high dose rate(HDR)intracavitary brachytherapy. Intraluminal 915 MHz microwave hypertherrrfia was given 30 rain to 1 h after radio-therapy. The temperature was increased and maintained at 43-45℃ for 45 minutes, once or twice a week for 7-10 times. Results The rates of local control and infection in H + R and R groups were 87.88% and 63.63%,15.15% and 36.36% respectively. The differences of the two groups were statistically significant( P <0.05).In H + R group, the level of CD4/CD8 and NK cells after being treated were higher than those before being treated and that of R group( P <0.05). The rates of 2-year disease-free survival and 3-year survival for H +R and R groups were 93.94% and 72.72%, 84.85% and 60.61% respectively. The differences of the two groups were statistically significant( P<0.05 ). The rates of bone marrow inhibition and radiatory rectum inju-ry were lower in H + R group than those in R group. Conclusion Hyperthermia plus radiotherapy can improve local control rate and survival rate in advanced cervical cancer.

Objective:To prepare loxoprofen sodium sustained release pellets, and investigate the in vitro drug release behavior. Methods:Loxoprofen sodium loaded pellets were prepared by extrusion-spheronization technology, and the sustained release pellets were prepared with Eudragit RL 30D and Eudragit RS 30D as the sustained release coating film materials. The drug release behavior of loxoprofen sodium sustained release pellets in vitro was studied. Results:Eudragit RL 30D and Eudragit RS 30D with the ratio of 20 ∶80 was used as the sustained release coating film materials, the coating weight was 20%, the plasticizer content was 10%, and the content of talc was 45%. The in vitro release of loxoprofen sodium from the sustained release pellets was steady and entire in 12 h. Conclusion:The release behavior of loxoprofen sodium sustained release pellets is quite satisfactory. And the preparation technology may be used in the industrial production.

Randomized controlled trial(RCT),considered as the strongest evidence-based method in clinical trial,can provide first-hand scientific evidence for clinical practice and instruct clinicians to make correct decisions in practice.This article introduces the principles for RCT designing,analyzes the common problems concerning RCT in clinical practice and the common mistakes made in RCT statistical methods.It is concluded that application of RCT method and correct statistical methods are of great importance in clinical medical research.

Objective:To find out an alternative method of determining the benign or malignant character of thyroid cyst.Methods:The color,viscosity,cell,thyroid hormones(T 3?T 4?TSH)concentration,electrolytes and biochemical composition of the cystic fluid were examined in 59 patients with thyroid cyst. Five index were evaluated in determining the benigh or malignate character of thyroid cyst.Results:Almost all malignant lesions had dark red or even bloody cystic fluid.Almost benign lesions had brown or yellowish fluid.Only 4(67%)of the malignant lesions were correctly diagnosed by fine needle aspiration biopsy(FNAB).The mean value of T 3 and T 4 concentration was significantly lower in malignant cystic fluid than that in benign lesions.The mean value of the LDH and isozyme was significantly lower in benign cystic fluid than that in malignant nodules.Conclusion:The combination of multiple variables such as color,thyroid hormone (T 3,T 4), electrolytes,LDH activity(espicially the LDH 1) can provide more valuable data for detecting the feature of thyroid cyst.

By analyzing the basic line of medical ethics,this paper points out the collapse of basic line of medical ethics is due to the lack of people-oriented spirit in medical activities.Hospitals and medical staff should build up people-oriented spirit and conscience,strengthen the sense of honor and humiliation,thus to prevent the recollapse of the basic line of medical ethics and build up a harmonious physician-patient relationship.This project is significant in conducting the educational program of social glory and humiliation sense.