Objective To assess the value of joint detection of serum cysteine proteinase inhibitors C (sCys-C),urinary kidney injury molecule 1 (uKIM-1),urinary neutrophil gelatinase-associated lipocalin(uNGAL) and urinary interleukin 18 (uIL-18) for early diagnosis of acute kidney injury (AKI) in critically ill patients.Methods A total of 256 adult patients who stayed Intensive Care Unit for 24 hours in the Third People's Hospital of Liaocheng between Aug 2011 and Dec 2012 were enrolled.According to Kidney Injury Net(AKIN) work,the patients were divided into non-AKI group and AKI group (including state 1,2 and 3).The concentrations of urine NGAL,KIM-1,IL-18 and serum sCys-C were measured.The diagnosis value of four biomarkers joint detection and single detection for AKI were analyzed with the receiver operating characteristic (ROC) curve and the area under curve (AUC).Results (1) The levels of uNGAL,uKIM-1,uIL-18 and sCys-C were higher in patients with AKI than the patients with no AKI (P ＜ 0.01).(2) The area under curves of uNGAL,uKIM-1,uIL-18,sCys-C and joint detection were 0.742,0.871,0.803,0.703,0.925 respectively.(3) The sensitivity and specificity of parallel tests and serial tests of four biomarkers were 97.9％,62.8％,64.3％ and 96.2％ respectively.There were significant differences of sensitivity or specificity between single test and joint tests.Conclusions The urine NGAL,KIM-1,IL-18 and serum Cys-C are sensitive indexes for the early diagnosis of acute kidney injury.Joint detection has high value for early diagnosis of AKI.

AIM:To study the effect of dexamethasone(Dex)on the expression of aquaporin-1(AQP-1)in cultured rat pleural mesothelial cells and to offer experimental support for the investigation of the mechanisms of pleural fluid treatment.METHODS:Rat pleural mesothelial cells were cultured in vitro.The expression of AQP-1 was detected by immunocytochemistry and reverse transcription-PCR(RT-PCR)after cells were identified,then the cells were treated with Dex for 24 hours at concentrations of 10-8,10-7,10-6,10-5 and 10-4mmol/L,and for 6 h,12 h,24 h,36 h,48 h,72 h at concentration of 10-4 mmol/L.Western blotting was used to analyze the expression of AQP-1 in cultured control and Dex-treated rat pleural mesothelial cells,and image analysis system to analyze the expression of AQP-1.RESULTS:Aquaporin-1 was expressed in cultured rat pleural mesothelial cells.The protein of AQP-1 expressed in rat pleural mesothelial cells was 755.04?19.81,843.72?19.41,862.96?26.53,694.80?32.00,938.08?13.32 in those treated with Dex at concentrations of 10-8,10-7,10-6,10-5 and 10-4 mmol/L,respectively,the levels was 2.02,2.26,2.31,1.86,2.52 fold higher than that in control group(372.90?16.46,P

AIM:To probe whether CpG oligodeoxyribonucleotides 7909 (CpG ODN7909) combined with Toll like receptor (TLR)9 affected the chemotherapeutic sensitivity of doctaxel (DOC) in human lung cancer A549 and H520 cell lines.METHODS:Sequences of TLR9 siRNAs were designed.A549 and H520 cells were transfected with TLR9 siR-NA by lipofectamine.The expression of TLR9 was detected by Western blot .The cell activity was measured by CCK-8 as-say.The experiments were divided into blank control group , control siRNA group and TLR9 siRNA interference group.The cell cycle distribution and cell apoptosis were analyzed by flow cytometry .The expression of P38 and Bax was determined by Western blot .The cells in each group were exposed to CpG ODN 7909 and/or DOC.RESULTS: In A549 cells and H520 cells, CpG ODN7909 alone had no obvious effect on the cell activity , G2/M phase arrest and apoptosis , but in-creased the protein expression of P 38 and Bax ( P<0.01) .In addition, there was no significant changes of the above inde-xes in CpG ODN7909 treated-TLR9 siRNA group was observed .DOC alone significantly inhibited the cell activity , higher the G2/M phase fractions, apoptotic rates and Bax expression (P<0.01), but didn’t affect the expression of P38 in all 3 groups.Compared with the cells treated with DOC alone , the cells treated with CpG ODN7909 combined with DOC exhibi-ted lower cell activity, higher G2/M phase fractions, apoptosis rates and more Bax expression (P<0.01), showed no sig-nificant change of P38 expression.In addition, there was no significant change of the above indexes in CpG ODN 7909 com-bined with DOC treated-TLR9 siRNA group was observed .CONCLUSION:CpG ODN7909 may enhance the chemothera-peutic sensitivity of DOC in human lung cancer cells by combining with TLR 9.The mechanism might be related to enhan-cing the inhibitory effect and apoptosis of DOC on the cell activity in vitro, arresting the cells at G 2/M phase of the cells .

Objective To explore the methods for endoscopy nasal microsurgery and multiple techniques in treatment of nasopharyngeal angiofibromas. Methods CT, MRI and digial substraction angiography (DSA) and endoscopic examination had been used. ALL 12 patients accepted preoperative feeding artery embolum, hypotention anesthesia and injected adrenaline-lidocaine. Microelectrotomy-electrocoagulation had been used to remove tumor. Results All patients were treated by endoscopic nasal surgery. No complications had occurred. No recurrence were found in follow-up period. Conclusion The important factors to reduce amount of introperative bleeding are to select proper operative patients and use multiple techniques. Endoscopy nasal surgery has dominance in reducing complications, wound, tumor recurrence, operative time and nasal function.

Objective: To investigate β2 adrenergic receptor (β2-AR) gene polymorphism, Arg16Gly, Gln27Glu and essential hypertension (EH) occurrence in Tibetan population living at high altitude area. Methods: Our research included in 2 groups: EH group, n=385 patients and Control group,n=297 normal healthy subjects. β2-AR polymorphisms of Arg16Gly and Gln27Glu were detected by Snapshot mini-sequencing technique and their frequencies were compared between 2 groups and male, female genders. Results: The genotype and allele frequency distributions of Arg16Gly and Gln27G1u were similar between 2 groups, P>0.05; there were no signiifcant differences between male and female genders,P>0.05. Conclusion: No obvious relationship was found between β2-AR gene polymorphism (Arg16Gly, Gln27Glu) and EH occurrence in Tibetan population living at high altitude area.

Objective To analyze the distributions of Chinese medical syndrome types of polycystic ovary syndrome(PCOS),and explore the differences of clinical features between different syndromes. Methods The data of 496 PCOS patients and the data of reproductive endocrine and metabolic indexes were collected and ana-lyzed retrospectively. Results The results of retrospective analysis:of the 469 patients with PCOS,163 cases were phlegm and blood stasis syndrome(34.75%),157 phlegm dampness syndrome(33.48%),90 kidney liver depression syndrome(19.19%),and 59 kidney deficiency and blood stasis syndrome(12.58%). Compared with the patients with PCOS of kidney liver depression syndrome and kidney deficiency and blood stasis syndrome,the score of acanthosis nigricans as well as the levels of BMI,WC,HC,SHBG,FAI,FPG,FINS,HOMA-IR,TG, CHOL,LDL,ApoB,and ApoB/ApoA-I ratio were significantly increased(P < 0.05),but the level of HDL and ApoA-I significantly decreased in the patients of phlegm and blood stasis syndrome and phlegm dampness syndrome (P<0.05).WHR was higher in the patients of phlegm and blood stasis syndrome than in the patients of kidney liver depression syndrome and kidney deficiency and blood stasis syndrome(P<0.05).Compared with the patients with phlegm and blood stasis syndrome,the level of ApoB and the ApoB/ApoA-I ratio were lower in the patients of phlegm dampness syndrome(P<0.05),the level of FSH and LH were higher in the patients of kidney deficiency and blood stasis syndrome(P<0.05).When compared with the patients of phlegm dampness syndrome,the level of LH was higher in the patients of kidney deficiency and blood stasis syndrome(P<0.05),but the level of T was lower in the patients of kidney liver depression syndrome(P < 0.05). Conclusions Compered with the PCOS patients with phlegm dampness syndrome,kidney liver depression syndrome,kidney deficiency and blood stasis syndrome, phlegm and blood stasis syndrome patients show more serious reproductive endocrine and metabolic disorder.

Objective To investigate the feasibility,security,indication and prophylactic measures of postpartum hemorrhage during the fetalintrapartum operation by analyze the maternal prognosis after intrapartum fetal operation(IFO) performed.Methods We performed a retrospective evaluation of 10 cases that has been performed intrapartum fetal operation(IFO group,n=10) successfully between August 2008 and October 2009 at Department of Obstetrics and Gynecology,Shengjing Hospital,China Medical University.Healthy pregnant women(n=10) were chosen as control group,who received Caesarean section for refusing to vaginal delivery.Between the two groups,we compared the indexes including blood lose during the operation and 24 hours post-operation,the hemoglobin level pre-operation and 24 hours post-operation,the involution of uterus,the puerperal infection,and the follow-up at 42 days post-operation.Results Good involution,no primary and secondary postpartum hemorrhage and no puerperal infection were found in both of the 2 groups.Intra-operation,24 hours post-operation and the total volumes of blood lose,the hemoglobin level before operation,24 hours post-operation and 42 days post-operation had no statistic significant difference between the IFO group and control group(P>0.05).No significant difference was found in the operation time between IFO group and the control group(66.40±53.40 minutes and 34.50±4.97 minutes,respectively.Intra-operation,24 hours post-operation and the total volume of blood lose had no relation to the maternal age and gestational weeks(P>0.05).The blood lose of intra-operation in IFO group had positive linear correlation to the operation time.(Pearson relation coefficient R=0.458,.P=0.021).The linear recurrence equation was:the volumes of blood lose intra-operation(ml)=172.68+1.342x(operation time).Conclusion IFO was safe to the mother.It did not affect the involution of uterus and could not increase the blood lose of postpartum and the puerperal infection morbidity.Through the effective measures of preventing postpartum hemorrhage,the postpartum blood lose of the patients that performed intrapartum fetal operation could be no more than that of the patients that had normal Caesarean section.Improving the technique of the intrapartum fetus operation and shortening the operation time are important to prevent postpartum hemorrhage.

Since the outbreak of coronavirus disease 2019 (COVID-19), chest computed tomography (CT) has been an important imaging modality in the diagnosis, treatment and follow-up of patients with COVID-19,but meanwhile the risk of cross-infection between the staff and patients in Department of Radiology is increasing. Shelter CT is specifically used for the examination of patients with suspected or confirmed COVID-19 to reduce the infection risk. Based on practical work experience, the management and prevention measures for COVID-19 in shelter CT are discussed from the aspects of the installation, function division and examination procedures of shelter CT, patient examination route, the staff management and infection prevention for radiology technologists, and the disinfection of CT equipments and object surface.

Hepatitis E virus (HEV) sequences including four major genotypes representative strains available in GenBank were aligned with the DNAMAN software. The highly conserved internal region of ORF2 was then subjected to design primers and a probe. Furthermore, a 0.3 kb fragment of HEV ORF2 containing the amplification region was transcribed in vitro to synthese cRNA standard and a universal real-time TaqMan PCR assay was optimized and developed to detect and quantify main genotypes RNA of HEV. The specificity and reliability of the real-time RT-PCR was confirmed by testing genotype I HEV, genotype IV HEV and clinical samples. The detection limit of real-time RT-PCR was found 2.0 x 10(1) copies per reaction using in vitro transcribed cRNA. Compared with nested RT-PCR in diagnosis of HEV, the real-time RT-PCR developed was 10 to 100-fold more sensitive than the nested RT-PCR. The detection results from 54 clinical specimens indicated real-time RT-PCR was a rapid, sensitive and reproducible diagnostic method for HEV. This assay will be useful as an early and rapid diagnostic assay for HEV.
Base Sequence ; Fluorescence ; Hepatitis E ; virology ; Hepatitis E virus ; isolation & purification ; Humans ; Molecular Sequence Data ; RNA, Viral ; analysis ; Reverse Transcriptase Polymerase Chain Reaction ; methods ; Sensitivity and Specificity ; Viral Proteins ; analysis ; genetics

Objective:To study the effect of the psychological counseling on the delivery mode of single birth elderly primiparas with anxiety and depression, and to seek a new and effective intervention way to improve the vaginal delivery rate.Methods:A preliminary screening was carried out for 486 single birth elderly primiparas received in the birth cohort research center of China Medical University from April 2018 to September 2019. Among them, 274 cases had mild, moderate or severe anxiety and depression. They were randomly divided into the observation group and the control group (n=137). The control group was given routine nursing measures and simple psychological education and the intervention group was given extra psychological counseling. Psychological counseling adopted the mode of combination of online and offline. The degree of anxiety and depression and the delivery mode were compared between two groups.Results:Before intervention, the degree of anxiety and depression between the observation group and the control group showed no significant difference. After intervention, the degree of anxiety and depression in the observation group was lighter than that of the control group ( χ2 value was 12.782, 6.647, P<0.05). The proportion of cesarean section, vaginal delivery, forceps delivery accounted for 32.1% (44/137), 67.2%(92/137), 0.7%(1/137) in the observation group, and 45.3% (62/137), 54.7%(75/137), 0 in the control group. The difference between the two groups showed statistical significance ( χ2 value was 5.787, P<0.05). Conclusion:The psychological counseling for the single birth elderly primiparas with anxiety and depression can effectively improve the psychological situation and increase the vaginal delivery rate.