Objective To evaluate the clinical value of serum procalcitonin (PCT) in the diagnosis and differentiation of bacterial infections in the critically ill patients. Methods A total of 53 critical patients were divided into bacterial infection group and non-bacterial infection group. Serum PCT was measured by immunoluminometric assay. Results PCT of bacterial infection group was significantly higher than that in non-bacterial infection group (?~2=0.05, P

10.3969/j.issn.2095-4344.2013.23.018

Objective To investigate the expression of hepatocyte growth factor activator inhibitor- 1 (HAl-1) gene in the tissues of renal cell carcinoma (RCC) and the correlation with tumor angiogenesis.Methods The expression of HAI-1 gene was detected by semi-quantitative RT-PCR in the tissues of 56 cases of RCC,corresponding adjacent non-cancer tissues and 12 nomad renal tissues,the expression of CD34was detected by immunohistochemistry SP method in the above-mentioned organizations,and counted the microvessel density (MVD),analyzed the relationship between the expression of HAI-1 gene in RCC and clinicopathological parameters,MVD.Results The positive expression rate of HAI-1 gene in RCC tissues,the adjacent non-cancer tissues and normal renal tissues were 58.93％(33/56),76.79％(43/56) and 91.67％(11/12),respectively.The expression of HAI-1 gene was a negative correlation to the Fuhrman histological grade,Robson clinical stage (r ＝ -0.617,-0.432,P ＜ 0.01 or ＜ 0.05 ).The positive expression rate in lymph node metastasis was significantly lower than that in without lymph node metastasis [ 35.29％(6/17) vs.69.23％(27/39),P＜ 0.05 ].The MVD in RCC tissues was significantly higher than that in the adjacent noncancer tissues and normal renal tissues(P＜ 0.05).The expression of HAI-I gene in RCC tissues was negative correlated to the MVD (r ＝ -0.516,P ＜ 0.01 ).Conclusions There is a certain relationship between the missing expression of HAI-1 gene in RCC and the development,invasion and metastasis of RCC.The HAI-1 gene deletion can be used as an important molecular marker in the invasion and metastasis of RCC.

Objective To investigate the interaction between uropathogenic Escherichia coli (UPEC) and host uroepithelial cells, define the role uroepithelial cells play in initiating and modulating the host response to infection with UPEC strain. Methods The human bladder transitional epithelial EJ cells were evaluated for their capacities to allow the adherence and invasion by UPEC132, a clinical strain isolated from Tianjin, China, and a cDNA microarray for 22 000 human genes was used to identify the gene expression differences between EJ cells infected with UPEC132 and uninfected EJ cells. Results Microscope observation showed that UPEC132 could adhere to EJ cells with the adherence rate of (73.20 ± 5.26)%. And visualization by confocal microscope revealed that this microorganism could be seen within the cells. EJ cells infected with UPEC132 changed mRNA expression of a total of 29 genes, including 28 genes up-regulated and 1 gene down-regulated. Of these, regulators of growth and proliferation, cytokines, and modulators of apoptotic responses were the most prominent. Conclusion The gene expression profiling of EJ cells is affected by the infection of UPEC strain. The differentially expressed genes may contribute to further investigate the interaction of UPEC and uroepithelial cells.

Objective To compare the mid- and long-term results of tricuspid valve (TV) repair with or without an annuloplasty ring. Methods Two hundred seventy-seven patients underwent TV repair at our division (Sep. 2001 to Sep. 2008) ,of which 203 had, predominantly, a De Vega or Kay procedure (non-ring group) and 74had an annuloplasty with an artificial ring (ring group). TV pathology mainly was functional (secondary) and several with rheumatic leaflets involvement. Concomitant procedures consisted of mitral valve surgery in all patients,aortic valve surgery in 81 ,and coronary bypass in 19. Clinical and echocardiographic data followed for 1.5 to 3.5years were obtained. Results Postoperationally,the mid-term(1.5 years) follow-up was 100% completed and the long-term follow-up for 3. 5 years was 89. 9%. The recurrence of TV regurgitation (TR) of moderate and lower degree was not significantly different(χ2 = 1.3128, P= 0.26) in the 1.5 years follow-up between the two group,whereas the recurrence of TR of moderate to severity degree was significantly less in the ring group (χ2 =5. 8159,P =0.023).In the long term follow up,the TR in the ring group (25%) was significantly lower than that of 15% in the non-ring group (χ2 = 4. 9328, P = 0.036) . There are higher proportion of patients developing to moderate TR in the non ring group(34%) than in the ring group (10%) (χ2 =7. 9120,P =0.005). The TR developed fast in the ring group,increasing from 18% at 1.5 years follow up to 10% at 3.5 years follow up (χ2 = 2. 1327, P = 0.016),whereas it was relatively stable in the non-ring group,with 7% at 1.5 year follow up and 10% at 3.5 year follow up. Conclusions Placement of an annuloplasty ring in patients undergoing TV repair could remarkably improved the mid and long terum outcome. In clinic practice, we should be more positive to the functional TR and prefer to the procedure with annuloplasty ring.

Objective To investigate the pathogenesis, diagnosis and treatment of gastric volvulus. Methods The clinical data of 30 patients with gastric volvulus were analyzed retrospectively. Results 17 patients(56.7%) were diagnosed preoperatively,and 13 patients(43.3%) at exploratory laparotomy. 21 cases(70.0%) was diagnosed as organo-axial type, 8 cases(26.7%) as mesenterico-axial type, and 1 case((3.3%)) as combined type.3 patients underwent gastric volvulus restoration by endoscopy;27 patients (received) operation,and all the 30 patients were discharged in good health.All of the cases were followed up for 5 years;one case,treated by endoscopy,recurred,but none of the other cases recurred. Conclusions Laxity of gastric suspensory ligaments is the main pathogenetic factor of gastric volvulus,but its occurrence is usually caused by multiple factors.The diagnosis depends on the combined analysis of the clinical (manifestations) and radiographic studies or exploratory laparotomy. Operation is the first choice of treatment.

Osteoarthritis is mainly caused by the degenerative changes of cartilage and cartilage extracellular matrix,while Aggrecanases degradate Proteoglycans which are the major components of cartilage.This review includes three aspects:(1) We have concluded the major enzymes(ADAMTS-4 and ADAMTS-5) which regulate the metabolism of cartilage extracellular matrix.Meanwhile,we have summarized the structure of aggrecanases(ADAMTS-4 and ADAMTS-5) and introduced the function of each regional structure;(2) We have concluded the way cytokines and glycosaminoglycans regulate the metabolism of aggrecanases,and discussed the regulation and control principle of cytokines and glycosaminoglycan;(3) We have summarized the majority of inhibitors to the aggrecanases,introduced the endogenic inhibitors,and put our emphasis on the extrinsic inhibitors(chelating agents,polypeptides and so on).Through deeper research on the enzymes,it will help us further understand the pathogenesis of osteoarthritis,and open up new avenues to clinical treatment.Abstract:SUMM ARY Osteoarthritis is mainly caused by the degenerative changes of cartilage and cartilage extra-cellular matrix,while Aggrecanases degradate Proteoglycanswhich are the major components of cartilage.This review includes three aspects:(1) W e have concluded the major enzymes(ADAMTS-4 and ADAMTS-5) which regulate the metabolism of cartilage extracellular matrix.Meanwhile,we have sum-marized the structure of aggrecanases(ADAMTS-4 and ADAMTS-5) and introduced the function of each regional structure;(2) W e have concluded the way cytokines and glycosam inoglycans regulate the metab-olism of aggrecanases,and d iscussed the regulation and control principle of cytokines and glycosam inogly-can;(3) W e have summarized the majority of inhibitors to the aggrecanases,introduced the endogenic inhibitors,and put our emphasis on the extrinsic inhibitors(chelating agents,polypeptides and so on).Through deeper research on the enzymes,it will help us further understand the pathogenesis of osteoar-thritis,and open up new avenues to clinical treatment.

Objective To investigate the relationship between the plasma neutrophil gelatinase-associated lipocalin (NGAL)and endothelin-1 (ET-1) levels and cognitive dysfunction in chronic obstructive pulmonary disease (COPD) patients.Methods A case-control study was performed,consisting of 128 patients with COPD(68 patients without cognitive dysfunction and 60 patients with cognitive dysfunction) and 70 normal controls.All patients with COPD were diagnosed by pulmonary function tests and plasma levels of NGAL and ET-1 were determined by enzyme immunoassay.The cognitive function was evaluated by the MMSE and MoCA.Results ①Compared with normal control,the levels of plasma NGAL and ET-1 were increased(NGAL:(2.20±0.60) μg/L vs (1.69±0.73) μg/L,P＜0.05;ET-1:(26.19± 10.55)pg/ml vs (13.05±2.37) pg/ml,P＜0.05) in COPD patients without cognitive dysfunction and in COPD patients with cognitive dysfunction(NGAL:(3.80±2.75) μg/L vs (1.69±0.73) μg/L,P＜0.01;ET-1:(37.82±0.29) pg/ml vs (13.05±2.37) pg/ml,P＜0.01).Compared with the COPD patients without cognitive dysfunction,the levels of plasma NGAL and ET-1 were also increased in COPD patients with cognitive dysfunction (all P＜0.05).②The plasma NGAL levels were correlated negatively with MMSE scores(r=-0.524,P＜0.05),and negatively correlated with MoCA scores (r=-0.527,P＜0.05).The plasma ET-1 levels were negatively correlated with MMSE scores(r=-0.549,P＜0.05),and negatively correlated with MoCA scores(r=-0.558,P＜0.05).The levels of NGAL and ET-1 were positively correlated(r=0.564,P＜0.05).Conclusion NGAL and ET-1 may be involved in the pathophysiological process of cognitive dysfunction in patients with COPD,which provides a certain clinical value for the assessment of cognitive dysfunction in patients with COPD.

OBJECTIVE: To study the activity of TQHXD on the learning and memory ability of rats with vascular dementia(VD) and its effects on the content of Ach in cerebral cortex. And to investigate the action mechanism of TQHXD on VD in rats. METHODS: VD model was made by common carotid artery injection of a co-thrombus inducer. The 8-arm radial maze experiment was adopted to evaluate the times of working memory errors and reference memory errors. The changes of the pathological area in hippocampus CA1 were observed by optical microscope. Enzyme-linked immunosorbent assay was used to determine the concentration of Ach in rats cerebral cortex. RESULTS: High and middle dose of TQXHD significantly reduce the times of working memory errors and reference memory errors (P<0.01), definitely improved the anormalies of pathological area in hippocampal CA1, and significantly increased the content of Ach in cerebral cortex (P<0.01). CONCLUSION: TQHXD can significantly ameliorate the learning and memory ability of in VD rats. The mechanism may be related to the improvement of the vertebral body cells anomalies in the hippocampal CA1 region and increasing the content of the Ach in cerebral cortex. Copyright 2012 by the Chinese Pharmaceutical Association.

Objective:To investigate the protective effects of quercetin on the periodontal tissue in Wistar rats with periodontitis. Methods:30 Wistar rats were randomly divided into 3 groups(n =1 0):Control group (group N),ligation group(group L)and liga-tion +quercetin group(group LQ).Bilateral first molars of the rats in group L and LQ were cervically ligated by an orthodontic wire with the diameter of 0.2 mm.The rats in group LQ were then treated with quercetin by gavage at 50 mg/(kg·d)after ligation.After 8 weeks,the rats were killed.Continuous slices of the periodontal tissue were made for HE staining and immunohistochemistry stai-ning.The morphological changes and the expression of TNF-αand COX-2 in the periodontal tissue were observed under light micro-scope.Results:The inflammatory cells and periodontal pocket were observed in group LQ were less than those in group L.The levels of TNF-α,COX-2 in group LQ were lower than that those in the group L(P <0.05).Conclusion:Quercetin has a protective effect on the periodontal tissues of Wistar rats with periodontitis.