Objective To analyze and compare the clinical application values of procalcitonin (PCT),leukocyte count (WBC) and C-reactive protein(CRP) in elder patients with infection.Methods In patients(age≥ 65 yrs,axillary temperature ＞38.0℃)with infection or suspected infection,PCT,WBC,CRP and other bacteriological examination were performed.The electronic medical records from the HIS system of our hospital were analyzed retrospectively in combination with medical history.Results Of the enrolled 219 patients,65 ones were in control group,48 ones SIRS,51 ones sepsis and 55 ones MODS.There was a positive correlation between the level of serum PCT and the infection degree.The Spearman correlation coefficient was 0.706 (95％CI:0.616-0.797,P=0.000).Based on the highest Youden index (sensitivity+specificity-1),the best cutoff point of diagnosis for PCT was ＞0.341 μg/L (sensitivity 84.5％,specificity 55.8％),a analysis of receiver operating characteristic(ROC) curve about PCT,WBC and CRP was carried.Area under the curve (AUC) of PCT to controlled infection was 0.916 (95％CI:0.864-0.967,P=0.000).Based on the highest Youden index (sensitivity+ specificity-1),the judging threshold of PCT to infection controlled or not was 0.73 μg/L (sensitivity 84.6％,specificity 88.0％).PCT level after treatment ＞0.73 μg/L showed the uncontrolled infection,＜ 0.73 μg/L controlled.Conclusions PCT has a higher specificity for elder patients with infection.The variation of PCT level can guide the application of antibiotics,avoid abuse and decrease the occurrence of drug-resistant bacteria.

AIMTo prepare TK-gene nanoparticles and investigate its expression.

METHODSBiodegradable and biocompatible polymer polylactic-co-glycolic acid (PLGA) was used to prepare recombinant plasmid pEGFP-AFP nanoparticles by double-emulsion evaporation technique. The characteristics of the nanopticicles including morphology, entrapment efficiency was investigated. The expression of TK gene was also investigated by MTT assay, which could determine the dying cells after the addition of gancyclovir (GCV). The enhanced green fluorescent protein (EGFP) expression in human hepatocarcinoma SMMC-7221 cells and human normal parenchymal Chang liver cells were assessed by flow cytometric analysis.

RESULTSThe resulting plasmid-nanoparticles had regular spherical surface and a narrow particle size with a mean diameter of (72 +/- 12) nm, The average entrapment efficiency was 91.25%, the enhanced transfection efficiency and ability protecting plasmid DNA from degraded by nuclease or sonication due to nanoparticles encapsulation.

CONCLUSIONDNA-nanoparticles need further study as gene delivery system.

Biocompatible Materials ; Carcinoma, Hepatocellular ; metabolism ; Cell Line, Tumor ; Drug Delivery Systems ; Ganciclovir ; pharmacology ; Genes, Reporter ; Green Fluorescent Proteins ; Herpesvirus 1, Human ; enzymology ; Humans ; Lactic Acid ; Liver ; cytology ; metabolism ; Liver Neoplasms ; metabolism ; Luminescent Proteins ; genetics ; metabolism ; Nanotechnology ; Particle Size ; Plasmids ; Polyglycolic Acid ; Polymers ; Recombinant Proteins ; genetics ; Thymidine Kinase ; genetics ; metabolism ; Transfection ; alpha-Fetoproteins ; genetics ; metabolism

ObjectiveTo explore the clinical characteristics of pathological fracture in extremities caused by bone tumors or tumor-like lesions. MethodsFrom August 2002 to December 2010, 139 patients with pathological fractures were entered in the study, including 79 males and 60 females with an average age of 31.1 years. Fractures included tumor-like lesion in 55 cases, benign tumor in 13, giant cell tumor (GCT)in 7, primary malignant tumors in 28, and metastatic tumors in 36. Forces induced to fractures were classified into four grades: spontaneous fracture, functional activity, minor injury, severe injury. Age, fracture location, histological results, fractures forces, prodromes, and misdiagnosis were all observed. Chi-square test were use to compare forces and prodromes within different tumors. ResultsThe highest morbidity rate is 32.4％(45/139) which lies in 11-20 years old. The cites of fractures including femurs in 71 cases, humerus in 36, tibia in 15, fingers in 7, radiuses in 4, fibula in 3, ulnas in 2, and metatarsus in 1. Fracture forces include spontaneous fractures in 29 cases, functional activity in 42, minor injuries in 65, and traumatic injuries in 3. Sixty-seven patients(48.2％) had local prodromes. The prodromes of both malignant tumors and metastatic tumors were more than benign tumors. Twenty cases experienced misdiagnosis with average delay time of 12 weeks. ConclusionMinor injury forces and local prodromes are clinical key features of pathological fractures. Both of them are key points of avoiding misdiagnosis.

Glucose ; Humans ; Hypothalamo-Hypophyseal System ; Lycium ; Pituitary-Adrenal System ; Resistance Training

ObjectiveTo analysis the clinical features of thoracic spine and spinal cord injury (SCI) and summarize the inclusive standard of cellular transplant clinical trial for SCI.MethodsThe data of 72 cases with thoracic spine and spinal cord injury from 1990 to 2005 were analyzed retrospectively.ResultsMean follow-up period was 20 months (6～48 months). There was no recovery in 12 spinal cord injury without radiographic abnormality (SCIWORA) patients, but improvement of urine function in 4 cases. 5 cases of 52 fracture-dislocation complete injury were improved to grade B (sense recovery), rate of recovery was 9.6%; recovery rate was 62.5% in incomplete injury. Sense recovery of all cases was better than motor recovery. Partial cases appeared spasm paralysis relief.ConclusionIncidence rate of complete injury is high and recovery is bad in thoracic spine and spinal cord injury. The inclusive standard of cellular transplant clinical trial for SCI is old complete thoracic spinal cord injury without residual compression.

To observe the effects of Panax Notoginosides (PNS) on up-regulation of AP-1 family transcription factors NF-E2, c-jun and c-fos for exploring intracellular signal pathway of PNS in hematopoietic cells, four human hematopoietic cells lines including myeloid HL-60, erythroid K562, megakaryoid CHRF-288 and Meg-01 were incubated in the presence of PNS for 14 days. The nuclear protein of cells were extracted and analyzed by Western blot with antibodies against NF-E2, c-fos and c-jun. Electrophoretic mobility shift assay (EMSA) was performed by using (32)P labeled AP-1 consensus oligonucleotide which contains binding site for NF-E2, c-jun and c-fos. The results showed that the transcription factors NF-E2, c-jun and c-fos of AP-1 family could be induced by PNS. Western blot demonstrated that the nuclear protein of both NF-E2 and c-jun in four cell lines treated by PNS were increased by 1.5-2.5- and 2.0-3.0-fold over untreated cells respectively. The c-fos protein in three cell lines of K562, CHRF-288 and Meg-01 was also elevated by 2.0-3.0-fold respectively, while c-fos protein in HL-60 cells was no detectable difference after PNS treatment. EMSA results in four cell lines indicated that AP-1 binding activity initiated by PNS was apparently elevated to form higher density band of AP-1-DNA complex. In conclusion, the intracellular transcription regulation initiated by PNS was involved in transcription factors NF-E2, c-jun and c-fos of AP-1 family members, which could play an important role in the up-regulation of genes expression related to proliferation and differentiation of hematopoietic cells.
DNA ; metabolism ; DNA-Binding Proteins ; genetics ; Erythroid-Specific DNA-Binding Factors ; Gene Expression Regulation ; drug effects ; Genes, fos ; Genes, jun ; Ginsenosides ; pharmacology ; HL-60 Cells ; Humans ; K562 Cells ; NF-E2 Transcription Factor ; NF-E2 Transcription Factor, p45 Subunit ; Panax ; Transcription Factor AP-1 ; metabolism ; Transcription Factors ; genetics ; Up-Regulation

Objective To build a supervision mechanism for independent clinical labs (ICL),surveyed the current situation of such novel institutions in China.Methods By way of the nationwide network of clinical labs,ICL in China were surveyed by written questionnaires and spot inspection.Results In the surveyed 38 ICLs,the maximum registered capital was 44 900 thousands,the minimum was 2 000 thousands.The maximum number of employee was 1 105,the minimum was 19.6 labs passed ISO15189 ratification,4 labs passed CAP ratification.17 labs participated in local external quality control,29 labs par-ticipated in national external quality control.Conclusion Although ICL in our country have developed well in the past dec-ade,such vulnerabilities as unbalanced staff ratio,full-range quality control bugs,cutthroat competition,asymmetrical infor-mation disclosure and bio-safety have loomed in the meantime.It is time to formulate a stricter industry access system and appropriate regulatory modes.

OBJECTIVETo observe the role of Panax notoginosides (PNS) in up-regulation of GATA family transcription factors, and explore intracellular signal pathway of PNS in the proliferation of hematopoietic cells.

METHODSHuman bone marrow cells were incubated with different concentrations of PNS for colony-forming assay. Human cell lines HL-60, K562, CHRF-288 and Meg-01 were incubated with PNS (10 mg/L) for 14 days. The cell nuclear proteins were extracted and analyzed by Western blot with antibodies against GATA-1, GATA-2. Electrophoretic mobility shift assay (EMSA) and antibody gel supershift assay was performed using (32)P labeled GATA consensus oligonucleotide which contains binding site for GATA transcription factors.

RESULTSPNS could promote the proliferation of CFU-GM and CFU-E and induce the expression of GATA-1, GATA-2. The nuclear proteins of both GATA-1 and GATA-2 in K562, CHRF-288 and Meg-01 cells treated by PNS were increased by (1.5 - 2.8) and (2.0 - 3.1)-fold over untreated cells respectively. GATA binding activity initiated by PNS was apparently elevated to form higher density band of GATA-DNA complex. While there was no detectable change in HL-60 cells before and after PNS treatment. The predominant GATA binding complex was mainly attributable to both GATA-1 and GATA-2 proteins being in phosphorylated status.

CONCLUSIONPNS can induce the synthesis of transcription factors GATA-1 and GATA-2 and enhance their DNA binding activity, which could play a role in the up-regulation of the expression genes related to proliferation and differentiation in hematopoietic cells.

Blotting, Western ; Bone Marrow Cells ; drug effects ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; GATA1 Transcription Factor ; metabolism ; GATA2 Transcription Factor ; metabolism ; Ginsenosides ; pharmacology ; HL-60 Cells ; Humans ; K562 Cells ; Panax ; chemistry ; Up-Regulation ; drug effects

Objective To studying the MR findings and pathology of peripheral small intrahepatic cholangiocarcinoma and improving the understanding of peripheral small cholangiocarcinoma with no-bile duct dilatation. Methods A retrospective analysis of 12 patients with intrahepatic peripheral cholangiocarcinoma which were confirmed by surgery and pathology, all patients were examined by abdominal MRI without and with contrast. Correlation was made with gross pathology and surgical pathological specimen. Results On T1WI, there were 4 cases of complex low signal intensity and 8 cases of low signal intensity. On T2WI, there were 8 cases of high signal intensity and 4 cases of complex high signal intensity. Enhanced MRI showed: marked nidus enhancement on arterial phase in 1 case, and the pathological diagnosis was poorly differentiated adenocarcinoma. Inhomogeneous enhancement or annular enhancement were seen in 10 cases on arterial phase, 3 of these cases showed thin annular enhancement on arterial phase, low signalintensity on portal venous phase and isointensity on delayed phase. One case showed delayed enhancement. Thick circular enhancement correlated with pathological changes of survival of tumor cells, center areas correlated with fibrous connective tissue, and a small amount of necrotic tissue. Island-like enhancement or inhomogeneous enhancement were seen in 3 cases. Corresponding pathological changes consisted of tumor tissue and a small amount of fibrous connective tissue, as well as somenecrotic tissue. In 1 case, no enhancement was seen on all three phases and pathological changes showed cystic changes, hemorrhage, necrosis, with survival tumor cells seen between cyst and normal liver tissue. Conclusions MRI scanning of peripheral small cholangiocarcinoma lacked characteristic features, but dynamic contrast-enhanced MR had certain specific findings. Due to different pathology, the fibrous tissue, necrotic tissue and survival tumor tissue components were exhibited different imaging findings.

OBJECTIVETo evaluate the treatment of recurrent acute cholangitis with hepatolithiasis.

METHODSWe retrospectively analyzed the clinical data of patients with recurrent acute cholangitis who were treated in Peking Union Medical College Hospitals emergency department from January 1998 to December 2008.

RESULTSTotally 408 patients underwent surgery, of which 167 patients received emergency operations and 241 underwent selective operations after medication and interventional treatment. The incidence of complications was 6.4% among those who received emergency operations and 3.2% among selective operations. The 30-day mortality rate of selective operations was zero.

CONCLUSIONAlong with the progress of percutaneous cholangiographic drainage and endoscopic retrograde cholangiopancreatography, selective operations have been increasingly applied for acute cholangitis with notably low complications and postoperative death.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cholangitis ; etiology ; surgery ; Cholelithiasis ; complications ; surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult