Objective To explore the clinical effect of detection of serum procalcitonin (PCT), C-reactive protein (CRP)and white blood cell (wBC)on diagnosis and treatment of severe pneumonia in children.Methods A total of 189 cases of pediatric patients with pneumonia including 51 severe pneumonia cases (severe pneumonia group)and 138 common pneumonia cases (common pneumonia group)treated from Mar 2014 to Dec 2014 and 30 healthy cases (control group)were enrolled,and the level of PCT,CRP and wBC of all cases were detected.Results The levels of PCT before treatment in severe pneumonia group,common pneumonia group,and control group were 1.12(0.44 ~3.07)ng /ml,0.14 (0.09 ~0.26) ng /ml and 0.03(0.01 ~0.06)ng /ml respectively,and there were significant differences among three groups (P ﹤0.05,respectively).The levels of CRP before treatment in severe pneumonia group,common pneumonia group,and control group were 82.2(25.9 ~120.3 )mg /L,10.8 (5.3 ~23.9)mg /L and 3.2 (2.1 ~6.9) mg /L respectively,and there were significant differences among three groups (P ﹤0.05,respectively).The counts of wBC before treatment in severe pneumonia group,common pneumonia group,and control group were 10.1 (9.1 ~14.1 )×109 /L,8.8(6.8 ~1 1.7)×109 /L and 6.2(4.8 ~7.9)×109 /L respectively,and there was significant difference only between severe pneumonia group and control group (P ﹤0.05 ).The level of PCT and CRP significantly decreased in severe pneumonia group after one week of treatment[PCT:0.15(0.09 ~0.24)ng /ml,CRP:9.9(3.6 ~19.0)mg /L](P ﹤0.05),but there was no significant differ-ence of wBC counts in severe pneumonia group between after and before treatment[8.5(6.3 ~9.8)×109 /L vs.10.1 (9.1 ~14.1 )×109 /L](t =1.312,P =0.205 ).After two days of anti-inflammatory treatment in severe pneumonia group,serum PCT dropped to 44% of the level before treatment,and smoothly dropped to nearly 10% of the basic value every two days.Serum PCT was correlated with serum CRP in children with pneumonia(R2 =0.550 4,P ﹤0.05).Conclusion The combined detection of PCT and CRP could provide important guidance for the differential diagnosis,treatment and prognosis for severe pneumonia in children.

Objective To evaluate the relationship between lactate,lactate clearance rate and prognosis of children with septic shock.Methods A total of 42 children with septic shock admitted in the PICU from Oct 2009 to Jun 2011 were enrolled in the study.All the children were given goal-directed therapy early according to the treatment routine of septic shock.The blood lactate levels before resuscitation and at 1h,2h,6 h after resuscitation were detected,the lactate clearance rates at 1 h,2 h,6 h after resuscitation were calculated.All the patients were divided into the survival group ( n =20 ) and the non-survival group ( n =22 ) by prognosis.The relationship between the early lactate level,lactate clearance rate and prognosis of the children with septic shock was evaluated.Results ( 1 ) The lactate levels before resuscitation and at 1 h,2 h,6 h after resuscitation in the survival group were significantly lower than those in the non-survival group [ (3.92 ± 2.58) mmol/L vs (6.91 ± 4.16) mmol/L,( 2.79 ± 1.89 ) mmol/L vs ( 7.93 ± 4.39 ) mmol/L,( 2.20 ±1.83) mmol/L vs (9.20 ±4.97) mmol/L,( 1.32 ±0.51 ) mmol/L vs (9.94 ±5.02) mmol/L,P ＜0.05].(2) The lactate clearance rates at 1 h,2 h,6 h after resuscitation in the survival group were significantly higher than those in the non-survival group [ (26.31 ± 20.82) ％ vs ( - 24.28 ± 53.39 ) ％,(43.46 ± 17.85 ) ％ vs (-34.31±58.98)％,(61.04±16.71)％ vs ( -45.33 ±83.51)％,P＜0.05].(3) The area under curve of the lactate and the lactate clearance rate at 6 h after resuscitation were 99.4％ and 96.7％ according to the receiver operating characteristic curve.The children had high mortality if the lactate value ＞ 2.20 mmol/L and lactate clearance rate ＜ 18.65％ at 6 h after resuscitation.Conclusion It is important to dynamicly monitor the lactate of the children with septic shock,the lactate and the lactate clearance rate at 6 h after resuscitation can be used to evaluate the prognosis.

Objective:To investigate the applied value of serum Cyfra21-1,NSE,CRP and SCCA and pleural effusion Cyfra21-1, NSE in pathological types, clinical stages and combination detection for diagnosis of lung cancer.Methods: Based on chemiluminescence immunoassay,the levels of serum NSE,Cyfra21-1,SCCA,CRP and pleural effusion NSE,Cyfra21-1 in 100 patients with lung cancer (case group) and 50 patients with benign diseases(control group) were determined.Results:The positive rates of serum Cyfra21-1,NSE,SCCA and pleural effusion NSE,Cyfra21-1 were significantly higher in case group than those in control group ( P<0.05).The positive rates of serum SCCA,Cyfra21-1,NSE in stageⅢ,Ⅳwere higher than stageⅠ,Ⅱ,the positive rates of serum CRP and the pleural effusion Cyfra21-1,NSE in stage Ⅱ-Ⅳ were higher than stage Ⅰ(P<0.05).The positive rates of serum and pleural effusion Cyfra21-1 were highest in squamous carcinoma ( P<0.05 ) , the positive rate of serum and pleural effusion NSE was highest in small cell carcinoma ( P<0.05 ) , and the positive rate of serum SCCA and CRP in patients were highest in squamous carcinoma ( P<0.05).The sensitivity of the combination detection of serum tumor markers in diagnosing lung cancer was significantly enhanced (P<0.05),however,the sensitivity of the combination detection of pleural effusion Cyfra21-1,NSE were not enhanced(P>0.05).Conclusion:The serum NSE, Cyfra21-1, CRP, SCCA and pleural effusion NSE, Cyfra21-1 play an important role in the diagnosis of lung cancer and contribute to the pathological type and TNM stage of lung cancer, the combination detection of tumor markers is helpful for the early diagnosis of lung cancer.

Objective To assess quality of the clinical hematology laboratory technique examination papers and to explore the teaching methods, in order to improve the quality of the course. Methods After gathering 27 clinical hematology laboratory technique theoretical and experimental papers of the first session four-year laboratory medicine students in China Medical University of Grade 2014, we adopted the method of SPSS 19.0 on test scores for statistics of distribution frequency and mean, and applied the corre-lation function formula to calculate the difficulty and discrimination of various types of test questions, and then evaluated the level of knowledge according to the score distribution, and analyzed the quality of the papers based on the difficulty and discrimination. Results The average score of theoretical papers was (76.81±9.12) points, the proposition scheme is reasonable, the overall difficulty was 0.78, and the discrimi-nation is 0.41. The average score of experimental papers was (14.33±1.21) points, the overall difficulty is 0.72, and the discrimination is 0.10. Conclusion The difficulty of the theoretical papers is moderate, equipped with better capacity to discrimination, the difficulty of the experimental papers is also moderate, otherwise with poor discriminatory ability. We should learn from advanced management concept of ISO 15189 and combining professional training requirements of the four-year laboratory medicine , and strengthen students' ability of using theoretical knowledge flexibly to further perfect the mechanism of the experimental exam, improve experimental teaching methods, and finally help further improvement of teaching work.

OBJECTIVETo investigate the expression of acetyl coenzyme A synthetase short-chain family member 2 (ACSS2) in patients with colorectal cancer (CRC) and its biological role.

METHODSA total of 74 CRC tissue samples and 40 normal colorectal tissues were tested by immunohistochemical staining to detect the expression of ACSS2 (cell staining intensity score: 0 points: without staining, 1 points: weak staining, 2 points: intensity staining, 3 point: strong staining; the percentage of positive cells in tumor or negative score: 0 points: negative, 1 point: <25% positive cells, 2 points: 25%-50% positive cells, 3 points: 50%-75% positive cells, 4 points: >75% positive cells. The product of above two scores was the final score.). Association of ACSS2 expression with clinicopathological characteristics was analyzed. Small interfering RNA (siRNA, including A and B group) was used to knock down the expression of ACSS2 in colorectal cell lines (Lovo, HCT116) and their proliferation, migration and epithelial-mesenchymal transition (E-cadherin and Snail as markers) after knocking down were observed.

RESULTSThe expression of ACSS2 was significant higher in CRC tissue than that in normal colorectal tissue (tumor average score 6.284, normal tissue average score 3.625, P<0.01) and the percentage of positive cell was higher than that in normal tissue (tumor 69.9%, normal tissue 45.1%, P=0.000). The use of ACSS2 siRNA successfully knocked down the expression of ACSS2 in Lovo and HCT116 cells. A mild suppression of cell proliferation was observed 5 days after planked (A450 value: Lovo-NC 1.758±0.041, Lovo-ACSS2-siA 1.485±10.026, Lovo-ACSS2-siB 1.371±0.049; HCT116-NC 2.609±0.038, HCT116-ACSS2-siA 2.260±0.042, HCT116-ACSS2-siB 2.295±0.029). While a remarkable ability decline of cell migration was found (Lovo-NC 225±5/field, Lovo-ACSS2-siA 40±5/field, Lovo-ACSS2-siB 79±3/field; HCT116-NC 198±7/field, HCT116-ACSS2-siA 96±7/field, HCT116-ACSS2-siB 77±9/field, P<0.05). Real-time quantitative PCR detection showed that in Lovo cells, expression of E-cadherin up-regulated and expression of Snail down-regulated, while in HCT116 cells, E-cadherin up-regulated slightly [E-cadherin: Lovo NC 1.000±0.211, Lovo-siA 3.403±0.207, Lovo-siB 2.658±0.420 (P<0.05); HCT116 NC 1.000±0.121, HCT116-siA 1.349±0.197, HCT116-siB 1.528±0.147(P>0.05); Snail: Lovo NC 1.000±0.085, Lovo-siA 0.468±0.030, Lovo-siB 0.499±0.088 (P<0.05); HCT116 NC 1.000±0.118, HCT116-siA 0.265±0.020, HCT116-siB 0.194±0.017 (P<0.05)].

CONCLUSIONCRC tissues have high expression of ACSS2, which may be associated with cell migration and epithelial-mesenchymal transition.

Objective To investigate the effect of long?term exposure of nitrogen dioxide on the incidence of hypertension. Methods From March to December 2009, 37 386 eligible residents from four cities in northern China (Tianjin, Shenyang, Taiyuan, and Rizhao) were enrolled in a follow?up study by using the random cluster sampling method. Demographic characteristics, lifestyle, history of diseases, and self?report situation of hypertension were collected by using questionnaire. Based on the average annual concentration of NO2 during the period from the cohort to the onset of hypertension as an estimate of exposure, the effect of NO2 exposure on hypertension was analyzed by employing Cox proportional hazards model. The interactions between NO2 exposure and different characteristics (age, sex, body mass index, smoking, alcohol consumption, education, economy, exercise, and fruit intake) were also examined. Results The baseline age of residents was (43.74±13.78) years, and the body mass index (BMI) was (22.56±2.92) kg/m2. During an average follow?up time of 11.40 years, 2 619 (7.0%) new cases of hypertension were reported. The overall mean environmental pollution levels during the study period for the entire cohort was (40.74±17.07) μg/m3. After adjusting for age, sex, BMI, family history of hypertension, socio?economic information, and lifestyle, the hazard ratio (HR) of incident hypertension with a 10 μg/m3 increase of NO2 was 1.21 (95%CI:1.18-1.25). Compared with residents aged 60 years and over ( HR=1.19, 95%CI : 1.14-1.26), former and current smoking ( HR=1.20, 95%CI : 1.14-1.25), and high?frequency fruit consumption ( HR=1.17, 95%CI :1.13-1.21), residents younger than 60 years ( HR=1.28, 95%CI : 1.25-1.32), non?smoker ( HR=1.23, 95%CI :1.19-1.27), and low?frequency fruit consumption ( HR=1.27, 95%CI : 1.20-1.35) had stronger interaction effect with NO2 (all P values for interaction<0.05). Conclusion NO2 exposure may lead to the onset of hypertension, which has a stronger effect on people younger than 60 years old, without smoking history and with low?frequency fruit consumption.

Objective To investigate the effect of long?term exposure of nitrogen dioxide on the incidence of hypertension. Methods From March to December 2009, 37 386 eligible residents from four cities in northern China (Tianjin, Shenyang, Taiyuan, and Rizhao) were enrolled in a follow?up study by using the random cluster sampling method. Demographic characteristics, lifestyle, history of diseases, and self?report situation of hypertension were collected by using questionnaire. Based on the average annual concentration of NO2 during the period from the cohort to the onset of hypertension as an estimate of exposure, the effect of NO2 exposure on hypertension was analyzed by employing Cox proportional hazards model. The interactions between NO2 exposure and different characteristics (age, sex, body mass index, smoking, alcohol consumption, education, economy, exercise, and fruit intake) were also examined. Results The baseline age of residents was (43.74±13.78) years, and the body mass index (BMI) was (22.56±2.92) kg/m2. During an average follow?up time of 11.40 years, 2 619 (7.0%) new cases of hypertension were reported. The overall mean environmental pollution levels during the study period for the entire cohort was (40.74±17.07) μg/m3. After adjusting for age, sex, BMI, family history of hypertension, socio?economic information, and lifestyle, the hazard ratio (HR) of incident hypertension with a 10 μg/m3 increase of NO2 was 1.21 (95%CI:1.18-1.25). Compared with residents aged 60 years and over ( HR=1.19, 95%CI : 1.14-1.26), former and current smoking ( HR=1.20, 95%CI : 1.14-1.25), and high?frequency fruit consumption ( HR=1.17, 95%CI :1.13-1.21), residents younger than 60 years ( HR=1.28, 95%CI : 1.25-1.32), non?smoker ( HR=1.23, 95%CI :1.19-1.27), and low?frequency fruit consumption ( HR=1.27, 95%CI : 1.20-1.35) had stronger interaction effect with NO2 (all P values for interaction<0.05). Conclusion NO2 exposure may lead to the onset of hypertension, which has a stronger effect on people younger than 60 years old, without smoking history and with low?frequency fruit consumption.

Background::T-cell-mediated immunity is crucial for the effective clearance of viral infection, but the T-cell-mediated immune responses that are induced by booster doses of inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in people living with human immunodeficiency virus (PLWH) remain unclear.Methods::Forty-five PLWH who had received antiretroviral therapy (ART) for more than two years and 29 healthy controls (HCs) at Beijing Youan Hospital were enrolled to assess the dynamic changes in T-cell responses between the day before the third vaccine dose (week 0) and 4 or 12 weeks (week 4 or week 12) after receiving the third dose of inactivated SARS-CoV-2 vaccine. Flow cytometry, enzyme-linked immunospot (ELISpot), and multiplex cytokines profiling were used to assess T-cell responses at the three timepoints in this study.Results::The results of the ELISpot and activation-induced marker (AIM) assays showed that SARS-CoV-2-specific T-cell responses were increased in both PLWH and HCs after the third dose of the inactivated SARS-CoV-2 vaccine, and a similar magnitude of immune response was induced against the Omicron (B.1.1.529) variant compared to the wild-type strain. In detail, spike-specific T-cell responses (measured by the ELISpot assay for interferon γ [IFN-γ] release) in both PLWH and HCs significantly increased in week 4, and the spike-specific T-cell responses in HCs were significantly stronger than those in PLWH 4 weeks after the third vaccination. In the AIM assay, spike-specific CD4 + T-cell responses peaked in both PLWH and HCs in week 12. Additionally, significantly higher spike-specific CD8 + T-cell responses were induced in PLWH than in HCs in week 12. In PLWH, the release of the cytokines interleukin-2 (IL-2), tumour necrosis factor-alpha (TNF-α), and IL-22 by peripheral blood mononuclear cells (PBMCs) that were stimulated with spike peptides increased in week 12. In addition, the levels of IL-4 and IL-5 were higher in PLWH than in HCs in week 12. Interestingly, the magnitude of SARS-CoV-2-specific T-cell responses in PLWH was negatively associated with the extent of CD8 + T-cell activation and exhaustion. In addition, positive correlations were observed between the magnitude of spike-specific T-cell responses (determined by measuring IFN-γ release by ELISpot) and the amounts of IL-4, IL-5, IL-2 and IL-17F. Conclusions::Our findings suggested that SARS-CoV-2-specific T-cell responses could be enhanced by the booster dose of inactivated COVID-19 vaccines and further illustrate the importance of additional vaccination for PLWH.

Objective: To investigate the prevalence of hyperuricemia and its correlation among adolescents aged 13-16 in Hanjiang district of Yangzhou city. Methods: Five hundred and nine adolescents aged 13-16 years in Hangjiang district of Yangzhou city were recruited. Their fasting serum uric acid level were measured by Benecheck premium UA monitoring system. The demographic imformation, family history, eating and living habits of the respondents were collected by questionnaires. Results: The average serum uric acid level of 509 adolescents in Hangjiang district of Yangzhou city was (374±98) μmol/L, and (420±103) μmol/L in males, higher than that of females [(329±70) μmol/L](t=11.69, P<0.05). The overall prevalence of HUA was 36.9%(188/509), and 43.2%(108/250) in males, higher than in females 30.8%(80/259)(χ²=4.16, P<0.05). Multivariate Logistic regression analysis showed that male [OR=1.70, 95%CI(1.18, 2.45)], obese [OR=8.99, 95%CI(4.58, 17.63)], high-salt oily diet [OR=1.67, 95%CI(1.05, 2.61)], soy products [OR=2.66, 95%CI(1.45, 4.88)], animal offal [OR=7.81, 95%CI(3.42, 17.83)], seafood [OR=4.80, 95%CI(2.83, 8.12)], sugary drinks [OR=6.49, 95%CI(3.08, 13.64)] and time spent on electronic products [OR=1.98, 95%CI(1.07, 3.65)] might be risk factors for hyperuricemia (P<0.05), while fruit [OR=0.52, 95%CI(0.32, 0.85)] and outdoor activities [OR=0.55, 95%CI(0.33, 0.92)] might be protective factors for HUA (P<0.05). Conclusion There is a high prevalence of hyperuricemia among adolescents aged 13-16 in Hangjiang district of Yangzhou city. The level of serum uric acid in adolescents significantly increased. Male, obesity, high salt and oily diets, soy products, animal offal, seafood, and sugary drinks may be risk factors for HUA. Fruits and outdoor activities may be protective factors for HUA. Relevant disciplines can take corresponding measures to prevent adolescent HUA.

Objective: To investigate the effect of long-term exposure of nitrogen dioxide on the incidence of hypertension. Methods: From March to December 2009, 37 386 eligible residents from four cities in northern China (Tianjin, Shenyang, Taiyuan, and Rizhao) were enrolled in a follow-up study by using the random cluster sampling method. Demographic characteristics, lifestyle, history of diseases, and self-report situation of hypertension were collected by using questionnaire. Based on the average annual concentration of NO₂ during the period from the cohort to the onset of hypertension as an estimate of exposure, the effect of NO₂ exposure on hypertension was analyzed by employing Cox proportional hazards model. The interactions between NO₂ exposure and different characteristics (age, sex, body mass index, smoking, alcohol consumption, education, economy, exercise, and fruit intake) were also examined. Results: The baseline age of residents was (43.74±13.78) years, and the body mass index (BMI) was (22.56±2.92) kg/m². During an average follow-up time of 11.40 years, 2 619 (7.0%) new cases of hypertension were reported. The overall mean environmental pollution levels during the study period for the entire cohort was (40.74±17.07) μg/m³. After adjusting for age, sex, BMI, family history of hypertension, socio-economic information, and lifestyle, the hazard ratio (HR) of incident hypertension with a 10 μg/m³ increase of NO₂ was 1.21 (95%CI: 1.18-1.25). Compared with residents aged 60 years and over (HR=1.19, 95%CI: 1.14-1.26), former and current smoking (HR=1.20, 95%CI: 1.14-1.25), and high-frequency fruit consumption (HR=1.17, 95%CI: 1.13-1.21), residents younger than 60 years (HR=1.28, 95%CI: 1.25-1.32), non-smoker (HR=1.23, 95%CI: 1.19-1.27), and low-frequency fruit consumption (HR=1.27, 95%CI: 1.20-1.35) had stronger interaction effect with NO₂ (all P values for interaction<0.05). Conclusion NO₂ exposure may lead to the onset of hypertension, which has a stronger effect on people younger than 60 years old, without smoking history and with low-frequency fruit consumption.