Objective To investigate the blood specimen collection site,inspection time and hemolysis influ-ence on biochemical test results.Methods The specimens of 2586 cases outpatients and hospitalized patients in our hospital who accepted blood routine and blood coagulation four check were analyzed.The hemolysis and qualified specimens of biochemical test results were compared.Results 2 586 specimens found unqualified blood samples in 18 cases,and the incidence rate was 0.70% (18 /2 586).Samples of different section and source were compared and found there were no significant difference (F =0.36,P >0.05).In 18 cases of unqualified blood samples due to technical problems and unqualified sample accounted for 88.89% (16 /18).The technical factors that lead to unqualified samples was significantly higher than that of the instrument factor or fixed factors,and the difference was statistically significant(χ2 =152.63,98.52,all P <0.05).In addition,hemolysis caused the most of the unqualified samples for the technical factors.To choose potassium infusion on the side ipsilateral to the site or from the opposite side of the site collected blood samples.Sodium,chlorine,creatinine,uric acid,glucose detection found in effect of blood on the same side of the infusion of the biochemical test results in varying degrees.Potassium,chlorine,sodium, creatinine decreased significantly,and uric acid,glucose and other indicators were significantly increased (t =4.51, 4.98,5.50,3.25,10.18,15.25,all P <0.05).Gamma transpeptidase,creatine kinase,sodium and uric acid and other index of hemolytic samples were significantly lower than those of normal samples,and alanine aminotransferase (ALT),direct bilirubin,potassium,phosphorus,serum creatinine and creatine kinase were significantly higher than those of the normal samples (t =14.85,21.21,7.15,4.86,10.33,4.02,3.11,8.20,7.54,5.11,all P <0.05).This may cause the depth in erythrocytes and some related substances.The time of collecting blood to sent to the room had obvious influence on the biochemical test results,alanine aminotransferase,aspartate amino transferase,glucose, creatine kinase and hydroxybutyrate and project them 1 h after submission were significantly lower than those of the standard inspection,and 1 hour after the submission of lactate dehydrogenase and creatine kinase isoenzyme index were significantly higher than those of the standardize inspection means (t =2.95,4.82,2.88,5.44,4.05,3.98, 4.89,all P <0.05).Conclusion Sampling sites,hemolysis and inspection time had effect on blood specimen,so for the collection of blood samples must be strictly in accordance with the requirements of the operation.

Objective To investigate the clinical therapeutic effect of Shenqi Fuzheng injection for treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods A prospective clinical study was conducted. Fifty-eight consecutive patients with AECOPD were admitted in Departments of Respiratory Disease and Critical Care Medicine in Zhuozhou City Hospital of Hebei Province from January 2012 to December 2013. They were randomly divided into western medicine (WM) control group (28 cases, the routine treatment of WM) and integrated traditional Chinese medicine (TCM) with WM group (30 cases, on the basis of conventional therapy, Shenqi Fuzheng injection 250 mL intravenous drip was given once a day for a therapeutic course of 10 days). The duration of mechanical ventilation, the successful rate of weaning from ventilator, the rate of using ventilator again after weaning, the length of stay in intensive care unit (ICU), and mortality were recorded respectively in the two groups. Before and after treatment, the arterial blood gas analysis, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, clinical pulmonary infection score (CPIS), pulmonary function and dyspnea score were evaluated. Results Compared with the WM control group, the duration of mechanical ventilation (hours: 104±16 vs. 125±24) and the length of stay in ICU (days: 6.3±2.1 vs. 7.2±3.6) were significantly shorter, the rate of successful weaning from ventilator was obviously higher [73.3% (22/30) vs. 60.7% (17/28)], and the rate of using ventilator again after weaning was remarkably lower [13.3% (4/30) vs. 28.6% (8/28)] in the combined TCM and WM group, the differences between the two groups being statistically significant (allP < 0.05); the mortality was lower in the combined group [10.0% (3/30) vs. 10.7% (3/28)], but there was no statistically significant difference (P > 0.05). Compared with those before treatment, the pH value, arterial partial pressure of oxygen (PaO2), forced expiratory volume in 1 second (FEV1), forced vital capacity(FVC) and the ratio of FEV1/FVC were all significantly higher in the two groups after treatment, while the partial pressure of arterial carbon dioxide (PaCO2), APACHE Ⅱ score, CPIS score, residual volume/total lung capacity (RV/TLC), and the dyspnea score were all lower in the two groups after treatment, the more obvious changes in levels being after 10 days of treatment in combined TCM and WM group [pH: 7.44±0.04 vs. 7.40±0.08, PaCO2 (mmHg, 1 mmHg = 0.133 kPa): 59.1±11.9 vs. 68.1±12.4, PaO2 (mmHg): 70.5±6.9 vs. 65.1±7.4, APACHE Ⅱ score: 14.5±4.2 vs. 17.4±2.2, CPIS score: 5.3±2.4 vs. 7.6±1.4, FEV1 (L): 1.60±0.47 vs. 1.54±0.34, FEV1/FVC: (65.33±2.65)% vs. (62.00±3.25)%, FVC (L): 1.72±0.21 vs. 1.66±0.21, RV/TLC: (42.13±1.67)% vs. (43.12±0.95)%, dyspnea scores: 1.71±0.54 vs. 2.32±0.65, allP < 0.05].Conclusion Shenqi Fuzheng injection possesses certain clinical value in treatment of patients with AECOPD, as it can obviously improve the pulmonary function and the data of arterial blood gas analyses, and effectively relieve the clinical symptoms.

Objective Using infrared spectroscopy to analyze three kinds of lignum Chinese medicine to provide a theoretical basis for the establishment of medicinal overall quality evaluation system. Methods Functional groups identification, Fourier Transform-infrared spectroscopy(FT-IR) and the second derivative infrared spectroscopy (SD-IR) could be applicable to analyze and identify the overall chemical composition of three kinds of lignum Chinese medicine. Results The main chemical components of Aquilariae Lignum Resinatum (ALR), Dalbergiae Odoriferae Lignum (DOL) and Sappan Lignum (SL) were cellulose, lignin and aromatics. The main chemical compositions of Sappan Lignum (SL) were cellulose, lignin and aromatics. The differences in FT-IR and SD-IR of DOL and SL indicated that they had different aromatic compounds. Conclusion Infrared spectroscopy can be used as a simple and accurate quality control method of three kinds of lignum Chinese medicine.

Objective To investigate the expression alteration and significance of long non-coding RNA (lncRNA)by GWAS(Genome-wide association study)between Esophageal squamous cell carcinoma(ESCC)and its adjacent normal esophageal tissues. Methods lncRNA and mRNA differential expression in 6 pairs of ESCC and matched non-cancerous tissues were screened by microarray assay. The target genes were predicted. Finally , GO(Gene Ontology)and Pathway analysis was used for the further research of lncRNA. Results A total of 680 lncRNA and 1472mRNA were differentially expressed at more than two-fold change(P ≤ 0.05,with 161lncRNA and 653mRNA up-regulated,519lncRNA and 819mRNA down-regulated between ESCC and its adjacent normal esophageal tissues. Gene ontology and pathway analysis results suggested that the differentially expressed genes were involved in 11 pathways.Theyare potentially associated with esophageal squamous cell carcinoma ,including post-translational protein modification ,mucin type O-Glycan biosynthesis and sphingolipid metabolism pathways , which mainly related to the changes of molecular function ,cellular components and biological processes. Through cis and trans analysis,a total of 15 differentially expressed lncRNA had cis-and/or trans-regulated target genes in the database,with 13 lncRNA had cis-regulated target genes,3 lncRNA had trans-regulated target genes,and 1 lncRNA had both cis- and trans-regulated target genes. Conclusion Compared with adjacent normal tissues ,a large number of lncRNA were expressed differentially in ESCC in Xinjiang Han people.Aberrantly expressed lncRNA may play important roles in ESCC development and progression through some signaling pathways ,which are of great significance for further search of new targets for the diagnosis and treatment of ESCC.

Objective To analyze the correlation between miR-31 and ESCC in expression of miR-31 in the plasma of ESCC in Xinjiang Kazak and Han nationality patients. Methods The plasma samples were collected respectively from patients with ESCC in 20 cases and healthy subjects in 20 cases. The relatively expression of miR-31 was detected by real-time Q-PCR. Results The expression of miR-31 with ESCC were higher than those of the normal control group, which related to the degree of tumor differentiation in Kazak ESCC patients (P < 0.01); the levels of miR-31 relative expression in Kazak were higher than that of Han (P = 0.008, P = 0.027). Conclusion miR-31 may be involved in the occurrence of ESCC in Han and Kazak nationality. miR-31 might be another risk factor in high incidence of ESCC in Kazak than Han nationality.

Objective To establish a Chinese hamster model of babesia infection, to find the changing pattern of organs and biochemical parameters in Chinese hamster infected with Babesia, and to promote the detection and treatment of babesiosis.Methods Healthy 5-week old Chinese hamsters were infected by intraperitoneal injection of blood containing Babesia.Blood samples were collected at 0, 2, 4, 6, 8, 10, 12, 14, 16, 23, 30, and 37 days after infection from 5 hamsters at each time point.Blood smears were prepared to detect the parasites using Giemsa staining.ELISA assay was employed to test the IL-2 concentration.The blood biochemical indexes were detected using an automatic biochemical analyzer.DNA was extracted from the whole blood and REAL-TIME RCR was performed to determine the reproduction of Babesia.Aftert the animals were sacrificed, the heart, lung, spleen, liver, and kidney were taken to analyze the changes of organ coefficients.Results The highest level of Babesia in the hamsters occurred on day 4 after the Babesia injection, and then showing a decreasing tendency.However, there was a transient increase on the 12th day after infection.The liver and spleen displayed most extensive response to the infection showing hepatomegaly and splenomegaly, but the variation of heart and kidneys coefficients was within the norm.There were prominent changes of blood cells, especially leucocytes, with two peaks at day 10 and 23 after the Babesia infection.The peak changes of blood biochemical indexes occurred at day 12 after infection.The concentration of serum IL-2 reached a peak on the 10th day after infection.Conclusions The Chinese hamsters display typical characteristics of tick-borne diseases such as hepatomegaly and splenomegaly.The immunological system is activated along with the infection and reaches a highest stage in the second week.Afterwards the Babesia can live in the hamster body for a long period of time.The results of this study provide useful information supporting further studies on the detection, treatment and prevention of Babesiosis.

Objective:To observe the effects of continuous light exposure on skeletal muscle fiber type transformation and lipid metabolism, and to explore its internal relationship.Methods:Mice were randomly divided into normal light group and 24-hour continuous light group by random number table. The serum and skeletal muscle lipid content and urine 6-sulfatoxymelatonin(6-SML)level were detected by ELISA. The expression of circadian clock and lipid metabolism related genes mRNA were observed by realtime PCR. The muscle fiber type and lipid deposition were evaluated by tissue immunofluorescence as well as oil red O staining.Results:Compared with the normal light group, the level of 6-SML in urine at night decreased( P<0.05), and the expression level and rhythm of brain and muscle ARNT-like protein 1(Bmal1), circadian locomotor output cycles protein kaput(Clock), and period 2(Per2)mRNA in the skeletal muscle changed in continuous light group. In addition, the body weight, blood lipid, free fatty acid, and triglyceride contents of skeletal muscle in continuous light group increased significantly( P<0.05 or P<0.01), the expression of carnitine palmitoyltransferase 1b (Cpt1b)mRNA, the key enzyme of fatty acid oxidation, decreased significantly( P<0.05), while the expression of stearoyl-CoA desaturase(Scd1)mRNA, a lipid synthesis related gene, increased significantly( P<0.01). Further immunofluorescence analysis showed that the proportion of slow muscle fibers decreased and that of fast muscle fibers increased in continuous light group(both P<0.05). Conclusion:The process of ectopic deposition of lipid in skeletal muscle in mice induced by continuous light exposure may be related to the remodeling of skeletal muscle fibers.

Objective To investigate the changes in serum procalcitonin (PCT) in patients with severe pneumonia, and to analyze its value on evaluating the clinical outcome of patients with severe pneumonia. Methods A total of 58 patients with severe pneumonia aged over 18 years, and admitted to intensive care unit (ICU) of Zhuozhou City Hospital of Hebei Province from January 2017 to July 2018 were enrolled. The patients were divided into recovery group (the symptoms and signs of pneumonia disappeared or improved, and the X-ray chest films improved or did not make significant progress) and deterioration group (the symptoms and signs of pneumonia persisted or progressed, while X-ray chest radiography progressed, as well as serious complications such as involvement of other organ functions due to deterioration of pulmonary infection or septic shock) according to the therapeutic outcome. The serum PCT levels at 1, 3, 5, 7, 9 days after severe pneumonia diagnosed were recorded, and procalcitonin clearance rate (PCTc) was calculated. The acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score was estimated within 24 hours when severe pneumonia was diagnosed. Receiver operating characteristic (ROC) curve was drawn, and the area under ROC curve (AUC) was calculated to analyze the value of PCTc on evaluating the clinical outcome of patients with severe pneumonia. Results Among 58 patients, 33 (56.9%) had better outcome after active treatment (recovery group), and 25 (44.1%) had worse condition (deterioration group). There was no significant difference in PCT level at 1 day or 3 days between the recovery group and the deterioration group [μg/L: 5.05 (3.89, 7.61) vs. 5.29 (4.15, 7.46) at 1 day, 4.59 (4.02, 6.90) vs. 5.70 (4.59, 7.28) at 3 days, both P > 0.05]. With the prolongation of treatment time, serum PCT level was gradually decreased in the recovery group, while remained at higher level in the deterioration group, which was significantly lowered at 5, 7, 9 days in the recovery group as compared with that in the deterioration group [μg/L:2.92 (2.09, 3.42) vs. 6.09 (3.24, 7.96) at 5 days, 1.94 (1.50, 2.07) vs. 7.65 (5.60, 10.52) at 7 days, 1.37 (0.91, 1.74) vs. 8.96 (6.09, 10.87) at 9 days, all P < 0.01]. PCTc at 3, 5, 7, 9 days in the recovery group were significantly higher than those in the deterioration group [15.10 (-17.80, 32.10)% vs. -1.53 (-20.80, 11.48)% at 3 days, 47.50 (30.25, 60.34)% vs. 6.25 (-14.58, 29.05)% at 5 days, 76.44 (53.18, 77.92)% vs. -11.20 (-66.75, -1.38)% at 7 days, 80.01 (59.86, 88.27)% vs. -38.15 (-99.38, -2.81)% at 9 days, all P < 0.05]. ROC curve analysis showed that PCTc at 3, 5, 7 and 9 days were valuable for evaluating the clinical outcome of patients with severe pneumonia, and 9-day PCTc had the greatest value, the AUC was 0.978 [95% confidence interval (95%CI) = 0.945-1.000, P = 0.000], which was higher than APACHEⅡ(AUC = 0.442, 95%CI = 0.280-0.610, P = 0.392); when the best cut-off value of 9-day PCTc was 93.00%, its sensitivity was 99.0%, and specificity was 87.3%. Conclusions The PCT level of patients with severe pneumonia remained at a high level, which was related with the deterioration of the disease. PCTc, as an index to evaluate the clinical outcome of patients with severe pneumonia, has good application value.

As a pandemic metabolic disease, obesity has become a worldwide problem, which endangering human health. The change in body weight reflects the energy imbalance. And the homeostasis regulation of the central and peripheral melanocortin system may maintain the energy balance and then affect the body weight. Recent studies have found that melanocortin receptor-4 ( MC4R) plays an important role in energy homeostasis and body weight changes, but its specific mechanism needs further elucidation. In this paper, we reviewed the research progress of MC4R in body weight and energy regulation, so as to provide a theoretical basis for further exploring the potential role of MC4R in improving energy metabolism imbalance and obesity.

Objective:Through comprehensive analysis of symptoms and signs, biochemistry, imaging, and dynamic tests, to explore the diagnosis and differential diagnosis of thyrotropin-secreting pituitary adenoma(TSH adenoma) and syndrome of resistance to thyroid hormone(RTH).Methods:A retrospective analysis was conducted on clinical data from 14 patients who visited the First Affiliated Hospital of Zhengzhou University from July 2016 to September 2022, exhibiting elevated levels of free thyroxine(FT4) and free triiodothyronine(FT3) in the presence of increased TSH.Results:There were 7 cases of TSH adenoma and 7 cases of RTH, with the average age of diagnosis at 40.0 years and 26.6 years, respectively. Thirteen patients showed thyrotoxicosis or occasional palpitation, some with pituitary occupancy manifestations or abnormal growth and development; One patient presented with neck thickening. Sex hormone binding globulin was elevated in 3 cases of TSH adenoma. Pituitary magnetic resonance imaging showed that all 7 cases of TSH adenoma were macroadenomas and 1 case of RTH was microadenoma. The octreotide suppression test in 13 patients was inhibited, but there was a significant difference in the inhibition rate of 24 h/2 h TSH inhibition rate of TSH adenoma and RTH, ranging from 46.6% to 83.9% and 4.6% to 28.8% respectively. Six cases of RTH had thyroid hormone receptor β mutation.Conclusion:Syndrome of inappropriate secretion of thyrotropin is a rare condition, mainly including TSH adenoma and RTH. The diagnosis and differentiation of the two conditions require comprehensive assessment incorporating family history, symptoms and signs, laboratory tests, dynamic test, and genetic test. Among these, the 24 h/2 h TSH inhibition rate of octreotide suppression test can effectively distinguish TSH adenoma from RTH.