Sepsis is featured with acute onset, rapid progress and high mortality.Because its clinical manifestations is very similar to noninfectious systemic inflammatory response syndrome, it is difficult to diffferentiate the two diseases, which results in delayed use or abuse of anti-infective drugs.Procalcitonin is widely recognized as a sepsis biomarker, but it has its limits.Procalcitonin must be interpreted cautiously, in conjunction with the clinical picture.Dynamic monitoring of procalcitonin can give clinicians more help.

Objective To learn about polysomnography (PSG) of the patients with spinal muscular atrophy (SMA),and the improvement of the moderate-severe sleep disordered breathing(SDB) patients after non-invasive ventilation (NIV) treatment.Methods The PSG examination of 11 SMA patients in Children′s Hospital Affiliated to Capital Institute of Pediatrics was performed.The PSG results and the levels of breathing disorder of these patients were collected.These patients were divided into 2 groups as follows.The mild group:apnea hypopnea index(AHI) was between 5 to 10 times/h,or average pulse oxygen saturation(SpO2)>95%;the moderate-severe group:AHI>10 times/h,and average SpO2≤95%.The moderate-severe levels of the patients were treated with NIV.Then the improvement of PSG after the treatment was evaluated.Results Within the 2 cases of type 1 SMA,1 was moderate-severe,the other 1 was mild.There were 2 cases moderate-severer and 6 cases mild SDB cases of type 2 SMA.The only 1 case of type 3 was categorized as mild disorder.The average hypopnea index(6.3 times/h) was higher than apnea index(4.9 times/h).The indicators to distinguish the moderate-severe and mild groups were as follows:AHI,average SpO2,hypopnea index,and arousal index associated with respiratory case,and there were statistically significant differences(all P<0.05).Significant improvement in PSG of the 3 NIV-treated patients was observed and it remained in normal range.The following indicators also remarkably improved after NIV treatment were hypopnea index [(1.5±0.1) times/h vs.(11.5±4.6) times/h,t=3.741,P<0.05],AHI [(2.4±1.1) times/h vs.(17.4±8.1) times/h,t=3.196,P<0.05],and average SpO2 [(96.7±0.6)% vs.(94.3±1.2)%,t=-3.130,P<0.05].Conclusions There are different levels of SDB within SMA patients.The major characteristic of SMA patients is hypopnea.There are more moderate-severer SDB in type 1 than those in type 2.The average SpO2,arousal index associated with respiratory incidents,AHI,and hypopnea index can reflect the levels of SDB of SMA patients.Besides,the results indicate NIV treatment can significantly improve SDB of SMA patients.

A canine model of sudden coronary death was established by intimal sur-face anodal direct current stimulation of the left circumflex coronary artery (LCX)on 5-8 days after the left anterior descending coronary artery (LAD) infarction. TheLCX intimal injury and subsequent thrombus formation produced ECG ST segment chan-ges at 104?30 minutes (X?SD), followed by premature ventricular beats, ventriculartachycardia (VT), and ventricular fibrillation (VF) in all normal saline (NS) treated dogs(n=6), in procainamide (PA) treated dogs (n=6), ECG ST segment changes appearedat 110?40 minutes, followed by VT and VF in only one dog (P

The peptidyl prolyl cis/trans isomerase Pin1 specifically binds phosphorylated Ser/Thr-Pro protein motifs and catalyzes the cis/trans isomerization of the peptide bond,changes the conformation and influences the stability and activity of the substrates.To date,a subset of proteins has been identified as substrates for Pin1.Pin1 interacts with its substrates and plays crucial roles in cell cycle,neural pathology and immune response.Accumulating studies have revealed that Pin1 isomerase activity is regulated by its post-translational modifications,including phosphorylation and oxidation.Over-expression or regulative imbalance of Pin1 plays an important role in the pathogenesis and therapeutics of human diseases such as cancer and AD.

Objective To conduct an investigation on diabetes nutrition knowledge, attitude and practice in outpatients with type 2 diabetes, understand the nutritional knowledge and dietary behaviors in patients with type 2 diabetes to guide individualized nutrition education. Methods The diabetes nutrition Knowledge, Attitude and Practice(KAP) questionnairewas designed based onChinese dietary guidelines (2007)andChinese diabetes medical nutrition therapy guidelines (2013). Data of out-patients with type 2 diabetes from January to March 2015 were collected. The method of investigation was face-to-face interview. Results Totally 915 patients were enrolled into this survey(male 495 and female 420). The mean BMI was (27.23 ± 3.18)kg/m2, glycosylated hemoglobin A1c (HBA1c) was (8.03 ± 2.17)%. Among the questions on knowledge, only on 4 questions the rate of awareness was over 80%, and there was a misunderstanding on diet, only 54.10%of diabetes patients believed that diabetes diet should be balanced and reasonable, rather than just limiting staple food and meat. Patients generally could realize the importance of diet for diabetes treatment. For questions on practice, the rate of reaching the standard generally was not over 80%. The rate of correct answers was not significantly different among different age groups, gender, and durations. There was a linear correlation between the rate of correct answers and glycosylated hemoglobin (P=0.043), the correlation coefficient was-0.258. The higher the rate of correct answers, the lower the level of glycosylated hemoglobin. Conclusion Outpatients with type 2 diabetes had good awareness level about diabetic nutritional knowledge and attitude but the awareness level of balanced diet needs to improve, the awareness rate on behavior was relatively low.

Identification of the histotype of the Wilms' tumor(WT) before operation, application of normative staging rules for WT and individualized combined therapy schedule are the main studying contents of WT' s diagnosis and therapy. Present article will review the overseas and domestic advancements of WT' s diagnosis and therapy, and provide some references for domestic doctors.

Objective: To study the expression of connexin43 (Cx43) gene and its correlation with the expression of apoptosis related genes bcl-2 and bax in transitional cell carcinoma of the bladder (BTCC), and to investigate the role of Cx43 in the BTCC. Methods: Reverse transcription polymerase chain reaction was used to detect the expression of Cx43 mRNA and immunocytochemistry technique was used to detect the expression of bcl-2 and bax proteins in 60 cases of BTCC tissue, and compared with that of 15 cases of pericancerous tissue and 15 cases of normal bladder tissue. Results: The positive rate of Cx43 mRNA expression in 60 cases of BTCC tissues was 43.33% which was significantly lower than that in pericancerous tissues (73.33% ) and normal tissues (100%) (x2 = 17.58, P < 0.01). The expression of Cx43 had significant negative correlation with the pathological degree and lymph node metastasis of BTCC (x2 = 9.33 and 9.74, respectively, P < 0.01). However, no correlation was found between the expression of Cx43 and the sex, age, clinical staging, and the diameter and the growth pattern of BTCC (P >0.05). Expression of Cx43 negatively correlated with bcl-2 protein (r = 0.63, P < 0.01) and positively correlated with bax protein (r = 0.52, P < 0.01). Conclusion: The down-regulated expression of Cx43 gene was closely associated with the development, invasion and metastasis of BTCC. It could be used a prognostic indicator for BTCC. Cx43 gene may have antagonistic effects with bcl-2 gene and synergistic effects with bax gene in the initiation and progression of BTCC.

AIM: To study factors affecting the stability of nylon monofilament for intraluminal middle cerebral artery occlusion in rats.METHODS:Successful rates and infarct volume of ischemic model were compared by polyvinyl alcohol (PVA) coated and silicon coated nylon monofilament intraluminal occlusion of middle cerebral artery under condition of ligation and without ligation of peterygopalatine artery.RESULTS:The successful rates were 60% and 53% in two groups under condition of ligation of peterygopalatine artery, and 20% and 27% in other two groups under condition of without ligation of peterygopalatine artery respectively. The intracranial length of nylon monofilament were about 7 mm in successful model and 4 mm in failure model. Animals in the PVA coated nylon monofilament group showed neurological dificit signs earlier, and had a significantly larger infarct volume at 12 hours of ischemia than those in the silicon coated group.CONCLUSIONS:The ligation of peterygopalatine artery is critical in the success of making this kind of ischemic model. The appropriate position of nylon monofilament entering crania and the good expansibility of PVA play an important role in occlusion of blood flow. Because of the relatively lower successful rate, a new substitute with unique quality, proper hardness and better elasticity needs to be explored in the future.

Objective To investigate the incidence and clinical significance of coronary artery anomalies in adults undergoing coronary angiography. Methods Data of all patients underwent coronary angiography from Jan 2001 to Nov 2003 in our hospital were reviewed retrospectively. Results Among 2?824 adult patients, 61 had coronary artery anomalies of which 84.1% were anomalous origin and distribution. The total detection rate of coronary artery anomalies was 2.1%. Anomalies were found to be happened more in the right coronary artery than in the left coronary artery. Four cases failed to undergo selective right coronary angiography. Conclusion Coronary artery anomalies are not rare in adults. Some types of coronary artery anomalies can induce myocardium ischemia and require intervention. Catheterization diagnosis and therapy of patients with anomalous origin of coronary artery may be difficult2?