Objective To explore the significance of shock index in the early assessment of patients with severe sepsis and septic shock.Methods A retrospective study of 100 patients with severe sepsis and septic shock admitted in the Emergency Department of the Beijing Friendship Hospital from September 2011 to August 2013 was carried out.According to the 28-day outcome,all patients were divided into survival group (n =48) and death group (n =52).Shock index of patients was calculated at admission (SI1) and 2 hours after resuscitation (SI 2).Results (1) The SI1 and SI2 (1.5 ± 0.05),(1.2 ± 0.04) in the death group were significantly higher than those (1.3 ± 0.08),(0.9 ± 0.05),in the survival group (P ＜ 0.01) ; (2) AUC of SI1 and SI2 of death group were 0.7075 and 0.8894,respectively.The SI2 showed higher sensitivity (80.3％) and specificity (78.4％) compared to SI1.The optimal cut-off point for SI2 was ≥ 1.Conclusions SI2 may potentially be utilized as a reliable predictor for death in patients with septic shock and severe sepsis in an emergency department.

0.05). The duration of normoglycemia in experimental group was 23～65 days (mean 48 days), while 3～6 days (mean 5 days) in control group, with the difference being very significant between the two groups (P

Objective To study the p53 gene mutation induced by organic extract of reclaimed water used in a city. Methods The organic extract of reclaimed water was collected by C18 solid-phase extraction (SPE) and the 16 kinds of polycyclic aromatic hydrocarbons (PAHs) in the reclaimed water were analyzed using gas chromatography-mass spectrometry (GC-MS). L-02 cells were treated with the organic extract of the reclaimed water at 0.84, 1.68, 3.34 ?l/ml for 24 h. DNA samples for p53 mutation detection was extracted from the cells and subjected to DNA sequencing for detection of mutations in exon 5 of the p53 gene. Results All 16 kinds of PAHs were detected both in input water and reclaimed water. The predominant ones were fluorene and phenanthrene,then naphthalene, acenaphthene, acenaphthylene, anthracene, fluoranthene, pyrene and so on. Total PAHs concentration was 1 777.9 ng/L in the input water and 1380.1 ng/L in the reclaimed water. Mutation in exon 5 within the p53 gene was detected in L-02 cells treated with the organic extract of the water. Conclusion PAHs in water can be removed by sewage treatment technology at present, but the remaining PAHs can still induce the mutation of p53 gene, so using reclaimed water has some potential health impacts, the sewage treatment technology employed today should be improved.

Objective:To investigate the correlation between microRNA-497 (miR-497) expression and invasion and metastasis and prognosis of colorectal cancer (CRC).Methods:The expression of miR-497 in 93 CRC patients (CRC group), 30 colorectal adenoma polyps (colorectal adenomatous polyp group) and 30 healthy patients (normal control group)were detected by real-time fluorescence quantitative polymerase chain reaction (qRT-PCR); meanwhile, the content of serum carcinoembryonic antigen (CEA) was detected by chemiluminescence; After 3 years follow-up, the expression of miR-497 was measured again; the correlation between the expression of miR-497 and the clinicopathological characteristics and prognosis of CRC was analyzed.Results:The expression of miR-497 in CRC group was significantly lower than that at the end of postoperative treatment, adenomatous polyps group and normal control group ( P<0.01), and the content of CEA in CRC group was significantly higher than that at the end of postoperative treatment, adenomatous polyps group and normal control group ( P<0.01); At the end of postoperative treatment, the expression of serum miR-497 in CRC group was lower than that in normal control group ( P<0.05), and the content of serum CEA was higher than that in normal control group ( P<0.05). The diagnosis positive rate of serum miR497 expression in CRC group was significantly higher than that of serum CEA ( P<0.01), and they showed no correlation ( r=0.232, P>0.05). The pre-and post-operative serum miR-497 expression levels in the recurred and metastasis group were significantly lower than those in the no postoperative recurrence and metastasis group ( P<0.01). The preoperative expression of miR-497 was related to the differentiation degree of CRC, tumor node metastasis (TNM) stage, lymph node metastasis, distant metastasis and survival period ( P<0.01), but not with the age, sex, tumor size and location of the patients ( P>0.05). Cox multivariate analysis showed that tumor differentiation, TNM stage, preoperative miR-497 expression, lymph node metastasis and distant metastasis were all independent risk factors influencing prognosis of CRC patients ( P<0.05); The survival rate of 1, 2, 3 years in the miR-497 low expression group was lower than that in the miR-497 high expression group ( P<0.05). Conclusions:The preoperative low serum miR-497 expression levels are closely relative with invasion and metastasis and poor prognosis of CRC, and can be a prognostic indicator of CRC. The reduced postoperative serum miR-497 expression levels may be a predictor of the postoperative recurrence and metastasis of CRC.

Objective To explore the role of BNP (B-type natriuretic peptide) in the early assessment of patients with acute pulmonary embolism (PE).MethodsEighty-six patients hospitalized in Beijing Friendship Hospital from November 2005 to June 2010 diagnosed as acute PE were studied retrospectively.The differences of BNP and other indicators and the relationship of BNP and right ventricular and right atrial pressure gradient value ( RV-RA PG) were compared between two groups divided by whether right ventricular dysfunction exists or not.imilarly,the differences of BNP and other indictors were compared between the two groups divided by complications exists or not.ResultsIn the right ventricular dysfunction group and control group,BNP was ( 1356.8 ±675.4) pg/ml and ( 103.8 ±51.4) pg/ml,respectively,and the differences are significant.BNP and RV-RA PG had a significant correlation (γ =0.824,P ＜0.01 ) by Linear correlation analysis.BNP had a reliable diagnostic power for right ventricular dysfunction ( AUC 0.907).In the group with complications and none -complication group,BNP value was ( 1356.8 ±675.4)pg/mlvs.(103.8 ±51.4) pg/ml,and pH value was (7.372 ±3.7) vs.(7.446 ±3.5),and the differences were all significant ( P ＜ 0.05 ). Conclusions BNP has important significance in early predicting the occurring,severity and prognosis of congestive heart failure caused by acute pulmonary embolism; pH of the early arterial blood gas has positive significance for early diagnose and treatment and predicting the severity and prognosis of patients suffering acute pulmonary embolism.

BACKGROUND:Data suggested that there were 24.5 million of human immunodeficiency virus (HIV) infected women in 16 countries in southern Sahara Africa.OBJECTIVE: To survey the HIV infection status among women in reproductive age in Mauritania so as to provide research direction and basic data for prevention and treatment of immunodeficiency diseases.DESIGN: Random sampling survey.SETTING: Epidemic Disease & Health Statistics Department of Radiation Medicine and Public Health College of Suzhou University;Institute of Iodin Absence of Harbin Medical University;and Public Health College and Epidemic Disease & Health Statistics Department of Harbin Medical University.PARTICIPANTS:The survey was conducted in the 14 main cities of the whole country from March to June 2001. Inclusion criteria: Women were in reproductive age, aged 15-49 years, from Mauritania; and all told the fact.Exclusion criteria: Women refused survey and not in reproductive age were excluded.Among 331 548 women,4 000-6 000 samples were surveyed and the sampling rate was 1.2％-1.8％.METHODS: Venous blood and isolated sera of women in reproductive age were collected. Sera were detected by ELISA test and confirmed by Western Blot test in order to know HIV infection and its subtypes.The detection rates of different population and cities were calculated and made statistical analysis.MAIN OUTCOME MEASURES: The infection and subtypes of HIV; infected rate of HIV among different crowd in different cities.RESULTS: Among 4 648 women in reproductive age in 13 provinces, 24infected cases aged of 15-49 years were found with the infected rate of 0.516％,of them 22 cases were infected with HIV-1 and 2 cases were in fected with HIV-2. The detection rates were 0.500％-1.010％ (5 cities), 0-0.500％ (3 cities) and 0％ (5 ities) respectively. The age of 95.83％ of the total infected cases was 15-29 years. The number of the HIV-infected cases was about 1 400 persons among women in reproductive age in 13 main cities.CONCLUSION: The total HIV-infected detection rate was 0.516％ among women in reproductive age in 13 main cities of Mauritania.HIV-1 2 was the dominant subtype. HIV infection was different among regions. HIV-in fected cases aged 15-29 constituted more than 95％ of the total cases. The prevalent trend of AIDS was in the stage of transmission after importing.

Objective To reveal the changes of catecholamine and lactate levels in myocardial interstitial fluid during cardiopulmonary resuscitation in order to prove the protective effects of sildenafil pretreatment on post-resuscitation myocardial function in swine model of ventricular fibrillation (VF).Methods Twenty-four swine were randomly (random number) divided into three groups:saline group,sildenafil group and shame operation group.Sildenafil in dose of 0.5 mg/kg dissolved in 40 mL of saline was given to swine once intraperitoneally 40 min prior to VF in sildenafil group.The equivalent volume of saline (0.9％ NaC1) alone was administered instead in saline groups.There was no treatment in shame operation group.After ventricular fibrillation untreated for 8 min,open-chest cardiopulmonary resuscitation was initiated.The hemodynamic variables were recorded at baseline,4 min,1 h and 6 h after restoration of spontaneous circulation (ROSC).The interstitial fluid from the left ventricle wall was collected by using the microdialysis tubes at given intervals,in which the levels of dopamine,norepinephrine,epinephrine,and lactate were measured.The samples for pathological examination were taken at 24 hours after ROSC.Results The levels of catecholamine and lactate in the sildenafil group were lower than those in saline group at all different intervals (P ＜ 0.05 or P ＜ 0.01).The cumulative defibrillation energy was lower in the sildenafil group than that in the saline group (P ＜ 0.05).The hemodynamic changes and myocardial histological damage in sildenafil group were milder than those in saline group (P ＜ 0.05).The pathologic changes of myocardium and mitochondria in saline group were more severe than those in sildenafil group.Conclusions Sildenafil pretreatment prior to VF can effectively reduce endogenous catecholamine secretion and lactate levels in myocardial tissue,protecting the myocardium and improving post-resuscitation myocardial function.

Objective To observe the effects of Tanshinone Ⅱ A sodium sulfonate (TSS ) on ischemia/reperfusion (I /R) induced cardiac injury in male (Sprague-Dawley,SD ) and explore its mechanisms.Methods Rats were subjected to a 30 min coronary arterial occlusion followed by 24 hours reperfusion.The survival rats were randomly (random number)divided into sham group (Sham group,n =10),ischemia reperfusion group (I /R group,n =10),low dose of TSS group (TSS-L group,n =10), medium dose of TSS group (TSS-Mgroup,n =9),high dose of TSS group (TSS-H group,n =9).A MAP heart function analysis system was used to measure hemodynamic variables,and TTC staining method was used to detect the myocardial infarct size.The levels of Bcl-2,Bax,Caspase-3,Lc3B/Lc3A,Beclin-1 and high mobility group box1 (HMGB1)were detected by western blot method.All data were analyzed by using One-way analysis of variance (ANOVA)(LSD-t test).Results Cardiac function in I /R group was lower than that in Sham group,and that was significantly improved by pretreated with TSS (P <0.05),but there were no significant differences in Pmin and DAP between Sham group and I /R group (P >0.05 ).The percentage of myocardial infarct size in TSS pretreatment group was significantly smaller than that in I /R group (P <0.05 ).Compared with Sham group,levels of Caspase-3 and Bax increased,and the Bcl-2 content was reduced obviously in I /R group (P <0.05).TSS pretreatment significantly down-regulated the levels of Caspase-3 and Bax protein (P <0.01).At the same time,the level of Bcl-2 was increased in all TSS pretreatment groups (P <0.01).Compared with Sham group,the ratio of Bcl-2 /Bax in I /R group was lower (P <0.05),and that was elevated in TSS groups (P <0.05 ).The change of autophagy related protein beclin-1 and Lc3B/Lc3A was in similar trend,and the levels of beclin-1 and Lc3B/Lc3A in I /R group were lower than that in Sham group (P <0.05),and those were raised in TSS pretreatment groups (P<0.05).The level of HMGB1 in I /R group was higher than that in Sham group (P <0.05),and compared with I /R group,the level of HMGB1 significantly decreased in TSS pretreatment groups (P <0.01 ). Conclusions The tanshinone ⅡA sodium sulfonate can protect the myocardium from ischemia/reperfusion injury and the mechanism may be attributed to the inhibition of cell apoptosis and activation of cell autophagy.

Objective To explore the situation of return-to-work (RTW) and its related factors in female injured works. Methods The da-ta of the basic information, counseling record and follow-up record after discharge were collected from social rehabilitation department in our center. The main influencing factors were analyzed by single factor analysis and two classification Logistic regression. Results 232 ob-jects were collected, among which, 149(64.2%) subjects had returned to work, and the median of absence time was 206.5 days. Single factor analysis indicated that their age, marriage, absence time and educational level were not correlated with the outcome of women injured work-ers' employment (P>0.05). However, place of social insurance, household register and injury severity correlated with the outcome (P<0.05). Conclusion Most of the female injured workers can return to work. The severity of injury, along with some system factors influence the RTW of them.

Nuclear medicine can not only display the anatomical structure of organs or lesions, but also provide the information of blood flow, function, metabolism and receptor density of organs and lesions in digestive system . It is not only complementary to computer tomography (CT) and magnetic resonance imaging (MRI) in organic diseases of digestive system, but aslo has unique clinical value in functional diseases of digestive system.