Objective To study the changes of Prealbumin (PA),C-reactive protein (CRP) and D-dimer (DD) levels in septic shock patients due to pneumonia so as to explore the relation to the severity of disease and prognosis.Methods PA,CRP and DD levels of 48 sepsis patients were measured on 1st 、 3rd、5th day after admission and the last day before discharge or death.Meanwhile APACHE Ⅱ score were documented.According to prognosis,patients were divided into death group and non-death group.Results The levels of PA、CRP and DD on the 1 st day were of no significant difference between the death group and non-death group( t = 2.315 ,P ＞ 0.05;t =2.013,P ＞0.05; t =2.511 ,P ＞0.05).The level of PA in death group on the 3rd day,the 5th day and the last day was much lower than that in non-death group ( t = 2.422,P ＜ 0.05; t = 2.557,P ＜ 0.05; t = 2.906,P ＜ 0.05 ).The level of CRP and DD in death group on the 3rd day,the 5th day and the last day was much higher than those in nondeath group(t =2.061 ,P ＜0.05 ;t =2.843,P ＜0.05 ,t =3.519,P ＜0.01 and t = 2.576,P ＜0.05,t = 2.823,P ＜0.05; t = 3.371 ,P ＜ 0.01 ).There was a negative correlation between PA and APACHE Ⅱ scores ( r = - 0.631,P ＜0.01 ) ,while a positive correlation was found between CRP,DD and APACHE Ⅱ score(r =0.687 ,P ＜0.01 and r =0.651 ,P ＜ 0.01 ).Conclusions Persistent low level of PA and high level of CRP,DD indicated severe disease course and unflavored prognosis.It is of clinical value to evaluate the severity of disease and predict prognosis in sepsis by combined dynamic observation of PA,CRP and DD levels.

Objective To evaluate the efficacy and safety of enoxacin in the treatment of lower respiratory tract bacterial infection in the old patients.Methods 48 cases were given enoxacin and 46 cefotaxime.Results There was no significant difference between the two groups in cure rate,effective rate,bacterial clearance and side effects incidence.Conclusion Enoxacin is effective and safe in the treatment of lower respiratory tract bacterial infection of the old patients.

To compare immunogenicity of vaccine produced by three rabies virus stains( aG-,CTN.,CaG) respectively and determine their the ability against lethel challenge of rabies virus.Methods: By ELISA to determine sera potency of rabbits as well as hamsters and guinea-pigs which have been vaccinated different rabies respectively .To neutralize three different rabies strain with sera of hamster vaccinated and carry on neutralization experiments in mice.Results:In rabbits and guinea-pigs groups,rabies vaccine protency(by ELISA determination) vaccinated cell-adapted virus strain (CaG and CTN) is higher than one of vaccinated guinea-pig' strain virus strain's (aG), sera ability of hamster vaccinated cell-adapted strain against three rabies virus lethel challenge is higher than one of guinea-pig strain virus strain' g, too. Conclusion: Immunogenicity of rabies vaccine produced by cell-adapted strain is better than one of guinea-pig'sbrain virus strain's.

ObjectiveTo investigate the diagnosis and trea tment of ankle impin gement syndrome (AIS). MethodsThirty-six cases of AIS encoun tered between March 1995 and May 2001 entered the study. Hereinto, open removals of involved soft tissue were performed in 14 cases after MRI examinations, and arthroscopic exam inations and removals were accomplished in 22 cases. Results Follow-up for 6 mo nths～7 years (mean, 22 months) in all the 36 cases revealed “excellent” outco mes in 9 cases, “good” in 19 cases, “fair” in 7 cases, and “poor” in 1 cas e, showing “good” or “excellent” results in 77 8% of the patients (28/36). ConclusionsArthroscopic examination and operation for AIS is effective.

Objective To study the value and significance of transcutaneous oxygen saturation monitoring from different parts in early diagnosis of neonatal critical congenital heart disease. Methods The transcutaneous oxygen saturation in right upper extremities and right lower extremities of neonates born in our hospital from July 2010 to July 2015 were detected at 2 hours to 24 hours after birth. If the transcutaneous oxygen saturation ≤ 0. 95 or difference between upper and lower extremities≥0. 03, color doppler ultrasound echocardiography were done. Results There were 24 385 cases of newborns in our study. 1 680 newborns with abnormal transcutaneous oxygen saturation ( ≤0. 95 or difference between upper and lower extremities ≥0. 03) were examined with color doppler ultrasound echocardiography. 204 cases of congenital heart disease (12. 1% ) contain 9 cases of critical congenital heart disease ( 0. 5% ) were detected. The critical congenital heart disease included complete transposition of great artery ( n = 3), tetralogy of Fallot ( n = 4), artery malformation ( n = 1), and pulmonary atresia with right ventricular dysplasia ( n = 1 ) . Conclusions Transcutaneous oxygen saturation monitoring from different parts has a high value for early detection of critical congenital heart disease in the newborn. It is recommended for clinical use in grass-roots hospitals.

In the treatment of primary epilepsy, Traditional Chinese Medicine (TCM) compounds and the combination of TCM and Western medicine with acupuncture and moxibustion, massage, acupoint embedding and other therapies are used most. The combined application of different therapies could enhance the curative effect, which could effectively control the frequency of the outbreak of this disease, reduce the adverse reactions of drugs, and further improve the quality of life of patients. In recent years, the number of TCM clinical studies related to this disease has increased, but most of the studies have a small sample size, unclear long-term efficacy, few double-blind trials, and unclear random methods. In addition, the criteria of syndrome classification and curative effect of primary epilepsy need to be unified.

Objective To investigate the effect of hydrogen on endotoxin-induced expression of zonula occludens-1 (ZO-1) in human colon epithelial cells (Caco-2 cells).Methods Caco-2 cells were cultured routinely,seeded in Transwell chambers or wells,and randomly divided into 4 groups (n =45 each) using a random number table:control group (group C);hydrogen-rich culture medium group (group H);endotoxin group (group E);hydrogen-rich culture medium + endotoxin group (group HE).The cells were cultured in high-glucose DMEM culture medium in group C.The cells were incubated in hydrogen-rich culture medium containing hydrogen 0.6 mmol/L in group H.The cells were incubated in highglucose DMEM culture medium containing 50 μg/ml lipopolysaccharide in group E.The cells were incubated in hydrogen-rich culture medium containing 50 μg/ml lipopolysaccharide and 0.6 mmol/L hydrogen in group HE.Transepithelial electrical resistance (TEER) was measured before incubation or culture,and at 6,12 and 24 h of incubation or culture.The viability of Caco-2 cells was measured by methyl thiazolyl tetrazolium assay at 24 h of incubation or culture.The expression of ZO-1 mRNA in Caco-2 cells was determined using real-time reverse transcriptase polymerase chain reaction at 6,12 and 24 h of incubation or culture.The distribution of ZO-1 in Caco-2 cells was observed by immunofluorescence at 24 of incubation or culture.Results Compared with group C,TEER was significantly decreased at 6,12 and 24 h of incubation or culture,and the expression of ZO-1 mRNA was significantly down-regulated in E and HE groups (P＜0.05),and no significant change was found in the parameters mentioned above in group H (P＞0.05).Compared with group E,TEER was significantly increased at 6,12 and 24 h of incubation or culture,and the expression of ZO-1 mRNA was significantly up-regulated in group HE (P＜0.05).The distribution of ZO-1 protein in cell membrane became discontinuous,and the distribution of ZO-1 protein in cytoplasm was significantly increased in group E.Compared with group E,the distribution of ZO-1 protein in cell membrane was significantly increased and gradually became continuous,and the distribution of ZO-1 protein in cytoplasm was significantly decreased in group HE.Conclusion The mechanism by which hydrogen reduces the damage to human colon epithelial cell barrier is related to up-regulation of ZO-1 expression and improvement in the redistribution of ZO-1 protein.

Objective To investigate the role of Rho kinase (ROCK) in the protective effects of hydrogen on intestinal epithelial barrier function in sepsis. Methods Caco-2 cells were cultured routinely, and divided into 6 groups randomly (n=3):control group (C group), hydrogen-rich medium group (H group), lipopolysaccharide (LPS)-treatment group (L group), hy?drogen+LPS-treatment group (HL group), Rho kinase inhibitor (Y-37632) treatment group (Y group) and Rho kinase inhibi?tor Y-27632+LPS-treatment group (YL group). H group was treated with 0.6 mmol/L hydrogen-rich media. The concentra?tion of LPS and Y-27632 were 50 mg/L and 25μmol/L separately. After the Caco-2 monolayer model was established, the transepithelial electrical resistance (TEER) values were measured regularly. When the TEER value reached 800Ω·cm2, the treatment was administered. Then TEER values were measured at 6 h, 12 h and 24 h, and FITC-dextran permeability was de?tected at 24 h. Cells were seeded on 6-well plates. After cell density reached 80%-90%, treatments were given randomly. The real time-polymerase chain reaction (RT-PCR) was conducted to assess mRNA levels of ZO-1 and ROCK mRNA. ZO-1 and ROCK protein expression levels were detected by Western blot assay. Results Compared with C group, TEER values were elevated in 12 h and 24 h in H group (P<0.05). There were no statistical significances in FITC-dextran permeability,
protein expression levels of ZO-1 and ROCK between C group and H group (P>0.05). TEER values were elevated at 6 h, 12 h and 24 h in Y group (P<0.05). There was no significant difference in FITC-dextran permeability between C group and Y group (P > 0.05). The mRNA expression of ZO-1 increased and mRNA expression of ROCK decreased in Y group (P <0.05). The TEER values reduced at 6 h, 12 h and 24 h in L group. The FITC-dextran permeability increased significantly, mRNA and protein expressions of ZO-1 significantly decreased, mRNA and protein expressions of ROCK significantly in?creased in L group (all P<0.05). Compared with L group, TEER values increased significantly at 6 h, 12 h and 24 h in YL group, FITC-dextran permeability decreased, mRNA expressions of ZO-1 increased, mRNA expressions of ROCK de?creased in YL group (P<0.05). Compared with L group, TEER values increased at 6 h, 12 h and 24 h in HL group, FITC-dextran permeability reduced markedly, protein expressions of ZO-1 increased at each time point, protein expressions of ROCK decreased at each time point in HL group (P<0.05). Conclusion Hydrogen can protect intestinal barrier function against sepsis, ameliorate the integrity and permeability of intestinal epithelium and increase the expressions of intercellular tight junction proteins. The suppression of Rho kinase over-expression induced by LPS may be involved in these protective effects of hydrogen.

Objective To investigate the role of JNK in intestinal barrier dysfunction in severe septic mice treated by hydrogen. Methods Eighty male ICR mice were randomly divided into four groups (n=20 each):sham operation group, hydrogen control group, sepsis group and hydrogen treatment group. Severe sepsis rat model was reproduced by cecal ligation and puncture (CLP). Laparotomy without CLP was performed in sham operation group and hydrogen control group. The mice in hydrogen control group and hydrogen treatment group received 1-hour inhalation of 2%hydrogen at 1 hour and 6 hours after sham operation or CLP, respectively. Ten mice of each group were selected at 20 h after CLP operation and were gavaged with fluorescein-isothiocyanate-conjugated dextran (FITC-dextran). Blood samples were obtained by cardiac puncture to measure the serum concentration of FITC-dextran 4 h after treatment with FITC-dextran . Ten mice in each group were sacrificed at 24 h after CLP operation. The colony-forming unit (CFU) numbers in the peritoneal lavage fluid were counted. The middle intestinal tissues were obtained for the measurement of tumor necrosis factor alpha (TNF-α), interleukin (IL)-1βand high mobility group box 1(HMGB1) by ELISA. The level of phosphorylated JNK (p-JNK) and the expression of tight junction protein ZO-1 and Occludin were detected by Western blot assay. The intestinal pathological changes and epithelial ultrastructure changes were observed by light microscope and transmission electron microscope (TEM). Results There was no statistical significance in clinical variables between sham operation group and hydrogen control group. Compared with sham operation group, the serum FITC-dextran concentration, the CFU numbers in the peritoneal lavage fluid, the levels of TNF-α, IL-1βand HMGB1 in intestine, and the expression of p-JNK were significantly increased, the expression of ZO-1 and Occludin were down-regulated in sepsis group(P < 0.05). There was a significant intestinal pathological injury along with epithelial ultrastrcture injury in sepsis group. Compared with sepsis group, the serum FITC-dextran concentration, the CFU numbers in the peritoneal lavage fluid, the levels of intestinal TNF-α, IL-1β and HMGB1, and the expression of p-JNK were significantly decreased, the expression of ZO-1 and Occludin were up-regulated in hydrogen treatment group(P < 0.05), and the pathological and ultrastructure damage was significantly reduced. Conclusion Hydrogen can decrease levels of proinflammatory factors and up-regulate the expression of tight junction to improve intestinal barrier dysfunction caused by severe sepsis, which is related with the inhibition of JNK signaling pathway.

Objective To explore the expression profiles and their clinical significance of microRNA (miRNA) molecules in different stages of chronic hepatitis B virus (HBV) infection.Methods The miRNA molecule expressions of 12 patients with chronic hepatitis B,12 chronic HBV carriers,12 inactive hepatitis B surface antigen (HBsAg) carriers,and 9 healthy controls were screened using miRNA microarray.The miRNA profiles were validated by the real time fluorescence quantitative polymerase chain reaction (PCR).The t-test was used for comparison between twogroups,whereas one-way ANOVA and SNK-q tests were used for multiple comparisons.Mann-Whitney and Kruskal Wallis H tests were used for comparison of two or more groups of data with skewed distribution.The receiver operation characteristic (ROC) curve was constructed to evaluate the diagnostic significance of miRNA molecules.Results Compared with the healthy controls,significant differences in the expression profiles of miRNA molecules were found in peripheral blood mononuclear cells of chronic HBV carriers (2 molecules up-regulated,and 18 down regulated) and chronic hepatitis B patients (33 molecules up-regulated and 19 down-regulated).No significant difference was found between inactive HBsAg carriers (2 molecules up regulated,and 3 down-regulated) and controls.The results of six miRNA molecules detected by real-time fluorescence quantitative PCR were basically consistent with the results detected by microarray.The area under ROC curve of the six miRNA molecules of hsa miR-4711-3p,hsa-miR-3191 5p,hsa-miR-5704-5p,hsa-miR 548ah-5p,hsa-miR-146a-5p and hsa-miR-29b-3p in distinguishing immune tolerance and clearance of chronic HBV infection were 0.994,0.984,0.967,1.000,1.000 and 0.996,respectively.Conclusions The different expression profiles of miRNA molecules could be used to distinguish the different stages of chronic HBV infection,and are closely related with the immune tolerance and activation in chronic HBV infection.