ObjectiveTo observe the changes in plasma interleukin-33 (IL-33) in patients with sepsis and its regularity, the association between IL-33 and the infection, and the significance of IL-33 in predicting the prognosis of sepsis.Methods A prospective single-center single-blind clinical study was conducted. Forty patients with sepsis in intensive care unit (ICU) of Shengjing Hospital of China Medical University from May 2012 to January 2013 were enrolled. The patients were divided into general sepsis, severe sepsis and septic shock groups according to the severity of systemic infection and presence of organ dysfunction. The sepsis patients were again divided into 28-day death group and survival group. Ten healthy volunteers and 11 patients with systemic inflammatory response syndrome (SIRS) were enrolled as healthy control and SIRS groups. The levels of procalcitonin (PCT), IL-33, IL-6, IL-1β, tumor necrosis factor-α (TNF-α), and IL-33 receptor sST2 were determined with enzyme linked immunosorbent assay (ELISA) within 3 hours, and 24 hours and 5 days after enrollment to ICU. The acute physiology and chronic health evaluationⅡ (APACHEⅡ) score was calculated. The clinical outcome, length of stay in ICU, and duration of mechanical ventilation were recorded. The relationship between IL-33 and each parameter was analyzed by Spearman analysis. Receiver operating characteristic (ROC) curve was drawn to evaluate IL-33 in predicting the outcome of sepsis.Results Plasma IL-33 in sepsis patients within 3 hours after admission was significantly increased compared with that of the healthy controls and SIRS group (ng/L: 15.43±7.22 vs. 0.67±0.24, 1.25±1.09, bothP< 0.01). Compared with SIRS group, PCT in sepsis group was significantly increased [μg/L: 52.23 (19.69, 73.37) vs. 1.22 (0.69, 3.73),Z = -2.447,P< 0.001]. With exacerbation of illness, APACHEⅡ score, the values of PCT and IL-33 were gradually increased in general sepsis, severe sepsis and septic shock groups, while the length of stay in ICU and the duration of mechanical ventilation were gradually prolonged (P< 0.05 orP< 0.01). The concentration of IL-33 (ng/L) of sepsis patients admitted to ICU within 3 hours, and 24 hours and 5 days of the illness was 15.43±7.22, 11.82±6.16, 5.55±2.25, respectively (F = 4.823,P = 0.004). There was a positive correction between IL-33 within 3 hours after ICU admission and APACHEⅡ score (r = 0.351,P = 0.031), PCT (r = 0.412,P = 0.005), IL-6 (r = 0.535,P = 0.030), IL-1β (r = 0.674,P = 0.030), TNF-α (r = 0.250,P= 0.030), sST2 (r = 0.620,P< 0.001), and length of stay in ICU (r = 0.296,P = 0.013), duration of mechanical ventilation (r = 0.385,P = 0.011). Decreased plasma IL-33 level could be found in the survivors (n = 37,F = 7.798,P< 0.01), and its level in non-survivors (n = 3) was increased (F = 37.283,P> 0.05). The area under the ROC curve (AUC) of IL-33 and PCT in ROC curve were 0.821, 0.829. When the cut-off value of IL-33 was 13.79 ng/L, the sensitivity was 74.2%, the specificity was 79.6%; when the cut-off value of PCT was 4.70μg/L, the sensitivity was 87.5%, and the specificity was 81.4%.Conclusions The concentration of IL-33 3 hours after ICU admission was obviously increased in sepsis patients, and it was positively correlated with PCT, therefore it is valuable in the diagnosis of the infection. In addition plasma IL-33 is related to the severity of sepsis. Its trend of change is valuable in predicting the outcome and in distinguishing sepsis from SIRS.

OBJECTIVE:To compare antidiuretic activity of Ootheca Mantidis before and after processing,and to explore the best medicinal part and mechanism of Ootheca Mantidis. METHODS:96 rats were randomly divided into blank group,model group,positive group,Ootheca Mantidis group,Ootheca Mantidis stir-fried with salt group,steamed Ootheca Mantidis group, crude product eggs and egg shell groups,processed product eggs and egg shell groups,with 8 rats in each group,12 groups in to-tal. Except blank group,other groups were given adenine 250 mg/kg,ig,for 4 weeks to induce kidney-yang and diuresis model. From third week,Ootheca Mantidis crude drug group and processed Ootheca Mantidis group were all given relevant medicine 0.11 g(crude drug)/ml i.g,and crude product eggs and egg shell groups and processed product eggs and egg shell groups were given rel-evant medicine,ig,once a day,by mass ratio of eggs to egg shell(cude drug 1∶2.4,salt stir-fried product 1∶1.7,steamed prod-uct 1∶2.1)for consecutive 4 weeks. The urinary volume,body weight,renal index and the serum contents of ADH and ALD were all determined. RESULTS:Compared with blank group,body weight and serum content of ADH and ALD decreased in model group,while renal index and urinary volume increased(P<0.05). After 4 weeks of treatment,compared with model group,body weight and serum content of ADH increased in Ootheca Mantidis groups,while urinary volume and renal index decreased (P<0.05);serum content of ALD increased in treatment groups;there was statistical significance in the serum content of ALD in those groups except Ootheca Mantidis group,Ootheca Mantidis stir-fried with salt group and steamed Ootheca Mantidis group (P<0.05);except for ALD,those index were in descending order of steamed Ootheca Mantidis group>Ootheca Mantidis stir-fried with salt group>Ootheca Mantidis group,and steamed Ootheca Mantidis shell group had best exchange. CONCLUSIONS:The an-tidiuretic activity of Ootheca Mantidis has been enhanced after processing. The egg shell of steamed Ootheca Mantidis is main me-dicinal part. To increase the serum content of ADH might be one of the main mechanism of arresting polyuria.

Actinomyces ; growth & development ; Coinfection ; Humans ; Maxillary Sinus ; Maxillary Sinusitis ; diagnosis ; microbiology

Female ; HIV Infections ; prevention & control ; transmission ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical

Chronic hepatitis B infection is a very important health problem in China, which is carrying an enormous economic and social burdens. The major routs of chronic hepatitis B infection in China are mother-infant vertical transmission and early childhood horizontal transmission. After more than 10 years implementation of universal vaccination against hepatitis B in newborns and safety injection in health care settings, the prevalence of HBsAg in general population has decreased from 9.75% to around 7%. In China, patients with hepatitis are cared by either hepatologists or physicians of infectious diseases. The Chinese Society of Hepatology, and Chinese Society of Infectious Diseases jointly issued an evidence-based guideline on the prevention and treatment of chronic hepatitis B in 2005. This guideline concisely describes the virology, epidemiology, natural history and prevention, as well as diagnosis and management of chronic hepatitis B. It also highlights the importance of active viral replication in disease progression in chronic HBV infection and explicitly states the necessity of antiviral therapy in patient care. The cornerstone of anti-hepatitis B therapy is optimal use of interferons or nucleos(t)ide analogs in those patients with active viral replication and elevated serum transaminase levels. Through an independent continue medical educational agency, a panel of selected speakers were trained to give well-formatted talks on the key points of the guideline in over 60 major cities across China. This educational campaign among health care providers has greatly improved the awareness and the stand of care for antiviral therapy.

Objective To explore the effect and safety of the regimen containing Moxifloxacin in intensive phase for pulmonary tuberculosis patients. Methods 88 cases with initial tuberculosis(each group of 44 cases) were studied in comparison in the same period. The treatment group contained isoniazid, rifampicin and moxifloxacin of antituberculosis regime and the control group contained isoniazid,rifampicin and pyrazineamide. Results After 2 months intensive phase anti-tubercular treatment ,the sputum negative conversion rates was 95.0% and control's was 94.4%(P ＞ 0.05); the absorb rate of lesions: the treatment group 77.3 % and the control group 79.5%; the liver damage rate: the treatment group and control group was 68.2% ,34.1% respectively(P ＜ 0.05). Conclusion Anti-tuberculosis intensive phase regimes containing moxifloxacin for tuberculosis treatment was safe and effective in initial treatment of pulmonary tuberculose.

Objective To evaluate the clinical effect of intracavitary microwave hyperthermia combined with radiotherapy for advanced cervical cancer. Methods 66 patients were randomized into two groups:33 pa-tients treated by radiotherapy plus hyperthermia ( H + R group) ,33 patients treated by radiotherapy alone ( Rgroup). Radiotherapies of both groups were alike:a midplane dose of 30 Gy to the whole pelvis and 20 Gy to the parametrical areas were given by using 8 MV-X rays, combined with 42 Gy with 192Ir high dose rate(HDR)intracavitary brachytherapy. Intraluminal 915 MHz microwave hypertherrrfia was given 30 rain to 1 h after radio-therapy. The temperature was increased and maintained at 43-45℃ for 45 minutes, once or twice a week for 7-10 times. Results The rates of local control and infection in H + R and R groups were 87.88% and 63.63%,15.15% and 36.36% respectively. The differences of the two groups were statistically significant( P <0.05).In H + R group, the level of CD4/CD8 and NK cells after being treated were higher than those before being treated and that of R group( P <0.05). The rates of 2-year disease-free survival and 3-year survival for H +R and R groups were 93.94% and 72.72%, 84.85% and 60.61% respectively. The differences of the two groups were statistically significant( P<0.05 ). The rates of bone marrow inhibition and radiatory rectum inju-ry were lower in H + R group than those in R group. Conclusion Hyperthermia plus radiotherapy can improve local control rate and survival rate in advanced cervical cancer.

Objective To investigate the therapeutic effect and nursing ways of pulmonary surfactant in premature babies with respiratory distress syndrome. Methods From July 2008 to January 2011,63 cases of premature babies with respiratory distress syndrome were admitted to our department, pulmonary surfactant was dripped through trachea into these patients, the treatment effect after medication was observed. Results Among these premature babies, one case died of respiratory failure, one case died from pulmonary hemorrhage, sixty-one cases were cured, the cure rate was 96.8%. After treatment, the arterial blood pH, partial pressure of oxygen(PaO2) and oxygen saturation(SaO2) of the 61 patients was significantly higher than before treatment, the arterial blood partial pressure of carbon dioxide (PaCO2)、 total carbon dioxide (TCO2)、actual bicarbonate (AB)was significantly lower than before treatment. Conclusions Pulmonary surfactant combined with appropriate nursing ways is able to cure premature babies with respiratory distress syndrome effectively.

Objective:To understand the effect and significance of rehabilitation nursing of the patients with total hip replacement. Method:In view of the rehabilitation nursing procedure, functional training before and after the operation were performed in 34 cases with total hip replacement. Result:21 cases made completely recovery; 9 cases complete independent living ;3 cases almost independent living; l case partial dependent, and no complications. Conclusion: Scientific rehabilitation nursing plan can decrease the incidence rate of complications after the operation and promotes functional recover to patients with total hip replacement.

Objective:To explore the effectiveness of methadone combined with buprenorphine on the alleviation of heroin withdrawal symptoms. Methods: One hundred and twenty patients with heroin dependence were randomly divided into two groups , namely the methadone combined buprenorphine treatment group (n=60)and the methadone alone treatment group (n=60). Rating scales were employed to assess the treatment outcomes. Results: Compared with patients in the methadone alone treatment group, patients in the combined treatment group reported fewer withdrawal symptoms, especially in first four days. They also subjectively considered the combined treatment as more acceptable. This effect was more pronounced in patients with relatively high levels of initial withdrawal symptoms. Conclusion: Methadone with buprenorphine was proved to be a favourable combination treatment in terms of reducing withdrawal symptoms, as well as improving the short-term detoxification success rate, especially in patients with severe heroin withdrawal symptoms.