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 investigate the effects of isotope labeled folate targeting albumin nanoparticles (188Re-fo-late-CDDP/HAS MNP) on human SKOV3 ovarian cancer cells in vivo. Methods The human SKOV3 ovarian cancer model was established in mice. Sixty-four tumor-bearing mice were randomly divided into eight groups:(A) negative control group, (B) chemotherapy group, (C) radiotherapy alone group, (D) hyperthermia alone group, (E) chemotherapy combined with radio-therapy group, (F) chemotherapy combined with hyperthermia therapy group, (G) radiotherapy combined with hyperthermia therapy group and (H) hyperthermia, chemotherapy and radiotherapy combined treatment group. After treatment, the cell pro-liferation and tumor growth were observed. The inhibitory rate of tumor mass was measured. The histopathological changes of tumor were observed in all groups. Results The quality of tumor was significantly lower in treatment groups than that of control group (P＜0.05). There was the lowest quality of tumor in hyperthermia, chemotherapy and radiotherapy combined treatment group than that of other treatment groups (P＜0.05). Conclusion The combination of magnetic induction hyper-thermia, chemotherapy, targeted radionuclide of radiation exposure can effectively inhibit the growth of ovarian cancer, which has the potential application for ovarian cancer treatment.

Objective To investigate the status of Chlamydia trachomatis(CT) infection in pregnant women in Wuxi ,and to ex‐plore the relationship between CT and abortion .Methods A total of 3 199 cases of pregnant women visiting this hospital from Jan‐uary 2013 to December 2014 were enrolled in this study and divided into the missed abortion group(2 633 cases) ,incomplete abor‐tion group(265 cases) ,the inevitable abortion group(137 cases) ,threatened abortion group(104 cases) and control group(60 cases , all women undergoing induced abortion) .The CT infection was detected by using the fluorescent quantitative polymerase chain reac‐tion(FQ‐PCR) .Results The positive rate of CT in missed abortion group ,incomplete abortion group ,the inevitable abortion group and threatened abortion group were 5 .62% ,4 .53% ,5 .11% and 4 .81% ,respectively ,all were higher than that in the control group (3 .33% ) ,without statistically significant differences (P>0 .05) .The positive rate of CT in women in 16- <21 years old age group and 21- <26 years old age group was higher than that in other age groups ,which was 7 .06% and 6 .20% respectively .However , there were no statistically significant differences in positive rate of CT between these age groups (P>0 .05) .Conclusion The posi‐tive rate in women undergoing spontaneous abortion is higher than that in women undergoing induced abortion ,and young women has a higher infection rate of CT .

Neurolymphomatosis(NL) is characterized by lymphomatous infiltration of the peripheral nervous system. We report a case of neurolymphomatosis(NL) which was confirmed by sural nerve biopsy. Sural nerve specimen from a 49-year-old female patient with weakness of limbs was examined with routine histochemical and immunohistochemistry staining, in which the first antibodies against CD3, CD20, CD45, CD45RO and CD68 were used. Numerous T-lymphoma cells invaded in the adipose tissue of epineurium of sural nerve. The nerve biopsy showed marked axonal degeneration of myelinated fibers. The clinical and histopathologic findings confirmed the diagnosis of neurolymphomatosis.

BACKGROUND: As a metal internal fixation material, magnesium alloy has more unique advantages, such as biodegradability and elastic modulus. The elastic modulus of magnesium alloy is similar to the compact bone,which is enough to avoid stress-shelter effect. However, biological activity represents bonding ability with the bone in the body for fracture fixation materials, which is of great significance for studies on new kinds of magnesium alloys.OBJECTIVE: To observe the microstructure of Mg-Zn-Gd alloys and to analyze the corrosion products on the material surface after immersed in simulation body fluid.METHODS: The Mg-Zn-Gd alloys were manufactured by the method of fusion casting. Scanning electron microscope with spectrometer was applied to observe microstructure and distribution of precipitated phase and corrosion products of Mg-Zn-Gd alloys in simulated body fluid.RESULTS AND CONCLUSION: The Mg-Zn-Gd alloy was composed of α-Mg solid solution containing Gd and Zn elements and eutectic structure. The eutectic structure was almost feathery, oval-shaped, herringbone-shaped and strip-shaped along the grain boundary. The main ingredients of eutectic structure included Mg, Zn and Gd elements.Deposition layer was composed of O, Mg, Ca and P elements on the surface of Mg-Zn-Gd alloy after 72 hours soak in Hank's solution. X-ray diffraction analysis showed that film layer contained Mg(OH)2 phase, which promoted calcium salt deposition and reduced the corrosion rate. So Mg-Zn-Gd alloy can obtain better biological activity.

Objective To investigate the effects of preconditioning and postconditioning with isoflurane on pro-inflammatory cytokines and lipid peroxidation in focal cerebral ischemic/reperfusion (I/R) injury in rats.Methods Thirty-two Sprague-Dawley (SD) rats were randomly divided into four groups:control group,model group,isoflurane preconditioning group and isoflurane postconditioning group,with 8 rats in each group.Rats in control group did not receive any challenge.In rats of model group right middle cerebral artery occlusion (MCAO) was conducted for 90 minutes.Rats in isoflurane preconditioning group received 2％ isoflurane exposure for 30 minutes 24 hours before MCAO for 90 minutes.Rats in isoflurane postconditioning group were given 60-minute 2％ isoflurane exposure after reperfusion of right MCAO.Twenty-four hours after the procedure,all rats were anesthetized with isoflurane,and blood sample taken from the heart was centrifuged,and the pro-inflammatory cytokines,including interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α),and lipid peroxidation products such as malonaldehyde (MDA) and superoxide dismutase (SOD) were determined.The mRNA and protein expression levels of matrix metalloproteinase (MMP-2,MMP-9),tight junction protein Calaudin-5 and Occludin were determined by reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot.Results Compared with control group,serum levels of IL-1 β (ng/L),TNF-α (ng/L) and MDA (μmol/L) were elevated and activity of SOD (U/L) decreased in rats of model group (IL-1β:76.81 ± 11.14 vs.52.43 ± 8.86,TNF-α:64.93 ± 10.81 vs.33.64 ± 7.94,MDA:8.63 ± 1.42 vs.4.14 ± 0.98,SOD:0.95 ± 0.21 vs.2.36 ± 0.80,all P＜0.05).After isoflurane preconditioning and postconditioning,compared with model group,the levels of IL-1 β,TNF-α and MDA were lowered,while activity of SOD was increased (IL-1 β:54.37 ± 9.06,56.82 ± 8.67 vs.76.81 ± 1 1.14,TNF-α:43.72 ± 6.16,39.49 ± 9.34 vs.64.93 ± 10.81,MDA:5.65 ± 0.83,5.82 ± 0.78 vs.8.63 ± 1.42,SOD:1.64 ± 0.47,1.71 ± 0.52 vs.0.95 ± 0.21,all P＜0.05).Focal cerebral I/R injury could lead to an increased expression of MMP accompanied with a decreased expression of tight junction protein.Compared with model group,after isoflurane preconditioning and postconditioning,it was found that there were decreased mRNA and protein expression of MMP-2 and MMP-9 (MMP-2 mRNA:1.25 ± 0.08,1.32 ± 0.12 vs.2.48 ± 0.26,MMP-2 protein:1.56 ± 0.09,1.50 ± 0.08 vs.2.12 ± 0.11 ; MMP-9 mRNA:1.26 ± 0.13,1.20 ± 0.12 vs.2.74 ± 0.28,MMP-9 protein:1.53 ± 0.04,1.51 ± 0.05 vs.2.23 ± 0.09,all P＜0.05) and increased levels of Calaudin-5 and Occludin (Claudin-5 mRNA:0.40 ± 0.08,0.38 ± 0.06 vs.0.28 ± 0.03,Claudin-5 protein:0.80 ± 0.06,0.81 ± 0.07 vs.0.39 ± 0.02; Occludin mRNA:0.54 ± 0.07,0.50 ± 0.08 vs.0.26 ± 0.06,Occludin protein:0.64 ± 0.06,0.69 ± 0.05 vs.0.49 ± 0.02,all P＜0.05).Conclusion Preconditioning and postconditioning with isoflurane can lower the levels of pro-inflammatory cytokines and the degree of lipid peroxidation,and lower the hydrolytic activity of MMP to the tight junction protein in cerebral tissue,thereby decrease the loss of tight junction protein and alleviate I/R injury.

Objective To analysis the characteristics of thromboelastography and coagulation test in patients with advanced pregnancy combined with severe preeclampsia. Methods A retrospective single?center study was conducted. 35 patients with advanced pregnancy combined with se?vere preeclampsia who were admitted to hospital from January 2012 to December 2014 were analyzed compared to 43 third trimester patients with?out any complication. All the patients were treated based on the routine strategy. Blood sample were taken from the middle elbow vein to test blood cell count,serum biochemistry test,routine coagulation test and thromboelastography. All the results,including R,K,CI,α?angle and MA value, were compared between two groups. Analysis was performed to evaluate the correlation between all parameters of TEG and coagulation test. Re?sults There was no statistical significance between two groups in age ,prothrombin time and activated partial prothrombin time. In the severe pre?eclampsia group,the R value of TEG was increased(5.21±1.20 min vs 6.19±1.55 min,t=-3.144,P=0.002),α?angel was decreased(64.43°± 7.90° vs 60.37°±7.09°,t=2.367,P=0.02),and CI was decreased(0.81±2.27 vs-0.37±1.82,t=2.495,P=0.015). In blood cell count test,the platelets count was decreased in severe preeclampsia group[(217.48±65.68)×109/L vs(166.65±61.39)×109/L,t=3.500,P=0.001]. In routine coagulation test,only thrombin clotting time was increased in severe preeclampsia group(14.59±0.51 s vs 15.28±0.97 s,F=-3.800,P<0.001). In serum biochemistry test,the albumin was decreased in severe preeclampsia group(34.75±3.90 g/L vs 28.77±4.05 g/L,t=6.632,P<0.001),while serum urea nitrogen was increased(2.78±0.87 mmol/L vs 5.98±8.07 mmol/L,F=-2.333,P=0.026). In correlation analysis,thrombin clot?ting time had relationship between R(r=0.290,P=0.010),CI(r=-0.257,P=0.023)andα?angle(r=-0.243,P=0.032). Platelets count cor?related with CI(r=0.383,P=0.001),K(r=-0.409,P<0.001),α?angle(r=0.375,P=0.001)and MA(r=0.512,P<0.001). Conclusion For those who suffered from severe preeclampsia patients with advanced pregnancy,low coagulation function occurs in most of the patients com?pared to those patients without any complications. Thromboelastography may be helpful for those who have high risk factors ,especially with low platelets count and increased thrombin clotting time ,so as to reduce the incidence of bleeding or thromboembolic diseases.

ObjectiveTo investigate the value of full-volume three-dimensional echocardiography (FV3DE) in evaluating left ventricular systolic function in normal pregnancy.MethodsFifty-five healthy pregnant women,including 18 cases in first trimester (first trimester group),18 cases in second trimester (second trimester group) and 19 cases in third trimester (third trimester group),and 20 healthy nonpregnant women(control group) were chosen.The hemodynamic indexes and left ventricular systolic function parameters were detected by FV3DE.ResultsThe imaging satisfactory rates of FV3DE of control group,first trimester group,second trimester group and third trimester group were 100.0％ (20/20),100.0％ (18/18),88.9％ (16/18) and 78.9％(15/19) respectively.Compared with control group,heart rates (HR) of first,second and third trimester groups were significandy quicker (P ＜ 0.05);total peripheral resistance (TPR)declined gradually (P ＜ 0.05);LVM,LVMI,LVEDV,LVSV and LVCO increased gradually (P ＜0.05) ; MAP,LVEF,PER of four groups had no significant differences (P＞ 0.05 ).LVCO in healthy pregnant women had negative correlation with TPR (P ＜0.01),and positive correlation with HR,LVM,LVMI,LVEDV,LVSV,LVEF and PER (P ＜0.01),PER had positive correlation with LVEF.ConclusionThe application of FV3DE has significant clinical value in early evaluation of left ventricular systolic function in normal pregnancy.

ObjectiveTo summarize the initial experience of transumbilical laparoendoscopic single-site surgery of urology.MethodsFrom February 2010 to March 2011,21 patients underwent laparoendoscopic single-site surgery using transumbilical single-site and common surgical instruments of laparoendoscopic.Nine patients underwent single-site laparoscopic ureterolithotomy,5 underwent transumbilical single-site laparoscopic ureteral stricture resection and anastomosis,5 underwent transumbilical single-site laparoscopic renalcyst unroofing and 2 had a nephrectomy.All of the cases were definitely diagnosed.A single umbilical incision of 1.5 cm to 2.5 cm was made for Triport.The procedures were performed according to the methods used in classical laparoscope methods using general instruments.ResultsAll the operations were successfully completed without conversion to open surgery.The mean operative time of ureterolithotomy was 143 (120-230) min,the mean operative time of ureteral stricture resection and anastomosis was 157 (120 -180) min,the mean operative time of unroofing of renal cysts was 110 (95 -132) min,and the operative time of the nephrectomy was from 95 to 120 min.The intestinal tract function recovered within 1 -2 d,the drainage tube was removed within 2 -3 d and the postoperative hospitalization duration was 4 -7 d.The symptoms were reduced or disappeared and no major intraoperative or postoperative complications occurred within 4 - 6 months.Conclusions Transumbilical laparoendoscopic single-site surgery represents a safe and feasible operation for urologic patients.With more clinical practice,laparoendoscopic single-site surgery could be generally applied.

Objective To investigate the levels of serum interleukin(IL)-18 in patients with chronic renal failure (CRF)and its relationship with relevant indexes. Methods Sixty patients with CRF were divided into three groups: patients with CRF (CRF group, n = 18) ,patients with bemedialysis (HD group, n = 22) and patients with peritoneal dialysis (PD group,n = 20). 20 healthy subjects were taken as controls. The levels of serum IL-18, tumor necrosis factor (TNF)-α and high sensitivity C-reactive protein (hs-CRP) were detected by means of ELISA. Serum albumin (ALB) ,total cholesterol (TC) ,triglyceride (TG) and serum creatinine (SCr) levels were detected by con-ventional means. The GFR was measured by using the abbreviated Modification of Diet in Renal Disease study (MDRD) equation. Differences in continuous variables between the three groups were evaluated. Results The lev-els of serum IL-18 were significantly increased in CRF[(497.7 ± 120.7) ng/L], HD[(538.1 ± 113.2) ng/L] and PD[(565.7 ± 122.1) ng/L] patients than those in healthy subjects[(163.9±42.2) ng/L] (P <0.01). Further-more,serum IL-18 levels in HD patients were higher than these in CRF patients (P <0.05). Serum IL-18 levels in CRF were positively related to serum TNF-α,hs-CRP and SCr(r =0. 636,0.436,0.367,P <0.01) ,and negatively related to GFR(r = -0.515 ,P <0.05). Conclusion The levels of serum IL-18 are markedly increased in patients with CRF,HD and PD,and related to the levels of TNF-α,hs-CRP and GFR,so IL-18 might be an important marker of sub-clinical inflammation in patients with chronic renal failure.