Objective To discuss the relativity between serum procalcitonin(PCT) level and renal impairment (RI) in critically ill patients. Methods A perspective study was performed in 60 critically ill patients. They were divided into 2 groups on the serum PCT level within 24 h: abnormal group (PCT ≥ 0.5 μg/L,38 cases) and normal group(PCT < 0.5 μg/L,22 cases). The serum creatinine (SCr) and blood urea nitrogen (BUN) were observed. Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) of the patients were recorded. Calculated the sensitivity and specificity for prediction of RI as well as acute renal dysfunction (ARD). Results SCr [(188.91 ± 199.48) μmol/L]and BUN [(13.03 ±9.19)mmol/L]in abnormal group were significantly higher than those in normal group [(67.40 ± 15.35) μ mol/L and (6.91 ± 2.06) mmol/L](P< 0.01). The sensitivity of PCT forecast RI was 71.79%, and specificity was 52.38%. The sensitivity of PCT forecast ARD was 91.67% , and negative predictive value was 95.45%. Conclusion Serum PCT level has an important value for judgement of RI and ARD in critically ill patients.

ObjectiveTo investigate the characteristics of sexual behavior and HIV infections between normal men who have sex with men (MSM) and money boy (MB) in Jining city,so as to provide the basis for intervention.MethodsSentinel surveillance,VCT and respondent-driven sampling were adopted to recruit the target population,and the data was aualyzed with SPSS13.0.ResultsThe average age of normal MSM was 26.45 ± 5.8 and MB was 22.23 ± 3.3.The rates of single,marriaged and divorced about normal MSM and MB were 48.24％,45.53％,6.7％ and 85.4％,9.8％,4.9％ respectively.The educational level of normal MSM(74.8％ )was higher than that of MB(51.22％ ).MB group's rate of condom used(75.61％ ;51.22％ ) was higher than that of normal MSM ( 52.03 ％ ;32.79％ ).There was statistical significance in age,educational level,marital status and infecting rates of HIV between MB group and normal MSM group.ConclusionCompared with normal MSM,MB is the high risk population and bridge population of transmission of HIV.

Objective To investigate the timing of endoscopic treatment for acute cholangitis of severe type(ACST) accompanying multiple organ dysfunction syndrome(MODS).Methods On the basis of routine medical measures,such as oxygen inhalation and antishock treatment,9 patients with ACST accompanying MODS were given endoscopic retrograde cholangiopancreatography(ERCP) with endoscopic sphincterotomy(EST),or endoscopic nasobiliary drainage(ENBD) after needle electrode fenestration and stone removal with basket,or endoscopic retrograde biliary drainage(ERBD) with internal stent.Results The endoscopic treatment was successfully accomplished within 35 min in all the 9 patients.Seven patients at stage 1~2 of MODS rehabilitated at 1~2 weeks after treatment,while 2 patients at stage 3 of MODS died in 2 weeks.Conclusions Endoscopic treatment should be applied to patients with ACST at stage 1~2 of MODS as early as possible.For patients with ACST at stage 3~4 of MODS,however,emphasis should be laid on the prevention of organ failure and the reversion of organ functions.

OBJECTIVE:To observe therapeutic efficacy and safety of Duhuo jisheng decoction combined with glucosamine gulfate for genual osteoarthritis. METHODS:Totally 86 patients with genual osteoarthritis selected from our hospital during Dec. 2015-Apr. 2016 were divided into trial group and control group according to random number table,with 43 cases in each group. Control group was given Glucosamine sulfate tablets 1-2 tablet,po (at mealtime),tid. Trial group was additionally given Duhuo jisheng decoction,one dose a day,decocting 200 mL with water,morning and evening at twice,on the basis of control group. Both groups received treatment for 28 d. Clinical efficacies of 2 groups were observed as well as the levels of hs-CRP,TNF-α, IL-6,MMP-3,MMP-9 and MMP-13. The occurrence of ADR was recorded during treatment. RESULTS:Before treatment,there was no statistical significance in hs-CRP,TNF-α,IL-6,MMP-3,MMP-9 and MMP-13 between 2 groups(P>0.05). After treat-ment,total response rate of trial group(95.3%)was significantly higher than that of control group(76.7%),with statistical signif-icance (P<0.05). The level of hs-CRP in trial group was significantly lowered,and the levels of TNF-α and IL-6,MMP-3,MMP-9,MMP-13 in 2 groups were decreased significantly;above indexes of trial group were significantly lower than those of con-trol group,with statistcal significance(P<0.05). The incidence of ADR in trial group(7.0%)was significantly lower than control group (46.5%),with statistical significance (P<0.05). CONCLUSIONS:Duhuo jisheng decoction combined with glucosamine gulfate shows good therapeutic efficacy for genual osteoarthritis with good safety.

0 05〕 but were significant difference in responsive congestion of the brachial artery between before and after treatment 〔(4 32?0 71)% vs (9 38?4 1)%, P

OBJECTIVE:To establish a method for the determination of4major caffeine metabolites and to discuss the significance of which in the evaluation of the activity of drug-metabolizing enzyme CYP1A2.METHODS:The caffeine metabolites in the urine like5-acetylamino-6-formamido-3-methyluric acid(AFMU),1-methyluric acid(1U),1-methylxanthine(1X)and1,7-dimethyluricacid(17U)were determined by RP-HPLC gradient elution method,the ratios of metabolins(AFMU+1X+1U)/17U was calculated,the frequency distribution histogram was drawn and the activity of CYP1A2was evaluated.RESULTS:The mean value of the ratio of the metabolins in the subjects was4.27,which was in normal distribution.CONCLUSION:The method is simple,accurate and rapid,which is suitable for the determination of caffeine metabolites in urine and the study of the activities of CYP1A2.

Objective To discuss the levels of inhibitory protein Ga-2 (Gαi2) in hippocampus of brain and the effects of Gαi2 on neuronal intracellular Ca2+ level in cerebral ischemia reperfusion injury model of rats.Methods Ninety SD rats were randomly (random number) assigned to sham group (n =30),ischemic-reperfusion (IR) group (n =30),Pertussis toxin (PT) group (n =30).The blood flow of right common carotid artery of rat was blocked for 90 min to make ischemia reperfusion model.The levels of Gαi2 in hippocampus was assayed by immunohistochemistry and Western blotting after ischemia reperfusion for 6,12,24 h in each group.The average fluorescence values of intracellular Ca2+ levels in hippocampus of rats in three groups were detected by using Flow CytoMeter (FCM).Neuronal cell apoptosis was measured by TUNEL.Results After restoration of middle cerebral artery blood flow for different lengths of time,the levels of hippocampus Gαi2 and Ca2+ levels in IR group were significantly higher than those in Sham group (P ＜0.01).The hippocampus Ca2+ levels in PT group were higher than those in IR group (P ＜ 0.01).The apoptotic rates of neurons in PT group were lower than those in IR group (P ＜0.05).Conclusions The level of Gαi2 in cerebral ischemia reperfusion injury model was increased.Gαi2 might reduce the calcium ion concentration of neurons after cerebral ischemia and rcduce the neuronal cell apoptosis in this model.Gαi2 might play a role in protecting neuron from cerebral ischemia reperfusion injury.

The emerging technologies change rapidly in the medical field, refresh the medical ethical scenari-os, brought some medical ethical blind spot.Therefore, building the platform of academic research, making use of the new media, MOOC and“flipped classroom”, inheriting the native“The Spirits of A Great Physician” in tradi-tional Chinese medicine and western medicine, life ethics education and sublation of new exploration, the ideolog-ical and moral education for medical students is expected to be improved in China.

Objective To explore the possibility of using 131I as a targeted therapy method for malignant glioma by infecting U87 and U251 cells with conditionally replicative adenovirus Ad-Tp-E1a-Gp-NIS.Methods Human telomerase reverse transcriptase (hTERT) promoter and glial fibrillary acidic protein (GFAP) promoter were cloned and their transcriptional activities were detected by luciferase assay.The conditionally replicative adenovirus Ad-Tp-E1 a-Gp-NIS was constructed,purified,and transfected into U87 and U251 glioma cells.For these transfected cells,the selective replication ability was evaluated by plaque forming assay,and protein expression was detected by Western blot assay.125I-iodide uptake and exflux,the clonoy formation of 131I-iodide treated cells were also measured.Results Transcriptions activity of the GFAP and hTERT promoters was 59.75％-62.10％ (F =11.89,P ＜ 0.01) in U87 cells and 37.31％-49.00％ (F =5.87,P ＜ 0.05) in U251 cells.The Ad-Tp-E1a-Gp-NIS could be selectively replicated and the hNIS gene was successfully expressed in the hTERT-positive and GFAP-positive glioma cells which showed two protein bands with relative molecular mass of 120 × 103 and 49 × 103 in Western blot assay.After infection with Ad-Tp-E1a-Gp-NIS,the cell ability of 125I uptake was increased by 78.80 (F =2 914.58,P ＜0.01) and 92.48 (F =2 275.91,P ＜0.01) times in U87 and U251 cells,respectively.The GFAP-negative MRC-5 cells could not take in 125I.The in vitro clonogenic assay indicated that,after 131I treatment,more than 90％ of the transfected cells were killed,while only about 65％ (t =11.73-78.33,P ＜ 0.01) of control cells were killed.Conclusions The Ad-Tp-E1a-Gp-NIS has a good ability in selective replication and the enhancement of antitumor therapy effect by increasing tumor-specific iodide uptake in malignant glioma cells.

Objective:To explore the characteristics of Traditional Chinese Medicine (TCM) syndromes in sepsis patients with different blood urea nitrogen (BUN) levels.Methods:From January 2017 to December 2018, 252 sepsis patients, who were admitted in the Department of Intensive Care Unit of the Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine) and met the inclusion criteria, were divided into lower level group (BUN<9.25 mmol/L) and higher level group (BUN≥9.25 mmol/L) according to BUN levels. The baseline data, complications, infection sites and other data were collected. TCM syndromes were judged according to the four diagnostic information of TCM and BUN levels. Variables with P<0.2 in univariate analysis were introduced as candidate variables, and the correlation between TCM syndrome elements and BUN was analyzed by multivariate logistic regression. Results:The comparison of TCM syndromes showed that the proportion of blood stasis syndrome in higher level group was significantly higher than that of the lower level group [74.60% (94/126) vs. 53.17% (67/126), P<0.01)], and the proportion of toxic heat syndrome in the higher level group was significantly lower than that of the lower level group [52.38% (66/126) vs. 65.87% (83/126), P=0.029]. The comparison of TCM deficiency syndromes showed that the proportion of qi deficiency syndrome and yang deficiency syndrome in the higher level group was significantly higher than that of the lower level group [67.46% (85/126) vs. 45.24% (57/126), P<0.01; 11.90% (15/126) vs. 3.97% (5/126), P=0.032, respectively]. Logistic regression analysis showed that the higher blood urea nitrogen level was correlated with the increased incidence of qi deficiency syndrome ( OR=3.425, 95% CI: 1.934-6.068, P<0.01), yang deficiency syndrome ( OR=3.460, 95% CI: 1.160-10.325, P=0.026) and kidney deficiency syndrome ( OR=2.212, 95% CI: 1.173-4.173, P=0.014) in sepsis patients. Conclusion:Sepsis patients with higher blood urea nitrogen level have a higher proportion of blood stasis syndrome, qi deficiency syndrome and yang deficiency syndrome and may be related to the increased incidence of qi deficiency syndrome, yang deficiency syndrome and kidney deficiency syndrome.