Objective To evaluate the diagnostic value of procalcitonin (PCT)in bacteremia.Methods Clinical data of adult pa-tients with suspected bacteremia were retrospectively analyzed for white blood cell counts(WBC),neutrophil absolute (NEU)and PCT levels in blood samples collected at the first time of blood culture.Receiver operating characteristic (ROC)curve was used to evaluate the values of different indexes for the prediction of bacteremia.Results A total of 120 patients were enrolled,including 47 patients (39.2%)with bacteremia and 73 patients (60.8%)without bacteremia.PCT,WBC and NEU levels were significantly higher in bacteremia patients than patients without bacteremia (P<0.01).Area under ROC curve of PCT was 0.836 (95%CI:0.767-0.904),which was significantly higher than WBC (0.676,95%CI:0.676-0.600)and NEU (0.696,95% CI:0.696-0.617).While area under ROC curve of WBC and NEU were no significantly different (P>0.05).Taking 0.43 ng/mL as cutoff value,the negative predictive value of PCT was 94.7%.The best cutoff value of PCT was 2.27 ng/mL,which was associated with sensitivity of 74.47%,specificity of 90.00%,positive predictive value of 83.3% and negative predictive value of 84.0%.Conclusion PCT might be with more clinical value for the prediction of bacteremi than WBC and NEU.

AIM: To optimize the extraction process for Banxiaxiexin Decoction (Rhizoma pinelliae, Radix Scutellariae, Rhizoma coptidis, Radix Ginsenp, Rhizoma zinpiberis, Fruents Jujubae, and Radix Glycyrrhizae). METHODS: The content of berberine、baicalin and total solid in extract liquor were determined by orthogonal design and single factor experiment in combination with glycyrrhizic acid content and identification of Rhizoma zingiberis, Radix Ginseng and Rhizoma Pinelliae. RESULTS: The extracting was arrived at in the condition of adding eighteen times of 70% alcohol as much as crude drug and refluxing 2 times, 2h and 1h, respectively. CONCLUSION: The extraction is stable and feasible.

Asbestos is widely used in all walks of life,but the hazard of asbestos to human is currently a major public health problem all over the world,especially carcinogenicity. Asbestos can cause lung cancer, mesothelioma,throat cancer,digestive system cancer,ovarian cancer and other diseases. In recent years,epi-demiological data and experimental results have confirmed the carcinogenicity of asbestos from multiple perspec-tives.

Objective This paper is aimed to study the effect of endurance training and supplementation of different-dosage L-Arg on skeletal muscle NOS gene expression in rats. Methods We used the reverse transcription polymerase chain reaction technique to measure the NOS gene expression of skeletal muscle in rats. Results Endurance training significantly increase the eNOS (P

Objective To investigate the effect of trichostatin A on the expression of growth arrest and DNA damage-inducible protein 45 alpha (Gadd45α) in,proliferation of and apoptosis in a human epithelial carcinoma cell line A431.Methods Cultured A431 cells were treated with different concentrations (0.05,0.1,0.25,0.5,1 μmogL) of trichostatin A for various durations (6,12,24,48 hours).Subsequently,cell proliferation,cycle and apoptosis were detected by cell counting kit-8 (CCK8) and flow cytometry respectively.The expression of Gadd45eα mRNA and protein in cultured A431 cells was detected by reverse transcription-PCR and Western blot respectively.Results Trichostatin A inhibited the proliferation of A431 cells in a dose (0.05-1.0 μmol/L)-dependent manner at all the 4 time points (F =3554.71,P ＜ 0.05),as well as in a time (6-48 hours)-dependent manner at these tested concentrations (F =1685.18,P ＜ 0.05).A statistical increase was induced in the early apoptosis rate,late apoptosis rate and Gadd45α mRNA expression in A431 cells by the 24 hour-treatment with trichostatin A of 0.1 to 0.5μmol/L.Elevated percentage of cells at G1 phase (26.910％ ± 0.799％,30.406％ ±0.625％,32.896％ ± 0.599％ vs.21.633％ ± 1.144％,F =105.93,P ＜ 0.05) and expression of Gadd45α protein (0.6536 ± 0.2193,0.6990 ± 0.0110,0.9040 ± 0.1971 vs.0.3766 ± 0.0241,F =332.88,P ＜ 0.01) were observed in A431 cells treated with trichostatin A of 0.1,0.25 and 0.5 μmol/L for 24 hours compared with untreated A431 cells.Conclusions Trichostatin A can enhance the mRNA and protein expression of Gadd45α in A431 cells,which may be involved in the suppression of cell proliferation as well as acceleration of apoptosis of A431 cells by trichostatin A.

Objective To evaluate clinical features,predisposing factors,therapeutic regimen and prognosis of non-traumatic rhabdomyolysis.Methods Clinical picture,therapeutic regimen and prognosis were investigated in 39 cases with non-traumatic rhabdomyolysis by retrospective analysis.Results Non-traumatic rhabdomyolysis mostly presented fever,asthenia,myalgia and/or muscular tenderness,swelling of involved muscles,red urine and oliguria or anuria.The complications and comorbidity of rhabdomyolysis included acute renal failure(ARF),disorders of metabolites and electrolytes,compartmental syndrome,infection,and multiple organ dysfunction.Infection(33.3%)was the most common etiology of non-traumatic rhabdomyolysis,followed by drugs(25.6%),metabolite or electrolyte derangements(10.3%)and alcohol intoxication(7.7%)etc.Therapeutic regimen covered treatment of the underlying diseases,volume repletion,alkalization and dealing with the complications.For the patients with established renal failure,renal replacement therapy was essential.Overall mortality was 15.4%,while the mortality in the patients with ARF was 20.7%.If surviving ARF,the patients' renal function promised to be normalized consequently.Conclusion Non-traumatic rhabdomyolysis is a syndrome with a variety of causes,different clinical presentations and versatile combination of complications,which confounds the diagnosis.However,if treated properly and in time,the survivors in all probability will recover from ARF.

Abtract: Acute coronary syndrome is a common clinical and frequently occurring disease, belonging to the chest discomfort, heartache, and true heart pain of TCM category. The clinical observation shows that the heat and blood stasis, and poison damage heart nutrient is one of the important mechanisms of triggering coronary syndrome. Therefore, the method of promoting blood circulation to remove meridian obstruction and the Qing Ying detoxication was established as the basic treatment, and Danshen Tongluo Jiedu Decoction is applied as the main formula. According to the different types of disease and syndrome differentiation, flexible modification can achieve good efficacy. It is expected that these will provide new ideas and methods for clinical treatment of acute coronary syndrome.

Objective To measure the changes in levels of tumor necrosis factor α(TNF-α) secreted by human endothelial cells EC-304 after hematoporphyrin monomethyl ether-photodynamic treatment (HMME-PDT),and to explore the relationship between cytokines and inflammation initiation after management of nevus flammeus with photodynamic therapy.Methods EC-304 cells were cultured in 6-well plates,and classified into 4 groups:HMME-PDT group pretreated with HMME followed by irradiation with laser,HMME control group treated with HMME only,laser control group irradiated with laser only,and blank control group without any treatment.Culture supematants of EC-304 cells were collected from HMME-PDT group at 12,24 and 48 hours after the irradiation,and from the other three groups at the same time points.The supernatant TNF-α level was measured with enzyme linked immunosorbent assay (ELISA).Results The difference was statistically significant in the supernatant TNF-α level between different time points in each group (F=62.276.P<0.01) and between the 4 groups at each time point (F=11.538,P<0.01).Multiple comparison analysis showed that HMME-PDT group differed significantly from the other 3 control groups in the supernatant TNF-αlevel at each time point (all P<0.01),while no significant difierence was observed among the other three control groups at any time point (all P>0.05).Conclusion HMME-PDT promotes the secretion of TNF-α by EC-304 cells.

Objective To explore the clinical features of renal and urinary lesions in IgG4-related disease (IgG4-RD).Methods Clinical manifestation,laboratory profiles,iconography images,pathologic findings,treatment and prognosis of 6 IgG4-RD patients with renal and urinary system involvement from Peking Union Medical College Hospital during Aug 2010 to Dec 2011 were analyzed retrospectively.Results Six patients had renal and/or urinary lesions among IgG4-RD cases diagnosed in our hospital,including 4 males and 2 women,with median age of 59 years (36 to 72 years) and median disease course of 10.5 months.All the patients presented multiple organ involvement simultaneously.Urinary system lesion varied,including renal dysfunction,abdominal pain and edema.Hyperglobulinemia,elevated serum IgG (median 23.3 g/L) and IgG4 (median 4227.0 mg/L),tubular proteinuria were found in all the 6 patients,and elevated Scr (median 237 μmol/L) in 5 cases.Kidney CT image often showed renal swelling,hydronephrosis,multiple low density focus with attenuation and kidney atrophy.Renal pathology revealed interstitial inflammatory cells infiltration comprising predominantly plasma cells and lymphocytes,with a high prevalence of IgG4-positive cells often admixed with fibrosis,which fit the features of tubulointerstitial nephritis.Patients with IgG4-RD nephropathy presented good response to glucocorticoids.After therapy,the symptoms were improved and serum IgG,IgG4 and Scr decreased.Conclusions Renal and urinary lesions of IgG4-RD are heterogeneous in clinical manifestation,and are often complicated with various organ lesions.The feature of renal histopathology is tubulointerstitial nephritis infiltrated by plasma cells and lymphocytes with positive IgG4.Glucocorticoids treatment is effective for this disease.

BACKGROUND:Preliminary experiments have demonstrated that rat liver homogenate supernatants can induce the morphological changes of human umbilical cord mesenchymal stem cells. However, little is known about whether the induced cells have some phenotypic and functional features of hepatocytes.
OBJECTIVE:To investigate whether human umbilical cord mesenchymal stem cells have some phenotypic and functional characteristic of hepatocytes after being induced by liver homogenate supernatants.
METHODS:Passage 3 human umbilical cord mesenchymal stem cells were used and divided into control group (cells were cultured in basic culture medium) and liver homogenate supernatant group (cells were cultured in liver homogenate supernatants for 3, 5, 7 days). Meanwhile, positive control group (QSG-7701 human liver celllines) and negative control group (simple liver homogenate supernatants) were set up. The protein and mRNA level of hepatocyte markers, alpha-fetoprotein, cytokeratin 18 and tryptophan 2,3-dioxygenase enzyme, were detected at different time points.
RESULTS AND CONCLUSION:After inducement, the stem cells of fusiform shape began to lose their sharp edges and progressively shrunk, and then they changed into hepatocyte-like cells with the morphous of triangle, polygon and anomalism shape. Compared with the control group, the protein and mRNA level of alpha-fetoprotein, cytokeratin 18 and tryptophan 2,3-dioxygenase enzyme significantly increased time dependently after inducement with liver homogenate supernatants (P<0.01). This study demonstrated that human umbilical cord mesenchymal stem cells are able to differentiate into hepatocyte-like cells in vitro that possess some functions of liver cells.