Objective To study the correlation between blood lactic acid level and PCIS scroing system.To study the relationship between dynamic lactic acid monitoring indexes and prognosis of critical patients.Methods Differences of mortality,incidence of MODS and shock,PCIS score between two groups were compared.The patients were divided into 3 groups by PCIS score to compare pathogenetic conditions prognosis, then to study the were divided into death group and survival group by the hospital prognosis. Differences of their lactic indexes and other clinical indicators which reflected organ/system status were compared, prognostic-significant lactic indexes were selected by mu fti-variable logistic analysis. Results Patients with elevated lactic acid level had more incidence of shock and MODS, higher PCIS scores and higher mortality, the differences had statistical significance compared with the normal lactic acid group. There were significant linear correlation between ICU lactic acid level, peak lactic acid level and PCIS scores respectively. For the patients with elevated lactic acid level, peak lactic acid level, 12h lactic clearance had significant correlation with prognosis. Conclusion PCIS scoring system had a significant linear correlation with lactic acid level. For the patients with elevated lactic acid level,peak lactic acid level,12h lactic clearance were good indicators to evaluate patients' prognosis.

Objective:To discuss the effect and significance of reasonable medication review mode for intravenous medical advice on the platform of pharmacy intravenous admixture service( PIVAS) . Methods:The effect of prescription review interference in intrave-nous drugs on the platform of PIVAS was studied through analyzing irrational prescriptions before and after the performance of PIVAS for 25 departments in our hospital. Results:The real-time review and interference procedure for intravenous transfusion was established, which could significantly increase the percentage of reviewed medical advice and the correction rate of irrational medical advice, and re-duce the percentage of irrational medical advice. The medical advice review quality was also increased, which could guarantee the med-ication safety in patients. Conclusion:The real-time review and interference procedure for intravenous transfusion on the platform of PIVAS can significantly improve the rational medication level of intravenous drugs and avoid the hidden danger of irrational medical ad-vice to the maximum extent to ensure the medication safety in patients, which is also beneficial to the provision of medication service and new platform establishment for the development of clinical pharmacy in hospitals.

OBJECTIVE:To compare the clinical efficacy and safety of salmeterol-fluticasone alone versus fluticasone propio-nate combined with montelukast sodium in the treatment of children with moderate persistent asthma. METHODS:275 children with moderate persistent asthma were randomly divided into inhaled corticosteroids(ICS)+ long acting β2 receptor agonist(LABA) group (139 cases) and ICS+ leukotriene receptor antagonists (LTRA) group (136 cases). ICS+LABA group was given Salmeter-ol-fluticasone powder inhalant,1 inhalation,bid;ICS+LTRA was given Fluticasone propionate inhalation aerosol,bid+Montelu-kast sodium chewable tablet 5 mg,before bedtime,qd. Both groups received more than 12 weeks of treatment. Body indexes of 2 groups were observed after treatment,such as asthma control degree,asthma score,the percentage of peak expiratory flow(PEF) in estimated value,aberration rate of PEF,the levels of eosinophi cationic protein(ECP)and leukotrienes E4(LTE4)in peripheral blood,the times of taking short acting β2 receptor agonist (SABA) during treatment,asymptomatic days,compliance,the inci-dence of ADR,etc. RESULTS:Total effective rate of ICS+LABA group(86.33%)after 4 weeks treatment was higher than that of ICS+LTRA group(58.09%),with statistical significance(P<0.05);that of ICS+LABA(99.28%)after 12 weeks treatment was higher than that of ICS+LTRA group (98.53%),without statistical significance (P>0.05). The day and night asthma score of 2 groups decreased significantly and the percentage of PEF in estimated value increased significantly after treatment,there was statisti-cal significance compared to before treatment(P<0.05). There was no statistical significance in above indexes between 2 groups af-ter treatment(P>0.05). The levels of ECP and LTE4 decreased significantly in 2 groups after treatment,there was statistical signif-icance compared to before treatment(P<0.05);those of ICS+LTRA group decreased significantly compared to ICS+LABA group, there was statistical significance between 2 groups(P<0.05). There was no statistical significance in the aberration rate of PEF af-ter treatment,the times of taking SABA,asymptomatic days,compliance and the incidence of ADR between 2 groups during treat-ment(P>0.05). CONCLUSIONS:Salmeterol-fluticasone alone versus fluticasone propionate combined with montelukast sodi-um in the treatment of children with moderate persistent asth-ma both have good therapeutic efficacy and safety,while thelatter one has stronger inhibition effect on ECP and LTE4,and to control asthma symptoms more rapidly.

Objective To study the expressions and clinical significances of activating transcription factor 3 (ATF3) and Runt-related transcription factor 2 (Runx2) in breast carcinoma tissues.Methods The expressions of ATF3 and Runx2 were detected in 105 cases of primary breast invasive ductal carcinoma (IDC) and their matched para-tumor breast tissues by immunohistochemistry.The relationships between the two transcription factors and the clinical pathological features of IDC patients were analyzed.Results The positive expression rates of ATF3 and Runx2 in IDC group were 80.95％ (85/105) and 69.52％ (73/105) respectively,much higher than those in para-tumor breast tissues 11.43 ％ (12/105) and 8.57％ (9/105),with statistically significant differences (x2 =102.097,P =0.000;x2 =11.595,P =0.001).ATF3 and Runx2 expressions showed significant relationships with histological grade (x2 =14.623,P =0.001;x2 =24.891,P =0.000),lymph node metastasis (x2 =7.059,P =0.008;x2 =6.358,P =0.012) and pTNM stage of IDC (x2 =5.807,P =0.016;x2 =4.902,P =0.027),while both were not correlated with patients' age (x2 =0.274,P =0.601;x2 =1.554,P =0.213) and tumor size (x2 =2.476,P =0.290;x2 =5.261,P =0.072).There was a significant positive relationship between ATF3 and Runx2 in breast carcinoma (C =0.498,P =0.000).Conclusion The over-expressions of ATF3 and Runx2 may participate in the tumorigenesis,invasion,metastasis and clinical stage of breast carcinoma,which suggests that they may be key factors to evaluate malignant degree and prognosis of breast carcinoma.

BACKGROUND:Spine minimaly invasive technique through foraminal mirror is the method to treat lumbar disc herniation with minimal wound. This technique can be conducted under local anesthesia, and does not need to resect the smal joint or destroy the vertebral plate, and has smal damage to the spine. OBJECTIVE: To explore the short-period effects of transforaminal endoscopic spine system for adjacent-segment degenerative changes-caused low back pain after lumbar fixation and fusion. METHODS:A total of 31 patients with degenerative changes after posterior lumbar bone graft fusion fixation, who required secondary surgery, were enroled in this study, including 23 males and 8 females, at the age of 45-81 years old. The postoperative time was 1.1-5.7 years. There were 3 cases of L3-4 single segment, 15 cases of L4-5 single segment, 8 cases of L5S1 single segment, and 5 cases of multi-segment. These patients were treated with transforaminal endoscopic spine system, and folowed up for 6 months. Visual Analogue Scale score and lumbar function Japanese Orthopedic Association score were observed. RESULTS AND CONCLUSION: Lumbar and leg pain symptoms were relieved noticeably during the operation. The patient could walk immediately after the surgery, and the postoperative recovery was quite satisfactory. Visual Analogue Scale score was lower immediately, 1, 3 and 6 months after treatment compared with pre-treatment. Lumbar function Japanese Orthopedic Association score was higher immediately, 1, 3 and 6 months after treatment compared with pre-treatment. Results verify that transforaminal endoscopic spine system for degenerative changes after posterior lumbar bone graft fusion fixation has some advantages such as high safety, short operation time, less hemorrhage, less complications, rapid restoration and easily accepted by patients.

Objective To evaluate the effect of sevoflurane postconditioning on microRNA-133a (miR-133a) expression during myocardial ischemia-reperfusion (I/R) in mice.Methods Thirty adult male C57 mice,weighing 20-30 g,were randomized to 3 groups (n =10 each) using a random number table:control group (group C),I/R group,and sevoflurane postconditioning group (group SP).In I/R and SP groups,hearts from adult male C57 mice were exposed and subjected to 30 min of ischemia and 180 min of reperfusion in anesthetized mice according to the method described by Das et al.In group C,only thoracotomy was performed without ligation of the coronary artery.In group SP,2.4％ sevoflurane was inhaled for 5 min starting from the onset of reperfusion to perform sevoflurane postconditioning.At 180 min of reperfusion,blood samples from the femoral vein were collected for determination of serum lactic dehydrogenase (LDH) and creatine kinase (CK) activities using the colorimetric method.The mice were then sacrificed,and myocardial specimens were obtained for determination of myocardial infarct size,miR133a and caspase-9 mRNA expression (by real-time reverse transcriptase polymerase chain reaction),and caspase-9 expression (by Western blot).Results Compared with group C,the serum LDH and CK activities and myocardial infarct size were significantly increased in I/R and SP groups,the expression of miR-133a was significantly down-regulated,and the expression of caspase-9 protein and mRNA was significantly up-regulated in group I/R,and the expression of miR-133a and caspase-9 protein and mRNA was significantly up-regulated in group SP (P＜0.05).Compared with group I/R,the serum LDH and.CK activities and myocardial infarct size were significantly decreased,the expression of miR-133a was significantly up-regulated,and the expression of caspase-9 protein and mRNA was significantly downregulated in group SP (P＜0.05).Conclusion The mechanism by which sevoflurane postconditioning inhibits cell apoptosis during myocardial I/R is related to up-regulation of miR-133a expression in mice.

Objective To investigate the effect and possible mechanism of bone marrow stem cell mobilized by stem cell factor (SCF) with granulocyte colony-stimulating factor(G-CSF)on renal peritubular capillary, fibrosis and renal function in unilateral ureteral obstruction (UUO) rats. Methods One hundred and twenty eight healthy male Wistar rats were randomly divided into four groups: Sham group, SCF-G group, UUO group and UUO+SCF-G group. Eight rats of each group were randomly selected and killed on the 5th, 14th, 21st and 28th day. Serum creatinine, CD34 positive cells and factor Ⅷ positive cells in renal interstitium, histopathologic lesion scores of interstitial fibrosis and interstitial pathology in kidney were measured. The mRNA expression of vascular endothelial growth factor (VEGF). and thrombospondin-1 (TSP-1) in the renal cortex was detected. Results (1) The renal interstitial fibrosis anti the loss of peritubular capillary were observed in UUO group after two weeks. (2) The number of bone marrow stem cells homing to renal interstitium in UUO +SCF-G group was significantly higher than that in UUO and Sham groups (P<0.05). (3) The loss of peritubular capillary in UUO+SCF-G group appeared later than that in UUO group (P<0.05). (4) The interstitial fibrosis and tubule injury was milder in UUO+SCF-G group than that in UUO group (P<0.05). (5) The decrease of VEGF mRNA expression of renal cortex in UUO +SCF-G group was seen later than that in UUO group. VEGF mRNA expression in UUO+SCF-G group was higher than that in UUO group. (6) The increase of TSP-1 mRNA expression of renal cortex in UUO+SCF-G group was seen later than that in UUO group. TSP-1 mRNA expression in UUO+SCF-G group was lower than that in UUO group (P<0.05). (7) In UUO and UUO+SCF-G groups, peritubular capillary index was negatively correlated with serum creatinine, interstitial fibrosis and interstitial lesion scores. VEGF mRNA expression of renal cortex was positively correlated with peritubular capillary index, and TSP-1 mRNA expression of renal cortex was positively correlated with peritubular capillary index. Conclusions (1)The loss of peritubular capillary is found in UUO group, and is correlated with interstitial fibrosis and interstitial lesion. (2) Application of SCF with G-CSF can effectively motivate stem cells to injured renal tissue, contribute to decrease the loss of peritubular capillary, lessen interstitial fibrosis and interstitial lesion, and ameliorate renal function. (3) Application of SCF with G-CSF can up-regulate VEGF mRNA expression and down-regulate TSP-1 mRNA expression, which may contribute to promote the repair of endothelial cells and protect peritubular capillary.

With the development of high-throughput sequencing technology, non-invasive prenatal testing (NIPT) has been rapidly used for fetal chromosomal aneuploidy screening and gradually become a first-line test. With the increase of sequencing depth and improvement of bioinformatic analysis ability, NIPT technology may also be used to detect chromosomal copy number variations and certain single gene diseases in fetuses. However, it has also encountered some problems such as insufficient understanding by different groups, false-positive and false-negative results, and selection of appropriate subjects and gestational age. This article has given a summary for such problems.

Objective To observe the effects of Curcumin on the cellular apoptosis of rat retinal vascular endothelial cells (RRVEC) induced by high glucose. Methods Generation 4 cultured RRVEC were used in this experiment, and identified with anti-vWF factor antibody by immunochemistry and immunofluorescence. The RRVEC were divided into control group (5.5 mmol/L glucose), high glucose group (30 mmol/L glucose), and treatment group (30 mmol/L glucose+30 μmol/L Curcumin), respectively. Flow cytometry was used to measure the cellular reactive oxygen species (ROS) level and apoptosis. The expression intensity and location of nuclear factor (NF)-κB p65 in the cells of the three groups were detected by immunochemistory. The expression of Bcl-2 and Bax protein was detected by Western blot test. Results Immunostaining showed that RRVEC were positive for vWF factor. The flow cytometry showed that the cellular ROS level in treatment group was higher than that in the control group (t=8.677, P=0.000), but less than that in the high glucose group (t=40.957, P=0.000). Compared with the high glucose group, the cellular ROS level in the treatment group was decreased significantly (t=6.568, P=0.000). The cellular apoptosis were significantly different among the three groups (F=325.137, P=0.000). Compared with the high glucose group, the cellular apoptosis in the treatment group was decreased significantly (t=12.818, P=0.000). Immunochemistry showed that NF-κB p65 was expressed strongly in the cellular nuclei and cytoplasm in the high glucose group than that in the control group and the treatment group with the significant differences (t=8.322, P=0.000). Western blot results demonstrated that compared with the control group, the expression of Bcl-2 of RRVEC and Bcl-2/Bax ratio decreased (t=4.362, 6.449; P=0.005, 0.001) and Bax increased (t=3.813, P=0.009)in the high glucose group, with statistically significant differences. Compared with the high glucose group, the expression of NF-κB and Bax decreased (t=2.577, 3.059; P=0.042, 0.022) and Bcl-2/Bax ratio increased significantly (t=3.831, P=0.009) in the treatment group. Conclusion Curcumin could suppress the cellular apoptosis of RRVEC induced by high glucose. The mechanism of Curcumin protecting RRVEC may be via regulating NF-κB signal pathway.

Objective To investigate the effect of NAIF1 in gastric cancer cell lines MKN45. Methods We constructed pLVX-Tight-Flag-NAIF1-puro plasmid with Tet-on system. DOX was added to induce NAIF1 expression in MKN45 cells. The cells were collected at 0, 6, 12 and 24 hours after DOX addition for gene expression microarray detection and biological analysis of differentially expressed genes. qRT-PCR and Western blot were used to verify the changes in mRNA and protein levels of the selected target differential genes. Results The biological analysis of gene microarray hybridization results showed that IFIT1, IFIT2 and IFIT3 expression significantly increased at 24h, qRT-PCR also showed this change, and Western blot further verified the change in protein level. However, IFIT5 showed no significant change in mRNA and gene expression. Conclusion Over-expression of NAIF1 in gastric cancer cells can promote the expression of some immune system-related IFIT family proteins.