Objective To evaluate the role of procalcitonin (PCT)in the early diagnosis for hand,foot and mouth disease (HFMD)with bacterial infection.Methods Clinical data of 234 HFMD children who were hospitalized be-tween January and July 2012 were analyzed retrospectively,according to discharge diagnosis,data were divided into simple viral infection group (n=178)and viral associated with bacterial infection group (n=56),and data of 20 healthy children were selected as the control group.Serum PCT,C-reactive protein (CRP)and peripheral white blood cell (WBC)count were compared.Results There was significant difference in the level of PCT,CRP and WBC among three groups (F=381.94,24.18,and 26.46,respectively,all P<0.05).The positive rate of PCT,CRP and WBC among three groups was significantly different(χ2=178.25,38.98,and 71.21,all P<0.05),PCT,CRP and WBC in bacterial infection group(92.86%[52/56],85.71%[48/56],and 87.50%[49/56]respectively)were significantly higher than those of simple viral infection group (3.93%[7/178],62.36%[111/178],and 30.90%[55/178]respectively)and healthy control group (5.00%[1/20],10.00%[2/20],and 5.00%[1/20]respectively).The sensitivity rate of PCT,CRP and WBC was 92.86%,85.71%,and 87.50% respectively,specificity rate was 95.00%,90.00%,and 95.00% respectively.Conclusion The level of PCT has important value for the early diagno-sis of HFMD with bacterial infection,and its accuracy rate and sensitivity are better than CRP and WBC levels.

Objective To develop the contents of Family Type Integration of Medical Care and Health Services in Hangzhou based on the Guiding Opinion on Promoting Integration of Medical Care and Pension issued by the State Council,Promotion Measures of Integration of Medical Care and Health Services in Hangzhou issued by the municipal government,and needs of health services for the elderly living in community.Methods The draft was formulated based on literature review,semi-structured interviews and expert meeting.Then,Delphi technique was used to identify the indicators through two rounds of expert consultation among 16 experts.Results The experts' authority coefficient was 0.790,the coefficient of determination was 0.906,and the familiar coefficient was 0.675.The contents of the Family Type Integration of Medical Care and Health Services in Hangzhou consisted of 8 firstlevel indicators,47 second-level indicators.The coordination coefficients of indicators were 0.341,0.222,and 0.426.Coordination of experts opinion had statistical significance (P＜0.01).Conclusion The contents of the Family Type Integration of Medical Care and Health Services in Hangzhou is reliable and scientific,which can be used as a basis for the formulation of items of the family type integration of medical care and health services in Hangzhou.

Objective To evaluate left ventricular systolic synchronicity in patients with dilated cardiomyopathy by V-plane imaging and compare with clinical commonly used tissue Doppler imaging (TDI),evaluate the relevance and consistency between these two parameters.Methods 20 patients diagnosed with DCM and 20 healthy controls were enrolled,2D images,V-plane imaging and TDI waveform were acquired.Time to peak velocity of left ventricular 12 segments were measured by TDI and the standard deviation (TDI_SD) were calculated.Displacement time to peak were measured by V-plane and the standard deviation (V-plane_SD) were calculated.Results Compared with control group,TDI_SD and V-plane_SD increased significantly (P ＜ 0.01),TDI time to peak increased and V-plane time to peak decreased significantly(P ＜0.01).In the two group,12 segment time to peak measured by V-plane were significantly higher than TDI(P ＜ 0.01).There was a significant correlation between TDI_SD and V-plane_SD (r =0.925,P ＜0.001).Bland-Altman plot showed that 95％ plots of ratio of TDI_SD and V-plane_SD were among limits of agreement,which was (0.50,1.36).Conclusions Left ventricular systolic synchronicity in DCM patients can be observed by V-plane imaging.V-plane has significant relevance and consistency with TDI,and can overcome the limitations of TDI that 12 segments can not be displayed in the same cardiac cycle.

Objective To evaluate immunogenicity of the recombinant protein GST-p55/570 of Pneumocystis carinii.Methods The fusion protein GST-p55/570 was expressed from the prokaryotic expression plasmid pGEX-570,and purified by using glutathione-agarose.The expressed product was analyzed by SDS-PAGE.Thirty-three mice were randomly divided into three groups,immunized with GST-p55/570,GST and PBS,respectively.Each group was immunized for four times at 2 week intervals.At the 7th day after final immunization,spleen was removed to obtain single cell suspension.Proliferation ability of lymphocytes was determined by MTT.Serum samples were collected at pre-immunizaton and two weeks after each immunization.Antibody level in sera of mice was determined by ELISA.The immune response to the recombinant GST-p55/570 recognized by sera of immunized mice was examined by Western blotting.Results The expressed fusion protein GST-p55/570 showed a Mr 47 000.Compared with GST group(1.134 5?0.073 5) or PBS group(1.124 8?0.041 6),a higher stimulation index(2.063 0?0.160 2) was revealed in GST-p55/570-immunized mice(P

To construct the eukaryotic expression plasmid containing the p55 gene fragment of Pneumocystis and to investigate the efficient expression in COS-7 cells, the gene fragment conaining the whole length of p55 gene was used as template to amplify this fragment with PCR and the amplified fragment was then cloned to vector pGEM-T. After enzyme digestion, p55 gene was cloned to the eukaryotic expression vector pcDNA3.1(+) to construct the plasmid pcDNA3.1(+)-582. This plasmid was then transfected to the eukaryotic expression cells COS-7 and PCR and SDS-PAGE assays were used to confirm the presence of target protein in these cells. In these ways, the eukaryotic expression vector for the p55 gene of Pneumocystis of rats was successfully constructed and expressed in COS-7 cells, thus providing the basis for further studies on the nucleic acid vaccine.

To develop a method for the determination of 18 elements such as Pb, Cu, As, Hg, Mn, Ni, & Tl in Panax notoginseng,Bulbus fritillariae thunbergii,Coix seed, Resina draconis, and to control the contents of heavy metal elements in Sanjie Zhentong Capsule, the samples were digested by microwaves and then analyzed by appropriate determination parameters through ICP-MS, with the internal standard method to improve the matrix effect and interference. The correlation coefficientR2≥ 0.999 2. The lowest limits of quantification were from 0.002 8 to 0.54 μg·L-1. The experiments had better repeatability, while the recovery values ranged from 73.01% to 109.13%. The method is simple, accurate and high sensitive, and it can be used for the determination of rapid monitoring the multi-elements inPanax notoginseng, Bulbus fritillariae thunbergii, Coix seed,and Resina draconis.

Objective: To investigate the effectiveness and adverse effects of Cyberknife stereotactic body radiotherapy (SBRT) on liver metastases from PCa. METHODS: From June 2009 to September 2016, we treated 20 cases of PCa liver metastases by Cyberknife SBRT, at a total dose of 36 (30－50) Gy, on 1－3 liver metastatic lesions, for 3－5 times, with a prescription isodose line of 70－92%. We assessed the therapeutic effect according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST), calculated the survival and disease-control rates using the Kaplan-Meier method, and analyzed the adverse events based on the National Cancer Institute Common Terminology Criteria for Adverse Events－Version 4.0 (CTCAE 4.0). RESULTS: Of all the cases treated, complete response (CR) was found in 8 (40.0%), partial response (PR) in 9 (45.0%), stable disease (SD) in 2 (10.0%), and progressive disease (PD) in 1 (5.0%), with a local control rate (CR+PR) of 85.0% and a disease-control rate (CR+PR+SD) of 95.0%. Among the 14 patients with elevated PSA, 10 (71.4%) showed a significant decrease after treatment. The median follow-up time was 17 months, the 1- and 2-year survival rates were 85.0% and 15.0%, respectively, and the median survival time of the 20 patients was 16.5 months (95% CI: 12.12－22.88). Cyberknife SBRT was well tolerated in all the patients, with only a few mild adverse events (mainly grades 1 and 2 but no 4 and 5) during the whole course of treatment. CONCLUSIONS Cyberknife SBRT is safe and effective in the treatment of PCa liver metastases, with a high local control rate, and capable of reducing the PSA level and raising the long-term survival rate of the patients.

Recently,with the further understanding of infected pancreatic necrosis(IPN),pancreatologists have reached consensuses on that the presence of gas on CT imaging could be the golden standard diagnosis for IPN,the intervention timing for IPN should be delayed to four weeks later,and the step-up approach acts as the first standard treatment strategy for IPN.Whereas in clinical practice,there are substantial new challenges awaiting our solutions,for instance,the lack of accurate and specific diagnostic criteria for IPN without typical gas sign on CT imaging,whether the intervention of wall-off necrosis(WON)which got infected prematurely should be delayed to four weeks later?What's more,whether the endoscopy centered step-up approach is superior to the surgical step-up approach?Is it time to abandon open surgery in IPN management?If not,when should we switch to open necrosectomy?All of these questions are still full of controversies.

OBJECTIVETo investigate the potential molecular mechanism underlying down-regulation of albumin expression induced by lipopolysaccharide (LPS) in rat hepatocytes.

METHODSThe albumin mRNA expression and albumin protein levels in the supernatant were observed at 0, 2, 8, 12 and 24 hours after 1 micro g/ml LPS treatment. The albumin mRNA expression was determined by RT-PCR, and albumin protein levels were assayed with EIA in the supernatant of hepatocytes pretreated with specific inhibitors of extracellular signal-regulated kinase (PD98059) and p38 kinase (SB203580).

RESULTSThe albumin mRNA expression was reduced to 70% of baseline value, meanwhile, the albumin protein concentration in the supernatant was reduced by 50% compared with the controls after 24 hours of LPS treatment. Pretreatment with PD98059 and SB203580 did significantly inhibit the reduction of albumin by LPS at the given dose.

CONCLUSIONThe results indicate that LPS can induce the reduction of albumin synthesis by down-regulation of albumin mRNA expression at transcription level, and the process may be related to the signal transducation of extracellular signal-regulated kinase and p38 kinase.

Albumins ; genetics ; metabolism ; Animals ; Calcium-Calmodulin-Dependent Protein Kinases ; antagonists & inhibitors ; Dose-Response Relationship, Drug ; Down-Regulation ; Enzyme Inhibitors ; pharmacology ; Enzyme-Linked Immunosorbent Assay ; Flavonoids ; pharmacology ; Hepatocytes ; drug effects ; metabolism ; Imidazoles ; pharmacology ; Lipopolysaccharides ; toxicity ; Male ; Mitogen-Activated Protein Kinases ; antagonists & inhibitors ; Pyridines ; pharmacology ; RNA, Messenger ; genetics ; metabolism ; Rats ; Reverse Transcriptase Polymerase Chain Reaction ; Time Factors ; p38 Mitogen-Activated Protein Kinases

OBJECTIVETo investigate the clinicopathologic features, immunohistochemic phenotypes and genetic alterations of extrapulmonary inflammatory myofibroblastic tumor (IMT) and the correlation with prognosis.

METHODSThirty cases of IMT with follow-up were analyzed morphologically and immunohistochemically. ALK FISH was also performed to determine the ALK gene status.

RESULTSPatients ranged in age from 12 to 73 years (mean 43.4 years). The male-to-female ratio was 1.0: 1.1. The tumors were located in various anatomical sites including gastrointestinal tract, liver, spleen, kidney, pelvic, retroperitoneum, mediastinum etc. Histologically, the majority of cases were composed of spindled fibroblastic and myofibroblastic cells accompanied by an inflammatory infiltrate of plasma cells, lymphocytes, and eosinophils. Most cases with aggressive behavior had features including prominent nucleoli and edematous myxoid background. Lymphohistiocytic reactions were usually absent. Some cases showed multinucleation, nuclear pleomorphism and mitoses. One case demonstrated epithelioid morphology with round-to-epithelioid cells. The immunohistochemical study showed vimentin, SMA, CK, desmin, and ALK were expressed in 100% (30/30), 70% (21/30), 13% (4/30), 27% (8/30), and 27% (8/30) of IMT, respectively. Diffuse cytoplasmic ALK staining was detected in seven cases. One case (containing round-to-epithelioid cells) demonstrated ALK nuclear membrane staining, coupled with positive reaction for CD30 and negative reaction for LCA. EMA, CD34, CD117 and S-100 protein, and MyoD1 were negative for all cases. Six ALK protein positive cases harbored ALK gene rearrangement, but not the remaining 22 cases. Follow-up data were available in 21 patients. After initial resection, 14 patients were alive with no evidence of disease, while 4 patients were alive with tumor recurrence and 3 patients died of the disease.

CONCLUSIONSMost IMT with aggressive behavior have features including prominent nucleoli, edematous myxoid background, and positive expression of ALK. Lymphohistiocytic reaction is usually absent. ALK may be a potential novel therapeutic target for IMT.

Adolescent ; Adult ; Aged ; Child ; Female ; Fibroblasts ; pathology ; Granuloma, Plasma Cell ; genetics ; pathology ; Humans ; Inflammation ; pathology ; Male ; Middle Aged ; Myofibroblasts ; pathology ; Prognosis ; Receptor Protein-Tyrosine Kinases ; genetics ; Young Adult