Objective:To explore the clinical significance of the combined detection of Clara cell secretory protein 16 (CC16) and soluble receptor for advanced glycation end product (sRAGE) in the diagnosis and prognosis of acute respiratory distress syndrome (ARDS).Methods:100 ARDS patients admitted to the intensive care unit (ICU) of Chu Hsien-I Memorial Hospital of Tianjin Medical University from July 2019 to September 2020 were enrolled as the ARDS group, and 100 non-ARDS patients admitted to the ICU during the same period were enrolled as the control group. The general information, vital signs, blood gas analysis, serum CC16 and sRAGE levels, duration of mechanical ventilation, length of ICU stay and prognosis during hospitalization were collected. The receiver operating characteristic (ROC) curve was drawn and the area under ROC curve (AUC) was calculated to evaluate the clinical value of CC16 and sRAGE lonely or combination in the diagnosis and prognosis of ARDS.Results:The duration of mechanical ventilation in the ARDS group was significantly longer than that in the non-ARDS group (days: 15.44±3.04 vs. 12.61±3.73, P < 0.01), and the hospitalization mortality was higher (38.0% vs. 9.0%, P < 0.01), but there was no significant difference in gender, age, body mass index (BMI), acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score or the length of ICU stay between the two groups. There were 62 ARDS patients survived and 38 ARDS patients died during hospitalization. The APACHEⅡ score of the death group was significantly higher than that of the survival group (23.55±2.83 vs. 19.40±4.10, P < 0.01), but there was no significant difference in age, BMI, oxygenation index, mean arterial pressure, duration of mechanical ventilation or the length of ICU stay between the two groups. The serum levels of CC16 and sRAGE in the ARDS group were significantly higher than those in the non-ARDS group [CC16 (mg/L): 38.78±14.70 vs. 21.87±2.45, sRAGE (pg/L): 2 470.95±288.70 vs. 2 013.22±131.15, both P < 0.01]; and the serum levels of CC16 and sRAGE of ARDS patients in the death group were significantly higher than those in the survival group [CC16 (mg/L): 42.02±10.81 vs. 30.52±9.47, sRAGE (pg/L): 2 638.34±324.07 vs. 2 279.91±163.70, both P < 0.01]. ROC curve showed that the AUC of CC16 and sRAGE in the diagnosis of ARDS alone were 0.859 [95% confidence interval (95% CI) was 0.808-0.911] and 0.821 (95% CI was 0.762-0.879), and the best cut-off values were 25.76 mg/L and 2 203.00 pg/L, respectively; the AUC of combined detection of CC16 and sRAGE was 0.932 (95% CI was 0.900-0.965) with the sensitivity of 89.0% and the specificity of 87.6%. The AUC of CC16 and sRAGE in predicting the death of patients with ARDS during hospitalization were 0.747 (95% CI was 0.651-0.843) and 0.819 (95% CI was 0.737-0.902), and the best cut-off values were 32.95 mg/L and 2 554.50 pg/L, respectively; the AUC of combined detection of CC16 and sRAGE was 0.900 (95% CI was 0.828-0.972) with the sensitivity of 88.7% and the specificity of 84.5%. Conclusions:Serum CC16 and sRAGE have clinical value for the diagnosis and prognosis of ARDS. The combined detection of them is superior to individual detection for early prediction of ARDS and prognosis.

Systemic lupus erythematosus(SLE) is an autoimmune connective-tissue disorder with a wide range of clinical features.Although the clinical symptoms and immunological findings of pediatric SLE are similar to those of adult SLE patients,the pediatric SLE has some special aspects.In the recent years,although there was no abrupt development in the diagnosis and treatment of SLE,there were some new findings,maybe not mature.On the basis of recent findings outsides,this study drew attention to the advances in the novel clinical manifestation,update treatment of pediatric SLE.

Objective To analyze the risk factors and distribution of pathogenic bacteria of urinary tract infection (UTI) patients with spi-nal cord injury (SCI). Methods A total of 452 patients with SCI collected from December, 2015 to June, 2016 were retrospectively analyzed. Results 104 cases (23.1%) were diagnosed as UTI. 119 strains were identified, including 96 strains of Gram-negative bacteria (80.7%) and 22 strains of Gram-positive bacteria (19.3%). Female, invasive operation, depressed lower limb muscle strength, neurogenic bladder and pre-vention of antibacterial agents use were considered to be the main risk infection factors. The invasive operation included indwelling urethral catheterization, intermittent catheterization and other transurethral operation. The incidence rate of UTI in patients with SCI who also accept-ed indwelling catheter was 100.0%. Conclusion Gram-negative bacteria is the dominated pathogenic bacteria in SCI patients with UTI. It should be noticed the characteristics of pathogen, which both may have the high drug resistance rate and high separation rate, to select exact-ly antimicrobial agents to control the spread and drug resistance of pathogenic bacteria. In addition, patients with underlying diseases, inva-sive operation and lower strength should be monitored targeted.

High-mobility group box 1 ( HMGB1 ) is a conserva-tive nuclear protein and plays an essential role in maintaining nu-cleosome stability, DNA recombination, replication, repair and transcription. It can be passively released by necrotic cells or ac-tively secreted into extracellular under appropriate stimulus. Re-cent studies show that the activation of HMGB1 signaling is closely related to the progress of lung diseases including lung in-jury, pulmonary fibrosis and lung cancer, while blocking HMGB1 signaling inhibits the pathological process, indicating the therapeutic potential of HMGB1 inhibition in treating these diseases. This review summarizes the role and mechanisms of HMGB1 in such diseases, in order to provide novel evidence for the diagnosis and treatment.

Cell Line, Tumor ; Humans ; Leukemia-Lymphoma, Adult T-Cell ; metabolism ; NF-kappa B ; metabolism ; Proto-Oncogene Proteins ; metabolism ; Transcription Factors ; metabolism

To study the antiarrhythmic effect of the newly developed alpha/beta-blocker TJ0711, a variety of animal models of arrhythmia were induced by CaCl2, ouabain and ischemia/reperfusion. Glass microelectrode technique was used to observe action potentials of right ventricular papillary muscle of guinea pig. The onset time of arrhythmia induced by CaCl2 was significantly prolonged by TJ0711 at 0.75, 1.5 and 3 mg x kg(-1) doses. TJ0711 (1.5 and 3 mg x kg(-1)) can significantly shorten the ventricular tachycardia (VT) and ventricular fibrillation (VF) duration, the incidence of VF and mortality were significantly reduced. On ischemia-reperfusion-induced arrhythmic model, TJ0711 (0.25, 0.5, 1 and 2 mg x kg(-1)) can significantly reduce the ventricular premature contraction (PVC), VT, VF incidence, mortality, arrhythmia score with a dose-dependent manner. At the same time, rats serum lactate dehydrogenase (LDH) and creatine kinase (CK) activities decreased significantly by TJ0711 (1 and 2 mg x kg(-1)). Ouabain could cause arrhythmia in guinea pigs, when TJ0711 (0.375, 0.75, 1.5 and 3 mg x kg(-1)) was given, the doses of ouabain inducing a variety of arrhythmia PVC, VT, VF, cardiac arrest (CA) were significantly increased with a dose-dependent manner. In the TJ0711 0.1-30 micromol x L(-1) concentration range, guinea pig right ventricular papillary muscle action potential RP (rest potential), APA (action potential amplitude) and V(max) (maximum velocity of depolarization) were not significantly affected. APD20, APD50 and APD90 had a shortening trend but no statistical difference with the increase of TJ0711 concentration. TJ0711 has antiarrhythmic effect on the sympathetic nerve excitement and myocardial cell high calcium animal arrhythmia model. Myocardial action potential zero phase conduction velocity and resting membrane potential were not inhibited by TJ0711. APD20, APD50 and APD90 were shortened by TJ0711 at high concentration. Its antiarrhythmic action mechanism may be besides the action of blocking beta1 receptor, may also have a strong selective blocking action on alpha1 receptor and reducing intracellular calcium concentration.

Objective To investigate effects of maintenance hemodialysis with citrate-bicarbonate dialysate on Th17 in peripheral blood of patients with chronic renal failure (CRF). Methods The CRF patients (n=57) with main-tenance hemodialysis for more than three months as well as free-active infection were selected and divided into two groups randomly, which were treated by citrate-bicarbonate dialysate and ordinary carbonate dialysate for mainte-nance dialysis in 12 month, respectively. The levels of interleulin-17 (IL-17) and percentages of Th17 subgroup in peripheral blood were detected by enzyme-linked immunosorbent assay and flow cytometer, respectively. ResultsThe levels of IL-17 and percentages of Th17 subgroup in patients treated with citrate-bicarbonate dialysate for more than six months were significantly lower than those treated with ordinary carbonate dialysate. Moreover, incidences of adverse reactions in group of citrate bicarbonate dialysate were lower than those of common carbonate dialysate group. Conclusion The pro-inflammatory effects of maintenance hemodialysis with citrate-bicarbonate dialysate on the patients are lower than those of ordinary carbonate dialysate. Citrate-bicarbonate dialysate causes the reduction of inflammatory state, and is worthy of being popularized in clinic.

Atherosclerosis ; Endothelial Cells ; Humans ; Nitric Oxide Synthase Type III ; Stem Cells

Objective To investigate the expressions of STAT3 and HIF-1α in esophageal squamous cell carcinoma (ESCC) and its relationships with clinical pathological characteristics and prognosis. Methods The expressions of STAT3 and HIF-1α protein were examined via immunohistochemistry in 50 cases of ESCC and normal esophageal mucosa tissue. Results In the immunohistochemistry of 50 ESCC , the positive expression rates of STAT3 and HIF-1α were 70% and 58%, respectively , significantly higher than those at the adjacent normal mucosa (P < 0.05). The expression of STAT3 in ESCC patients was significantly related to the lymph node metastasis, depth of invasion and TNM stage. The 30-month survival rates were positively correlated with the positive expression of STAT3 (P < 0.05). The expression of HIF-1α in ESCC patients was significantly related to the degree of differentiation and lymph node metastasis. The patients with HIF-1α negative had a higher cumulative survival rate than those with HIF-1α positive (P < 0.05), but the difference was not significant. STAT3 and HIF-1α were positively correlation with statistical significance (r = 0.362,P < 0.05). Conclusion STAT3 and HIF-1α are frequently expressed in ESCC. High expressions of STAT3 and HIF-1αmay contribute to the poor prognosis of human esophageal squamous cell carcinoma.