Objective To investigate the correlation between Bispectral index (BIS) value and the prognosis of patients with coma in ICU.Methods A total of 208 patients with coma in ICU were divided into 4 groups according to the BIS value.In group I,BIS value was 0 to 20; groupⅡ,BIS value 21 to 40; group Ⅲ,BIS value 41 to 60; and group Ⅳ,BIS value greater than 60.Comparison of the difference in BIS value with the differences in prognosis of patients with coma was carried out between four groups,and the prognosis of patients with coma was stratified into consciousness,coma,vegetative state,and brain death.Subsequently,the best cutoff score of BIS value calculated for determining the correlation between BIS and mental state was proposed.Results There are no significant differences in the age and APACHE Ⅱ scores between four groups (P ＞ 0.05).It was inverse correlation between BIS value and mental state (r =-0.749,P =0.00).According to the ROC curve,as BIS value was greater than 42.5,there were higher sensitivity and specificity in Conscious-Coma patients.Conclusions BIS value is correlated with the prognosis of patients with coma in ICU,and BIS value can be a useful marker for estimating the prognosis of comatose patients.

AIM: To investigate the relation between the changes of the cerebral microvasculature and the expression of plasminogen activator inhibitor-1 (PAI-1) in ischemic focal and perifocal areas after 2 hours focal cerebral ischemia with reperfusion in rats. METHODS: The changes of cerebral microvascular structure were observed by optical microscope and electric microscope, the expression of PAI-1 were assessed by immunohistochemical staining, Western blotting in ischemic focus and perifocal areas after focal cerebral ischemia with reperfusion. RESULTS: The edema of extra-cellular matrix and the hemorrhage of extravessels in ischemic focus and perifocal areas were most severe, and degradation and the defect of basement membrane were also observed after 6 hours and 3 days reperfusion following focal cerebral ischemia. The expression of PAI-1 decreased significantly compared with control group (P

Lentiviral vectors have drawn considerable attention recently and show great promise to become important delivery vehicles for future gene transfer manipulation. In the present study we have optimized a protocol for preparation of human immunodeficiency virus type-1 (HIV-1)-based defective lentiviral vectors (DLV) and characterized these vectors in terms of their transduction of different cells. Transient co-transfection of 293T packaging cells with DNA plasmids encoding lentiviral vector constituents resulted in production of high-titer DLV (0.5-1.2 × 107IU/mL), which can be further concentrated over 100-fold through a single step ultracentrifugation. These vectors were capable of transducing a variety of cells from both primate and non-primate sources and high transduction efficiency was achieved using concentrated vectors. Assessment of potential generation of RCV revealed no detection of infection by infectious particles in DLV-transduced CEM, SupT-1 and MT-2 cells. Long-term culture of transduced cells showed a stable expression of transgenes without apparent alteration in cellular morphology and growth kinetics. Vector mobilization to untransduced cells mediated by wild-type HIV-1 infection was confirmed in this test. Challenge of transduced human T-lymphocytes with wild-type HIV-1 showed these cells are totally resistant to the viral infection. Considering the effective gene transfer and stable gene expression, safety and anti-HIV activity, these DLV vectors warrant further exploration for their potential use as a gene transfer vehicle in the development of gene therapy protocols.

Objective To study the effects of Fluvastatin on the expression of intercellular adhesion molecule-1 (ICAM-1) in human umbilical vein endothelial cells (HUVECs) induced by C-reactive protein (CRP). MethodsThe HUVECs were primary cultured. HUVECs from third to sixth generations were stimulated with different concentrations CRP and at different times. Then the cells were treated with Fluvastatin in different concentration of 10-7,10-6 and 10-5mol/L. The content of ICAM-1 protein was detected with ELISA, the mRNA expression of ICAM-1 was evaluated by RT-PCR. Results In the control group, HUVECs produce ICAM-1 protein and mRNA in low concentrations. In CRP group, the content of ICAM-1 protein was increased significantly (P

Objective To search specific biomarkers of pathogenic bacteria in patients with sepsis so as to guide early using rationally antibiotic treatment.Methods Prospective survey of 147 patients with sepsis in ICU was carried out from Jan 2012 to Mar 2015.When patients blood culture was positive, clinical data including age, gender, vital signs, blood and, urine routine examination, DIC, blood biochemistry, c-reactive protein (CRP), procalcitonin (PCT), microbial detection, etc were recorded.Cultured blood samples were from central venous catheter and peripheral vessel.ELISA method was employed to detect soluble toll-like receptor 2 ( sTLR2 ) and interleukin-8 ( IL-8 ) , and the Acute Physiology and Chronic Health Evaluation Ⅱ( APACHEⅡ score ) was calculated.The chi-square test and analysis of variance were performed where necessary.Receiver operating characteristic ( ROC ) curves were used to calculate cut-points ( CP ) and area under the curve ( AUC) .Results According to the results of blood culture, patients were divided into three groups:GP group [ gram-positive bacteria ( G+) group];GN group [ gram-negative bacteria ( G-) group];FG group ( fungi group) .There were no significantly statistical differences in age, APACHEⅡ score, vital signs and markers of inflammation among three groups (P>0.05).Gram negative pathogenic bacterium was the most common microbe.Compared with GN group, the level of sTLR2 in the GP group was obviously higher ( P=0.000); but there was no significant difference in sTLR2 level between GP group and FG group (P=0.187). The amount of (1, 3) -beta glucan in the FG group was significantly higher than that in the GP group ( P=0.000).The sTLR2 level in FG group was obviously higher than that in the GN group (P=0.000).There were no significantly statistical differences in PCT, CRP and IL-8 among the three groups (P>0.05).For the diagnosis of gram negative bacteria infection, sTLR2 area under the curve was 0.768, and the sensitivity and specificity were 88.90%and 59.60%, respectively and the best cut-off point was 8.083 pg/mL.Namely, the diagnosis of gram negative bacteria infection was less likely, when level of sTLR2 was higher than 8.083 pg/mL.The markers of PCT, CRP, (1, 3) -beta glucan and IL-8 were less valuable for the diagnosis of Gram negative bacteria infection because the area under the curve was less than 0.5.Conclusions The combination of inflammatory indicators such as sTLR2 and (1, 3) -beta glucan etc, can imply the kind of pathogenic microorganisms partly.

Objective To study the feasibility of the acute gastrointestinal injury (AGI) classification standard for evaluation of gastrointestinal function in intensive care unit (ICU) patients,and to discuss its value in administration of early enteral nutrition (EN).Methods A perspective study was conducted.85 patients with AGI admitted to ICU of Tianjin First Center Hospital from January 2013 to June 2013 were enrolled.EN was conducted after ICU admission or within 12-24 hours after high catabolic state.The patients were divided into four groups according to the AGI classification,i.e.grade Ⅰ,Ⅱ,Ⅲ,and Ⅳ,and they were treated according to the treatment procedure for AGI.The primary end points were 7-day rate of intake of standard EN,the degree of disease and nutrition,and their correlation with AGI classification.Secondary endpoint was rate of giving EN within 48 hours.Results Gastrointestinal dysfunction patients accounted for 49.42％ (85/172) of the ICU patients,and number of patients in grade Ⅰ,Ⅱ,Ⅲ,Ⅳ were 29,28,19,9 respectively.On the first day of ICU stay,there were no statistical differences in age,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,serum albumin (ALB) and prealbumin (PA) among four groups,and it was demonstrated that the baseline data were comparable.APACHE Ⅱ score on the seventh day of ICU stay was significantly lower than that on the first day in grade Ⅰ,Ⅱ and Ⅲ patients (grade Ⅰ:20.48 ± 2.45 vs.22.59 ± 2.06,t=-3.120,P=0.031 ; grade Ⅱ:19.34 ± 1.80 vs.21.65 ± 2.22,t=-4.316,P=0.012; grade Ⅲ:20.63 ± 1.34 vs.23.31 ± 1.70,t=-5.640,P=0.000),and serum PA (g/L) was significantly increased (grade Ⅰ:24.37 ± 6.54 vs.10.62 ± 7.24,t=-4.866,P=0.000; grade Ⅱ:19.79± 12.48 vs.11.57±8.94,t=-2.116,P=0.031; grade Ⅲ:19.15±8.43 vs.13.78 ± 6.59,t=-3.601,P=0.000).On the seventh day ofICU stay,the APACHE Ⅱ score was higher in grade Ⅳ than that in grade Ⅰ,Ⅱ and Ⅲ patients (22.87 ± 3.31 vs.20.48 ± 2.45,19.34 ± 1.80,20.63 ± 1.34,P＜0.05 or P＜0.01),and PA was obviously lower in grade Ⅳ than that in grade Ⅰ,Ⅱ and Ⅲ patients (g/L:14.02 ± 8.70 vs.24.37 ± 6.54,19.79 ±12.48,19.15 ± 8.43,P＜0.05 or P＜0.01).There was no statistically significant difference among four groups in respect of serum ALB (F=0.454,P=0.722).The rate of giving EN in 24 hours in grade Ⅰ,Ⅱ,Ⅲ,Ⅳ patients was 95.4％,72.1％,52.0％ and 0,respectively (x2=8.310,P=0.016),and in 48 hours it was 100.0％,83.0％,76.0％,and 0 (x2=5.470,P=0.025).7-day standard EN intake rate was 100.0％,88.7％,84.0％ and 34.0％ respectively in grade Ⅰ,Ⅱ,Ⅲ,Ⅳ patients (x2 =0.720,P=0.017).Correlation analysis showed that there was a negative correlation between AGI classification and rate of giving EN in 1 day (r=-0.62,P=0.04) and 7-day standard EN intake rate (r=-0.76,P=0.02).Conclusions AGI classification can be used to estimate the gastrointestinal function of patients with critical illness,and it has a significant correlation with early EN support.An early goal achieving intervention based on the AGI classification can improve the nutritional status and the general state of the patients.

Objective To investigate the application value of three-dimensional power Doppler ultrasonography(3D-PDU) for synovial disease in patients with rheumatoid arthritis(RA). Methods Forty four patients with RA were divided into active (23 cases) and non-active (21 cases) groups. 3D-PDU was used in the wrists to measure the volume of synovium(V) ,vascular index(VI) in synovium.and Doppler spectrum was used to measure synovial artery peak systolic blood flow velocity(PSV) , end diastolic velocity (EDV) and resistance index(RI). Results There were significant differences of the V [(1. 73 0. 73) cm3] and VI (9. 53 6. 11) in the group of active patients compared to the V [(1. 09 0. 76) cm3 , P = 0. 008] and VI [(3.86 4.99), P = 0.000] in the ones of inactive patients. No differences were found for PSV [(16. 8 6. 29) cm/s vs (13. 5 8. 54) cm/s, P = 0. 282] ,EDV [(5. 51 1.77) cm/s vs (5. 03 2. 76) cm/s, P = 0. 539] and RI (0. 66 0. 07 vs 0. 62 0. 08, P = 0. 095)in the comparison of two groups. Conclusions 3D-PDU in determining RA disease activity in patients with synovial medium has a higher application value, VI can be used as an effective indicator to determine the disease activity.

Objective To observe the effect of Astragalus injection on the expressions of inflammatory cytokines in human primary macrophages stimulated by lipoteichoic acid (LTA) and lipopolysaccharide (LPS),and investigate its effects on inflammatory reactions of Gram-positive (G+) and Gram-negative (G-) bacteria sepsis and its mechanisms.Methods Percoll density gradient centrifugation was used to isolate the human peripheral blood mononuclear cells,then they were purified by immune Anti-Biotin Microbeads with magnetic character and under the induction of recombinant human granulocyte-macrophage colony stimulating factor (rhGM-CSF),the cells were cultivated for 12 days in vitro,eventually the human monocyte-derived macrophage was formed.The cultured human macrophages were inoculated in 96-well plates (each group 3 wells) and 6-well plates (each group 3 wells).The cells were divided into control group (200 μL DMEM added in each well),LTA 1 mg/L group,LPS 0.1 mg/L group and low astragalus injection (0.1 mg/L) and high astragalus injection (0.2 mg/L) dose groups.After the incubator plates were put in an incubator for 24 hours,the protein content of IL-8 and IL-10 in supernatant were detected by enzymelinked immunosorbent assay (ELISA),and the mRNA expression levels of IL-8 and IL-10 were detected by real time fluorescence quantitative reverse transcription-polymerase chain reaction (RT-qPCR).Results LTA and LPS all can obviously up-regulate the expression levels of pro-inflammatory factor IL-8 and anti-inflammatory factor IL-10 of macrophage.The expressions of IL-8 and IL-10 protein and mRNA in LTA group and LPS group were significantly higher than those in control group after cuhure for 8 hours and 24 hours,the degrees of increment were more significantly at 24 hours [LTA stimute group:IL-8 protein (ng/L,× 103):41.57± 1.90 vs.1.58 ±0.24,IL-8 mRNA (A value):21.49±8.05 vs.1.00±0.16;IL-10 protein (ng/L):5.90±3.02 vs.2.91 ± 1.54,IL-10 mRNA (A value):1.35±0.34 vs.0.95±0.14;LPS stimute group:IL-8 protein (ng/L,× 103):345.00±22.80 vs.5.60±0.31,IL-8 mRNA (A value):29.84 ± 8.93 vs.1.00 ± 0.16,IL-10 protein (ng/L):122.37 ± 39.26 vs.44.79 ± 3.67,IL-10 mRNA (A value):7.38 ± 1.58 vs.1.35 ± 0.34,all P ＜ 0.05].The Astragalus injection could regulate LTA and LPS to stimulate the macrophage to decrease the expression levels of pro-inflammatory factor IL-8 protein and mRNA and increase the expression levels of anti-inflammatory factor IL-10 protein and mRNA in the macrophage;the changes of regulatory effect in the 24 hour-culture of Astragalus injection high dose group was the most significant [LTA stimute group:IL-8 protein (ng/L,×103):22.63±1.91 vs.41.57±1.90,IL-8 mRNA (A value):12.10±1.93 vs.21.49±8.05,IL-10 protein (ng/L):14.03±2.22 vs.5.90±3.02,IL-10 mRNA (A value):10.37±6.08 vs.1.35±0.34;LPS stimute group:IL-8 protein (ng/L,× 103):167.75 ± 19.90 vs.345.01 ±22.80,IL-8 mRNA (A value):15.61 ± 3.63 vs.29.84±8.93;IL-10 protein (ng/L):243.22±14.41 vs.122.37±39.26,IL-10 mRNA (A value):16.14±4.10 vs.7.38± 1.58,all P ＜ 0.05].Conclusions In the process of inflammatory response,the pro-inflammatory and anti-inflammatory factors co-exist simultaneously.Astragalus injection can inhibit the expression levels of pro-inflammatory factor gene and protein in the inflammatory response of G+ and G-bacteria sepsis and in the mean time,it can promote the expression levels of anti-inflammatory factor gene and protein,thus the immune mechanism of sepsis is affected,achieving the balance between pro-inflammation and anti-inflammation.

Objective To explore the causes of death of patients with cerebral hemorrhage of hypertension in recent 6 years and the countermeasure of decrease death rate.Methods The clinical data,different kinds of treatment and curative effects of the patients of two groups,admitted in recent six years,with cerebral hemorrhage of hypertension was refrospectively analysied.Results Of 157 cases of cerebral hemorrhage of hypertension in group A,there were 69 cases died(44%).Of 158 cases of cerebral hemorrhage of hypertension in group B,there were 48 cases died(30.4%).Death rate between the two of group had significant difference(P