OBJECTIVE To investigate the changes in and clinical significance of C-reactive protein(CRP) and endotoxin in patients who are firstly examined in fever clinic.METHODS To review and study the results of CRP and endotoxin from 81 patients(including 48 patients who were diagnosed as bacterial pneumonia and 33 patients who were diagnosed as a cold) in fever clinic of our hospital in 2005.RESULTS In 81 bacterial infection patients, the analysis indicated the levels of endotoxin between the pneumonia patients and the patients with a cold had significant difference.And the levels in the first group were significantly higher than in the latter one.The levels of CRP had no difference in two groups.CONCLUSIONS The result indicates plasma endotoxin detection helps to determine the early diagnosis of serious infection.It is also of significance to select antibacterial rationally and handle syndrome in time.In fever clinic,the levels of endotoxin may be a method to help diagnosis and treatment.CRP could be help to estimate the bacterial infection or virus infection,but it could not adjudge the seriousness in bacterial infection.

Health ; Health Promotion ; methods ; Health Status ; Humans ; Medicine, Chinese Traditional ; methods

Objective To investigate the effect of recent blood glucose control level of diabetes on prognosis in the patients with general surgery. Methods To analyze the clinical data of 126 diabetic patients with general surgery and the relatiouship among the average hospitalized length,medical cost and the complications of sugery due to glycosylated hemoglobin. Results Comparing with controls, diabetic patients HbA1c＞7.5% had more days longer than those HbA1c＜6.5 % at the time of average in-hospital duration, stitch removing, food-taking and using antibiotics after the operation,Diabetics HbA1c＜6.5 % with cholecystolithiasis, thyroid adenoma had lower surgery cost than those HbA1c＞7.5 %. Conclusion To intensify the control of blood glucose of the patients of limited or selective general surgery as to lower glycosylated hemoglobin＜6.5 % is very important for improving prognosis, and decreasing the complications and medical cost of the operation.

Objective: To investigate the effect of irrational use of traditional Chinese patent medicines (CPM) on medication safety.Methods: The adverse drug reaction (ADR) reports on traditional CPM (including traditional Chinese medicine for injection) in our hospital during January 2013 to October 2016 were collected and analyzed retrospectively.After finding the corresponding prescriptions, the situation of irrational drug use in the reports including indications, usage and dosage, combination of traditional CPM, combination of Chinese and western medicines and course were analyzed, and the rate of irrational drug use was calculated.Results: A total of 217 reports were collected including 217 patients.The primary diseases ranked top three were cardio-cerebral vascular system diseases, digestive system diseases and respiratory system diseases.The cases involved 81 kinds of drugs, and among them, 37 cases were induced by Shenmai injection.The rate of irrational drug use associated with indications, usage and dosage, combination of traditional Chinese patent medicines, combination of Chinese and western medicines and course was 6.45% , 5.99% , 2.76% , 0.92% and 1.84% , respectively, and the total rate was 17.97% (39/217).Conclusion: The irrational drug use maybe one of the important factors related to ADR of CPM.According to syndrome differentiation, CPM should be used rationally, and pharmaceutical care should be strengthened to reduce the incidence of ADR.

Objectives To investigate the possible role of perforin (PFN) in the pathogenesis of severe preeclampsia.Methods Thirty-two cases of severe preeclampsia were included in the study.Thirtytwo cases of normal pregnancy were selected as control group in random.The expression of PFN mRNA in the peripheral blood mononuclear cells (PBMC) was detected by reverse transcription (RT)-PCR, and its correlation with mean arterial pressure was analyzed in severe preeclamptic patients.The expression of PFN protein in the decidua was detected by immunohistochemistry.Results ( 1 ) The expression of PFN mRNA in PBMC:the PFN mRNA level in severe preeclamptic group was 1.19 ± 0.31, and that in normal pregnancy group is 0.82 ± 0.28.The PFN mRNA level in severe preeclamptic group was significantly higher than that of control group (P ＜ 0.0l ).(2)Correlation analysis:the mean blood pressure in severe preeclampsia group was (133 ±5) mm Hg( 1 mm Hg =0.133 kPa).There was significant positive correlation between level of PFN mRNA in PBMC and mean blood pressure in severe preeclamptic patients ( r = 0.701, P = 0.000).(3)Decidual PFN protein expression:PFN protein was mainly expressed in lymphocytes and the cytoplasm of decidual stromal cells.The positive ratio of PFN in the decidua of severe preeclamptic patients was 84% ( 27/32), significantly higher than that of control group (53%, 17/32, P ＜ 0.01 ).Conclusions Expression of PFN was significantly increased in severe preeclampsia, and it was of significant positive correlation with mean blood pressure.PFN may participate in the pathogenesis of severe preeclampsia.

Objective To investigate the effect of natural killer (NK) cells treated by serum of severe preeclampsia patient on the function of endothelial cells.Methods Fifteen patients with severe preeclampsia and 15 normal pregnant women from the Obstetrics department,Shengjing Hospital,China Medical University were admitted into this case-control study from January 1,2006 to December 31,2008.NK cells from healthy non-pregnant woman were incubated with 20% serum from severe preeclampsia patients or normal pregnant women for 20 hours.Then,human umbilical vein endothelial cells ( HUVEC) and serum-treated NK cells were co-incubated for 24 hours.Apoptosis of HUVEC was checked by flow cytometry and electronic microscope.Endothelin-1 (ET-1) levels in the supernatants of HUVEC and NK cells were examined by radioimmunologic method.Results In severe preeclampsia group,the percentage of early apoptosis cell (Annexin V-FITC+ /PI+ ) was (23.81±4.79)%,that of late apoptosis cell (AnnexinV-FITC+/PI+ ) was (3.29±1.04) %,while those were (16.59±5.13)% and (2.24±0.72)% respectively in normal pregnant group (P＜0.01).There was no significant difference in dead cells (Annexin V-FITC- /PI+ ).Under electronic microscope,typical morphologic changes of apoptosis were shown in severe preeclampsia group.Level of ET-1 in

AIM:To investigate the influential factors of the blood-brain barrier (BBB) permeability and to observe the effects of zileuton,a selective 5-lipoxygenase inhibitor (5-LO),on focal cerebral ischemia-reperfusion injury (CIRI).METHODS:The right middle cerebral artery of the rat was occluded by inserting a thread through internal carotid artery for 2 h,and then reperfused for 24 h. Zileuton (10,50 mg?kg-1,po) was orally administered 2 h before ischemia and at 0,5,10 h after reperfusion. The permeability of blood brain barrier (BBB) was detected by using Evans blue (EB) as a labelling compound. The degree of cerebral edema was estimated by AutoCAD image analysis software. The mRNA of cysteiny leukotrienes receptor1 (CysLTR1) was detected by RT-PCR. The content of LTB4 in serum was measured by enzyme linked immunosorbent assay (ELISA). The expressions of AQP4 and MMP-9 proteins were measured by immunohistochemical staining method. RESULTS:After middle cerebral artery occlussion 2 h/reperfusion 24 h,the permeability of BBB in the brain tissue of injured side and the brain edema degree were increased. The content of LTB4 in serum was elevated. The expression of CysLTR1 mRNA from the brain tissue of occluded side was enhanced. The expressions of MMP-9 and AQP4 proteins of the ischemia realm and ischemia penumbra (IP) of the infarct focus perimeter were increased. Both 10 and 50 mg?kg-1 doses of zileuton dramatically relieved the BBB permeability destruction and the degree of the brain edema,inhibited the expression of CysLTR1 mRNA in the brain tissue and also reduced the content of LTB4 in serum. The expressions of AQP4 and MMP-9 proteins in the brain tissue were also decreased.CONCLUSION:The permeability of BBB is destroyed after the focal CIRI. The mechanisms of protective effect of zileuton might be attributed to its effects by inhibiting the activation of 5-LO pathways on the brain tissue and circulatory blood,reducing the expressions of AQP4 and MMP-9 proteins of the ischemia and IP realm in the brain tissue.

Objective To compare the concordance among RECIST, EASL and modified RECIST criteria for the evaluation of tumor response after transarterial chemoembolization of primary liver cancer.Methods Fifty patients with primary liver cancer underwent 2 TACE cycles separated by 30-40 days.Triphasic helical CT or MRI scans were performed at baseline, at 4 weeks after TACE procedure, and 2 independent radiologists evaluated tumor response according to above-mentioned three different criteria. Chisquare test was used to compare the response rate, and kappa coefficients were used to evaluate the coherence. Results When tumor responses were evaluated using the RECIST-EASL and modified RECIST criteria, the numbers of the patients achieved complete response, partial response, stable disease,progressive disease were 0, 10, 30, 10; 6,21,14,9; 6,21,13,10 respectively. The objective response rates for three different criteria were 20%, 54%, 54% respectively ( P ＜ 0. 01 ). Kappa coefficients between RECIST and EASL, between RECIST and modified RECIST, between EASL and modified RECIST were 0. 382, 0. 170, and 0. 857 (P = 0. 000). Conclusions RECIST criteria underestimates the extent of tumor response after TACE in primary liver cancer. Both EASL and modified RECIST criteria appear to agree with each other in determining treatment response. Furthermore, the modified RECIST is more convenient in clinical practice compared with EASL criteria.