Sepsis and septic shock are the major causes of death in intensive care units (ICUs) worldwide. A large amount of studies on their pathophysiology have revealed an imbalance in the inflammatory network leading to tissue damage, organ failure, and ultimately, death. Cytokines, proteases, lipid mediators, vasoactive peptides, and cell stress markers play key roles in pathophysiology of sepsis. Although anti-inflammatory mediators can neutralize the promoting role of pro-inflammatory mediators, but persistent immune regulation may cause host susceptibility to concurrent infections. Therefore, it is a great challenge to seek effective clinical therapy against sepsis. To understand the complicated interplay between pro- and anti-inflammatory agents in sepsis, and their interaction in signal transduction and immune regulation in sepsis constitute vital significance to the prevention and control of sepsis. Summarize the latest findings about mediators associated with sepsis and innate and adaptive immune system at home and abroad in recent years, and illustrate the impact of its effects on sepsis, which may lead to resolution of many unexplored queries in the future.

Objective:To investigate the value of combined detection of biomarkers in early diagnosis and prognosis of patients with septic myocardial injury.Methods:The clinical data of 103 patients with sepsis admitted to the intensive care unit (ICU) of the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology from October 2018 to January 2021 were enrolled. According to the cardiac troponin I (cTnI) at admission of ICU, they were divided into septic myocardial injury group (cTnI ≥ 0.15 μg/L) and non-septic myocardial injury group (cTnI < 0.15 μg/L). The serum levels of heart-type fatty acid-binding protein (H-FABP), procalcitonin (PCT), C-reactive protein (CRP), MB isoenzyme of creatine kinase (CK-MB), cTnI and N-terminal pro-brain natriuretic peptide (NT-proBNP) within 6 hours after ICU admission and the worst value of acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score within 24 hours after ICU admission in 103 patients was recorded as well as the 28-day prognosis of patient with septic myocardial injury. Spearman correlation analysis was used to analyze the correlation of each index; receiver operating characteristic curve (ROC curve) was drawn, and the area under ROC curve (AUC) was calculated to analyze the early diagnosis and prognostic value of each index and APACHEⅡ score alone or combined detection in patients with septic myocardial injury.Results:① Among 103 patients with sepsis, 58 patients were complicated with myocardial injury and 45 patients were not complicated with myocardial injury. The serum levels of PCT, CRP, NT-proBNP, CK-MB, cTnI, H-FABP and APACHEⅡ score in patients with septic myocardial injury were significantly higher than those in patients without septic myocardial injury [PCT (μg/L): 3.46±1.35 vs. 1.89±0.43, CRP (mg/L): 81.1±26.8 vs. 65.3±19.1, NT-proBNP (U/L): 8 261.4±2 346.9 vs. 6 120.2±1 809.6, CK-MB (U/L): 15.89±6.25 vs. 12.14±4.24, cTnI (μg/L): 1.50 (0.91, 2.21) vs. 0.18 (0.16, 0.19), H-FABP (μg/L): 26.45±8.24 vs. 12.82±5.73, APACHEⅡ score: 24.0 (18.0, 29.0) vs. 16.0 (14.0, 18.0), all P < 0.01]. Spearman correlation analysis showed that PCT, CRP and APACHEⅡ scores were positively correlated with NT-proBNP, CK-MB, cTnI and H-FABP. ROC curve analysis showed that H-FABP in the diagnosis of septic myocardial injury (AUC = 0.916) was superior to NT-proBNP (AUC = 0.756) and CK-MB (AUC = 0.675); the AUC of NT-proBNP and CK-MB combined with H-FABP was 0.921, the sensitivity was 82.1%, and the specificity was 88.2%.② Twenty-three patients survived in 28 days, and 35 died. The levels of serum PCT, CRP, NT-proBNP, CK-MB, cTnI, H-FABP and APACHEⅡ score in death group were significantly higher than those in survival group [PCT (μg/L): 3.86±1.27 vs. 2.84±1.24, CRP (mg/L): 92.3 (65.0, 101.7) vs. 74.3 (65.7, 79.8), NT-proBNP (ng/L): 9 106.4±2 013.9 vs. 6 975.5±2 266.7, CK-MB (U/L): 17.90±6.49 vs. 12.82±4.46, cTnI (μg/L): 2.11±0.86 vs. 1.12±0.44, H-FABP (μg/L): 30.08±7.90 vs. 20.93±5.14, APACHEⅡ score: 25.0 (20.0, 30.0) vs. 19.0 (17.0, 24.0), all P < 0.01]. ROC curve analysis showed that H-FABP in evaluating 28-day death of patients with septic myocardial injury (AUC = 0.839) was superior to PCT (AUC = 0.707), CRP (AUC = 0.716), NT-proBNP (AUC = 0.761), CK-MB (AUC = 0.733), cTnI (AUC = 0.824) and APACHEⅡ score (AUC = 0.724); the AUC of NT-proBNP and cTnI combined with H-FABP was 0.888, the sensitivity was 91.4%, and the specificity was 82.6%. Conclusions:H-FABP plays an important role in the early diagnosis and prognosis of septic myocardial injury. Early combined detection of NT-proBNP, CK-MB and H-FABP can significantly improve the diagnostic ability of septic myocardial injury, and NT-proBNP and cTnI combined with H-FABP can significantly improve the ability to predict the adverse prognosis of sepsis myocardial injury.

Objective:To study the chemical constituents in the dry roots of Rubus pinfaensis. Methods:The compounds were sep-arated from the alcohol extract of the roots of Rubus pinfaensis by silica gel column chromatography, and identified by IR, 1 H-NMR and EI-MS methods. Results:Five compounds were isolated and identified as oleanolic acid (Ⅰ) , 3-keto, 16α-hydroxy, 24-noroleanolic acid (Ⅱ) , 3′-methoxy myricetin (Ⅲ) , 2′-deoxyuridine (Ⅳ) and p-hydroxy phenylacetic acid (Ⅴ) . Conclusion: Compound Ⅰ,Ⅱ,Ⅲ,Ⅳ and Ⅴ are isolated from Rubus pinfaensis for the first time.

Objective To investigate the diagnostic value of preoperative real-time three-dimensional color Doppler transthoracic echocardiography on assessment of patients with structural heart disease (SHD). Methods A total of 111 pa?tients were assessed preoperatively using real-time three-dimensional color Doppler transthoracic echocardiography (RT-3D-CDTTE), which include 31 SHD patients and 80 patients without SHD that were designed as negative control. Conven?tional two-dimensional color Doppler transthoracic echocardiography (2D-CDTTE) were used to compared with RT-3D-CDTTE while cardiovascular angiography and intraoperative findings were used as“Golden Standard”simultaneously. First of all, preoperative echocardiographic examination were performed and diagnosis was given. Angiography and intraoperative findings were hired to verify the accuracy of echocardiographic diagnosis before operation. Results (1) The preoperative RT-3D-CDTTE displayed three-dimensional structure and hemodynamic status of SHD cardiac lesions clearly, which were consistent with cardiovascular angiography and intraoperative findings. (2) P value of McNemar test between 2D-CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.654 (P<0.001). P value of McNemar test between RT-3D-CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.932 (P<0.001). Conclusion RT-3D-CDTTE can provides essen?tial information for preoperative evaluation which is important for decision of SHD management.

Objective To investigate the effect of heroin abuse on attention switching. Methods Thirty-six Heroin abusers (33 males, 3 females) and 36 controls (32 males, 4 females) were enrolled in the study. Their cognitive function was tested by using the Switching Task, including Sustained Attention trials and Switching Attention trials. The reaction time and accuracy were recorded separately by the computer. Results The accuracy or reaction times were not signifi-cantly different between Switching Attention trial and Sustained Attention trial in heroin abusers, suggesting a lower Switch Costs value compared to the healthy controls [(19.7 ± 66.8) ms vs. (85.1 ± 92.4) ms]. The healthy controls showed faster reaction speed [Sustained Attention trial (695.3 ± 95.9) ms vs. Switching Attention trial (780.3 ± 93.3) ms, P<0.05] and higher accuracy [Sustained Attention trial (98.0%±2.2%) vs. Switching Attention trial (93.8%±5.0%), P<0.05] under the Sustained Attention trial. Compared with the healthy controls, the heroin abusers showed slower reaction speed [(791.6 ± 74.3) ms vs. (695.3±95.9) ms, P<0.05] and lower accuracy [(92.5%±8.4%) vs. (98.0%±2.2%), P<0.05] in Sus-tained Attention trial, but not in Switching Attention trial. Conclusions The present study has revealed absence of Switch Costs in heroin abusers, which may be related to the damage of heroin abusers in their Sustained Attention function.

Bletilla striata has been used as traditional Chinese medicine for several centuries. In recent years, the quality and quantity of wild B. striata plants have declined sharply due to habitat deterioration and human over-exploitation. Therefore, it is of great urgency to evaluate and protect B. striata wild plant resource. In this study, sequence-related amplified polymorphism (SRAP) markers were applied to assess the level and pattern of genetic diversity in twelve populations of B. striata. The results showed a high level of genetic diversity (PPB = 90.48%, H = 0.349 4, I = 0.509 6) and moderate genetic differentiation among populations (G(st) = 0.260 9). Based on the unweighted pair-group method with arithmetic average (UPGMA), twelve populations gathered in three clusters. The cluster 1 included four populations. There are Nanjing, Zhenjiang, Xuancheng and Hangzhou. The seven populations which come from Hubei Province, Hunan Province, Jiangxi Province and Guizhou Province belonged to the cluster 2. The cluster 3 only contained Wenshan population. Moreover, Mantel test revealed significant positive correlation between genetic distances and geographic distances (r = 0.632 9; P < 0.000 1). According to the results, we proposed a series of conservation consideration for B. striata.

In this study, 17 kinds of Dendrobium species of Fengdous including 39 individuals were collected from 4 provinces. Mitochondrial gene sequences co I, nad 5, nad 1-intron 2 and chloroplast gene sequences rbcL, matK amd psbA-trnH were amplified from these materials, as well as nrDNA ITS. Furthermore, suitable sequences for identification of Dendrobium species of Fengdous were screened by K-2-P and P-distance. The results showed that during the mentioned 7 sequences, nrDNA ITS, nad 1-intron 2 and psbA-trnH which had a high degree of variability could be used to identify Dendrobium species of Fengdous. However, single fragment could not be used to distinguish D. moniliforme and D. huoshanense. Moreover, compared to other combined fragments, new type combined fragments nrDNA ITS+nad 1-intron 2 was more effective in identifying the original plants of Dendrobium species and could be used to identify D. huoshanense and D. moniliforme. Besides, according to the UPGMA tree constructed with nrDNA ITS+nad 1-intron 2, 3 inspected Dendrobium plants were identified as D. huoshanense, D. moniliforme and D. officinale, respectively. This study identified Dendrobium species of Fengdous by combined fragments nrDNA ITS+nad 1-intron 2 for the first time, which provided a more effective basis for identification of Dendrobium species. And this study will be helpful for regulating the market of Fengdous.

Purpose To investigate the diagnostic value of prenatal MRI in fetal intracranial hemorrhage (FICH). Materials and Methods The imaging and clinical data of 41 cases of FICH accepting MRI diagnosis were retrospectively analyzed. The hemorrhage location, signal characteristics and the associated intracranial abnormalities were observed. The pregnancy outcomes and clinical data after birth were followed up. The correlation between periventricular hemorrhage/intraventricular hemorrhage (PVH/IVH) classification and clinical outcomes was analyzed by combining prenatal risk factors. Results Forty-one cases of FICH were evaluated. There were 23 cases of multifocal cerebral hemorrhage and 18 cases of single focal hemorrhage. According to the bleeding site, the 41 cases were classified into PVH/IVH (33 cases), cerebral hemispheres near cortex hemorrhage (3 cases), cerebellar hemorrhage (2 cases), subdural hemorrhage (2 cases) and subarachnoid hemorrhage (1 case). Most of the FICH cases were in subacute period (36/41) and a few were in chronic period or forming encephalomalacia (5/41). The associated changes included ventriculomegaly, vascular malformation, agenesis of corpus callosum, agenesis of vermis, etc. Follow-up results showed that there were 25 cases of labor induction (autopsy after labor induction was performed in 3 cases), 16 cases were followed-up after birth. Among the 16 newborn, there was 1 case of PVH/IVH grade II fetus showing left ear hearing loss after birth, 1 case of grade II fetus showed dyskinesia within one year after birth, and 1 case of grade IV fetus showed unilateral limb movement disorder. The other 13 cases had no obvious neurological sequelae. Spearman correlation test of ranked data indicated that PVH/IVH classification was moderately correlated with birth outcome (r=0.689, P<0.05). Conclusion Prenatal MRI can evaluate the type and severity of fetal intracranial hemorrhage, and provide references for clinical diagnosis and treatment.

Objective:To explore the clinical significance of patient for patient safety strategy in inpatients with traumatic fracture.Methods:Convenience sampling method was used to randomly select 120 patients with traumatic fracture from September to December 2019 in the Department of Orthopaedics and Traumatology of a third-class hospital of Zibo city. Sixty patients with traumatic fracture treated from September to October 2019 were the control group, and 60 patients with traumatic fracture treated from November to December 2019 were the intervention group. The control group implemented routine safety management, and the intervention group implemented patient for patient safety strategy on the basis of routine safety management. The general information questionnaire, Hamilton Anxiety Scale (HAMA), patient for patient safety attitude questionnaire, incidence of adverse events during hospitalization and inpatient satisfaction scale were used to evaluate the effect after application.Results:HAMA score was 17.6±3.4,11.5±2.7 3 days after operation and at discharge in the intervention group, whcih were significantly lower than 23.3±4.3, 14.3±3.2 in the control group ( t values were 7.919, 6.912, P<0.001). The score of patients for patient safety attitude questionnaire was significantly higher in the intervention group at discharge compared with one day after operation ( t values were 3.246-6.558, P<0.001), as well as compared with those in the control group ( t values were 2.251-6.445, P<0.05). The total incidence rate of adverse events during hospitalization and satisfaction degree was 6.7%(4/60) and 95.0% (57/60) in the intervention,better than 13.3%(8/60), 90.0% (54/60) in the control group ( χ2 values were 7.260,16.008, P<0.001). Conclusions:The patient for patient safety strategy can effectively alleviate patients' negative psychological emotions, enhance patients' attitude to participate in safety behaviors, increase their enthusiasm to participate in safety behaviors, reduce the occurrence of adverse events during hospitalization, and improve patients' satisfaction with hospitalization.

Objective: To assess the impact of viable myocardium in left ventricular aneurysm (LVA) and ventricular arrhythmia on prognosis of LVA patients.
Methods: A total of one hundred and sixty LVA patients who received99Tcm-MIBI SPECT and18F-FDG PET were enrolled, including 139 male and 21 female with the mean age of (58 ± 10) years.There were 42 (26.3%) patients combining ventricular arrhythmia. LVEDV, LVESV and LVEF were detected. Semi-quantitative analysis of myocardium perfusion imaging was conducted, viable myocardium in aneurysm was deifned as the perfusion-metabolism mismatch score (MMS) ≥ 2.0. According to myocardium viability, the patients were divided into 2 groups: No viability group,n=97 and With viability group,n=63;based on ventricular arrhythmia, the patients were divided into another 4 groups: Group①, viability-, ventricular arrhythmia-, n=68, Group②, viability-, ventricular arrhythmias+,n=29, Group③, viability+, ventricular arrhythmias-,n=50 and Group④, viability+,ventricular arrhythmias+,n=13. The average follow-up time was (50 ± 7) months, the end point was cardiac death. The survival curve was obtained by Kaplan-Meier method and survival rates were compared by Log-rank analysis.
Results: The mean LVEF in 160 patients was (34 ± 11) %, cardiac death occurred in 19 (11.9%) patients. Long-term survival rates in Groups①,② and③ were 94.1%, 89.7% and 86.0%, respectively,P>0.05; while in Group④, the survival rate was 61.5%, which was lower than the other 3 groups,P=0.004. Multivariate Cox regression analysis showed that female (HR=5.101, 95% CI 1.853-14.044, P=0.002), GPET-ESV (HR=1.009, 95% CI 1.002-1.015,P=0.013), interaction between MMS and ventricular arrhythmia (HR=1.368, 95%CI 1.113-1.681,P=0.003) were independent risk factors for cardiac death;while surgical treatment (HR=0.199, 95% CI 0.054-0.742,P=0.016) could decrease the risk of cardiac death.
Conclusion: Patients with viable aneurysm and ventricular arrhythmia had poor long-term prognosis; while early and active treatment is needed for them (surgery with anti-arrhythmic therapy).