Sepsis is still a leading cause of death in infants and children.It is the result of multiple organ dysfunction syndrome caused by infection.For sepsis,early diagnosis is very important.Biomarkers (procalcitonin,C-reactive protein,pro-inflammatory cytokines,white blood cell count,neutrophil count,left shift and CD64) during the response to infection can be used for early diagnosis.In addition,continuously monitoring these biomarkers can be used for evaluating severity of illness,monitoring of treatment responses and predicting outcome.

It is evident that metabolic memory,whereby diabetic complications continue to develop and progress in individuals who returned to normal glycemic control after a period of transient hyperglycemia,has long lasting effects.Recent studies suggest that “metabolic memory” may be due to epigenetic changes in target oells.Understanding the molecular changes in chromatin structure and the functional relationship with altered signaling pathways is now considered to represent an important conceptual challenge to explain diabetes and the phenomenon of metabolic memory.Emerging evidences indicate that critical gene-activating epigenetic changes may confer future cell memories. Many experimental evidences show that histone acetyltransferases (HATs), histone deacetylases (HDACs),histone methyltransferases (HMTs),histone lysine demethylases (KDMs),and microRNAs play important roles in the epigenetic changes of several key genes related to diabetic complications. Transient hyperglycemia promotes gene-activating epigenetic changes and signaling events critical in the development and progression of diabetic vascular complications.Further characterisation of these glucose-induced epigenetic events and the identification of key enzymes involved will help us to develop new therapeutic strategies for diabetes and its complications.

Objective To measure the blood levels of mercury and arsenic of mother and umbilical cord, and analyze the relationship between these levels and outcome of pregnancy and complications. To explore the influential factors in order to guide a good birth and good care in pregnancy and lying-in women.Methods A total of 400 cases who were hospitalized in Xinhua hospital from March 2009 to August 2009 were included in this study. The blood levels of arsenic of mother and umbilical cord were determined by microwave digestion method and inductively coupled plasma emission mass spectroscopy method ( ICP-MS),while mercury determination was made using flame atomic absorption spectrophotometer (AAS). In addition, pregnant women were required to fill the questionnaire including their living environments, life styles,diet habits and etc. Results The newborn cord blood levels of mercury and arsenic were positively related to those of their mothers( r =0.88,0.91 respectively, P ＜0.05). The adverse pregnancy rates and complications rates in blood elevated mercury and arsenic groups were significantly higher than in the normal groups( x2 =7.07, 9. 94 respectively, P ＜ 0.01 ). Multiple regression analysis showed that the newborn blood mercury levels were significantly correlated to sea-fish eating, fruits supplement and ventilation during pregnancy. The former was a risk factor( Wald χ2 =8.28, P ＜0.01 ) and the later two were protective factors( Wald χ2 = 9.02, 6.05 respectively, P ＜ 0.05 ). Multiple regression analysis also showed that the newborn blood arsenic levels were significantly correlated to eating canned food, using cosmetics and education degree. Eating canned food and using cosmetics were risk factors(Wald χ2 =7.35, 10.38 respectively,P ＜ 0.05 ) while high education degree was protective factor( Wald χ2 = 8.87, P ＜ 0.05 ). Conclusion The newborn cord blood levels of mercury and arsenic were related to those of their mothers, environmental factors and health care during pregnancy. Health education and care during pregnancy were effective approaches for preventing mercury and arsenic poisoning.

Objective To investigate the inhibition mechanism of rohdea roth on hyphae formation by Candida albicans.Methods MTT assay was used to detect the minimum inhibitory concentration(MIC)and minimum fungicidal concentration(MFC)of C.albicans.The inhibitory effect of fungicidal adherence was detected by MTT assay.Inverted fluorescence microscope was used to observe effect on hyphae formation.The influence on Efg1 and Hwp1gene expression were detected by RT-PCR method.ResultsMIC and MFC of C.albicans were 16 mg/mL and 32 mg/mL, respectively.The inhibitory effects of rohdea roth on C.albicans adherence and hyphae formation were significantly inhibited,and the concentration was dose-dependent.After the concentration of 16 mg/mL acted on C.albicans for 6 h, hyphae disappeared completely.The results of RT-PCR showed that the gene expression of Efg1 and Hwp1 could be inhibited by rohdea roth.Compared with the control group,the expression of Efg1 and Hwp1in the experimental groupwere reduced by 84.18% and 59.57%(P<0.01).Conclusion The inhibitory effect of rohdea roth on the adherence and hyphae formation of C.albicans is mainly through inhibiting the expression of Efg1 and Hwp1genes.

Objective Survival rates of pancreas cancer during the years 1972-2011,from a population-based cancer registry in Qidong,were analyzed in order to provide information for the prognosis assessment and control of this disease.Methods The deadline of the last follow-up for survival status of 3279 registered cases was April 30th,2012.DCO (death certificates only) cases were excluded,leaving 3272 cases for survival analysis.Cumulative observed survival rate (OS) and relative survival rate (RS) were calculated by the SURV3.01 software.Results The 1-,5-,10-,15-,20-,25-,and 30-year OSs were 12.69％,4.87％,3.76％,3.07％ 2.66％,1.94％ and 1.28％,respectively,and OSs in male were 12.39％,4.67％,3.41％,2.77％ 2.22％,1.35％,0.75％,and in female were 13.08％,5.12％,4.22％,3.45％,3.28％,3.00％ 2.40％.The 1-,5-,10-,15-,20-,25-,and 30-year RSs were 13.34％,6.30％,6.47％,7.34％ 9.27％,10.33％ and 10.65％,respectively;and the RSs in male were 13.06％,6.14％,6.06％ 6.91％,8.06％,7.44％,6.44％,and in female were 13.70％,6.47％,6.99％,7.88％,10.91％ 15.25％,19.12％.The 5-year OS rates at age groups of 15-34,35-44,45-54,55-64,65-74 and ＞75 were 17.81％,6.34％,8.32％,5.04％,3.75％ and 3.82％,respectively.The 5-year RSs were 17.97％,6.47％,8.65％,5.47％,4.68％ and 8.03％.Five-year OSs increased from 2.01％ in 1973-1977 to 5.11％ in 2003-2007.Conclusions The overall survival rate of pancreas cancer has increased during the past 40 years in Qidong,but the improvement is marginal.

Objective To investigate whether liraglutide treatment can prevent catch-up fat in high-fat dietinduced catch-up growth rats,and to discuss the possible underlying mechanisms.Methods Sixty-four SpragueDawley rats were stratified into 4 groups:normal control group,catch-up growth (CUG) group,catch-up growth with liraglutide treatment (CUGL) group,and catch-up growth with liraglutide plus exendin (9-39) treatment (CUGLE) group.All the catch-up growth animals underwent a4 week high-fat diet re-feeding phase after a4 week food restriction phase.Body weight and food intake were measured every day.At the end of food restriction and re-feeding,body composition was measured via Dual energy X-ray absorptiometry.After the rats were sacrificed,body fat distribution and plasma lipid levels were determined.Results By the end of catch-up growth,body weight,energy intake,Lee' s index,fat body mass,visceral adipose tissue/body weight,subcutaneous adipose tissue/body weight,triglyceride,free fatty acid,low density lipoprotein-cholesterol levels were lower in CUGL rats compared with CUG rats (all P＜0.01).There were no significant differences in energy intake,body composition,fat body mass,and blood lipid levels between CUGLE rats and CUG rats,while the weight of CUGLE rats was significantly lower than CUG ones.Conclusions Liraglutide infusion protects rats with high-fat diet induced catch-up growth from catch-up fat mainly via a glucagon-like peptide-1 receptor dependent manner.

OBJECTIVE:To investigate the role of clinical pharmacists in the therapy for acute exacerbation of chronic obstruc-tive pulmonary diseases (AECOPD) complicated with pulmonary infection. METHODS:Clinical pharmacists participated in the therapy for a case of acute exacerbation of AECOPD complicated with pulmonary infection. According to the patients’signs,assis-tant examination and disease condition,clinical pharmacists provided suggestions,i.e. Piperacillin sodium and sulbactam sodium for injection (4∶1) 5.0 g,ivgtt,q12 h,for anti-infective treatment;Bisacodyl enteric-coated tablet 5 mg,po,qd,for promoting defecation;Clostridium butyricum viable bacteria tablet 20 mg,po,tid,for regulating gastrointestinal flora;Pinaverium bromide tablet 50 mg,po,tid,for regulating gastrointestinal smooth muscle tension;Shexiang baoxin pills 22.5 mg,po,tid,instead of flu-id infusion for protecting heart,and isosorbide 5-mononitrate 20 mg,po,tid,for preventing angina pectoris;Cefminox capsule 100 mg,po,tid,for anti-infective treatment;fluconazol 0.4 g,ivgtt,qd,for antifungal treatment,and Bacillus licheniformis 500 mg,po, tid,for preventing alteration of intestinal flora. RESULTS:The physicians adopted clinical pharmacist’s suggestions. No ADR was found during treatment,and the patients transferred to ordinary ward after the disease condition had been controlled. CONCLU-SIONS:The participating of clinical pharmacists in pharmaceutical care can promote rational drug use in the clinic and guarantee the safety of drug use.

Objective To analyze the survival rates of patients with non-Hodgkin lymphoma (NHL) in Qidong from 1972 to 2011,in order to provide the basis for the prognosis assessment and the control of this cancer.Methods A total of 1 472 registered NHL cases were followed up to April 30, 2012.Cumulative observed survival (OS) rate and relative survival (RS) rate were calculated using Hakulinen method performed by the SURV 3.01 software developed at the Finnish Cancer Registry.Results The 1-, 3-, 5-, 10-, 20-and 30-year OS rates were 32.48 ％, 19.30 ％, 15.78 ％, 12.76 ％, 9.54 ％ and 7.63 ％, and the RS rates were 33.49 ％, 21.18 ％, 18.46 ％, 17.79 ％, 19.37 ％ and 22.44 ％, respectively.The 1-, 3-, 5-, 10-, 20-and 30-year RS rates of males vs females had no statistically significant differences (x2 =3.32, P =0.767).The 5-year RS rates of age groups 0-14, 15-34, 35-44, 45-54, 55-64, 65-74, and ≥75 were 22.99 ％, 20.51％,18.42 ％, 20.96 ％, 18.72 ％, 17.32 ％, 10.60 ％, and the 10-year RS rates were 23.04 ％, 15.55 ％, 15.91％,16.36 ％, 18.59 ％, 19.70 ％, 20.93 ％, respectively.The age group 0-14 had the highest 5-and 10-year RS rates.Remarkable improvement could be seen in the 5-year RS rate from 7.76 ％ in 1973-1977 to 26.79 ％ in 2003-2007, and the 10-year OS rate from 6.63 ％ in 1973-1977 to 15.52 ％ in 1998-2002, respectively.Conclusions The outcome of NHL in Qidong has been improved gradually from 1972 to 2011, but the gaps of survival rates in NHL patients between China and the developed countries still exist.Research on the diagnosis and treatment of NHL should be further emphasized.

Background and purpose:There are few studies referring to population-based cancer survival of bladder cancer for more than forty years in China. This paper was to offer basis for assessing long-term survival trends of bladder cancer and the prognosis of this cancer through analysis of the survival rates based on cancer report documents from 1972 to 2011 in Qidong.Methods:The deadline of the last follow-up for survival status of the 1 619 registered cases was Apr. 2012. Cumulative observed survival rate (OS) and relative survival rate (RS) were calculated using Hakulinen’s method performed by the SURV3.01 Software which is developed by Finnish Cancer Registry.Results:The one-, three-, five-, ten-, fifteen-, twenty-, and thirty-year OS rates were 59.91%, 43.49%, 35.98%, 26.91%, 21.30%, 18.37% and 12.24%; and the one-, three-, five-, ten-, fifteen-, twenty-, and thirty-year RS rates were 64.07%, 53.02%, 50.06%, 52.42%, 59.59%, 76.39% and 115.75%, respectively. For males, these OS rates were 60.84%, 43.91%, 36.95%, 27.31%, 21.49%, 18.29% and 12.59%, and RS rates were 65.23%, 53.95%, 52.02%, 54.57%, 62.59%, 79.12% and 117.07%, respectively; For females, these OS rates were 56.61%, 42.03%, 32.44%, 25.65%, 20.78%, 18.80% and 0%, and RS rates, 59.99%, 49.91%, 43.37%, 45.86%, 51.21%, 69.02% and 0%, respectively. There were no statistical differences couldbe found between both sexes (P=0.256). Five-year RS rates of age groups 15-34, 35-44, 45-54, 55-64, 65-74, and more than 75 were 49.10%, 67.53%, 62.77%, 53.92%, 46.59% and 39.85%, and 10-year RS rates, 49.79%, 61.23%, 52.99%, 48.21%, 54.94% and 51.21%, respectively. Remarkable improvement could be seen for the five-, ten-, and fifteen-year RS rates in this setting since 1980’s.Conclusion:The survival outcome from Qidong registered cases with bladder cancer shows gradual progress during the past 2 decades. Early detection and improvement of therapies may be the factors affecting the prognosis of bladder cancer. Although the disparities in survival rates between Qidong and the developed countries are getting narrower, potential for survival improvement still exists.

Objective To identify the pathogen distribution and antibiotics resistance of blood stream infection(BSI) in the pediatric surgery intensive care unit(PSICU).Methods The clinical data of 138 pediatric patients diagnosed with BSI from January 2011 to December 2015 were collected in PSICU,and the distribution of pathogens and drug resistance were retrospectively analyzed.Results The incidence of BSI was 3.88‰(138/35.524)in the five years,the majority of the BSI cases occurred under one year old,and the mortality was 13.77%(19/138).A total of 179 strains were isolated from blood samples of 138 patients,of which gram-positive bacteria,gram-negative bacteria and fungi accounted for 60.89%(109/179),22.91%(41/179)and 16.20%(29/179)respectively.The most common gram-positive bacteria was coagulase-negative staphylococcus (84/179,46.93%).The predominant gram-negative bacteria were Acinetobacter baumannii(15/179,8.38%),Klebsiella pneumonia(12/179,6.70%) and Escherichia coli(6/179,3.35%).The rate of carbapenems-resistant Acinetobacter baumannii increased continuously in the study period.Non-albicans Candida was the most common fungi (14/179,7.82%).The resistance rate of multi-drug resistant strains to carbapenems significantly increased.Conclusion The incidence of BSI in PSICU increases,and the mortality in children younger than one year is high.Better understanding of distribution of BSI pathogen could provide more effective antibiotic prescription.