Objective To clinically validate the precision of diagnostic Sepsis-3 criteria, and to guide and generalize its clinical application.Methods A multicenter retrospective observational study was conducted. The patients admitted to intensive care unit (ICU) of 6 tertiary hospitals in Zhejiang Province from January to June 2015 were enrolled, and the patients satisfying the diagnostic criteria of Sepsis-2 and Sepsis-3 were screened. Population characteristics between the patients satisfying two editions were compared, and the diagnosis accuracy rate in different degree hospitals were investigated. According to the doctor's diagnosis, the patients who met the criteria of Sepsis-2 were divided into diagnosis group and non-diagnosis group, and the factors influencing the diagnosis of sepsis were analyzed by logistic regression. The patients meeting Sepsis-2 but no meeting Sepsis-3 were served as exclusion group, and those meeting Sepsis-2 and Sepsis-3 were served as enroll group, and the characteristics of patients between the two groups were compared. Receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of systemic inflammatory response syndrome (SIRS) score, sepsis-related quick sequential organ failure assessment (qSOFA) and sequential organ failure assessment (SOFA) on death, and whether the consistency of qSOFA and SOFA would affect the sensitivity of definition. The patients meeting Sepsis-2 were divided into non-survived group and survived group, and the factors associated with death were analyzed by logistic regression.Results Finally, 1423 patients were enrolled, 3 patients with age < 18 years and 19 patients with missing data were excluded. There were 363 patients and 329 patients met Sepsis-2 and Sepsis-3, respectively. No significant differences were found in populationcharacteristics between the groups of Sepsis-2 and Sepsis-3 (allP > 0.05) except for acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score [19.10 (8.00) vs. 20.28 (8.00),P < 0.05]. It was shown on the clinical data analysis of the hospitals that the patients meeting Sepsis-2 and Sepsis-3 in hospital 3 had the highest 28-day mortality (60.4% and 60.0%) with the lowest rate of diagnosis (0). While in the hospital 1, the patients had the lowest 28-day mortality (22.9% and 27.2%), and the rate of diagnosis was 19.5%. Interestingly, the patients in hospital 4 had the highest diagnosis rate of sepsis (44.8%), but 28-day mortality was both 58.6%. It was shown by logistic regression analysis that the patients with old age [odds ratio (OR) = 0.970,P = 0.021], high blood lactate (OR= 0.443,P = 0.004), high blood pressure (OR = 0.957,P = 0.009) and low oxygenation index (OR = 1.004,P = 0.024) were easy to neglect diagnosis. Compared with Sepsis-3 exclude group, the patients in Sepsis-3 enroll group were older [years: 68.52 (26.00) vs. 53.75 (18.00),P < 0.01] with higher APACHEⅡ score [20.38 (8.00) vs. 7.72 (6.00),P < 0.01], higher blood lactate [mmol/L: 3.45 (3.00) vs. 1.95 (1.20), P > 0.05], longer length of ICU stay [days: 22.42 (22.00) vs. 15.13 (16.00),P < 0.01], and higher 28-day mortality [45.29% (149/329) vs. 14.71% (5/34),P < 0.01], indicating that the diagnostic efficiency of Sepsis-2 was low, the diagnostic specificity of Sepsis-3 was high, and the prognosis of Sepsis-3 patients was worse. It was shown by ROC curve analysis that the prognostic value of SIRS, qSOFA and SOFA to mortality was gradually increased [area under ROC curve (AUC) was 0.567, 0.597, 0.683, respectively], but the prognostic value were all low. Comparing patients meeting qSOFA and (or) SOFA in Sepsis-2, significant differences were found in APACHE Ⅱ score [17.55 (7.00) vs. 23.24 (8.00)] and 28-day mortality [38.75% (31/80) vs. 58.59% (75/128), bothP < 0.01]. The patients who just met the qSOFA or SOFA, their 28-day mortality was up to 38.75%, suggesting that qSOFA should not be ignored. Compared with survived group, the patients in survived group were older with higher APACHE Ⅱ score and shorter length of ICU stay (allP < 0.05). It was shown by logistic regression analysis that APACHE Ⅱ score (OR = 1.199,P = 0.000) and length of ICU stay (OR = 0.949,P = 0.000) were related with death.Conclusion Patients satisfied Sepsis-3 were easier to develop more organ failure, Sepsis-3 and higher death prediction than Sepsis-2 and higher diagnosis specificity, but data shows that there is extra room for improvement.

Objective To observe clinical effects of Sanqi wound tablets combing with Western medicine to conservative treatment of acute thalamic hemorrhage.Methods72 patients with acute thalamic hemorrhage from Department of Neurosurgery from December 2014-June 2016 were grouped two groups by random number table method.The control group was treated with Western medicine, and observation group was treated with Sanqi wound tablets combing with Western medicine.Relevant indicators were analyzed between two groups.ResultsEffective rate of observation group was 88.89%, higher than control group with 69.44%(P<0.05).NSE and hs-CRP level of observation group were (7.02±1.86)μg/L,(11.75±2.64)mg/L, lower than control group(13.98±2.01)g/L,(19.82±3.07)mg/L(all P<0.05).Fugl-Meyer and NIHSS of observation group were (93.07±4.25),(12.01±2.30)points, better than control group(81.16±4.10),(18.42±2.45)points(all P<0.05).Thalamic residual bleeding of observation group was (2.82±0.41)mL, lower than control group (3.97±0.57)mL(P<0.05).ConclusionOn the basis of Western medicine, Sanqi wound tablets can improve the therapeutic effect, reduce inflammation, improve the patient's motor function and nerve defect degree and accelerate the absorption of hematoma.

Objective To investigate the effect of lidocaine on Staphylococcus aureus exotoxin-stimulated peripheral blood mononuclear cells (PBMCs) from patients with atopic dermatitis (AD).Methods Peripheral blood samples were collected from 6 patients with AD,and PBMCs were isolated by a routine method.Then,the PBMCs were stimulated by the Staphylococcus aureus exotoxin toxic shock syndrome toxin-1 (TSST-1) in the absence or presence of lidocaine at varying concentrations.The 3H-TdR incorporation method was performed to detect the proliferation of monocytes,and enzyme-linked immunosorbent assay (ELISA) to quantify the levels of T helper type 1 (Th1) and Th2 cytokines released by PBMCs.Human HaCaT keratinocytes were co-cultured with lidocaine-and TSST-1-stimulated PBMCs from patients with AD for 72 hours,then,Western blot was conducted to examine the expression of filaggrin protein in HaCaT cells.Results TSST-1 (100 μg/L) significantly enhanced the proliferation of PBMCs from patients with AD (stimulation index =75 ± 2.12,P ＜ 0.05),as well as the release of tumor necrosis factor-α (TNF-α),interferon (IFN)-γ,interleukin (IL)-2,IL-12,IL-4,IL-5 and IL-13 by the PBMCs (all P ＜ 0.05).Compared with the blank control group,100 μmol/L lidocaine significantly inhibited the TSST-1-stimulated proliferation of PBMCs from patients with AD (stimulation index =58 ± 3.14,P＜ 0.05),as well as the release of IL-4,IL-5,IL-13,TNF-α and IFN-γ by the stimulated PBMCs (all P ＜ 0.05).Western blot showed that 100 μmol/L lidocaine significantly blocked the down-regulation of filaggrin expression in HaCaT cells (P ＜ 0.01).Conclusion Lidocaine has a significant inhibitory effect on the activation of TSST-1-stimulated PBMCs from patients with AD.

Background and purpose:Hepatocellular carcinoma suppressor gene-1(HCCS1)is a potential hepatocellular carcinoma supressor gene,and it also plays an important role in sorting of some cytoplasmic proteins.Its carcinoma suppressor function may be related to its sorting function.So it is important to identify the minimum region of functional sequence in HCCS1 that related to the transportation.Methods:The expression vectors containing various lengths of HCCS1 gene were constructed and transfected into HeLa cells mediated by liposomes.The localizations of different HCCS1 fragments and the colocalizations of M6PR with various truncated HCCS1 were determined by laser scanning confocal microscopy,respectively.Results:10 different expression vectors containing various lengths of HCCS1 gene were successfully constructed,it had been shown that the polar localization of HCCS1 protein and the co-localizations with M6PR disappeared when HCCS1 gene was truncated to 1 120 bp from the 3'end by laser scanning confocal microscopy.Conclusions:We identified the minimum localization of the HCCS1 functional sequence that related to the transportation.

Background and purpose:Wuxing soup is popular for it's anti-cancer effect in folk medicine and deserved to be further studied by modern scientific methods.This research aimed to explore its anti-cancer effect and to study the influence on the immunity of melanoma in mice. Methods :Inhibition of different ingredients and concentrations of Wuxing soup on the growth of the mouse melanoma B16 cells was detected by MTT in vitro.Animal experiment was performed to determine its anti-cancer effect in vivo.C57/BL6 mice were randomly divided into three groups after vaccination of B16 cell,and then given intragastrically with different soups for 25 days.All mice were killed on day 26 after inoculation.The weight of tumors were recorded.The anti-tumor immune function was measured by T lymphocyte transforming assay and NK killing assay.The different effect of different ingredients was also observed. Results :Our result showed that different ingredients soup exerted different inhibition on B16 cell growth and Wuxing soup was the strongest one of all and in dose-dependent manner in vitro.The animal experiment indicated that different ingredients soup has different inhibition on melanoma,the soup-treated mouse display improved T lymphocyte transforming assay and NK killing ability.Among the different soups,Wuxing soup showed the strongest anti-cancer effect and immune enhancement. Conclusions :Wuxing soup is an effective anti-cancer agent in melanoma mice and can enhance the immunity of the mice with melanoma.

OBJECTIVETo investigate the role of histone acetylation in regulating influenza virus replicative intermediate double-stranded RNA (dsRNA)-induced interleukin-6 (IL-6) expression in A549 cells.

METHODSA549 cells were treated with influenza virus replicative intermediate dsRNA, histone deacetylase (HDAC) inhibitor trichostatin A (TSA), or HADC small interfering RNA (siRNA). The changes in the cellular IL-6 promoter activities were detected by dual-luciferase assay, and IL-6 mRNA and protein expressions in the cells were determined using real-time RT-PCR and ELISA, respectively.

RESULTSInfluenza virus replicative intermediate dsRNA obviously up-regulated IL-6 expression in the cells. HDAC inhibitor TSA significantly enhanced the activity of IL-6 promoter and increased IL-6 mRNA expression in A549 cells, and HDAC3 may play an important role in this process. HDAC inhibitor TSA and DNMT inhibitor DAC showed no synergic effect in regulating IL-6 expression.

CONCLUSIONSInfluenza virus replicative intermediate dsRNA-induced IL-6 expression in A549 cells is regulated by histone acetylation.

Acetylation ; Cell Line, Tumor ; Gene Expression Regulation ; Histone Deacetylase Inhibitors ; pharmacology ; Histones ; metabolism ; Humans ; Interleukin-6 ; metabolism ; Orthomyxoviridae ; genetics ; metabolism ; Promoter Regions, Genetic ; RNA, Double-Stranded ; RNA, Messenger ; genetics ; RNA, Viral

Objective:This thesis aims to construct the evaluation index system ethics management in Beijing medical institutions for application research.Method:The author applied the evaluation system which was agreed and adjusted by expert groups in four medical and health institutions.Result:After three rounds of expert groups have reached the agreement,the Evaluation Index System on Human Research Ethics Management in Beijing Medi-cal Institutions is established,which contains 6 first-class indicators,16 second-class indicators and 39 third-class indicators.The application on four medical and health institutions show that the evaluation index system is practical,operable and is of high degree of distinction.Conclusion:The evaluation index system is scientific,rea-sonable,practical and is of high degree of validity,credibility and distinction.

Liver injury caused by viral and non-viral factors is an important stage of chronic liver disease, and the pathogenesis of liver injury is still a research hotspot. With the deepening of the research on gut microbiota, substantial evidence indicates that gut microbiota participates in the development and progression of liver injury, and it has been confirmed that Akkermansia muciniphila (Akk) has a beneficial effect against liver injury. This article summarizes the role and potential mechanism of Akk in immune-mediated liver injury, alcoholic liver disease, and nonalcoholic fatty liver disease. It is believed that Akk may provide new directions and choices for the prevention and treatment of liver injury.

Objective To improve the quality standard of Tongluo-Zhujing pills.Methods We added the identification ofradix notoginseng andtypha orientalisby TLC and determination of the content of wedelolactone by HPLC. The study used Agilent ZORBAX SB-C18 (4.6 mm × 250 mm, 5 μm) column and the velocity of flow manufactured by the proper proportion was 1 ml/min. The detection wavelength was 249 nm . Results The new method could well identify radix notoginsengandtypha orientalis. The calibration curves of wedelolactone was in good linearity over the range of 0.064-0.642 μg (r=0.999 7) and the average recovery was 98.74%(RSD=1.61%).Conclusions The quality standard of Tongluo-Zhujing pills was proved effectively.

Through the questionnaire survey on the current situation of human research ethical management in Beijing medical and health institutions, this paper analyzed the problems existing in ethical management of Beijing medical and health institutions and put forward corresponding countermeasures and suggestions. The results showed that overall status of human research ethical management in Beijing medical and health institutions was satisfying. But the ethical management levels of different types of medical and health institutions were quite different, and medical and health institutions, health family planning administration departments and academic teams should all make corresponding contributions.