Objective To evaluate prognostic value of pentraxin3 (PTX3) content combining with extravascular lung water index (EVLWI) in patients with sepsis.Methods A retrospective analysis of complete clinical data of septic patients admitted to Department of Critical Care Medicine of the First Affiliated Hospital of Zhengzhou University from February 2013 to February 2014 was conducted.These patients were divided into two groups,survival group and death group,according to the outcome on the 28th day.Pulse index continuous cardiac output (PiCCO) was used to record the levels of EVLWI on the 1st,2nd and 3rd day of intensive care unit (ICU) admission.The plasma level of PTX3 was measured simultaneously by enzyme-linked immunosorbent assay (ELISA).At the same time,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and sequential organ failure assessment (SOFA) were calculated.Correlation analysis between plasma PTX3 and EVLWI values was performed,receiver operating characteristic curve (ROC) was drawn,and the prognostic value of each parameter was assessed finally.Results A total of 74 septic patients were enrolled,with 41 cases in the survival group and 33 cases in the non-survival group.Blood lactate,APACHE Ⅱ,SOFA scores in the non-survival group were significantly higher than those of the survival group at ICU admission,and the length of ICU stay was significantly shorter than that of the survival group,while differences of the other clinical characteristics between two groups were not statistically significant.The plasma PTX3 level gradually declined with time in both groups,and plasma PTX3 at 1,2,3 days after ICU admission in non-survival group were significantly higher than those in survival group [PTX3 (μg/L) at 1 day:46.3± 10.5 vs.19.4±6.5,t =-13.486,P =0.000; 2 days:34.8± 10.7 vs.17.7±8.4,t =-8.284,P =0.000; 3 days:23.9± 11.2 vs.15.6 ± 7.9,t =-5.036,P =0.000].EVLWI gradually declined in survival group,but increased in death group.EVLWI at 1,2,3 days after ICU admission in non-survival group were significantly higher than those in survival group [EVLWI (mL/kg) at 1 day:12.12 ± 4.31 vs.10.02 ± 2.87,t =-2.502,P =0.023; 2 days:13.67 ± 4.95 vs.9.08 ± 2.89,t =-5.188,P =0.000; 3 days:14.51±5.06 vs.8.09±2.50,t =-7.126,P =0.000].PTX3 at 1,2,3 days after ICU admission showed a significant positive correlation with EVLWI (r1 =0.747,r2 =0.719,r3 =0.705,all P =0.000).ROC curve analysis showed that the area under the ROC (AUC) of PTX3 at 1 day was 0.845 ± 0.045,at the cut-off point of 23.0 μg/L,PTX3 showed a sensitivity of 84.8％,a specificity of 74.1％,a negative predictive value of 85.81％,and a positive predictive value of 72.42％.AUC of EVLWI at 3 days was 0.838 ± 0.048,at the cut-off point of 10.5 mL/kg,EVLWI showed a sensitivity of 83.9％,a specificity of 82.9％,a negative predictive value of 86.45％,and a positive predictive value of 79.79％.Their sensitivities and specificities were found to be better than APACHE Ⅱ,SOFA score.AUC of PTX3 combined with EVLWI at 1 day was 0.886 ± 0.038.On the 1st day after ICU admission,with combination of the two indicators,cut-off point was found to be 0.312,a sensitivity of 86.8％,a specificity of 85.4％,a negative predictive value of 88.93％,and a positive predictive value of 82.72％.On the 3rd day after ICU admission,AUC of PTX3 combined with EVLWI was 0.856 ± 0.046,and showed a cut-off of 0.471 for the prognosis of sepsis,a sensitivity of 85.8％,a specificity of 85.4％,a negative predictive value of 87.97％,and a positive predictive value of 82.50％.Compared with other single index,a combination of above mentioned two indexes showed a better sensitivity and specificity.Conclusions PTX3 can serve as a novel prognostic indicator at early stage in septic patients.Combined with EVLWI,it shows important value in predicting prognosis of septic patients,and it also provides guidance in treatment of high-risk patients.

Objective To explore the effect of tumor necrosis factor (TNF)-α inhibitors therapy on bone mineral density (BMD) in active rheumatoid arthritis (RA) patients with low bone mass.Methods Sixtytwo active RA patients with low bone mass were treated with a standard treatment of calcium carbonate 0.5 g/d and alfacalcidol 0.25 μg/d,and were divided into two groups.Patients of the control group were treated with methotrexate 10 mg per week,while patients of the experimental group were treated with combined recombinant human type Ⅱ tumor necrosis factor receptor-antibody fusion protein 50 mg per week or adalimumab 40 mg/2 week subcutaneously for 12 months with methotrexate.BMD of lumbar spine (L2-4),femoral neck,trochanter and Ward's triangle region by dual energy X-ray absorptiometry (DEXA),as well as the bone turnover markers serum C telopeptide of type-Ⅰ collagen (CTX-Ⅰ) and serum procollagen type-Ⅰ N propeptide (PINP) were measured by enzyme-linkedimmunosorbent assay (ELISA) in both groups at the baseline,treatment for six-month and twelve-month.T test and Chi-square test was used to process the data.Results ① After 6 months of treatment,the BMD of lumbar spine,femoral neck and trochanter in the group with TNF-α inhibitors were higher than the control group [(0.68±0.08) g/cm2 vs (0.65±0.06) g/cm2,t=2.269,P=0.027; (0.63±0.08) g/cm2 vs (0.58±0.09) g/cm2,t=2.111,P=0.040; (0.61±0.10) g/cm2 vs (0.56±0.07) g/cm2,t=2.203,P=0.032; respectively].And after 12 months,the BMD of all regions were significantly higher thanthe control group [spine,(0.68±0.07) g/cm2 vs (0.62±0.08) g/cm2,t=5.115,P=0.000; femoral neck,(0.63±0.08)g/cm2 vs (0.56±0.08) g/cm2,t=3.475,P=0.001; Ward's triangle region (0.60±0.08) g/cm2 vs (0.56±0.08) g/cm2,t=2.309,P=0.025; trochanter,(0.61±0.10) g/cm2 vs (0.53±0.08) g/cm2,t=3.254,P=0.002; respectively].② Compared to the baseline,BMD of lumbar spine was significantly decreased in the control group after 12 months.While in the group of TNF-α inhibitors,BMD of lumbar spine was increased[(0.66±0.08) g/cm2 vs (0.68±0.07)g/cm2,t=3.411,P=0.001].③ Compared to the baseline,CTX-Ⅰ,a marker of bone resorption was significantly decreased at 6 months and 12 months in the group with TNF-αinhibitors [6 months,(0.33±0.2) ng/ml vs (0.46±0.22) ng/ml,t=5.548,P＜0.01; 12 months,(0.31±0.21) ng/ml vs (0.46±0.22) ng/ml,t=5.974,P＜0.01],while this decline was not found in the control group.PINP,a marker of bone formation was stable in both 2 groups during the study.Conclusion In active RA patients with low bone mass,loss of BMD in the spine and hip can be arrested by the treatmentof TNF-α inhibitors.

To investigate chemical constituents from Radix Pittospori, chloroform extract of the roots was subjected to column chromatography with various chromatographic techniques. The structures were elucidated on the basis of physico-chemical property and spectral analysis. Two triterpenoids were identified as 22-acetyl-21-(2-acetoxy-2-methylbutanoyl)-R1-barrigenol(1) and 3alpha-hydroxyl-20-demethylisoaleuritolic-14(15)-ene-28, 30-dioic acid (2). Compound 1 is a new triterpene and compound 2 is isolated from this plant for the first time.

0.05).Combination of NGF with bFGFs(10 U/ml NGF+10 ?g/L bFGF or 5 U/ml NGF+5 ?g/L bFGF) not only promoted the proliferation of HDPCs(P

Objective To establish an HPLC method for determination of the content of radiosensitizer YABQ and its related substances.Methods Diamonsil C18 column (250 mm ×4.6 mm,5 μm) was used.The mobile phase consisted of methanol-0.1%formic acid (22∶78) and isocratic elution at a flow rate of 1.0 ml/min.The detection wavelength was 266 nm,the temperature of the column was 30℃, and the injection volume was 10 μl.Results The linear range of YABQ was 7-84 μg/ml, r=0.9992.The detection limit was 8 ng (S/N≥3), and the quantitation limit was 24 ng (S/N≥10). According to destructive sample processing, the separation coefficient between the peaks was above 1.5, indicating that this chromatographic method could meet the YABQ monitoring requirements.Conclusion Method validation and destructive testing show that both the precision and specificity are fine with this method, which could be used for quality control of YABQ and its related substances.

Objective To explore the prognostic value of serum C-reactive protein/albumin (CRP/ALB) ratio in the adult patients with sepsis.Methods A retrospective study was conducted.Clinical data were collected from septic patients who were at least 18 years old and whose intensive care unit (ICU) lengths of stay were at least 3 days,and who were admitted in the Department of Critical Care Medicine of the First Affiliated Hospital of Zhengzhou University in Henan Province from September 2013 to September 2015.These patients were divided into survival group and death group according to 28-day outcome.The serum CRP,ALB,and CRP/ALB ratio levels at the start of treatment (0 hour),24 hours and 72 hours after treatment in ICU were analyzed.And the receiver-operating characteristic (ROC) curve was plotted to assess the value of CRP,ALB and CRP/ALB ratio at different time points for predicting the outcome.Results Sixty-nine patients with sepsis were selected,among whom 28 cases were in the death group and the mortality was 40.6％.The characteristic of the baseline data in the two groups was balanced.The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and sequential organ failure assessment (SOFA) score at the first 24 hours of ICU admission in the death group were significantly higher than those in the survival group (APACHE Ⅱ score:25.18 ± 3.18 vs.17.88±3.20,SOFA score:11.71± 1.78 vs.9.17 ± 2.38,both P ＜ 0.05).And the ICU length of stay in the death group was significantly longer than that in the survival group [days:9.0 (2.5) vs.8.0 (3.0),P ＜ 0.05].The ALB level increased gradually as the treatment was extended in both groups while the levels of CRP and CRP/ALB declined gradually.The ALB levels at 0,24,72 hours after treatment in the death group were significantly lower,and the CRP and CRP/ALB levels were significantly higher than those in survival group [ALB (g/L):23.40 (4.20) vs.25.20 (8.20) at 0 hour,24.18±4.33 vs.28.54±4.88 at 24 hours,25.50±4.88 vs.34.88±7.23 at 72 hours;CRP (mg/L):179.32±34.04 vs.159.55±36.82 at 0 hour,160.08±22.91 vs.146.23±30.31 at 24 hours,159.36±25.81vs.142.53±36.30 at 72 hours;CRP/ALB:7.52±1.32 vs.6.04±1.46 at 0 hour,6.77±1.42 vs.5.23±1.24 at 24 hours,6.40± 1.34 vs.4.19± 1.21 at 72 hours;all P ＜ 0.05].ROC curves analysis showed that the area under ROC curves (AUC) of CRP/ALB at all time points were larger than those of CRP and ALB,with higher sensitivity and specificity;the AUC of ARP/ALB at 0,24,72 hours were 0.767,0.807,0.895,respectively;the cut-off values were 6.96,5.44,4.91,the sensitivity were 71.4％,85.7％ and 89.3％,and the specificity were 73.2％,63.4％ and 82.9％,respectively.Conclusions High serum CRP,CRP/ALB and low ALB in adult patients with sepsis indicate a poor prognosis,while the prognostic value of CRP/ALB is obviously better than the single value of CRP or ALB.CRP/ALB at 72 hours may be one of the best indicators for the assessment of clinical therapy and prognosis of patients with sepsis.

The content of endogenous anabolic steroids is extremely low in biological matrices.Its chemical structure contains polar functional groups such as hydroxyl and carbonyl, which limits their applicability in GC-MS.The lack of ionized groups in the chemical structure leads to poor sensitivity in LC-MS, which plays a significant role in various physiological activities analysis.It is an effective way to enhance the response of mass spectrometer by modifying the chemical structure of endogenous anabolic steroids through derivatization technology.This review summarizes various derivatization reagents and corresponding derivatization processes of endogenous anabolic steroids analysis in the methods based on different testing instruments and methodologies.The advantage and disadvantage of all kinds of derivatiaztion methods and the prospect of the endogenous anabolic steroids derivatiaztion techniques are also discussed.

Objective To establish an high performance liquid chromatography method for determination of 2-indole ketone derivative and its related substances. Methods Agilent Eclipse XDB-C18(250 mm×4.6 mm,5 μm) column was adopted.The mobile phase was acetonitrile-water with gradient elution mode at a flow rate of 1. 0 mL?min-1; the column temperature was 35 ℃;the injection volume was 20 μL and the detection wavelength was set at 257 nm. Results 2-indole ketone derivative ID and related substances could be well separated. The 2-indole ketone derivative had good linear correlation ( r=0.999 4) within the range of 40-300 μg?mL-1 . It had a good precision ( RSD<1%) . The limit of detection was 8 ng. Conclusion The method is accurate,simple,sensitive and selective,which can be used for the quality control of 2-indole ketone derivative and related substances.

Objective To establish a RP-HPLC method for the determination of 3-amide-indole derivative and its related substances. Methods Diamonsil C18(250 mmí4. 6 mm,5 μm) column was adopted. The mobile phase consisted of a mixture of methanol-acetonitrile-water(431245) at the flow rate of 1. 0 mL·min-1 . The wavelength for ultraviolet detection was 224 nm. The injection volume was 20 μL and the column temperature was room temperature. Results 3-amide-indole derivative and related substances could be well separated. The linearity of the 3-amide-indole derivative curve was well correlated (r=0. 999 7) within the range of 0. 04-0. 16 mg·mL-1. The RSD was 0. 52%with good repeatability. The detection limit was 2. 65 ng. Conclusion The method is accurate,reliable,sensitive and specific,which could be used for the determination of 3-amide-indolederivative and related substances.

BACKGROUND:There are less studies addressing whether bone marrow mesenchymal stem cells from systemic lupus erythematosus patients are different from healthy people.
OBJECTIVE:To compare the multi-differentiation capacity of bone marrow mesenchymal stem cells isolated from systemic lupus erythematosus model mice and normal control mice.
METHODS:Bone marrow mesenchymal stem cells of systemic lupus erythematosus model mice and C57BL mice were isolated and cultured fol owed by osteogenic and adipogenic differentiations, respectively. Differentiation abilities of two kinds of mouse bone marrow mesenchymal stem cells were observed.
RESULTS AND CONCLUSION:Passaged bone marrow mesenchymal stem cells from C57BL mice were long spindle-shaped and evenly distributed, while bone marrow mesenchymal stem cells from systemic lupus erythematosus model mice showed slow growth and were relatively smal er than those from C57BL mice. After osteogenic induction, the amount of calcium salt and calcium nodules were significantly less in the bone marrow mesenchymal stem cells from systemic lupus erythematosus model mice than from normal control mice. PCR detection showed that expressions of Runx2, alkaline phosphatase and osteocalcin were also significantly decreased in the bone marrow mesenchymal stem cells from systemic lupus erythematosus model mice. After adipogenic induction, the number of lipid droplets in the bone marrow mesenchymal stem cells from systemic lupus erythematosus model mice was significantly less than the control group, and PCR detection also showed significantly decreased expression of adipogenic genes, including PPARγ2 and lipoprotein lipase. These findings suggest that the bone marrow mesenchymal stem cells from systemic lupus erythematosus model mice exhibit lower osteogenic and adipogenic capacities than those from normal C57BL mice, and also have the impaired multi-differentiation ability.