Objective To investigate the value of pro-adrenomedullin (pro-ADM) levels for severity as-sessment of community-acquired pneumonia (CAP).Methods 214 CAP patients who were admitted to the emer-gency department were prospectively studied.The levels of plasma pro-ADM were determined using a new sandwich immunoassay.At the same time, procalcitonin, C-reactive protein, interleukin-6 levels, leukocyte count, clinical varia-bles and the pneumonia severity index (PSI) were measured.Results Pro-ADM levels,in contrast to procalcitonin,interleukin-6 levels, increased with increasing of the severity of CAP, which was classified according to the PSI score (P<0.05).In patients who died during follow-up, pro-ADM levels on admission were significantly higher than that in survivors [2.08 vs.4.94 μg/L,Z=-4.081 ,P<0.001].In a receiver operating characteristic (ROC) analysis for survival, the area under the ROC curve (AUC) for pro-ADM was 0.79, which was significantly higher than that for procalcitonin(0.72), C-reactive protein (0.58), interleukin-6 (0.64 ), and total leukocyte count (0.50) and sim-ilar to the AUC of the PSI (0.75).Conclusion Pro-ADM is a useful biomarker for the risk stratification of CAP patients.

Objective To evaluate the effect on inflammatory mediators and mechanism of dynamic factors on lung injury in a dog model of acute respiratory distress syndrome (ARDS). Method The ARDS dog model was duplicated by instillation hydrochloric acid. The dogs were randomly (random number) divided into six groups: (1) normal control group (N group); (2) ARDS group (M group); (3) low VT (6 mL/kg) at respiratory rate 30, low inspiratory flow 6 mL/(kg·s). (4) large VT (20 mL/kg) at respiratory rate 30, high inspiratory flow 20 mL/kg·s.(5) large VT (20 mL/kg) at respiratory rate 15, high inspiratory flow 17 mL/(kg·s). (6) large VT (20 mL/kg) at respiratory rate 15, low inspiratory flow 10 mL/(kg·s). All the dogs were killed after 4 h ventilation. TNF-α、IL-8, p38 MAPK and NF-κB activity in the lung were measured. Results The expression of IL-8 protein in B and C groups was much higher than that of other groups ( P < 0.01) . There was no significant difference among M, A and D groups (P > 0.05). The gray scale ratio of B group was obviously higher than that of other groups (P < 0.01), except C group (P > 0.05). There was no significant changes among M, A and D groups in TNF-α protein contents. p38 MAPK value of positive staining of B group was the strongest, significantlyhigher than that of D group ( P < 0.01) .The expression of p38 MAPK in B and C groups was much higher than other groups (P <0.01). NF-κB activity in B group (33.56±2.85%) was significantly higher than that in A (10.35±0.6%)、D(7. 11 ± 0.47%)group, but there was no difference between B and C group (30.87 ± 1.16%). Conclusions Ventilation at high tidal volume, high inspiratory flow rate, high respiratory rate could activate p38 MAPK and increase the activity of NF-κB with the result of aggravating the release of inflammatory mediators. p38 MAPK and NF-κB activation are the major mechanisms in the development of VILI.

Objective To investigate the influence of the biofeedback electrostimulation against the pelvic floor muscles to cure female pelvic floor dysfunction disease (PFD). Method Fifty-four female PFD patients treated with the biofeedback electrostimulation against the pelvic floor muscles by applying with different frequency and pulse width for different patients. Results The cure rate of the pelvic organ prolapse (POP) patients was 10.0%(1/10) and the cure rate of the post partum pelvic floor injury patients was 100.0%(32/32) except the stress urinary incontinence(SUI) patients. But the SUI patients improved efficacy rate was 91.7%(11/12) and the POP patients improved efficacy rate was 70.0%(7/10). The total efficacy rate was 94.4%(51/54). Conclusions It shows that the biofeedback electrostimulation against the pelvic floor muscles could cure the female PFD,reduce the disease morbidity of the PFD and improve the quality of female patient's lfie. As a result, the curing method could have clinical application prospect extensively.