Objective This study was designed to evaluate the correlations between soluble E-selectin (sE-selectin) and intedeukin-8 (IL-8) levels and the condition and prognosis of severe pneumonia. Methods A total of 67 patients with pneumonia were identified at the intensive care unit and the Respiratory Department of Zibo Central Hospital between April 2007 and March 2008. The patients were divided into two groups according to the severity of pneumonia: severe (Group A, n = 35) and non-severe (Group B, n = 32). Group A was also subdivided into two groups of patiems: patients with Multiple Organ Dysfunction Syndrorae(MODS) (Group A_1, n = 13) and pa-tients with severe pneumonia alone (Croup A_2, n= 22). Thirty healthy people whose age and sex matched with the patients were enrolled as a control group (Group C). Patients with cancer, who had undergone surgery within the past 1 month, connective tissue disease or acute conplications of diabetes, for example, were excluded from the study. The serum levels of s-Eselectin and IL-8 were measured by EI.ISA, and correlations with Acute physiol-ogy and chronic Health Evaluation Ⅱ (APACHE-Ⅱ)score, Oxygenation index(PaO_2/FiO_2), percentage of poly-morphonuclear leukocyte (PMN)and high sensitive C-reactive protein (hs-CRP)levels were determined. The data were analyzed using t tests, one-way ANOVA, X~2 tests and linear correlation analysis using SAS 8.2 software. Results The sermn levels of sE-selectin and IL-8 in Croup A and Group B were significant higher than Group C (P < 0.05), and the levels in Group A were higher than those in Group B (P < 0.05). Furthermore, the levels of sE-selectin and IL-8 were higher in Group A_1 than in Group A_2(P < 0.001). The correlation analysis showed a positive correlation between the levels of sE-selectin and IL-8 in patients with pneumonia (r = 0.781,P < 0.01) ; and both were positively correhted with APACHE-Ⅱ score, PMN% and hs-CRP (P < 0.01), and nega-tively correlated with PaO_2/FiO_2 (P < 0.01).Conclusions sE-selectin and IL-8 levels are important indices for the assessment of the severity of pneumonia in tetras of the condition and prognosis.

Objective To analyze the correlations between acute respiratory distress syndrome ( ARDS) and extravascular lung water(EVLW),tumor necrosis factor alpha (TNF-α),E-selectin,vasostatin-2.To discuss the value of EVLW, TNF-α, E-selectin and vasostatin-2 in evaluating the severity of ARDS and prognosis of this disease . Methods There are thirty-six patients with ARDS were selected .According to the level of EVLWI shown by pulse indicator continuous cardiac output ( PiCCO) monitor,they were divided into the two groups:EVLWI≥14mL/kg group (n=18) and EVLWI<14mL/kg group(n=18).To monitor and record the levels of EVLWI ,PVPI,CI,ITBV,record oxygenation index ,calculate APACHEII score .The levels of TNF-α,E-selectin and vasostatin-2 in serum were meas-ured by ELISA.Results In EVLWI≥14mL/kg group,the APACHEⅡscore was (23.93 ±4.44),28-day mortality was 61.1%,the stay time in ICU was (19.05 ±4.0) d,which were higher than those in EVLWI <14mL/kg group [APACHEII score (18.58 ±3.66),28-day mortality(27.8%),the stay time in ICU(14.35 ±3.39) d](t=3.941,χ2 =4.050,t=3.797,all P<0.01).And the levels of TNF-α[(85.28 ±18.25)μg/L]and E-selectin[(74.07 ± 14.57)μg/L]in serum were higher than in EVLWI <14mL/kg group[TNF-α(63.27 ±20.28)μg/L,E-selectin (40.99 ±16.35)μg/L](t=3.422,5.847,all P<0.01).The oxygenation index of EVLWI≥14mL/kg group was (122.86 ±25.45),which was lower than that in EVLWI <14mL/kg group[(156.77 ±37.58)](t=-3.170,P<0.01).In the two groups of patients still alive within 28 days,after active treatment for 72 hours,the level of EVLWI was significantly lower than before in these 20 patients(Z=-0.392,P<0.01),oxygenation index was significantly higher than before(Z=-3.845,P<0.01),and the levels of TNF-αand E-selectin were significantly lower than before(t=7.194,4.025,all P<0.01).But 16 patients in the death group,after active treatment for 72 hours,the levels of EVLWI ,TNF-α,E-selectin and oxygenation index had no significant change ,there was no statistically signifi-cant difference(P>0.05).EVLWI had positive correlation with PVPI,TNF-αand E-selectin (r=0.605,0.649, 0.549,all P<0.01),and EVLWI had a negative correlation with oxygenation index (r=-0.715,P<0.01).Results showed no difference in vasostatin-2 between the two groups(P>0.05).Conclusion There were significant correla-tions between EVLWI and TNF-α,E-selectin in patients with ARDS.The levels of EVLWI,TNF-α,E-selectin were higher,and the mortality rate was higher,the the stay time in ICU was longer.The levels of EVLWI,TNF-αand E-selectin can provide a good reference value to the judgement of the severity of disease and prognosis in patients with ARDS.The level of vasostatin-2 had no correlation with EVLWI .

Objective To observe the change of plasma neuropeptide Y(NPY) concentration in patients with essential hypertension,and its relevance to target organ damage.Methods The plasma NPY concentration was determined by radioimmunoassay(RIA) in 115 patients with essential hypertension,including 45 patients with single target damage(left ventricle hypertrophy 21,stroke 13,nephropathy 11) and 19 patients with multiple target damage,with 30 normal as controls.Results 1) Plasma NPY concentration in patients with essential hypertension was significantly higher than normal controls(P0.05).Conclusion NPY may involve in the physiopathologic progress of essential hypertension and associate with the development of target organ damage.Evaluation of plasma NPY concentration may be valuable biomarker in estimation the severity of hypertension and target organ damage.

Objective To evaluate the effect of global end diastolic volume index (GEDVI) on fluid resuscitation in elderly patients with septic shock. Methods A prospective randomized controlled trial (RCT) was conducted. Septic shock patients over 65 years admitted to intensive care unit (ICU) of Shandong Province, Zibo Central Hospital from January 2013 to December 2015 were enrolled. The patients were randomly divided into control group and observation group, 20 cases in each group. In accordance with the guidelines for the treatment of septic shock, early goal-directed therapy (EGDT), rehydration in the control group was treated with the guide of central venous pressure (CVP); observation group was received pulse indicator continuous cardiac output (PiCCO) monitoring, and rehydration was treated according to the GEDVI and extravascular lung water index (EVLWI), i.e. GEDVI was maintained in 650-800 mL/m2, EVLWI was not obviously increased compared with the basic value and without the emphasis of CVP. Initial acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score, sequential organ failure score (SOFA), procalcitonin (PCT), mean arterial pressure (MAP), lactic acid (Lac) and oxygenation index (PaO2/FiO2); serial Lac, central venous to arterial carbon dioxide pressure (Pcv-aCO2), fluid balance, the amount of noradrenaline accumulation, PaO2/FiO2 after 6, 24 and 48 hours resuscitation; mechanical ventilation time, incidence of acute heart failure, ICU hospitalization time and 28-day mortality were recorded. Results There was no significant difference in gender,age, APACHE Ⅱ score, SOFA score, primary disease, infection site and basal PCT, MAP, Lac, PaO2/FiO2 between the two groups. Compared with the control group, 6 hours Lac, Pcv-aCO2 recovery, positive fluid balance, noradrenaline accumulation and PaO2/FiO2 of the observation group showed no significant difference; positive fluid balance 24 hours in the recovery was significantly reduced (mL: 2919.80±986.44 vs. 3991.40±933.53), Pcv-aCO2 significantly decreased [mmHg (1 mmHg = 0.133 kPa): 5.55±1.43 vs. 7.10±2.38], PaO2/FiO2 significantly improved (mmHg: 194.80±28.57 vs. 177.65±23.46), and noradrenaline accumulation was increased significantly (mg: 40.99±20.69 vs. 27.31±19.34) with statistically significant difference (all P < 0.05); the blood level of Lac 48 hours in the recovery was significantly decreased (mmol/L: 1.16±0.89 vs. 1.85±1.01), Pcv-aCO2 (mmHg: 5.35±1.18 vs. 6.70±2.34), and PaO2/FiO2 (mmHg: 215.75±33.84 vs. 190.60±32.89) were further improved, the positive fluid balance was significantly reduced (mL: 3141.55±1245.69 vs. 4533.85±1416.67, all P < 0.05). Compared with the control group, mechanical ventilation time (days: 3.65±1.31 vs. 4.50±1.19), ICU hospitalization time (days: 5.80±1.67 vs. 7.15±2.30) was significantly shorter in the observation group (both P < 0.05), acute heart failure rate was decreased significantly (5.0% vs. 30.0%, P < 0.05), but the 28-day mortality showed no statistical significance (25.0% vs. 40.0%, P = 0.311). Conclusions Compared to the conventional EGDT methods, fluid resuscitation under the guidance of GEDVI in elderly patients with septic shock with less liquid loading, can achieve better oxygenation and reduce heart failure, shorten the duration of mechanical ventilation and ICU stay, and play an important significant guidance for elderly patients' fluid resuscitation with septic shock.

Objective To investigate the production path of major histocompatibility complex class Ⅰ chain-related gene A(MICA) antibodies and the impact on the therapeutic efficacy after acute rejection in renal transplantation recipients.Methods Luminex flow cytometry was used to detect antiMICA antibodies and the antibody specificity in 157 pre-transplant kidney transplant recipients randomly selected.The clinical data were collected,anti-MICA antibody production pathway and immunoglobulin types were analyzed,and the impact of IgM anti-MICA antibody and IgM&IgG complex anti-MICA antibodies on acute rejection (AR) incidence and therapeutic efficacy after renal transplantation.Results Of the total 157 recipients,19 recipients were positive for anti-MICA antibodies before renal transplantation in 68 recipients who had history of blood transfusion,pregnancy and transplant sensitized experience (27.9％ ); In 89 recipients having no sensitized experience,MICA antibodies were positive in 26 recipients (29.2％ ) (P＞0.05).In 45 anti-MICA antibody-positive recipients,the anti-MICA antibodies type was IgM in 26 cases having no sensitized experience; and that was IgG and IgM complex in 19 cases having sensitized experience.In 38 antiMICA antibody-positive recipients undergoing kidney transplantation,7 out of 22 IgM anti-MICA antibodies recipients had AR (31.8％) that was reversed by methylprednisolone pulse therapy,and 7out of 16 IgM&IgG complex anti-MICA antibodies recipients had AR (43.8％) and treated with methylprednisolone pulse therapy:reversion in 3 recipients (42.9％),and the graft function loss in 4 recipients.The AR incidence was not associated with the two immunoglobulin types of MICA antibodies(P＞0.05),but there was significant difference in the reversal rate of AR (P＜0.05).Conclusion For non-allergenic history recipients,there exists the classic “natural antibodies” pathway in the production of the anti-MICA antibodies whose immunoglobulin type was IgM.In addition,the reversal effect of AR in recipients with IgM anti-MICA antibodies was much better.We need to attach importance to IgM&IgG complex anti-MICA antibodies for the pre-transplant anti-MICA antibodies in renal transplant recipients,because their AR treatment outcome is poor.

Objective:To explore the effect of the interval of radical prostatectomy after prostate puncture on the perioperative period and prognosis of patients.Methods:Patient’s data from September 2016 to September 2018 whom performed laparoscopic radical prostatectomy at the Affiliated Hospital of Xuzhou Medical University were collected and retrospectively analyzed. All prostate biopsy confirmed prostate cancer and 66 patients underwent laparoscopic radical prostatectomy. The average age was (70.11 ± 5.01) years, ranged from 60 to 79 years. The patients were divided into two groups according to the interval time from prostate biopsy to laparoscopic radical prostatectomy: <7 d group ( n=32) and 6-8 weeks group ( n= 34). The operation time, intraoperative blood loss, postoperative hospital stays, positive rate of incisional margin, postoperative urinary incontinence rate and the rate of urinary incontinence 6 months after operation, rate of postoperative erectile dysfunction and bone metastasis were compared and analyzed between the two groups. When the data conformed to the normal distribution, the data were expressed in Mean±standard deviation ( Mean± SD), and the independent sample t-test was used to evaluate the statistical significance between groups. When the data did not conform to the normal distribution, the measurement data was expressed as Median (interquartile range) [ M( P25, P75)], and the Mann-Whitney U test was used for the comparison between groups. Count data comparison between groups using Chi-square test or Fisher exact probability method. Unconditional multivariate Logistic regression was used to analyze the relationship between outcome and exposure. Results:All the 66 patients successfully underwent surgery, the surgery success rate was 100%. The average operation time of <7 d group and group 6-8 weeks group was [185.00(174.50, 193.50)] min and [183.00(175.00, 187.50) min], respectively, the difference was not statistically significant ( P=0.685 8, U=512.0). The average intraoperative blood loss of group <7 d group and 6-8 weeks group was [185.50(177.75, 205.25)]ml, [189.00(180.75, 206.00)] ml, respectively, the difference was not statistically significant ( P=0.685 9, U=512.0). The average postoperative hospital stays of <7 d group and 6-8 weeks group was [14.00(11.75, 16.00)] d, [13.50(12.00, 15.00)] d, respectively, the difference was not statistically significant ( P=0.785 7, U=522.5). The positive rate of incisal margin of<7 d group and 6-8 weeks group was 18.75%, 14.71%, respectively, the difference was not statistically significant ( P=0.659 5, χ2=0.194). The postoperative urinary incontinence rate of <7 d group and 6-8 weeks group was 6.25% and 8.82%, respectively, the difference was not statistically significant ( P=1.000 0). The urinary control after follow-up for six months of <7 d group and 6-8 weeks group was 6.25% and 2.94%, respectively, the difference was not statistically significant ( P=0.607 7). The postoperative erectile dysfunction rate of<7 d group and group 6-8 weeks group was 9.38% and 8.82%, respectively, the difference was not statistically significant ( P=1.000 0). The postoperative bone metastasis rate of group<7 d and 6-8 weeks group was 6.25% and 5.88%, respectively, the difference was not statistically significant ( P=1.000 0). Conclusions:Performing laparoscopic radical prostatectomy within 7 days following prostate biopsy did not adversely affect the postoperative outcomes and prognosis, also not increased postoperative complications, can shorten the patient′s treatment cycle.

Ureteral stricture, urine leakage and other urinary complications are likely to occur after kidney transplantation, which severely affect the function of renal allograft and even lead to renal allograft loss. Ureteral stent plays a critical role in kidney transplantation, which could promote the urine flow from kidney to bladder after kidney transplantation, lower the pressure within the ureter and reduce the risk of early urinary complications. However, it may also cause urinary tract infection, stent-related complications and BK virus infection, etc. Therefore, clinicians should flexibly grasp the indications for ureteral stent removal. In this article, the application, potential adverse reactions and the timing of removal of ureteral stent in the field of kidney transplantation were reviewed, aiming to provide reference for clinical decision-making related to ureteral stent after kidney transplantation.

Objective:To investigate the relationship between thyroid hormone levels during pregnancy and neonatal thyroid function.Methods:Forty pregnant women with abnormal thyroid stimulating hormone (TSH) level during pregnancy and their newborns who received treatment in Yongkang First People's Hospital, China between July 2019 and August 2020 were included in the observation group. An additional 38 healthy pregnant women and their newborns who concurrently received health examination were included in the control group. The clinical data in the two groups were retrospectively analyzed. The levels of thyroid hormones [(triiodothyronine (T 3), tetraiodothyronine (T 4), TSH, free T 3 (FT 3), free T 4 (FT 4)] in pregnant women were compared between the two groups. TSH level in newborns was compared between the two groups. Thyroid dysfunction in newborns was assessed in each group. The correlation between thyroid hormone levels during pregnancy and neonatal thyroid function was analyzed. Results:TSH level during pregnancy in the observation group was significantly higher than that in the control group [(2.89 ± 0.44) mU/L vs. (2.13 ± 0.22) mU/L, t = 9.570, P < 0.001]. T 3, T 4, FT 3 and FT 4 in the observation group were (0.45 ± 0.07) μg/L, (90.87 ± 8.93) μg/L, (1.08 ± 0.19) ng/L and (10.45 ± 1.73) ng/L, respectively, which were significantly lower than those in the control group [(2.13 ± 0.22) μg/L, (1.31 ± 0.21) μg/L, (2.16 ± 0.34) ng/L, (15.31 ± 21) ng/L, t = 24.514, 9.254, 17.432, 10.845, all P < 0.001]. TSH level in newborns in the observation group was significantly higher than that in the control group ( t = 37.041, P < 0.05). The incidence of thyroid dysfunction in the observation group was significantly higher than that in the control group ( χ2 = 4.780, P < 0.05). TSH level in pregnant women was positively correlated with that in newborns ( r = 0.819, P < 0.05). T 3, T 4, FT 3 and FT 4 levels in pregnant women were negatively correlated with TSH level in newborns ( r = -0.773, -0.802, -0.794, -0.824, all P < 0.05). Conclusion:Compared with healthy pregnant women, pregnant women with abnormal thyroid hormone levels have higher TSH levels and lower T 3, T 4, FT 3 and FT 4 levels. The newborns of pregnant women with abnormal thyroid hormone levels have higher TSH levels and a greater risk of thyroid dysfunction than the newborns of healthy pregnant women. The level of thyroid hormone during pregnancy is related to the thyroid function of newborns. This study is scientific and innovative.

This paper is to investigate the apoptosis effect of ovarian cancer SKOV3 cells induced by nanosecond plused electric fileds (nsPEFs) and to study its influence on Fas-mediated apoptosis. SKOV3 cell were exposed to the 45kV/cm of field intensity, 30 pulses, and 50ns, 100ns, and 200ns of pulse width, respectively. Flow cytometry were used to assay apoptosis. Agarose gel electrophoresis was used to detect DNA ladder. Real time PCR (RT-PCR) and Western blot analysis were used to measure the expression level of Fas, FasL, caspase-8 and Bid. Flow cytometry results revealed that the late apoptosis rates and (or) necrosis were significantly higher than those in control group (3.03% +/- 0.57%) (P < 0.05), with apoptosis rates and (or) necrosis being (18.31 +/- 0.65%), (45.55% +/- 3.71%), (47.47% +/- 7.01%) in the groups of 50ns, 100ns, 200ns, respectively. A typical DNA ladder pattern of internucleosomal fragmentation was observed in the groups of 50ns and 100ns, but not clear in the 200ns group. RT-PCR results revealed that the mRNA expression of Fas, FasL, caspase8 and Bid were significantly increased in groups of 50ns, 100ns, but significantly decreased in group of 200ns (P < 0.05). Meanwhile, Western blot analysis demonstrated that the Fas, FasL, Caspase-8 and Bid expression were significantly higher in groups of 50ns, 100ns, but significantly lower in group of 200ns (P < 0.05). It indicated that 45kV/cm, 50ns, 100ns nsPEFs could induce apoptosis in ovarian cancer SKOV3 cells and activate Fas-mediated apoptosis pathway.
Apoptosis ; radiation effects ; Caspase 8 ; metabolism ; Cell Line, Tumor ; Electromagnetic Fields ; Electroporation ; methods ; Fas Ligand Protein ; Female ; Humans ; Ovarian Neoplasms ; pathology ; fas Receptor ; metabolism

Objective To compare the clinical effect of two-person operations of disposable circumcision stitching instrument and one-man operations of disposable circumcision stitching instrument.Methods Clinical data of 340 patients with redundant prepuce or phimosis from March 2015 to August 2017 were randomly divided into control group which patients with two-person operation of disposable circumcision stitching instrument and study group which patients with one-man operation of disposable circumcision stitching instrument were reviewed prospectively.There were 188 patients in the study group,including 22 patients with phimosis and 166 patients with redundant prepuce;Among the 152 patients in the control group,there were 17 cases with phimosis and 135 cases with redundant prepuce.Two groups with operation time,intraoperative blood loss,postoperative skin staple missing,2 hours postoperative pain,postoperative edema,the swelling subsided time,postoperative complications,postoperative patient satisfaction,and so on.Measurement data were represented as (x) ± s,and comparison between groups was analyzed using t test;count data were represented as percentage and comparison between groups was analyzed chi-square.Results All operations were finished successfully for the patients by two-person or one-man of operations of disposable circumcision stitching instrument.In terms of operation,the operation time of the observation group and the control group was (7.76 ±0.45) minutes and (7.86 ±0.91) minutes respectively,and the difference was not statistically significant(P ＞ 0.05).Intraoperative hemorrhage of observation group and control group were (1.77 ± 0.22) ml and (1.72 ± 0.26) ml,and the difference was not statistically significant (P ＞ 0.05).There was no statistically significant difference between the observation group and the control group (P ＞ 0.05) in the postoperative 2 hours pain score and skin staple missing.In the postoperative complications,the deviation rate of the prepuce was 1.11％,significantly lower than the control group 5.92％,and the difference was statistically significant (P ＜ 0.05).There was no statistically significant difference between the observation group and the control group in terms of edema on the third postoperative day,short postoperative anastomosis,patient satisfaction,and postoperative infection.Conclusion The way of one-man operation of disposable circumcision stitching instrumente not only saves labor costs,but also has a good postoperative clinical effect,meanwhile,it has high efficiency and strong operability,and is worthy of promotion for clinical first-line urologists.