Objective To discuss the diagnostic value of N-terminal-pro-brain natriuretic peptide (NT-proBNP) for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with left heart failure. Methods Patients with medical history of AECOPD, or are diagnosed as AECOPD from March 2014 to February 2015 were involved in the study. Based on echocardiography and clinic characteristics , the patients were divided into left heart failure group (group A) and non-left heart failure group (group B). Related factors of elevated NT-proBNP in AECOPD and the diagnostic value of NT-proBNP for patients with AECOPD complicated with left heart failure were analyzed , and exclusive and diagnostic cutoff were worked out. Results In this study , 109 AECOPD patients were collected , including 21 patients in group A and 88 patients in group B. Multivariate linear regression analysis indicated NT-proBNP was positively associated with PCT (β=0.180,P = 0.011) and PAP(β = 0.333,P = 0.000), and negatively with LVEF(β = -0.511,P = 0.000)and the area under the ROC curve(AUC) was 0.959 (95% confidence interval:0.915-1.002,P = 0.000). The exclusive cutoff was 794.6 pg/mL(sensitivity:90.5%,specificity:92%), and the diagnostic cutoff 1 618 pg/mL(sensitivity:85.7%,specificity: 97.7%). Conclusions NT-proBNP can help to diagnose whether AECPOD patients are complicated with left heart failure. Besides left heart dysfunction and the state of systemic inflammation , pulmonary hypertension may be the reasons for the elevated NT-proBNP in AECOPD patients.

Objective To observe the early changes of related indexes after high dose of 60Co γ-ray irradiation on rhesus monkey hematopoietic system.Methods A total of 33 rhesus monkeys were randomly divided into normal control and different irradiation control group,rhesus monkeys in irradiation control group were given different doses(4,8,12 Gy) irradiation to establish acute radiation sickness(ARS) models.XE-2100 automatic blood cell analyzer detected the peripheral blood before and after the irradiation of 3,6,9,12,24,48,80 h.The rhesus monkeys were sacrificed to have a observation of sternum pathological changes at 6,48 and 80 h after 4,8,12 Gy 60Co γ-ray irradiation.Results The number of white blood cell in peripheral blood of the rhesus monkeys after 4 and 8 Gy 60Co γ-ray irradiation were lower than that before irradiation at 3 h after irradiation,as was significant increased at 6 h after irradiation,the highest values were 136.04%.and 221.38% after 9 h(with before irradiation values was 100.00%,the same below),become obviously drooped from 12 h after irradiation,show clearly temporary peak.But the number of white blood cell after 12 Gy 60Co γ-ray irradiation was significant increased at 6 h after irradiation,at the highest of 9 h,become obviously drooped from 12 h after irradiation.Peripheral blood neutrophile count was significant increased at 6 h after irradiation,at the highest of 9 h,become obviously drooped from 12 h after irradiation.Peripheral blood lymphocyte count fell sharply after irradiation,3 h detection value was only 12.02%-25.04% of before irradiation.Sternal bone marrow nucleated cell number decreased sharply after irradiation,the more irradiation dose,the less residual hematopoietic cells.Conclusion In the early stage of BM-ARS,temporary peaktime node of the white blood cell and neutrophil count could be regarded as the best delivery time of hematopoietic cytokine therapy.

ObjectiveTo investigate the expression and significance of hypoxia-inducible factor (HIF)-1α and vascular endothelial growth factor (VEGF) in liver tissues after ischemia-reperfusion injury (IRI) in rats.MethodsSixteen Sprague-Dawley (SD) rats were randomized into the IRI group and the Sham group according to the random number table, 8 rats in each group. The portal vein and branches of hepatic artery of the rats in the IRI group were clamped with the atraumatic vascular clamp. After 45 min of ischemia, reperfusion was performed for 6 h. The porta hepatis of rats in the Sham group was exposed and the hepatic blood flow was not occluded. The morphological changes of the liver tissues in two groups were observed. The serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were tested and the contents of HIF-1α and VEGF in liver tissues were determined. Data comparison between two groups was conducted usingt test.ResultsUnder light microscope, swelling, vacuolar degeneration of the liver cells, inflammatory cell infiltration, hepatic sinusoidal dilatation, disorganized hepatic cords and spotty necrosis were observed in the IRI group. The histomorphology of liver tissues in the Sham group was normal. The serum ALT and AST in the IRI group was respectively (1 007±130) and (1 307±72) U/L, which were significantly higher than (59±4) and (81±3) U/L in the Sham group (t=20.700, 48.448;P<0.05). The relative expression of HIF-1α and VEGF in liver tissues of IRI group was 1.77±0.10 and 1.86±0.05 respectively, which were significantly higher than 0.60±0.22 and 0.83±0.06 in the Sham group (t=13.623, 35.563;P<0.05).ConclusionThe expression of HIF-1αand VEGF in liver tissues increase significantly during early IRI, which may play a role in reducing the IRI of organism.

Androgen insensitivity syndrome (AIS) is a recessive single gene disease of X chromosome, which is rare clinically and has a very low incidence in newborn boys. This is mainly due to the abnormal pathway in which androgens play a role, resulting in sexual differentiation disorder in patients. A pair of identical twins were admitted to our hospital, and a new pathogenic mutation site of the androgen receptor gene was found, resulting in an androgen insensitivity phenotype.

Objective:To investigate the related genes, signaling pathways and possible mechanisms of malignant transformation of human papillomavirus type 16 (HPV-16) immortalized cervical epithelial cell line H8.Methods:The malignant transformed H8 cell model was constructed, and the changes of cell invasion ability and cell migration ability of H8 cells after malignant transformation were detected by Transwell assay, and the changes of clone formation ability of H8 cells after malignant transformation were detected by plate clone formation assay. Total RNA was extracted from malignant transformed H8 cells and H8 cells, and the two groups of cells were sequenced by transcriptome using Illumina novaseq 6000 sequencing platform, differentially expressed genes (DEGs) were identified and analyzed, and Gene Ontology (GO) function enrichment analysis, Kyoto Encyclopedia of genes and genomes (KEGG) pathway enrichment analysis and protein-protein interaction were performed.Results:The invasion ability, migration ability and clone formation ability of malignant transformed H8 cells significantly increased as compared to H8 cells. A total of 203 differentially expressed genes were identified in H8 cells before and after malignant transformation, of which 98 were up-regulated and 105 down-regulated. GO enrichment analysis showed that DEGs were mainly involved in biological processes such as cellular processes, biological regulation, and metabolic processes. KEGG pathway enrichment analysis showed that DEGs were mainly enriched in alanine, aspartate and glutamate metabolic pathway, glycine, serine and threonine metabolism pathway, p53 signaling pathway and TGF-β signaling pathway, PI3K-Akt signaling pathway. PPI analysis screened 10 hub genes including DDIT3, TRIB3 and ASNS.Conclusions:Compared with H8 cells, malignant transformed H8 cells have a large number of differentially expressed genes and pathways at the transcriptional level, which could further provide new ideas for the mechanism of malignant transformation and carcinogenesis as well as finding new targets for the prevention of malignant transformation.

Objective:To clarify the effect and related factors of antiviral therapy on the change of esophageal varices in patients with hepatitis B virus-related cirrhosis.Methods:Fifty-two cases with hepatitis B virus-related cirrhosis who underwent endoscopy before and after antiviral therapy were selected from prospective cohorts. Patients were divided into three groups: no, mild, and moderate-severe based on the degree of esophageal varices. The changes in the severity of esophageal varices in each group were compared after antiviral therapy. Clinical characteristics (platelet, liver and kidney function, liver stiffness, and virological response) of patients with different regressions were analyzed. Measurement data were analyzed by independent sample t-test, one-way ANOVA, Mann-Whitney U test and Kruskal-Wallis H test, and Chi-Square test was used for count data.Results:All patients received entecavir-based antiviral therapy. The median treatment time was 3.1 (2.5-4.4) years. The proportion of patients without esophageal varices increased from 30.8% to 51.9%, the proportion of mild esophageal varices decreased from 40.4% to 30.8%, and the proportion of patients with moderate-to-severe esophageal varices decreased from 28.8% to 17.3% ( χ2=14.067, P=0.001). A total of 40.4% of patients had esophageal varices regression, and 13.5% had esophageal varices progression. The progression rate was significantly higher in patients with moderate-severe esophageal varices than patients with mild and no esophageal varices ( χ2=28.126, P<0.001), and 60.0% of patients with moderate-severe esophageal varices still remained in moderate-severe state after antiviral treatment. Baseline platelet count and 5-year mean change rates were significantly lower in patients with progressive moderate-to-severe esophageal varices than in those without progression (+3.3% vs. +34.1%, Z=7.00, P=0.027). Conclusion:After effective antiviral treatment, 40.4% of patients with hepatitis B virus-related cirrhosis combined with esophageal varices has obtained esophageal varices regression, but those with moderate to severe esophageal varices still have a considerable risk of progression while receiving mono antiviral treatment only. Thrombocytopenia and without significant improving are the clinical signs of progression risk after receiving antiviral treatment.

Objective To systematically retrieve,evaluate and integrate evidences about the assessment and management of perioperative pain in patients with acute aortic dissection.Methods PIPOST model was used to identify themes of assessment and management of perioperative pain.The literatures in the themes was systematically searched through the databases of UpToDate,JBI,BMJ Best Practice,practice guide REgistration for trans RAREncy(PREPARE),Guidelines International Network(GIN),National Guideline Clearinghouse(NGC),National Institute for Health and Care Excellence(NICE),Scottish Intercollegiate Guidelines Network(SIGN),New Zealand Guidelines Group(NZGG),Registered Nurses'Association of Ontario(RNAO),Australian Clinical Practice Guidelines(ACPG),American Heart Association(AHA),European Society of Cardiology(ESC),the Chinese Cochrane Center,Medlive,Cochrane library,PubMed,SinoMed,CNKI,Wangfan Data,and VIP.The retrieved literatures were evaluated and the evidences that met the inclusive criteria were extracted from the literatures by researchers who had trained for evidence-based study.Results A total of 17 studies,including 5 guidelines,3 expert consensus,6 systematic reviews and 3 randomised controlled trials were included in this study.Totally,29 pieces of best evidence were extracted in the assessment and management of pain in perioperative patients with acute aortic dissection,including pain assessment,basic principles of pain management,medication intervention strategies of pain management,non-medication intervention strategies of pain management,pain evaluation,education of pain management and organising pain management.Conclusion Evidences in assessment and management of pain in perioperative patients with acute aortic dissection can provide references and guidance for clinical practice.