Objective To study the variation and prognostic value of serum heparin-binding protein (HBP),a potent inducer of vascular leakage in septic shock.Methods A total of 82 sepsis patients admitted to central ICU from August 2011 to July 2012 were enrolled in the prospective study.Eighty-two sepsis patients were divided into septic shock group (group A,n =39) and sepsis without shock group (group B,n =43).At the same time,another 30 shock patients without sepsis were enrolled as group C and 35 patients without sepsis and shock were enrolled as group D.Blood samples obtained within 24 hours after enrollment,and the concentrations of HBP were measured by ELISA and lactate by electrode method.Comparisons of HBP,lactate and APACHE Ⅱ score between groups were carried out by Studers't test,and the early prognostic value in septic shock and mortality was studied by receiver operating characteristic (ROC) curve.Results Patients in group A (t =3.862,P＜0.001) and group B(t =5.193,P＜ 0.001) both had higher HBP level than patients in group D.HBP level in group A patients was also higher than that of group B (t =3.270,P =0.002).Septic shock patients (group A) had higher HBP than patients of group C (t =3.029,P =0.004).The area under curve (AUC) of HBP predicting septic shock patients was 0.834,with sensitivity 0.795,specificity 0.795.The AUC of HBP predicting 28-day mortality of all enrolled patients was was 0.680,and the AUC of predicting 28-day mortality of sepsis patients was 0.784.Conclusions HBP levels were increased in septic patients,especially in septic shock patients.HBP is a better predictor than traditional predictors like lactate and APACHE Ⅱ score for predicting septic shock.HBP is a good and specific evaluation marker for predicting septic shock and the mortality of sepsis patients.The measurement of HBP during the early stage of disease presents valuable information about diagnosis and treatment.

Objective To isolate cancer stem cells from human colon cancer cell line CW-2,and observe the biological characteristics.Methods The percentage of CD44＋EpCAM＋ cancer stem cells which were isolated by multi-combination method was evaluated by flow-cytometry.The biological characteristics of the stem cells were analyzed by cell cycle analysis,in vitro invasion assay and in vivo tumorigenicity assay.Results The percentage of CD44＋EpCAM＋ cancer stem cells was 89.57%,and their capabilities of generation,invasion,tumorigenicity were higher than non-cancer stem cells（P 0.05）.Conclusion CD44＋EpCAM＋ cancer stem cells showed low generation,high invasiveness,high tumorigenesis,and they could be isolated by multi-combination.

Objective To investigate the effect of the Kolb experience learning theory applied in Surgical Nursing teaching.Methods 120 students were selected randomly and were divided into 2 groups,the observation group operated the teaching mode based on the Kolb experience learning theory,the control group operated traditional teaching.After the experiment,using the theory test,the skill test,the questionnaire survey to evaluate the teaching effectiveness.Results The two groups showed statistical difference in theory exam results,learning effect of each dimension and evaluation of teaching effect.Conclusions The teaching mode based on the Kolb experience learning theory can improve the students' interest in learning and study effect,and push forward the reform of teaching implementatiou.

Objective To study the role of heparin-binding protein (HBP) in sepsis-associated acute respiratory distress syndrome (ARDS),and to evaluate the prognostic value of HBP in ARDS.Method Sixty seven sepsis patients were enrolled in the prospective study.According to whether present ARDS,patients were divided into two groups:ARDS group and non-ARDS group.Blood samples were obtained within 2 hours after patients were diagnosed with sepsis.We measured the level of interleukin-6,interleukin8 and HBP by ELISA,counted the number of polymorphonuclear neutrophils (PMN),and calculated Acute Physiology and Chronic Health Evaluation Ⅱ score.We compared interleukin-6,interleukin-8,PMN and HBP between two groups by Student's t test.Correlation analysis was studied between HBP and other indicators by Spearman rank correlation coefficient.We also studied the early prognostic value on sepsisassociated ARDS by establishing receiver operating characteristic (ROC) curve.Results Interleukin-6 (t=4.25,P＜0.01),interleukin-8 (t=10.10,P＜0.01),PMN (t=3.47,P=0.0009) and HBP (t =0.0225,P =2.336,all showed significant difference between ARDS group and non-ARDS group.Interleukin-6 (r=0.535,P=0.002),interleukin-8 (r=0.419,P=0.017) and PMN (r=0.419,P =0.017) all had positive correlation with HBP.The area under curve (AUC) of HBP predicting ARDS was 0.796.Conclusions HBP level elevated in sepsis-associated ARDS patients and were correlated with interleuki-6,interleuki-8 and PMN.HBP show a high value on predicting emergence of sepsis-associated ARDS.HBP may play an important role in sepsis-associated ARDS pathological process.From this study we can conclude one of possible ARDS pathogenesis:inflammatory mediators,such as interleuki-6,interleuki8,activate PMN.Subseqoently PMN releases HBP.Then HBP resolts in vascolar leakage,which is one of the basic ARDS pathology.

Objective To observe the NTBC dependence of Fah-knockout mice and study the biological characteristics in order to use the model more effectively.Methods Examine the progressive changes in body weight, survival time, liver pathology and serological markers after the NTBC withdrawal.Results After removing of NTBC, Fah-knockout mice lost their body weight gradually, and finally died in 5 to 7 weeks, along with increased serum ALT, AST levels and deformation of the hepatocytes.Conclusions Fah-knockout mice have a strong drug dependence of NTBC and could be the ideal model to hereditary tyrosinemia type I and other liver injury.

Objective To detect the immunoregulation and clinical effect ofYupingfeng capsule combined with Seretide on patients with cough variant asthma (CVA).Methods CVA Patients were randomly divided into the Seretide control group (n=54) andYupingfeng capsule combined with Seretide group (n=54). Seretide group received inhaled Seretide. Combined traditional Chinese medicine group received Seretide and Yuping Feng capsule. Two groups were treated for 12 weeks. The IL-17, IL-10 and IL-6 expression was detected by ELISA analysis. The clinic effect rate and adverse events were compared.Results After treatment, compared with the Seretide group, the expression of IL-17 (18.72 ± 4.26 ng/mlvs. 26.17 ± 5.58 ng/ml;t=2.462,P<0.05) and IL-6 (21.58 ± 4.12 ng/mlvs. 30.66 ± 6.27 ng/ml;t=2.523,P<0.05) were significantly lower in combined traditional Chinese medicine group than that in Seretide group; and IL-10 (15.56 ± 2.74 ng/mlvs. 12.25 ± 2.81 ng/ml;t=2.244, P<0.05) was significantly higher in combined traditional Chinese medicine group. The daytime (1.12 ± 0.26 vs.1.42 ± 0.33,t=2.283) and night time cough score (1.24 ± 0.28vs. 1.52 ± 0.37,t=2.291) in combined traditional Chinese medicine group was significantly lower than that in Seretide group (P<0.05). The clinic effect rate (92.6%vs. 77.8%,χ2=2.438) in combined traditional Chinese medicine group was significantly higher than that in Seretide group (P=0.037).ConclusionYupingfengcapsule combined with Seretide can decrease IL-17 expression and increase IL-10 expression to inhibit inflammatory reaction in CVA patients, and showed significantly higher clinical effect rates.

Background and purpose:Life expectancy has continuously improved in recently years with the development of medical level. In 2012, the amount of people who were above 60 years old has reached 810 million and account for 11% of worldwide population. The worldwide population shift towards older ages will inevitably lead to more elderly patients being diagnosed with non-small cell lung cancer (NSCLC). It still remains controversial whether sublobar resection is effective in such cases. In order to solve this question, we need to understand the clinical characteristics of these tumors. Methods:From 2006 to 2012, a total of 310 patients with NSCLC who were above 65 years old underwent surgical resection in Department of Thoracic Surgery, the First Afifliated Hospital of China Medical University and the Second Department of Thoracic Surgical Oncology, Jilin Province Tumor Hospital. The clinical data were retrospectively analyzed in sex, stage, histology, smoking status, smoking amount, drinking status, surgical approaches, multimodality therapy and overall survival. Survival was analyzed by Kaplan–Meier method and log-rank test. Results:There were 256 (82.6%) elderly patients who underwent standard lobectomies and 54 (17.4%) patients who underwent sublobar resections. The overall 5-year survival rate was 52.9%. Patients with different surgical approaches (lobectomy and sublobar resection) had nearly the same 5-year survival rates (60.5%vs 60.8%, P=0.381). The prognosis were signiifcantly inlfuenced by gender (P=0.024), stage of disease (P=0.028), smoking status (P=0.034) and smoking amount (P=0.028). The multivariate Cox proportional hazards analysis revealed that the smoking status was associated with the hazard ratio of 1.660 (1.058-2.606;P=0.028). Conclusion:In elderly NSCLC patients, sublobar resection is considered to be an appropriate treatment in comparison with lobectomy, as this procedure provides an equivalent long-term survival. The survival of elderly patients with lung cancer is closely related to the smoking status.

BACKGROUND: Ahmed glaucoma valve (AGV) is usually implanted at the superotemporal area of eyes. Comeal endothelial calls cannot regenerate,.so the repair of the endothelial cells mainly depend on the extension and progradation of the healthy cells in other area. Therefore, changes of density and shape are observed in the corneal endothelial cells after AGV implantation. OBJECTIVE: To observe the changes of density and morphology of corneal endothelial cells after AGV implantation. METHODS: Ahmed glaucoma valves were implanted in 34 eyes of 34 patients with refractory glaucoma. Density and morphology of corneal endothelial calls were evaluated in the superotemporal, superonasal, infratemporal, infranasal, and central corneal areas to calculate mean value of total comea before and at 3 and 6 months after surgery. Percentage of hexagonal cells was statistically summarized.RESULTS AND CONCLUSION: Mean density of corneal endothelial calls was statistically decreased following AGV implantation (P < 0.05), In particular, the decrease was obvious in the superetemporal area. Density of corneal endothelial cells was not changed in central area before and after AGV implantation. Morphological changes demonstrated that hexagonal cells were increased, but polygon cells were increased (P< 0.05). Density of corneal endothelial cells was gradually decreased, and morphology was also changed at 6 months after AGV implantation, suggesting that more care should be taken during intra-operation in order to minimize damage td the endothelium and prolong monitoring time of corneal endothelial cells following AGV implantation.

Objective To investigate the diagnostic values of serum free fatty acids (FFA) and urine podocalyxin (PCX) in the patients with type 2 diabetic nephropathy(DN).Methods A total of 120 patients with type 2 diabetes mellitus (DM) were enrolled,and they were divided into three groups,normal albumin group(NA),microalbuminuria group(MA) and heavy albuminuria group(HA),based on the urinary albumin-creatinine ratio(UACR).In addition,40 healthy persons participated in medical examination were selected as the control group.Serum FFA levels were detected by a biochemical analyzer and urine PCX levels by ELISA.The correlation between them was analyzed by Pearson correlation,and their diagnostic values in type 2 DN were evaluated by the receiver operating characteristic curve (ROC).Results Serum FFA levels in the NA,MA,HA and control groups were (0.61 ± 0.14),(0.81 ± 0.13),(0.95 ± 0.18) and (0.49 ± 0.11) mmol/L,respectively,and urine PCX levels were (1.86 ± 0.45),(4.47 ± 1.48),(6.72 ± 1.40)and(1.38 ±0.24) ng/mL,respectively.The levels of serum FFA and urine PCX in type 2 DM patients were significantly higher than those in the control group(P ＜ 0.05),and increased with the progression of type 2 DM.Pearson correlation analysis showed that serum FFA levels were positively correlated with urine PCX levels(r =0.73,P ＜ 0.05).The sensitivity of serum FFA,urine PCX and combined detection in the diagnosis of type 2 DN were 74.1％,80.6％ and 89.5％,respectively,and the latter significantly higher than the former two (P ＜ 0.05).Conclusion Serum FFA and urine PCX levels increase significantly in diabetic patients with renal injury,and both of them have important clinical values in the diagnosis of type 2 DN.

ObjectiveTo investigate the characteristics of personality in patients with depression. Methods24 patients with depression and 24 normal controls were measured with Minnesota Multiphasic Personality Inventory (MMPI) software. ResultsCompared with the control, patient with depression showed significantly difference in neuroticism, extraversionn-introversion, anxiety, repression, manifest anxiety scale, ego strength, dependency, dominance (P<0.05). the T score of N and repression is higher than the Chinese usual score. ConclusionThe depression patients show their personality as repression, inferiority, melancholy, anxiety, bad tolerance, overstrung and dependent.