ObjectiveTo study the way for establishing prediction model of acute pancreatitis with secondary multiple organs dysfunction syndrome (MODS) in the early stage.MethodsThe linical data were collected from 113 hospitalized patients with acute pancreatitis admitted from October 2008 to October 2011.Some biomarkers within 48 h after the onset of acute pancreatitis were statistically analyzed by univariate and multivariate binary logistic regression analysis in order to establish the prediction model evaluated by the ROC curve. ResultsThere were statistically significant differences in lactate dehydrogenase ( LDH ),serum creatinine ( CR),serum albumin ( P ＜ 0.05 ) identified by univariate regression analysis.These independent risk factors in the regression model were:ln (P/1 -P) =2.243 +0.002 × LDH + 0.014 × CR - 0.186 × ABL,likelihood ratio test ( x2 =66.46,P =0.000) ; in the ROC curve analysis:AUC 0.927 (95％ CI:0.875 -0.980),the best cut- off value of the model predicting probability was 0. 177 (sensitivity 82. 14％,specificity 85.88％,correctly classified 84.96％ ).ConclusionsEfficient prediction model could be set up by the logistic regression analyzing the early risk factors in multiple organ dysfunction syndrome following acute pancreatitis.

Objective To study the effect of climate change on physiological indexes of elderly people.Methods From January,2006 to January,2007,30 elderly couples were selected and blood pressure,pulse,body weight were investigated.The weather data was collected.Results The lowest value of body weight appeared in February in normotensive subjects,in September in hypertension subjects.The lowest value of body temperature in two groups appeared in February and March.The lowest value of pulse appeared in March and April in normotensive subjects,in September in hypertension subjects.The curve of blood pressure change(SBP and DBP) presented"V"in two groups.The lowest value appeared in summer(July-September).The highest value appeared in winter(December-February).The blood pressure in winter was higher than that in summer(P

Objective To investigate the relationship between the serum high sensitive c-reactive protein (hs-CRP) and prealbumin (PAB) and the acute heart failure during the early stage of acute myocardial infarction (MI) patients.Methods A total of 181 MI patients (male:n =154,85.1％ vs.female:n =27,14.9％),admitted between Seppember 2010 and September 2012,were enrolled.They were divided into heart failure group (n =114,63.0％) with Killip classification recorded and control group (n =67,37.0％) without heart failure.The levels of serum hs-CRP and PAB were determined from the venous blood in the followed morning after admission.The clinical data were analyzed by logistic regression,Spearman correlation,and ROC curve.Results The serum level of hs-CRP (mg/L) in the heart failure group was significantly higher than that in the control group (P =0.000),while the serum level of PAB (mg/L) in the heart failure group was significantly lower than that in the control group (P =0.000).High level of hs-CRP and low level of PAB were significantly correlated with Killip classification (rhs-CRP =0.234,Phs-CRP =0.003 ; rPAB =-0.321,PPAB =0.000).Serum hs-CRP (P =0.023,OR 1.086,95％ Cl 1.012-1.167) and PAB (P =0.038,OR O.991,95％ CI O.983-0.999) were the independent risk biomarkers of acute heart failure subsequent to myocardial infarction determined by multivariate logistic regression analysis.The area under the ROC curve:AUChs-CRP =0.722,95％ CI 0.651-0.786; AUCPAB =0.723,95％ CI 0.652-0.787.Conclusions With high level of serum hs-CRP or low level of serum PAB during the early stage of acute myocardial infarction,patients were predisposed to the development of acute heart failure consequently.Both of them are the independent risk biomarkers of acute heart failure subsequent to myocardial infarction.Furthermore,they were significantly correlated with severity of the heart failure in terms of Killip classification.

ObjectiveTo investigate the effect of propofol repeated anesthesia on the expression of CaMK Ⅱ α in the hippocampus in neonatal rats.MethodsThirty-two SD rats aged 7 days weighing 12-16 g were randomly divided into 2 groups (n =16 each): group C received intraperitoneal 0.9％ normal saline 7.5 ml/kg once a day for 7 days and group P received propofol 75 mg/kg once a day for 7 days.Learning and memory function were assessed using Morris warier maze at 28 days old of rats.The animals were sacrificed at 24 h after the tests and brain tissues were removed.The expression of CaMK Ⅱ α and phosphorylated CaMK Ⅱ α (pCaMK Ⅱ α) in hippocampal CAI region were determined by immunochemistry and Western bolt.ResultsCompared with group C,the escape latency was significantly prolonged,space exploration time shortened and expression of CaMK Ⅱ α and pCaMK Ⅱ α down-rugulated in group P than in group C( P ＜ 0.01 ).ConclusionPropofol repeated anesthesia decreases congnitive function through down-regulating the expression and inhibiting the activity of CaMK Ⅱ α in hippocampus in neonatal rats.

Objective To investigate the value of extravascular lung water (EVLW) in predicting the prognosis of sepsis acute lung injury (ALI) / acute respiratory distress syndrome (ARDS).Methods Relevant published articles concerned with EVLW both in Chinese and in English from 1991-2011 were searched,and Meta-analysis was carried out with Stata software. Results Seven articles were selected for Meta-analysis according to the inclusion and exclusion criteria.The results indicated EVLW of dead patients group kept in a high level,while EVLW showed a down-trend in the survival group.The difference in level of EVLW between the two groups became more obvious with the day ( SMDd1＜ SMDd2 ＜ SMDd3 ) ( the 1st day:SMDd1=0.29,95％CI:0.047-0.532; the2nd day:SMDd2=1.64,95％CI:0.14-3.13; the 3rd day:SMDd3 =1.83,95％ CI:0.56-3.10).Conclusions EVLW and its dynamic change in the early stage of sepsis ALI/ARDS could predict the prognosis.This suggested the sustained high level would lead to high mortality.

Objective To study the clinical values of dynamic changes of yon Willebrand factor (vWF) and ADAMTS13 (a disintegrin and metalloprotease with thrombospondin repeats-13 ) in aneurysmal subarachnoid hemorrhage. Methods Twenty-nine patients with aneurysmal subarachnoid hemorrhage admitted to Department of Neurosurgery from April 2010 through April 2011 were enrolled for retrospective study.They could be categorized into 3 sets of grouping:delayed cerebral ischemia group ( DCI group) and non-delayed cerebral ischemia group ( no DCI group ),cerebral vasospasm group ( CVS group ) and no vasospasm group (no CVS group),and good prognosis group and poor prognosis group,and another 20 healthy subjects as control group.All patients were examined with CT,DSA,or/and CTA to identify the intracranial subarachnoid hemorrhage resulted from aneurysm rupture.The exclusion criteria included:(1)the time from onset to admission was longer than 72 hours or patient was in imminent danger of death; (2)patients had surgery,interventiona] or conservative treatment outside the hospital; (3) patients were under the treatment of antiplatelet medicine such as aspirin,clopidogrel,or other anticoagulants such as warfarin,etc ; (4) patients had blood diseases,impaired kidney or liver function,pregnant,or with recent infections.Venous blood were taken one day,4 days and 10 days after SAH to determine plasma concentrations of ADAMTS13 and vWF by using enzyme-linked immunosorbent assay (ELISA). Transcranial Doppler ultrasonography (TCD) was used to measure mean blood flow velocity of middle cerebral artery (VMCA).Glasgow outcome scale (GOS) score was measured before discharge. Data were analyzed by using SPSS version 13.0 software. Results The levels of vWF were significantly higher in DCI group,CVS group and poor prognosis group compared with those in the control group 1 day,4 days and 10 days after SAH.There were differences in vWF between DCI group and no DCI group 1 day and 4 days after SAH ( P ＜ 0.05 ).There were significantly differences in vWF between CVS group and no CVS group,and between good prognosis group and poor prognosis group 4 days and 10 days after SAH ( P ＜ 0.01 ).In DCI group and poor prognosis group,the level of plasma ADAMTS13 was significantly lower 1 day after SAH than that in the normal control group (P ＜0.01) and in the no DCI group (P ＜0.O1 ); and there were no differences in ADAMTS13 between CVS group and no CVS group.Conclusions In the early stage,the increase in plasma vWF and decrease in ADAMTS13 activity are associated with DCI,and the decrease in ADAMTS13 activity can be used to predict the outcome.

Objective To investigate the value of plasma soluble triggering receptor expressed on myeloid cells-1 as a diagnosis marker of sepsis.Methods Articles on plasma soluble triggering receptor expressed on myeloid cells-1 as a marker of sepsis which were public published in the PubMed,Ovid,Springer,Wanfang database from 1991-2012 were searched and conducted a meta-analysis by MetaDiSc and Stata.Results Seven articles were selected to the meta-analysis according to the inclusion criteria,of which cut-off values varied signicantly from studies.Due to the data heterogeneity (I2 ＞ 50％,P ＜0.05),random model was used to pool the effect sizes.The overall combined effect sizes:sensitivity =81％ (95％CI:0.76-0.86); specificity =81％ (95％ CI:0.76-0.86); DOR =30.03 (95％ CI:7.89-114.37) ; AUC of SROC =0.905 9; Q*-0.837 6.Deek' s funnel plot showed little publication bias.Conclusions Plasma soluble triggering receptor expressed on myeloid cells-1 may be a useful adjunctive tool for the diagnosis of sepsis.However,further studies are needed in order to identify the best cut-off value in the diagnosis of sepsis.

Objective To explore the developmental tendency of eco-migrant children's extroversive behavior and the relationship between extroversive behavior and personality and family environment.Methods 856 eco-migrant children(aged 6-16)participated in the present longitudinal study.At first time the Child behavior checklist(CBCL),Eysenck personality questionnaire (EPQ) and Family environment scale (FES) were used to assess their behavioral problems,personality and family environment.Participants' parents subsequently completed measures assessing behavioral problems every nine months for 27 months.Data were analyzed using hierarchical linear modeling analyses.Results The scores of extroversive behavior in eco-migrant children were(10.09±7.11) at first time,(7.66±7.56) at the second wave,(8.54±7.49)at the third wave and(8.11±7.33) at the last time.During the longitudinal period,the descending trend of eco-migrant children's extroversive behavior was significant (β=-0.51,P＜0.05).The scores of psychoticism,neuroticism,family conflict,organization,cohesion and cultural factors were differently correlated with children's extroversive behavior (β=-0.67-0.32,P＜0.05).Family conflict predicted the developmental trend of children's externalizing (β=-0.46,P＜0.05).Conclusion During the longitudinal period,the level of eco-migrant children's extroversive behavior decreased,and personality and family environment have significant influences on it.

Objective To investigate the predictive value of serum uric acid for patients with traumatic brain injury.Methods A total of 330 patients with traumatic brain injury (Glasgow Coma Scale score,GCS:3-14) admitted to the First Affiliated Hospital of Soochow University between November 2010 and October 2012 were enrolled.They were divided into a survival group (GOS:2-5) and a non-survival group (GOS:1).The levels of serum uric acid were measured from venous blood in the morning of the second day after admission.Clinical data were analyzed by logistic regression model,spearman correlation,and ROC curve analysis.Results Spearman correlation analysis showed that serum uric acid was significantly correlated with GCS (r =-0.270 1,P =0.000) and GOS (r =-0.251 2,P =0.000).Age,GCS,pupil reaction and serum uric acid were determined as independent predictors for death by logistic model.The adjusted OR of uric acid was 1.0048,(95％ CI:1.001 9-1.007 6,P =0.001).The area under the ROC curve was 0.718,(95％ CI:0.666-0.766),the optimal cut-off value determined by the Youden index was 304 μmol/L (sensitivity:60.24％,specificity:78.14％,correctly classified:73.64％).In the core model (Age + GCS + Pupil reaction),theR2 value was 0.476 4.With uric acid added into,the predictive power of the model increased to R2 =0.510 5 (7.2％ increased).Conclusions The level of serum uric acid is significantly correlated with the severity of TBI and could be used as an independent predictor for death.

Objective To investigate the effect of propofol anesthesia on the expression of β-secretase 1 (BACE1) and content of anyloid beta protein 1-42 (Aβ1-42) in the neonatal rat hippocampus.Methods Ninety Sprague-Dawley rats,aged 7 days,weighing 12-16 g,were randomly divided into 3 groups ( n =30 each):control group (group C),single dose of propofol anesthesia group (group SP),and repeated doses of propofol anesthesia group (group RP).Group C received intraperitoneal normal saline 7.5 ml/kg once a day for 7 consecutive days.Group SP received normal saline 7.5 ml/kg once a day for 6 consecutive days and propofol 75 mg/kg on 7th day.Group RP received propofol 75 mg/kg once a day for 7 consecutive days.Six rats in each group were chosen at 15 min after the end of injection on 7th day and blood samples were taken from the left ventricle for determination of the blood glucose level and for blood gas analysis.Eight animals in each group were sacrificed on 1st,3rd and 7th day after the end of injection on 7th day to determine the expression of BACE1 (using Western blot) and content of Aβ1-42 in the hippocampus (by ELISA).Results Compared with groups C and SP,the expression of BACE1 was up-regulated and the content of Aβ1-42 was significantly increased at each time point in group RP ( P ＜ 0.01 ).There was no significant difference in the expression of BACE1 and content of Aβ1-42 at each time point between groups C and SP ( P ＞ 0.05).Conclusion Repeated doses of propofol up-regulate the expression of BACE1 and increase the content of Aβ1-42 in neonatal rat hippocampus,which may be one of the mechanisms by which propofol leads to long-term cognitive dysfunction.Single dose of propofol does not have the effect.