Objective To investigate influence of nutritional status on prognosis in patients with systemic inflammatory response syndrome (SIRS). Methods Retrospective analysis for clinical data of 533 patients who hospitalized at the Internal Medicine Department of Beijing Social Welfare Hospital and the Emergency Department of Chaoyang Hospital, Beijing during 2005 to 2010 were performed. All the patients were divided into SIRS (323 cases) and non-SIRS (210 cases) groups based on diagnostic criteria of SIRS and pyemia, and groups of the survival (431 cases) and the dead ( 102 cases) based on their end outcomes.Patients of SIRS were further divided into sub-groups of pyemia (287 cases) and non-pyemia (36 cases)based on their infection status. The Acute Physiology and Chronic Health Evaluation Ⅱ ( APACHE Ⅱ ),serum levels of prealbumin ( PAB), albumin ( ALB), total cholesterol (CHOL) and C-creative protein (CRP) were measured for all the patients on the 1st, 3rd, 7th days after admission, before discharge and prior to death, respectively. Results Scores of APACHE Ⅱ were significantly higher in SIRS and the dead groups than those in non-SIRS and the survival groups (P ＜0. 05 ). Serum level of albumin was significantly lower in SIRS and the dead groups than that in non-SIRS and the survival groups on the 7th day after admission (SIRS vs. non-SIRS: F=9.812, P=0.035; the dead vs. the survival: F =45.285, P=0. 003). Change in serum level of prealbumin was the same as the level of albumin, with significant difference between various groups since the 3rd day after admission ( P ＜ 0. 05 ). Significant time effects could be found in the dead and survival groups (for the dead group: F = 19. 188, P = 0. 000; and for the survival group: F = 47. 250, P ＜ 0. 01 ). Multiple regression analysis showed that serum levels of prealbumin and total cholesterol correlated with scores of APACHE Ⅱ[with a regression formula of scores of APACHE Ⅱ = 52.032-21.407 PAB-8.971 CHOL (R2 =0.801, F=48.016, P =0.023)]. Logistic regression analysis showed that low level of prealbumin and high scores of APACHE Ⅱ both were predictors for survival of SIRS patients, with an overall accuracy of 77. 1 percent, 73.5 percent for survival and 79. 5 percent for death prediction. Conclusions Severe malnutrition can be found in patients with SIRS and serum level of prealbumin can be used to evaluate their nutritional status and severity of the disease. High scores of APACHE Ⅱ combined with low serum level of prealbumin can predict prognosis of the patients.

Objective To investigate the application of combined detection of three serum markers,anti-cyclic citrullinated peptide antibody (anti-CCP),rheumatoid factor (RF),anti-keratin antibodies (AKA),for the diagnosis of rheumatoid arthritis.Methods This was a prospective study.Serum samples were randomly obtained from 137 RA patients,265 other autoinmmune diease patients,and 111 normal controls.All of the volunteers were outpatients or inpatients of Peking University Third Hospital from January 2011 to September 2013.Levels of AKA,anti-CCP antibody,RF were measured by indirect immunofluorescence,chemiluminescence,and immune turbidimetry,respectively.The values of 3 serum biomarkers and their varied combinations for RA diagnosis were systemically assessed.The results were compared using fourfold table chi-square (x2) test.Results When using one serum marker,anti-CCP had the highest accuracy (80.39％),Youden's index (YI) (0.51),and Kappa (κ) value (0.55) for the diagnosis of RA.While using three serum markers,anti-CCP + (AKA/RF),AKA /(anti-CCP + RF),anti-CCP/(AKA + RF) and (AKA + RF)/(anti-CCP + RF)/(AKA + anti-CCP) had the highest accuracy (80.94,80.94,80.66),YI (0.51,0.51,0.50),and κ value (0.55,0.56,0.54).Conclusion AntiCCP is the vital marker for RA diagnosis.Anti-CCP + (AKA/RF),AKA/(anti-CCP + RF),and (AKA +RF)/(anti-CCP + RF)/(AKA + anti-CCP) are the most ideal combinations for RA diagnosis.

Objective To evaluate the effects of ulinastatin (UTI) on brain protection after cardiopulmonary resuscitation in a porcine model.Methods A total of 20 female swine were induced to make ventricular fibrillation (VF) by programmed stimulation method,and CPR was stared after 8 mins after VF.Swine after ROSC (return of spontaneous circulation) were randomly (random number) divided into two groups,namely UTI group and control group.In UTI group,UTI was administered slowly in a dose of 100 000 U dissolved in 5 ml saline immediately after resuscitation and then given every 3 h until 24 h after CPR (UTI not given at the time of 24 h) ; and 5 ml saline was used instead in control group.Venous blood samples were taken separately before VF,immediate after resuscitation and 3 h,12 h and 24 h after ROSC for detecting levels of TNF-o and IL-1β.Cerebral performance category (CPC) scores were assessed 24 h after ROSC,and subsequently the swine were sacrificed to get brain specimens for histopathological and ultrastructural examination under ordinary light microscope.Results Fifteen of twenty domestic swine were successfully rescued 8 mins after ventricular fibrillation.Swine of UTI group (n =8) and control group (n =7) were all survived over 24 h.Both TNF-α and IL-1β levels were significantly lower in UTI group than those in control group at intervals of 3 h,12 h and 24 h after ROSC (P ＜0.05).Twenty-four hours after ROSC,CPC scores of swine were higher in UTI group than those in control group (P ＜ 0.05).The brain injury 24 h after ROSC was significantly attenuated in UTI group than that in control group.Conclusions UTI can reduce the injury of brain tissue and improve the recovery of cerebral function after CPR.

Limb rehabilitation is one of the key issues for improving the quality of life in patients with stroke. Studies have demonstrated that the retention and recovery of active movement of hemiplegic limb have predictive value for the prognosis in acute stroke. The responsible lesion sites and rehabilitation training in the acute phase may be an important factor in influencing the recovery of active movement ability of hemiplegie upper limb. However, there is still lack of a large, multi-center study, and further related studies are needed.

Objective:To explore the influence of the veneering porcelain thickness on the compressive strength of zirconia all-ceramic crown.Methods:25 zirconia basement crowns with the thickness of 0.5 mm were made by CAD-CAMsystem,and then were divided into 5 groups randomly with the veneering porcelain thickness of 0.5(A),1.0(B),1.5(C),2.0(D)and 2.5 mm(E)respectively. The compressive strength of the samples was measured by a testing machine.Statistical analysis was conducted by SPSS13.0 software. The microstructure of the fractured bonding interface of the specimens was observed by scanning electron microscope(SEM).Results:The compressive strength in group A,B,C,D and E were:(1 279.96 ±42.85)N,(2 235.44 ±50.14)N,(2 216.38 ±48.97)N, (2 169.22 ±60.40)N and (2 028.70 ±47.37)N respectively(A or E vs B,C or D,P <0.01;A vs E,P <0.01;B vs C or D,P >0.05;C vs D,P >0.05).SEMobservation found that in group A and E the bonding interface was uneven and loose,the cracks and spores in veneering porcelain appeared more and larger,and had a more intensive distribution.Conclusion:When the veneering porce-lain is too thick or too thin,the compressive strength of zirconia all-ceramic crown decreases,the thickness of the veneering porcelain should be controled in an appropriate range.

Objective:To compare the titanium-porcelain bonding strength between CAD/CAM and cast pure titanium.Methods:Pure titanium samples were prepaired by CAD/CAMand casting respectively and fused with porcelain.The bond strength between tita-nium and porcelain of the samples was measured with three-point test.The titanium-porcelain interface was investigated under scanning electronic microscope(SEM).Results:The bond strength of CAD/CAMpure titanium to porcelain was (35.95 ±3.74)MPa and cast pure titanium to porcelain was (28.37 ±1 .98)MPa(P <0.05).SEMobservation showed that there was thin transition layer between titanium substrate and ceramic in CAD/CAM bond interface,titanium and porcelain combined closely,no obvious pores.However, there was thicker transition layer and small pore in cast pure titanium to porcelain bonding interface.Conclusion:The bonding strength of porcelain to CAD/CAMpure titanium is greater than that of porcelain to casting pure titanium.

Objective To evaluate 18F-fluorodeoxyglucose (FDG) PET/CT in detecting occult malignancy in patients with suspected paraneoplastic neurological syndrome (PNS).Methods Twenty consecutive patients who underwent PET/CT scanning with the indication of suspected PNS were retrospectively reviewed.The gold standard of PNS was either cytology or clinical follow-up, and the final diagnosis was compared with PET/CT findings.Results Of the 20 patients, six were PNS.PET/CT detected nine cases.Six were true positive and three were false positive.The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET/CT were 100% (6/6), 78.57% (11/14), 85.00% (17/20),66.7% (6/9) and 100.00% ( 11/11 ) respectively.The treatment plan was modified based on the PET/CT results in 4 patients.Conclusions 18F-FDG PET/CT may play a role in detecting the underlying malignancy of PNS.It is also valuable in staging of the malignancy thus providing information for therapy decision making.

Objective To investigate the application of statins in secondary prevention of ischemic stroke and transient ischemic attacks (TIA) in different risk groups,and to identify the factors influencing the compliance of statins. Methods Data were prospectively collected on consecutively encountered ischemic stroke or TIA patients admitted to the First Affiliated Hospital of Zhengzhou University from April 2009 to January 2010.All clinical characteristics and possible factors influencing the compliance of statins were collected; the application of statins was investigated at 3-month follow-up.The multivariate Logistic regression analysis was used for the analysis of influence factors of the compliance of statins.Results All 369 patients were collected,52.8％ of cases were prescribed statins for therapy during hospitalization.The application rate of statins in accordance with guidelines in high-risk group,extremely high-risk Ⅱ group and extremely high-risk Ⅰ group was 25.0％ (16/64),44.1％ (30/68) and 71.4％ (135/189),respectively. Logistic regression analysis showed that the statins application during hospitalization was associated with diabetes history ( P =0.032,OR =1.789,95％ CI 1.052-3.043 ) and the presence of carotid vulnerable plaques(P =0.000,OR =5.308,95％ CI 3.340-8.434).The general application rate of statins was 22.3％ (81/363),which was significantly lower than that during hospitalization. The application rate of statins in accordance with guidelines in high-risk group,extremely high-risk Ⅱ group and extremely high-risk Ⅰ group was 9.7％ ( 6/62 ),25.8％ (17/66) and 29.4％ (55/187) respectively.Logistic regression analysis showed that good compliance of statins was associated with discharge instructions on statins application ( P =0.000,OR =34.852,95％ CI 14.673-175.452 ). Conclusions The compliance of statins in secondary prevention of ischemic stroke and TIA is poor,and there is still a large gap between clinical practice and guidelines; Discharge instructions on statins application increase the compliance of statins.

Objective To explore the regulation function of Icariine on the expression of bone morphogenetic protein signaling pathway Smad1,Smad5,Smad4 and to explore the mechanism of promoting MC3T3-E1 cell proliferation and differentiation.Methods MC3T3-E1 cells were treated by 0,10-9,10-8 and 10-7 mol/L Icariine respectively.After stimulated by Icariine 1 d,2 d and 3 d,MTT method and population diploid time were used to observe the cell proliferation,and the cell alkaline phosphatase (ALP) level was assayed.At 21 days later,the alizarin red staining was proceeded.At 1,2 and 3 days later,the RT-PCR was used to detect the mRNA expression level about Smad1,Smad5 and Smad4,and the Western blot was to detect the Smad1,5 and Smad4 protein.At 2 days later,the RT-PCR was used to detect the mRNA expression level about Runx2,BMP-2 and osteoprotegerin (OPG),and the Western blot was used to analyze osteocalcin (OCN) protein level.Results After simulated by Icariine,the proliferation (MTT test),the ALP activity and mineralization of osteoblasts were increased,the cell population diploid was reduced (P＜0.05).At 1,2 and 3days later,the results of RT-PCR showed that Icariine continued increasing the mRNA level of Smad1,5 and Smad4 in 10-8 mol/L.At 2 days later,Smad1,Smad5 and Smad4 mRNA expression were obviously reduced in 0 mol/L group,and At 3 days later,Smad1,Smad5 and Smad4 mRNA expression were obviously reduced in 10-9 and 10-7 mol/L groups.At 2 days later,BMP-2,Runx2 and OPG mRNA were obviously increased in 10-8 mol/L group.The results of Western blot showed that OCN,Smad1,Smad5 and Smad4 protein were obviously up-regulated in 10-8 mol/L group.Conclusion Icariine occurs the expressions of BMP-2,Runx2,Smad1,Smad5 and Smad4 by stimulating the bone morphology of MC3T3-E1 cells directly,and promotes the osteogenic differentiation in the manner of expression level synchronous rising.

Objective This study was aimed at investigating the ability of temporal gap detection (TGD) in listeners with auditory neuropathy spectrum disorder (ANSD ) .Methods The temporal gap detection thresholds were measured for subjects using a TGD program developed by University of California ,Irvine .Three groups of subjects were recruited in this study ,including 12 subjects with normal hearing ,12 subjects with sensorineural hearing loss (SNHL) ,and 15 subjects with ANSD .The differences of TGD thresholds among the three groups of subjects were analyzed using a one - sample ANOVA method .Results No significant difference of the TGD thresh‐old was observed between two ears for all the subjects .The mean and standard deviation of the gap - detection threshold for both ears was about 3 .9 ± 1 .1 ms ,3 .6 ± 1 .1 ms ,and 13 .7 ± 9 .9 ms for normal - hearing subjects , subjects with SNHL ,and subjects with ANSD ,respectively .The TGD threshold in subjects with ANSD was sig‐nificantly higher than those of in normal hearing group (P< 0 .01) and SNHL group (P< 0 .01) ,while no signifi‐cant difference was found in TGD thresholds between normal - hearing subjects and subjects with SNHL .Conclusion For listeners with auditory neuropathy spectrum disorder ,their ability to resolve temporal information was de‐graded with a large individual variability .