Early recognition of severe sepsis and septic shock,early initiation of effective interventions,implementation of early goal-directed therapy may be key approaches for reducing the mortality and improving the prognosis.This article focused on the staging diagnosis systems for sepsis (PIRO sepsis classification system) and the systematic early warning or rapid response system.We also discussed the diagnostic value of biomarkers,proteomics and metabolomics in sepsis and severe sepsis.No single marker as golden standard has emerged that can provide clinicians with all the information they need for early recognition of sepsis.Therefore,we suggested that clinicians should have even more reason to combine the sepsis symptoms,signs and biomarkers for a comprehensive evaluation,and that they needed to dynamically monitor the changes in these parameters,in order to make reasonable clinical decisions and strategies.

Objective To investigate the effect of pre pregnancy body mass index and maternal weight gain on pregnancy outcome. Methods The data of 3225 cases of single term birth primigravidae were collected from Guangzhou Maternity and Infant Hospital from June 1998 to June 1999. All of the cases were divided into three groups according to pre pregnancy body mass index (BMI): under weight group (BMI0.05). 2 Neonatal birth weight had a positive lineal correlation with the maternal weight gain in the three groups (calculated coefficient r were 0.596, 0.328 and 0.249, both of the P value were less than 0.01). 3 The incidence of pregnancy induced hypertension (PIH) increased significantly when maternal weight gained≥18 kg in the under weight and the ideal weight groups ( P

In this article, monoclonal antibody to mouse uterine cervical carcinoma (U_(14)), AU_(14-1), was used for immunohistochemical analysis of premalignant and malignant lesions of the cervix to investigate the incidence and significance of the expression of the antigen detected by AU_(14-1) in human cervical lesions. Peroxidase-antiperoxidase (PAP) staining was performed on formalin-fixed, paraffin-embedded biopsy specimens. It was reported that positive staining with AU_(14-1) was detected in 20 of the 20 squamous cell carcinomas, 13 of the 13 adenocarcinomas, 15 of the 21 carcinomas in situ, 2 of the 24 anaplasia, and 2 of the 20 chronic cervicitis. It is suggested that the expression of the U_(14) antigen may be related to malignant transformation in the cervix.

The TD。 of mouse uterine cervical carcinoma (U_(14)) were inoculated subcutaneously in syngenic mice. After that experimental mice were administered diverse doses of monoclonal anti-U_(14) antibody (AU_(14-1)). It was found that within a 267 day interval after the tumor cell inoculations, all control animals were tumor free with tumor free survival, but 86% (6/7)and 88% (7/8)of experimental mice that had been treated with high dose AU_(14-1) showed progressive tumor growth at the inoculation site and died of systemic tumor disease. These results indicate immune enhancement of AU_(14-1) on U_(14) cells. AU_(14-1) was used to study the response of U_(14) cells to specific anti (?)dy in vitro. The results demonstrate that AU_(14-1) induces antigenic modulation of U_(14) cells, which is shown to be a loss of AU_(14-1) antibody and U_(14) antigen from the surface membrane of these cells as determined by indirect membrane immunofluorescence assay. This suggested that antigenic modulation may be proposed as a mechanism by which cervical cancer cells escape monoclonal antibody therapy.

The polycystic ovray syndrome(PCOS) is a heterogeneous condition with genetic predisposition. It is characterized by a myriad of symptoms including oligomenorrhea or amenorrhea,anovulation or infertility,hirsutism or acne. Insulin resistance appears to be an important factor in PCOS though the lack of an etiology has led to symptom oriented therapy which includes lifestyle modification,the use of cyclical progestagens and antiandrogens. Therapeutic approaches to PCOS remain an ongoing source of debate. Insulin sensitizing agents may bring new hope in therapy. Future research is aimed at shedding light on the pathophysiology so as to optimize treatment of women with PCOS.

Objective Study changes and clinical significance of collagen and cytokine during COPD episode and remission in order to guide clinical treatment. Methods From Mar.2002 to Nov.2004,the COPD patients of episode and remission period were compared with the healthy elderly people.The collagen and cytokine of the serum from the COPD patients and healthy elderly people were detected by applying ABC-ELISA and radio-immunity means. Results The level of serum C_Ⅰ、C_Ⅲ、C_Ⅳ increased obviously in the COPD patients during COPD episode and remission episode compared with that in the healthy elderly people( P

Objective To evaluate the effect of combination of HANS (Han's Acupoint Nerve Stimulator) and diazepam(D) or tramadol(T) on labor pain and influence on mother and infant. Methods Two-hundred and seventy normal term pregnancy and primipara with single vertex presentation were randomly divided into six groups, HANS+D ((HANS plus diazepam 10mg, iv), HANS, D(diazepam 10 mg, iv), HANS +T (HANS plus tramadol 100mg, im), T (tramadol 100mg, im) and control group . Pain relief methods were given when the cervix dilated to 2~3 cm. Labor pain was evaluated by VAS (visual analogue scale) at different stage. Results The effective rate of analgesia for HANS+D was the highest, 90.5%, for HANS+T and HANS were 78.9% and 59.8%, respectively. The VAS of the groups combination of HANS and drugs at the time one hour after analgesia, cervix dilating 7~8 cm, second stage, were much lower than that before analgesia and that of control group (P

A simple and rapid method was established for the determination of the content of L-malic acid in fermentation liquor. This procedure includes six steps: (1) Use a microi- njector to inject the fermentation liquor quantitively on the filter paper, then use the chromatography solution (n-butanol: formic acid: water=8:1.5:1) for paper chromatography. (2) Atomize the display reagent (10ml 0.02?10~(-2) bromocresol green: 0.2ml 10?10~(-2) sodium hydroxide) on the chromatography paper. (3) Scissor off L-malic acid spots from the paper and put in into 5 ml distilled water for three hours. (4) In 1ml eluent, add 6 ml 96?10~(-2) sulphuric acid and 0.1ml 1.0?10~(-2) ?-naphthol.(5) Heat the reaction system in 100℃ water for sixty minutes. (6) After cooling determine the optical density at the wavelength 476 am in the colorimeter.

BACKGROUND: Promoting immunological function of patients with chronic obstructive pulmonary disease (COPD) can control development of COPD.OBJECTIVE: To investigate the effect of bufei yishen granule on pulmonary ventilation function and immunological function of COPD patients and compare with placebo.DESIGN: A randomized grouping comparison and placebo controlled study.SETTING: Respiration Department of the First Affiliated Hospital of Henan Traditional Chinese Medical.PARTICIPANTS: A total of 62 COPD patients selected from Department of Respiration of the First Affiliated Hospital of Henan College of Traditional Chinese Medicine from January 1999 to October 2004,were randomly divided into two groups :Observation group and control group with 31 in each group.METHODS: Patients in observation group were treated with bufei yishen granule consisting of ginseng, mongolian milkvetch root, largehead atractylodes rhizome, divaricate saposhnikovia root, dwarf lilyturf tuber, Chinese magnoliavine fruit, malytea scurfpea fruit, medicinal evodia fruit, Chinese cster pillar fungus, Chinese eaglewood wood, scorpion, almond, thunberg fritillary bulb, szechwan lovge rhizome, etc., produced by Pharmaceutic Department of the First Affiliated Hospital of Henan College of Traditional Chinese Medicine. Each granule of 1 g contained an equivalent of 5.78 g raw drugs. Three times a day with 10 g for each; and patients in control group were treated with placebo consisting of hawthorn fruit and malt. The dosage and medication were the same as those in observation group. Both therapies were respectively administered in a treatment course of two months. Before and after the therapy course,the followed indexes were measured.① Assay of immunological function: The levels of IgG, IgA and IgM from blood serum were detected with simple agar diffusion.② Assay of Ag level in nucleolus organizer region (Ag-NORs): The ratios non-histone staining acidity non-histone vs core area (IS%) was calculated by staining the activating lymphocytes of the blood by silver staining technique with microscope image analysis technique. ③ Assay of pulmonary function: The pulmonary function was measured by Sensor Medics Ros System in all of the people with the levels of forced expiratory volume in first second (FEV1.0), mean maximu expiratory flow (MMEF), peak expiratory flow (PEF), once after and before treatment. The examination was repeated three times in order to obtain the peak number. The difference of the three examinations was within ±5%.MAIN OUTCOME MEASURES: Comparison of T lympholeukocyte subpopulation and pulmonary ventilation function in the patients before and after 1 course.RFSULTS: Data of totally 62 patients was entered the final analysis without any loss.① Comparison of pulmonary ventilation function of patients in the two groups before and after 1 course: FEV1.0, MMEF, PEF,and ratio of FEV1.0 and forced vital capacity (FEV1%) in observation group were significant higher than those before treatment (t=2.12-3.41,P ＜ 0.05-0.01), thoseindexes in observation group were higher than those in control group (t=2.54-3.17, P ＜ 0.05-0.01). ② Changes of T lymphocyte subgroups of patients in the two groups before and after 1 course:The levels of CD3+, CD4+, CD4+/CD8+ in observation group after 1 course were high.er than those before treatment (t=2.71-13.20, P ＜ 0.01), but the level of CD8+ was decreased as compared with that before treatment (t =8.63, P ＜ 0.01). The levels of CD3+, CD4+, CD4+/CD8+ in observation group were higher than those in control group (t=2.85-11.84, P ＜ 0.01), but the level of CD8+ was decreased as compared with that in control group (t =5.83, P ＜ 0.01).CONCLUSION: The bufei yishen granule can obviously improve the pulmonary ventilation function and immunological function of COPD patients,and its intervention is superior to that of placebo.

Objective:To evaluate the analgesic effect of low dose ropivacaine combined with fentanyl in patient controlled epidural analgesia (PCEA) and its influence on labor and safety of mothers and their newborns. Methods:One hundred and forty healthy nullipara at term were randomly assigned to epidural analgesia or control group. The analgesia group received PCEA when their labor stage reached active period in the first stage of labor.The PCEA mode was background infusion 6 ml/h, bonus 2 ml,lockout time 10 min/each infusion. The VAS, modified Bromage scale(MBS),duration and mode of labor, postpartum hemorrhage,Apgar scores of newborns were recorded. Results:Fifteen minutes after application of PCEA,98.58% of patients felt no pains(VAS 0.057?0.48),only 4.8% showed a mild motor block(MAS 0.07?0.31).By the 60 min,all patients could move the lower limbs freely (MAS 0). The analgesia group had a significantly shorter duration of active period in the first stage of labor than that of the control group, but a significant longer duration of the second stage. In addition, the oxytocin usage was significantly more frequently in analgesia group than those in placebo group.There was no difference between the two groups in the duration of third stage, postpartum hemorrhage, Apgar scores of newborns in 1 min and 5 min, rate of cesarean section and instrumental delivery.Conclusion:Epidural analgesia with low dose ropvicaine combined with fentanyl is safe and effective, which has no influence on mothers and their infants. It could shorten the active period of labor, but may increase oxytocin usage. The ratio of cesarean section and instrumental delivery was similar between the two groups. This kind of labor analgesia is beneficial and do no harm to mothers as well as newborns.