The triggering receptor expressed on myeloid cells (TREM) -1 is a recently identified molecule involved in the inflammatory response.It belongs to the immunoglobulin superfamily,it was reported that it has relation with inflammatory response mediated by several microbial components,besides its soluble form was observed and identified at significant levels in bacterial infection of neonate.So it may become a valuable diagnostic marker of serious bacterial infection in neonate.

Cell division cycle 42 (Cdc42)has been shown as an important regulator of many biological processes.Studies have suggested the role of Cdc42 in the diseases of digestive tract,but the mechanisms remain unclear.More studies are needed to advance the knowledge of roles of Cdc42 in the pathogenesis of digestive tract diseases,which may lead to therapeutic improvements.

Objective To study the expressions and clinical significance of E cadherin(E CD) and CD44v6 in bladder transitional cell cancinoma. Methods The expressions of E CD and CD44v6 of 96 cases of bladder transitional cell cancer were detected by streptavidin peroxidase immunohistochemical method. Results The positive expression rates of E CD and CD44v6 were as follows:Grade Ⅰ,86.7%(26/30),80.0%(24/30);Grade Ⅱ,52.8%(19/36),69.4%(25/36);Grade Ⅲ,26.7%(8/30),33.3%(10/30), P

Objective To observe the changes of serum soluble form of triggering receptors expressed on myeloid cell-1 (sTREM-1) level in full-term newborns with infection and to investigate the relationship between serum sTREM-1 and neonatal bacterial infection.Methods Eighty-five full-term newborns admitted to the neonatal ward of Shanghai Children s Hospital of Shanghai Jiaotong University were selected into this study.According to the locations and severity of infection,patients were divided into 3 groups: severe infection group (n = 27),mild infection group (n = 28),non-infection group (n = 30).The samples of infection groups were collected before using antibiotics and within 48 h after infection symptom occurred; others were collected during hospitalization.For the neonates with organ dysfunction in the severe infection group,samples were also collected at the third and seventh day of infection.Serum sTREM-1 was measured by enzyme-linked immunosorbent assay.Analysis of variance was used to compare the difference between groups.Receiver operating characteristic (ROC) curve was used to calculate the sensitivity,specificity,positive and negative predictive value and Youden index.Results (1) Serum sTREM-1 level of severe infection group[(91.2±47.3) pg/ml] was significantly higher than that of mild infection group[(68.8 + 30.4) pg/ml] and non-infection group[(35.5±17.6) pg/ml],respectively (P＜0.05).(2) Serum sTREM-1 level of the survival newborns (n= 17) in the severe infection group was lower than that of dead ones[(73.1±34.9) pg/ml vs (121.6±49.3) pg/ml,t= - 2.995,P = 0.006].(3) For the survival patients,the serum sTREM-1 level decreased in the first week of infection,while that of dead patients increased,the cut-off value was 100.6 pg/ml.(4) Based on the ROC analysis,43.8 pg/ml was selected as the the cut-off value,area under the curve was 0.868,and sensitivity was 85.5%,specificity 80.0%,positive predictive value 0.887,negative predictive value 0.750,Youden index 0.655.Conclusions Serum sTREM-1 level increases in neonatal infection.The change of serum sTREM-1 level in patients with severe infection is correlated to the prognosis.

Objective To investigate the CT characteristics of primary pulmonary sarcoma (PPS).Methods The CT findings,clinical and pathologic data of 5 patients with PPS were analyzed retrospectively and summarized by reviewing the relevant literatures.Results Mass were bigger, the largest diameter was about 9.8 cm, with an average of 6.3 cm.The tumors displayed staghorn shape in 1 case,quasi-circular mass in 1 case and irregular agglomerate in 3 cases.Spicule sign was not found in all cases.No hilar lymph nodes swelling were seen and mediastinal lymph nodes swelling were seen in 2 cases.Calcification was not found in all cases.1 case with ipsilateral pulmonary artery aneurysms caused by pulmonary artery infringed.1 case with pulmonary embolism under the same side.The lesions of all cases were mild enhancement.2 cases were accompanied by ipsilateral hydrothorax.Bone destruction was not found in all cases.Conclusion CT features of PPS are of certain relative specificity.A definite diagnosis is depended on pathology.

Objective To evaluate and compare the value of interleukin(IL)-6,IL-8,tumor necrosis factor(TNF)-α,and soluble form of triggering receptor expressed on myeloid cells (sTREM)-1 in neonatal infection and detect the relationship between them.Methods Eighty-five full-term newborns who were admitted to the neonatal ward of Shanghai Children's Hospital of Shanghai Jiaotong University were enrolled,according to the locations and severity of infection,the patients were divided into three groups:systemic infection group (n =27),local infection group(n =28),and non-infection group (n =30).The level of plasma sTREM-1 was measured by enzyme-linked immunosorbent assay,and the levels of IL-6,IL-8 and TNF-α were measured using cytometric bead array.Results (1) The levels of sTREM-1,IL-6,IL-8 and TNF-α were significantly higher in infants with systemic infection group than local infection group and non-infection group(P ＜0.05).(2) There were 17 survivors and 10 deaths in systemic infection group,and the level of sTREM-1 in the non-survivor [(121.64 ±49.31) pg/ml] was higher than the survivor[(73.13 ± 34.92) pg/ml,P =0.006].But the levels of IL-6,IL-8 and TNF-α were not statistically significant in the survivor and the death (P ＞ 0.05).(3) Based on the receiver operating characteristic analysis,cutoff values were identified for each variable that maximized both the sensitivity and specificity.These markers were considered positive if sTREM-1 ≥43.75 pg/ml,IL-6 ≥ 89.80 pg/ml,IL-8 ≥569.55 pg/ml and TNF-α ≥ 24.80 pg/ml.Among these indexes,the sensitivities were 85.5％,89.1％,70.1％ and 69.5％ respectively; the specificity were 80.0％,100％,100％ and 93.3％ respectively.Compared the area under curve(AUC) of them,IL-6(AUC =0.981)＞ sTREM-1 (AUC =0.868) ＞ TNF-α (AUC =0.864) ＞ IL-8 (AUC =0.852).sTREM-1 was correlated with IL-6,IL-8 and TNF-α(Spearman coefficient of rank r =0.532,P ＜0.01 ;r =0.420,P ＜0.01 ;r =0.531,P ＜0.01).Conclusion (1) The levels of plasma sTREM-1,IL-6,IL-8 and TNF-α were higher in neonatal infections;(2) sTREM-1 was associated with prognosis; (3) sTREM-1 was correlated with IL-6,IL-8 and TNF-α.

With the developing of the immunology,genetic diagnosis, and flow cytometry technology, the diagnosis of neonatal infectious diseases have been a lot of new improvement.Serum amyloid protein A,interferon-gamma-inducible protein 10 and triggering receptor expressed on myeloid cells-1 may be valuable in neonatal infectious diseases. Detection of the bacterial genes by gene chip hybridization technology can diagnose neonatal septicemia rapidly. Each of the diagnosis indicators for infection has their respective clinical and laboratory features. The comprehensive understanding of the biological characteristics,sensitivity,specificity of each indicator, and continuous and joint monitoring of several indicators can improve the diagnostic sensitivity and negative predictive value. It is the direction of infectious diseases diagnosis in future.This paper reviews the current diagnostic indicators for neonatal infectious disease.

Objective To monitor the blood glucose concentration, and then provide the scientific evidence of diagnosis and treatment for burn patients in time. Methods Using the same glucose meter to monitor the intravenous glucose and the peripheral glucose respectively for the same patient in the same time, and then compared the difference of them. The blood glucose samples were taken from 71 burn patients and 50 outpatients. Results There were significant difference between the intravenous glucose and the peripheral glucose, P

Objective To analyze the variation tendency of correlative test indexes in the patients with type 2 diabetic mellitus (T2DM) and diabetic nephropathy (DN) .Methods The urinary microalbumin (M‐Alb) ,blood glucose and renal function were de‐termined in 167 cases of T2DM .Then the cases were divided into the simple DM group ,early DN group and clinical DN group ac‐cording to the excretion rates of urinary M‐Alb .The determined results were compared among 3 group and analyzed .Results The age in the simple DM group was smaller than that in the early DN group and clinical DN group (P<0 .05) .The positive rates of u‐rinary M‐Alb and urinary protein were highest in the clinical DN group ,the differences among 3 groups had statistical significance (P<0 .05) .The difference of blood glucose indexes had no statistical difference between the simple DM group and early DN group , the clinical DN group was apparently higher than that in the simple DM group and early DN group (P<0 .05) .The levels of urea (Urea) and creatinine(Cr) in the simple DM group were significantly lower than those in the early DN group and clinical DN group ,the differences among 3 groups had statistical significance (P<0 .01) .Conclusion The severe the DN ,the higher the urina‐ry M‐Alb ,blood glucose and renal function indicators ,the higher the positive rates of urinary protein and urinary glucose ,the more significant the tendency of renal function damage .

Objective To evaluate the clinical value of transesophageal echocardiography (TEE) on minimally invasive surgical closure of heart septal defects. Methods Thirty-four patients with atrial septal defect (ASD) and 38 patients with ventricular septal defect(VSD) were selected by transthoracic echocardiography (TTE) prepared for minimally invasive surgical closure. TEE was performed to choose appropriate occluder and guide occluder release during the procedure. The immediate closure effect also evaluated by using TEE. A week follow-up was done by using TTE. Results Successful occlusion was in 32 patients with ASD and 29 patients with VSD. On 1 week follow-up,neither displacement for the occluders nor residual shunt except minimal residual shunt in 3 patients. The ventrieular remodeling was improved, the valvular regurgitation and pulmonary arterial pressure decreased. Conclusions TEE is important in minimally invasive surgical closure of atrial, ventricular septal defects, especially in choosing the candidate for the procedure and occluder, guiding occluder released and evaluating the procedure.