Obiective To study the value of procalcitonin (PCT) and C-reaction protein (CRP)in the diagnosis of bacterial infection.Methods PCT and CRP in 2120 patients were retrospectively analyzed.Receiver operating characteristic (ROC) curve was used to compare the diagnostic capacity between two indices.Correlation between PCT and CRP was analyzed among 178 patients with bacterial infection.Results Areas under ROC curve (AUC) were 0.957 ±0.016 for PCT and 0.712 ± 0.04 for CRP.There was statistical significance of the AUC for PCT and CRP.The optimum cutoff value for PCT was 0.4 μg/L,which had a sensitivity of 90.0％ and a specificity of 90.9％.The optimum cutoff value for CRP was 2.27mg/L,which had a sensitivity of 72.0％ and a specificity of 57.3％.In the 2120 patients,there was the situation which PCT was normal (＜0.1 μg/L) when CRP was normal (＜0.8 mg/L).Conclusions In prediction of bacterial infection,CRP was not good,but PCT had high clinical value because of rapid detection,less interference and high specificity.In suspected bacterial infection patients,PCT was considered not to be detected temporarily if CRP was normal.In this way,there was the economic value which the patient's medical costs may be Controlled and medical resources be saved.Combined with its half-life,monitoring and analyzing the PCT change is valuable for efficacy determination and assessment of the patients'conditions.

Objective To investigate the effects of exercise on behavior and serum cortisol levels in depression caused by chronic,unpredictable,mild stress(CUMS).Methods Forty-eight male Sprague-Dawley rats were randomly divided into 3 groups:A,B and C.Each group was then divided into 3 subgroups:a blank control subgroup,a model subgroup,and an intervention subgroup.CUMS such as unpredictable forced swimming in cold water,electric stimulation of the animals'feet and shaking of the cage was used to establish a model of depression.Swimming exercise was administered as a therapeutic intervention.In group A it was administered while the animals were under stress,while in groups B and C,exercise was administered before and after the depression model had been established.Open-field test and fluid consumption data were recorded during the whole procedure.At the end of the experiment,radioimmunity assays were used to measure the levels of serum cortisol.Results Rats exposed to CUMS showed reduced water consumption;a preference for sucrose solutions;and decreased squares crossed,less rearing and increased bowel movement in open-field test.All of these changes were mitigated by the exercise performed while the animals were under stress,but not by exercise before or after the depression model had been established.Rats exposed to CUMS showed significant increases in serum cortisol,which was mitigated by exercise prior to and during stress.Conclusion Different exercise routines have different effects on behavior and serum cortisol levels in depressive rats under chronic unpredictable mild stress.Exercise has cumulative effects in decreasing the serum level of cortisol,but has only immediate effects on the behavior of depressive rats.

Proper use of biochemical software is helpful for medial post-graduate students to establish scientific thinking behavior during research and to improve their creative capability.Exploration on curriculum of biomedical software application was made based on course objective and content,modern teaching methods and practical assessment methods.Results showed that this training course can enhance the students' understanding and practical skill of related software,which is fundamental for further research work.

The enzyme activity of α－Acetolactate Decaroboxylases (ALDC)from different microbes was studied, the results demonstrated that it was quite different among them. There were diversities of their enzyme reaction velocities. It was clear that the enzyme activity was affected by the pH of the enzyme reaction system, for example, the optimum pH of ALDC from Lactococcus lactis was 6.6, while for Aerobacter Aerogenes it was 5.8. Addition leucine,valine and isoleucine into enzyme reaction system obviously affected the enzyme activity of ALDC from different microbes.

An adult patient with hypophosphatasia caused by compound heterozygous mutations in alkaline phosphatase,liver /bone /kidney(ALPL)gene was investigated through comprehensively reviewing the medical history and clinical records of the proband and her family members in order to better understand the disease.The proband and her older sister had mild decreased serum alkaline phosphatase level accompanied with frequently nontraumatic fractures at limbs and all the teeth fell off at the age of 20 and 7, respectively.Both of them carried a missense mutation c.407G>A(p.Arg136His)in exon 5 and a deletion mutation c.1318_1320delAAC(p.Asn440del)in exon 12 simultaneously.Other four family members were p.Arg136His mutation carriers and two members were p.Asn440del mutation carriers.We found that p.Asn440del mutation was associated with the oral disorders.In this family, compound heterozygous manifested more serious symptoms, while heterozygous showed relatively mild symptoms.In addition, it is necessary to differentiate it from primary osteoporosis and other diseases of disturbed bone mineralization.

Objective To evaluate the role of astrocyte chemokine (C-C motif) ligand 2 (CCL2) in microglial activation in an in vitro experiment.Methods Primary astrocytes and microglias were isolated from the brain tissues of C57BL/6J mice at postnatal day 1-2.The experiment was performed in two parts.Experiment Ⅰ Astrocytes were inoculated in 6-well culture plates at a density of 3 × 104 cells/well (2 ml/well) and divided into 5 groups (n=3 each) using a random number table:control group (group C),tumor necrosis factor-alpha (TNF-cα) group,1 μg/ml CCL2 small interference RNA (siRNA) group (group CCL2-siRNA1),2 μg/ml CCL2-siRNA (group CCL2-siRNA2) and negative control siRNA group (group NC-siRNA).Astrocytes were cultured routiuely in group C,and 10 ng/ml TNF-α was added and astrocytes were incubated for 15 min followed by washout with phosphate buffer solution (PBS),and then astrocytes were incubated for 3 h in the other 4 groups.At 24 h before TNF-α was added,CCL2-siR-NA 1 and 2 μg/ml were added in CCL2-siRNA1 and CCL2-siRNA2 groups,respectively,and NC-siRNA 2 μg/ml was added in group NC-siRNA.The concentrations of CCL2 were determined by enzyme-linked immunosorbent assay.Experiment Ⅱ Microglias were inoculated in 6-well culture plates at a density of 3×104 cells/well (2 ml/well) and divided into 3 groups (n=3 each) using a random number table:control group (group C),TNF-α group and CCL2-siRNA group.Microglias were cultured routinely in group C.In group TNF-α,10 ng/ml TNF-α was added to astrocytes which were incubated for 15 min followed by washout with PBS,astrocytes were then incubated for 3 h,and the supernatant was collected and added to microglias which were incubated for 24 h.In group CCL2-siRNA,2 μg/ml CCL2-siRNA was added to astrocytes which were incubated for 24 h,10 ng/ml TNF-α was also added to astrocytes which were incubated for 15 min followed by washout with PBS,astrocytes were then incubated for 3 h,and the supernatant was collected and added to microglias which were incubated for 24 h.The activity of microglias was measured by immunofluorescence,and the migration of microglias was evaluated by Transwell migration assay.Results Experiment Ⅰ The concentrations of CCL2 were significantly higher in TNF-α,CCL2-siRNA1,CCL2-siRNA2 and NC-siRNA groups than in group C (P＜0.05).The concentrations of CCL2 were significantly lower in CCL2-siRNA1 and CCL2-siRNA2 groups than in TNF-α and NC-siRNA groups (P＜0.05).There was no significant difference in CCL2 concentrations between group TNF-α and group NC-siRNA (P＞0.05).Experiment 1Ⅱ Compared with group C,the activity of microglias was significantly increased,and the migration of microglias was enhanced in TNF-α and CCL2-siRNA groups (P＜0.05).Compared with group TNF-α,the activity of microglias was significantly decreased,and the migration of microglias was weakened in group CCL2-siRNA (P＜0.05).Conclusion Astrocyte CCL2 is involved in mieroglial activation in an in vitro experiment.

This article selected several typical clinical cases, analyzed many factors affect the doctor-patient relationship of ethical issues and new technology of differentiating the ethical dilemma for clinical application, and put forward some suggestions for the reference of medical staff , hospital ethics committees and health policy makers.

ObjectiveTo investigate the distribution of high-intensity zone (HIZ) of lumbar intervertebral disc in patients with low back and/or leg pain,and analyze its related factors.MethodsSix hundred and twenty-eight patients with low back and/or leg pain were examined by MRI scan from June 2009 to August 2010.According to the diagnostic criteria of HIZ,the features of distribution of HIZ on age,segment and degree of intervertebral disc degeneration were analyzed retrospectively.ResultsAmong 3140 intervertebral discs of the 628 patients,172 cases (27.39％,172/628) and 206 discs (6.56％,206/3140)were involved with HIZ.There was no significant difference between men and women [26.38％(86/326)vs.28.48％(86/302)] (P=0.556).HIZ occurred more often [40.22％(72/179)] in those patients between 40 and 49 years of age.The incidence of HIZ at the segments from L1-2,L2-3,L3-4,L4-5,L5-S1 was 0.80％(5/628),2.07％(13/628),2.07％(13/628),14.01％(88/628) and 13.85％(87/628) respectively.In cases with and without HIZ,the incidence of intervertebral disc degeneration up to grade V was 49.03％(101/206) and 23.76％(697/2934) respectively (P ＜ 0.01 ).HIZ was correlated with age,degree of intervertebral disc degeneration and disc segment (r =-0.040,P=0.025 ;r =0.217,P＜ 0.01 ;r =0.179,P＜ 0.01 ).Conclusions HIZ is correlated with age,degree of intervertebral disc degeneration and disc segment.Intervertebral disc degeneration plays the most important role in the occurence of HIZ.HIZ_mainly occur in L4-5 and L5-S1 segment and in those between 40 and 49 years of age.

Purpose:To evaluate the role of multi - detector row CT(MDCT) using reconstruction techniques in the assessment of patients with obstructed diseases of biliary tract.Materials and Methods: 47 Patients with obstructed diseases of biliary tract confirmed clinically underwent MDCT and their reconstructed images of biliary tract including multi-planar reconstruction (MPR) images and curved planar reconstruction(CPR) images were compared with those of 50 patients without obstruction and dilatation of biliary tract.The display effect of biliary duct structure and biliary duct wall and the display ability of biliary tract by MPR and CPR images between the 2 groups were compared and analysed.The reconstruction images of biliary tract were analysed retrospectively to evaluate the location and possible causes of biliary obstruction.Results: The display effect of biliary duct structure and biliary duct wall in MPR and CPR images of the group with biliary obstruction is better than that of control group,and the display ability of biliary tract in CPR images of the group with biliary obstruction is also better than that of control group.The accuracy of localization and cause evaluation of obstruction by MPR and CPR images is 100% and 89.4% respectively.Conclusions: The MPR and CPR images of MDCT provide a good display of biliary duct structure,biliary duct wall and an accurate evaluation of obstruction localization.The reconstruction technique of MDCT such as MPR and CPR should be widely applied in the evaluation of biliary obstruction.

Objective To investigate the survival data and acute toxicities in patients with locoregionally advanced nasopharyngeal carcinoma who receive intensity-modulated radiotherapy (IMRT)with concurrent chemotherapy using nedaplatin plus 5-fluorouracil (PF) or taxol plus nedaplatin (TP).Methods A retrospective analysis was performed on the clinical data of 152 patients with stage Ⅲ or Ⅳa nasopharyngeal carcinoma who were admitted to our hospital in 2009-2010.Of the 152 patients,80 received IMRT with concurrent PF chemotherapy,and 72 received IMRT with concurrent TP chemotherapy;there were at least 2 cycles of concurrent chemotherapy in both groups.The Kaplan-Meier method was used to calculate the survival rates,and the log-rank test was used to analyze the survival difference ; the chisquare test was used to compare the acute toxicities in the two groups.Results The follow-up rate was 100％.The 2-year relapse-free survival rate,distant metastasis-free survival rate,progression-free survival rate,and disease-specific death rate for the IMRT/PF group were 95％,82％,81％,and 13％,respectively,versus 97％,83％,79％,and 12％ for the IMRT/TP group (x2 =0.03,0.02,0.62,and 0.22,P=0.861,0.881,0.431,and 0.638).The incidence rates of leukopenia (grade ≥3),neutropenia (grade ≥ 3),thrombocytopenia (grade ≥ 3),ALT elevation (grade ≥ 2),and oral mucositis (grade ≥3) for the IMRT/PF group were 33％,23％,14％,8％,and 12％,respectively,versus 60％,47％,28％,18％,and 25％ for the IMRT/TP group (x2 =11.33,10.29,4.59,3.94,and 3.94,P =0.001,0.001,0.032,0.047,and 0.047).Conclusions Compared with IMRT with concurrent PF chemotherapy,IMRT with concurrent TP chemotherapy does not lead to significantly better survival and results in more acute toxicities in the patients with locoregionally advanced nasopharyngeal carcinoma.