Objective To determine if the fibrinogen/C reactive protein (CRP) ratio could be used in sepsis patients as a predictor for disseminated intravascular coagulation.Methods A total of 61 patients with sepsis admitted to emergency intensive care unit (EICU) were enrolled.C reactive protein (CRP) and variables of coagulation such as Platelet (PLT),prothrombin time (PT),activated partial thrombopastin time (APTT),fibrinogen and D-dimer were analyzed during 24 hours after admission to EICU.APACHE Ⅱ score,ISTH score and JAAM score were evaluated.According to DIC score (JAAM score and ISTH score),the patients were divided into two groups:overt DIC and no overt DIC.Data were expressed in mean ±standard deviation and were statistically analyzed by SPSS 17.0.The differences of CRP,PLT,PT,APTT,fibrinogen and D-dimer of patients in each group were analyzed by independent samples t test.The receiver-operating characteristics (ROC) analysis was performed to predict the diagnostic power of the variables fibrinogen,CRP,and fibrinogen/C reactive protein (CRP) ratio.In addition,the odds ratios (OR) were estimated by chi-square test and the 95％ confidence intervals were calculated.Results In overt DIC group fibrinogen/C reactive protein (CRP) ratio was significantly lower.The receiver-operating characteristic analysis showed for the fibrinogen/C reactive protein (CRP) ratio (area under the curve:ISTH criteria 0.691 and JAAM criteria 0.814) significantly better discriminative power than for fibrinogen (area under the curve:ISTH criteria 0.608 and JAAM criteria 0.429) and CRP (area under the curve:ISTH criteria 0.561 and JAAM criteria 0.788).The odds ratio for fibrinogen/C reactive protein (CRP) ratio (＜ 45) was 11.14 and CRP (＞ 70 mg/L) was 8.05.Conclusions We suggest that the fibrinogen/C reactive protein (CRP)ratio could be a diagnostic factor for the occurrence of disseminated intravascular coagulation in sepsis patients.

Objective To investigate whether preemptive intrathecal administration of CRH has an antinociceptive efficacy on inflammatory pain model rats. Methods The antinociceptive efficacy of preemptive intrathecal administration of CRH was evaluated by the flinch-licking time and the tail flicking latency in formalin-subjected pain model rats. The c-fos gene expression in spinal cord dorsal horn was analyzed by immunohistochemical technique and computer image technique. Results Comparing with NS control group, preemptive intrathecal administration of 0.5 ?g CRH could markedly inhibit the phase Ⅱpain reaction and meanwhile decrease c-fos gene expression by 25.02% in the superficial lamella of spinal cord dorsal horn of the model rats. The antinociceptive efficacy could be counteracted by preemptive intraperitoneal injection of CP-154526 (the specific antibody of CRHR1, 10 mg/kg). Conclusion CRH could significantly inhibit pain reaction and spinal cord c-fos gene expression, and thereby preemptive intrathecal administration of CRH will contribute to the antinociceptive efficacy because of its potency of inhibiting hyperalgesia.

Objective To study the changes of coagulation and fibrinolysis in rabbit model of non-overt disseminated intravascular coagulation induced by low-dose endotoxin and therapeutic effects of anticoagulation by heparin.Methods Twelve male rabbits were randomly divided into 2 groups,one receiving endotoxin intravenously(10 ?g/kg,n=6),one receiving endotoxin intravenously and 100 U/kg Heparin simultaneously(n=6).The blood sample obtained before experiment was used as control.Coagulation parameters including prothrombin time(PT),activated partial thromboplastin time(aPTT),thrombin time(TT),fibrinogen concentration,D-dimers,thrombelastography(TEG)were measured during 6 h after endotoxin induction.Tissue specimens of lungs and kidneys were examined.Results Parameters of coagulation deteriorated significantly in the endotoxin-induced rabbits,but was not altered in heparin-treated rabbits.TEG monitoring in the endotoxin-induced rabbits reflected consumption of clot factors and platelet dysfunction,and hypocoagulation status in heparin-treated rabbits.In endotoxin-induced group,fibrin deposition was found in lungs and kidneys.Conclusion Non-overt disseminated intravascular coagulation induced by low-dose endotoxin in rabbits is improved by heparin.

Adhesins, Bacterial ; Biomedical Research ; Fusobacterium nucleatum

Objective To find out the accurate resonance frequencies and vibration characteristics of intestine,lung,kidney,stomach,heart and liver of rat and rabbit in low frequency and to provide basic data for the study of organs' resonance injury and reaction.Methods Eight rats and eight rabbits were anaesthetized with 1.5％ sodium pentobarbital and acceleration sensor was fixed to the surface of their bowels.The rats were fastened on their back on the veneer hung horizontally by rubber band.The veneer was hammered upward from the down side,and the biggest value of frequency spectrum was considered the resonance frequency.Rabbits were fastened on their back on vibration platform and 2 mm amplitude vibration was given with the sweeping-frequency from 2 Hz to 50 Hz.The bowels amplitudes on each frequency point were measured.The frequency corresponding to the biggest amplitude was considered the resonance frequency.Results The resonance frequencies of rat intestine,lung,kidney,stomach,heart and liver were respectively 3.8,3.2,6.6,7.0,4,6 and 3.0 Hz within frequency interval of 0 Hz to 20 Hz.The resonance frequencies of rabbit intestine,lung,kidney,stomach,heart and liver were respectively 6.0,5.0,7.0,8.0,6.0 and 7.0 Hz within frequency interval of 2 Hz to 50 Hz.The vibration amplitude of lung was the biggest at the resonance frequency.The resonance frequencies of both rat and rabbit bowels showed no statistical correlations to body weights,bowel mass and bowel volumes.Conclusion Bowel resonance frequencies of rat and that of rabbit are evidently statistical different except for that of kidney.The resonance frequency values of rabbit bowels are closer to that of dog and monkey than to that of rat.Thus the resonance injury characteristic of rabbit bowels can be the research basis for dog,monkey,and even human bowels resonance injury.

Objective:To assess the implications of hormone therapy on confirmation of clinical diagnosis and prognosis of adult hemophagocytic syndrome (HPS) in the emergency department setting.Methods:The eligible 34 patients admitted with suspected HPS in the Emergency Department of Peking University People's Hospital from September 2019 to August 2021 were respectively collected. The patients were divided into the death group and survival group according to the prognosis and divided into early hormone therapy group and standard hormone therapy group according to the timing of hormone application. Patients in the early hormone therapy group were divided into the routine 4 criteria group and non-routine 4 criteria group according to the conditions of meeting the four HLH-2004 diagnostic criteria. Medical records of the following were collected and statistically analyzed: complete blood count, blood biochemical index, coagulation function, serum ferritin, NK cell activity, sCD25 level, peripheral blood smear, bone marrow biopsy, abdominal ultrasound scan, and abdominal CT on admission, and recheck the clinical indicators such as blood count, blood biochemical index and blood coagulation dunction 5-7 days later.Results:①Patients from the death group were older, with higher APACHEⅡ scores and SOFA scores, higher total bilirubin, and lower serum albumin. ② Univariate Logistic analysis showed age ( OR=1.098, CI: 1.019-1.183, P=0.014), APACHE Ⅱ score ( OR=1.144, CI: 1.017-1.285, P=0.024), SOFA score ( OR=1.441, CI: 1.079-1.925, P=0.013) were associated with the risk of death. Multivariate Logistic analysis showed that age ( OR=1.099, CI: 1.014-1.190, P=0.021) was associated with the risk of death. There was no significant correlation between early hormone therapy and clinical prognosis. Kaplan-Meier survival curves showed that there was no difference in the 60-day survival rate between the early hormone therapy group and the standard hormone therapy group. ③ The level of triglyceride still increased after early hormone therapy, and the number of indexes meeting the diagnostic criteria of HLH-2004 increased significantly. All patients met the criteria of Hscore>169, and 3 patients did not meet at least 5 diagnostic criteria of HLH-2004, accounting for 16.7% of the total cases of early hormone therapy. ④ Starting hormone therapy when the four HLH-2004 diagnostic criteria were met could reduce the length of hospital stay. Prothrombin time and activited partial thomboplastin time were closer to normal levels in patients 5-7 days after treatment. Early hormone therapy had no significant effect on treatment response and in-hospital death risk. There were no significant differences in APACHE Ⅱ score, SOFA score, confirmation of diagnosis, treatment response, clinical prognosis, and related clinical indicators after hormone therapy between the routine 4 criteria and non-routine 4 criteria groups. Conclusions:Initiation of early hormone therapy has no significant effect on the confirmation of clinical diagnosis, treatment response, in-hospital mortality, and 60-day survival rate of patients with HPS, and can quickly correct coagulation dysfunction and effectively reduce the length of hospital stay. An earlier start of hormonal therapy (meeting the four HLH-2004 diagnostic criteria) may be considered by the emergency physician when a patient is highly suspected of HPS diagnosis

Objective To study the characteristics of the sciatic nerve injuries inflicted by highvelocity triangle fragments in swine.Methods According to the injury position,14 swines weighing (34.29±5.2)kg were divided into two groups.All swines were shot by 0.37 g triangle fragments at (773.1±12.4)m/s aimed at the midpoint of the lateral body surface projection of the right sciatic nerve in Group A(n=7)and at 2 cm aside from sciatic nerve in Group B(n=7).The entrance,exit and length of wound tract,distance between nerve and wound tract were detected,and the pathology of sciatic nerve and wound tract at 48 hours after injury were observed under light microscope and electron microscope.Results The course of the fragments was deviated to different extent.Six sciatic nerves were in primary wound tract,four of which were lacerated and ruptured at different degrees.The light microscope showed pathological changes including severe hemorrhage and edema,leukocytic infiltration,neurotmesis,axonotmesis and light myelin coloration;while electron microscope showed severe degeneration of myelin sheath and neuraxon distortion.Six nerves(one in Group A and five in Group B)were in the concussion zone,with the distance between sciatic nerve and primary wound tract for(2.07±0.45)cm.Hyporrhea and hyperemia under perilemma and perineurium,partial nerve fiber disrupt and axonotmesis were observed by light microscope and partly myelin sheath delamination by electron microscope.Two nerves (one in Group A and another in Group B)were in the contusion zone,with moderate pathological changes.Conclusions The track of high velocity triangle fragments is unstable in the tissues.High disrupt rate,severe and wide extent lesion,early Wallerian degeneration are the main characteristics of direct injuries of swine's sciatic nerves.Indirect injuries can induce pathologic changes too,for which the lesion severity is related to the distance between nerves and primary wound tract.

Objective The aim of this study was to investi-gate the changes of brain function in patients with drug-naive idiopath-ic epilepsy ( DNIE ) using resting-state functional MRI ( rs-fMRI ) amplitude of low-frequency fluctuation ( ALFF) , analyze the correlation of abnormal brain regions with the clinical variable ( disease course) , and gain a deeper insight into the pathophysiological mechanisms of idiopathic epilepsy. Methods This study included 25 cases of DNIE (15 males and 10 females) and 34 cases of drug idiopathic epilepsy (DIE, 22 males and 12 females).Another 25 healthy volunteers matched with the DNIE patients in sex, age, education and handedness were recruited as normal controls.The rs-fMRI data obtained from all the subjects were processed, subjected to ALFF analysis, and compared among the DNIE, DIE, and nor-mal control groups.The correlation was evaluated between the ALFF statistical brain mapping and the course of disease. Results Obvious differences were found in ALFF among the DNIE, DIE and control subjects.Compared with the normal controls, the DNIE pa-tients showed increased ALFF in the right inferior temporal gyrus, right lingual gyrus and right cuneus, but decreased ALFF in the right insula, left hippocampus, right midbrain, right middle frontal gyrus, left anterior cingulated gyrus, left middle cingulate gyrus and right inferior parietal lobule.In comparison with the DIE patients, those of the DNIE group exhibited increased ALFF in the left inferior occipital gyrus, right middle occipital gyrus and left middle occipital gyrus, but decreased ALFF in the right inferior frontal gyrus, left insula, right superior temporal gyrus and right middle frontal gyrus.In the DNIE patients, the disease course was found to be correlated positively with ALFF in the right cerebellum posterior lobe, left cerebellar tonsil, right lingual gyrus, left orbital gyrus, left middle oc-cipital gyrus, left corpus callosum, left caudate nuclear, left superior frontal gyrus, left medial frontal gyrus, right precuneus and left middle frontal gyrus, but negatively with ALFF in the right parahippocampal, right superior temporal gyrus, left superior temporal gyrus and right post-central gyrus. Conclusion The ALFF of resting-state cerebral function is abnormal in DNIE patients.The correlation between ALFF and the clinical variable ( disease course) provides a new insight into the pathophysiological mechanisms of epilepsy.

Objective To evaluate the clinical effect of CT-guided radiofrequency thermal coagulation in treating primary trigeminal neuralgia.Methods A total of 165 patients with primary trigeminal neuralgia were selected as research objects.The patients were randomly divided into radiofrequency thermal coagulation group (study group,n=83) and drug damage group (control group,n=82).For the treatment of trigeminal neuralgia,CT-guided radiofrequency thermal coagulation was carried out in the patients of the study group,and CT-guided percutaneous puncturing of oval foramen with epirubicin injection as chemical damage therapy was employed in the patients of the control group.Follow-up check-up was conducted at 3,6,12 and 36 months after the treatment.Visual analog score (VAS),total effective rate and incidence of complications were calculated and the results were compared between the two groups.Results The excellent therapeutic rate of the study group was significantly better than that of the control group,the difference between the two groups was statistically significant (P＜0.05).The incidence of complications in the study group was remarkably lower than that in the control group,the difference between the two groups was statistically significant (P＜0.05).The VAS pain score of the study group was much lower than that of the control group.The total therapeutic effect in the study group was more prominent.Conclusion In treating primary trigeminal neuralgia,CT-guided radiofrequency thermal coagulation has excellent clinical effect.Therefore,this technique is worthy of popularization and application in clinical practice.

Objective: To illuminate the temporal expression of the triggering receptor expressed on myeloid cells-1 (TREM-1) in the experimental periodontitis in rat and to investigate the function of TREM-1 in the pathogenesis of experimental periodontitis in rat. Methods: The experimental periodontitis model was established in the maxillary first molar by means of 'wire ligation + vaccination periodontal pathogen Porphyromanus gingivalis (Pg) + high-sugar diet' in Sprague-Dawley (SD) rats. The experimental animals were divided into six groups: the control group and each of the time points of establishing the models for one week and two to five weeks. There were six rats for each of the six groups. The bone loss of the palatal site was calculated to estimate whether the periodontitis model was successfully established. The expression of TREM-1, proinflammatory cytokines: tumor necrosis factor-α (TNF-α), interleukin (IL)-1β and IL-6, anti-inflammatory cytokines: IL-4, IL-10 and transforming growth factor-β (TGF-β) were examined by using quantitative real-time PCR. The expression level of TREM-1 protein was analyzed by the method of immunohistochemistry. Results: The average bone loss area of the palatal site was (0.17±0.04) mm² in the group of three weeks and was statistically significant (P<0.05) compared to the control group [(0.10±0.01) mm²]. The experimental periodontitis model was successfully established in the group of three weeks. The expression of TREM-1 increased significantly in the inflamed periodontal tissues and reached to its maximum expression in the three weeks group accounting for 159.50±38.26 in protein expression and 4.35±0.60 in mRNA expression, respectively. TREM-1 expression difference between the three weeks group and control group was statistically significant (P<0.01). The expression of IL-6 by gingival tissues was correlated with the mRNA level of TREM-1 (r=0.813 P=0.049). Conclusions TREM-1, as a proinflammatory receptor, could facilitate the periodontal inflammatory response. The possible way of TREM-1 to promote inflammation may be through controling the expression of IL-6.