Objective To study the serum procalcitonin (PCT)in patients with sepsis clinical application value,for the hospi-tal,infection control,to provide a scientific basis for reasonable Shaanxi General of antibiotics.Methods Retrospective anal-ysis of Shaanxi General hospital of CARF in 2011 May~2013 May 201 cases of patients with ICU,According to the severi-ty of infection were divided into 4 groups(SIRS)63 cases,(Sepsis)40 cases,(Severe sepsis)70 cases,(Septic shock)19 ca-ses,Dynamic analysis of ICU monitoring in 1,3,5,7,10,14,17 days each in the blood in patients with PCT,hs-CRP and WBC levels and blood culture,and PCT on the sensitivity,sepsis diagnostic specificity,positive predictive value,and negative predictive value,diagnostic accordance rate.Results PCT levels of SIRS and Sepsis (1.92 ng/ml)(10.8 ng/ml)group,the Severe Sepsis (24.0 ng/ml),and Septic shock compared (34.0 ng/ml)group,the difference was statistically significant (q1=13.8,q2=15.6,q3=17.9,P<0.05).Four groups of hs-CRP and WBC count,and there was no statistically significant difference (F=5.10,P>0.05),PCT levels and the severity of sepsis in positive correlation (r=0.781).The positive rate of blood culture in 26.6%,and PCT the on diagnosis of sepsis sensitivity,specificity,positive predictive value (PP),negative predictive value (NPV)were 87.2%,85.4%,78.9% and 89.3%,respectively,for sepsis diagnosis coincidence rate 85%, the increase of PCT level(≥ 1 ng/ml)was anindependent index 28 natural deposit rate.Conclusion Compared with PCT hs-CRP and WBC could better evaluate the severity of sepsis,and dynamic j udgment of sepsis disease prognosis was more sensitive.Joint detection with blood culture could improve the of accuracy differential diagnosis of sepsis,and to guide clinical rational application of antibiotics.The change of concentration of PCT daily can help predict mortality risk in patients with sepsis in ICU of the hospital,reduce complications and reduce mortality.

Animals ; Antigens, CD34 ; metabolism ; Cell Culture Techniques ; methods ; Cells, Cultured ; Endothelial Cells ; cytology ; metabolism ; Female ; Kidney Glomerulus ; cytology ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Vimentin ; metabolism

Objective:To evaluate the value of Cook MOB-15 system in guiding wire insertion during endoscopic retrograde cholangiopancreatography (ERCP). Methods: The clinical data of 51 patients who received Cook MOB-15 system-guided wire insertion during ERCP between Jan. 2005 to Dec. 2007 were retrospectively analyzed. Forty patients who received conventional ERCP catheter for malignant jaundice between Jan. 2002 and Dec. 2004 were taken as control. The successful insertion rates were compared between the 2 groups. Results: The successful insertion rate was 90.2% (46/51) in the Cook MOB-15 system group and 72.5% (29/40) in the conventional group; there was significant difference between the 2 groups (P

OBJECTIVETo explore etiologic fraction (EF) and interaction of hepatitis B virus (HBV) infection and other risk factors for primary hepatocellular carcinoma (PHC) in Guangxi, China.

METHODSA hospital-based case-control study including 500 PHC patients and 500 nontumorous patients was carried out in Guangxi. EF and interactions of HBV infection and other risk factors for PHC were analyzed by crossover analysis and nonconditional multiple logistic regression.

RESULTSHBV infection, family history of PHC, diabetes mellitus, eating raw fish, heavy alcohol consumption, frequently used drug, low income, mental oppression and blood type B all were risk factors for PHC. With EFs of 0.725, 0.186, 0.119, 0.486, 0.385, 0.438, 0.277, 0.607, 0.299, respectively and with etiologic fractions attributable to interaction [EF(A xB)] of 0.736, 0.643, 0.849, 0.551, 0.592, 0.618, 0.902, 0.577; and indices of interaction of 0.743, 0.651, 0.853, 0.560, 0.600, 0.626, 0.907, 0.586, respectively.

CONCLUSIONMain risk factors for PHC might include HBV infection, family history of PHC, diabetes mellitus, eating raw fish, heavy alcohol consumption, frequently used drug, low income, mental oppression and blood type B. HBV infection with other risk factors might exert synergistic action on developing PHC and increase the risk of PHC.

Adolescent ; Adult ; Aged ; Carcinoma, Hepatocellular ; etiology ; China ; epidemiology ; Data Interpretation, Statistical ; Female ; Humans ; Liver Neoplasms ; etiology ; Male ; Middle Aged ; Risk Factors

Middle East respiratory syndrome coronavirus (MERS-CoV) has caused outbreaks of SARS-like disease with 35% case-fatality rate, mainly in the Middle East. A more severe outbreak of MERS occurred recently in the Republic of Korea, where 186 people contracted the infections, causing great concern worldwide. So far, there has been no clinically available drug for the treatment of MERS-CoV infection. The potential drugs against MERS-CoV mainly consist of monoclonal antibodies, peptides and small molecular agents. Small molecular agents have an advantage of easier synthesis, lower cost in production and relatively higher stability. There is better chance for those candidates to gain a quick development. This article reviews the progress of developing small molecular MERS-CoV agents.
Antibodies, Monoclonal ; pharmacology ; Antiviral Agents ; pharmacology ; Coronavirus Infections ; drug therapy ; Drug Design ; Humans ; Middle East Respiratory Syndrome Coronavirus ; drug effects

Objective To discuss the ability of 64 slices CT to display the image of peripancreatic vessels. Methods 105 patients underwent abdomen enhancement scans. The scan data of aterial phase and venous phase were reconstructed respectively, the peripancreatic vessels were displayed by means of volume rendering (VR) and multiplanar volume reconstructions (MPVR). The percentage of successful display of the peripancreatic vessels were calculated. Results ①The display frequency of the peripancreatic big arteries and veins, including celiac trunk artery(CTA), common hepatic artery (CHA), 1eft gastric artery(LGA), splenic artery (SA), gastroduodenal artery (GDA), right gastloepiploic artery(RGEA), superior mesenteric artery (SMA), portal vein(PV), superiormesenteric vein(SMV), spleenic vein (SV)was 100%. ②The display frequency of small arteries including superior pancreaticoduodenal artery (PSPDA), inferior pancreaticoduodenal artery (PIPDA), dorsal pancreatic artery (PDA), transverse pancreatic artery (PTA), pancreaticomegana artery (PMA) and caudal pancreatic artery (PCA) ranged from 43.3% to 97.20%,while of the posteriorsuperior pancreaticoduodenal vein (PSPDV) and posterior-inferior pancreaticoduodenal vein (PIPDV) was 71.4% and 30.5% respectively. ③The display frequency of the peripancreatic small vessels by the multiplanar volume reconstruction (MPVR) was higher than that of the volume rendering (VR)(P＜0.05). Conclusions Multislice CT can display the peripancreatic peripancreatic vessels. Furthermore, there is a significant difference in the display frequency of the peripancreatic small vessels between the MPVR and VR reconstruction methods.

ObjectiveTo study the clinical features, arterial involvement, therapeutic strategies and outcomes of Takayasu arteritis (TA). MethodsThe clinical symptoms, arterial images, inflammatory parameters and follow-up information of 173 patients with TA were retrospectively studied. Comparisons between groups were performed by t-test. ResultsThere were 136 female and 37 male patients in this study. The mean age at onset was(26±11 ) years. Hypertension, pulse deficit or asymmetrical pulse, and fever were present in 46.6％, 41.1％, 28.7％ of patients, respectively. The distribution of arterial involvement were 64.7％in aorta, 9.8％ in pulmonary artery, 19.1％ in innominate artery, 65.9％ in common carotid arteries, 65.3％in the subclavian artery, 36.2％ in the renal artery, 12.1％ in the vertebral artery, and 5.8％ in coeliac axis.Elevated erythrocyte sedimentation rate(ESR) was found in 61.0％ patients. Active tuberculosis or history of tuberculosis was implicated in 45 patients(26.0％). Ten patients(5.8％) were hepatitis B virus carriers.Among 105 followed-up patients, 98 patients(94.2％) achieved persistent remission, 17 patients relapsed when corticosteroids were tapered. ConclusionCorticosteroids combined with or steroid alone, supplemented with endovascular intervention procedures or surgical bypass procedures when necessary, can effectively control the clinical symptoms and inflammatory parameters and improve the quality of life of patients.

ObjectiveTo compare the efficacy of single-stage and two-stage revision prosthesis-relative chronic infection causing by methicillin-resistant Staphylococcus aureus(MRSA) after total knee arthroplasty(TKA) in rabbits, and evaluate the clinical feasibility of single-stage revision TKA. MethodsA new kind of prosthesis was implanted into the right knee joints of 48 New Zealand white rabbits following proper anesthesia. After 4 weeks, the dose of 5×105 colony forming unit MRSA was inoculated into every knee to establish prosthesis joint infection model. The rabbits were divided into 2 groups randomly: experimental and control group. Four weeks after inoculation, the treatments of the experimental and control group were singlestage and two-stage revision respectively. The levels of serum C-reaction protein (CRP) and Erythrocyte sedimentation rate (ESR) were monitored in ten phase, i.e. prior to primary arthroplasty and revision, at 1, 3, 5, 7days, and 2, 4, 6, 12 weeks after revision. Twelve weeks after revision, animals were sacrificed and joint samples were collected for bacterial culture. The positive results were judged as reinfection, and the negative results were judged as successful healing. ResultsFive rabbits were excluded out of the group for some reasons. The recurrence rates of infection in the experimental group and control group were 22.7％ (5/22) and 14.3％(3/21) respectively after revision. The difference between them was statistically insignificant(χ2=0.102,P=0.750). The levels of serum CRP of the two groups raised, and reached their peaks at 3 days, then dropped into the normal level prior to primary arthroplasty at 4 weeks after revision. The difference between them was statistically insignificant (F=0.157, P=0.694). The ESR levels of the two groups elevated after revision, and reached their peaks at 5 days, then declined slowly into the original level prior to primary arthroplasty at 12 weeks. The difference between them was statistically insignificant (F=0.936,P=0.339). ConclusionThough the prosthesis-relative chronic infection caused by high virulence organism after TKA, the short-term efficacy of single-stage revision is similar to that of two-stage if the stain of pathogenic bacteria and its spectrum are obtained.

Objective To study the relationship between hepatocellular carcinoma and the interaction of polymorphisms in DNA repair gene XPD with environmental factors. Methods A hospital-based ease-control study on hepatoeellular carcinoma was conducted. All the hepatocellular carcinoma eases (n=300) were newly diagnosed and controls (n=312) were diagnosed with non-tumor cases. XPD genotype (Lys751 Gin and Asp312 Ash) from blood derived DNA was determined using TaqMan MGB Real-time PCR. Unconditional logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). Results For XPD condon 751 genotypes, there was no significant difference between frequencies of the AC or CC among patients and controls (P>0.05) (referent AA). The frequency of XPD312A allelic gene was higher in eases than that in controls and was associated with an increased risk (adjusted OR = 2.62,95% CI: 1.626-4.222) for hepatocellular carcinoma when compared with GG genotype. Interactions were found between infection of HBsAg and XPD312 (OR=7.348), as well as between smoking and non-wild type gene of XPD751 (0R=4.291) and XPD312 (OR=5.341). Conclusion DNA repair XPD312A allelic gene might increase the risk of Hepatocellular carcinoma. Interactions between HBsAg infection, smoking and XPD were observed in Hepatocellular carcinoma.

Objective To investigate the association between single nucleotide polymorphisms (SNPs)in cytokine IL-6, IL- 10 genes and HBV-related hepatocellular carcinoma(HCC). Methods A hospital-based case-control study was conducted in 381 cases with HBV-related HCC, 340 HBsAg carriers and 359 non-tumor controls. Genotypes of-572 site of IL-6 gene and-819, -592 sites of IL-10 gene were determined by real-time polymorphism chain reaction. Unconditional logistic regression was used to estimate the odds ratios(ORs)and 95 confidence intervals(C/s). Results For the G/C alleles of -572 loci on IL-6 gene, there were significant differences between the three groups(P＜0.05). Compared with CC genotype, GG genotype increased the risk of HBV infection (OR=2.171,95% Ch 1.068-4.415), but did not seem to be associated with HCC. For the alleles of-819 and -592 site of IL-10 gene, there were significant differences between the three groups(P＜0.05). Compared with CC genotype, TT genotype increased the risks of both HCC(OR=2.791,95%CI:1.326-5.874), and HCC in HBsAg carriers(0R=3.522,95%CI: 1.707-7.266). When compared with CC genotype on -592 site, the AA genotype reduced the risk of both HCC(OR=0.389, 95% CI:0.173-0.875), and HCC in HBsAg carriers(OR=0.336, 95% CI: 0.154-0.734). Conclusion The SNPs in -572 site of IL-6 gone might be associated with the risk of HBV infection. The SNPs in -819 site of IL-10 gene increased the risk of HCC, but -592 site of IL-10 gene decreased the risk of HCC.