Sepis s is the leading cause of death in critically ill children,but it lack biomarkers with a higher sesn itivity and specificity for sepsis diagnosis,severity assessment,and prognostication.Soluble uroki-nase plasminogen activator receptor( suPAR) ,as a nvo el receptor ts imual ted by inflammation,is involved in the plasminogen activating pathways,inflammation and migration,adhesino ,chemotaxis,signal transduction of v ra ious immuen cell.suPAR serum levels have been shown to significantly incer ase in various infectious dis-easse .This revei w provided a ed scriptive overview of the role of suPARd etection in sepsis judgmne t and prognostication,hoping to find a perfetc biomarker for timely evaluait ng of chidlr en with spe sis and screening for childrena dmitted to the intensive care uin t in order to improve outcome and reduce mortality.

Objective: To investigate the detection ability of two reagents by automated coagulation analyzer ACL-TOP using immune turbidimetric method, and to determine the merits and demerits of them. Methods:Two reagents were compared in the study. We selected 532 cases of hospitalized patients in Anzhen Hospital, 388 cases of which were unstable angina, 60 cases were pulmonary thromboembolism, 70 cases were coronary atherosclerosis, 14 cases were abdominal aneurysm, and the rest were the patients with high blood pressure and coronary heart disease. The plasmas of all the patients were extracted, and D-dimer was detected on ACL-TOP by D-Dimer (referred to as reagent A) and D-DHS (referred to as reagent B). Results:The results of D-dimer increased in different degrees, and there are 88 cases of false positive cases. The case whose FDP and individual D-dimer of D-dimer simultaneous detection was elevating and clinical symptoms were disappeared was detected by the VIDAS instrument platform verification. There were significant differences between A and B. The detection result of reagent A was [1594.15±2286.18], and reagent B was [912.97±1814.06]. There were significant differences between them (t=3.654, P<0.05). In addition, the consistency of the two reagents was poor (r=0.419, P<0.05). Conclusion:Comparing two reagents to detect D-dimer quantitatively by automated coagulation analyzer ACL-TOP, D-DHS owns greater ability to exclude false-positive results, so does the ability of anti-interference with jaundice, hemolysis and chylemia.

Objective To investigate the relationship among serum levels of suppressors of cytokine signaling-3(SOCS-3),insulin-like growth factor binding protein-1(IGFBP-1) and hyperglycemia in critically ill children. Methods The 64 critically ill children who suffered from sepsis,after surgical repair of congenital heart dis-ease by extracorporeal circulation, and after surgery of severe traumatic from January 2009 to January 2012 in Depart-ment of Pediatric Intensive Care Unit( PICU) of Guangzhou Women and Children′s Medical Center were selected as the research object. According to the blood glucose levels on admission, the 64 children were divided into the normal glu-cose group and the hyperglycemia group. The 15 cases of healthy children in the same period in Guangzhou Women and Children′s Medical Center were selected as the healthy control group. The levels of blood glucose,insulin,SOCS-3,IG-FBP-1 and insulin resistance index( HOMA-IR) were measured and compared among groups when they were on ad-mission. Results (1) The blood glucose of the hyperglycemia group was significantly higher than those in the normal glucose group and the healthy control group[(9. 83±2. 48) mmol/L vs (4. 82±0. 76) mmol/L,(4. 49±0. 81) mmol/L] (P<0. 05). (2) Both of the insulin and HOMA-IR in critically ill children with hyperglycemia were significantly higher than those in the other 2 groups[9. 68(5. 85,17. 35) mU/L vs 4. 08(2. 00,7. 41) mU/L,2. 83(2. 00,10. 10) mU/L;4. 30(2. 70,7. 66) vs 0. 87(0. 39,1. 94),0. 52(0. 38,2. 56)](P<0. 05). (3) The serum SOCS-3,IGFBP-1 levels among the hyperglycemia group,the normal glucose group and the healthy control group were not of significant difference (P>0. 05). (4) The blood glucose was positively correlated with the insulin and HOMA-IR(r=0. 455,0. 773,P<0. 05),but there was no significant correlation among the blood glucose,insulin,HOMA-IR,SOCS-3 and IGFBP-1(P>0. 05). Con-clusions In the critically ill children,hyperglycemia was related to the insulin resistance which can not be evaluated through changes in serum levels of SOCS-3 and IGFBP-1. In addition,it cannot be excluded that the critically ill chil-dren may have insulin resistance and pancreaticβ-cell dysfunction simultaneously.

BACKGROUND:Location relationship between maxilary incisor labial inclination and the thickness of anterior alveolar bone displays ethnic and regional differences. OBJECTIVE:To study the correlation of alveolar bone structure and incisor labial inclinationin adolescents with skeletal class II malocclusion in Uygur and Han populations of Xinjiang, China. METHODS:Sixty Uygur and 60 Han patients at 11-16 years of age (average 13.8 years old), 32 males and 28 females, with skeletal class II malocclusion wereincluded. The thickness of anterior alveolar bone and incisor labial inclination were measuredon lateralcephalometric films, and the results were analyzed using SPSS 17.0 statistical software. RESULTS AND CONCLUSION:In Han and Uygur populations, palatalalveolar bone thicknessin maxilary incisor regionwas significantly negatively correlated with the inclination of maxilary incisor (r=-0.715 for Han,r=-0.651 for Uygur,P< 0.05), while labial alveolar bone thicknessin mandibular incisor regionwas significantly positively correlated with the lower incisor inclination (r=0.902 for Han,r=0.745 for Uygur,P< 0.05). These results indicate thatthepalatal alveolar bone thicknessin maxilary incisor region decreases with the increase of the inclinationof maxilary incisor; however,thelabial alveolar bone thicknessin mandibular incisor regionincreases with the increase of the lower incisor inclination.

Objective: To evaluate the phenomenon of post-coronary artery bypass graft (CABG) supply-dependent oxygen consumption and the critical level of oxygen delivery. Methods: 53 patients undergoing CABG were randomized selected for this study. The oxygen delivery, oxygen consumption, and oxygen extraction were studied 1,4,12,24, and 48 hours post-operatively. Data were analyzed by SPSS. Results: The oxygen delivery of post-op 1 hour was the lowest (363.88ml?min -1 ?m -2 ). The 4th and 12th hour post-operatively oxygen deliveries were 396.02 ml?min -1 ?m -2 and 412.92 ml?min -1 ?m -2 respectively, lowers than that post-op 24 hour. After post-op 24 hour, the oxygen delivery was relatively stable, and the value was 468.78 ml?min -1 ?m -2 . The oxygen consumption of post-op 12 hour was the highest (143.02 ml?min -1 ?m -2 ), which closed to the normal value. The oxygen extraction of post-op 1 hour was the highest (35.6%). The oxygen extraction of post-op 12 hour was 32.6%, slightly lower than that post-op 1 hour. The oxygen extraction of after post-op 24 decreases obviously to be relatively stable, the value was 30.2%. Conclusion: 1, Postoperative 1 to 4 hour of CABG, hypoxia exists and oxygen delivery should be increased by maintain a higher pulmonary capillary wedge pressure and cardiac index. 2,There is a pathologic oxygen supply dependency for critical patients of post-CABG, the patients is still in hypoxia post-CABG 48 hour. Therefore, it is very important to keep oxygen supply and decrease oxygen consumption. It is better that the assistant ventilation is kept about 24 hours postoperatively. The pulmonary complications should be controlled as soon as possible. 3, The critical level of oxygen delivery is between 363.88 ml?min -1 ?m -2 and 396.02 ml?min -1 ?m -2 .

Objective To establish an in vitro oxygen-glucose deprivation/reoxygenation axon injury model in rat hippocampal neurons in order to found a basis for research concerning the injury of oxygen glucose deprivation and axons regeneration. MethodsThe hippocampal neurons isolated from rats 24 h after born and cultured for 7 d were exposed to D-hanks solution with nitrogen gas instead of the original culture medium for 0.5, 1.0 and 1.5 h respectively, and then continue to be cultured in the original culture medium with oxygen. LDH content in the culture media was measured at 1, 5, 24, 48 and 72 h after reoxygenation. The morphological changes of neuron and axon were observed with inverted phase contrast microscopy. ResultsAfter oxygen-glucose deprivation/reoxygenation injury, hippocampal neurons became darker, swollen, and were with shorten axons. With the elapse of time, the LDH content was increased. The survival rate of hippocampal neurons was higher and the change of axon length was more obvious in the group of oxygen-glucose deprivation for 0.5 h than in the other groups. ConclusionAn in vitro oxygen-glucose deprivation/reoxygenation axon injury model in rat hippocampal neurons is successfully established.

To investigate causes and clinical picture of fever of unknown origin (FUO), and to sum up the experiences in diagnosis of FUO, the medical records of 107 patients with FUO were reviewed retrospectively. Specific causes were identified in 99. 1% of these patients, including infections in 50 patients(46. 7%) , rheumatic problems in 22(20. 6%) and malignancies in 17(15. 9%). The main pathogens responsible for the infections were pyogenic bacteria(72. 0% , 36/50) and M tuberculosis (18. 0% , 9/50), mostly extrapulmonary. Lymphatic and he-mopoietic tissue neoplasms were the main forms of malignancy (88. 2%, 15/17), including histiocytosis, malignant lymphoma and leukemia. Drug fever was another common cause of FUO, accounting for 8. 4% in our series.

Objective To investigate the effect of clinical nursing pathway on patients with cerebral infarction. Methods Two hundred patients with cerebral infarction were randomized by random digit table into the clinical pathway group and the conventional nursing group.The former was managed with the clinical nursing pathway and the latter received conventional nursing. The neurologic impairment and the activities of daily life were assessed respectively by national institute of health stroke scale(NIHSS) and Barthel index(BI).The two groups were compared in terms of hospital stay,medical expense,patient’s satisfaction and curative effect. Results Compared to the conventional nursing group,the clinical pathway group was shorter at hospital stay,lower at lower hospitalization cost,higher at patient’s satisfaction and higher in the score by Barthel index,compared to the conventional nursing group(all P<0.05). Conclusion The application of clinical nursing pathway in patients with cerebral infarction can improve the activities of daily living and the quality of care,shorten length of stay,reduce medical cost and increase patients’satisfaction drgree.

As an important force in the process of China’s public medical education, private higher medical education is faced with severe challenges at the same time the development is made. On the basis of analyzing the development situation of private higher medical colleges and the deep space of development, the article promotes suggestions of the healthy development of private medical colleges, by macro-coordination from the government, private schools running orderly, improving the quality of education, and social support.