Objective To select valuable biomarkers for diagnosis and predicting outcome of sepsis-related acute respiratory distress syndrome(ARDS) from D-dimmer (DD),yon Willebrand factor (vWF),platelet (PLT),N terminal-pro brain natriuretic peptide (NT-ProBNP),interleukin-6 (IL-6),interleukin-8 (IL-8) and surfactant protein D (SP-D).Methods A total of 48 sepsis accompanied with ARDS patients and 40 sepsis patients were prospectively studied with comparison.The clinical characteristics of all the patients were recorded in detail.The blood samples were obtained within 24 hours of ICU admission.The concentration or activity of the seven biomarkers was quantitatively assayed and the results were recorded.To select the most valuable biomarkers as clinical indices,diagnosis model and death predictive model were constructed by Logistic regression.Results Among the seven candidate biomarkers,SP-D,vWF and IL-8 showed the most value.Their area under the receiver operator characteristic curve (ROC) were 0.758 (P ＜ 0.01),0.783 (P ＜ 0.01) and 0.747 (P ＜ 0.01) respectively,and raised to 0.847 (P ＜ 0.001) when the three biomarkers were combined.IL-8,age greater than or equal to 60 years and APACHE Ⅱ score greater than or equal to 20 were related to ARDS death with 12.138(lnIL-8)(P=0.022),6.157(P=0.040) and7.415(P=0.014) of OR values respectively.Conclusion SP-D,vWF,IL-8 should be valuable for early prediction of sepsis-induced ARDS and the diagnostic accuracy raised through combined utilization.IL-8 may be predictable for prognosis of sepsis related ARDS and the comprehensive evaluation combining clinical indices with IL-8 should be suggested in clinical practice.

Objective:To investigate the effect of recombinant Elafin on A549 apoptosis induced by paraquat and the underlying mechanism.Methods:pEGFP-C1-Elafin was transformed into A549 competent cells by electroporation.Transformed A549 was cultured for additional 24 h before Elafin mRNA was detected by RT-PCR and cocultured with or without various concentration of paraquat( PQ ) for different duration.A549 apoptosis percentage and reactive oxygen species ( ROS ) content were tested by flow cytometry .Nuclear factor erythroid like-2(Nrf2) heme oxygenase-1(HO-1) were examed by Western blot .Results:Elafin expressed successfully in A549 after transformation.PQ caused A549 apoptosis in a concentration dependent manner and leaded to ROS content increasing and Nrf2 and HO-1 decreasing.However,elafin could inhibit ROS production and A549 apoptosis,upregulate Nrf2 and HO-1.Conclusion:Elafin could restrict A549 apoptosis to some extent and the possible mechanism lied in its ability to upregulate Nrf2 ex-pression.

Objective To investigate the prevalence of GJB2 ,SLC26A4 and mitochondrial DNA 12S rRNA m .1555A>G(mtDNA 1555A>G) mutations in Hui ethic group patients with nonsyndromic hearing loss (NSHL) from Northwest China .Methods A total of 420 peripheral blood samples were collected from unrelated Hui ethic group probands with NSHL in Northwest China .Amplified the target gene by polymerase chain reaction (PCR) af-ter extracting genomic DNA from whole blood .The mtDNA 1555A>G mutation was detected by PCR -Alw26I di-gestion ,then direct sequencing was used to the positive samples of mtDNA 1555A> G ,the coding region of GJB2 gene ,exon 8 and 19 of SLC26A4 gene .Results There were 11(2 .62% ) cases caused by mtDNA 1555A>G homo-zygous mutation in 420 patients with NSHL .There were 41(9 .76% ) cases including homozygote and compound het-erozygote ,caused by GJB2 gene mutation ,which was the most frequent deafness -related gene .The allel frequency of c .235delC accounted for 6 .90% ,as well as the most frequent(51 .33% ) mutational pattern in GJB2 gene .There were 20 patients(4 .76% ) were found carring two allel mutations in SLC26A4 gene .The allel frequency of c .919 -2A>G was 5 .0% ,accounting for a total of 68 .85% in all base alterations of SLC26A4 gene ,which was the major mutant form of SLC26A4 gene .Conclusion GJB2 gene is the most common deafness -gene in Hui ethnic group pa-tients with NSHL from Northwest China ,while c .235delC is the main mutant form ,and c .919-2A>G is the hot-spot mutation of SLC26A4 gene .Through this study we can provide the molecular epidemiology basis for Hui ethnic group patients with NSHL from Northwest China in genetic diagnosis ,genetic counseling and therapy by associated testing of three frequent hearing loss genes .

Objective To investigate the prognostic significance of serum vascular endothelial cadherine (VE-Cad) in patients with acute respiratory distress syndrome (ARDS) induced by sepsis . Methods A prospective observational study was performed between June 2015 and Dec 2017 ,and 48 ARDS patients induced by sepsis from intensive care unit (ICU) were enrolled .And 30 healthy volunteers were enrolled as control .ARDS group was divided into mild group (n=17) ,moderate group (n=18) and severe group (n= 13) .The dynamic levels of serum VE-Cad ,tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were monitored at day 1 ,3 and 7 of admission .Clinical data including extravascular lung water index (EVLWI) ,pulmonary vascular permeability index (PVPI) ,lung injury score (LIS) , APACHEⅡand SOFA were also collected .The t-test or chi square test were used in the comparison between the two groups .One-way ANOVA was used for comparison among multiple groups .Results The serum VE-Cad level of septic group was higher than control group at day 1 of admission ([5 .67 ± 0 .29] vs [0 .28 ± 0 .03] μg/L ,t= 101 .2 , P< 0 .01) .The serum VE-Cad levels in the mild group , moderate group and severe group were (1 .52 ± 0 .59) ,(3 .45 ± 0 .68) ,and (4 .68 ± 0 .53) μg/L , respectively (F=15 .45 ,P<0 .01) .There were positive correlation between VE-Cad levels and EVLWI , PVPI ,LIS ,TNF-αand IL-6 (r=0 .640 ,0 .601 ,0 .507 ,0 .584 ,and 0 .456 ,respectively ,all P<0 .01) . The PaO2/FiO2 and serum albumin level in death group (n=17) were lower than survival group (n=31) ([146 .74 ± 16 .45] vs [245 .42 ± 12 .13] mmHg [1 mmHg=0 .133 kPa] ,t=23 .72 ,P<0 .01 ;[23 .18 ± 3.24]vs[29.16±3.45]g/L,t=5.865,P< 0.01,respectively),andEVLWI ,PVPI,LIS,serum lactate ,mechanical ventilation time ,7 d fluid balance ,APACHEⅡ and SOFA in death group were all higher than survival group .The serum VE-Cad levels at day 1 ,3 and 7 in death group were all higher than survival group ([4 .72 ± 0 .96] vs [3 .36 ± 0 .47]μg/L ,t=8 .801;[3 .87 ± 0 .28] vs [1 .95 ± 0 .42]μg/L , t=16 .86 ;[3 .92 ± 0 .53] vs [0 .96 ± 0 .28]μg/L ,t=25 .42 ,respectively ,all P<0 .01) .The area under curve (AUC ) of VE-Cad for ARDS outcome prediction was 0 .878 with sensitivity of 100 .00％ and specificity of 58 .06％ with a cutoff of 3 .035 μg/L .Conclusion Serum VE-Cad level increases in patients with ARDS induced by sepsis ,and positively correlates with disease severity ,which could be a potential predictor for prognosis .

Platelets are anuclear cell fragments derived from megakaryocytes, playing a critical role in hemostasis and thrombosis through adhesion,activation,release and aggregation. Antiplatelet therapy represents as the cornerstone of secondary prophylaxis of cardiovascular diseases. Increasing evidences sup-port the emerging role of platelets in innate immunity and inflammation and their involvement in the patho-physiological processes of sepsis, atherosclerosis, autoimmune diseases and tumors. Anti-inflammatory and anti-tumor effects of aspirin and P2Y12 receptor antagonist have been reported in clinical trials, suggesting that antiplatelet therapy may have a broad prospect in application. In this review,we focused on the molecu-lar mechanism of platelet involved in immunity and inflammation. In addition,recent findings of antiplatelet therapy for sepsis,atherosclerosis and tumors were discussed.

Objective To investigate the prognostic significance of serum VE-cadherin in patients with septic shock. Methods A prospective observation study was performed between January 2016 and December 2017, forty-eight septic shock patients from intensive care unit (ICU) were enrolled, and 25 healthy volunteers served as the controls. Meanwhile, patients in the septic shock group were divided into two subgroups of the survival and death groups according to the 28-day mortality. The dynamic value changes of serum VE-cadherin (VE-Cad), vascular endothelial growth factor (VEGF), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were monitored on the 1st, 3rd and 7th day after admission. Results The serum VE-Cad level of the septic group was significantly higher than that of the control group on the 1st day (3.02±0.18 ng/mL vs. 0.26±0.05 ng/mL, t=3.275, P=0.002). There was a positive correlation between VE-Cad level and VEGF, TNF-α and IL-6 (r=0.826, 0.723, and 0.870, respectively; P<0.01). The PaO2/FiO2 and serum albumin (ALB) level of the death group were lower than that of the survival group, and extravascular lung water index (EVLWI), serum lactate, mechanical ventilation time, 7 day fluid balance, APACHE Ⅱ and SOFA levels of the death group were higher than those of the survival group. The serum VE-Cad levels of the death group were higher than those of the survival group on the 1st, 3rd and 7th day. The serum VE-Cad levels were positively correlated with APACHE Ⅱ and SOFA. The area under the ROC curve of VE-Cad predicting septic shock death on day 1 was 0.723 (95％CI 0.568-0.878). The sensitivity and specificity of VE-Cad with cut-off of 3.1 ng/mL in predicting septic shock death were 60％ and 70.83％, respectively. Conclusions Serum VE-Cad is positively correlated with disease severity and could predict a poor outcome in septic shock patients.

Objective To detect the expression levels of insulin-like growth factor 1 (IGF-1) and leptin (LP) in serum of patients with colorectal cancer, and to analyze its clinical significance. Methods Seventy-three patients with colorectal cancer, 37 patients with benign colorectal cancer and 40 healthy subjects were enrolled. Serum IGF-1 and LP levels of all the subjects were measured. A two-year follow-up study of colorectal patients was performed to observe the occurrence of lymph node metastasis. Logistic regression was used to analyze the factors affecting lymph node metastasis in colorectal cancer patients. The area under the receiver operating characteristic curve (AUC) was used to analyze the diagnostic value of IGF-1 and LP for colorectal cancer and recurrence. Results The serum IGF-1 concentration in colorectal cancer was significantly lower than that in the control group (P<0.05), but there was no significant difference between the patients with benign lesions (P>0.05). The serum LP level of colorectal cancer was significantly higher than that of benign lesions and control group (P<0.05). Both IGF-1 and LP have certain diagnostic value for colorectal cancer, and the combined test and efficacy of the two methods are higher than those of the separate test (P<0.05). The two-year recurrence rate of colorectal cancer patients was 16.43％, and the patient age (≥40 years old), TNM grade (Ⅲ～Ⅳgrade), tumor diameter (≥4 cm), vascular infiltration and deep muscle infiltration in the recurrent patients were significantly higher than that in the untreated patients (all P<0.05). In the cancer metastasis patients, the level of serum IGF-1 and LP was significantly lower and higher than that in non-metastatic patients, respectively (all P<0.05). Vascular infiltration, deep myometrial invasion, low IGF-1 levels, and high LP levels were independent predictors of recurrence in colorectal cancer patients, and the combined predictive AUC of the above four factors was 0.956 (95％CI:0.9881～0.990). Conclusions In patients with colorectal cancer, IGF-1 level is low and LP level is high, which is closely related to cancer recurrence.

Objective:To evaluate the effects of bosutinib on acute lung injury in mice with endotoxemia.Methods:Sixty clean-grade healthy male C57BL/6 mice, aged 8-12 weeks, weighing 20-25 g, were divided into 4 groups ( n=15 each) using a random number table method: control group (group C), bosutinib group (group B), endotoxemia group (group lipopolysaccharide [LPS]) and bosutinib plus endotoxemia group (group B+ LPS). Septic acute lung injury model was developed by intraperitoneal injection of LPS.Bosutinib 5 mg/kg was injected via the tail vein at 0.5 h before establishing the model in group B+ LPS and at the corresponding time point in group B. At 24 h after developing the model, the mice were sacrificed for microscopic examination of the pathological results of lung tissues which were scored for calculation of the lung coefficient (LI) and wet/dry lung weight (W/D) ratio, and for determination of the content of Evans blue in lung tissues (by Evans blue staining), expression of vascular endothelial cadherin (VE-cadherin), vascular cell adhesion molecule 1 (VCAM-1), phosphorylated nuclear transcription factor κB p65 (p-NF-κB p65), phosphorylated nuclear factor κB inhibitory protein α (pIκB-α) (by Western blot) and expression of interleukin-1beta (IL-1β), IL-6 and tumor necrosis factor-alpha (TNF-α) mRNA (using real-time polymerase chain reaction). Results:Compared with group C, the LI, W/D ratio, Evans blue content in lung tissues and lung injury score were significantly increased, and the expression of IL-1β mRNA, TNF-α mRNA, IL-6 mRNA, VCAM-1, p-NF-κB p65 and pIKB-α was up-regulated, and the expression of VE-cadherin was down-regulated in group LPS ( P<0.05), and no significant change was found in the parameters mentioned above in group B ( P>0.05). Compared with group B, the LI, W/D ratio, Evans blue content in lung tissues and lung injury score were significantly decreased, and the expression of IL-1β mRNA, TNF-α mRNA, IL-6 mRNA, VCAM-1, p-NF-κB p65 and pIKB-α was down-regulated, and the expression of VE-cadherin was up-regulated in group LPS ( P<0.05). Conclusions:Bosutinib can ameliorate the acute lung injury in mice with endotoxemia.

Objective: To investigate the consistency of plasma prothrombin time (PT) results detected by the STAGO STA-R Evolution and Mindray Precil C3510 automatic coagulation analyzers. Methods: The PTs from 69 plasma samples were detected by the STA-R Evolution and Precil C3510 coagulation analyzers, respectively, and the obtained results were compared. Based on the CLSI EP9-A3 protocol, the ESD test was used to detect outliers, the scatter plot, difference plot, and frequency distribution plot were drawn, and the method comparison and bias evaluation were performed using the Passing-Bablok regression and Bland-Altman plot. Results: The PTs (median \[P 25, P 75\]) detected by the STA-R Evolution and Precil C3510 analyzers were 19.00 (13.85, 25.65) s and 20.50 (13.83, 26.30) s, respectively, and there was no significant difference between them (P＞0.05). No outliers were detected by the ESD test, and the variation of PTs (CV) was constant. There were no systematic, random and proportional differences in PT results from two coagulation analyzers. The bias between two coagulation analyzers was within the acceptable range (1/2 CLIA′88 TEa). The predicted bias of PT at each medical decision point was also within the acceptable range. Conclusion The results of PT detected by the Precil C3510 and STA-R Evolution coagulation analyzers are comparable, and the bias is within the acceptable range, which can meet the needs of clinical diagnosis and treatment.

Objective: To investigate the association of D-dimer (DD) level on admission with the hospital length of stay (LOS) for the children with community-acquired pneumonia (CAP). Methods: The children diagnosed as CAP hospitalized in the Second Hospital of Tianjin Medical University from December 2016 to December 2017 were studied. The clinical and biological variables were retrieved via electronic medical record system. Binary logistic regression model and Cox proportional risk model were constructed to estimate the assosiation of DD level with hospital length of stay(LOS). Results: A total of 413 children met the inclusion criteria. Their median of LOS was 7 days (range from 3 to 21 days). The median of DD level on admission was 510.87 ng/mL and tertiles were 400 ng/mL and 712.23 ng/mL. In logistic regression model, both the high (＞712.23 ng/mL) and middle (400-712.23 ng/mL) DD level groups were in more risk for hospital stay of more than 7 days in comparison with the low DD level group (＜400). The OR values were 3.335 (95%CI:1.973-5.637, P＜0.001) and 2.015 (95%CI:1.195-3.398, P=0.009) respectively. Consistently, in Cox model high level of DD was associated with low probability of discharge (HR=0.652, 95%CI: 0.486-0.874, P=0.004 ), suggesting more risk of prolonged LOS in contrast to the low DD level group. Conclusion The DD level on admission should be independently associated with the hospital length of stay, suggesting the consideration of DD levels may be helpful for clinical management of the hospitalized children with CAP.