Sepsis constitutes a serious threat to human health and represents a major burden to the health care system.Recent years have witnessed a deeper insight into the mechanism of the onset of sepsis,together with some new therapeutic strategies,including early aggressive volume therapy,activated protein C,potentiated insulin therapy,adrenal function replacement therapy,and some new therapeutic targets,which have offered some hope for the management of sepsis.

Objective To establish a method for the quantitative determinations of the ingredients in yiqi hewei capsules. Methods RP-HPLC method was used. The separation was performed on a Thermo C18 column with mobile phase consisting of acetonitrile-water (20: 80) (pH was adjusted to 3 with glacial acetic acid) at the flow rate of 1. 0 mL·min-1. The detection wavelength was 283 nm. Results The linear ranges were ( 0. 5735 -5. 7360) × 10 -2 mg·mL-1 for baicalin, (0. 1940-1. 9395) × 10 -2 mg·mL-1 for hesperidin, (0. 2051 -2. 0510) × 10 -3 mg·mL-1 for naringin and (0. 2020 -2.0200) ×10 -2 mg·mL-1 for neohesperidin;RSD =0.28%,0.54%,0.54%,0.31%(n =5),respectively. The average recoveries were 103. 94%, 98. 06%, 103. 09%, 95. 67%, respectively. Conclusion The established method is simple, sensitive and accurate,which can be used for the quality control of yiqi hewei capsules.

Objective To investigate the single nucleotide polymorphism of 5,10-methylenetetrahy-drofolate reduetase gene and its association with the treatment of methotrexate in rheumatoid arthritis (RA).Methods A total of 184 patients with RA were divided into methotrexate (MTX) treatment group, MTX+other DMARDs treatment group, and treatment with other DMARDs but not MTX group. The clinical and laboratory data were evaluated before treatment and 24 weeks later. Efficacy and toxieities of each medication were also analyzed. Real-time fluorescent quantitative PCR was conducted to test gene mutations in RA patients and 100 healthy controls. Results There was no significant difference in the frenqueney of 677CC,CT, "IT and 1298AA, AC, CC between RA patients and the healthy controls. There was significant difference in the frenqueney of 677CC, CT, Tr between RA patients with cardiovascular eomplieations and the healthy controls. In the MTX treatment group, there was significant difference in the frenqueney of 1298AC, CC between the group in which MTX was effective and the other groups in which MTX was not effective, the occurrence rate of side effects of MTX in the patients with 677TT was higher than those without mutation(CC).In MTX+other DMARDs group, the occurrence rate of side effects of MTX in the patients with 677TT and CT was higher than that without mutation (CC). Conclusion There is no relationship between the pathogenesis of RA and the 677C/T, 1298A/C mutation of MTHFR gene. MTHFR gene 677C/T mutation is probably one of the genetic risk factors for cardiovascular complications of RA patients and the side effects of MTX. MTHFR gene 1298A/C allel is associated with the efficacy of MTX.

Angiotensin I ; Hepatic Stellate Cells ; Insulin-Like Growth Factor Binding Protein 2 ; Peptide Fragments ; Peptidyl-Dipeptidase A

Objective To investigate the role of IL-12 in lung ischemia-reperfusion(L/R)injury in rats.Methods Twenty-four healthy male SD rats,8-10 weeks,weighing 250-280 g,were randomly divided into 3 groups(n =8 each):sham operation group(S),I/R group,IL-12 monoclonal antibody group(group IL-12).LungI/R was induced by clamping the left hilum of lung for 60 min followed by 120 min reperfusion in groupsI/R and IL-12.IL-12 monoclonal antibody 200tg/kg was injected via the caudal vein at I h before clamping the left hilum.The blood samples were collected at the end of reperfusion,the rats were then sacrificed and lungs removed for determination of the plasma TNF-α concentration,Th1 and Th2 levels,W/D lung weight ratio,MDA content,MPO activity,PaO2 and PaCO2 in lung tissues and for microscopic examination.Results Compared with group S,W/D ratio and the level of MPO,MDA and TNF-α were significantly increased in groups I/R and IL-12,and PaO2 was significantly decreased,and PaCO2,Th1 level and Th1/Th2 sere significantly increased in group I/R(P ＜0.01),and no significant change was found in PaO2,PaCO2,the level of Th1 and Th2,and Th1/Th2 in group IL-12(P ＞ 0.05).PaCO2,W/D ratio,the levels of MDA,MPO,plasma TNF-u,Th1 and Th1/Th2 were significantly lower,and Th2 level and PaCO2 were significantly higher in group IL-12 than in group I/R(P ＜ 0.01).The pathologic changes of the lung were attenuated in group IL.12.Conclusion IL-12 is involved in the lung I/R injury through inducing Th1/Th2 imbalance in rats.

Objective To investigate the effect of GSK-3β inhibitor TDZD-8 on activation of NF-κB during lung ischemia-reperfusion (I/R) in rats.Methods Thirty-two healthy male Sprague-Dawley rats,aged 8-10 weeks,weighing 250-280 g,were randomly divided into 4 groups (n=8 each): sham operation group (sham group) ; I/R group,I/R + dimethyl sulfoxide (DMSO) group and I/R + TDZD-8 group.Lung I/R was induced by clamping the left hilum of lung for 1 h followed by 2 h reperfusion.10％ DMSO and TDZD-8 1 mg/kg were injected intravenously at 5 min betore reperfusion in groups I/R + DMSO and I/R + TDZD-8,respectively.Blood samples were taken at 2 h of reperfusion for determination of arterial partial pressure of oxygen (PaO2) and concentrations of plasma interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α).The animals were then sacrificed and the left lung was removed for determination of W/D lung weight ratio,myeloperpxidase (MPO) activity,expression of phosphorylated glycogen synthase kinase-3 beta (p-GSK-3β) and phosphorylated nuclear factor-kappa B p65 (pNF-κB p65) and for microscopic examination.Results Compared with sham group,PaO2 and the expression of pGSK-3β were significantly decreased,and the concentrations of plasma IL-6 and TNF-α,W/D lung weight ratio,MPO activity and expression of p-NF-κB p65 were significantly increased in the other groups (P ＜ 0.05),and PaO2 and the expression of p-GSK-3β were significantly increased and the other parameters were significantly decreased in I/R+ TDZD-8 group (P＜ 0.05).There were no significant differences in the parameters mentioned above among groups I/R and I/R + DMSO (P ＞ 0.05).Microscopic examination showed that I/R-induced lung injury was ameliorated by TDZD-8.Conclusion GSK-3β inhibitor TDZD-8 can attenuate lung I/R injury by downregulating phosphorylation of NF-κB p65 and inhibiting inflammatory response.

Objective To investigate the efficacy of tumor necrosis factor alpha (TNF-α) antagonists therapy and the possible eauses of new onset or exacerbation of psoriatic skin lesion in patients with arthritides treated with TNF-α atagonists therapy. Methods One patient with definite psoriatie arthritis and one patient with definite ankylosing spondylitis, who were treated with TNF-α antagonist therapy developed an unexpected exacerbation or new onset of psoriatic skin lesion, were investigated in this study. Furthermore, the literatures associated with psoriasis induced by anti-TNF-α therapy were reviewed. Results The patient with psoriatic arthritis experienced exacerbation of psoriatic skin lesion and the skin lesions subsided after discontinuation ofetanereept therapy. The skin lesions recurred with re-introduction of etanereept, which improved after withd-rawal of etanercept therapy. The patient with ankylosing spondylitis unexpectedly developed psoriasis vulgaris after receiving etanercept therapy. The skin lesion waxed and waned followed the administration or discon-tinuation of etanercept therapy. The same settings were reported in patients with rheumatoid arthritis receiving different types of anti-TNF-α therapy. Conclusion Blockage of TNF-α is highly effective in arthritides. Ho-wever, some patients with arthritides can unexpectedly develop either a new onset or exacerbation of psoriatic skin lesions after initiation of TNF-α antagonist therapy. The skin lesions subside after discontinuation of the TNF-α antagonist therapy, but the causes remain unclear.

Objective To analyze the prognosis of people with impaired glucose tolerance (IGT) after 10 years follow-up. Methods 30 patients with IGT, screened out in 1995 census, were intervened with medication and the change of life style for ten years. Results There were 7 cases (23.3%) in 30 patients with IGT were developed into DM and 13 cases (43.3%) were still IGT, others (10 cases, 33.3%) were reverted to NGT. In the beginning of the study, the means of TG and HBCI in DM turnover group were significantly higher than those of IGT and NGT turnover group (P0.05). After Ten years of follow-up, the prevalence rates of obesity and abdominal obesity in DM groups were significantly higher than those in NGT group (P

Objective We make a retrospective analysis , to compare to COPD group and discuss the risk factors and the clinical features in acute exacerbation in patients with ACOS to follow-up the exacerbating frequency after regular treatment in both two groups in one year. Methods There were 56 patients with ACOS and 80 patients with COPD from 2013 to 2015 in our hospital in 30%≤FEV1<80% in the stable phase. The common data of the enrolled patients included the age,sex,smoking, and allergic rhinitis or other allergic diseases in family. We analyzed laboratory index including PaO2,PaCO2,CRP,white blood cells,IgE of serums and compared the proportion of antibiotics,system used of glucocorticoid and noninvasive ventilation in hospitalization of acute exacerbation and followed up exacerbating frequency after using ICS united LABA/LAMA. Results The age and smoking index in the ACOS group were lower than the COPD group (P < 0.05). The allergic rhinitis or other familial allergic diseases,lower age of 60,the high IgE in serum were risk factor, in ACOS. In acute exacerbation, the PaCO2,IgE and WBC in serum were higher than that of the COPD group(P <0.05). The midian length of stay in hosipital was 12 days in the ACOS group and 8 days in the COPD group. The proportion of antibiotics,systemic administration of glucocorticoid and noninvasive ventilation in hospitalization of acute exacerbation in the ACOS group were higher than that of the COPD group (P < 0.05). The exacerbating frequency was decreased after using ICS united LABA/LAMA(1.2±0.6 vs 3.8±1.3,P < 0.05)in both ACOS and COPD groups. Conclusions The allergic diseases may participate in ACOS, in which it has familial tendency. In acute exacerbation, ACOS patients had even more inflammation and faster course than COPD patients. Using ICS united LABA/LAMA can reduce exacerbating frequency in ACOS.

Objective To detect the plasma level of osteopontin (OPN)in systemie lupus erythematosus (SLE) patients,and its correlation with disease activity as well as organ damage was analyzed.Methods The plasma level of osteopontin was measured by enzyme-linked immunosorbent assay in 68 SLE patients and 36 healthy controls.Results The plasma level of OPN was significantly higher in SLE Datients than in healthy control group(P＜0.01).In SLE patients,the plasma OPN level was significantly higher in patients with renal damage than in patients without renal damage(P＜0.01).Patients with lung interstitial disease and gastrointestinal tract involvement,their plasma level of OPN was significantly higher than those of patients with inactive lupus (P＜0.01).The plasma level of OPN correlated positivelv and significantly with SLEDAI score(r=O.523,P＜0.001)and 24-hour urine protein excretion(r=0.403,P=0.001),but negativelycorrelated with serum C3 level (r=-0.398,P=0.001).There was no correlation between the Dlasma level of OPN and anti-dsDNA antibody,Sm antibody,erythrocyte sedimentation rate,serum IgG,IgA,IgM levels(P＞0.05 ). Conclusion OPN may be involved in the pathogenesis of SLE,and may be a potential marker for dis-ease activity and organ damage.