Objective To study the changes of plasma copeptin level in pneumonia patients and to explore the correlation between copeptin and disease severity,outcome as well as stress hyperglycemia.Methods A total of 45 patients with severe pneumonia were included in a prospective observation.The plasma levels of copeptin,CRP and blood glucose were measured after admission,and the APACHE Ⅱ scores were recorded within 24 hours.The patients were given insulin therapy by intravenous micro-dosage pump,and the total doses of insulin were recorded.All the patients with 28-day survival were followed up.Results The plasma levels of copeptin of severe pneumonia patients after admission were positively correlated with APACHE Ⅱ (r =0.481,P =0.001) and blood glucose (r =0.417,P =0.004),and were also correlated with the total insulin doses in patients under insulin therapy (blood glucose ≥ 10.0 mmol/L).The plasma levels of copeptin of the survival group were significanatly higher than the non-survival group,COX regression multivariate analysis showed that copeptin was an independent risk factor of death in severe pneumonia patients (P =0.005,OR =1.022,95％ CI:1.00-1.044),and the area under the ROC curve was 0.740 9 (P =0.006).Conclusion The plasma levels in all patients with copeptin of severe pneumonia after admission is positively correlated with APACHE Ⅱ and stress hyperglycemia,suggesting a useful approach to the judgment of disease severity,outcome and glucose control.

Objective To explore the feasibility of end-to-side neurorrhaphy in repairing nerve injury. Methods A group of 15 SD rats had the peroneal nerve sectioned and the distal endings sutured to the collateral face of tibial nerve after removing a 1 mm epineural window. Results After 3 months, electrophysiological studies showed electrical impulse conducted through the end-to-side junction. The electrical impulse conduction speed was lower than normal(P

Objective:To observe the nutritional status and respiratory function of the patients with mechanical ventilation in Intensive Care Unit after high fat and low carbohydrate enteral nutrition treatment.Methods:271 patients with mechanical ventilation in Intensive Care Unit were randomly divided into two groups:study group and control group.The study group was given high fat and low carbohydrate enteral nutrition treatment,while the control group with Enteral Nutritional Suspension.Thealbumin,prealbumin,blood gas analysis(PaC02,Pa0) and RQ,VC02,V02,IgG,CD4,CD4/CD8 were observed.Results:After nutritional support,nutritional status of two groups were improved,but there was no significant difference regarding the serum albumin and prealbumin.The PaO2,VO2,VCO2,RQ,IgG,CD4,CD4/CD8 and the total time of mechanical ventilation were improved,and the study group was superior to the control group.Conclusion:High fat and low carbohydrate enteral nutrition improves the nutritional status and respiratory function of the patients with mechanical ventilation in Intensive Care Unit,and decreases the total time of mechanical ventilation and total medical expenses.

Objective To establish a rat model of bone cancer pain-chronic morphine tolerance. Methods Thirty-six adult female Sprague-Dawley rats weighing 180-200 g in which intrathecal catheters were successfully placed without complications were randomly divided into 3 groups ( n = 12 each) :group sham operation (group S),group chronic morphine tolerance (group M) and group bone cancer pain + chronic morphine tolerance (group BM). Bone cancer pain was induced by intra-tibia inoculation of Walker256 mammary gland carcinoma cells (4 ×102 cells/μl) in group BM, while in group M heat-inactivated Walker256 mammary gland carcinoma cells were given instead, and then 10 days later, intrathecal morphine 20 μg,/kg was administered twice a day for 9 consecutive days. The mechanical paw withdrawal threshold (MWT) and mechanical paw withdrawal duration (MWD) were measured before inoculation, at day 1, 3, 6 and 9 after inoculation, and at day 1, 3, 5, 7 and 9 of morphine administration. The degree of bone destruction was assessed by radiological analysis at day 9 after inoculation. After the last measurement of pain threshold, the rats were given innoxious touch-stimulus. The rats were sacrificed 3 h after stopping the stimulus, and L4-6 segment of the spinal cord was isolated to determine the expression of Fos protein in the spinal dorsal horn. Results Compared with group S, MWT was significantly decreased, MWD was significantly prolonged and the expression of Fos protein was up-regulated in group M ( P ＜ 0.05 or 0.01 ). MWT was significantly decreased, MWD was significantly prolonged, bone destruction scores were significantly increased,and the expression of Fos protein was up-regulated in group BM compared with group M ( P ＜ 0.05 or 0.01 ). Conclusion A rat model of bone cancer pain-chronic morphine tolerance is successfully established.

Objective To investigate the effects of intrathecal(IT)CX3 CR1 neutralizing antibody(antiFKR)on morphine tolerance in rats with bone cancer pain(BCP)and the unlerlying mechanism.Methods Forty-eight adult female SD rats aged 3 months weighing 180-200 g were randomized into 4 groups(n =12 each):group I sham operation(S); group Ⅱ BCP + normal saline(NS); group Ⅲ BCP + IgG(IgG)and group ⅣBCP + anti-FKR.Bone cancer pain(BCP)was induced by injecting Walker 256 cancer cells 10 μl(400 cells/ μl)into the medullary cavity of right tibia in groups Ⅱ,Ⅲ and Ⅳ.Ten days later morphine 20 μg/kg was administered IT twice a day for 7 consecutive days.Starting from the 8th day NS,IgG and anti-KFR 10 μl was administered IT once a day for 3 consecutive days in groups Ⅱ,Ⅲ and ⅣⅣ respectively.Paw withdrawal threshold to yon Frey filament stimulation(MWT)and paw withdrawal duration(MWD)were determined bcfore(To,baseline)and at 3,6,9 day after intra-tibial cancer cell inoculation(T1.2,3),on the 3rd and 7th day of IT morphine(T4.5)and on the 3rd day of IT NS/lgG/anti-KFR(T6).The animals were killed at T6 after last pain behavior assessment.The lumbar segment(L4-6)of the spinal cord was removed for determination of the expression of CX3 CR1 protein(by Western blot),μ-opioid receptor and TRPV1 receptor(by immuno-histochemistry)in the dorsal horn of spinal cord.Results IT morphine significantly eased BCP at T4,but morphine analgesia was significantly reduced on the 7th day of IT morphine in the 3 groups indicating morphine tolerance which was significantly relieved by anti-KFR in group Ⅳ.IT anti-KFR significantly down-regulated CX3CR1 prolein and TRPVI receptor expression and up-regulated μ-opioid receptor in group Ⅳ as compared with IT NS and lgG in groups Ⅱ and Ⅲ.Conctusion IT anti-KFR can relieve morphine tolerance in the rats with bone cancer pain by up-regulating μ-opioid receptor and down-regulating CX3 CR1 protein and TRPVI receptor expression.

Objective To analyze the epidemiological characteristics of pituitary apoplexy and investigate the changes and features of endocrine hormones caused by pituitary apoplexy.Methods A retrospective analysis of the clinical and laboratory data of pituitary tumor and pituitary apoplexy was carried out.Results (1) The incidence of pituitary apoplexy was 31.78％,patients were 15-75 (47.5 ± 11.7) year old,most patients were female.(2)Diabetes,coronary heart disease,menopausal hormone therapy,radiotherapy,surgery,and bromocriptine administration may be related to pituitary apoplexy.(3) There was high incidence of apoplexy in nonfunctioning adenoma.(4) According to the relationship between apoplexy and pituitary tumor,cases with pituitary apoplexy were divided into 5 types.(5) Pituitary apoplexy was associated with low serum creatinine,hypernatremia,hyperchloremia,hypoeosinophilia,and hypobasophilia.(6) 61.61％ of the patients had pituitary hormone deficiency,especially the GnH deficiency.(7)98.10％ of the patients were treated by surgery.Conclusion Pituitary apoplexy has its own clinical characteristics,and more attention should be paid in clinical practice.

OBJECTIVETo evaluate the effects of different treatments on the prognosis of patients with synchronous colorectal liver metastasis(CLM).

METHODSClinicopathological data of 121 patients with synchronous CLM in The First Affiliated Hospital of Xinjiang Medical University between January 2010 and December 2014 were retrospectively analyzed. According to the metastatic lesions, patients were divided into simple operation group(22 patients, receiving operation only), simple chemotherapy group(43 patients, receiving chemotherapy only), and combination group(56 patients, receiving chemotherapy based on operation). The prognosis of patients in three groups was investigated. Univariate and multivariate analyses were performed through the long-rank test and Cox model to evaluate the related factors affecting prognosis.

RESULTSThe median survival time was 10(3-39) months in simple operation group, 7(3-36) months in simple chemotherapy group, and 18 (4-66) months in combination group. The differences among groups were all statistically significant (all P<0.05). Extent of lymph node metastasis, number of liver metastatic lesion, size of liver metastatic lesion, resection edge extent of liver metastatic lesion, and treatment method were independent factors of synchronous CLM(all P<0.05).

CONCLUSIONCombination therapy of a variety of treatment can prolong the survival of patients with synchronous CLM.

Objective To analyze the epidemiological characteristics of annual reported people living with HIV/AIDS (HIV/AIDS) in Qingdao city,Shandong province from 2010 to 2014 and to provide theoretical evidence for strategies on targeted prevention and control.Methods Information on annual reported HIV/AIDS and sentinel surveillance data from 2010 to 2014 was abstracted from the HIV/AIDS Comprehensive Response Information Management System (CRIMS).Statistical analysis was done by SPSS software.Results The number of annual reported HIV/AIDS increased from 2010 to 2014 in Qingdao,with the sex ratio as 10.8.Among all the patients,77.1％ were aged 20-39 years,65.6％ were unmarried,67.6％ graduated from high school or above.Homosexual contact was the major mode of transmission,and the prevalence of MSM increased yearly (P＜0.05).Conclusions MSM appeared the major high risk population for AIDS epidemic in Qingdao.However,surveillance projects should also be strengthened among the female population with multiple sexual partners.Optimal prevention and control measures based on the characteristics of AIDS epidemic should be developed to explore the stem spread and epidemics of the disease,in Qingdao.

Objective To analyze the influencing factors on condom use among 35-yearsor-older female sex workers (OFSWs) in Qingdao by using the three-level logistic model.Methods From March to June 2014,OFSWs were recruited in Qingdao,using respondent-driven sampling.Related information on OFSWs and their recent five sexual partners (not including husband) were obtained by conducting a questionnaire survey on OFSWs.A Three-level logistic regression model was conducted to analyze the influencing factors of condom use between OFSWs and their sexual partners.Results A total of 420 OFSWs participated the survey as well as information on 2 100 sexual partners.Results from the empty model showed that the use of condoms among OFSWs having an aggregation that related to the levels of working sites and their own behaviors.Results from the three-levels of logistic model analysis showed that,OFSWs that having had junior middle school education (OR=1.450,95％CI:1.054-1.994)/high school education or above (OR=2.264,95％ CI:1.215-4.222),knowing the function of condom use (OR=2.004,95％ CI:1.273-3.154) would have higher rates of condom use.OFSWs with higher score of attitude on condom use (OR=0.796,95％CI:0.745-0.849),having had syphilis infections in the past (OR=0.657,95％ CI:0.478-0.902) would have lower rate of condom use.For the sexual partners,the rate of condom use among OFSWs' regular partners were higher than that of OFSWs' boyfriends (OR=15.291,95％CI:8.441-27.700;OR=29.032,95％ CI:15.413-54.682).Conclusion Condom use of OFSWs was affected by behaviors of both OFSWs themselves and their sexual partners.Prevention and control programs should focus on OFSWs and their sexual partners at the same time.The key intervention contents should include target populations as:OFSWs with low level of education,having had infections of syphilis,those who do not use condoms with their trusted partners.

Objective This study aimed to analyze the behavior change and related factors regarding HIV/STD epidemics among female sex workers (FSWs) in Qingdao city.Methods According to the requirements set by the "National HIV/AIDS sentinel surveillance program",information on demographics,sexual and drug use behaviors,and HIV-related services among female sex workers (FSWs) was collected from ten consecutive annual cross-sectional surveys from 2006 to 2015.Blood samples were drawn for serological tests on both HIV and syphilis antibodies.Results Data from the sampled FSWs over the ten years,a higher proportion of participants who were aged 30 or more,married or cohabited and on-call FSW were followed.The prevalence of syphilis increased significantly from 1.0％ (4/420) in 2006 to 13.3％ (53/400) in 2015 (trendx2=54.22,P＜0.001).Rates on illicit drug use were ranging from 12.0％ (48/400) and 55.5％ (222/400) while the rate on consistent condom use with clients in the last month showed decreasing,with trendx2=170.62,P＜0.001.The proportion of HIV-related knowledge score ≥ 6 (trend x2 =152.96,P＜ 0.001),or ever been tested for HIV (trendx2=114.87,P＜0.001) were both significantly increased over the last ten years.Between 2009 and 2015,results from the annual stratified analysis showed that the FSWs who used drugs were more likely than the FSWs who were non-drug users less consistently using condoms with clients in last month and being syphilis positive (P＜0.05).On-call FSWs were more likely to be syphilis positive (P＜0.05) than the non on-call FSWs.Conclusions The prevalence of syphilis among FSWs in Qingdao city had been rising over the last ten years,with synthetic drug abuse as an important risk factor.Better targeted surveillance and intervention efforts among those drug-using FSWs seemed important to reduce the epidemics.