Objective Based on the 2012 Atlanta classification criteria, to study the value of C-reactive protein (CRP) and procalcitonin (PCT) in the early forecasting acute pancreatitis (AP). Methods Eighty-three patients with AP were selected. The patients were divided into mild AP (MAP) group (39 cases), moderately severe AP (MSAP) group (31 cases) and severe AP (SAP) group (13 cases) according to the 2012 Atlanta classification criteria. Twenty-seven healthy people were selected as control group. The levels of serum CRP and PCT were measured. The predictive value of serum CRP and PCT levels for SAP, infectious pancreatic necrosis (IPN), organ failure and death risk was assessed using the area under the curve (AUC). Results The serum CRP and PCT levels in MAP group, MSAP group and SAP group were significantly higher than those in control group: (49.84 ± 12.26), (89.77 ± 22.10) and (123.69 ± 37.09) mg/L vs. (3.92 ± 1.37) mg/L, (1.15 ± 0.42), (2.44 ± 0.61) and (3.27 ± 0.96)μg/L vs. (0.41 ± 0.13)μg/L, and those in MSAP group and SAP group were significantly higher than those in MAP group, those in SAP group were significantly higher than those in MSAP group, and there were statistical differences (P<0.05). The Spearman correlation analysis result showed that AP severity was positively correlated with serum CRP and PCT levels (r = 0.652 and 0.714, P<0.05). The accuracy of serum CRP level for forecasting SAP and IPN was medium (AUC = 0.73 and 0.76), and for forecasting organ failure accuracy was low (AUC = 0.67). Serum CRP showed no significance in forecasting death risk (AUC = 0.46). The accuracy of serum PCT level for forecasting SAP, IPN and death risk accuracy was medium (AUC = 0.71, 0.86 and 0.80), and for forecasting organ failure accuracy was low (AUC =0.64). Conclusions Based on the 2012 Atlanta classification criteria, the accuracy of serum CRP level for forecasting SAP is higher than that of serum PCT level, the accuracy of serum PCT level for forecasting IPN and death risk is higher than that of serum CRP level, and accuracy of serum CRP and PCT levels for forecasting organ failure are low.

Carcinogens ; Occupational Exposure

Streptococcus pneumoniae is one of the most common cause of invasive disease,such as bacteremia,meningitis,and empyema,et al.But there has significant difference on the incidence of invasive pneumococcal disease among different regions and differernt groups of people.In addition the severity and mortality of invasive pneumococcal disease are closely related to the changes of serotypes,virulence of streptococcus pneumoniae and also the human immune response.The pneumococcal vaccination is an important measure to prevent streptococcus pneumoniae infection,providing good protection to vaccinees and createing herd immunity effect.This article briefly describes the pathogenesis,risk factors and preventive strategies of invasive pneumococcal disease.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Aged ; Catgut ; Female ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; physiopathology ; Spasm ; physiopathology ; therapy ; Treatment Outcome

Adult ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Prostatitis ; drug therapy ; prevention & control

Objective The significance of serum cytokine profile in coronary heart disease patients have been evaluated by observing the variation cytokines Methods The serum IL-1 a,IL-1 ?,IL-2,IL-4, IL-6 ,IL-8,IL-10,VEGF,IFN-?,,TNF-?,MCP-1 and EGF in 76 patients and 26 matched healthy volunteers have been observed.Serum cytokines had been measured by protein chips methods in EVIDENCE 180 automatic biochips analyzer and cytokine profile were got by bioinformatics.Results The serum level of IL-1?,IL-6,IL-8,and TNF-? were (4.32?8.14) ng/L ,(13.16?16.81) rig/L,(375.53?292.14) ng/L,(15.46?15.38) ng/L respectively,which increased obviously in patients (P

Objective To establish a rapid assay for genotyping of IL-6-597G/A and-572G/C polymorphisms by duplex real-time PCR assay.Methods One pair of primers and two pairs of fluorescent hybridization probes had been used to genotype two mutation sites in the promoter region of IL-6 gene by fluorescent resonance energy transfer and melting curves.Results Duplex real-time PCR method for genotyping of two mutation sites simultaneously had been developed and 123 health people samples were analyzed by this new method.The results showed that three genotypes were found in IL-6 gene-572G/C polymorphisms.They were GG,GC and CC genotypes.IL-6 gene promoter-597G/A polymorphism analysis showed 4 cases displayed GA genotype and other possessed GG genotype.No AA genotype had been found.Conclusions Duplex real-time PCR method is simple and fast.It provided an accurate and economic method which is suitable for clinical gene genotyping.

The effects of positive end-expiratory pressure (PEEP) on pulmonary shunt were studied during gen- eral anesthesia and postoperative period.Twenty cholecystectomy patients were randomly divided into experiment group (group P) and control group (group Z). PEEP and ZEEP were used separately after induction. Artery blood and mixed blood from the right ventricle were taken for blood gas analysis and determine the amount of pulmonary shunting before anesthesia. half and hour, one and half an hour and two and half an hour after anesthesia and one hour after the operation.The results showed that shunt in group P decreased gradually during general anesthesia and returned to the level of preoperation at an hour after operation. Shunt in group Z was increased continually and the level was significantly higher than preoperation an hour after operation. Shunt between two groups was significant difference (P

Purpose:To investigate method of early detection of breast cancer with microcalcification observed by mammograph but without palpable mass clinlcally.Methods:Stereotatic core needle biopsy (SCNB) were performed in 35 patients with calcification observed by mammography,and 29 people received stereotatic needle localized breast biopsies (NLBB).All tissues were routinely processed.Microscopic analysis of calcification and morphologic analysis of calcifica- tion were done,as well as histologic diagnosis.Results:Among the 35 specimens of SCNB,microscopic calcification,in- traductal carcinoma and invasive ductal carcinoma were detected in 24,8,and 4 respectively.Calcification was identified in 25 of the 29 cases of NLBB.Five cases of intraductal carcinoma,six cases of invasive ductal carcinoma as well as one case of invasive lobular carcinoma were diagnosed in these 29 patients.Conclusions:With close cooperation among pathol- ogists,surgeons and radiologists,the application of SCNB and NLBB may benefit the early detection of breast cancer with microcalcification observed by mammograph but without mass being palpable clinically and finaly improve the survival of breast cancer patients.

Objective To explore the clinical efficacy of anatomic liver resection in treatment of hepatocellular carcinoma (HCC) with microvascular invasion (MVI).Methods The retrospective cohort and case-control study was conducted.The clinical data of 150 HCC patients with MVI who were admitted to the Anhui Medical University Affiliated Provincial Hospital from June 2007 to June 2012 were collected.Sixty patients undergoing anatomic liver resection were allocated into the AR group and 90 undergoing non-anatomic liver resection in the NR group.Patients in the AR group underwent anatomic liver resection according to results of preoperative ICG R15 test,and patients in the NR group underwent non-anatomic liver resection.Observation indicators:(1) operation situations:operation time,volume of intraoperative blood loss,number of patients with blood transfusion;(2) postoperative recovery situations:time of drainage-tube removal,duration of hospital stay,Clavein grade of complication within 30 days postoperatively,number of patients with hepatic failure within 30 days postoperatively and number of death within 30 days postoperatively;(3) follow-up:postoperative median survival time,5-year overall survival rate and 5-year tumor-free survival rate;(4) prognostic factors analysis of 150 HCC patients with MVI.Measurement data with normal distribution were represented as-x±s and comparison between groups was analyzed using the independent-sample t test.Count data were represented as the chi-square test or Fisher exact probability.The survival rate was calculated using the Kaplan-Meier method and survival analysis was done using Log-rank test.The univariate analysis and multivariate analysis were done using the COX regression model.Results (1) Operation situations:all the 150 patients received successful radical resection of HCC.Operation time,numbers of patients with volume of intraoperative blood loss ≥ 500 mL and with volume of intraoperative blood loss ＜ 500 mL and number of patients with blood transfusion were (165±39) minutes,12,48,15 in the AR group and (136±30)minutes,34,56,38 in the NR group,respectively,with statistically significant differences between the 2 groups (t =29.172,x2=5.351,4.673,P＜0.05).(2) Postoperative recovery situations:time of drainage-tube removal and duration of hospital stay were (2.7± 1.1)days and (5.2± 1.3) days in the AR group,(3.8±1.6)days and (7.1±2.3)days in the NR group,respectively,with statistically significant differences between the 2 groups (t =4.641,5.812,P＜0.05).Numbers of patients with grade Ⅰ-Ⅱ of Clavein grade and with grade Ⅲ-Ⅳ and number of death within 30 days postoperatively were 45,15,1 in the AR group and 61,29,2 in the NR group,respectively,with no statistically significant difference between the 2 groups (x2 =0.906,P＞0.05).Number of patients with hepatic failure within 30 days postoperatively in the AR and NR group were respectively 4 and 17,with a statistically significant difference (x2=4.467,P＜0.05).(3) Follow-up:all the 150 patients were followed up for 1-106 months,with a median time of 26 months.The postoperative median survival time,5-year overall survival rate and 5-year tumor-free survival rate were 46 months,33.3％,21.7％ in the AR group and 18 months,15.6％,2.2％ in the NR group,respectively,with statistically significant differences in overall survival and tumor-free survival between the 2 groups (x2=23.718,63.932,P＜ 0.05).(4) Prognostic factors analysis of 150 HCC patients with MVI:result of univariate analysis showed that maximum diameter of tumor,tumor capsule,TNM stage,Edmondson grade and surgical procedures were relative factors affecting overall survival and tumor-free survival of HCC patients with MVI,with statistically significant differences (x2=5.519,2.790,13.639,8.321,42.470,31.057,15.963,19.594,23.718,63.932,P＜ 0.05).Result of multivariate analysis showed that missing tumor capsule,stage Ⅲ-Ⅳ of TNM stage,grade Ⅲ-Ⅳ of Edmondson grade and non-anatomic liver resection were independent factors affecting poor overall survival and tumor-free survival of HCC patients with MVI,and maximum diameter of tumor ＞5 cm was an independent factor affecting poor overall survival of HCC patients with MVI,with a statistically significant difference [HR =0.527,0.683,0.333,0.522,0.576,0.514,0.523,0.268,95％ confidence interval (CI):0.355-0.782,0.475-0.983,0.219-0.504,0.361-0.755,0.389-0.852,0.358-0.737,0.342-0.800,0.174-0.413;HR=0.559,95％CI:0.370-0.845,P＜0.05].Conclusions Anatomic liver resection in the treatment of HCC patients with MVI is safe and effective,with good short-term and long-term outcomes,and it can also improve prognosis of patients.Missing tumor capsule,stage Ⅲ-Ⅳ of TNM stage,grade Ⅲ-Ⅳ of Edmondson grade and non-anatomic liver resection are independent factors affecting poor overall survival and tumor-free survival of HCC patients with MVI,and maximum diameter of tumor ＞5 cm is an independent factor affecting poor overall survival of HCC patients with MVI.