Objective: To explore the correlation among plasma level of brain natriuretic peptide (BNP), serum D-dimer level and patient's status in patients with acute pulmonary embolism (APE).Methods: A total of 122 APE patients who were hospitalized from Mar 2012 to Dec 2015 were selected.According to right heart function and clinical symptoms, patients were divided into low risk group (n=61), medium risk group (n=36) and high risk group (n=25);after discharge, all patients were followed up for six months, then according to survival or not, they were divided into survival group (n=105) and death group (n=17).Plasma BNP and serum D-dimer levels were measured and compared among all groups, then correlation among BNP, D-dimer levels and severity of patient's status was analyzed.Results: Compared with low risk group, there were significant rise in levels of plasma BNP [(133.28±74.92)ng/L vs.(273.89±179.29)ng/L vs.(834.80±509.09)ng/L] and serum D-dimer [(761.80±333.65)ng/ml vs.(966.67±370.33)ng/ml vs.(1228.40±569.11)ng/ml] in medium risk group and high risk group, and those of high risk group were significantly higher than that of medium risk group, P<0.01 all.Compared with survival group, there were significant rise in levels of plasma BNP [(257.33±27.11)ng/L vs.(696.47±64.92)ng/L] and serum D-dimer [(818.57±64.92)ng/ml vs.(1513.25±48.14)ng/ml] in death group, P<0.01 all.Pearson correlation analysis indicated that plasma BNP, serum D-dimer levels were significant positively correlated with severity of patient's status (r=0.69, 0.41, P<0.01 both), and plasma BNP level was significant positively correlated with serum D-dimer level (r=0.79, P=0.002).Conclusion: Measurements of plasma BNP and serum D-dimer in APE patients are help to assess severity of patient's status and short-term prognosis, and provide basis for clinical individualized therapy.

Selective extraction of low molecular weight ( LMW) proteins and peptides from complex biological samples plays an important role in the discovery of useful biomarkers and signaling molecules. It is demonstrated that the unique pore structure of mesoporous material makes it efficient to enrich LMW proteins and peptides from complex matrixes. In this study, a mesoporous material, alkyl-diol@ phenyl-SiO2 , with modified exterior ( alkyl-diol group) and interior ( phenyl group) surfaces, was synthesized by co-condensation and post-grafting, and its characteristic was evaluated by FTIR and MS. The LMW proteins and peptides enriched by the alkyl-diol@phenyl-SiO2 mesoporous material could be easily eluted by organic solvents, which was compatible with the following detection by mass spectrometry ( MS ) . This new mesoporous material exhibited good selectivity for the extraction of LMW proteins and peptides ( less than 10 kDa) from complex biological samples.

Objective To investigate the changes of PTX3,NT -ProBNP level and the correlation between them and the prognosis of the patients with AMI combined T2DM.Methods 143 patients with primary AMI were enrolled,of which 63 patients with type 2 diabetes (observation group)and 80 patients with no diabetes (control group).Plasma PTX3 values were measured with ELISA method and NT -ProBNP was detected by the electrochemi luminescence method.All patients were observed for the occurrence of MACE during hospitalization and 12 months after discharge.The correlation between PTX3,NT -ProBNP concentration and occurrence of MACE in observation group were analyzed.Results The PTX3,NT -ProBNP concentration[(8.95 ±5.06)ng/mL,(1 609 ±1 049)pg/mL]in the observation group were significantly higher than those in the control group[(7.03 ±3.70)ng/mL,(1 198 ± 809)pg/mL](P =0.010,P =0.009);The number(n =26)of patients with occurrence of MACE in the observation group was significantly higher than 15 cases in the control group(P =0.003).In the observation group,the PTX3, NT -ProBNP concentration[(10.98 ±5.45)ng/mL,(2 007 ±1 097)ng/mL]in patients with MACE were signifi-cantly higher than those in patients without MACE[(7.53 ±4.28)ng/mL,(1330 ±930)ng/mL](P =0.007,P =0.010),and in MACE group,the PTX3,NT -ProBNP concentration[(13.88 ±6.84)ng/mL,(2 596 ±1 333)ng/mL] in patients with death weresignificantly higher than those in patients without death[(9.18 ±3.52)ng/mL,(1 639 ± 751)ng/mL](P =0.029,P =0.023).Conclusion More strong chronic inflammatory reaction and serious myocar-dial injury might occur in the patients with AMI combined and T2DM,and those patients would have poorer prognosis. The combined detection of PTX3,NT -ProBNP has an important significance in evaluating of the degree of myocardial damage and the prognosis of the patients with AMI combined T2DM.

Objective To discuss the influence of microRNA(miR)-155/miR-21 on toll-like receptor 4 (TLR4) in children with sepsis.Methods Fifty children with sepsis who were hospita-lized in Pediatric Intensive Care Unit,Shenzhen Children's Hospital,were enrolled in the study,and 15 healthy children at the same age were selected as healthy control group.Expression levels of TLR4 protein and human leukocyte antigen(HLA)-DR in CD14 + monocytes (MC) were detected by using flow cytometry,and sepsis patients were divided into 2 groups according to whether they exceeded the value of HLA-DR by 30％ or not.Expression level of programmed cell death factor 4 (PDCDM) and inositol phosphatases 1 containing SH2 (SHIP1) were detected at the same time.MC were separated by CD14 + immune magnetic bead,and expression level of miR-155,miR-21 and tumor necrosis factor-α (TNF-α),interleukin-10 (IL-10) mRNA in CD14 + MC were detected by using real-time fluorescent quantitative PCR.Results Sepsis group consisted of 27 male and 23 female,and their ages were (2.34 ± 0.79) years old,among whom 9 patients died.There were 36 patients in the HLA-DR increase group and 14 patients in the HLA-DR decrease group.Expressions ofTLR4(2.33±0.90),miR-155[(7.19±3.75) ×10 3] and TNF-α[(21.98±14.15) ×10-2 pg/L] in CD14 + MC were higher in the HLA-DR increase group than those in the HLA-DR decrease group [1.24±0.60,(4.83 ±1.17) × 10-3,(14.18±5.45) ×10-2 μg/L] and healthy control group[1.57±0.55,(3.99 ± 1.29) × 10-3,(1.61 ± 0.84) × 10 2 pg/L],and the differences were statistically significant(F =11.943,7.583,18.538,all P ＜0.05),while the expressions of miR-21 (12.10 ±5.66),IL-10[(29.74 ± 12.55) × 10-4 μg/L] in CD14 + MC were lower in the HLA-DR increase group than those in the HLA-DR decrease group[4.68 ± 2.07,(12.50 ± 5.73) × 10-4 μg/L] and healthy control group [2.39 ± 0.86,(2.04 ± 0.92) × 10-4 μg/L],and the differences were statistically significant(F =41.673,54.991,all P ＜ 0.05).The levels of SH1P1 and PDCD4 decreased in sepsis compared with healthy control group[0.70 ±0.36)vs.(1.59 ±0.48);(1.55 ±0.56) vs.(3.01 ±0.70)],and the differences were statistically significant (t =7.682,8.339,all P ＜ 0.05),but SHIP1 decreased more significantly in the HLA-DR increase group than that in the HLA-DR decrease group [(0.60 ± 0.34) vs.(0.97 ± 0.26)],and the difference was statistically significant (F =39.214,P ＜ 0.05).PDCD4 decreased more significantly in the HLA-DR decrease group than that in the HLA-DR increase group (0.94 ±0.19 vs.1.79 ±0.47),the difference was statistically significant(F =65.367,P ＜ 0.05).Conclusions Regulation imbalance of miR-155/miR-21 may be one of the reasons for abnormal expression of TLR4 in children with sepsis,and it plays a role in enlarged or inhibited expression of TLR4 in the sepsis process which results in different immune status in sepsis patients.

Objective To establish a flow-cytometric method to detect microvesicles (MVs) in rat peripheral blood, and to detect platelets-derived MVs (PMVs) and endothelial cell-derived MVs (EMVs) in blood from ischemic precondition-ing (IPC) treated rats. Methods Blood was withdrawn from rat abdominal aorta and anticoagulated with sodium citrate. Platelets-free plasma (PFP) was isolated through two centrifugations at room temperature. PFP was incubated with FITC-conjugated mouse anti-rat CD61 or PE-conjugated mouse anti-rat CD144. Standard beads in diameter of 1 and 2μm were used for calibration and absolute counting, respectively. Analysis was performed on flow cytometer. Results When 3.5%so-dium citrate was mixed with blood at volume ratio of 1∶4, clear supernatant was collected after centrifugation. Signals of parti-cles smaller than 1μm accounted for more than 99%of overall signals. PMVs and EMVs were CD61 positive and CD144 positive, respectively. Their diameters were both smaller than 1 μm. The concentration of PMVs and EMVs in peripheral blood from IPC treated rats was (4 053±1 987)/μL and (4 870±825)/μL, respectively. Conclusion The method for MVs de-tection by flow cytometry was successfully established and optimized, and verified through detecting PMVs and EMVs in pe-ripheral blood from IPC treated rats.

On the basis of expounding the concepts of primary medical institutions and position competence,this paper summarized the demand and level of post competence index of nurses in primary medical institutions,and the factors influencing position competence of nurses in primary medical institutions,and pointed out the shortcomings of existing research,so as to provide the direction for follow-up study.

To study the changes of metabolites in rat urine after treatment of Aristolochia fangchi decoction by metabonomic method.

OBJECTIVE: To observe the short-term and long-term curative effect of the xenogenic acellular dermal matrix membrane (or joint muscle flap transfer) application used in the 82 cases postoperative tissue shortage repair that after the head neck carcinoma resection. METHOD: To held the 82 cases head neck carcinoma postoperative mucosa shortage repaired after resection by the xenogenic acellular dermal matrix membrane (or joint muscle flap transfer), 65 cases mucosa shortage wound be directly covered by the repair membrane and the other 17 cases mucosa shortage wound be repaired by the tranfered muscle tissue flap with the repair membrane covered; 53 cases underwent additional postoperative radiotherapy between 2-4 weeks and follow-up in 1, 3, 6, 12, 18, 24, 30, 36, 48, 60 months and observed the operation site repair process through the electronic laryngoscope, observed the patients respiration, swallow, phonation function. RESULT: Seventy-seven cases patients operation incision reached I phase healing standard, another 5 cases patients operation incision reached II phase healing standard because of the wound infection and fully-recovered through the local wound drainage,dressing process. All the patients tracheal cannula,the stomach tube be extubated successfully and without the local cicatricial constriction occurred. Seventy-eight cases follow up period reached 1 year including 53 cases who underwent postoperative radiotherapy, 49 cases follow up period reached 3 years including 32 cases who underwent postoperative radiotherapy, 14 cases follow up period reached 5 years including 12 cases who underwent postoperative radiotherapy. The patients with static local lesions discovered no reaction such as exclusion, allergy. CONCLUSION The application of xenogenic acellular dermal matrix membrane (or joint muscle flap transfer used in in the postoperative tissue shortage repair that after the head neck carcinoma resection have several advantage such as comparatively easily implementation, operation safety edge enough,well preserved organ function, comparatively low incidence about the laryngeal stenosis, the short-term and long-term repair effect are all exact.
Acellular Dermis ; Carcinoma, Squamous Cell ; radiotherapy ; surgery ; Female ; Head and Neck Neoplasms ; radiotherapy ; surgery ; Humans ; Male ; Mucous Membrane ; surgery ; Postoperative Period ; Squamous Cell Carcinoma of Head and Neck ; Surgical Flaps ; transplantation ; Wound Healing

Objective To investigate the safety and short-term effectiveness of the hybrid operation for the treatment of intracranial complex ruptured aneurysms.Methods From December 2014 to March 2017,14 consecutive patients with complex ruptured aneurysm treated with hybrid operation at the Department of Neurosurgery,Nanfang Hospital,Southern Medical University were enrolled retrospectively,including 13 with acute spontaneous aneurismal subarachnoid hemorrhage and 1 with hemorrhage in the recurrent aneurysm embolization.Twelve aneurysms were treated with shape clipping.Digital subtraction angiography (DSA) was used to evaluate the clipping effect of aneurysms.Two patients with aneurysm were treated with extracranial-intracranial (EC-IC) bypass and aneurysm trapping.Endovascular balloon occlusion for trapping aneurysms was performed after DSA evaluation of the patency of bridge vessel.Results Of the 14 patients,11 were treated with emergency hybrid operation after angiography,2 were treated with elective surgery,and 1 with emergency surgery for rescue because of bleeding during embolization.DSA revealed that the aneurysm clips in 3 of 12 patients needed to be adjusted,including 2 parent artery stenosis and 1 with incomplete clipping.After adjustment,the clipping was satisfactory.In intracranial and extracranial bypass surgery,angiography revealed that the blood vessels were patent.Trapping of the aneurysms was performed in the one-stage operation.One patient discharged voluntarily after procedure because of serious vasospasm.Onepatient had perfusion pressure breakthrough after surgery and received hematoma evacuation and decompression.The Glasgow outcome scale (GOS) score was 3 at discharge.Other patients had no new neurological dysfunction after operation.Thirteen patients were followed up for 3-24 months after operation.There were no new neurological dysfunction,including GOS 5 in 8 cases and 4 in 5 cases.Six patients underwent DSA examination,in 4 of them the aneurysm clipping did not show aneurysm recurrence,and the parent arteries were patent.Two patients treated with vascular bypass.There were no recurrence of aneurysms,and the parent arteries and anastomotic vessels were patent.Conclusion After preliminary observation,using hybrid operation for the treatment of complicated intracranial ruptured aneurysms was safe and effective.