The mechanism of sepsis is complicated,currently the treatment of severe sepsis is still a challenge.When infected,the body would release cytokines and inflammatory mediators,resulting in out of control of inflammatory reaction and disorder of immune system.Furthermore,sepsis and severe sepsis will be developed.The technique of continuous blood purification (CBP)can powerfully clear solute as water,metabolic wastes,toxic substances,cytokines and inflammatory mediators.Now this technique is not only applied in renal disorders,but also widely used in rescue treatment for critically ill patients.Recently,the guide of sepsis recommended CBP as a method of treating severe sepsis.With CBP application in the early stage of children severe sepsis,it can improve function of heart and lung function,renal function,immune function,coagulation function,and etc.CBP is becoming more and more important in the treatment of children severe sepsis.There are some remaining problem to be resolved,and the individaulized treatment for children sepsis is the focus in the future study.

Objective To study the extraction technology of the polysaccharides from Sporophyll of Undaria pinnatifida Suringar and find out the optimum extraction condition.Methods The extraction technology was studied by the orthogonal design.Results The optimum extraction conditions were to add 50 times of water to the Undaria pinnatifida Suringar material at 90℃ for 4 hours.Conclusion This optimum extraction technology based on the orthogonal design was confirmed by the experiment and was available in the future research.

Objective To explore the advantages and disadvantages of transvaginal hysterectomy for patients with non-prolapsed uterus,and explore the cause and preventive measurements of the complications of transvaginal hysterectomy.Methods The complications of transvaginal hysterectomy ( group TVH ) in 110 patients with non-prolapsed uterus and of transabdominal hysterectomy ( group TAH ) in 120 patients were compared with each other.These patients were chosen randomly from June 2006 to April 2010.Results In the TVH group,rectum hurt occurred in one patient,prolapse of fallopian tube in one patient and celiac internal bleeding in one patient.The preoperative diagnosis were not consistent with the postoperative diagnosis in four patients.Two patients encountered with postoperative residual end bleeding and four patients with vaginal residual end polyps.In the TAH group,three patients had postoperative diagnosis inconsistent with their preoperative diagnosis.In addition,there were four abdominal wall incision liquefaction ( including two phase suture in two patients),three postoperative bronchial lung infection and two residual end polyps.No celiac internal bleeding and visceral injury occurred in this group.Conclusion TVH has a higher risk of visceral injury and postoperative bleeding than TAH.These complications should be avoided when treating the patients with TVH technique.

Aim To investigate the effect of 15-ketoeicosatetraenoic acid(15-KETE)and its mechanism through ion channels on rat isolated pulmonary arterial rings by using organ bath technique.Methods Sixteen healthy Wistar rats weighing 220?20 g were divided into two groups(n=8): normoxia group breathing fresh air(FiO_2=21%) and hypoxia group breathing hypoxic air(FiO_2=10%) in a hypoxic box.Pulmonary arteries(PA)were extracted after 9 d and cut into rings(0.5~1.0 mm in diameter and 3 mm in length) for organ bath experiments.Results(1) With increasing concentration from 0 to10~(-6) mol?L~(-1),15-KETE increased PA rings tension gradually in a dosedependent fashion;(2) 4-aminopyridine(2 mmol?L~(-1)),a Kv channel blocker significantly decreased constriction of rat isolated PA rings induced by 15-KETE,and results were similar in two groups;(3) The K_(ATP) channel blocker glyburide(10~(-6)6 mol?L~(-1)) and the BK_(Ca) channel blocker tetraethylammonium(10 mmol?L~(-1)) did not affect constriction of rat isolated PA rings induced by 15-KETE;(4) The BKCa channel blocker nifedipine(10~(-6) mol?L~(-1)) and Ca~(2+)-free Krebs solution significantly decreased constriction of rat isolated PA rings induced by 15-KETE.Conclusion Kv channels play a role in constriction of PA induced by 15-KETE;L-type Ca~(2+) channel blocker and extracellular calcium ion also influence constriction of isolated PA rings induced by 15-KETE.

Objective:To investigate the role of heme oxygenase-1(HO-1) in molecular mechanism of experimental allergic encephalomyelitis (EAE). Methods: Seventy-eight healthy female Wistar rats were randomly divided into 3 groups(n=26): rats in control group received no treatment; rats in EAE group were induced with complete Freund's adjuvant and Guinea pig spinal cord homogenate(CFA-GPSCH); and rats in pyrrolidine-dithiocharbamate (PDTC) group received PDTC (100 mg/kg), a specific inhibitor of NF-kB, 1 h before and after(once a day for 7 d) CFA-GPSCH treatment. HO-1 mRNA expression were analyzed with reverse transcription polymerase chain reaction(RT-PCR) on 1 d,7 d,14 d,and 21 d after EAE induction, respectively. The relationship between HO-1 and symptoms of EAE was also investigated. Results: The expression of HO-1 mRNA was very low in the brains of the control group (0.27?0.05), whereas enhanced gradually with onset and development of EAE in EAE group, peaked on d 7 (1.11?0.12), kept at a high level till d 14(1.06?0.18) and decreased on d 21 (0.37?0.1). HO-1 mRNA expression change was in parallel with severities of EAE. In PDTC group,the EAE symptoms were mitigated markedly and the expression of HO-1 mRNA reduced noticeably compared with that of EAE group. Conclusion: Brain HO-1 mRNA expression may play an important role in the pathogenesis of EAE,and application of some inhibitors of NF-kB may be one of the potential therapies for prevention and treatment of EAE.

ObjectiveTo estimate the value of serum soluble scavenger receptor CD163 (sCD163) to the prognosis of patients with stroke associated pneumonia (SAP).Methods A prospective study was conducted. The clinically suspected SAP patients admitted to Department of Intensive Care Unit (ICU) and Emergency ICU (EICU) in Zhejiang Province Zhuji City Chinese Medicine Hospital from February 2014 to January 2015 were all enrolled. According to clinical pneumonia severity index (PSI), they were divided into SAP group and non SAP group according to the presence or absence of SAP, the patients of SAP group were subdivided into mild SAP group (PSI grade Ⅰ-Ⅲgrade) and severe SAP groups (PSI grade Ⅳ-Ⅴ grade) and according to the 28-day prognosis, the patients were subdivided into hospitalized death group and survival group. The clinical data were collected, including gender, age, history of stroke presence or absence, present stroke pattern, National Institutes of Health Stroke Scale score (NIHSS) on the day of stroke suspect diagnosis, Glasgow coma scale (GCS) score, acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score, clinical pulmonary infection score (CPIS), PSI score, body temperature, result of chest X-ray film, oxygenation index (PaO2/FiO2), result of sputum culture, serum levels of white blood cell (WBC) and C-reactive protein (CRP) in a period of 7 days after the suspected diagnosis, PCT, sCDl63 levels on days 1, 3, 5, 7 days, length of stay in ICU, the total time of hospitalization and 28-day survival situation, etc. The ability of each index to evaluate the prognosis of SAP was analyzed by the receiver operating characteristic curve (ROC curve). The risk factors influencing the prognosis of SAP patients were analyzed by multivariate logistic regression analysis.Results ① Seventy-eight patients were finally enrolled in the study, 44 patients were diagnosed as SAP, 34 were non SAP. In 44 patients with SAP, there were 28 cases of severe SAP and 16 cases of mild SAP. On the first day of the suspected diagnosis, the NIHSS score [13 (7, 22) vs. 8 (4, 17), the CPIS score [6 (4, 9) vs. 4 (3, 5), sCD163 [mg/L: 0.80 (0.59, 1.32) vs. 0.33 (0.22, 0.46)], CRP [mg/L: 84.2 (50.8, 114.9) vs. 51.4 (26.2, 79.9)] and 28-day mortality [38.6% (17/44) vs. 11.8% (4/34)] in SAP group were significantly higher than those in non SAP group (allP < 0.05), and other basic indexes between the two groups were all of no statistical significant differences (allP > 0.05). ② The levels of sCD163 reached the peak value on the third day after the suspected diagnosis among SAP group and non SAP group, mild SAP group and severe SAP group, survival group and death group and then began to fall; the levels of sCD163, WBC, CRP, PCT within 7 days in SAP, severe SAP and death groups were higher than those in non SAP, mild SAP and survival groups (allP < 0.05). ③ROC curve analysis indicated: sCDl63 showed a better capacity for evaluating the 28-day prognosis of SAP [ROC curve (AUC) =0.673, 95% confidence interval (95%CI) = 0.515-0.807, sensitivity and specificity were 41.2% and 96.3% respectively and the cut-off was 2.65 mg/L]. However, the levels of other inflammatory indexes and scores on the first day after the suspected diagnosis had no value for early prognosis of SAP. The multiple logistic regression analysis showed that the level of sCD163 on the first day after the suspected diagnosis was the independent risk factor of death in hospital of SAP patients [dominance ratio (OR = 1.27, 95%CI = 1.06-1.52,P < 0.05]. Age (OR = 1.04, 95%CI = 1.01-1.06,P = 0.015), NIHSS score (OR = 2.86, 95%CI = 1.64-4.92,P = 0.010), CPIS score (OR = 1.52,95%CI = 1.28-1.90,P < 0.001) and APACHEⅡ score (OR = 2.06, 95%CI = 1.53-3.07,P < 0.001) were also the risk factors of influencing the death of patients with SAP.Conclusions Early sCD163 level is an independent risk factor in predicting the 28-day mortality of patients with SAP, and it has a certain value for the prognosis of SAP.

Objective To compare main adverse cardiac events of patients with coronary heart disease and diametes,but normal lipids after statin on lowering lipids , and to bring out necessity of early lowering lipids . Methods A total of 324 patients with coronary heart disease and diametes were enrolled ,LDL-C was measured in-hospital for all patients and LDL-C<3.36mmol/L suitable for the experiment .They were divided into statin group (n=176,rosuvastatin 10 mg/d)and control group(n=148)randomly,all patients received second prevention for cor-onary heart disease including anti-platelet,anti-myocardial ischemia,smoke quitting,adjust diets and exercise,the CAG or PTCA(and stent implanting),CABG.the end events were main adverse cardiac events (cardiac events,recur-rent angina and target vessel reconstruction ).The mean follow-up time was(13 ±6)months.Results The fasting plasma glucose,LDL-C,hs-CRP in statin group were all significantly lower than those of control group [FPG:(5.3 ± 0.9)vs.(6.7 ±1.2)mmol/L,P=0.042;LDL-C:(1.7 ±0.6)mmol/Lvs.(3.9 ±1.6)mmol/L,P<0.01;hs-CRP:(1.4 ±0.5)mmol/L vs.(3.8 ±1.2)mg/L,P <0.01],MACE were less(15.6% vs.37.1%,P =0.032). Conclusion Early statin on patient with coronary heart disease and diametes ,though normal lipids ,which can down-regulate main adverse cardiac events significantly .

Objective To develop a stable and simple method to measure the polysaccharide in Ecklonia kurome Okam.Methods After the conversion coefficient of polysaccharide from Ecklonia kurome Okam to glucose was obtained,the content of polysaccharide was measured by phenol-sulfuric acid method.Results The correlation coefficient of standard curve was(0.9998),the recovery rate was 97.35% and RSD was 4.68%.Conclusion The method was convenient for content determination of polysaccharide from Ecklonia kurome Okam as well as its related products.

Aim The purpose of this study was to compare the effect of AA、15-HETE、15-KETE and 8(S),15(S)-DiHETE on hypoxic and normoxic rabbit pulmonary arterial rings and to discuss their roles in the formation of PA hypertension.Methods Twelve neonatal rabbits were randomly divided into two groups(n=6):the normoxic group breathing fresh gas(FiO_2 =21%) and the hypoxic group breathing hypoxic gas(FiO_2=10%).After 9 days,they were anesthetized with pentobarbital sodium,and the chest was opened for removal of the heart and lungs en bloc,then PA rings(0.5~1.5 mm in diameter and 3 mm length) were prepared.We used tension studies of PA rings to observe the effect of AA、15-HETE、15-KETE and 8(S),15(S)-DiHETE on hypoxic and normoxic rabbit pulmonary arterial rings.Results ① AA、15-HETE、15-KETE and 8(S),15(S)-DiHETE constricted normoxic rabbit PA rings in a dose-dependent manner,respectively.Constriction of normoxic rabbit PA rings induced by 15-KETE、8(S),15(S)-DiHETE was significant,but that of AA、15-HETE wasn′t significant.② AA、15-HETE、15-KETE and 8(S),15(S)-DiHETE increased hypoxic rabbit PA rings' tension.Constriction of AA、15-HETE on rabbit PA rings in hypoxic group was significantly greater than that of normoxic group(P0.05).③ Constriction of 15-KETE on rabbit PA rings in normoxic group was significantly greater than that of hypoxia group(P

Objective To investigate the prevalence of healthcare-associated infection(HAI)in medical institutions in Pudong New Area.Methods Ten medical institutions in Pudong New Area were selected as monitored hospitals, cross-sectional survey on HAI in each hospital at a given day of November 2013 and November 2014 were conduc-ted.Prevalence of HAI in different levels of hospitals were compared.Results The prevalence rates of HAI in 2013 and 2014 were 4.04% and 3.75% respectively,there was no significant difference between two years(χ2 =0.709,P=0.400).The prevalence rates of HAI in primary,secondary,and tertiary hospitals in 2013 were 0.66%,3.32%, and 4.60% respectively,in 2014 were 0,3.52%,and 4.01 % respectively,prevalence rates of HAI in different lev-els of hospitals of each year were significantly different (all P <0.05).Prevalence rates of HAI were high in depart-ments of neurosurgery,hematology,intensive care units(ICUs),and gerontology.The prevalence rate of infection in ICUs increased obviously,from 10.09% to 18.78% (χ2 =3.921 ,P =0.048),departments of gerontology de-creased obviously,from 10.07% to 5.02%(χ2 =5.698,P =0.017).The main HAI sites were lower respiratory tract (36.72%),upper respiratory tract (9.96%),and urinary tract (12.89%).172 pathogenic isolates were de-tected in 2013,and 177 were detected in 2014,gram-negative bacteria,gram-positive bacteria,and fungi accounted for 60.74%,26.37%,and 12.89% respectively.Constituent ratios of pathogens causing HAI between two surveys were not significantly different (χ2 =5.819,P =0.830).Conclusion Among different levels of hospitals in Pudong New Area,tertiary hospitals have the highest prevalence rate,HAI in ICU increases obviously,the main HAI site is lower respiratory tract,the main pathogens are gram-negative bacteria.