Objective To evaluate the clinical value of serum procalcitonin (PCT) in the diagnosis and differentiation of bacterial infections in the critically ill patients. Methods A total of 53 critical patients were divided into bacterial infection group and non-bacterial infection group. Serum PCT was measured by immunoluminometric assay. Results PCT of bacterial infection group was significantly higher than that in non-bacterial infection group (?~2=0.05, P

Adolescent ; Female ; Humans ; Hypothyroidism ; etiology ; Lupus Erythematosus, Systemic ; complications

OBJECTIVE:To observe the occurrence of paclitaxel(PTX)-induced muscle soreness and therapeutic efficacy and safety of diclofenac sodium. METHODS:Among 84 patients with malignant tumor receiving PTX chemotherapy,56 patients suf-fered from PTX-induced muscle soreness,among which 22 female patients suffered from medium and severe muscle soreness and then were randomly divided into group A and B,with 11 cases in each group. Group A was given Diclofenac sodium sustained-re-lease tablet 75 mg orally,once a day;group B was given Paracetamol and tramadol hydrochloride tablets one tablet orally,once a day,and then given Promethazine hydrochloride injection 100 mg subcutaneously,2-3 times a day when muscle soreness could not be born. Treatment course of both groups lasted for 5 d. The distribution of muscle soreness were observed. The onset time and dura-tion of muscle soreness were also observed as well as pain relief and the occurrence of ADR in group A and B. RESULTS:Among 84 cases,the incidence of muscle soreness was 66.67%,among which mild pain accounted for 23.81%,moderate pain accounted for 13.10%,and severe pain accounted for 29.76%. Among 56 patients with muscle soreness,earliest muscle soreness occurred on the day of medication,and most of muscle soreness occurred on 1-3 days after medication,mainly manifesting as sore,activity limitation when severe,associated with fatigue. The pain relief rate of group A and B were 100%,but the incidence of adverse re-actions in group A was significantly lower than group B,with statistical significances(P<0.05).CONCLUSIONS:Diclofenac sodi-um is similar to paracetamol and tramadol hydrochloride in the treatment of PTX-induced muscle soreness,but it is better than paracetamol and tramadol hydrochloride in safety.

Objective To study the COX regression model of 28-day mortality in ARDS patients.Methods Four hundred and fifty-two ARDS patients from 2003 to 2005 was prospectively analyzed in a multi-center and random way. Results In the ARDS pathogeny,sepsis accounted for 41%,severe trauma and operation accounted for 36.3%,severe pancreatitis for 8.8%,and other for 13.9%.The 28-day mortality was 62.2%.Compared with the survived group,the number of dysfunction organs,age,APACHEII,PaCO_2,FiO_2,and A-aDO_2 were higher in the succumbed group,while PaO_2,PaO_2/FiO_2,and pH were lower.Conclusion The 28-day mortality was related with the number of dysfunction organs,age,GLASGOW score,and shock.

Objective To investigate the risk factors for preeclampsia (PE) in pregnancies complicated with chronic aplastic anemia ( CAA ) by analyzing the obstetric management and pregnancy outcome.Methods Retrospectively review the clinical data including the obstetric management,the laboratory findings and the pregnancy outcome of 41 pregnant women complicated with CAA,all of whom were hospitalized in Peking University People's Hospital from May 2002 to February 2011.Multiple logistic regression was used to explore the risk factors associated with PE.Results ( 1 ) Twenty-eight patients were diagnosed before conception while 13 were diagnosed during gestation.Eleven patients including all the 7 who were categorized as severe CAA presented with mild bleeding in the third trimester.( 2 ) The medians of white blood cell counts,hemoglobin concentrations and platelet counts were 5.0 × 109/L,66.0 g/L and 12.0 × 109/L respectively.(3) The obstetric management consisted of strict assessment, intensive surveillance and follow-up,appropriate supportive measures,timely recognition of complications,and delivery when necessary.Twenty-one patients received supportive transfusions.Ten patients developed PE,all of whom were diagnosed as severe PE( SPE).Twelve patients suffered postpartum hemorrhage,and 3 of them had blood loss more than 1000 mL All were conservatively treated in success.(4) The median gestational age of delivery was 37 weeks.Sixteen cases delivered before 37 weeks and 5 delivered before 34 weeks.Two patients developed SPE at 29 weeks and 30 weeks respectively,and both of the neonates died for severe asphyxia.The birth weight of the live neonates ranged from 1500 to 3660 g.(5) The postpartum follow-up period ranged from 6 months to 7 years.Thirty-three patients got improvement without dependence on transfusions.Four achieved no remission and still needed intermittent transfusions.Four were lost in followup.(6) Significant differences were found in the bleeding tendency,the platelet counts and the delivery weeks when comparing the patients developing PE and those without PE.No differences were found with regard to the age,the gestational age of first visit,the percentage of patients diagnosed before conception,the percentage of severe CAA,the choice of treatment,the white blood cell counts and the hemoglobin level.The Multiple logistic regression showed that the platelet count less than 10 × 109/L was an independent risk factor for CAA patients developing PE (P =0.006).Conclusions Most pregnancies complicated with CAA could achieve good maternal and fetal outcome, when intensive prenatal care and supportive management are provided SPE is the most common complication.The platelet count less than 10 × 109/L is perhaps an independent risk factor for CAA patients developing PE.

Vascular endothelium plays an important role in regulating vascular homeostasis. Over the past years, it has become clear that endothelial dysfunction is a key event of pathophysiological changes in the initiation and progression of injuries induced by extreme environmental factors. The present review summarizes current understanding of vascular endothelial dysfunction induced by hypoxia, cold and heat, and provides the information for prevention and treatment of environmental exposure injuries.
Endothelium, Vascular ; physiopathology ; Environment ; Humans ; Hypoxia ; physiopathology ; Temperature ; Vascular System Injuries

Polymerase Chain Reaction (PCR)in recent years is a new disease detection methods basedon molecular biology level.It has the advantage of sensitive,specific,trace,simple,fast,but in the operation due to multiple factors,quality control is not easy to control.Especially in the first stage of quality control,it engages alot of operations and is weakest stage such needs most concern.It is necessary and important to have a good quality control;it not only improve the reliability and accu-racy of PCR testing,treatment of molecular biology,the professional level of work staff,but also reduce patient disputes and increase technology access,acceptance of the PCR laboratory.In this paper,the author from the factors which influence the first stage of PCR:whether correctly fill PCR test application form,patient preparation,handling,transportation,storage of good sample,unqualified specimen rejection,the requirement of laboratory technicians,calibration and maintenance on the in-struments;quality check on reagents,consumables quality inspection,standard operating procedures (SOP)writing,and la-boratory safety.Hope this paper can do a good reference for other same profession.

AngiotensinⅡ( AngⅡ) is the main functional bioac-tive peptide of the renin angiotensin system,and its basic function is to regulate salt-water homeostasis and blood pressure. Howev-er,recent studies have shown that AngⅡ plays a very important role in tumor formation and angiogenesis by acting on its type 1 receptor (AT1R) as a kind of potential growth factor. This arti-cle is a brief overview of the research on effects of AngⅡ-AT1R system in the process of tumor angiogenesis in recent years.

Objective To explore the dynamic changes and clinical significance of relative pituitary hormones in children after craniocerebral injury.Methods The quantitative analysis and dynamic observation were performed in 125 children after craniocerebral injury and 20 voluntary healthy children of relative pituitary hormones including serum prolactin(PRL),cortisol(PTC),three free triiodothyronine (FT3),free thyroxine (FT4),thyroid stimulating hormone (TSH),growth hormone (GH) by applying electrochemical luminescence method.Tbe hormone variational characteristics were analyzed according to posttraumatic time,Glasgow Coma Scale(GCS) scores on admission and Glasgow Outcome Scale (GOS) scores on discharge,and the relationship between hormone variational characteristics of 58 cases was followed up over 2 years and the activities of daily living (ADL) were also investigated.Results The serum PRL was significantly increased on the first,third and fifth day compared with the healthy control group (P =0.000 0,0.000 0,0.006 7),respectively.There was significant difference between mild,moderate and severe groups within 30 days after suffering from craniocerebral injury (P ＜ 0.05).PTC was heavily increased within 3 days,and significant difference existed among mild and moderate groups mild and severe groups (all P ＜ 0.05) ; TSH,FT3,FT4 decreased slightly after injury and gradually rose in later;GH change wasn't significant;and the larger variation of relative pituitary hormones was responsible for lower GCS scores;FT3,FT4,TSH,and GH decreased in different degrees,which were found in parts of children with craniocerebral injury,and the significant difference of serum PRL existed between GOS scores 4-5 and GOS scores 1-3 groups (P =0.000 1).Conclusions The changes of relative pituitary hormones were associated with the posttraumatic time and the severity of craniocerebral injury.The PRL in serum can aid in prediction of outcome for the children with craniocerebral injury.

Pepole pay more attention to the medicinal value and health function of Monascus day by day,however,the existence of citrinin restricted the further development of Monascus products heavily. How to ruduce the content of citrinin is a problem need to be solved urgently.Briefly introduced the toxicity,the biosynthetic pathway,and the relative standards of citrinin in monascus. According to the research progress on citrinin,the strategies of citrinin control were described from the three aspects of fermentation technology,mutation breeding,and genetic engineering. The expectation about the direction of citrinin in the future was also discussed.