Objective To investigate the application value of procalcitonin(PCT) in fever of the patients with malignant tumor.Methods A total of 254 patients with malignant tumor complicating fever from January to October 2016 were collected and grouped after clearly diagnosing the causes of body temperature increase according to the clinical manifestations,laboratory examination and imaging examination results.The difference of PCT level was compared among various groups.Results Compared with tumor thermal group,the PCT level in the sepsis and non-sepsis groups was significantly increased(P<0.001).Moreover no matter which was bacterial infection,fungal infection or both mixed infection,the PCT level was significantly higher than that in the tumor thermal group;compared with the fungal infection group,the PCT level in the bacterial infection group was increased significantly(P<0.01).The PCT level distribution difference among the tumor thermal group,fungal infection group and bacterial infection group was statistically significant(P<0.01).The critical values of PCT for diagnosing fungal and bacterial infectious fever were 0.575,0.945 ng/mL respectively.The areas under ROC curve were 0.812(95%CI:0.805-0.934);0.951(95%CI:0.917-0.985).Conclusion It is priliminarily considered that PCT can serve as an effective clinical auxiliary diagnostic indicator for differentiating the fever cause in the patients with malignant tumor.

Objective To investigate the effect of 1α, 25-dihydroxyvitamin D3 [1α,25-(OH)2 D3] on tumor necrosis factor-α ( TNF-α) induced activation of human umbilical vein endothelial cells ( HUVECs ) . The mechanism involved in this process was also studied. Methods HUVECs were cultured and treated with TNF-α( 40 ng/ml), 1α,25-(OH)2D3(10-8 mol/L), and SN50 as indicated. Vascular cell adhesion molecule (VCAM) and E-selectin were used as markers of endothelial activation, which were detected by Western blotting and realtime PCR (RT-PCR). NF-κB signaling pathway was investigated to study the mechanism. Western blotting, RT-PCR, immunofluorescence assay, and chromatin immunoprecipitation ( ChIP ) method were used to evaluate the effects of 1α,25-( OH) 2 D3 on its early activation, nuclear transport, and binding to VCAM and E-selectin promoters. Results (1) Western blotting and RT-PCR showed that TNF-α could significantly up-regulate the expression of VCAM and E-selectin in HUVECs, which can be inhibited by specific NF-κB blocker SN50. 1α,25-( OH) 2 D3 down-regulated the expression of VCAM and E-selectin induced by TNF-α. ( 2 ) Western blotting showed that TNF-α induces I-κBαphosphorylation, thereby activating NF-κB p65 subunit. Immunofluorescence showed that 1α, 25-( OH ) 2 D3 significantly inhibited the nuclear translocation of NF-κB p65 subunit. ChIP analysis revealed that 1α,25-( OH) 2 D3 inhibited the binding of NF-κB p65 to VCAM and E-selectin promoters and thus affected gene expression. Conclusions TNF-αenhanced the expression of E-selectin and VCAM in HUVECs via NF-κB signaling pathway. 1α,25-( OH) 2 D3 may inhibit NF-κB early activation, nuclear transport and the binding of NF-κB p65 to VCAM and E-selectin promoters, thereby inhibiting TNF-α-induced endothelial cell activation.

Artificial blood is a type of liquid preparation with oxygen-loading capacity and can temporarily substitute some function of blood.The developed artificial blood can be divided into four categories:artificial synthetic hemo-globin,artificial red blood cells made from natural hemoglobin,perfluorocarbons,and stem cell-differentiated red blood cells.This review focuses on the domestic and foreign research progress of artificial blood in recent years,and discusses its clinical application value,development trend,and future research,in order to provide new ideas to the development the artificial blood products and promote clinical application.

Objective To evaluate the role of clinical pharmacists on the pharmacological monitoring and management of diabetic patients. Methods 406 adult outpatients with diabetes in outpatient were selected as research object. The patients were given the questionnaire and intervened with diabetes education and management by the clinical pharmacist regularly. The patient’s knowledge of the diabetes medication before and after intervention, blood glucose and glycosylated hemoglobin values, treatment compliance, non-reserved outpatient visit, emergency, hospitalization, etc. were compared and statistically analyzed. Results After pharmacy intervention, the patients' knowledge of diabetes and drug-related information, treatment compliance, blood glucose and glycosylated hemoglobin were better than before intervention, P<0.01. Non-reserved outpatient visits and emergency cases were better than before intervention, P<0.05. There are significant differences. Conclusion Clinical pharmacists carry out diabetes chronic disease management and build a clinical pharmacist-led chronic disease management model, which helps to promote standardized treatment, improve patient compliance, promote rationalized medication, achieve the goal of controlling blood sugar and reduce complications.