Objective To evaluate the changes of blood coagulation and their clinical significance in pa-tients with severe acute pancreatitis (SAP). Method Two hundred and seven patients with acute pancreatitis ad-mitted from January 2005 to Deeember 2008 in People' s Hospital, Peking University, were recruited in this study. Patients were divided into two groups, severe acute pancreatitis (53 cases) and mild acute pancreatitis (154 cas-es), according to the diagnostic criteria set by the Chinese Medical Association in 2004. Plasma coagulation pa-rameters including prothrombin time (PT), prothrombin activity (PTA), international normalized ratio (PT-INR), activated partial thromboplastin time (APTT), fibrinogen (FIB) and D-dimmer were redorded. Results Com-pared with MAP group, there were significant differences on PT, PTA, PT-INR, FIB, and D-dimmer in SAP group [in MAP group, (12.45 ± 1.13) s,(94.01±21.21)% ,(1.08±0.14),(4.81±1.86)g/L,340.38 ng/ mL, respectively;in SAP group, (13.08±1.47)s,(86.92±17.36) %, (1.14±0.20), (5.49±2.30)g/L, 943.82 ng/mL, respectively; P <0.05]. There was no significant difference on APTT between the two groups (P > 0.05). D-dimmer was correlated to the APACHE Ⅱ score , and it was also correlated to the SIRS score (P < 0.05). The rate of systemic inflammatory response syndrome (SIRS) and the mortality were higher in patients with SAP patients than those in the MAP patients (in SAP group, 35.5%, 5.6%, respectively; in MAP group, 10.4%, 0, respectively; P < 0.05). Conclusions Disorders of coagulation and microcirculation disturbances were observed in patients with severe acute pancreatitis. These alterations may be useful in the assessment of the disease severity and prognosis of patients with acute pancreatitis.

AIM: To investigate the influence of tumor necrosis factor ?(TNF ?) or angiotensin Ⅱ(Ang Ⅱ) on tissue factor(TF) gene expression and the regulatory effect of upstream sequence on TNF ? or Ang Ⅱ-induced TF gene transcription in human vascular endothelial cells.METHODS: TF mRNA in endothelial cells was analyzed by in situ hybridization. By means of gene recombinant technique, we constructed two luciferase reporter genes containing different upstream sequence of TF gene. The two luciferase reporter genes, together with the intracontrol plasmid pSV-?-gal were co-transfected respectively into cultured human vascular endothelial cells. The relative luciferase activities were detected.RESULTS: TNF? or Ang Ⅱ could increase the expression of TF mRNA in vascular endothelial cells. TNF? and AngⅡ could significantly increase the luciferase expression in the p-244/+121bp Luc transfected endothelial cells, respectively. The luciferase expression in the p-111/+121bp Luc transfected endothelial cells decreased significantly compared with that in the p-244/+121 bp Luc transfected endothelial cells and there was no significant difference compared with control group. CONCLUSION: Upstream sequence p-244/-112bp of TF gene may play an important regulatory role in TNF ? or AngⅡ-induced TF gene expression in human vascular endothelial cells.

AIM:To investigate the dissolvability of thundergodvine extract(Tripterygium wilfordii) and triptolide in different dissolvent in transdermal drug delivery system and to study the relationship among dissolvability of extract,and its active component and mean diameters of suspension. METHODS:To determine dissolvability of extract,dissolvability of active component and mean diameters by precipitation method,dissolvability of active component method and mean diameters method. RESULTS:① solvents in sequence of dissolvability of extract,alcohol,isopropanol,ethyl,IPM,water,glycerol;② solvents in sequence of dissolvability of active component alcohol,isopropanol,ethyl,IPM,water,glycerol;③ mean diameters of suspension in sequence:IPM,ethyl,alcohol,isopropanol. CONCLUSION:① The change in dissolvability between extract and active component is identical;② The relationship between the changes in mean diameters and the dissolvent of active component is negative correlation on the whole.

BACKGROUND: It is commonly thought that the expression of tissue factor (TF) gene in human umbilical vein endothelial cells (HUVECs) could be induced by tumor necrosis factor(TNF-α) . But the intervention effect of monomer extract of radix salviae miltiorrhizae(764-3) on TF expression in duced by TNF-α in endothelial cells has not been reported and the mechanism is still unclear.OBJECTIVE: To investigate the intervention effect of 764 - 3 on TF expression and calcium ion( [Ca2+] i) induced by TNF-α in HUVECs so as to probe into the possible mechanism of 764 - 3 for preventing cardiovascular thromboembolic diseaseDESIGN: Randomized and controlled trial.SETTING: Laboratory of Department of Pathophysiology, Institute of Basic Medical Sciences, Peking Union Medical College MATERIALS: This study was conducted in the Department of Pathophysiology, Institute of Basic Medical Science, Peking Union Medical College,Chinese Academy of Medical Sciences from May 1998 to September 1999. Umbilical cord was chosen from Beijing Obstetrics and Gynecology Hospital.INTERVENTIONS: ECV304 cell strain and HUVECs were cultured in vitro. With gene recombination techniques, two luciferase reporter genes containing different length of human TF gene promoter were constructed. The two-luciferase reporter genes, together with the intracontrol plasmid pSV-3-gal were respectively cotransfected into cultured ECV304 and HUVECs.MAIN OUTCOME MEASURES: The activities of luciferase and βgalactosidase were detected in ECV304 and HUVECs treated by TNF-α or/and 764 -3. Taking Fluo- 3/AM as fluorescent indicator, [Ca2+]i in single HUVEC was observed with laser-scanning confocal microscope.RESULTS: The luciferase expression in the p - 244/ + 121 bp luc transfected endothelial cells was significantly increased when the cells were exposed to 100 U/mL TNF-α. The induction of TNF-α could be inhibited by 764 -3 ( P ＜ 0.05). The luciferaseexpression in the p - 111/+ 121 bp Luc transfected endothelial cells was significantly lower than that in the p - 244/+ 121 bp ones and at the same time, 764 -3 did not cause the significantly change of the luciferase expression. Under laser-scanning confocal microscope, TNF-α increased [Ca2 +] i in single HUVEC, but the effect was inhibited by 764 - 3.CONCLUSION: TF gene expression induced by TNF-α was inhibited by 764 - 3 in endothelial cells, which was dependent on the p-244/+ 121 bp,and [Ca2+ ]; might be involved in it.

Objective To evaluate the diagnostic value of the common test parameters in acute fever without obvious infection focus and sick appearance in children under 5 years.Methods The hospitalized children with fever duration less than 7 days, anal temperature higher than or equal to 38°C, age younger than or equal to 5 years, and without obvious infection focus and sick appearance were recruited, we investigated the diagnosis value of common test parameters including C-reactive protein (CRP), procalcitonin (PCT), the white blood cell count (WBC), and neutrophil percentage (N%) , according to the ifnal diagnostic.Results Of 228 children, 42 children (18.42%) had serious diseases, the difference of CRP, PCT between serious diseases group and non-serious diseases group were statistically signiifcant (P<0.001). The diagnostic cut-off point of CRP was 67.1 mg/L by speciifcity of 0.810 and sensitivity of 0.715, that of PCT was 0.505 ng/L by speciifcity 0.762 and sensitivity 0.672. The speciifcity and sensitivity combining CRP with PCT was respectively 0.918 and 0.617. Of 228 children, 32 children had viral infections, 40 children had bacterial infections, 15 children had mycoplasma infections. The difference of CRP, PCT, WBC, and N% among three groups were statistically signiifcant (P<0.01).The cut-off point of CRP was 38 mg/L by sensitivity 0.900 and spec-iifcity 0.813, that of PCT was 0.450 ng/L by sensitivity 0.700 and speciifcity 0.812, and the speciifcity and sensitivity combining CRP with PCT was respectively 0.965 and 0.630, to distinguish bacterial infections from viral infections. The diagnostic cut-off point of CRP was 80.75 mg/L by sensitivity 0.700 and speciifcity 0.933 distinguishing bacterial infections from mycoplasma infections.Conclusions The parameters CRP and PCT have the diagnostic value for the children with the acute fever and age younger than or equal to 5 years and without obvious infection focus and sick appearance in etiology and serious diseases, espe-cially the value of combining CRP with PCT is better.

To explore the effects of nutritional risks on clinical outcomes [length of stay (LOS),hospitalization expense & mortality] in chronic kidney disease (CKD) patients.A total of 127 CKD patients completed the screening of nutritional risks by Nutritional Risk Screening 2002 (NRS-2002) within 24-48 hours of admission.The data of nutritional supports within 2 weeks of admission,LOS,hospitalization expense and mortality were collected.① Among them,the prevalence of nutritional risks was 18.1％.And the values were 8.2％,9.4％ and 44.1％ in early,middle and advanced CKD groups respectively; ② LOS and hospitalization expense in nutritional risk group were significantly more than the non-nutritional risk group (12.5 d vs.5.2 d,P =0.00 ; 11 806 vs.5311 yuan,P =0.00).There was a positive correlation between NRS score and LOS or hospitalization expense; ③ The nutritional support rate of nutritional risk group was only 17.4％.The progression of CKD increased the nutritional risks leading to greater LOS and hospitalization expense.We should pay more attention to the nutritional risk screening and nutritional intervention in moderate-advanced CKD patients.

Objectives:To investigate the nutritional status of the maintenance hemodialysis(MHD) patients. Methods:The dietary investigation, anthropometry and biochemical tests were conducted in 46 MHD patients,including weight,triceps skinfold(TSF), arm muscle circumference(AMC), serum total protein(TP), albumin(Alb), prealbumin(PA), transferrin(TF) and ideal weight rate(IBW%).Then nutritional status was evaluated. Results:①The energy intake of most MHD patients was lower than 125.4 kJ/(kg?d) and the mean protein intake was nearly 1.0 g/(kg?d).②According to each single index,the incidence of malnutrition was:39.13% by IBW%, 71.74% by TSF, 58.70% by AMC, 30.43 % by Alb and 82.61% by TF respectively.Only 6.52% patients had all normal paremeters. Conclusions:Malnutrition incidence of MHD patients was as high as 93.48% in our study. The regular nutritional assessment and the nutritional advice are very important for the better clinical outcome in the MHD patients.

AIM: To observe the effect of Retinervus luffae fructus (RLF) on the myocardial ischemia in mice. METHODS: Mice were supplied with RLF (166.7,333.3, 666.7 g/L) twice daily (0.01 mL/g, ig). One week later, 30 U/kg pituitrin was injected intraperitoneally. The electrocardiogram was recorded, and the content of lactose dehydrogenase (LDH) in the serum and the activities of superoxide dismutase (SOD), maleicdialdehyde (MDA) in the myocardium were examined. RESULTS: RLF reduced the height of T wave in electrocardigram in myocardial ischemia mice and inhibited the decrease in heart rate. RLF also reduced the content of LDH in serum and the content of MDA in myocardium. The increase in the activity of SOD in myocardium was also observed. CONCLUSION: RLF may protect myocardium against ischemia injury. The mechanism may be related to the increase in activity of SOD and the suppression of the lipid peroxidation.

Objective To study comparatively the clinical efficacy of pelvic floor muscle exercise (PFMlE)and surgical therapy in women with moderate stress urinary incontinence(SUI),in order to provide theoretical reference for finding an appropriate SUI treatment method. Methods 114 cases of women with moderate SUI were randomly divided into the treatment group and the control group. The control group Wag given surgical thempy. while the treatment group was given the PFME treatment. After 12 weeks the clinical efficacy and quality of life of the two groups were evaluated, the cost-benefit was analyzed. Results The total effective rate of treatment group was 86.2%.higher than 83.9% of the control group. Compared with before treatment, the I-QOL scores of the two groups increased significantly, the ICIQ scores of the two groups decreased significantly, and the treatment group was significantly different compared with the control group. The cost-benefit analysis showed that the total medical cost and the spending cost of the total clinical effective rate increased l percent and the I-QOL increased 1 score were significantly lower than that of the control group. Conclusions The PFME therapy of women with moderate SUI is the preferred treatment and it is worthy of promotion and application.

Objective The transformations of clinical state in aged patients suffered from hepatocirrhosis incorporated with diabetes were observed through the lamivudine therapy.Methods The clinieal state,state of diabetes related to the grade of liver function and the influence of clinical state by lamivncline treatment in 36 patients were analyzed.Results Those with representative symptom of diabetes were less observed(2.8%) in these 36 patients.The patients complicating with the spontaneous bacterial peritonitis had a high chance.The blood glucose level show obviously abnormas after the liver function got worse.With the liver function improved through combined therapy include lamivudine,the blood glucose level turned to a low level.Conclusion The clinical state in aged patients suffered from hepatocirrhosis with Ⅱ type diabetes is untypical.The blood glucose level appearances direct correlation with the condition of hepatocirrhosis.Treatments with lamivudine was favorable for control of blood glucose level and better liver function.