Objective To observe the expression levels of Mig in the patients with chronic hepatitis B .Methods The study pop‐ulation consisted of 88 chronic hepatitis B patients and 53 healthy controls .The ELISA ,RT‐PCR and Western‐blotting were used for analysing the expression levels of Mig in serum ,peripheral blood mononuclear cells and liver tissue of the patients with chronic hepatitis B ,while the immunohistochemistry was applied for analysing the distribution of Mig in liver tissue .Results The expres‐sion of Mig in serum ,peripheral blood mononuclear cells and liver tissue of the chronic hepatitis B patients with HBeAg negative were (247 .03 ± 63 .14)pg/mL ,(0 .95 ± 0 .21) ,(0 .79 ± 0 .23) ,and that in the chronic hepatitis B patients with HBeAg positive were (243 .05 ± 53 .00)pg/mL ,(0 .98 ± 0 .35) ,(0 .74 ± 0 .18) ,which were both significantly higher than those in healthy controls ,the difference was statistically significant(P<0 .05) .Conclusion Increased levels of Mig in the patients with chronic hepatitis B may be related to immune state of patients .

BACKGROUND: In the management of critically ill patients, the assessment of volume responsiveness and the decision to administer a fluid bolus constitute a common dilemma for physicians. Static indices of cardiac preload are poor predictors of volume responsiveness. Passive leg raising (PLR) mimics an endogenous volume expansion (VE) that can be used to predict fluid responsiveness. This study was to assess the changes in stroke volume index (SVI) induced by PLR as an indicator of fluid responsiveness in mechanically ventilated patients with severe sepsis. METHODS: This was a prospective study. Thirty-two mechanically ventilated patients with severe sepsis were admitted for VE in ICU of the First Affiliated Hospital, Zhejiang University School of Medicine and Ningbo Medical Treatment Center Lihuili Hospital from May 2010 to December 2011. Patients with non-sinus rhythm or arrhythmia, parturients, and amputation of the lower limbs were excluded. Measurements of SVI were obtained in a semi-recumbent position (baseline) and during PLR by the technique of pulse indicator continuous cardiac output (PiCCO) system prior to VE. Measurements were repeated after VE (500 mL 6％ hydroxyethyl starch infusion within 30 minutes) to classify patients as either volume responders or non-responders based on their changes in stroke volume index (ΔSVI) over 15％. Heart rate (HR), systolic artery blood pressure (ABPs), diastolic artery blood pressure (ABPd), mean arterial blood pressure (ABPm), mean central venous pressure (CVPm) and cardiac index (CI) were compared between the two groups. The changes of ABPs, ABPm, CVPm, and SVI after PLR and VE were compared with the indices at the baseline. The ROC curve was drawn to evaluate the value of ΔSVI and the change of CVPm (ΔCVPm) in predicting volume responsiveness. SPSS 17.0 software was used for statistical analysis. RESULTS: Among the 32 patients, 22 were responders and 10 were non-responders. After PLR among the responders, some hemodynamic variables (including ABPs, ABPd, ABPm and CVPm) were significantly elevated (101.2±17.6 vs.118.6±23.7,P=0.03; 52.8±10.7 vs. 64.8±10.7,P=0.006; 68.3±11.7 vs. 81.9±14.4,P=0.008; 6.8±3.2 vs. 11.9±4.0,P=0.001). After PLR, the area under curve (AUC) and the ROC curve of ΔSVI and ΔCVPm for predicting the responsiveness after VE were 0.882±0.061 (95％CI 0.759–1.000) and 0.805±0.079 (95％CI 0.650–0.959) when the cut-off levels of ΔSVI and ΔCVPm were 8.8％ and 12.7％, the sensitivities were 72.7％ and 72.7％, and the specificities were 80％ and 80％. CONCLUSION: Changes in ΔSVI and ΔCVPm induced by PLR are accurate indices for predicting fluid responsiveness in mechanically ventilated patients with severe sepsis.

Aim.To elucidate whether an inhibited superoxide production(O2-) of neutrophils induced by commercial lactate-based peritoneal dialysates(PDS)could be corrected after a transient intracellular acidosis.Methods.The intracellular pH([pHi])of human neutrophils incubatd in PDS was monitored with a spectrofluorometer with a pH-sensitive dye (BCECF-AM). Neutrophilic O2- stimulated by zymosan was determined in PDS with the superoxide dismutase inhibitable ferricytochrome c reduction,using a spectrophotometer.Results.The severe intracellular acidosis induced within 5 min by PDS at an extracellular pH of 5.2 could be promptly and completely recovered by a neutralization of the pH of media.However,O2- by neutrophils exposed to the PDS for as little as 5 min was drastically and persistently inhibited，even the acidic [pHi]of cells had been fully returned for 1h.Conclusions.The intracellular acidification of cells in the initial phase could be transient and reversible,but impaired cell functions，at least in part including O2- generating system,might be consistent and irreversible in the early stage of the cellular acidosis in the peritoneal cavity of CAPD patients.The findings above may be of particular importance in both clinic and cell biology.

OBJECTIVETo study the correlation between intrusion of nucleus gelatinosus into vertebral body and low back pain after thoracolumbar fractures.

METHODSOne hundred and two patients who were treated in Peking university third hospital from January 2005 to September 2007 were evaluated retrospectively and included into this study. They were followed up for an average of 18 months and complete data were kept. Fifty-four patients were treated operatively and forty-eight patients were treated conservatively. VAS questionnaire was applied to evaluate the low back pain. Spearman Correlation Coefficients module and Wilcoxon 2-Sample Test module of SAS software were used to analyze the relation between intrusion of nucleus gelatinosus, different treatments, kyphotic Cobb angles and VAS.

RESULTSThere were strong correlations between intrusion of nucleus gelatinosus and VAS in both operative group, P < 0.01 and non-operative group, P < 0.01; there were poor correlations between different treatments and VAS in both intrusion group, P > 0.05 and non-intrusion group, P > 0.05; and there were also poor correlations between Cobb angles and VAS, gamma = 0.2584, P > 0.05.

CONCLUSIONThere is correlation between the intrusion of nucleus gelatinosus into vertebral body and the low back pain after thoracolumbar fractures.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Back Pain ; etiology ; Female ; Humans ; Intervertebral Disc ; pathology ; Lumbar Vertebrae ; injuries ; Male ; Middle Aged ; Spinal Fractures ; complications ; pathology ; Thoracic Vertebrae ; injuries ; Young Adult

Objective To summarize the experience of diagnosis and treatment for pancreatic neuroendocrine neoplasms (pNENs).Methods Forty-seven patients with pNENs who were treated at Anhui Province Hospital during January 2002 to December 2013 were retrospectively analyzed.They were followed by telephone or clinic interview,and the deadline date was January 31st,2014.Survival was analyzed with the Kaplan-Meier method,and the prognostic factors for survival were identified.Results Among the47 patients,there were 13 males and 34 females,aged from 16 to 74 years old,with a median age of 45 years,There were 17 cases of non-functioning pNENs,30 cases of functioning pNENs.The detection rate of B ultrasound,CT,MRI was 71.8％ (28/39),92.7％ (38/41),75.6％ (6/8).Forty-six patients underwent radical surgery,and 1 patient underwent palliative surgery.The pathologic type included 41 cases of pancreatic neuroendocrine neoplasms,6 cases of neuroendocrine cancer.There were 22,19,6 cases of grade G1,G2,G3 lesions,respectively.There were 32,11,4 cases of TNM staging Ⅰ,Ⅱ,Ⅲ,respectively.Vascular structure was invaded in 15 cases,and nerve was invaded in 18 cases.Lymph node was examined in 15 cases,and 5 were found to have metastatic lesion.After surgery,pancreatic fistula occurred in 9 patients,ascites in 4 patients,wound infection in 4.The follow-up period ranged from 2 to 144 months.The overall 1,3,5-year survival rates were 94.9％,88.4％,and 84.4％.The 5-year survival rates of patients with grade G1,G2,G3 were 100％,73.3％,60％;and the 5-year survival rates of patients with TNM staging Ⅰ,Ⅱ,Ⅲ were 100％,70.0％,33.3％.It was showed that TNM staging system,WHO classification,lymph node metastasis,vascular and neural invasion were associated with the prognosis.Conclusions CT is the imaging test of choice for pNENs,while surgery is the first choice for treatment.Surgical resection of pNENs results in long-term survival.TNM staging,WHO classification,lymphatic metastasis,vascular and neural invasion are closely related to the prognosis of pNENs.

ObjectiveTo explore the clinical feature of severe hand, foot and mouth disease (HFMD) in pediatric patients, and to observe the hemodynamic changes in those with acute pulmonary edema.Methods A prospective observation study was conducted. Thirty-five severe HFMD pediatric patients with acute pulmonary edema admitted to the intensive care unit (ICU) and Department of Pediatric of First People's Hospital of Foshan from May 2008 to September 2014 were enrolled. The clinical features were thoroughly investigated. Hemodynamic data were monitored by pulse-indicated continuous cardiac output (PiCCO) in 5 cases, and the changes in PiCCO parameters were observed at ICU admission (0 hour), and 24, 48, 96 hours after treatment.Results Thirty-five patients who met the diagnostic standard of severe HFMD were enrolled, including 22 male and 13 female, aged from 7 months to 4 years. Six patients were younger than 1 year, 13 1-2 years, 12 2-3 years, and 4 patients 3-4 years old. The most common time of occurrence of pulmonary edema was 3-4 days after the onset of the disease. Fever and central nervous system symptoms were found in all the patients, and examination of the cerebral spinal fluid (CSF) revealed non-bacterial inflammatory changes. PiCCO results showed a tendency of lowering of heart rate (HR), systemic vascular resistance index (SVRI), and extravascular lung water index (EVLWI) after the treatment, and the values obtained at 96 hours were significantly lower than those at 0 hour [HR (bpm): 119.0±14.7 vs. 200.8±19.7, SVRI (kPa·s·L-1·m-2):148.9±14.6 vs. 209.6±58.7, EVLWI (mL/kg): 10.5±1.9 vs. 34.8±10.8,P< 0.05 orP< 0.01], global end-diastolic volume index (GEDVI) was also gradually decreased without significant differences among all the time points, together with a tendency of increase in stroke volume index (SI) and cardiac index (CI). The values of the parameters at 96 hours were significantly higher than those at 0 hour [SI (mL/m2): 38.5±6.5 vs. 17.4±2.8, CI (mL·s-1·m-2): 75.0±8.0 vs. 55.5±8.5, bothP< 0.01]. Left atrium was found to be enlarged, and left ventricular systolic function decreased in two patients by cardiac ultrasonic. Four out of 35 patients died, and functional disability of extremities was found in 1 patient. Other patients were cured and discharged without any sequelae.Conclusions Severe HFMD complicated by acute pulmonary edema is a perilous condition in children, accompanied commonly by pathologic changes in central nervous system and systolic dysfunction of left ventricle. According to the results with PiCCO monitoring, HFMD patients suffering from acute pulmonary edema may be of cardiac origin in addition to neurogenic origin.

Objective To investigate the level and clinical significance of nerve growth factor ( NGF) , transforming growth factor ( TGF )-β1 , estradiol ( E2 ) and testosterone ( T ) in serum and ex-pressed prostatic secretion (EPS) of patients with category Ⅲprostatitis. Methods From August 2011 to January 2012, 64 patients with (chronic prostatitis/chronic pelvic pain syndrome , CP/CPPS) and 20 health people were enrolled in this study.In CP/CPPS group, the age of patients ranged from 18 to 56 years, mean (36.6±9.3) years.The history of CP/CPPS ranged from 3 months to 6 years, mean 2 years.All patients were asked to complete NIH-CPSI questionnaires with CP/CPPS, including group ⅢA 35 cases and groupⅢB 29 cases.The age of healthy controls ranged from 25 to 41 years.The average healthy control age was (33.1±3.9) years.EPS and serum samples from CP/CPPS and control group were collected and frozen . NGF, TGF-β1 , E2 and T level in EPS and serum were measured by ELISA and radioimmunoassay and com -pared in each group. Results The mean E2, E2/T, TGF-β1 level in serum of patients with CP/CPPS were (175.7±82.4) pmol/L, (7.9±6.7), (2 216.2±581.6) ng/L, which were higher than that in healthy controls, (131.7±49.4) pmol/L, (4.6±2.4), (1 599.8±469.5) ng/L.The mean T level in CP/CPPS pa-tients′serum was (24.7±8.9) nmol/L, which was lower than that in controls (29.2±7.0) nmol/L.The E2/T (34.5±29.8), TGF-β1(6 859.3±5 229.4 ng/L), NGF (467.0±164.3 ng/L) levels in EPS of CP/CPPS patients were higher than that in controls (16.5±13.8), (1 774.1±1 304.3) ng/L, (310.8±106.6) ng/L. The TGF-β1 level in EPS of CP/CPPS patients showed the positive correlation ship with urination symptom score (6.1±2.4) (r=0.641, P<0.05).The NGF level in EPS of CP/CPPS patients also showed the positive correlation ship with pain score (7.6±2.6) (r=0.497, P<0.05).E2/T,TGF-β1 levels in serum and E2/T, TGF-β1,NGF levels in EPS of group ⅢA were (7.1±4.6), (2131.5±412.0)ng/L and (31.5±22.3), (7 667.1±5 652.4)ng/L, (440.6±134.3)ng/L, which were significantly higher than those in healthy con-trol (P<0.05).E2/T, TGF-β1 levels in serum and E2/T, TGF-β1, NGF levels in EPS of group ⅢB were (8.9±8.5), (2 340.5±728.2) ng/L and (38.2±37.1), (5 884.4±4 574.3) ng/L, (498.9±192.1) ng/L, which were also higher than those in healthy control ( P<0.05) . Conclusions Hormonal imbalance in es-tradiol and testosterone with TGF-β1 , NGF higher levels in EPS is closely related with pathogenesis and clin-ical symptom of category III chronic nonbacterial prostatitis .

Objective To investigate the trend of antimicrobial resistance and the prevalence of resistant genes in Pseudomonas aeruginosa strains isolated from Hangzhou First People's Hospital.Methods Antimicrobial susceptibilities of 1489 Pseudomonas aeruginosa strains isolated from 2003 to 2007 were statistically analyzed using WHONET.MICs of 11 antimicrobisis to 36 multi-drug-resistant Pseudomonas aerugionosa strains were determined by agar dilution method.Genes of β-lactamases(BLA)and aminoglycoside-modifying enzymes(AMEs)were detected by PCR and the PCR products were sequenced.Results The resistant rates to aztreonam,imipenem,ceftazidime,cefepime,piperacillin,piperacillin/tazobactam.cefoperazone/sulbactam,ciprofloxacin,levofloxacin,gentamicin and amikacin were increased from 13.4%,10.6%,8.7%,7.9%,12.7%,12.7%,6.7%, 15.8%,20.5%,24.7% and 10.9%in 2003 to 35.3%,40.9%,18.4%, 32.4%,32.9%,32.0%,21.9%,37.8%,38.6%, 39.4% and 34.8% in 2007.respectively.Hish MICs of 11 antimicrobiMs for multi-drug resistant Pseudomonas aerouginosa were determined with MIC90≥128 μg/mL.In 36 multi-drug resistant Pseudomonas aeruginosa strains,21(58.3%)strains carried β-lactamase genes and 32 strains(88.9%)carried aminoglycosidemodifying enzyme genes,while the deletion rate of oprD2 was 80.6%(29/36).Conclusions The resistant rates to common antibiotics of Pseudomonas aeruginosa have increased.resulting in multi-drug resistance.Genes of β-lactamases and aminoglycoside-medifying enzymes are prevalent in multi-drug resistant Pseudomonas aeruginosa strains,with the common deletion of oprD2.

The Monascus mutant with high yield of yellow pigment was obtained by using conventional relevant mutation techniques, e.g., treating with physical mutagens(such as UV light) and chemical sub- stances (such as N-methyl-N'-nitro-N-nitrosoguanidine). The yellow pigment was scanned from 300 nm to 600 nm with UV spectrometer, the maximal absorption was determined at 410 nm. The growth characteristic of Monascus mutant is stable, the yellow pigment value and colour hue in liquid fermentation can reach 100 U/mL and 3.5 respectively. The yellow pigment is stable from pH 3 to pH 8, but the precipitation appeared as the pH of the pigment solution lower than 3.

Objective To explore the correlation between the levels of estradiol E2 and testosterone T in serum and expressed prostatic secretion(EPS) with the erectile function in the patients with type Ⅲ prostatitis(CP/CPPS) .Methods The E2 and T lev‐els in serum and EPS from 64 cases of CP/CPPS ,including 35 cases of type Ⅲ A and 29 cases of Ⅲ B ,and 20 individuals of physical examination were detected by using the radioimmunoassay .All cases were evaluated by the scores of NIH‐CPSI and the Internation‐al Index of Erectile Function 5(IIEF‐5) .64 patients were grouped according to the IIEF‐5 scores ,the erectile dysfunction(ED) group(32 cases) and the non‐ED group(32 cases) .Results The mean E2/T levels in serum and EPS of the Ⅲ A group and the Ⅲ B group were higher than those in the control group ,the difference had statistical significance(P<0 .05) .20 cases(57 .14% ) of ED were found in the Ⅲ A group ,which were more than 12 cases(41 .38% ) of ED in the Ⅲ B group ,but there was no statistically signifi‐cant difference (>0 .05 .There was a positive correlation between the IIEF‐5 score and the T level in serum and EPS in the CP/CPPS group(r=0 .218 ,r=0 .231 ,P<0 .05) .There was a negative correlation between the IIEF‐5 score and the E2/T level in ser‐um and EPS(r= -0 .189 ,r= -0 .652 ,P<0 .05) ,which had no correlation with the NIH‐CPSI score(P>0 .05) .The serum T level in the ED group was (6 .32 ± 1 .86)ng/mL ,which was lower than(7 .89 ± 2 .92)ng/mL in the non‐ED group and (8 .41 ± 2 .02)ng/mL in the control group ;the .E2/T level in EPS in the ED group was (55 .02 ± 29 .26) ,which was higher than (14 .06 ± 9 .36) in the non‐ED group and (16 .45 ± 13 .76) in the control group ,the differences among them were statistically significant (P<0 .05) .Con‐clusion The imbalance degree of hormone estradiol and testosterone in serum and EPS is related with erectile function in the pa‐tients with CP/CPPS .