Objective To compare and analyze the predictive value of different immune-inflammatory parameters for adverse outcomes in severe community-acquired pneumonia(SCAP).Methods A total of 196 severe pneumonia patients admitted to the Second Affiliated Hospital of Zhengzhou University from May 2021 to April 2024.Patients were divided into good prognosis group(n=107)and poor prognosis group(n=89)based on the 28-day hospital outcome.Laboratory indicators were collected and inflammatory indices such as neutrophil-to-lymphocyte ratio(NLR)and NLR to hemoglobin ratio(NLR/Hb)were calculated.Logistic regression analysis was used to identify independent risk factors for poor prognosis in SCAP and to construct a regression model.The diagnostic efficacy of NLR/Hb for adverse outcomes in SCAP was evaluated using the receiver operating characteristic curve.Results NLR during hospitalization in good prognosis group was higher than that in poor prognosis group.Hemoglobin(Hb)in good prognosis group was higher than that in poor prognosis group,and Hb value of admitted patients generally showed a downward trend.platelet(PLT)count in good prognosis group showed an overall upward trend during hospitalization,while poor prognosis group showed a downward trend.NLR/Hb at day 7 showed the most stable significance in multi-model multi-factor Logistic regression analysis(P＜0.001).The indicators with differences were included in multi-factor Logistic regression model.NLR/Hb at day 7,D-dimer,and invasive mechanical ventilation were risk factors for poor prognosis,and platelet count at day 7 was a protective factor for poor prognosis(P＜0.05).Conclusion Dynamic monitoring of blood routine is very necessary in clinical practice,and NLR/Hb is expected to become an effective indicator for judging the poor prognosis of severe pneumonia patients.

Objective To compare and analyze the predictive value of different immune-inflammatory parameters for adverse outcomes in severe community-acquired pneumonia(SCAP).Methods A total of 196 severe pneumonia patients admitted to the Second Affiliated Hospital of Zhengzhou University from May 2021 to April 2024.Patients were divided into good prognosis group(n=107)and poor prognosis group(n=89)based on the 28-day hospital outcome.Laboratory indicators were collected and inflammatory indices such as neutrophil-to-lymphocyte ratio(NLR)and NLR to hemoglobin ratio(NLR/Hb)were calculated.Logistic regression analysis was used to identify independent risk factors for poor prognosis in SCAP and to construct a regression model.The diagnostic efficacy of NLR/Hb for adverse outcomes in SCAP was evaluated using the receiver operating characteristic curve.Results NLR during hospitalization in good prognosis group was higher than that in poor prognosis group.Hemoglobin(Hb)in good prognosis group was higher than that in poor prognosis group,and Hb value of admitted patients generally showed a downward trend.platelet(PLT)count in good prognosis group showed an overall upward trend during hospitalization,while poor prognosis group showed a downward trend.NLR/Hb at day 7 showed the most stable significance in multi-model multi-factor Logistic regression analysis(P＜0.001).The indicators with differences were included in multi-factor Logistic regression model.NLR/Hb at day 7,D-dimer,and invasive mechanical ventilation were risk factors for poor prognosis,and platelet count at day 7 was a protective factor for poor prognosis(P＜0.05).Conclusion Dynamic monitoring of blood routine is very necessary in clinical practice,and NLR/Hb is expected to become an effective indicator for judging the poor prognosis of severe pneumonia patients.

Objective:To investigate the dynamic expression of protein tyrosine phosphatase SHP2 in liver tissue of rats with carbon tetrachloride (CCl 4)-induced liver fibrosis. Methods:Rat liver fibrosis model was established by intraperitoneal injection of CCl 4. Rat liver tissue histopathological changes were detected by HE and Masson-trichrome staining. Immunohistochemical staining, Western blot and real-time fluorescent quantitative PCR were used to detect SHP2 protein and mRNA expression in rat liver tissue. One-way analysis of variance was used for the comparison of means between multiple groups, and the LSD test was used for further inter-group comparison. Results:CCl 4-induced rat liver fibrosis model was successfully constructed, and with the extension of modeling time, the degree of liver fibrosis in rats were aggravated gradually. Immunohistochemical staining results showed that SHP2 was mainly expressed in the cytoplasm of rat liver tissues. With the aggravation of liver fibrosis, the number of cells with positive expression of SHP2 was aggravated gradually ( P < 0.05). Western blot and real-time fluorescent quantitative PCR results showed that the expressions of SHP2 protein and mRNA in rat fibrotic liver tissues at different times in week 2, 4, 6, and 8 were higher in modeling than control group ( P < 0.05), and was aggravated gradually with the liver fibrosis aggravation ( P < 0.05). Conclusion:The expression of SHP2 protein and mRNA in the liver tissue of rats with CCl 4-induced liver fibrosis increased gradually with the degree of liver fibrosis, and the degree of increase was consistent with the degree of liver fibrosis.

Objectives To provide reference for the improve of health care system and healthcare insurance con-trolling method, through researching on the value-based healthcare paying system in South Korea. Methods The basic characteristics of the Korean health care system was researched, Specifically, its reform experiences of value-based health insurance review and assessment paying system,which government took. Results South Korea’s health care pay-ing system had achieved both good social and policy effects. Conclusions Value-based health care paying system is the main reason for the reducing of health care expenditures and making of scientific health policy.

Objective To investigate the relationship between the expression of glucose regulated protein 78 (GRP78) in the placental trophoblast cells and the pathogenesis of gestational diabetes mellitus (GDM).Methods All the patients were recruited from Qingdao Municipal Hospital from May 2013 to May 2014.Among them, fifty women with GDM were assigned to the GDM group, and fifty healthy women were defined as the control group.All of them received cesarean section because of breech presentation, contracted pelvis, scarred uterus or on mother's demand.Real-time PCR was conducted to analyze the expression of GRP78 mRNA in the trophoblasts.Immunohistochemistry was performed to detect the localization of GRP78 protein in the placentasl trophoblast cells.Results (1) GRP78 mRNA expressed in the cytoplasm of trophoblasts of both the GDM group and the control group.The GRP78 mRNA levels in the GDM group and the control group were 15.6±0.4 and 6.0±0.7, respectively.The relative expression level of GRP78 mRNA in the GDM group was 2.6 times of that in the control group, with statistically significant difference (P＜0.01).(2) The expression of GRP78 protein was found in the cytoplasm of the trophoblasts of the GDM group.It showed in deep, light brown or yellow after staining, according to the expression degree.The expression of GRP78 protein was also found in the cytoplasm of the trophoblasts of the control group, but it mainly showed yellow color (38/50).The strong positive rate of GRP78 protein in the GDM group (96％, 48/50) was higher than that in the control group (22％, 11/50;P＜0.01).Conclusion The expression of GRP78 increased in the placental trophoblast cells of GDM patients.It might suggest that GRP78 had some effect on the pathogenesis of GDM.