Objective:To investigate the value of systemic inflammatory response syndrome (SIRS), pediatric sequential organ failure assessment (pSOFA) and pediatric critical illness score (PCIS) in predicting mortality of pediatric sepsis in pediatric intensive care units (PICU) from Southwest China.Methods:This was a prospective multicenter observational study. A total of 447 children with sepsis admitted to 12 PICU in Southwest China from April 2022 to March 2023 were enrolled. Based on the prognosis, the patients were divided into survival group and non-survival group. The physiological parameters of SIRS, pSOFA and PCIS were recorded and scored within 24 h after PICU admission. The general clinical data and some laboratory results were recorded. The area under the curve (AUC) of the receiver operating characteristic curve was used to compare the predictive value of SIRS, pSOFA and PCIS in mortality of pediatric sepsis.Results:Amongst 447 children with sepsis, 260 patients were male and 187 patients were female, aged 2.5 (0.8, 7.0) years, 405 patients were in the survival group and 42 patients were in the non-survival group. 418 patients (93.5%) met the criteria of SIRS, and 440 patients (98.4%) met the criteria of pSOFA≥2. There was no significant difference in the number of items meeting the SIRS criteria between the survival group and the non-survival group (3(2, 4) vs. 3(3, 4) points, Z=1.30, P=0.192). The pSOFA score of the non-survival group was significantly higher than that of the survival group (9(6, 12) vs. 4(3, 7) points, Z=6.56, P<0.001), and the PCIS score was significantly lower than that of the survival group (72(68, 81) vs. 82(76, 88) points, Z=5.90, P<0.001). The predictive value of pSOFA (AUC=0.82) and PCIS (AUC=0.78) for sepsis mortality was significantly higher than that of SIRS (AUC=0.56) ( Z=6.59, 4.23, both P<0.001). There was no significant difference between pSOFA and PCIS ( Z=1.35, P=0.176). Platelet count, procalcitonin, lactic acid, albumin, creatinine, total bilirubin, activated partial thromboplastin time, prothrombin time and international normalized ratio were all able to predict mortality of sepsis to a certain degree (AUC=0.64, 0.68, 0.80, 0.64, 0.68, 0.60, 0.77, 0.75, 0.76, all P<0.05). Conclusion:Compared with SIRS, both pSOFA and PCIS had better predictive value in the mortality of pediatric sepsis in PICU.

Objective:To observe the effects of alprostadil at different doses on C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) in patients with angina pectoris.Methods:From August 2017 to April 2018, 120 patients with angina pectoris admitted to China Coast Guard Hospital of the People's Armed Police Force were selected and divided into control group (60 cases) and observation group (60 cases) by random number table method.Both two groups received routine anti-angina treatment, while the control group received 10 μg alprostadil, the observation group received 20 μg alprostadil for 2 weeks.The changes of CRP, TNF-α, IL-6 and hemorheological indicators before and after treatment were compared between the two groups.Results:Before treatment, there were no statistically significant differences in the CRP, TNF-α and IL-6 between the two groups (all P>0.05). After treatment, the CRP, TNF-α and IL-6 levels in the observation group were (4.63±0.62)mg/L, (0.46±0.08)μg/L, (46.59±4.72)ng/L, respectively, which were significantly lower than those in the control group [(6.18±0.74)mg/L, (1.19±0.28)μg/L, (58.62±5.07)ng/L]( t=12.437, 19.418, 13.452, all P<0.05). The high shear viscosity, low shear viscosity, plasma viscosity and platelet aggregation rates in the observation group were (4.27±0.46)mPa/s, (8.07±0.18)mPa/s, (1.03±0.25)mPa/s, (37.42±1.05)%, respectively, which were lower than those in the control group [(5.14±0.588)mPa/s, (10.43±0.42)mPa/s, (2.01±0.46)mPa/s, (40.19±1.86)%] ( t=9.103, 40.006, 14.499, 10.046, all P<0.05). Conclusion:The conventional dose of alprostadil (20 μg) is effective in the treatment of angina pectoris.It can improve CRP, TNF-α, IL-6 and hemorheological parameters of patients.

Objective:To observe the efficacy of meglumine adenosine cyclophosphate (MAC) in the adjuvant treatment of chronic congestive heart failure(CHF) in the elderly, and its effects on cystatin C(Cys-C) and plasma B-type natriuretic peptide(BNP).Methods:From August 2017 to August 2018, 110 elderly patients with chronic CHF admitted to Zhejiang Provincial Armed Police Corps Hospital were selected and randomly divided into control group(55 cases) and observation group(55 cases) by random number table method.The control group was treated with routine treatment, while the observation group was treated with MAC on the basis of routine treatment.Both two groups were treated for 2 weeks.The clinical efficacy, left ventricular ejection fraction (LVEF), cardiac output, Cys-C and plasma BNP were compared between the two groups.Results:The total improvement rate of the observation group was 94.55%(52/55), which was higher than 78.18%(43/55) of the control group, the difference was statistically significant(χ 2=6.253, P<0.05). Before treatment, there were no statistically significant differences in LVEF, cardiac output, BNP and Cys-C between the two groups(all P>0.05). After treatment, the LVEF[(44.16±6.82)%], cardiac output[(8.07±1.45)L/min] of the observation group were significantly higher than those of the control group[(40.71±5.38)%, (6.44±1.37)L/min], and BNP[(1.65±0.24)mg/L], Cys-C[(552.79±10.46)mg/L] of the observation group were significantly lower than those of the control group[(2.31±0.48)mg/L, (681.73±12.71)mg/L], the differences were statistically significant( t=2.945, 6.060, 9.121, 0.551, all P<0.05). Conclusion:MAC has significant effect in the treatment of elderly patients with chronic CHF.It can improve the cardiac function of patients and reduce the plasma concentrations of Cys-C and BNP.

Objective: To evaluate the efficacy and safety of compound Lactobacillus acidophilus tablets or Saccharomyces boulardii Sachets combined with standard protocols for eradication of Helicobacter pylori(Hp) in children. Methods: From March 2017 to March 2018, 120 children aged 3-10 years with Hp infection were admitted into the Department of Gastroenterology, Maternal and Child Health Hospital of Hubei Province, including 67 male and 53 female childen.They were divided into 3 groups (control group, compound Lactobacillus acidophilus group, Saccharomyces boulardii Sachets group) by the method of random number table.Control group was given Clarithromycin+ Amoxicillin+ Omeprazole, for 14 days orally; compound Lactobacillus acidophilus group and Saccharomyces boulardii Sachets group were given drugs respectively on the first day, 500 mg of compound Lactobacillus acidophilus was added, twice a day or 250 mg of Saccharomyces boulardii Sachets group, twice a day orally, for 14 days, respectively.The adverse reactions in children were observed during the treatment, andurea ¹³C breath test or the stool Hp antigen test was performed at least 4 weeks by the end of the treatment, and the children with negative results were judged to be eradicated successfully.The ulcer healing, Hp eradication rate and incidence of adverse reactions(nausesa, vomiting, loss of appetite, constipation, diarrhea) among the 3 groups were observed and the Hp eradication rate and the incidence of adverse reactions (nausea, vomiting, loss of appetite, constipation, diarrhea) were compared. Results: The eradication rates in the control group, the compound Lactobacillus group, and Saccharomyces boulardii Sachets group were 80.0% (32/40 cases), 85.0% (34/40 cases), and 87.5% (35/40 cases), respectively, and the difference was not statistically significant (P=0.646); the ulcer healing rate was 100.0% of 101 Hp eradicators in 3 groups, and the ulcer healing rate of 19 cases without Hp eradicated was 48.15%, and there was a significant difference between them (χ²=51.30, P<0.01). However, there was no significant difference in the total effective rate among 3 groups (P>0.05). The overall incidence of adverse reactions in Saccharomyces boulardii Sachets group (P=0.021) and the incidence of diarrhea (P=0.002) and loss of appetite (P=0.021) was lower than that in the control group, and the differences were statistically significant.There was no significant difference in the incidence of adverse reactions between the two probiotic groups (P>0.05). Conclusions Both compound Lactobacillus acidophilus tablets and Saccharomyces boulardii Sachets group can reduce the overall incidence of adverse reactions and the incidence of diarrhea and appetite declines in children′s standard Hp eradication regimen without affecting Hp eradication rate.

Objective To establish the HPLC fingerprints of petroleum ether parts from five traditional medicine (Alpinia officinarum Hance, Alpinia galangal ( L.) Wild, Alpinia galanga Will., Alpinia katsumadai Hayata, and Alpinia oxyphylla Miq), and to explore the similarities and differences of chemical composition,as well as the correlation between the genetic relationship and the chemical composition. Methods HPLC method was used to analysis the five traditional medicines. The data were evaluated by using the"similarity evaluation system for chromatographic fingerprint of TCM" software. Results The similarity chemical composition from Alpinia officinarum Hance,Alpinia galangal(L.) Wild,Alpinia galanga Will.,Alpinia katsumadai Hayata,and Alpinia oxyphylla Miq in ethyl acetate were 0.741,0.855,0.610,0.510, 0.680,respectively. Conclusion Though there were differences of fingerprint peak of petroleum ether parts between five the traditional Chinese medicines, similarities were also observed among them.

Objective To assess the efficacy and safety of morinidazole combined with appendectomy in treating purulent or gangrenous appendicitis.Methods Double-blind randomized controlled multicenter clinical trial was designed and conducted.Totally 437 patients were included,219 in the control group and 218 in the experimental group.Cases of purulent or gangrenous appendicitis were enrolled and assigned to each of the two groups.The control group received ornidazole injection for 5 to 7 days while the experimental group received morinidazole injection.Both groups underwent appendectomy.Clinical response,micrombiological outcomes,overall response were evaluated.Adverse events and side effects were recorded.Results No significant difference was observed between the two groups regarding the clinical healing rate at 5-10 days after medicine withdrawal,anaerobia clearance and overall healing rates.Adverse events occurred in 140 patients (32.1％).Incidence of adverse events in the control group and the experimental group was 34.7％ and 29.4％,respectively (P ＞ 0.05).The overall incidence of side effects was 15.1％ (66 cases).Side effects were less seen in the experimental group compared with that in the control group (11.5％ vs.18.7％,P ＜ 0.05).The most frequent side effects were aminotransferase rising,thrombocytosis,nausea,vomiting and electrocardiographic abnormality.Conclusions The effect of morinidazole plus operation was comparable with ornidazole in treating purulent or gangrenous appendicitis.The safety of morinidazole is better than ornidazole.

Objective: To investigate the effect of intracoronary administration of nicorandil prior to primary percutaneous coronary intervention (PPCI) on myocardial perfusion and short-term clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). Methods: A total of 158 patients with STEMI undergoing PPCI from January 2014 to December 2015 in Fuzhou General Hospital were enrolled consecutively in this prospective controlled randomized trial. Patients were assigned into three groups with random number table: the nicorandil group (patients received intracoronary administration of 6 mg nicorandil after guide wire or balloon successfully crossed the target lesion, n=53), the nitroglycerin group (patients received intracoronary administration of 300 μg nitroglycerin after after guide wire or balloon successfully crossed the target lesion, n=52) and the control group(patients received routine treatment, n=53). The primary outcomes were myocardial perfusion, including the levels of corrected TIMI frame count (cTFC), and the incidence of no reflow or slow flow after PPCI. The secondary outcomes included the incidence of major adverse cardiovascular events (MACE) during hospitalization (all-cause death, reperfusion arrhythmia within 2 hours after PPCI, angina within 24 hours after PPCI, new heart failure or worsening cardiac function, and repeat revascularization) and within 3 months of follow-up (all-cause death, nonfatal myocardial infarction, repeat revascularization, post-infarction angina, and re-hospitalization for congestive heart failure). Results: The age of enrolled patients was (62.9±11.3) years old, and 130 cases (82.3%) of them were male. The median time of symptom-onset to balloon was 4.50 (3.20, 6.43) hours. There were significantly difference in cTFC immediately after PPCI((21.68±7.43)frames, (24.74±8.66)frames, and(27.06±10.40)frames), incidence of no reflow or slow flow after PPCI(5.7%(3/53), 13.5%(7/52), and 22.6%(12/53)), ST-segment resolution at 2 hours after procedure(90.6%(48/53), 84.6%(44/52), and 74.5%(38/53)), and reperfusion arrhythmia at 2 hours after procedure(15.1%(8/53), 36.6%(19/52), and 34.0%(18/53)) among the 3 groups(P<0.01 or 0.05). In the multivariate logistic regression models, intracoronary administration of nicorandil could lower the cTFC level (OR=0.17, 95%CI 0.10-0.41, P=0.001), acted as a protecting factor on lowering the incidence of no reflow or slow flow (OR=0.13, 95%CI 0.02-0.96, P=0.045) and reperfusion arrhythmia (OR=0.26, 95%CI 0.09-0.74, P=0.012), as well as facilitating the ST-segment resolution at 2 hours after procedure (OR=4.62, 95%CI 1.14-18.82, P=0.033). However, observed parameters were similar between intracoronary administration of nitroglycerin group compared with control group (all P>0.05). MACE within 3 months of follow-up were similar among the 3 groups(all P>0.05). Conclusion Intracoronary administration of nicorandil prior to balloon dilation can significantly improve the myocardial perfusion and reduce the occurrence of reperfusion arrhythmia during PPCI for STEMI, but does not affect the short-term prognosis in STEMI patients.

Objective To detect the expression of BclGL in peripheral blood mononuclear cells (PBMCs) from patients with systemic lupus erythematosus (SLE) and to investigate its significance.Methods Peripheral blood was obtained from 20 patients with active SLE (A-SLE),18 patients with inactive SLE (Ⅰ-SLE) and 30 healthy controls.Flow cytometry was performed to calculate the number of PBMCs,flow cytometry combined with annexin V-fluorescein isothiocyanate (FITC)/propidium iodide (PI) staining to determine the early apoptotic rates of PBMCs,fluorescence-based quantitative PCR and Western blot to measure the expression of BclGL mRNA and protein,respectively.The serum level of interferon (IFN)-α was determined by enzyme-linked immunosorbent assay (ELISA).Data were analyzed by using the software SPSS13.0.Mann-Whitney U-test or Kruskal-Wallis test was used for group comparisons.Pearson correlation coefficient test was applied to evaluate the relationship of BclGL expression with cell apoptotic rate and some clinical parameters.Results The number of PBMCs was significantly lower in patients with A-SLE than in those with Ⅰ-SLE and healthy controls ((0.16 ± 0.06) × 109/L vs.(0.27 ± 0.14) × 109/L and (0.34 ± 0.23) × 109/L,both P ＜ 0.01).Increased apoptotic rate of PBMCs was observed in patients with A-SLE compared with those with Ⅰ-SLE and healthy controls ((22.6 ± 1.1)％ vs.(16.4 ±0.9)％ and (10.1 ± 0.4)％,both P ＜ 0.01),and in patients with Ⅰ-SLE compared with the healthy controls (P ＜0.01).The mRNA and protein expressions of BclGL in PBMCs were both significantly higher in patients with ASLE than in those with Ⅰ-SLE and healthy controls (all P ＜ 0.01).A significant increase was observed in serum IFN-α level in the patients with SLE compared with the healthy controls ((32.5 ± 2.2) μg/L vs.(15.5 ± 1.3) μg/L,P ＜ 0.01).The mRNA expression of BclGL in PBMCs from patients with SLE was positively correlated with the apoptotic rate in PBMCs (r =0.486,P ＜ 0.01),SLE disease activity index score (r =0.496,P ＜ 0.01),titers of antinuclear antibodies (r =0.516,P ＜ 0.01) and serum IFN-o level (r =0.535,P ＜ 0.01),but was negatively correlated with complement C3 level (r =-0.515,P ＜ 0.01).Conclusions The increased expression of BclGL in PBMCs may contribute to the abnormal apoptosis in PBMCs,which in turn takes part in the pathogenesis of SLE.

Objective To study the expression of signal transducer and activator of transcription 1 (STAT1) in human renal clear cell carcinoma (RCC) and the effect of STATI inhibition on the radiosensi-tivity of RCC. Methods The expression of STAT1 in 34 human RCC samples compared with 12 normal kid-ney tissues was examined by immunohistochemistry method. For in vitro experiments, a human RCC cell line, CRL-1932, was used. Western blotting was performed to evaluate the expression of total and phospory-lated STAT1. Fludarabine and siRNA were respectively used to inhibit the expression of STAT1 in CRL-1932 cells. Clonogenic assay and trypan blue staining assay were used to evaluate the radiosensitivity of CRL-1932 cells. Results The expression of both total and phospborylated STAT1 in human RCC samples was signifi-cantly higher when compared to normal kidney tissues. Similarly, the expression of STAT1 was higher in CRL-1932 cells when compared to fibroblast and Wilm's tumor cell lines. STAT1 expression was inhibited by both fludarabine and siRNA. Radiosensitivity of CRL-1932 cells was enhanced by both fludarabine and siRNA induced STAT1 inhibition. Conclusions STAT1 is over-expressed in both human RCC tissue and cell line. Inhibition of STAT1 can enhance the radiosensitivity of RCC cells.

OBJECTIVETo evaluate the risk of nasopharyngeal carcinoma (NPC) through EB virus antibody profile by enzyme linked immunosorbent assay (ELISA).

METHODSEBNA 1/IgA, EBNA 1/IgG and zta/IgG by ELISA and VCA/IgA by immmunoenzymatic method were detected in 121 NPC patients and 332 healthy subjects (HS) in the Pearl river estuary.

RESULTSThe sensitivity rates were 85%, 83% and 79% for EBNA 1/IgA, EBNA 1/IgG and zta/IgG, all three of which if combined was the highest 92%. The specificity rates were 86%, 86% and 80% for EBNA 1/IgA, EBNA 1/IgG and zta/IgG, all three of which if combined was also the highest 93%. According to the level of odds ratio, nasopharyngeal carcinoma risk could be divided into 3 groups: low, moderate and high-risk groups. 93% of HS had low risk of NPC with the odds ratio 0.0 to 0.3. 0.4% of HS had high risk of NPC with the odds ratio of 137.9%.

CONCLUSIONELISA is more objective than the traditional immunoenzymatic method in the detection and diagnosis of NPC. The combination of EBNA 1/IgA, EBNA 1/IgG and zta/IgG is able to evaluate the risk of NPC.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antibodies, Viral ; analysis ; Enzyme-Linked Immunosorbent Assay ; Epstein-Barr Virus Nuclear Antigens ; analysis ; Female ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnosis ; virology ; Risk Factors