Objective To investigate the expression of CD200/CD200R1 in the PBMC of primary immune thrombocytopenia patients and its clinical significance. Methods The mRNA relative expression of CD200/CD200R1 in ITP patients (n=19) and healthy controls (n=19) were measured by RT-PCR. Then we determined the protein levels of TNF-α, IFN-γ and IL-17 in plasma. We further analyzed the correlation between CD200/CD200R1 expression and platelet counts. The changes of CD200/CD200R1 after effective treatment were also be tested by RT-PCR. Results Compared to healthy controls, CD200/CD200R1 were decreased in ITP patients. TNF-α, IFN-γ and IL-17 protein expressions were increased compared with healthy controls. TNF-α and IFN-γ were negatively correlated with CD200/CD200R1, and the platelet counts in ITP patients were positively correlated with CD200/CD200R1. Moreover, after effective treatment by dexamethasone, the mRNA expression of CD200/CD200R1 showed an obviously increase trend. Conclusion CD200/CD200R1 may be involved in the pathogenesis of ITP and related to the decreased inhibition effect of inflammatory cytokines expression, which provides a new cluefor future immunotherapy.

Objective To investigate the effects of intraoperative blood salvage and allogeneic blood transfusion on liver function and plasma protein indexes in patients undergoing cesarean delivery. Methods A total of 100 patients undergoing cesarean delivery from February, 2017 to October, 2018 were enrolled in the retrospective study. The patients were divided into autologous transfusion group (interoperative blood salvage, n=50) and allogeneic transfusion group. (allogeneic blood transfusion, n=50). General clinical data, liver function indicators [alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP)] and plasma protein [total protein (TP), Albumin (Alb), globulin (Glo)] before and after surgery in the two-group patients were compared. Correlation and linear regression analysis were used to test correlation of the intraoperative autologous blood transfusion volume with intraoperative blood loss, postoperative liver function index, plasma protein index. Results There was no significant difference in clinical general data between the two groups (P>0.05). The amount of allogeneic blood was significantly lower in the autologous transfusion group than that in the allogeneic transfusion group (P<0.05). There was no significant difference between the average hospital stay and the 1 min neonatal score in the two groups. Compared with the preoperative, the ALP, TP, Alb and Glo of the two groups were significantly different (P<0.05), but ALT, AST changes were not obvious (P>0.05); there was no significant difference in postoperative indexes between the two groups (P>0.05); there was a significantly negatively correlation between ALP, TP, Glo and intraoperative autologous blood transfusion volume e (P<0.05). Conclusion Intraoperative blood salvage is a safe and effective way to save allogeneic blood. It is worthy of clinical promotion since Intraoperative blood salvage does not cause liver function damage and allogeneic immune response in patients with cesarean delivery.

Objective Study on changes of related parameters in platelet from dogs with different concentrations of dimethyl sulfoxide in cryopreservation. Methods Platelets of experimental dog were prepared with 2% or 5% dimethyl sulfoxide concentrations and stored at -80℃ for cryopreservation from 1 to 180 days. After thawed, the stock of platelet were tested in platelet count (PLT), mean platelet volume (MPV), platelet count (PCT), platelet distribution width (PDW), platelet glycoprotein-Ib (GP-Ib), platelet selectin (P-Selectin), platelet factor- 4 (PF4), β-thromboglobulin (β-TG). Results The platelets after the cryopreservation with 2% or 5% dimethyl sulfoxide concentrations, which differences were observed in MPV, PDW (P<0.05), while the changes of PLT, PCT, GP-Ⅰb, P-Selectin, PF4, β-TG were not significant (P>0.05). With the prolongation of cryopreserved platelet, MPV, PCT, PDW, GP-Ib, P-Selectin, PF4 and β-TG had different degrees of change in 1-180d except PLT (P<0.05). In addition, there was no significant differences between 2% and 5% dimethyl sulfoxide concentration for cryopreservation of platelets in PLT, MPV, PCT, PDW, GP-Ib, P-Selectin, PF4, β-TG (P>0.05). Conclusion The 2 % and 5 % dimethyl sulfoxide concentrations could be chosen for deep cryopreservation of platelets in experimental dogs within 180 days, PLT, MPV, PCT, PDW, GP-Ib, P-Selectin, PF4, and β-TG was no significant difference between the two indicators. In order to reduce the residual amount of DMSO resulting in various effects of clinical animal tests, it is recommended that 2% dimethyl sulfoxide concentration be used.

Objective To establish the predictive models of erythrocyte transfusion efficacy for non-surgical patients. Methods A total of 1 039 cases were collected from departments of hematology, nephrology and oncology. Multivariable logistic regression was used to screen independent risk factors and ROC curve was used for evaluating the two predictive models of erythrocyte transfusion efficacy. The actual application effect of the models were verified in 266 clinical cases. Results Two hundred and sixty of the 1 039 cases (25.0%) showed invalid erythrocyte transfusion, with the rates of 28.8% (227/787)in hematology, 14.5% (30/207)in nephrology and 6.7% (3/45)in oncology (χ2=26.439, P<0.05). The results of multivariable logistic regression showed that the volume of red blood cell transfusion, average Hb values below 40, 40~50, 50~60, and different clinical diagnoses were positively correlated with the uneffective transfusion. The AUC, intercept, sensitivity and specificity of prediction models 1 and 2 were 0.855, -3.189, 80.38%, 75.99% and 0.814, 15.52, 74.23%, and 77.79%, respectively. The prediction effect of model 1 was prior to that of model 2, with the difference of AUC of 0.040 5. The sensitivity of parallel assays for the combined detection of models 1 and 2 was 94.94%, and the sequence test specificity was 94.67%. Actual application results showed that the sensitivity, specificity, and accuracy of models 1 and 2 were 93.75%, 88.71%, 90.23% and 91.25%, 84.41%, 86.47%, respectively. Conclusion Uneffective transfusions were common in hematology, nephrology and oncology, and several clinical characteristics were associated with the transfusion efficacy. Models 1 and 2 may be useful for accurate blood transfusion due to their predicting effects of erythrocyte transfusion.

Objective To evaluate the RhD polypeptide's inhibitory effect of the reaction of RhD antigen and anti-D. Methods RhD phage polypeptides were synthesized according to the amino acid sequence from phage display library screening. The physical and chemical properties and secondary structure of polypeptides were analyzed by bioinformatics. The effective polypeptides were verified by agglutination inhibition experiment using microcolumn gel (LISS and anti-human globulin). The effective blocking concentration of polypeptides was observed by using microscope to observe the agglutination reaction. The blocking effect of polypeptides was detected by flow cytometry. Results Peptide 4 is the most stable polypeptide. There are no random coil and antigenic in this polypeptide. Peptide 4 is able to inhibit the agglutination of IgG monoclonal anti-D and D+ cells in a concentration dependent manner and completely inhibit the reaction when the concentration reached 2.5 mg/50 μL. Conclusion Peptide 4 is the effective polypeptide. It is able to block the binding sites of anti-D and RhD antigen. The result has great significance to study the structure and function of RhD protein, to modify the antigen of RhD protein, and to improve the safety of clinical blood transfusion.

Objective To observe the role of PRP releasate prepared with calcium gluconate and calcium chloride in promotion of migration and adhesion of human umbilical cord mesenchymal stromal cells (h-ucMSCs). Methods Blood cell separator was used to collect PRP releasate, which was subsequently subjected to the preparation with 10% calcium gluconate or 5% calcium chloride. The h-ucMSCs cultured with FBS was taken as the control. The migration and adhesion of the cells in the three treatments were examined by transwell or matrigel. Western blotting was used to check the expression of Cdc42, RhoA and Rac1. Results The PRP releasate prepared with both calcium gluconate and calcium chloride notably promoted the migration and adhesion of h-ucMSCs compared to the control. Meanwhile, expression of Cdc42, RhoA and Rac1 associated with cell migration and adhesion were elevated. Conclusion PRP releasate prepared with calcium gluconate may improve the migration of h-ucMSCs compared with calcium chloride, suggesting that combined use of both calcium agents with h-ucMSCs might provide a therapeutic strategy for tissue repairs.

Objective To assess biological variation of 23 routine laboratory tests from 100 healthy subjects for 5 consecutive years. Methods One hundred healthy study participants were enrolled from a tertiary hospital and fasting blood samples were collected once a year for 5 consecutive years and analyzed for 23 routine laboratory tests, including white blood cell counting (WBC), red blood cell counting (RBC), hemoglobin (HGB), Hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), platelet count (PLT), total bilirubin (TBIL), total protein (TP), albumin (ALB), Alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutathione transdermal enzyme (GGT), alkaline phosphatase (ALP), uric acid (URIC), urea (UREA), creatinine (CREA), glucose (GLU), triglyceride (TG), total cholesterol (CH), high density lipoprotein cholesterol (HDL) and Low density lipoprotein cholesterol (LDL), using a Hematology analyzer or biochemical analyzer. The data were subject to within-subject biological variation (CVI) and between-subjects biological variation (CVG) analysis. Results We found that CVI varied from 1.26% to 26.42%. Of these CVI, those of TBIL, ALT, GGT and TG were displayed above 20% while those of RBC, HGB, HCT, MCV, MCH, MCHC, TP and ALB were less than 5%. For CVG, there were more significantly different among these parameters. The estimates of CVG were obtained from 2.49% for MCHC to 52.98% for GGT. Of 23 parametres, CVG of TBIL (30.25%), ALT (37.72%), TG (39.70%) and GGT (52.98%) were above 30%, whereas those of MCHC, MCV and MCH were less than 5%, 2.49%, 3.71% and 3.73%, respectively. Most CVI and CVG estimates appear to be higher than those previously published in the online 2014 Westgard updated database. However, a few CVI and CVG estimates were superior to those online, such as CVI for RBC, MCH and PLT and CVG for MCV, MCH, PLT, ALT, ALP, CH, HDL and LDL. Conclousions Most biological variation estimates in this study were similar with the online database in Westgard website except a few of parametres. And our study made up for the lack of long-term biological variation in the database.

Objective Application of value of Clinical application of combined detection of plasma microRNA-27b-3p, PGR, CA15-3 and CEA in early screening and evaluation of gastric cancer. Methods One hundred patients with gastric cancer who underwent surgery in our hospital from February 2012 to February 2013 were selected as the study subjects. Another 92 patients with normal physical examination were selected as the control group. The tumor stage, tumor location, volume, differentiation degree, metastasis, infiltration, pathological type and survival of patients with TNM were analyzed. RNA-27b-3p, PGR, CA15-3 and CEA combined detection of early screening for gastric cancer and malignancy assessment value were statistically analysed. Results The levels of RNA-27b-3p, CA15-3 and CEA in the study group were significantly higher than those in the control group, while PGR was significantly lower than that in the control group. There was no significant difference in serum RNA-27b-3p, PGR, CA15-3 and CEA levels among patients with different sex, age, tumor location, size, infiltration depth, TNM stage and pathological type (P>0.05). The serum levels of RNA-27b-3p, CA15-3 and CEA in patients with lymph node metastasis exceeding 12, tumor recurrence and 5-year follow-up death were significantly increased, while PGR levels were significantly decreased. The higher the serum levels of RNA-27b-3p, CA15-3 and CEA, the lower the PGR, the higher the lymph node metastasis, tumor recurrence and follow-up death. Clearly, RNA-27b-3p, PGR, CA15-3 and CEA were independent risk factors for five year survival of gastric cancer patients. Conclusion RNA-27b-3p, CA15-3 and CEA were positively correlated with the progression of gastric cancer. PGR level was negatively correlated with the progression of gastric cancer. RNA-27b-3p, PGR, CA15-3 and CEA had positive significance in the screening and progression of gastric cancer.

Objective To explore the correlation between serum DAPK, MGMT DNA methylation and pathological metastasis features of lung cancer. Methods From January 2015 to February 2018, 78 cases of non small cell lung cancer (NSCLC) were selected as observation group, and 100 healthy people as the control group at the same time in our hospital. The peripheral blood samples of two groups were collected, the plasma DNA methylation molecular markers-DAPK and MGMT levels were detected. Results The proportion of DAPK and MGMT methylation in the plasma samplesin the observation group were 51.3% and 53.8%, and those in the control group were 14% and 15% respectively, and observation group were significantly higher than those in the control group (P<0.05). In the observation group, there were significant correlation between plasma DAPK and MGMT methylation and histopathological type, lymph node metastasis and distal metastasis (P<0.05). Conclusion There are significant correlation between DAPK, MGMT methylation and the pathological features in the NSCLC patients.

Objective To analyze the relationship between pathological features of NSCLC patients and serum high mobility group box 1 (HMGB 1) and programmed death 1 ligand 1 (PD-L1). Methods From 2016 to 2018, 78 NSCLC patients and 48 healthy volunteers were selected. The expression of serum HMGB 1 and PD-L1 was detected by ELISA, and the pathological characteristics of peripheral blood HMGB 1 and PD-L1 and NSCLC were analyzed. Results The serum HMGB 1 (6.89±1.58 ng/ml) and PD-L1 (389.3±68.5 pg/ml) in the NSCLC patients were increased (P<0.001) compared with the control (P<0.001). Comparision of HMGB 1 with PD-L1 in different pathological types of NSCLC indicated that both the serum levels of HMGB 1 and PD-L1 were gradually increased in phases I, II, III, and IV. HMGB 1 and PD-L1 were fund to be remarkably elevated in the patients with lymph node metastasis (P<0.05). Conclusion Detection of HMGB 1 and PD-L1 in the sera of NSCLC patients is clinically valuable for prediction of tumor invasiveness and prognosis.

Objective To assess the clinical value of serum propionic acid at diagnosis and mortality predicts in patients with septic shock. Methods From March 2015 to December 2017, a total of one hundred and forty-nine septic patients as well as fifty healthy volunteers were enrolled in this study. Septic patients were divided into septic shock group and non-septic shock group. Univariate analyses for the differece of clinical data, multivariate logistic regression analysis was employed to further identify the independent predictors of mortality and septic shock. Receiver operating characteristics (ROC) curves was used to evaluate prognostic and mortality of the biomarkers predicted sepsis shock. Survival rate of different PA concentration were performed by Kaplan-Meier method. Results Respiratory rate, heart rate, PA, CRP, PCT, LA, WBC were significantly higher in both septic shock group and non-septic shock group than control group. Meanwhile, MAP, PA, CRP, PCT, LA, APACHEⅡ score, SOFA score, 30 d mortality and 90 d mortality were significantly higher in septic shock group than non-septic shock group, the differences between two groups were statistically significant (P<0.05). Multivariate logistic regression analysis showed that age, PA, PCT, APACHEⅡ score was independent factor of sepsis shock. Besides, low levels of MAP and high serum PA was independent factor of sepsis shock 30 d mortality and 90 d mortality (P<0.05). Correlation analysis showed that serum PA was positive correlation to PA, PCT and APACHEⅡ score (P<0.05). The ROC analysis showed the AUC of PA for predicting septic shock were 0.912, with cut-off 10.95 μg/L, with sensitivity and specificity was 90.1% and 77.6%, respectively. Using a PA cut-off of 12.52 μg/L for predicting septic shock 30 d mortality and 90 d-mortality, the sensitivity was 75.9% and 70.6%, the specificity was 70.5% and 74.1%, respectively. Log-rank survival analysis showed that 30 d survival and 90 d survival was significantly higher in low PA concentration group than high PA concentration group (P<0.05). Conclusion Propionic acid is markedly increased in septic shock patient, it can be used as a parameter for diagnostic and prognostic of septic shock.

Objective To analyze the sensitivity of carbapenem-resistant Klebsiella pneumoniae and Acinetobacter baumannii to tigecycline so as to provide an evidence for control of carbapenem-resistant bacteria neumonia. Methods One hundred and twelve specimens of carbapenem-resistant K.pneumoniae and 98 specimens of A.baumannii were collected in the hospital from 2016 to 2017. All of the isolates exhibited a broad spectrum antibiotic resistance. Results Ninety of 112 isolates (86.61%) of K.pneumoniae showed their sensitivity to tigecycline whereas 68 of 98 (69.39%) isolates of A.baumannii showed the sensitivity to tigecycline, demonstrating a higher sensitivity of K.pneumoniae to tigecycline than that of A.baumannii (P=0.001). All strains of carbapenem-resistant K.pneumoniae were found to be sensitive to tigecycline at MIC 4 mg/L when compared with A.baumannii that showed 71.21 percent of sensitivity (χ2=18.488, P=0.002). Conclusion Carbapenem-resistant K.pneumoniae has a higher antibiotic sensitivity to tigecycline than A.baumannii, suggesting a choice of use of tigecycline in control of pneumonia.

Objective to analyze the effect of Nintedanib on endothelin-1 and angiotensin in patients with pulmonary fibrosis. Methods Eighty patients with pulmonary fibrosis were followed up from 2016 to 2018. The patients were randomly divided into the control group (n=40) and observation group (n=40) and treated with routine therapy combined with Nintedanib for 4 weeks. The efficacy and adverse reactions were monitored in hospital. Results The curative effect in the observation group was significantly increased compared to that in the control (P<0.05). The serum levels of endothelin-1 and angiotensin and scoring of chest radiographs, in the patients of both groups were decreased following treatments (P<0.05) but more remarkably in the observation group than the control group (P<0.05). Conclusion Nintedanib adjuvant treatment for pulmonary fibrosis may improve the curative effect and inhibit lung fibrosis, showing down-regulation of endothelin -1 and angiotensin production.

Objective Investigate the effects of TLR agonists on the morphology and immunophenotype of DC loaded with CD34+leukemia cells. Providing a basis for studying the function of DC, and further explore the enhancement of immunogenicity of leukemia cells in vitro. Methods After signing the informed consent with the patient or the authorized person of the patient, the fresh bone marrow or anticoagulant blood was collected from the patients diagnosed as acute myeloid leukemia (excluding M3, according to FAB classification). The peripheral blood mononuclear cells (PBMC) of CD14 were obtained by density gradient centrifugation and immunomagnetic bead sorting. CD34+leukemia cells were separated by immunomagnetic beads and frozen for further study. DC was obtained in vitro and then DC was fused with apoptotic CD34+ leukemia cells. Different combinations of Toll-like receptor (TLR) agonist (TLR-3 agonist combined with TLR-9 agonist) were used to further mature DC to obtain functional DC, s cellular morphology and immunophenotype were observed. Results ① Under inverted microscope, mature DC cells became larger in volume, semi-suspended, irregular in shape, and had multiple spiny protuberances on the surface with typical morphological features of mature DC.② The expression of CD11c was increased and the expression of CD14 was down-regulated via flow cytometry detection, indicating the transformation of DC.③ Poly I:C combined with TLR9 agonist (CpG ODN) induced the maturation of DC loaded with CD34+ leukemia cells. The positive expression of CD11c, CD86 on the surface of DC was significantly higher than that of single drug group and blank control group, and DC maturation could be further enhanced in combined stimulation group. Thus, the anti-tumor effect was enhanced. Conclusion In this study, TLR3 agonists and TLR9 agonists have clinical application prospects as adjuvants for stimulating DC mature.

Objective To explore the predictive and prognostic value of MAPK biomarkers for HER-2 positive breast cancer patients with chemotherapy. Methods A total of 83 cases of HER-2 positive breast cancer patients treated were selected in hospital from May 2010 to May 2012. All patients received neoadjuvant chemotherapy and surgery. The levels of MAPK and MAPK pMAPK in cancer and its adjacent tissues were detected by immunohistochemical staining. MAPK and pMAPK mRNA expression was detected by RT-PCR. The correlation between age, operation method, clinical stage, menstruation, estrogen receptor, MAPK, pMAPK and chemotherapy efficacy was analyzed. Results The levels of MAPK and pMAPK mRNA and protein expression in cancer tissues were significantly higher than those in adjacent tissues (P<0.05). Eighty three cases of breast cancer included 15 of CR (18.1%), 45 of PR (54.2%), 22 of SD (26.5%), and 1 of PD (1.2%). Sixty patients (72.3%) showed their clinical effects. Patients with high levels of MAPK and pMAPK had a significantly low clinical efficacy compared with those with low levels of MAPK and pMAPK (P<0.05). Multivariate analysis showed that pMAPK and MAPK expression were independent risk factors in the efficacy of chemotherapy (all P<0.05). MAPK-positive patients with 3 years survival without recurrence accounted for 41.8%, while 60.7% of MAPK-negative patients had 3 years survival (χ2=11.037, P=0.000). In contrast, 39.1% of the patients with positive pMAPK had 3 years survival compared with those with negative pMAPK who had as high as 58.7% of 3 years survival (χ2=11.037, P=0.000). Conclusion MAPK and pMAPK can be used as markers in the patients with HER-2 positive breast cancer for evaluation of chemotherapy and survival prognosis.

Objective To investigate the level and clinical value of autoantibodies in patients with malignant pulmonary nodules. Methods Seventy-one patients with asymptomatic pulmonary nodules admitted to our hospital from November 2018 to January 2019 were enrolled, including 58 malignant pulmonary nodules and 13 benign pulmonary nodules. And ten healthy people as control group.The levels of p53, PGP9.5, SOX2, GAGE7, GBU4-5, MAGEA1 and CAGE in all specimens were detected by ELISA kit. The ROC curve was used to analyze the diagnostic value of autoantibodies for malignant pulmonary nodules. Results Compared with the benign pulmonary nodules group and the normal control group, the level of autoantibodies in the malignant nodules of the lungs was significantly increased (P<0.05);ROC curve analysis showed that seven autoantibodies were important for the differential diagnosis of benign and malignant pulmonary nodules (AUC>0.5, P<0.05), and seven autoantibodies combined detection could improve the differential diagnosis efficiency (AUC=0.822);The positive detection rate of lung malignant nodules was 81.7% by LDCT and was increased to 94.0% combining with autoantibodies detection (P<0.05). Conclusion Serum autoantibody detection has potentialclinical value in the differential diagnosis of benign and malignant pulmonary nodules.

Objective To explore the value of serum procalcitonin and mean platelet volume (MPV) in prediction of prognosis of acute pancreatitis (AP). Methods One hundred and thirty four inpatients with acute pancreatitis were divided into light, moderate, and severe groups according to the criteria of classification, and subsequently divided into the survival group and the death group based on the clinical outcomes. The MPV, serum PCT level and APACHE II score in different severities and clinical outcomes were compared. The ROC curve was used to evaluate the clinical value of PCT, MPV, and combined detections to determine the prognosis of AP. Results With the progression of the disease, the levels of MPV, PCT and the score of APACHE II increased, showing a significant elevation in the cases of death group compared with those of the survival group (P<0.05). A strong positive correlation was noted between MPV and PCT and APACHE II scores (r=0.630, 0.704, P<0.05). ROC curve analysis showed that the sensitivity, specificity, and AUC were 88.9%, 97.2%, and 0.972, respectively if MPV≥13.04 fl was taken as the prediction cutoff value, whereas the sensitivity and specificity were found to be 74.1% and 92.5% when PCT≥4.65ng/ml was used as the prediction value. Conclusion of MPV with PCT examinations is promising for prediction of the outcomes of acute pancreatitis.

Objective To investigate the effect of heparin-binding protein (HBP) and procalcitonin (PCT ) in the diagnosis of pediatric respiratory bacterial infection. Methods From January 2016 to June 2018 pediatric with infectious diseases were treated in our hospital, among them 45 children with respiratory bacterial infection, 39 cases children with Non-bacterial infection of the respiratory tract at the same time, 40 children with non-infections.The levels of serum HBP and PCT in each group were detected. Results HBP and PCT of pediatric respiratory bacterial infection group were significantly higher than that of Non-bacterial infection and non-infection group.When the cut-off value of HBP was 13.78 ng/ml, the diagnostic sensitivity and specificity were 87.46% and 94.42%.When the cut-off value of PCT was 0.13ng/ml, the diagnostic sensitivity and specificity were 71.23％ and 85.69%.The sensitivity and specificity of HBP and PCT in the combined diagnosis of pediatric respiratory bacterial infection were 92.67% and 94.42%. Conclusion The combined detection of HBP and PCT has gooddiagnostic value in the diagnosis of pediatric respiratory bacterial infection, which is worthy of clinical use．

Objective To investigate the diagnostic value of dynamic changes of serum procalcitonin (PCT) and C-reactive protein (CRP) levels in patients with severe craniocerebral injury. Methods Sixty patients with severe craniocerebral trauma who were admitted to our hospital from January 2015 to December 2017 were selected, and they were divided into infection group (n=36) and non-infection group (n=24) according to whether the patient eventually had pulmonary infection. In the infection group, 21 cases were cured and 15 cases were persistent infectious. The differences of PCT and CRP levels between the first day of hospital admission and the day of infection, 3d, 7d were analyzed and compared. Results ① The PCT level in the infection group was significantly higher than that in the uninfected group on the first day of admission (P<0.05), while there was no significant difference in the CRP level between the two groups (P>0.05), WBC and NG were higher in both groups, but the difference was not significant (t=1.333 3, 1.872 9, all P>0.05).②There was no significant difference in PCT and CRP levels between the improvement group and the continuous group on the day of infection (t=-0.696 1, -0.593 4, all P>0.05), the levels of PCT in the improved group was significantly lower than those in the continuous group on the 3d, 7d after infection (t=-7.856 3, -14.558 5, all P<0.05), the levels of CRP in the improved group was significantly lower than those in the continuous group on the 3d, 7d after infection (t=-3.011 4、-18.113 9, all P<0.05)③The PCT and CRP levels in the improved group showed a decreasing trend. The PCT level in the continuous group increased generally and the CRP level did not change significantly.④ After treatment, the WBC and NG levels in the improved group were significantly lower than those in the continuous group (t=2.670 0, -3.441 5, all P<0.05). Conclusion The dynamic monitoring of PCT and CRP levels during the treatment of severe craniocerebral injury patients is helpful for the prediction of pulmonary infection and the progress of diagnosis and treatment of disease. The diagnostic value of PCT in early pulmonary infection is higher than that of CRP.

Objective To investigate the clinical significance of serum β-hCG, ICAM-1 and MMP9 in the intrauterine infection and prognosis of premature rupture of membranes. Methods 296 patients with precancerous premature rupture of membranes were collected. Blood samples were drawn at the time of prenatal fasting. After treatment, the serum levels of β-hCG, ICAM-1 and MMP9 were measured. The patients were divided into non-infected group and infected group according to the infection status of the patients. There were 184 cases of non-infected group and 112 cases of infection group. Then, Serum levels of β-hCG, ICAM-1 and MMP9 were compared between the two groups, and the prognosis of the two groups was evaluated. Results The levels of MMP9, ICAM-1 and β-hCG in the non-infected group were significantly lower than those in the infection group (P<0.05). Serum MMP9, ICAM-1 and β-hCG levels were predictive of the value of intrauterine infection, the sensitivity, specificity and accuracy of ICAM-1>MMP9>β-hCG, the positive predictive value of MMP9>ICAM-1>β-hCG, The predicted value of MMP9>β-hCG> ICAM-1, but after χ2 test, no significant statistical difference, P>0.05; The combined value of the above serum markers for the predictive value of intrauterine infection in premature rupture of membranes was compared. Compared with the combined detection of the two, there was no significant difference in sensitivity and specificity (P>0.05), but the accuracy was significantly higher (P<0.05).The time and length of hospitalization of antibiotics in patients with MMP9, ICAM-1 and β-hCG positive were significantly higher than those in MMP9, ICAM-1 and β-hCG negative patients (P<0.05). Conclusion Detection of serum β-hCG, ICAM-1 and MMP9 levels in pregnant women with premature rupture of membranes can predict the situation of intrauterine infection in pregnant women more accurately and can predict the prognosis of patients.

Objective To investigate the change of cytokines (IL-6, IL-10, PCT, CRP, and NEUT) and the indicators of immunity (CD4+, CD8+, CD4+/CD8+) in the patients with sepsis so as to determine the association of the markers with severity of the disease. Methods Fifty-four patients were divided into moderate group (18 cases), severe group (19 cases) and septic shock group (17 cases). The levels of serum IL-6, IL-10, PCT, and CRP, the counts of WBC, NEUT, CD4+, and CD8+, and the ratio of CD4+ /CD8+ were measured in all of the patients and the correlation between the data and acute physiology and chronic health evaluation (APACHE- II) was compared. Results The levels of PCT, CRP, IL-6, and IL-10, the counts of WBC and NEUT increased gradually, and the indicators of immunity (the number of CD4+ and CD8+, and the ratio of CD4+/CD8+) decreased (P<0.05) with exacerbation of sepsis. The levels of PCT, CRP, IL-6, IL-10, and the count of WBC in the patients were positively correlated with APACHE- II scores (P<0.05). As the contrary, the numbers of CD4+ and CD8+, and the ratio of CD4+/CD8+ were negatively correlated with APACHE- II scores (P<0.05). Conclusion The inflammatory markers of PCT, CRP, IL-6, and IL-10 as well as the count of WBC in septic patients were elevated while the numbers of CD4+ and CD8+, and the ratio of CD4+/CD8+ decreased with deterioration of the disease.

Objective To explore the predictive value of serum and urinary PTX-3 in recent occurrence of acute kidney injury (AKI) in critical patients. Methods A total of 217 critical patients were classified into AKI group (n=87) and non-AKI group (n=130) based upon the guideline of KDIGO, the levels of serum and urinary PTX-3 were detected by using ELISA, the predictive value of PTX-3 for the recent occurrence of AKI was analyzed by area under the receiver operating characteristic curve. Results The shocking rate, APACHE Ⅱ score, SCr level, and PTX-3 level in AKI group were markedly higher than those in non-AKI group (P<0.05). Besides, the level of PTX-3 in the classes 2 and 3 group were significantly elevated compared with that in class 1 group (P<0.05). However, no significant difference was noted between class 2 and class 3 (P>0.05). The level of PTX-3 was an independent risk factor for the prediction of AKI (all P<0.05). Moreover, both serum and urinary PTX-3 had a positive correlation with SCr (all P<0.05). The AUC value of PTX-3 was 0.875 and 0.868, respectively, which relatively higher than that of SCr (AUC=0.747, P<0.05). The AUC of PTX-3 for prediction of classes 1 and 2 AKI was 0.858 and 0.829, respectively, which was more reliable than that of SCr (AUC=0.727, P<0.05). Conclusion Serum and urinary PTX-3 may effectively predict the occurrence of AKI in critical patients when served as a potential biomarker for diagnosis of AKI in the early stage.