Research progress in evaluating severity and prognosis of children with community acquired pneumonia by scales and biomarkers / 中国小儿急救医学

Community acquired pneumonia(CAP)has a high morbidity and mortality rate, and can bring a heavy social and economic burden.Its etiology is complex.How to identify high-risk children, early diagnosis, prognosis prediction are the focus of clinical research.Early identification and active intervention of high-risk children who need hospitalization or admission to pediatric intensive care unit by using score scales and biomarkers are crucial to improve the survival rate.This review summarized the assessment of severity and prognosis of CAP in children by different score scales and biomarkers.

Qingshen granule-medicated serum attenuates high glucose-induced epithelial-mesenchymal transition of HK-2 cells via inhibiting oxidative stress-mediated NF-κB signaling pathway / 中国病理生理杂志

AIM:To investigate whether Qingshen granules(QSG)-medicated serum inhibits oxidative stress-mediated NF-κB signaling pathway and attenuates epithelial-mesenchymal transition(EMT)of human proximal tubule epi?thelial HK-2 cells induced by high glucose. METHODS:The active components in QSG were analyzed by HPLC. The HK-2 cells were randomly divided into control group,mannitol group,high glucose group,low-dose QSG group,medium-dose QSG group,high-dose QSG group and pyrrolidine dithiocarbamate(PDTC)group. The morphological changes of the cells were observed by inverted phase contrast microscopy. MTT assay was used to detect the cell viability. Flow cytometry was used to detect the content of reactive oxygen species(ROS)in HK-2 cells. ELISA was used to detect the content of malondi?al dehyde(MDA)and the activity of superoxide dismutase(SOD). The DNA binding activity of nuclear factor-κB(NF-κB) p65 in HK-2 cells was detected by electrophoretic mobility-shift assay(EMSA). The protein expression of NF-κB p65, phosphorylated inhibitor of kappa B alpha(p-IκBα),inhibitor of kappa B kinase alpha(IKKα),monocyte chemoattractant protein-1(MCP-1)and intercellular adhesion molecule-1(ICAM-1)in HK-2 cells was detected by Western blot. Immuno?fluorescence staining was used to detect NF-κB p65 andα-smooth mucle actin(α-SMA)protein expression in HK-2 cells. RESULTS:Chlorogenic acid,berberine hydrochloride,plantamajoside,6,7-dimethoxycoumarin,epiberberine,copti?sine,lithospermicacid B,palmatine,leonurine hydrochloride,rheic acid and tanshinone ⅡA in QSG were preliminarily de?termined by HPLC. Compared with control group,the levels of ROS and MDA in HK-2 cells induced by high glucose in?creased(P<0. 05),while the activity of SOD decreased(P<0. 05). The protein levels of NF-κB p65,p-IκBα,IKKα, MCP-1,ICAM-1 andα-SMA were increased(P<0. 05). After intervened by QSG-medicated serum,the levels of ROS and MDA were decreased(P<0. 05),while the activity of SOD was increased(P<0. 05). The protein levels of NF-κB p65,p-IκBα,IKKα,MCP-1,ICAM-1 andα-SMA were decreased(P<0. 05). CONCLUSION:QSG-medicated serum inhibited oxidative stress-mediated NF-κB signaling pathway,thus attenuating the EMT of HK-2 cells induced by high glucose.

Effect of Ethyl Acetate Extract of Acanthopanacis Senticosi Radix et Rhizoma seu Caulis on Intestinal Flora in ApoE-/- Mice with Atherosclerosis / 中国实验方剂学杂志

ObjectiveTo observe the effect of ethyl acetate extract of Acanthopanacis Senticosi Radix et Rhizoma seu Caulis on high-fat diet-induced apolipoprotein E gene knockout （ApoE-/-） mice， and explore its mechanism of treating atherosclerosis by regulating intestinal flora. MethodThirty-two 8-week-old male ApoE-/- mice were randomly divided into model group， rosuvastatin group （10 mg·kg-1）， high-， low-dose groups of ethyl acetate extract of Acanthopanacis Senticosi Radix et Rhizoma seu Caulis （75， 25 mg·kg-1）， with 8 mice in each group. Eight C57BL/6 mice were used as blank group. After 8 weeks of continuous administration， blood was taken to determine the blood lipid level. Enzyme-linked immunosorbent assay （ELISA） was used to detect the contents of related indexes in serum of mice. Hematoxylin-eosin （HE） staining was used to observe the formation of aortic plaque in mice. Cecal contents were collected and 16S rRNA amplicon sequencing was used to detect intestinal flora. ResultCompared with the blank group， the plaque area of the model group was significantly increased with inflammatory infiltration， the contents of triglyceride （TG）， total cholesterol （TC）， low-density lipoprotein cholesterol （LDL-C）， inflammatory factors and inducible nitric oxide synthase （iNOS） were increased， while the content of high-density lipoprotein cholesterol （HDL-C） was decreased. Compared with the model group， rosuvastatin group and high- and low-dose groups of ethyl acetate extract of Acanthopanacis Senticosi Radix et Rhizoma seu Caulis could improve the deposition of aortic plaque， reduce the contents of TG， TC， LDL-C， inflammatory factors and iNOS， and increase the content of HDL-C. Compared with the blank group， the relative abundances of Firmicutes and Proteobacteria in the model group increased， while the relative abundance of Bacteroidetes decreased. Alpha and Beta diversity analysis showed that samples of each group could be significantly isolated， and the total number and abundance of intestinal flora species in the model group were low. Compared with the model group， ethyl acetate extract of Acanthopanacis Senticosi Radix et Rhizoma seu Caulis could increase the relative abundance of beneficial bacteria and decrease the relative abundance of pathogenic bacteria. ConclusionEthyl acetate extract of Acanthopanacis Senticosi Radix et Rhizoma seu Caulis was mainly composed of flavonoids， which can treat atherosclerosis by regulating the intestinal flora and improve the pathological changes in the aorta of ApoE-/- mice induced by high-fat diet. The mechanism may be related to its ability to reduce the level of inflammatory factors， improve antioxidant capacity and repair the disorder of intestinal flora structure.

The formation and repair of DNA double-strand breaks in mammalian meiosis / 亚洲男科学杂志(英文版)

Programmed DNA double-strand breaks (DSBs) are necessary for meiosis in mammals. A sufficient number of DSBs ensure the normal pairing/synapsis of homologous chromosomes. Abnormal DSB repair undermines meiosis, leading to sterility in mammals. The DSBs that initiate recombination are repaired as crossovers and noncrossovers, and crossovers are required for correct chromosome separation. Thus, the placement, timing, and frequency of crossover formation must be tightly controlled. Importantly, mutations in many genes related to the formation and repair of DSB result in infertility in humans. These mutations cause nonobstructive azoospermia in men, premature ovarian insufficiency and ovarian dysgenesis in women. Here, we have illustrated the formation and repair of DSB in mammals, summarized major factors influencing the formation of DSB and the theories of crossover regulation.

Assessing in-situ conservation status of threatened medicinal vascular plants in central China / 中国中药杂志

It is of great significance to carry out scientific investigation of threatened species and assess their in-situ conservation status in order to guide the conservation and management of these species within a region. In this study, we explored and assessed the biodiversity and in-situ conservation status of the threatened medicinal vascular plants(TMVPs) in central China. The results showed that there were 276 TMVPs in central China, including 18 critically endangered(CR), 77 endangered(EN), and 181 vulnerable(VU) species. Of which, 222 TMVPs were distributed in 49 national nature reserves, with an in-situ conservation rate of 80.43%. And the in-situ conservation rate of CR, EN and NR species were 83.33%, 77.92% and 81.22%, respectively. The complementary algorithm was used to select the nine national nature reserves with the highest protection and complementary contribution to the TMVPs. The cumulative protection contribution rate of these nine nature reserves was 81.98%. Fifty-four TMVPs were distributed outside of national nature reserves, while mainly distributed within 10 hotspot counties including Badong county, Hubei province, Sangzhi county, Hunan province, Jianghua Yao Autonomous county, Hunan province and so on. In general, TMVPs are well protected by the national nature reserves in central China. However, there are still some conservation gaps. It is necessary to carry out further field investigation on the species with conservation gaps and identify the gap areas, so as to provide scientific guidance for the optimization of the conservation of TMVPs in this region.

Analysis on international trade competitiveness of licorice extract / 中草药

Licorice extract has the efficacy of anti-inflammatory, anti-viral, anti-oxidation and anti-aging. It is widely used in the pharmaceutical, food and cosmetic industries. This paper analyzes the status of licorice extract’s global trade and its international competitiveness. The main purpose is to clarify the status of our country’s licorice extract in the international market and provide reference for improving the international competitive advantage of licorice extract of China. Germany, the United States, Netherlands, France, Japan, Israel and China were the main import and export countries for licorice extract. The international market share (IMS), trade competitiveness index (TC Index), revealed comparative advantage index (RCA Index) and competitive advantage index (CA Index) were used to compare the licorice extract’s international competitiveness of these countries. It showed that Israel has the strongest international competitiveness and followed by France. The United States has the maximum IMS, but its competitiveness was on sagging tendency. Germany and the Netherlands are the major importers of licorice extract. Although they are lack of international competitiveness, its international competitiveness is on the rise, especially in Germany. China’s licorice extract has a high IMS, but its international trade competitiveness is weak, far lower than the United States and France. Japan was the basic export country of China’s licorice extract. The TC index and CA index of licorice extract in Japan are less than zero, which means Japan’s licorice extract is not competitive.

Analysis of monitoring results of coal-burning-borne arsenic poisoning in Xiangyang City, Hubei Province from 2014 to 2018 / 中华地方病学杂志

Objective:To analyze the monitoring results of coal-burning-borne arsenic poisoning in Xiangyang City, Hubei Province from 2014 to 2018.Methods:In 2014-2018, according to "the Monitoring Plan for Coal-burning-borne Endemic Arsenic Poisoning in Hubei Province", five villages in Xiangyang City were selected as monitoring sites every year. Coal samples from 8 households were collected by four-point method after multi-point sampling and mixing in each site every year, coal arsenic content was detected. Urine samples of 10 adults (half male and half female) were collected to detect the arsenic content in urine. The disease condition of residents with coal-burning-borne arsenic poisoning was surveyed.Results:From 2014 to 2018, there was a significant difference in coal arsenic content ( F=21.572, P < 0.05), and the coal arsenic content in 2018 was significantly lower than those in other years ( P < 0.05); there was no significant difference in arsenic content in adult urine (χ 2=1.647, P > 0.05). During the past five years, 266 suspected cases, 736 mild cases, 633 moderate cases and 18 severe cases were detected. There was no significant difference in the detection rates of arsenic poisoning among different years (χ 2=1.094, P > 0.05). Conclusions:The detection rate of coal-burning-borne arsenic poisoning in Xiangyang City from 2014 to 2018 is relatively stable, and the management of high arsenic coal has achieved initial results. It is necessary to further strengthen disease monitoring, energy diversification transformation and health education of residents, so as to further improve the prevention and management mechanism of coal-burning-borne arsenic poisoning.

Research on protection mode of Dao-di herbs-taking the protection mode of geographical indications as an example / 中国中药杂志

Dao-di herbs have been synonymous with quality medicinal herbs in our mind hearts since ancient times and are the essence of Chinese medicine culture. The development of genuine regional herbs faces problems such as insufficient supply of local resources and lack of competitive advantages. It is necessary to seek a suitable model to protect and develop authentic medicinal materials. The protection mode of geographical indication products has become more mature. Geographical indication(GI) products and authentic medicinal materials are all related to the origin. There is certain commonality between them. However, there are also differences between authentic Chinese herbal medicines and geographical indications, and it is unsuitable to simply equate the authentic Chinese medicinal materials with GI products. This article comprehensively combs and compares the development of the authentic Chinese herbal medicines and geographical indication products, and believes that it is necessary to fully learn from the experience of GI products and combine the characteristics of authentic medicinal materials to establish a set of protection systems that meet the characteristics of authentic medicinal materials. Through this research, it has positive significance to promote the protection and management of authentic medicinal materials.

Research on competitiveness of traditional Chinese medicine industry's international trade based on diamond theory / 中国中药杂志

China has a long history of the international trade of traditional Chinese medicine(TCM).And the export products mainly composed of Chinese herbal medicine and its extracts with Chinese patent herbal medicine and health care products as complementary items.The international trade of TCM faces problems of structural disequilibrium in export products and trade barriers.In this study,we used Michael Porter's diamond model to analyze the international competitiveness of TCM industry.We found that TCM industry in China was rich in production factors and broad in market demands,but lack of the related and supporting industries.In addition,compared with the herbal medicine manufacturers in European,American and Japanese,enterprises in China were weaker in the strategy making,market positioning and industry competing.The development of the international market of herbal medicine,the arrival of the aging society,and the introduced policies of the TCM,provide great opportunities for TCM industry' s development.In order to improve the competitiveness of the TCM industry,we propose to increase the international recognition of TCM by developing clinical study,cope with international trade barrier by strengthen international standardization research,and improve the competitiveness of TCM industry by economies of scale formed by the accumulation of the pharmaceutical industry.

Analysis of characteristics and problems of international trade of Poria cocos in China / 中国中药杂志

Poria cocos is one of medical materials frequently used in China and well marketed at home and abroad. Based on the analysis of exports and imports data of P. cocos, we found that large proportions of P. cocos were exported, while only a small proportions of those were imported in China between 2011 and 2016. During periods of these six years, the annual exporting trade of P. cocos in quantity significantly decreased, but that in dollars tend to increase slightly and the unit-prices of P. cocos significantly increased. Statistically, the average annual export trade of P. cocos from 2011 to 2016 in quantity and dollars were 9 279.73 tons and 35.454 million dollars, respectively. And the average annual export in unit-price was 4.14 dollars per kilogram. In total, P. cocos came from 29 provinces and exported to 44 countries through 21 ports. More than 98% of total exports of P. cocos were flew to the markets of countries in Asia, of which Hong Kong was the major partner in import trade of P. cocos. Large amount of P. cocos came from Guangdong province and exported mainly through Shenzhen port. Except the exports, China also imports P. cocos from other countries, among which Korea was the major country exports largest amount of P. cocos to China. And most of P. cocos were imported by Jilin province and mainly through Changchun port. To improve the export kinetic, quality and profits of P. cocos, and thus enhance the international competitiveness of the industry of P. cocos, Chinese governments should emphasize the researches on the products of P. cocos, broaden the demand space of the high-end customers, stimulate the high-end market grow in high speed and accelerate the process of standardization in future.

Association between exposure to organophosphate pesticides and levels of oxidative stress in pregnant women with different paraoxonase 1 genotypes / 上海交通大学学报（医学版）

Objective·To investigate whether paraoxonase 1 (PON1) genotypes were effect modifiers in the relationship between exposure to organophosphate pesticides (Ops) and oxidative stress level in pregnant women.Methods · A total of 204 pregnant women recruited from a hospital in Shandong Province were included in the study.Four nonspecific dialkyl phosphate (DAP) metabolites of Ops were measured in each urine sample.Levels of two oxidative stress biomarkers [total free sulfhydryl (-SH) and malondialdehyde (MDA)] were measured in serum samples.Blood samples were also analyzed for detecting PON1 genotypes (PONI-108,PON1192 and PON155).Separate linear regression models were conducted to explore the relationship between DAP metabolite levels and oxidative stress levels in all 204 pregnant women or women within each PON1 genotype.Results· There was no significant association between DAP metabolite levels and oxidative stress levels in all 204 women.Levels of dimethyl phosphates [β (95％ CI):-104.10 (-191.31,-16.88)] and dialkyl phosphates [f (95％ CI):-111.78 (-221.84,-1.72)] were negatively associated with-SH level among pregnant women with PON1192RR genotype,but this association was not found among women with other genotypes.Conclusion· OP exposure may be associated with a higher oxidative stress level among pregnant women with PONI192RR genotype.

Novel mutations in the USH2A gene in a family affected with Usher syndrome type 2 / 中华眼底病杂志

Objective To identify the pathogenic genes and mutations in a family with Usher syndrome type 2.Methods A three-generation family including 7 individuals was enrolled in this study.There were 2 male patients and 5 unaffected individuals.All participants was underwent related ophthalmologic examination,including best corrected visual acuity,slit-lamp,indirect ophthalmoscopy,electroretinogram (ERG),optical coherence tomography and visual field test.DNA was extracted from 3 ml peripheral venous blood of all participants.A total of 136 hereditary retinal disease target genes were screened and the DNA sequence was performed by Next-generation sequence analysis.Then the suspected mutations compared with databases to identify the suspected mutations,which should be verified with non-affected family members and 100 normal subjects by PCR and Sanger sequence.Results The sequence result showed that 2 patients,the proband and his brother,carried complex heterozygous mutations in the USH2A gene:c.5459T＞C (p.M1820T) in exon 27,c.802G ＞A (p.G268R) in exon 5 and c.1190T＞A (p.I397K) in exon 7.The c.5459T ＞ C and c.1190T ＞A mutations in USH2A have not been reported in the literature and database.Although their mother carried c.5459T＞C (p.M1820T) and c.802G＞A (p.G268R),and their father carried c.1190T＞A (p.I397K) heterozygous mutations,the parents did not present phenotype.These mutations were not detected in other normal family members.The result was supported by co-segregation analysis.Conclusion The heterozygous mutations c.5459T＞C (p.M1820T),c.1190T＞A (p.I397K) and c.802G＞A (p.G268R) in USH2A gene cause Usher syndrome in this family.

Clinical study on the perioperative psychological intervention and intraoperative perfusion of total saponins in patients with breast hematoma and skin stasis after operation / 中国生化药物杂志

Objective To study the clinical treatment effect of intraoperative perfusion of Panax notoginseng saponins on the postoperative mammary gland hematoma and skin ecchymosis. Methods A total of 100 patients who underwent breast minimally invasive surgery from August 2015 to May 2016 in Wenling First People's Hospital were randomly divided into control group and experimental group 50 cases in each group.The control group underwent intraoperative perfusion of Panax notoginseng saponin,on the basis of this, the experimental group were given psychological intervention, pay attention to the psychological state of the patients, strengthen the communication and exchanges with the patients, increased the patient's treatment confidence and treatment compliance. The clinical indicators of the experimental group and the control group were compared. Results After the corresponding treatment, the incidence of postoperative hematoma in the experimental group (4.0%) was significantly lower than in the control group (12.0%), the difference was statistically significant (P<0.05). The probability of skin staining in control group (26.0%) was significantly higher than that in the experimental group (8.0%), the difference was statistically significant (P<0.05). Conclusion Breast minimally invasive biopsy perioperative psychological intervention, intraoperative perfusion of panax notoginseng saponins can reduce the incidence of postoperative mammary gland hematoma, skin ecchymosis.

Clinical study on the perioperative psychological intervention and intraoperative perfusion of total saponins in patients with breast hematoma and skin stasis after operation / 中国生化药物杂志

Objective To study the clinical treatment effect of intraoperative perfusion of Panax notoginseng saponins on the postoperative mammary gland hematoma and skin ecchymosis. Methods A total of 100 patients who underwent breast minimally invasive surgery from August 2015 to May 2016 in Wenling First People's Hospital were randomly divided into control group and experimental group 50 cases in each group.The control group underwent intraoperative perfusion of Panax notoginseng saponin,on the basis of this, the experimental group were given psychological intervention, pay attention to the psychological state of the patients, strengthen the communication and exchanges with the patients, increased the patient's treatment confidence and treatment compliance. The clinical indicators of the experimental group and the control group were compared. Results After the corresponding treatment, the incidence of postoperative hematoma in the experimental group (4.0%) was significantly lower than in the control group (12.0%), the difference was statistically significant (P<0.05). The probability of skin staining in control group (26.0%) was significantly higher than that in the experimental group (8.0%), the difference was statistically significant (P<0.05). Conclusion Breast minimally invasive biopsy perioperative psychological intervention, intraoperative perfusion of panax notoginseng saponins can reduce the incidence of postoperative mammary gland hematoma, skin ecchymosis.

Design and implementation of real-time control of changes to national Chinese medicine resources fill system based on GIS / 中国中药杂志

The dynamic monitoring data of traditional Chinese medicine resources is one of the important tasks of the dynamic monitoring system of Chinese medicine resources,the system has formed a periodic monitoring data reporting mechanism. Data authenticity and accuracy are the basis for the sustainable and healthy development of Chinese medicine resources dynamic monitoring,information technology is an effective means to improve the efficiency of data reporting, reporting quality. Data production based on dynamic monitoring is of great significance for grasp the trend of change and development of Chinese medicine resources. In order to achieve the real-time control of changes to the national Chinese medicine resources, we build the Chinese medicine resources dynamic monitoring system. In order to solve the problems in practice, we have upgraded the fill system by using the data of GIS. In order to achieve the multidimensional, improve safety, practicality and standardization of the data, which laid a foundation for subsequent processing of data. The system can collect the information of the cultivation of Chinese herbal medicines,production and sales of daily reporting data, provide the Chinese herbal medicine market,fast growing industry environment such as positioning center. In this paper, the design and implementation of the system are expounded.According to the business requirements, we designed 12 forms, 98 collection indicators to meet the needs of dynamic monitoring of traditional Chinese medicine resources. This paper will introduce the development content, design and implementation, main function characteristics and application effect of the national Chinese medicine resources fill System. To explain the role that GIS technology plays in the system and how to realize the cultivation of Chinese herbal medicines, production and sales of daily reporting data, provide the Chinese herbal medicine market,fast growing industry environment such as positioning center,and information collecting.

Status of traditional Chinese medicine materials seed and seedling breeding bases / 中国中药杂志

Seeds and seedlings are the material basis of traditional Chinese medicine materials production, and the construction of traditional Chinese medicine materials seed and seedling breeding bases is beneficial to the production of high-quality traditional Chinese medicine materials. The construction of traditional Chinese medicine materials seed and seedling breeding bases is one of the major topics of Chinese medica resources census pilot. Targets, tasks of traditional Chinese medicine materials seed and seedling breeding bases based on Chinese medica resources census pilot were expounded.Construction progress including hardware construction, germplasm conservation and breeding, procedures and standardsestablishment, social servicesare presented. Development counter measures were proposed for the next step: perfect the standard and system, maintain and strengthen the breeding function, strengthen the cultivation of multi-level talents, explore market development model, joint efforts to deepen services and development.

Intestinal absorption of Ginseng Radix et Rhizoma extract combined with Acori Tatarinowii Rhizoma in rats / 中国中药杂志

To investigate the changes in intestinal absorption of ginsenosides Rg₁, ginsenosides Re and ginsenosides Rd after combined administration of Ginseng Radix et Rhizoma extract and Acori Tatarinowii Rhizoma, in order to confirm whether the combined administration is scientific and rational, and provide experimental basis for pharmaceutical studies of the formula. An in vivo single-pass perfusion method was performed to study the effect of various concentrations of ginsenosides Rg₁, ginsenosides Re, ginsenosides Rd on the intestinal absorption at duodenum, jejunum, ileum and colon. The concentrations of ginsenosides Rg₁, ginsenosides Re, ginsenosides Rd were determined by RP-HPLC.The absorption rate constant (Ka) and the apparent absorption coefficient(Papp) of ginsenosides Rg₁, ginsenosides Re, ginsenosides Rd were calculated.The result showed that ginsenosides Rg₁, ginsenosides Re, ginsenosides Rd had a high absorption rate on upper portion of the small intestine. The drug concentration had not significantly impact on the absorption rate, suggesting that ginsenosides Rg₁, ginsenosides Re, ginsenosides Rd were absorbed via passive diffusion.Volatile oil of Acori Tatarinowii Rhizoma had obvious effect in enhancing intestinal absorption of ginsenosides Rg₁, ginsenosides Re, ginsenosides Rd, indicating that the combined administration of Ginseng extract and Acorus tatarinowii Schott is scientific and rational.

Discussion of price forecasting of Notoginseng Radix et Rhizoma based on ARIMA model / 中国中药杂志

Based on the analysis of price fluctuations on Notoginseng Radix et Rhizoma, this paper takes advantage of the price data of Notoginseng Radix et Rhizoma which specification is 120 from January 2004 to August 2015, using autoregressive integrated moving average model [ARIMA (p, d, q)] forecasting the price of Notoginseng Radix et Rhizoma from September 2015 to August 2016. In the process of determining the form of model, the stability test used to determine the model of p, and the autocorrelation function and particles autocorrelation functions to identify the p and q of model. According to test the model, the forecast minimum error model was identified. In this paper, ARIMA (2,1,3) model was used to predict next year's price of Notoginseng Radix et Rhizoma, for providing information for Notoginseng Radix et Rhizoma growers, pharmaceutical companies.

Interpretation and Use of Natriuretic Peptides in Non-Congestive Heart Failure Settings

Natriuretic peptides (NPs) have been found to be useful markers in differentiating acute dyspneic patients presenting to the emergency department (ED) and emerged as potent prognostic markers for patients with congestive heart failure (CHF). The best-established and widely used clinical application of BNP and NT-proBNP testing is for the emergent diagnosis of CHF in patients presenting with acute dyspnea. Nevertheless, elevated NPs levels can be found in many circumstances involving left ventricular (LV) dysfunction or hypertrophy; right ventricular (RV) dysfunction secondary to pulmonary diseases; cardiac inflammatory or infectious diseases; endocrinology diseases and high output status without decreased LV ejection fraction. Even in the absence of significant clinical evidence of volume overload or LV dysfunction, markedly elevated NP levels can be found in patients with multiple comorbidities with a certain degree of prognostic value. Potential clinical applications of NPs are expanded accompanied by emerging reports regarding screening the presence of secondary cardiac dysfunction; monitoring the therapeutic responses, risk stratifications and providing prognostic values in many settings. Clinicians need to have expanded knowledge regarding the interpretation of elevated NPs levels and potential clinical applications of NPs. Clinicians should recognize that currently the only reasonable application for routine practice is limited to differentiation of acute dyspnea, rule-out-diagnostic-tests, monitoring of therapeutic responses and prognosis of acute or decompensated CHF. The rationales as well the potential applications of NPs in these settings are discussed in this review article.