Objective To investigate the prevalence and severity of malnutrition in patients with stable chronic obstructive pulmonary disease (COPD) , analyze serum levels of myostatin, tumor necrosis factor alpha (TNFα) and C reactive protein (CRP) , and investigate the relationship between serum myostatin and malnutrition in COPD. Methods Seventy-one patients with stable COPD and 60 age-matched healthy volunteers were recruited in this study. Pulmonary function was tested in all of the subjects and the severity of malnutrition was evaluated by a multiple-parameter malnutritional index (MNI). Based on the MNI scores, patients with COPD were divided into group Ⅰ (MNI≥5 score) and group Ⅱ (MNI ＜ 5 score) , the former represents the patients with severe or very severe malnutrition while the latter represents the patients with mild or without malnutrition. Serum concentration of myostatin, TNFα and CRP were measured by enzyme-linked immunosorbent assay. Results The MNI score was significantly elevated in patients with COPD [(7. 75 ±3. 86)score] compared with the controls [(1. 13 ±0. 96)score; P＜0.001],and 55 patients (77%) in COPD group Ⅰ showed MNI ≥ 5 (9. 30 ± 3. 01) score. Serum myostatin concentration was significantly elevated in COPD group Ⅰ [(12. 18 ±4. 76)μg/L] than in COPD group Ⅱ [(9. 73 ±2.85) μgL] and controls [(7.93 ±2.35) μg/L], with each P ＜ 0.001. Serum TNFα concentration was also significantly elevated in patients with COPD compared with the controls (P ＜ 0. 001).Pearson correlation analysis showed that serum myostatin levels were significantly correlated with MNI scores (r = 0. 438, P - 0. 000) and TNFa levels (r = 0. 234, P = 0. 041) in COPD group (combined group I and Ⅱ) while MNI scores were correlated inversely with BMI in COPD group (r = - 0. 530, P = 0. 000) . After stratified with subgroups, the correlation between myostatin levels and MNI scores was more significant and the correlation coefficient was higher (r =0.464, P =0.000) in COPD group I patients. Moreover,myostatin levels were inversely correlated with BMI (r = - 0. 287, P = 0. 034) and forced expiratory volume in one second of the predicted value (r = - 0. 264, P = 0. 049) in COPD group I patients. Conclusions Malnutrition commonly and substantially exists in patients with COPD; serum myostatin concentration is significantly elevated and is correlated with the severity of malnutrition in the patients. The elevation of serum myostatin may contribute to malnutrition in COPD patients.

Objective Backgrounds and Objectives Skeletal muscle dysfunction is an important systemic manifestation of several diseases such as chronic obstructive pulmonary disease and chronic heart failure.Quadriceps function assessment was used in majority of the studies for assessment of peripheral skeletal muscle function as it is readily accessible and is a primary locomotor muscle.Appropriate evaluation of the prevalence and severity of quadriceps dysfunction relies on the proper control data from the age-matched normal subject.So,the present study was aimed to measure the quadriceps function in healthy elderly,to investigate the multiple factors related to quadriceps functions,and to establish the normal ranges for quadriceps functional performance in healthy elderly.Methods Sixty healthy volunteers were recruited for the study.Quadriceps function was assessed by measurement of the following 3 items:maximum of twitch tension (TwQmax) induced by magnetic stimulation of femoral nerve,maximal volitional contraction (QMVC),and endurance time.The intensity and frequency of quadriceps exercises were quantified with physical activity (PA) scores by using a special PA questionnaire.Anthropometric measurements such as height,weight and mid-thigh muscle mass (MTMC) were measured in all of the subjects.Multiple regression models were developed by stepwise method to determine the independent factors respectively contributing to the quadriceps functional performance.Results Quadriceps functional tests results showed that the data of the three items fit normal distributions in both female and male subjects,and the gendcr-related difference was observed in quadriceps strength,with TwQmax and QMVC being significantly decreased in female than in male subjects.The mean values and normal ranges for TwQmax,QMVC,and endurance time were [13.86(10.53-17.65)] kg,[42.06(34.45-49.67)] kg,and [81.08(58.52-103.66)] second,respectively,in male subjects; and they were [7.41(6.02-9.52)] kg,and [29.40(24.66-33.82)] kg,and [83.44 (60.81-106.67)] second,respectively,in female subjects.Stepwise regression correlation analysis showed that QMVC was related with sex,PA scores and weight (R2=0.61,P＜0.01) ; endurance time was predicted by PA scores,MTMC,body weight and sex (R2 =0.58,P ＜0.01) ; and TwQmax was predicted by sex,height and PA scores (R2 =0.67,P＜0.01).Conclusions Our study results demonstrate that quadriceps functional performance fits normal distributions in healthy elderly,and that quadriceps function is related to multiple factors such as subjects' sex,muscles exercises,weight,height,muscle mass,and etc,with muscles exercises being the most significant one,except of gender.We conclude that muscles exercises take a very important role in muscles functional performance in healthy elderly.

Objective To establish an automated spectrophotometic assay for serum total and free L-carnitine with enzymatic method(CAT-BTND). Methods To optimize the reaction conditions of hydrolysis,pH and L-carnitine Acetyl-transferase (CAT)concentration in the assay,to evalute the assay method and to measure the serum L-carnitine of health adults ( n =63) and children ( n =56). Results The calibration curve for L-carnitine was linear between 4 81 and 150 ?mol/L( r =0 999).The inter and intra average CV were 5 52% and 5 90% in free carnitine,5 78% and 6 14% in octanoylcarnitine.The mean recovery rate was 98 5% and 98 4% respectively.This method was free from interference by bilirubin(≤120 ?mol/L),hemoglobin(≤7 g/L),and ascorbate(≤500 ?mol/L).Total and free carnitine and acylcarnitine reference range: adults (48 5?17 7) ?mol/L , (39 2?14 2) ?mol/L and (9 3?5 3) ?mol/L(male, n =32),(42 7?17 3) ?mol/L, (32 4?18 0) ?mol/L and (10 5?5 5) ?mol/L respectively(female, n =31).Children (age between 9～12 years old) (57 3?19 3) ?mol/L , (45 1?14 4) ?mol/L and (12 3?10 4) ?mol/L(male, n =31), (59 4?15 7) ?mol/L, (46 6?12 6) ?mol/L and (12 8?7 8) ?mol/L respectively(female, n =25). Conclusion The procedure is rapid,accurate and automatable,and could be used to diagnose L-carnitine deficiency,and to estimate and monitor the effect of treatments.

Education should include two parts:teaching and learning.Therefore,during the course of medical ehtics teaching,if we want to get better teaching effect,besides the factor of teachers,we must make the students get interest in the studying of medical ethics and arouse the students' initiative and enthusiasm of studying.This thesis would discuss that in the following respects:enhancing the students'initiative and enthusiasm of studying;teacher's deep love for education enterprise and for students;person of exemplary virtue,example is better than precept;performing elicitation teaching method of developing the student's initiative and strictly avoiding cramming method of teaching

Objective To evaluate an agarose gel electrophoresis for quantitative determination of Lipoprotein(a) cholesterol and its clinical application.Methods Quantification of LP(a)-C was performed by a new agarose gel electrophoresis method that allows the separation of LP(a) by Hellen REP system and the determination of LP(a)-C by enzymatic staining of cholesterol,The results of electrophoresis method were compared with the ones of INA and ITA. The specimens of 135 health men were assayed by electrophoresis for the reference range.Results The inter and intra CV of electrophoresis method at low, middle and high LP(a) concentration specimens were 4.7%～5.3% and 5.8%～6.4%. The linearity was 0.058～1.55 mmol/L. Interference with bilirubin (

BACKGROUND: Triiodothyronine (T3) is an important regulation factor at the critical period of brain development. It maybe control the successive differentiation during the development of central nervous system (CNS).OBJECTIVE: To monitor the differentiation of neural stem cells (NSCs) induced by T3 and the thyroid hormone receptor (TR) mRNA expression changes.DESIGN: Open experiment.SETTING: Department of Pathology, Tianjin Medical College of Chinese People's Armed Police Force; Institute of Endocrinology of Tianjin Medical University.MATERIALS: This study was carried out in the Tianjin Medical University between January 2003 and March 2005.Ten-to-twelve-week-old aborted fetuses were obtained from the General Hospital of Tianjin Medical University with the approval of the local ethical committee. Informed consents were obtained from the mothers and their relatives.METHODS: ①Under the aseptic condition, the bilateral cortex of human fetal brain was removed and dissociated by brief mechanical trituration in D-Hanks. Then, 20 μg/L bFGF and 30 nmol/L T3 were used to induce the proliferation of NSCs and inoculated to poly-L-lysine-coated 24-well plate and 25 mL culture flask for routine culture at 1 ×109 L-1. The culture medium was DMEM/F12 serum-free complemented with N2. Half of the culture medium was changed every 48 hours.Seven days later, bFGF was discarded, only T3 was used for induction and differentiation. ② At 1, 2 and 3 weeks of culture, cells were collected, and RT-PCR was semiquantitatively used to detect TR mRNA expression changes at different stages of differentiation of NSCs. Isoforms were identified by immuocytochemistry.MAIN OUTCOME MEASURES: ①Cellular morphology observation and isoforms identification before and after differentiation of NSCs induced by T3. ② TR mRNA expression changes during the differentiation of NSCs.RESULTS: ①The hNSCs were round and had a smooth surface and gradually gathered to neurospheres. The proliferative hNSCs were nestin-positive and incorporated BrdU. When NSCs were induced by T3 for one week, most of the cells took on monopole or double poles, and had long and thin processes. The differentiated cells were neurofilament protein (NFP)-positive, galactocerebroside (GC)-positive or glial fibrillary acidic protein (GFAP)-positive. When NSCs were induced by T3 for three weeks, most of the cells were big, with unclear cell membrane, round nucleus, many thick processes which had many branches. The spider-like cells were scattered, and 80% of the cells were myelin basic protein-positive. ② TRα1 mRNA expression level was the highest before inducing NSCs. With the induction of T3, the expression level was decreased gradually, and was the lowest at 2 weeks, and then was rebounded gradually, but the final level was still lower than that of NSC (F =32.49, P =0.008). The tendency of TRα2 mRNA expression alteration was identical with that of TRα1 mRNA. TRβ1 mRNA expression level was the lowest in NSC, was increased gradually with the induction of T3 and attained the highest level at 2 weeks of induction of T3. Furthermore, the expression level of TRβ1 mRNA was also higher than that of TRα1 at the same time (t =15.64,P =0.001), and it reached the lowest level at 3 weeks of the induction. TRα3 expression level was firstly decreased after the differentiation induced by T3, and was close to the expression level of NSC at 2 weeks of induction (F =51.94, P =0.378), then was decreased to lower lever.CONCLUSION: T3 can induce NSC to differentiate into neurons, oligodendrocyte and astrocytes. TR mRNAs are expressed in different time intervals during the differentiation of NSCs.

Objective:To identify a suitable biomarker for early diagnosis and prognosis of Candida albicans pneumonia ( CAP) ,we investigated the expression of several biomarkers,such as soluble triggering receptor expressed on myeloid cells-1 ( sTREM-1),soluble hemoglobin-haptoglobin scavenger receptor (sCD163),C-reactive protein (CRP),and procalcitonin (PCT),in rabbits with CAP. Methods:A rabbit model was established after immunosuppression of 40 rabbits,randomly divided into 2 groups of 20 each. The experimental group received 1 ml injection of 5×107 cfu/ml C. albicans solution via percutaneous tracheal puncture,while the control group received normal saline. Rabbit blood samples were collected on days 2,3,4,5,6 and 9 post-inoculation and examined for levels of sTREM-1,sCD163,CRP,PCT,interleukin-6 (IL-6),IL-8,IL-10 and tumor necrosis factor-α (TNF-α). Other tests included routine blood examination,arterial blood gas test,chest thin-layer computed tomography on days 3 and 9 post-inoculation,lung tissue biopsy, and blood culture to confirm C. albicans infection. Results:The levels of sTREM-1,SCD163,PCT,and TNF-αwere higher in the exper-imental group as compared to control. Additionally,sTREM-1 and CRP indices showed an upward trend during 9 days of observation period in the experimental group,while others showed a short-term increase after inoculation and then declined gradually. Areas under the receiver operating characteristic curve for CAP diagnosis were calculated as 0. 882,0. 814,0. 685 and 0. 55 for sTREM-1,SCD163, PCT and CRP,respectively. Conclusion: The diagnostic value of biomarkers,sTREM-1 and SCD163,is superior to that of CRP and PCT in the diagnosis of CAP.

BACKGROUND:Human umbilical cord mesenchymal stem cel s belong to a special class of stem cel s with a limited number, which are difficult to isolate and purify. Importantly, there is a lack of clinical understanding of biological characteristics of human umbilical cord mesenchymal stem cel s. OBJECTIVE:To study the bioactive properties and cardiomyocyte-like differentiation of human umbilical cord mesenchymal stem cel s. METHODS:Under a sterile col ection, umbilical cord blood of newborn from cesarean section was col ected to isolate human mesenchymal stem cel s by digestion using col agenase II. Immunohistochemical staining was used to detect cel surface markers and observe morphological characteristics, and MTT assay used to detect cel proliferation and draw cel growth curve. Cel s grown to 70%-80%confluence were treated with 10μmol/L 5-azacytidine for 24 hours. RESULTS AND CONCLUSION:One week after adherent tissue culture, human umbilical cord mesenchymal stem cel s were seen, and then the cel s cultured in culture medium showed colony growth. Within 24 hours of cel seeding, cel s at passages 3 and 10 were at latency period and then grew logarithmical y with a doubling time of 30 hours. Immunocytochemical staining showed that passage 3 cel s at over 90%confluence expressed CD44 and CD29, rather than CD28 and CD31.Three weeks after induced culture, the cel s with the absence of processes grew irregularly;after 4 weeks, the cel s were round in shape and expressed cardiac-specific immune markers. Taken together, isolated human umbilical cord mesenchymal stem cel s with strong proliferative ability have the basic biological characteristics of mesenchymal stem cel s, which are capable of differentiating into cardiomyocyte-like cel s induced by 5-azacytidine.

Objective To evaluate the effectiveness of melformin sustained release tablets in treatment of patients with abnormal glucose tolerance. Methods 78 cases with abnormal glucose tolerances were selected and divided into two groups. Patients in treatment group took melformin sustained release tablets, while patients in control group took normal therapy. The impaired glucose tolerance (IGT) and body mass index (BMI) were observed and compared. Results The blood glucose level of OGTT 2 h in treatment group was (7.61±1.04)mmol/L, while it was only (9.96±1.08) mmol/L in control group. The BMI of treatment group was 23.71±3.41, while it was 29.53±3.72 in control group. The glycosylated hemoglobin was (5.79±0.41)%, while it was (6.23±0.52)%in control group. The fasting blood glucose in treatment group was (5.34±0.39)mmol/L and in control group was (8.16±0.48)mmol/L. The differences of those indicators between two groups were signiifcant. Conclusion Melformin gains excellent clinical effects in treating patients with abnormal glucose tolerance. It can adjust blood glucose, improve glucose tolerance, and decrease blood glucose level of OGTT 2 h and BMI effectively.

Objective: To study the amount of fat, cholesterol and fatty acid intake in China and provide the basic material for dietary guidance. Methods: Two areas were selected both in North and South China and each area included 3 provinces, or municipality or autonomous region. Three representative survey sites were selected in each province, or municipality or autonomous region. Dietary survey was conducted by the method of weighing and recording and cooking method was also recorded. The amount of food consumption was calculated as standard person (adult male, light physical activity). All foods were gathered as 12 kinds of foods, and each kind of food was cooked and then mixed. The content of fat and fatty acid was analyzed for 8 kinds of foods and the content of cholesterol was analyzed for 4 kinds of foods. The intake of fat, fatty acid and cholesterol per capita was calculated. Results: The amount of fat intake among North I, North II, South I, South II was 70.5 g, 46.5 g, 58.7 g, 71.0 g respectively and the amount of cholesterol intake was 329.6 mg, 128.5 mg, 400.9 mg, 306.0 mg respectively. The main source of dietary fat was from meat and vegetables. Egg was the main source of dietary cholesterol and meat and egg were both the main source of dietary cholesterol in south II area. About 90% of saturated fatty acid was palmitic acid and stearic acid and 90% of monounsaturated fatty acid was oleic acid. Linoleic acid was the principal n-6 polyunsaturated fatty acid and linolenic acid was the principal n-3 polyunsaturated fatty acid. The ratio of S∶M∶P in North I was 1∶1.1∶1, in North II was 1∶1.6∶1.3, in South I was 1∶1.6∶1.3 and in South II was 1∶1.5∶1. Conclusion: The amount of fat intake and fatty acid profile was quite different among different areas and the dietary guidance should be more pertinent The current cholesterol intake was more than dietary guidance in most areas. In addition to egg, meat was also an important source of cholesterol.