The purpose was to helps and inspire clinical research beginners on how to identify research directions and topics that are linked with clinical work.Based on a research project,this paper reviewed how the author started the ideas of the research,selected and set research directions,and established specific goals.

Parkland formula is the most widely used resuscitation formula in burn care. However, a growing number of disputes have been raised along with the development of medical technology, among which its total volume and composition of the fluid are the two foci. Firstly, Parkland formula may lead to an untoward phenomenon nicknamed "fluid creep", which may lead to complications such as abdominal compartment syndrome. Secondly, along with the deeper understanding of how permeability of blood vessels changes after burn injury, colloid is recommended to be given after the third 8 h post-burn. Additionally, controversy exists in the choice of different colloid solutions. The safety of different colloid solutions remains to be further elucidated. This article will deal with all of the above-mentioned problems.
Burns ; physiopathology ; therapy ; Fluid Therapy ; methods ; Humans ; Isotonic Solutions ; therapeutic use ; Resuscitation ; methods ; Treatment Outcome

Objective To investigate the clinic significance of serum carbohydrate antigen ( CA)125 for cirrhosis. Methods 88 patients with type B posthepatitic cirrhosis (male 46,female 24,average age 45?24 years) were divided into three group (A stage35,B stage 28,C stage 25) according to Child-pugh integration. 36 healthy persons as normal controls were studied(male 20,female 16,average age 42?22 years). Serum CA125 was measured by ELISA. We investigated the alteration of serum CA125 with hepatic functional classification. Results The levels of serum CA125 in cirrhosis patients were markedly higher than those in control subjects(P

AIM: To obtain nerve growth factor subunit ?(NGF ?) gene from Chinese fetal hippocampus tissue, prove its sequence, clone the mature peptide sequence, and make it express in E.coli .METHODS: Total RNA was extracted, amplified by RT-PCR method. Its 650 bp DNA sequence was inserted into PCR Ⅱ vector. PCR/NGF ? vector was used as the template to amplfy the C-terminate mature peptide sequence, then subcloned it into PG5 vector. The recombinant was transferred into E.coli BL21. BL21 was cultured and induced by IPTG. The activity of the expressed product was measured after purified and refolded.RESULTS: A complete cDNA sequence was determined as 1 047 nucleotides. The cloned 636 bp encoding 212 amino acids was proved homological to Genbank by sequence analysis. The expressed mature peptide showed an clear band of the prospected 14 kD by SDS-PAGE electrophoresis, and was testified by Western blot. The expression level was about 10% of the total cell lysate. CONCLUSION: The chinese NGF ? gene was homological to the foreigners'. The recombinant NGF ? was efficiently expressed in E.Coli and the recombinant protein has high immunological activities.

Objective To explore the therapeutic effect of phenylethanoid glycosides on cyclophosphamide (CTX)-induced dyszoospermia in mice and to preliminary elucidate the mechanisms involved in the process. Methods Phenylethanoid glycoside was extracted by ethanol extraction.Forty male BALB/C mice were randomly divided into control group,model group,low dose of phenylethanoid glycosides group (50 mg· kg-1 )and high dose of phenylethanoid glycosides group (100 mg·kg-1 ).Except control group,the dyszoospermia mouse model was established by peritoneal injection of CTX at the daily dose of 80 mg· kg-1 ,once daily for successive 5 d. After modeling, phenylethanoid glycosides were intragastrically administered at corresponding doses to each phenylethanoid glycosides group.Equal volume of normal saline was given to the mice in control group and model group by gastrogavage.All the medication was performed once daily for successive 30 d.The testis tissue was obtained 24 h after the last intragastric administration.The level of testosterone in the testis tissue homogenate was determined by enzyme linked immunosorbent assay.The sperm counts, the motility rates, and the teratospermia rates in various groups were compared.The morphological changes of the testis tissue were observed using HE staining.Results Compared with control group, the sperm count and the motility rate were decreased, the teratospermia rate was increased,and the testosterone level in the testis tissue homogenate was decreased in model group(P<0.01).Compared with model group,the sperm counts and the motility rates were increased,the teratospermia rates were decreased, and the testosterore levels in the testis tissue homogenate were increased in phenylethanoid glycosides groups (P<0.05 or P<0.01).The histological results showed atrophy and degeneration of seminiferous tuble,thicker seminiferous epithelium and azoospermic lumina in model group;the number of seminiferous epithelial layers was increased and the seminiferous cells orderly arranged, and many sperms were found in the tubules in phenylethanoid glycosides groups.Conclusion Phenylethanoid glycosides has obviously therapeutical effect on CTX-induced dyszoospermia in mice,and its mechanisms might be correlated with recovering the testosterone level.

AIM: To establish a fluorogenic quantitative polymerase chain reaction (FQ-PCR) method for the routine examination of c-erbB-2 gene expression in breast cancer. METHODS: The c-erbB-2 standard gene was obtained by in vitro amplification of cloned c-erbB-2 fragment in plasmid PGEM-T easy vector. FQ-PCR product was detected by using a 7700 ABI PRISM sequence detector system and c-erbB-2 standard curve was obtained to quantity c-erbB-2 in unknown samples. RESULTS: “S” kinetics curve of FQ-PCR amplification was generated by relating the fluorescence signal intensity (△Rn) to the cycle number. The standard curve of c-erbB-2 was constructed by the linear relationship between the cycle threshold (ct) and the log of starting copy number. The high correlation (0.999) revealed the reliability of FQ-PCR. CONCLUSION: The FQ-PCR is a rapid, sensitive, reliable method for quantity of c-erbB-2 gene expression.

ObjectiveTo evaluate the efficacy and safety of hydroxychloroquine(HCQ) in pregnant patients with systemic lupus erythematosus (SLE).Methods Twenty-four pregnant patients with SLE treated with HCQ during pregnancy from May,2006 to February,2011 were studied retrospectively.All babies were followed up during early infancy for growth development.ResultsOf them,22 patients were treated with HCQ throughout the whole pregnancy with no lupus flare occurred in 21 patients (95.4％),while temporary discontinuation of HCQ precipitated a flare of disease in two patients.Three patients ( 12.5％ ) had premature delivery,and pregnancy induced hypertension happened in 3 patients (12.5％ ).No congenital abnormalities occurred and mean follow-up of 26 months ( range 1 - 47 months) revealed no abnormalities in these children.Conclusion Our findings reinforce the safety of HCQ therapy during pregancy and HCQ should probably be maintained throughout the pregancy in patients with SLE.

Objective To investigate the characteristics and related risk factors associated with tuberculosis(TB) in patients with systemic lupus erythematosus (SLE) who received glucocorticoid and immunosuppressive therapy. Methods Among the 452 SLE patients underwent the treatment of glucocorticoid and immunosuppressive agent, the clinical data was reviewed and summarized retrospectively.Results 42 of 452(9.29% ) patients were diagnosed as TB infection. 11 patients (23.81% )had exudative pulmonary tuberculosis and 31 patients(73.81% ) had extra-plumonary TB. Statistics of the 31 patientsshowed that 8 patients( 19.05% ) had hematogenous disseminated pulmonary tuberculosis;6 (14.29%) had tuberculo-meningitis ;2 (4.76%) had thoracic cavity TB; 2 ( 4.76% ) had abdominal cavity TB; 1 ( 2.38% )had crewels ; 1 ( 2.38% ) had bone tuberculosis and 1 (2.38%) had nephronophthisis. The focus of infection was not found in 10 patients. Of all 42 patients with TB infection, 38 cases suffered form lupus nephritis, 40 with hypoalbuminosis, 10 with TB history, 14 had leucocytopenia or hyperglycaemia, respectively. The effect of antiTB therapy started up at least 7 days, or in 4 weeks as longest. 2 patients died of hematogenous disseminated pulmonary tuberculosis. Conclusion Under the treatment of glucocorticoid and immunosuppressive agent ,TB incidence in patients with SLE is obviously higher than that of common people.Extra-pulmonary rib and serious infection are more frequently. It is shown that those who had lupus nephritis or TB history are more susceptible to TB.

Objective To understand the distribution of clinical departments visited by patients with antineutrophil cytoplasmic antibody associated small vessel vasculitis (ANCA-SVV) to improve physicians' awareness and recognition of its clinical manifestations.Methods Literatures of ANCA-SVV published in Chinese during 1991 to 2001 were retrieved from the compact disks of China Biomedical Literatures.Data from retrieval were analyzed by the clinical departments where the authors worked and the number of patients visited there.Patients with ANCA-SVV hospitalized in China Japan Friendship Hospital during 1997 to May 2002 were analyzed based on the departments they visited and the interval between illness onset to diagnosis established.Results Totally,44 papers about ANCA-SVV published in Chinese during the past 10 years,including 24 case reports,8 short articles and 12 original articles,were retrieved.18 of them were reported by nephrologists with 128 cases,11 by rheumatologists with 46 cases,7 by respiratory physicians with 34 cases,and others of case reports.There were 31 patients with ANCA-SVV hospitalized in China Japan Friendship Hospital during the past five years,11 of them stayed at department of nephrology,8 at department of rheumatology,4 at department of respiratory diseases,3 at department of gerontology,and 2 at department of traditional Chinese medicine.Conclusions Patients with ANCA-SVV,a systematic disease involving multiple organs,could visit varied clinical departments of hospital,and majority of them visited the department of nephrology and then the departments of rheumatology,respiratory diseases and gerontology.

Objective To explore the value of serum SC5b-9, anti-C1q antibody, C3 and C4 levels in the assessment of lupus activity. Methods The enzyme linked immunosorbent assay (ELISA) was used to measure SC5b-9 and anti-C1q antibody, rate nepheiometry was used to detect the serum level of C3 and C4 in sera of 62 SLE patients, 35 patients with other rheumatic diseases (including rheumatoid arthritis, ankylosing spondylitis, primary Sjogren' s syndrome, mixed connective tissue disease, dermatomyositis, polymyositis, systemic sclerosis and vasculitis) and 35 healthy controls. And the correlation between above-mentioned parameters and lupus clinical manifestations, disease activity and histological type of lupus nephritis were analyzed. Results In SLE patients, the levels of SC5b-9 and anti-C1q antibody were significantly higher than those in patients with other rheumatic diseases and healthy controls (P<0.05). The titers of SC5b-9 and anti-C1q antibody negatively correlated with C3 and C4 (P<0.05), and positively correlated with SLEDAI (P<0.05). The sensitivity and specificity of the combination of these three measurements for SLE was 95.37% and 98.46 respectively. SC5b-9 and anti-C1q antibody were associated with the presence of proliferative glomerulonephritis (P <0.05). Conclusion Taking the evaluation of all these three measurements simultaneously is valuable for the diagnosis of lupus flare. SC5b-9 and anti-C1q antibody may play major roles in the immunopathogenesis of lupus nephritis.