Objective To study the clinical significance of C-reactive protein(CRP),neutrophil granulocyte ratio(N% ) in acute exacerbations of hospitalized patients with chronic obstructive pulmonary disease ( COPD ). Methods The serum CRP levels,the gross of N% were detected of the same 71 patients with acute exacerbations of COPD before treatment and after getting better. And the correlations among above-mentioned indexes,the days counter before getting better and the days counter during hospitalization were observed. Results (1) The levels of CRP and N% of patients after getting better were significantly lower than those before treatment(P ＜0. 01). (2) There was a significant correlation between N% and the days counter before getting better(r =0.240,P ＜0.05) and also a significant correlation between the days counter before getting better and the days counter during hospitalization (r = 0. 567, P ＜0.01). Conclusion The serum CRP level and N% were objective markers in estimating pulmonary infection in COPD patients with acute exacerbations. And N% was a reliable indicator of judging the days counter before getting better and better than CRP.

Relapse/refractory multiple myeloma must be the main tough for the current clinical therapy,thus at the 56th American Society of Hematology annual meeting the latest treatment studies for the disease in 2014 were described in detail,including the joint application of drugs,the new drug clinical research,the safety and efficacy that could be inspiring.This chapter shows the mechanism of these new drug action,as well as the methods and side effects.

Objective To investigate the relationship between preoperative prognostic nutritional index(PNI) and prognosis in elderly patients with gastric cancer.Methods The clinical data of 62 patients over age 65 with gastric cancer who underwent radical gastrectomy for gastric cancer were retrospectively analyzed.PNI values were calculated and the relationship between PNI and untoward reactions and prognosis were discussed.Results PNI value is closely related with patient age(t=5.576,P<0.001),tumor size(x2=4.846,P=0.033),lymphatic metastasis(x2=13.742,P<0.001),preoperative CEA level(t=5.226,P<0.001).Among the 62 patients,12 cases with high-PNI had recurrence and 5 patients died during the follow-up period, while 11 case in low-PNI had a recurrence and 7 patients died.The recurrent rate(x2=4.055,P=0.044) and mortality rate(x2=4.630,P=0.043) of the high-PNI group were significantly lower than the low-PNI group.Conclusion PNI is a simple and useful marker for predicting the long-term outcomes of elderly gastric cancer patients, which should be included in the routine assessment of gastric cancer patients.

BACKGROUND:Percutaneous kyphoplasty with bone cement injection for repair of multi-segmental thoracolumbar vertebral osteoporotic fractures can restore the compressed vertebral height, correct deformity and reduce complications. OBJECTIVE: To explore the therapeutic effects of percutaneous kyphoplasty with bone cement in patients with multi-segmental thoracolumbar vertebral osteoporotic fractures. METHODS:Eighty patients with multi-segmental thoracolumbar vertebral osteoporotic fractures were enroled, 29 males and 51 females, aged 61-78 year, including 52 case of two-segmental vertebral fractures, 22 cases of three-segmental vertebral fractures, 6 cases of four-segmental vertebral fractures. Al the patients were divided into experimental group and control group randomly. Patients in the control group were given active basic treatment and anti-osteoporosis treatment and stayed in bed. Patients in the experimental group were given percutaneous kyphoplasty with bone cement injection on the above basis. Al the patients were folowed-up 12 months after treatment. Then the Oswesty dysfunction index, Barthel index, visual analog scale score, and theanterior vertebral height and midline height, Cobb angle were compared between the two groups. RESULTS AND CONCLUSION: In the experimental group, the Oswesty dysfunction index, Barthel index, visual analog scale score, and the anterior vertebral height and midline height, Cobb angle were al significantly improved at 3 days, 3 months and 12 months after treatment than before (P < 0.05). In the control group, the Oswesty dysfunction index, Barthel index and visual analog scale score were improved significantly at 3 and 12 months after treatment (P < 0.05), while the anterior vertebral height and midline height were improve dramaticaly at 12 months after treatment (P < 0.05). Compared with the control group, the experimental group showed better the Oswesty dysfunction index and Cobb angle than the control group at 12 months after treatment (P < 0.05), but there were no difference in the other indicators between the two groups. No adverse reactions associated with bone cement material occurred in the experimental group. Taken together, the percutaneous kyphoplasty with bone cement injection can rapidly relieve pain in patients with multi-segmental thoracolumbar vertebral osteoporotic fractures, which can correct kyphosis and improve patient's quality of life.

Objective To observe the therapeutic effect of general combinable external fixator for the treatment of femoral intertrochanteric fracture(FIF).Methods One hundred and seventeen FIF patients were randomized into two groups: the treatment group(N =56) received treatment with general combinable external fixator,and the control group(N =61) received bone traction.A follow-up of 6~13 months was carried out.The therapeutic effect and the incidence of complications were compared in both groups.Results The total effective rate was 96.43% in the treatment group and 50.82% in the control group,and the incidence of complications was 7.1%(4/56) in the treatment group and 45.9%(28/61)in the control group,the difference being significant(P

Objective To obtain the short peptides mimicking antigenic epitopes of Trichinella spiralis ( T\^s\^ ), and explore their cross protective immunity against Schistosoma japonicum ( S\^j. ) in mice. Methods IgG antibodies were purified from sera of mice infected with T\^s\^ . The purified IgG was used to immunoscreen a phage random peptide library of 7 amino\|acid residues displayed as a fusion to protein of filamentous phage. Positive clones were obtained by affinity selection, the reactivity of each clone binding to specific IgG was detected by ELISA. Kunming mice were immunized subcutaneously three times with mixed phage clones. The mice were sacrificed 45 days after challenge. The worms and the liver eggs were counted. Results After three rounds of panning, the relevant phages had been enriched approximately 150 times in production as compared to those from the first round. Of 24 phage clones randomly selected from the third round biopanning, 21 clones were shown to actually bind to the specific IgG. As compared with the control group, the worm and the liver egg reduction rates in vaccination group were 42\^8% and 66\^3% ( P

BACKGROUND:Tumor necrosis factor-α-induced protein-8 like-2 (TIPE2), an anti-inflammatory protein, through the T cel receptor (TCR) and TOLL-like receptor signaling pathway, implements negative regulation of adaptive immunity and innate immunity, and thus effectively maintains the stable internal environment of the body.
OBJECTIVE:To construct a recombinant adenovirus that can overexpress rat TIPE2 gene.
METHODS:TIPE2 cDNA target gene was amplified from rat’s lymphocytes using RT-PCR, cloned into shuttle plasmid pShuttle-clontech, and then subcloned into artificial adenovirus vector AdC68. Hereafter, HEK 293 cel s were transfected to generate a recombinant adenovirus. HEK293A cel s were infected using this recombinant adenovirus, and then TIPE2 gene level was tested by western blot method.
RESULTS AND CONCLUSION:Based on results of PCR, digestion identification and sequencing, the obtained cDNA was the coding sequence region of TIPE2. Western blot findings showed that the recombinant adenovirus could overexpress TIPE2 gene. These findings indicate that the recombinant adenovirus is constructed successful y and can express TIPE2 gene stably.

Objective To investigate the genetic stability, immunogenicity and protective efficacy of AdC68-rab. gp, a novel rabies vaccine based on the replication-defective chimpanzee adenoviral vector AdC68-ept. Methods The recombinant adenovirus AdC68-rab. gp expressing the glycoprotein of rabies vi-rus ERA strain was constructed. Genomes of the AdC68-rab. gp of different generations were extracted and analyzed. HEK293 and Huh7 cells were infected with the AdC68-rab. gp of different generations. ICR mice were immunized with the AdC68-rab. gp and blood samples were collected 4 weeks or 6 months after immuni-zation. Rapid fluorescent focus inhibition test ( RFFIT) was performed to detect the neutralizing antibody against rabies virus in mice serum samples. ICR mice were challenged with lethal dose of rabies virus 4 weeks after the immunization with AdC68-rab. gp to evaluate the protective efficacy of AdC68-rab. gp. Re-sults The genome of AdC68-rab. gp was stable after 15 passages, which was identical to that of the 5th and 1st generations. High levels of neutralizing antibody against rabies virus in serum samples were detected in mice immunized with AdC68-rab. gp and maintained for a long period of time. Immunization mice with one dose of AdC68-rab. gp could protect all mice from the lethal dose challenge of rabies virus. Conclusion The novel AdC68-rab. gp was characterized by good genetic stability and ideal protective effi-cacy. The adenoviral vector based vaccine could be further developed as a potential candidate for the substi-tute of current rabies vaccine.

Objective To discuss the influent factors and managements of lower urinary tract injury caused by tension-free vaginal tape (TVT) procedure. Methods From Mar.2001 to Feb.2011,609stress urinary incontinence (SUI) patients were trested by TVT.Lower urinary tract injury appeared in 39 cases (6.4％),which age from 39 to 78 years (average age 52.7 ± 18.3).The history of disease was 2 to 12 years.Preoperative SUI types were 12 cases of Ⅱ type SUI,22 cases of Ⅱ/Ⅲ type SUI and 5 cases of Ⅲ type SUI.The patients who had low urinary tract injury were retrospective analyzed to figure out the causes and influent factors,and recorded the treatments and follow-ups. Results 39 patients (6.4％) suffered from low urinary tract injury,including 36 oases (5.9％) of bladder perforation and 3 cases of urethral injury.In these 39 patients,34 (87.2％) patients had history of pelvic surgeries,including 18 (52.9％) cases of total hysterectomy,9 (26.5％) cases of cesarean section delivery,4 (11.8％) cases of hysteromyomectomia and 3 (8.8％) cases of ovarian surgery.All of the 36 bladder peeroration patients were re-punctured and the catheter was kept for 4 - 5 d.Three urethral injury patients were re-punctured after the urethral rupture was sutured and the catheter was kept for 2 weeks.All the 39 patients were cured and discharged.No urinary fistula,infection or other postoperative complications occurred. Conclusions The history of pelvic surgery may be an important risk factor of the lower urinary tract injury,which should pay attention.If the bladder perforation occurred,re-puncture should be taken by adjust the direction.If there was a urethral injury,the re-puncture should be taken after the suturing of the urethral rupture.

Objective To investigate the value of modified T staging system in the diagnosis and treatment of hilar cholangiocarcinoma (HCCA).Methods The clinical data of 95 patients with HCCA who were admitted to the Memorial Sun Yat-Sen Hospital from December 1995 to January 2010 were retrospectively analyzed.Based on the results of imaging examination,preoperative staging was determined according the modified T staging system.The prognosis of the patients in difference T stages were compared.The data were analyzed by using the chi-square test and Fisher exact test.The survival curve was drawn by Kaplan-Meier method and the survival rate was compared by using the Log-rank test.Results The diagnostic rates of ultrasound + magnetic resonance cholangiopancreatography (MRCP),ultrasound + computed tomography (CT) or spiral CT were 93％ (37/40) and 66％ (23/35),respectively.The diagnostic rates of ultrasound + CT or spiral CT and endoscopic retrograde cholangiopancreatography (ERCP),ultrasound + CT or spiral CT and MRCP were 14/15 and 15/15,respectively.Of the 95 patients,44 received operation (including 28 cases of radical resection and 16 cases of palliative resection),16 received exploratory laparotomy,and 35 received simple internal or external drainage.For patients in T1,T2 and T3 stages,the resection rates were 71％ (30/42),50％ (12/24) and 7％ (2/29),respectively,with significant differences (x2 =30.182,P ＜0.05).The negative rates of the resection margins of patients in T1 and T2 stages were 77％ (23/30) and 5/12,respectively,2 patients in T3 stage were found with tumor residuals at the resection margin.There was a significant difference in the radical resection rate among patients in different T stages (x2 =8.204,P ＜ 0.05).Of the 44 patients who received surgical treatment,30 (68％) received concomitant partial hepatectomy.The ratios of patients in T1 and T2 stages who received concomitant partial hepatectomy were 70％ (21/30) and 9/12,respectively,with no significant difference (x2 =0.101,P ＞ 0.05).Fourteen (32％) patients received tumor resection.The incidences of complications and perioperative mortalities were 53％ (16/30) and 10％ (3/30) for patients who received concomitant partial hepatectomy,and 5/14 and 1/14 for patients who received tumor resection,with no significant differences between the 2 groups (x2 =1.188,0.094,P ＞ 0.05).The median survival time of patients who received concomitant partial hepatectomy was 29 months,which was significantly longer than 19 months of patients who received tumor resection (x2 =11.317,P ＜0.05).Eighty-six patients were followed up,and the median time of follow up was 15.6 months (range,3-70 months).The 1-year cumulative survival rates of patients in T1,T2 and T3 stages were 73.8％,58.0％ and 9.2％,respectively,and the 3-year cumulative survival rates of patients in T1,T2 and T3 stages were 33.5％,12.1％ and 0,respectively.The median survival time of patients in T1,T2 and T3 stages were 24,16 and 7 months,respectively.The prognosis of patients was getting poor as the increase of the T stages (x2 =37.07,P ＜ 0.05).Conclusions The modified T-staging system is beneficial to preoperative evaluation of patients with HCCA.Concomitant partial hepatectomy could improve the radical resection rate and prolong the median survival time of HCCA patients.