Objective To investigate the clinical significance of related inflammatory biomarkers on chronic obstructive pulmonary disease (COPD) associated mortality,in order to provide the basis for clinical screening of high risk patients.Methods One thousand five hundred cases of outpatients and inpatients from Feb.2012 to Mar.2013 were selected as our subjects.All patients were conducted 15-27 months followup.According to patient outcome,they were divided into survival(1346 cases) and death groups (154 cases).The clinical data,pulmonary function,level of respiratory difficulty and inflammatory biomarker levels were recorded.Results The average age of the death group was (65.3 ± 12.2) years old,significantly higher than that of the survival group ((60.2 ± 11.5) years old,and the difference was significant (t =5.180,P ＜ 0.01).Body mass index(BMI) in death group was (19.8 ±5.4) kg/m2,significantly lower than that of the survival group(23.2 ± 5.6) kg/m2 and the difference was significant (t =7.373,P ＜ 0.01).There was no statistical difference between the two groups in terms of gender (P ＞ 0.05).The levels of 1 s forced expiratory volume (FEV1),FEV1/forced vital capacity (FVC),the British Medical Research Council dyspnea scale (MMRC) rating in death group were (1.1 ± 0.4) L,(40.8 ± 8.2) ％ and (2.8 ± 1.3),significantly lower than those of the survival group((1.5 ±0.5) L,(46.3 ± 11.2) ％,(2.1 ± 1.2))..FEV1 and FEV1/FVC of death group were significantly lower than those of the survival group,while the MMRC significantly higher,and the differences were significant (t =9.582,5.914,6.797,P ＜ 0.01).The levels of C-reactive protein(CRP),interleukin-6(IL-6),IL-8,tumor necrosis factor-α (TNF-α),neutrophil levels in death group were (4.8 ± 1.2)mg/L,(154.4 ± 28.6) ng/L,(398.8 ± 86.3) ng/L,(942.6 ± 212.8) ng/L,(6.0 ± 2.8) × 109/L,significantly higher than those of the survival group ((3.4 ± 1.1) mg/L,(112.8 ±23.6) ng/L,(332.7 ± 76.3) ng/L,(1 482.8 ± 223.6) ng/L,(5.1 ± 1.5) × 109/L),and the differences were statistically significant (t =14.818,20.242,10.041,29.684,6.299,P＜0.01).Conclusion Inflammatory biomarkers including CRP,IL-6,IL-8,TNF-α and neutrophils are the risk factors of death in patients with COPD.Then clinical attention should be paid to the patients with inflammatory biomarkers for monitoring physical level,in order to guide the clinical screening for high-risk cases,timely take corresponding measures and improve the prognosis.

Japan,one of the countries near China,has obtained great success in medical education through a long time exploration.Professor of R.Harsha Rao from America concluded the drawbacks in the early medical education in Japan,then proposed corresponding blueprint including reforming education systems,breaking the limitation in subjects and establishing comprehensive education system.Japanese medical education has been well promoted,the experience can be used in our country's medical education reforms.

Objective To determine the diagnostic significance of serum Cystatin C (Cys C),neutrophil gelatinase-associated lipocalin (sNGAL),urinary kidney injury molecule1 (uKIM-1) and urinary interleukin-18 (uIL-18) in patients with septic acute renal injury.Methods A total of 62 adult patients with sepsis admitted to the Intensive Care Unit over 24 hours in the Tianjin Hospital between August 2012 and March 2013 were divided into acute renal injury group (n =39) and non-acute renal injury group (n =23) according RIFLE diagnostic criteria.Measurements of Cys C,sNGAL,uKIM-1 and uIL-18 were performed.The diagnostic values of the biomarkers were assessed by comparing their levels between the patients of different groups.Results The levels of Cys C (2.27 ± 0.93) μg/L,sNGAL (275.04 ±79.37) μg/L,uKIM-1 (2.52 ± 1.06) μg/L in acute renal injury group were higher than Cys C (1.19 ± 0.77) μg/L,sNGAL (137.51 ± 99.33) μg/L,uKIM-1 (1.27 ± 0.62) μg/L in non-acute renal injury group (P ＜ 0.05).There was no significant difference in uIL-18 between the acute renal injury group (374.87 ± 70.23) ng/L and the non-acute renal injury group (354.09 ± 66.42) ng/L (P ＞ 0.05).The area under ROC curve for diagnostic values of serum Cystatin C,sNGAL and uKIM-1 in acute renal injury were0.84 (0.74-0.95),0.90 (0.79-1.00),0.87 (0.78-0.96).Conclusions CysC,sNGAL and UKIM-1 might be valid as diagnostic biomarkers of septic acute renal injury.

Weight increasing would happen with the control of glucose in diabetic patients,whether the application of insulin or that of oral medication.Long-term and effective weight control should be done in order to lower the mortality rate.A large number of studies have shown that the mortality rate has increased along with weight gain,especially death caused by cardiovascular disease.The following measures can be used:(1)Rational target should be formulated.It would be the best that weight decrease 0.5~1.0 kg every week.(2)Diet should be controlled.Low-calorie,high protein,low-fat diet can be used.(3)Exercise therapy:Aerobic exercise will be recommended.(4)Drug intervention treatment:Metformin or Thiazolidinediones drugs can be use,Sibutramine or Orlistat can be used in the patients with serious obesity.

Objective:To study the force system of teeth produced by utility arch and rocking-chair arch for the treatment of deep o-verbite.Methods:Finite element model of mandible,mandible teeth,edgewise brackets and arch was established,utility arch and rocking chair arch were applied respectively,the force direction and magnitude of molars and incisors was analyzed by ANSYS.Re-sults:When utility arch was used,incisors bear intrusive force and molars bear extrusive force.With the utility arch wire was giving intrusive force to canine,the intrusive force to incisors reduced,the extrusive force to the first molars increased.When adding the bracketed teeth,the intrusive force to incisors increased,but the extrusive force to the canines and the force direction of the molars changed.Conclusion:While the utility arch exerts intrusive pressing force to the canines,the intrusive force to the lateral incisors de-crease,therefore,pressing of canines shall be independently completed after completing pressing of incisors.Different application methods of rocking-chair arches will produce different force to teeth.With addition of teeth applied with rocking-chair arch,the force to lateral incisors and molars changes the most.

Objective To evaluate the efficacy of isolated ultrafiltration (IUF) for patients with cardiac insufficiency after acut emyocardial infarction (AMI).Methods The acut emyocardial infarction patients admitted from August 2010 to August 2014 were recruited for study.After primary percutaneous coronary intervention (PCI),102 patients presented cardiac insufficiency taking the form of hypotension and acute left heart failure.All heart failure patients dealt with routine medications at first,and were then randomly (random number) divided into two groups,group A was routine medication group and group B was isolated ultrafiltration after routine medication group.Data recorded at different intervals in the same group were analyzed by ANOVA.Data recorded from two groups at the same intervals were analyzed by t test.Data of mortality in the two groups were analyzed by x2 test.P value less than 0.05 was considered statistically significant.Results Of them,51 patients were treated with routine medication resulting in gradual improvement of cardiac function,but the improvement was slower compared with the isolated ultrafiltration group.Other 51 patients were treated with isolated ultrafiltration,and isolated ultrafiltration was discontinued in 2 patients owing to progressive thrombocytopenia and in another one patient owing to systolic blood pressure below 90 mmHg,with clinical manifestations of organ hypoperfusion,poor peripheral circulation,cool clammy skin and oliguria.In the rest of 48 patients in the isolated ultrafiltration group,vital signs were stable,and heart failure symptoms and serum electrolytes improved significantly (P ＜0.05).After one week of using isolated ultrafiltration,left ventricular ejection fraction (LVEF) also improved (P ＜ 0.05).The differences in mortality within one month,the mean ICU stay,the mean hospitalized stay,and the rate of recurrent heart failure were significant between the two groups (P ＜ 0.05)Conclusions The isolated ultrafiltration is a relatively safe and effective strategy for patients with cardiac insufficiency and hypotension after acut emyocardial infarction.

This study was conducted under the background of the internationalization of traditional Chinese medicine (TCM) terminology. Current TCM symptom terminology related to sweat was taken as basis in the extended study. The ICD classification of multiple axis and hierarchical level was used as guidance thought. This paper proposed the principle of detailed classification of TCM sweat symptoms and finally made classification rules for TCM sweatsymptoms. This study has promoted the development of TCM terminology standardization.

Objective To study the effect of inhibition of human lung carcinoma-associated antigen gene(ALT04-AG) expression on the growth characteristic and associated gene expression of human lung carcinoma cells(L78).Methods L78 cells were transfected with recombinant plasmid vector expressing(ALT04-AG) antisense RNA mediated by liposome reagent,and treated with DFMO respectively. The growth characteristics were studied by MTT,FCM analysis.The associated gene expression was detected by immunocytochemical staining,Northern blot and gene chip analysis.Results The recombinant plasmid expressing ALT04-AG antisense RNA pALT04-AG as constructed.It was shown that the down-regulation of ALT04-AG gene expression was observed not only in pALT04-AG as transfected L78 cells,but also in DFMO-treated L78 cells,which resulted in growth inhibition of these cells.Gene chip analysis indicated that inhibition of(ALT04AG) gene expression by ALT04-AG antisense RNA regulated some proliferation associated gene expression,while inhibition of polyamine biosynthesis by DFMO regulated proliferation associated genes and also some apoptosis associated genes.Conclusion It is suggested that human lung carcinoma associated antigen gene ALT04-AG plays an essential role in maintaining malignant phenotype of cancer cells.

Objective This study compared the efficacy and safety of atorvastatin and simvastatin treatment for 8 weeks in hypercholesterolemic Chinese adults.Methods This randomized,open-lable,single center study enrolled the patients with LDL-C≥4.14mmol/L(1.6 g/L) but

Objective:To explore the anticoagulant strategies during perioperative period for the patients with long-term anticoagu-lation therapy to show the important role of clinical pharmacist in drug treatment. Methods:The anticoagulant regimen during the peri-operative period participated by clinical pharmacists for one patient with long-term use of warfarin was reviewed, and combined with the related literatures, the drug choice, the administration time, dosage and treatment course were analyzed. Results: The clinical phar-macists could optimize the anticoagulant regimen by using the pharmacokinetic knowledge to decrease the risk of hemorrhage and embol-ism to the largest extent. Conclusion:During the perioperative period, warfarin should be withdrawn at least 5 days before the opera-tion, and the international normalize ratio ( INR) should be monitored. After the operation and no further bleeding, low molecular weight heparin combined with warfarin can be used in 12h, and INR should be monitored. Low molecular weight heparin can be with-drawn till the standard is reached. If the patient undergoes operation for many times, low molecular weight heparin is suggested to be used for anticoagulation during the whole operation period.