Objective To study the effect of lesion level and completeness on activities of daily living(ADL) of patients with spinal cord injury(SCI).Methods The functional status of 313 SCI patients were assessed using the Functional Independence Measurement(FIM),and FIM scores were calculated for statistical analysis with different lesion levels and completeness.Results FIM scores presented significant differences among cervical-level group,thoracic-level group and lumbar-level group(P<0.05～0.01).Patient with a high lesion level had lower FIM score.In the same lesion level group,FIM scores presented significant differences between the incomplete SCI patients and the complete ones(P<0.05～0.01).However,the lumbar lesion patients had no significant differences in FIM score between the complete group and the incomplete group(P>0.05).Conclusion FIM can objectively reflect the ADL level in SCI patients with different lesion level and completeness.

To investigate the relationship of between p21wAF1 and PCNA expression and the patients' prognosis in breast carcinoma. MethodExpression of p21wAF1 and PCNA was determined by S-P immunohistochemical technique in 152 patients with breast carcinoma. ResultsPositive immunostaining of p21WAf1was detected in 61(40.1% ) primary breast carcinoma, in which 43(70.5% ) were low expression, and 18(29.5% ) over expression of 152 PCNA positive cases, 69(45% ) expressed with low index and 83(55% )expressed with high index. p21wAf1 expression level was correlated with tubule formation (γs＝ 0.341, P＜0.01 ),nuclear atypia(γs=0.516, P＜0.01), mitosis(γs=0.351, P＜0.01)and histological grade(γs=0.415, P＜0.01)in breast cancer tissue. Univariate analysis demonstrated less disease-free survival in patients with higher p21WAF1 (x2 = 6.92, P＜ 0.01 ) and PCNA (x2 = 5.14, P＜0.05)expression than in those with lower expression. The survival term of the patients with p21WAF1 -/PCNA low index, p21wAF1 +/PCNA low index, p21WAF1 +/PCNA high index and p21WAF1 -/PCNA high index groups was successively shortened. Conclusions( 1 ) Combined detection of p21wAF1/PCNA is helpful to judge the proliferating activity of the tumor cells and the patients prognosis. (2) Different expression level of p21WAF1in breast carcinoma is probably related the different regulating directions.

Objective:To investigate current situation of overweight and obesity among population from coastal areas of Fujian province ,and study their correlation with blood pressure (BP) and blood lipids . Methods :A total of 3343≥30 years people from coastal areas of Fujian province were enrolled using cross -sectional survey .Body height and mass ,BP ,waist circumference (WC) ,blood glucose and blood lipids etc .were measured .The correlation among BP ,blood lipids and BMI were statistically analyzed . Results:Detection rates of overweight and obesity were 34.6% and 10.0% respectively .Overweight rate of men was significantly higher than that of women (40.4% vs . 30.7% , P<0.05);percentages of overweight and obese population gradually rose along with age increased before 70 years ,and it showed declining trend after 70 years .Compared with normal weight people of corresponding age , BP and WC significantly rose in overweight and obese young people (<40 years) , P<0.01 all;there were signifi‐cant rise in BP ,WC ,TC and LDL‐C levels ,and significant reduction in HDL‐C level in overweight and obese mid‐dle-aged and aged people (>40 years) , P<0.05 or <0.01. Partial correlation analysis indicated that BMI was positively correlated with WC ,SBP ,DBP ,TC ,LDL‐C and HbA1c levels ( r=0.701 ,0.218 ,0.238 ,0.068 ,0.120 , 0.135 ,P<0.01 all) ,and inversely correlated with TG and HDL‐C levels (r= -0.069 both ,P<0.01 both) .Mul‐tifactor linear regression analysis indicated that BMI was significantly correlated with WC ,sex ,age ,DBP ,HDL‐C and FBG levels .After controlling age ,sex and blood glucose etc .,binary Logistic regression analysis indicated that overweight (OR=2.283 ,95% CI 1.915~2.721) and obesity (OR=4.419 ,95% CI 3.329~5.865) were risk fac‐tors for hypertension and dyslipidemia [overweight (OR= 1.356 ,95% CI 1.160~ 1.584) ,obesity (OR= 1.691 , 95% CI 1.319~2.167 )] , P<0.01 all .Conclusion:Prevalence rates of overweight and obesity are high in coastal population in Fujian province .Percentages of hypertension ,dyslipidemia ,DM and cardiovascular risk factor aggre‐gation significantly rise among overweight and obese people ,so controlling body mass is of important significance for prevention and treatment of chronic diseases ,including hypertension ,DM and dyslipidemia etc .

Objective:To explore the clinical effects of early bed-out intervention based on enhanced recovery after surgery (ERAS) in elderly patients with hip fracture.Methods:Totally 80 patients with hip fracture admitted in Zhejiang Taizhou Hospital from January 2017 to December 2018 were selected and divided into observation group ( n=40) and control group ( n=40) according to the random number table. Patients in the control group received conventional nursing care, while patients in the observation group received early ERAS-based bed-out interventions. The incidence of adverse events, including pulmonary infection, abdominal pain and constipation, was compared between the two groups within 2 weeks. Postoperative hip joint function, daily living activities and quality of life were evaluated in the two groups. Results:The incidence of pulmonary infection, urinary tract infection, bloating, constipation and deep vein thrombosis (DVT) in lower limbs in the observation group was lower than that in the control group, and the difference of total complication rate was statistically significant ( P<0.05) . The hip joint function, daily life activity and quality of life scores in the observation group were higher than those in the control group, and the differences were statistically significant ( P< 0.05) . Conclusions:Early ERAS-based bet-out interventions taken for elderly patients with hip fracture can reduce the incidence of postoperative adverse events, and improve their hip joint function, daily activities and quality of life.

Yeast surface display involves that the exogenous protein, which was fused with the yeast outer shell cell wall protein, was genetically anchored on the yeast cell surface. It has been widely used in expression and screening of functional protein. Here, we focused on the construction of lipase-displaying systems and its application in enzymatic biosynthesis, such as fatty acid methyl esters, short-chain flavour esters and sugar esters applications, and so on.
Candida ; enzymology ; genetics ; Lipase ; biosynthesis ; genetics ; Pichia ; enzymology ; genetics ; Recombinant Proteins ; biosynthesis ; genetics ; Solvents ; Yeasts ; enzymology ; genetics

Objective To establish the HPLC fingerprints of petroleum ether parts from five traditional medicine (Alpinia officinarum Hance, Alpinia galangal ( L.) Wild, Alpinia galanga Will., Alpinia katsumadai Hayata, and Alpinia oxyphylla Miq), and to explore the similarities and differences of chemical composition,as well as the correlation between the genetic relationship and the chemical composition. Methods HPLC method was used to analysis the five traditional medicines. The data were evaluated by using the"similarity evaluation system for chromatographic fingerprint of TCM" software. Results The similarity chemical composition from Alpinia officinarum Hance,Alpinia galangal(L.) Wild,Alpinia galanga Will.,Alpinia katsumadai Hayata,and Alpinia oxyphylla Miq in ethyl acetate were 0.741,0.855,0.610,0.510, 0.680,respectively. Conclusion Though there were differences of fingerprint peak of petroleum ether parts between five the traditional Chinese medicines, similarities were also observed among them.

Objective To investigate the clinical efficacy and safety of high-dose caspofungin (70 mg/d)as initial or salvage treatment for invasive pulmonary aspergillosis.Methods Twenty-one patients with proven or probable invasive pulmonary aspergillosis from June 2014 to October 2017 in Huashan Hospital,Fudan University were retrospectively reviewed.According to the anti-fungal treatment before high-dose caspofungin application,patients were divided into initial treatment group and salvage treatment group.Patients' clinical data and laboratory data were collected.The characteristics,clinical efficacy,adverse reactions,one-year survival rate and the overall effective rate were evaluated.The prognosis of the two groups was compared by Kaplan-Meier analysis.Results Twenty of the 21 patients opportunistic acquired invasive pulmonary aspergillosis during the treatment of underlying diseases.Five patients were initially treated with high-dose caspofungin for 68 (62) days.At week 12,one patient achieved complete response,3 patients achieved partial response,and the overall effective rate was 80％ (4/5).Sixteen patients received caspofungin as salvage therapy for 66.50 (58) days,of which one patient got complete response at week 12,10 had partial response,and the overall effective rate was 68.75％ (11/16).One-year follow-up showed that no patient died in the initial treatment group,and the one-year survival rate was 100％ (5/5).In salvage treatment group,3 patients died of pulmonary bacterial infections and the one-year survival rate was 81.25％ (13/16).During treatment,one patient had elevated total bilirubin,which was possibly associated with high-dose caspofungin.Conclusions High-dose caspofungin regimen has good efficacy and safety,both for initial treatment and salvage therapy in patients with invasive pulmonary aspergillosis.

Objective: To evaluate the efficacy and safety of high-dose fluconazole alone or combined with flucytosine as initial therapy for cryptococcal meningitis (CM) in non-human immunodeficiency virus (HIV)-related patients. Methods: Twenty-five non-HIV-infected patients with CM from June 2015 to September 2018 in Huashan Hospital, Fudan University, who were initially treated with high-dose fluconazole with or without flucytosine for at least seven days were retrospectively reviewed.Clinical features and antifungal (600-800 mg/d) regimens were recorded, clinical responses and drug-related adverse events were evaluated. Mann-Whitney test and Fisher′s exact probabilities test were applied to compare variables between groups. Results: Of the 25 patients enrolled in this study, 15 had predisposing factors. Headache (25 cases), fever (21 cases), vomiting (13 cases) and neck stiffness (13 cases) were common manifestations. Abnormalities of cranial computed tomography (CT) scan and/or magnetic resonance imaging (MRI) were found in 22 cases.Nineteen patients were treated with high-dose fluconazole plus flucytosine for initial therapy, and six patients were treated with high-dose fluconazole alone. The course of initial regimens with high-dose fluconazole was 42 (29, 120) days. At the end of initial therapy, partial response in 20 patients, stable response in three patients and death in two patients were observed, and the overall effective rate was 80%(20/25). In treatment failure group of initial treatment, the proportion of patients with baseline cerebrospinal fluid opening pressure over 300 mmH₂O (1 mmH₂O=0.009 8 kPa) and with altered mental status were both significantly higher compared with those in treatment success group. Fluconazole related adverse drug events were observed including elevated transaminases (one case), gastrointestinal symptoms combined with hypokalemia (two cases), and systemic rash (three cases). Except for three patients with rash reduced the dosage of fluconazole, no other patients were given dosage adjustment. Conclusion High-dose fluconazole alone or combined with flucytosine is effective and safe for the initial therapy of non-HIV-related CM patients.

Objective:To investigate the appetite of patients with lymphoma during chemotherapy and its influencing factors.Methods:A total of 103 patients with lymphoma who underwent chemotherapy were sequentially selected in Fujian Medical University Union Hospital from December 2020 to August 2021. The questionnaire survey was carried out by using general information and Karnofsky score was performed. Appetite score was calculated according to Chinese version of the appetite symptom questionnaire for cancer patients. Multiple linear regression analysis was used to analyze the influencing factors of appetite status of lymphoma patients during chemotherapy, and Pearson correlation analysis was used to explore the relationship between Karnofsky score and appetite score of patients.Results:For patients with lymphoma during chemotherapy, Karnofsky score was (75±18) scores and the appetite score was (25.0±5.0) scores. Univariate analysis showed that age, body mass index (BMI), nausea and vomiting, oral mucosa rupture, gum infection, fever, throat infection were influencing factors of appetite score of patients (all P < 0.05). Multivariate analysis showed that patients ' age ( B = -1.118, β = -0.187, P = 0.016), BMI ( B = -2.047, β = -0.271, P = 0.001), nausea and vomiting ( B = -4.352, β = -0.411, P < 0.001) were the independent influencing factors of appetite score. Correlation analysis showed that the Karnofsky score was positively correlated with appetite score ( r = 0.361, P < 0.05). Conclusions:Special attention should be paid to the appetite of elder lymphoma patients with lower BMI during chemotherapy, and nausea and vomiting should be paid more attention; targeted measures of increasing the patients' appetite could improve their nutritional level and prognosis.

Objective:To investigate the clinical characteristics and prognosis of cryptococcal meningitis patients with anti-granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibodies.Methods:A total of 216 non-acquired immunodeficiency syndrome (AIDS) related cryptococcal meningitis cases with positive cultures of Cryptococcus, hospitalized at Huashan Hospital, Fudan University during January 2014 and December 2021, were retrospectively included. The serum anti-GM-CSF autoantibodies were detected by enzyme linked immunosorbent assay, and the clinical characteristics and prognosis were compared between patients with and without anti-GM-CSF autoantibodies. Statistical comparisons were mainly performed using the chi-square test or Fisher′s exact test. Cox proportional-hazards model was used to analyze the risk factors associated with prognosis. Results:Among 216 enrolled patients, 23 patients were positive of anti-GM-CSF autoantibodies, with a positive rate of 10.6%. Among 23 patients, seven cases were infected with Cryptococcus gattii, and 16 cases were infected with Cryptococcus neoformans. In the group with positive anti-GM-CSF autoantibodies, 30.4%(7/23) of the patients were infected with Cryptococcus gattii, which was higher than that of 1.6%(3/193) in the group with negative anti-GM-CSF autoantibodies, and the difference was statistically significant ( χ2=38.82, P<0.001). In the group with positive anti-GM-CSF autoantibodies, 30.0% (6/20) had mass lesions with a diameter greater than three centimeters in the lungs, and the one-year all-cause mortality rate was 50.0% (10/20), which were both higher than those of 3.4%(5/145) and 16.1% (29/180) in the negative group, respectively. The differences were both statistically significant (both Fisher′s exact test, P<0.01). Age≥60 years (hazard ratio ( HR)=4.146, P=0.002), predisposing factors ( HR=3.160, P=0.021), epilepsy ( HR=6.129, P=0.002), positive anti-GM-CSF autoantibodies ( HR=2.675, P=0.034), white blood cell count of cerebrospinal fluid (CSF)<100 ×10 6/L ( HR=2.736, P=0.039), the titers of cryptococcal capsular polysaccharide antigen of CSF≥1∶1 280 ( HR=4.361, P=0.009) were independent risk factors for one-year all-cause mortality in patients with cryptococcal meningitis. Conclusions:In non-AIDS related cryptococcal meningitis patients, the positive rate of serum anti-GM-CSF autoantibodies is as high as 10.6%. Patients with anti-GM-CSF autoantibodies could be infected with both Cryptococcus neoformans and Cryptococcus gattii, and they have higher proportion of lung mass lesions than patients with negative anti-GM-CSF autoantibodies. The one-year survival rate decreases significantly in patients with anti-GM-CSF autoantibodies, which is an independent risk factor for the prognosis of cryptococcal meningitis.