Objective To investigate the efficacy of early nutrition support combined with glutamine and low molecular hepa‐rin in elderly patients with severe pneumonia and its influence on immune function regulation and RAGE .Methods Totally 148 eld‐erly patients with severe pneumonia in ICU of our hospital from October 2012 to May 2015 were selected and randomly divided into the treatment group 1 (55 cases) ,treatment group 2 (55 cases) and control group(38 cases) according to the randomized digital ta‐ble .The control group was given the routine treatment .Based on the control group ,the treatment group 1 was treated with the early nutrition support combined with glutamine .On the basis of the treatment group 1 ,the treatment group 2 adopted low molecular heparin .The APACHEⅡ score ,PaCO2 ,SaO2 ,and PaO2 before and after treatment were compared among three groups .The levels of PT ,APTT ,FIB and D‐D were detected in three groups .The immune function indexes and RAGE level were compared among three groups .Results The APACHEⅡ score ,PaCO2 and RAGE level after treatment in two treatment groups were lower than those in the control group ,while SaO2 ,PaO2 and immune function indexes levels were higher than those in the control group ,more‐over the APACHEⅡscore ,PaCO2 and RAGE level in the treatment group 2 were lower than those in the treatment group 1 ,while SaO2 ,PaO2 and immune function level were higher than those in the treatment group 1 ,the differences were statistically significant (P<0 .01) .The levels of PT ,APTT ,FIB and D‐D after treatment in the treatment group 2 were lower than those in the treatment group 1 and control group(P<0 .01) .The total effective rates in the treatment group 1 and 2 were 96 .36% and 98 .18% respec‐tively ,which were higher than that in the control group ,moreover the obviously effective rate in the treatment group 2 was 85 . 45% ,which was superior to the control group and treatment group1 ,the differences were statistically significant (P<0 .01 or P<0 . 05) .Conclusion Early nutrition support combined with glutamine and low molecular heparin in treating elderly severe pneumonia can decrease the APACHEⅡscore ,improve the coagulation function ,enhance the immune function and decreases the RAGE level .

Deep vein thrombosis (DVT) is a serious complication of fractures. The incidence of ankle fracture which occurs most frequently intra-articular is 200/100 000, about 3.9%of all fractures. Domestic and foreign reports of ankle fractures and DVT were allocated and analyzed to review their correlation. Furthermore, different methods of rou-tined thromboprophylaxis was discussed. DVT incident after ankle fractures and the necessity of routined thromboprophy-laxis were reviewed. DVT incidence after ankle fractures was low and routine thromboprophylaxis was not necessary to all ankle fracture patients except the ones who had risk factors of thrombosis which could induce DVT.

OBJECTIVE:To provide reference for strengthening the cultural construction and promoting the cultural develop-ment of TCM in Chongqing. METHODS:Questionnaire was adopted to investigate the status quo and cognition of some citizens, staffs in medical and health institutions for the cultural construction of TCM in public TCM medical and health institutions above Grade Two in Chongqing,and the data was statistically analyzed. RESULTS:Totally 45 questionnaires were sent out for TCM med-ical and health institutions,45 were effectively received with effective recovery of 100%;3 500 were sent out for the citizens,2 250 were effectively received with effective recovery of 64.29%;1 100 were sent out for the staffs in TCM medical and health institu-tions,702 were effectively received with effective recovery of 63.82%. In terms of cultural construction in surveyed institutions,or-ganization,principles and unit markings carried out a relatively high proportion in the core cultural soft power construction,the de-velopment of behavioral norms system carried out a relatively low proportion;and the proportion was higher in the hardware envi-ronment construction. In terms of the cognition of surveyed citizens for the TCM culture,62.98% believed in TCM;the first rea-son for choosing TCM was its less side effects(24.76%);89.42% thought it was necessary to keep in good health. In terms of the cognition of surveyed staffs for the cultural construction of TCM,81.91%thought the TCM culture was taken seriously in their hos-pital;60.54% showed great satisfaction with the cultural construction of TCM;only 23.08% was very familiar with the concept of TCM core values;the surveyed staff thought the main problems in the cultural construction of TCM were lack of facilities (69.09%)and talent personals(44.59%). CONCLUSIONS:The organization,principles,unit markings and facilities in Chongq-ing TCM medical and health institutions are taken seriously,while the behavioral norms system needs to be strengthened;the citi-zens’cognition for TCM culture should to be improved,as well as the staffs’TCM cultural awareness in TCM medical and health institutions.

In plant genetic engineering, selectable marker is needed to distinguish transformant. As the commercialization of transgenic plants, people are more and more paying close attention to their safety, among which mainly refers to the safety of selectable marker. In order to increase the safety of transgenic plants, biologists began to search for biosafe selectable marker.Current research progress of taking key enzyme in metabolic pathways were overviewed,which include glycometabolism, amino acid metabolism, hormone metabolism ,nucleotide metabolism and protein metabolism et cetera, as selectable marker in transgenic plants.

We reported a case of rheumatoid arthritis (RA) combined with pigmented villonodular synovitis (PVNS) from Peking University People's Hospital. The clinical data were introduced and the related literature was reviewed. The clinical features, treatment and prognosis of the disease were summarized to improve clinicians' understanding of this rare disease and avoid misdiagnosis and delayed diagnosis. A 45-year-old female, with 15 years of RA history and unregular treatment, was admitted to the hospital with the complaint of aggravating pain and swelling in the right knee for 3 months. The puncture of the right knee was performed and there was a large amount of bloody synovial fluid that could not be explained by her RA history. Moreover, the magnetic resonance imaging (MRI) of the right knee revealed hemosiderin deposition with low-intensity signals on both T1-weighted and T2-weighted images which suggested PVNS to us. Then, the patient underwent knee arthroscopy and biopsy to assist in diagnosis. The arthroscopic appearance and pathology were consistent with PVNS and the hyperplastic synovium was removed during arthroscopy. After the operation, she did active functional exercises and took disease-modifying antirheumatic drugs to control RA. She recovered well and remained asymptomatic after half a year of follow-up. Also, there was no recurrence of the right knee. As we all know, RA is a systemic autoimmune disease characterized by chronic synovitis and joint damage. And PVNS is characterized by synovial proliferation and infiltrative process. Both of them are synovial involvement and the clinical manifestations are quite similar. PVNS has occasionally been reported in association with RA. So it is difficult to make a clear diagnosis of RA combined with PVNS. Literature was searched with RA+PVNS in the WanFang Medical Network Database and China National Knowledge Infrastructure and there were no related Chinese cases. Then we searched literature from PubMed with RA+PVNS. The cases were still rare and eventually 2 related articles were yielded including 2 similar patients. It is necessary to fully understand the disease development, complicated MRI appearance and various pathological morpho-logy. They can contribute to making a correct diagnosis which is effective to guide the proper treatment.
Arthritis, Rheumatoid/diagnosis* ; Arthroscopy ; China ; Female ; Humans ; Knee Joint/diagnostic imaging* ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Recurrence, Local ; Synovitis, Pigmented Villonodular/diagnosis*

Objective To observe the effect of motor relearning program (MRP) on balance function of stroke patients.Methods Sixty stroke patients were randomly divided into the MRP group and control group with 30 cases in each group. The patients of the control group were trained with proprioceptive neuromuscular facilitation (PNF) therapy; those of the MRP group were trained with the MRP therapy. The balance function of all patients was assessed with the Fugl-Meyer Balance Function Assessment before and after training.Results After training, the scores of Fugl-Meyer Assessment of all patients increased ( P<0.05), but scores of the patients of the MRP group were significantly higher than that of the control group ( P<0.05).Conclusion The MRP training can improve the recovery of balance function of stroke patients.

BACKGROUND: p38 mitogen-activated protein kinase signal transduction pathway is a member of the mitogen-activated protein kinase family. It plays an important role in the development of osteoarthritis. OBJECTIVE: To review the progress of p38 mitogen-activated protein kinase signal transduction pathway in the pathological process of osteoarthritis. METHODS: An online search of CNKI and PubMed databases was performed for articles using keywords of “p38 mitogen-activated protein kinase signal transduction pathway, osteoarthritis, articular cartilage, chondrocyte” in Chinese and English, respectively. Relevant articles were summarized from three aspects of introduction of p38 signal transduction pathway, the role of p38 mitogen-activated protein kinase signal transduction pathway in osteoarthritis and the inhibitor of p38 in osteoarthritis. A total of 90 articles were included. According to inclusion criteria, a number of 46 articles were retained at last. RESULES AND CONCLUSION: p38 mitogen-activated protein kinase signal transduction pathway has a close relation with chondrocyte hypertrophy and calcification, chondrocyte apoptosis, synthesis of cartilage matrix metal oproteinase, production of proinflammatory cytokines, and exerts a significant effect on the development of osteoarthritis. p38 mitogen-activated protein kinase is involved in the formation and development of osteoarthritis through a variety of complex mechanisms and plays a very important role. Therefore, blocking p38 mitogen-activated protein kinase signaling pathway may be a new target in the treatment of osteoarthritis.

BACKGROUND: Weightlessness is one of the important reasons to cause lower limb muscle atrophy of the astronauts, which is serious harm to the health of astronauts. OBJECTIVE: To explore the progress of weightlessness that cause lower limb muscle atrophy. METHODS: A computer-based online search of PubMed database and CNKI database was performed to search related articles between May 1981 and March 2013 with the key words of “weightless, weightlessness, muscle, atrophy, space” in English and Chinese, respectively. Literatures related to progress of weightlessness that cause lower limb muscle atrophy were selected; in the same field, the literatures published lately in authoritative journals were preferred. RESULTS AND CONCLUSION: A total of 409 literatures were primarily selected, and 47 documents were involved for summary according to the inclusion criteria. The progress of weightlessness that cause muscle atrophy is the hot topic among the space medical research. The main reasons that cause weightlessness muscular atrophy include the reduced muscle spindle neurotrophic factor synthesis caused by reduced information transmission of peripheral sensory nerve, damage of muscle cel ultrastructure, substantial decline in mitochondrial myofibrils, troponin decreasing, decreased intracel ular calcium content, and decreased antigravity muscle blood flow in lower limbs.

Tumor lysis syndrome (TLS) results from a sudden and rapid release of nuclear and cytoplasmic degradation products from malignant cells. It is a rare complication in adult patients with solid tumors who are undergoing treatment. Herein, the authors present a case with advanced hepatocellular carcinoma (HCC) who developed TLS after transarterial chemoembolization (TACE), which was successfully treated with aggressive fluid administration, oral allopurinol and urine alkalization, hemodialysis and other supportive therapies. TLS following TACE should be suspected in HCC patients who has large and rapidly-growing lesion.

BACKGROUND: It remains poorly understood regarding the incidence of panel reactive antibody (PRA) production and its influence to renal function and long-term survival in China. OBJECTIVE: To investigate the incidence of PRA after living renal transplant, so as to provide reference for predicting long-term renal survival. METHODS: A total of 54 patients who received living renal transplantation in Beijing Friendship Hospital from March 2005 and October 2007, were selected. PRA, serum creatinine and urea nitrogen level were detected 1-2 years after transplantation. PRA assay was conducted using One Lambda ELISA HLA-Ⅰ +Ⅱ antigen tray. Serum creatinine and urea nitrogen data were offered by clinical laboratory. RESULTS AND CONCLUSION: A total of 12.96% (7/54) patients showed PRA positive after transplantation, with HLA-Ⅱ antibody positive in 6 patients, and HLA-Ⅰ + Ⅱ antibody positive in 1 patient. In these 7 patients, 6 underwent primary transplantation, and PRA negative before transplantation; 1 patient underwent transplantation for the second time, and HLA-Ⅱ antibody positive before transplantation. Creatine and urea nitrogen level were abnormal in 1 patient with HLA-Ⅰ + ⅠⅡ antibody positive and 2 patients with HLA-Ⅱ antibody highly positive. Creatinine and urea nitrogen levels were normal in 4 patients with low level HLA-Ⅱ antibody. Results show that HLA-Ⅰ +Ⅱ antibody positive and high level HLA-Ⅱ antibody affect renal function in living renal recipients, but low level HLA-Ⅱ antibody has no effect on renal function.