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 .

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.

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.

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.

Heart ; drug effects ; Heart Failure ; drug therapy ; Humans ; Hydrogen Bonding ; Nitrogen Oxides ; pharmacology ; therapeutic use

BACKGROUND: It is confirmed that panel reactive antibody (PRA) and its immune level is closely related to rejection activation, renal survival rate and the realization of the renal function. Study addressing the relation PRA level and acute rejection has great clinical significance for forecasting acute rejection and improving the renal survival rate.OBJECTIVE: To analyze the relation of PRA and acute rejection prior to and after transplantation by detecting PRA level combined with patient rejection.DESIGN, TIME AND SETTING: Retrospectively case analysis was performed at the Affiliated Beijing Friendship Hospital of Capital University of Medical Sciences from September 1998 to May 2005.PARTICIPANTS: A total of 633 patients receiving renal transplantation were collected, including 348 males and 285 females, aged 16-67 years.METHODS: Company Lymphocyte Tray produced by One Lambda and Biotest were used for this study, serum PRA level was detected prior to and within 2 months after transplantation.MAIN OUTCOME MEASURES: Pre- and post-transplant PRA level and clinical rejection.RESULTS: Totally 591 patients were PRA negative in pre-transplant assay, and 164 patients were positive, 10.32% (61/591) patients occurred acute rejection; 42 patients were PRA positive in pre-transplant assay, and 71.42% (30/42) patients occurred acute rejection. The difference between PRA negative or positive and acute rejection had significance (P < 0.001). 427 patients were PRA negative in both pre- and post- transplant assay, 5.6% (24/427) patients occurred acute rejection. 164 patients were PRA negative in pre-transplant assay, but positive in post-transplant, 42.7% (70/164) patients occurred acute rejection. The comparison of PRA negative pre-transplant and PRA positive post-transplant combined with acute rejection had difference (P < 0.001). The correlation coefficient of pre-transplant PRA and acute rejection was 0.612, which was 0.658 between post-transplant PRA and acute rejection, there was obvious association when P=0.01.CONCLUSION: PRA plays an important role in forecasting renal rejection. The acute rejection probability is higher in patients with positive PRA; in other hand, the probability is lower in patients with negative PRA.

Objective To observe the behavior changes and connexin 32(CX32),connexin 43(CX43)expressions in hippocampus and the effect of carbenoxolone on their expression in epileptic immature rats induced by lithium-pilocarpine.Methods Seventy-two SD immature rats of 21 d were randomly divided into control group(n=24),lithium-pilocarpine kindled group(n=24)and carbenoxolone treated group(n=24),each group by 24 h,3 d,7 d and 30 d were subdivided into 4 groups(n=6).Immuno-histochemisty was used to observe the expressions of CX32 and CX43 in hippocampus areas of immature rats,and to observe their behavior changes.Results The scores of the severe elileptiform seizures(Racine Ⅳ/Ⅴlevel)in lithium-pilocarpine group were significantly higher than those in carbenoxolone treated group;The latency in carbenoxolone treated group was prolonged significantly(P

Objective To study the correlation between transplanted kidney dysfunction and oc-currence of the panel reactive antibody ( PRA, also referred as anti-HLA antibody ) and anti-Major-Histo-compatibility-Complex class Ⅰrelated chain A (MICA) antibody.Methods The tests for detecting PRA and anti-MICA antibody were performed on 679 renal transplant patients from December , 2009 to June, 2010 who received transplantation before 2008 in Beijing Friendship Hospital .Enzyme-Linked Immunosor-bent Assay ( ELISA) was used to detect anti-HLA antibody using LAT-1240 ( OneLambda Inc .) .MICA Ab-Scan Kit was adopted to detect anti-MICA antibody .Continuous observation of graft function was conducted . Results 108 out of 679 patients showed anti-HLA antibody and/or anti-MICA antibody positive results . Among them, 81 patients were positive only for anti-HLA antibody, 18 patients were positive only for anti-MICA antibody and other 9 patients showed anti-HLA and anti-MICA antibodies double positive .Among all of the kidney transplant patients with a failed or decreased renal function , 71 patients were positive for anti-HLA antibody;16 patients were positive for anti-MICA antibody;and other 9 patients were positive for both anti-HLA and anti-MICA antibodies .The results demonstrated that anti-HLA and anti-MICA antibodies af-fected the renal functions in patient with renal transplantation (χ2 =353.92, P <0.001).Conclusion Anti-HLA and MICA antibodies showed significant positive correlations with chronic allograft failure in the patients with renal transplantation .