Objective To estimate the effect of low molecular weight heparin (LMWH) combined with conventional treatment on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Literature on randomized control trials( RCTs) with AECOPD treated by LMWH combined with conventional methods was collected in PubMed.The studies were selected according to inclusive and exclusive criteria.The data were extracted,the quality was assessed, and meta-analysis was conducted with RevMan 5.2 software.Results There were twelve RCTs including 879 patients with AECOPD in the current study.The results of meta-analysis showed that:①LMWH could obviously improve PaO2 and PaCO2 of patients with AECOPD as compared with the control group.②There was no statistically significant difference between the LMWH-treated group and control group in the improvement of FEV1 or hematocrit.Conclusion LMWH can significantly improve arterial blood gas analysis in AECOPD, but does not improve FEV1 or hematocrit.

Objective To compare the early analgesic effects of continuous femoral nerve block analgesia (CFNB) and patient controlled intravenous analgesia (PCIA) and their effects on functional recovery after total knee arthroplasty.Methods Retrospective analysis was conducted on 60 ASA Ⅰ and ASA Ⅱ patients with unilateral total knee arthroplasty in our hospital from January 2014 to January 2015.The patients were divided into two groups,CFBN group (treatment group) and PCIA group (control group),with 30 patients in each group.VAS scores of postoperative ipsilateral knee resting and movement pain,range of postoperative knee joint motion (ROM),muscle strength of femoral quadriceps,incidence rates of adverse reaction within 7 days after operation,HSS score 3 months before and after the operation,and discharge time were observed.Results Postoperative VIS score in CFNB group was lower than that in PCIA group.ROM and muscle strength of femoral quadriceps in CFBN group were better than those in PCIA group on day 1,2,3,5,and 7 after the operation.Postoperative adverse reaction rate within 7 days in PCIA group was significantly higher than that in CFNB group.HSS score three months after the operation in CFNB group was higher than that in PCIA group.Discharge time of CFNB group was significantly earlier than that of PCIA group (P＜0.05).Conclusion Compared with PCIA analgesia,CFNB analgesia shows better analgesic effect.It can alleviate early knee joint pain after TKA,increase joint motion,significantly shorten the hospitalization time,promote joint exercises which are effective in functional rehabilitation,and decrease the incidence of adverse reactions like nausea and vomiting.

Aim: To construct a prokaryotic expression vector carrying NuBCP-9-tumstatin(74-98) (abbreviated as NT) gene and to obtain the fusion peptide with antitumor activity. Methods: Nucleotide sequences of antitumor peptides, NuBCP-9 and Tumstatin( 74-98), were connected via a linker(G_4S)_3 based on biased codons of E. coli the fused NT gene was reconstructed using SOE PCR, and inserted into pET32a(+) vector, and transformed in E. coli BL21(DE3). After expression, the novel fusion peptide was purified through nickel-affinity chromatogra-phy, Factor Xa digestion and ultrafiltration. Biological activity of the fusion peptide on ECV304 and A549 cells was evaluated by MTT assay. Results: A prokaryotic expression system with NT gene was successfully constructed. The soluble fusion peptide was accounted for approximately 25% when induced by 0. 5 mmol/L IPTG at 30 ℃ for 4 h. The purified fusion peptide could inhibit cell growth of ECV304 and A549 with inhibition rates of 60. 8% and 65. 2% at 20 μmol/L, respectively. Conclusion: A novel fusion peptide with antitumor activity was cloned, expressed and purified.

OBJECTIVE To investigate clinical features and etiology of inhalation pneumonia.METHODS Totally 108 cases of inhalation pneumonia during from Jan 2000 to Dec 2005 were completely surveyed and analyzed. RESULTS There were underlying diseases and susceptible factors, and it was not typical in their clinical signs and symptoms.Totally 177 pathogens were isolated from sputa. There were 96 strains of Gram-negative bacilli (54.2%), 41 strains (23.2%) of Gram-positive cocci, and 40 strains (22.6%) of fungi. The 45 cases (41.7%) were with polyinfections, and 19 cases (17.6%) with double infections.CONCLUSIONS We should enhance diagnosis of inhalation pneumonia, make rational use of antibiotic, and take vigorous precautions against inhalation pneumonia.

BACKGROUND: Insulin-like growth factor-1 (IGF-1) is a peptide hormone, it has been proved a promotion role on the proliferation of precursor cells. OBJECTIVE: To explore the intravenous injection of IGF-1 on the proliferation, migration and differentiation of neural stem cells in rats after cerebral ischemia. METHODS: Eight adult male SD rats were randomly divided into control group and experimental group, with 40 rats in each group. The rats in two groups were used to prepare models of focal cerebral ischemia using modified suture method, the rats in the experimental group were treated with tail vein injection of IGF-1, according to 100 μg/kg computation, the injection was given for 6 continuous days; in the control group, rats were given equal volume of saline. The rats were decapitated at 7, 14, 21, 28 days following intervention, respectively, and rats in each group were given intraperitoneal injection of the BrdU at 1 day before death. Immunohistochemistry and double staining were applied to detect the expressions of BrdU-positive cells, PSA-NCAM-positive cells, BrdU + PSA-NCAM double-positive cells, and BrdU + MAP2 double-positive cells. RESULTS AND CONCLUSION: The number of BrdU-positive cells and PSA-NCAM positive cells reached the peak at 7 days after ischemia; BrdU + PSA-NCAM double-labeled-positive cells could be detected in ischemic bilateral subependymal zone and dentate gyrus, the number was the most at 7 days, then followed by a gradual decrease; the BrdU + MAP2 double-positive cells began to increase from 14 days, and then gradually increased along with the decrease of BrdU + PSA-NCAM double-positive expression, showing a reverse trend. Intravenous injection of IGF-1 can induce the proliferation, differentiation and migration of neural stem cells in rats following ischemic brain injury.

ObjectiveTo explore the effect of the calcium phosphate cement (CPC) /calcium polyphosphate fiber (CPPF) composites mixed with different proportion of minimal morselized bone on repair of bone defect in vivo. MethodsA total of 36 New Zealand white rabbits were completely randomly designed into A, B, C, D groups and their bilateral radial bone defect model was prepared. The minimal morselized bone (300-500 μm in diameter) was made from the iliac of those rats. The CPPF and CPC were evenly mixed into CPC/CPPF composites which were divided into four groups in accordance with the CPPF weight O, 10％, 30％ and 50％ in CPC/CPPF composite. The CPC/CPPF composites of the four groups was mixed with the minimal morselized bone with ratio of 6:4 and then the mixture was implanted the bone defect of the rabbits in four groups. The gross, X-ray and histological observations were done at four and eight weeks. The biomechanical test was performed at eight weeks. Results When CPPF occupies 30％ of the CPC/CPPF composite, the maximum compressive load and bending loads were better than those in the other groups ( P ＜ 0.05 ), when the histological observation showed the most tight link between the artificial composite and the bone interface and the closest similarity between material degradation rate and the ossification rate, with the best osteogenesis and the optimal ratio.ConclusionThe repair of bone defect can attain the optimal outcome through adding a certain ratio of minimal morselized bone into the CPC/CPPF to adjust the degradation rate of composites.

Tertiary rehabilitation hospitals should not only serve patients with systemic and specialized rehabilitations but also have capabilities in diagnosis/treatment,and even emergency responses.This paper introduced an integrated care mode at a rehabilitation hospital,in practicing in-depth and phased integration of clinical service and rehabilitation.Phase 1 (March 2015-March 2016) witnessed the "two-way" model,with coexisting rehabilitation pathway and clinical pathway.The second phase,from April 2016 to September 2017,witnessed the integrated care mode in which clinicians and physiatrists jointly took care of patients.A comparison between the same period of 2016 with data of 2015,and that of 2017 with data of 2016,found average length of stay was shortened by 0.5 day and 3.6 days respectively,the drug ratio fell by 4.63％ and 8.47％ respectively;the rehabilitation effective percentage was increased from 95.2％ to 98.0％.The percentage of cure or improvement for primary diseases was over 97％.The integrated care mode by both clinicians and physiatrists can shorten the length of stay,lower the drug ratio,raise medical efficiency,and encourage a more reasonable ratio of medical expenses.

The demand for rehabilitation therapists is rising in response to social development, disease spectrum changes and population aging. Under the guidance of the integration of rehabilitation and clinical medicine, Beijing Rehabilitation Hospital has carried out a comprehensive scientific design and practice in the sub-professional training mode for new rehabilitation therapists according to the discipline development and clinical needs, strengthened their training of sub-professional skills, and provided an effective way to standardize the profession admission and specialty advancement.

OBJECTIVETo evaluate the diagnostic efficiency of colloidal gold and dot ELISA rapid tests in clinical screening of influenza A virus.

METHODSThe pharyngeal swabs were collected from 297 outpatients suspected of influenza between June and October, 2009 for detection with colloid gold and dot ELISA rapid test, with real-time PCR as the golden methods. The discrepant results of colloid gold and dot ELISA methods were confirmed by sequencing, and the diagnostic efficiency of the two methods was evaluated.

RESULTSAmong the 166 samples with influenza A virus infection as confirmed by real-time PCR and sequencing, the diagnostic sensitivity of dot ELISA and colloid gold methods was 54.82% (91/166) and 4.22% (7/166), respectively. The total concordance rate with PCR was 66.67% (Kappa value of 0.35). Among the 133 samples negative for influenza A virus, the specificity of dot ELISA and colloid gold methods was 81.68% (107/131) and 98.47% (129/131), respectively, with a total concordance rate with PCR of 45.79% (Kappa value 0.02). Of the 99 H1N1 influenza samples confirmed by real-time PCR, the detection rate of dot ELISA was 67.3%, whereas that of colloid gold was 5.1%. Out of the 107 dot ELISA-positive but colloid gold-negative samples, 84 were confirmed to be influenza A virus-positive by real-time PCR and sequencing. One sample negative for dot ELISA but positive for colloid gold test was confirmed to be influenza A virus-negative. The detection rate and diagnostic concordance rate for influenza A virus by dot ELISA were significantly higher than those of colloid gold (P<0.05).

CONCLUSIONDot ELISA is better than colloid gold in influenza A virus detection and shows great prospect in clinical screening.

Enzyme-Linked Immunosorbent Assay ; Gold Colloid ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; diagnosis ; virology ; Real-Time Polymerase Chain Reaction ; Sensitivity and Specificity

OBJECTIVETo increase local blood supply of bone graft, a novel posterior lumbar spine fusion method with orthotopic paraspinal muscle-pediculated bone flaps was constructed, and the fusion rate and clinical effect.were observed.

METHODSFrom June 2007 to December 2010, 117 patients of lumbar spinal stenosis or lumbar destabilization treated with the novel posterior lumbar fusion method were studied, 49 males and 68 females, aged from 40 to 77 years, average 61.5 years. Clinical effect was evaluated by JOA and VAS score preoperatively and postoperatively, and the fusion result was evaluated by three-dimensional CT reconstruction postoperatively.

RESULTSSeventeen cases lost of follow up, the rest were followed up from 7 to 38 months, average 19 months. There was significant difference between pre- and postoperative JOA and VAS score (P < 0.01), the preoperative JOA score was 10.3 ± 1.9, and 25.4 ± 4.2 at the latest follow-up, the improvement rate was 81.0% ; the preoperative VAS score was 8.5 ± 0.8, and 2.3 ± 0.4 at the latest follow-up. The three-dimensional CT reconstruction showed that 126 of the 133 segments formed solid fusion in 100 patients who completed the follow-up, the fusion rate was 94.7%.

CONCLUSIONThe novel posterior lumbar fusion method make the bone graft position more precise, stable and increases the fusion rate, which can effectively reduce pseudarthrosis and have a promising clinical effect.

Adult ; Aged ; Bone Transplantation ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; Male ; Middle Aged ; Spinal Fusion ; methods ; Spinal Stenosis ; surgery ; Treatment Outcome