Objective To investigate the effect of enteral nutrition on patients with COPD during acute exacerbation stage. Methods Subjects hospitalized for an acute exacerbation of COPD (n=58) were assigned into two groups: enteral nutrition group (n=33) or parenteral nutrition group (n=25). The blood indexes of nutrition at day 5 and day 10,the incidence of complication and the mortality were observed. Results Less decrease of serum proteins was detected in the enteral nutrition group as compared with that in the parenteral alimentation group (day 5 P

Objective To probe the mechanism of metronidazole resistance to Helicobacter pylori (Hp). Methods (1) The selective pressure test of metronidazole. (2) SDSPAGE electrophoresis. (3) Nitrate reduction test. (4) Test for detecting the enzyme activities associated with 95 substrates of gram negative. Results After the mutation of Hp from sensitive to resistant strains, the activities of enzymes associated with monomethyl succinate, succinic acid and Dalanine is decreased, and those associated with Lfucose 6phosphate glucose is increased. Conclusions The metronidazole resistance of Hp is associated with the metabolism and the change of enzyme activities.

Objective To investigate the in vitro quinolones resistance in Helicobacter pylori ( HP) strains isolated in Zhejiang province and to provide references for the clinical application of quinolones in the eradication of HP infection.Methods A total of 713 HP strains were isolated from several hospitals located in different regions of Zhejiang province from April to June 2013.Drug sensitivity test was performed to measure the resistance of those HP strains to levofloxacin and moxifloxacin by using the agar dilution method recommended by the Clinical and Laboratory Standards Institute ( CLSI) .The antibiotic solutions were added to the agar and diluted into corresponding critical concentrations.The mixed liquors were placed in dilution plates and added with the bacteria suspension.If there were bacterial expansion on the plates after incuba-tion, the strains were considered to be drug-resistant strains.Results The resistance rates of 713 HP strains to levofloxacin and moxifloxacin were 19.50%.In addition to the Jinhua area, drug resistance rates in the other 7 areas including Hangzhou, Wenzhou, Shaoxing, Jiaxing, Taizhou, Lishui and Zhoushan were above 15%.The highest drug resistance rate of HP was found in Wenzhou, which was significantly higher than that in Jinhua area (26.40%vs 9.52%, P<0.05).No significant differences in the resistance rate of HP to quinolone were found between Wenzhou area and the other regions in Zhejiang.Conclusion Com-pared with amoxicillin and furazolidone, higher resistance rates of HP to levofloxacin and moxifloxacin were observed in Zhejiang province.Because the mechanisms of drug resistance to levofloxacin and moxifloxacin were same and the drug targets within HP to which the two antibiotics binding were similar, levofloxacin and moxifloxacin shared common characteristics of drug resistance among HP strains, indicating that prescription of the two antibiotics in replacement should be avoided in clinical treatment of HP drug-resistant strains.

Objective:This study aimed to determine the function of herbs in preventing diarrhea after irinotecan chemotherapy and analyze the efficacy of the herbs based on UGT1A1*28 gene polymorphism. Methods:A total of 200 patients admitted to the De-partment of Synergistic Chinese and Western Medicine, Tianjin Medical University Cancer Institute and Hospital between October 2011 and May 2013 were randomly divided into the control (chemotherapy alone) and herb (chemotherapy combined with herbs) groups. All patients consented to UGT1A1*28 gene polymorphism detection prior to chemotherapy. Herbs were administered from 2 d prior to chemotherapy to 5 d post chemotherapy, with or without the regimen of fluorouracil, folinic acid, and irinotecan. Adverse reac-tions were recorded, and short-term effect was evaluated regularly. Results:A total of 144 patients had TA6/6 wild genotype, and anoth-er 56 patients had non-wild genotype (12 of the 56 cases were TA7/7 homozygous, and the other 44 cases were TA6/7 hybrid). A total of 58 patients experienced grades 2 to 4 diarrhea. A 14%decrease in the incidence of diarrhea was observed in the herb group compared with that of the control group (22%vs. 36%, P=0.029). In addition to diarrhea, grades 2 to 4 vomiting was significantly lower in the herb group than in the control group (15% vs. 27%, P=0.037). The overall response rate was 37.5%. No significant difference was found between the two groups (40% vs. 35%, P=0.465). The incidences of grades 2 to 4 diarrhea (22.9% vs. 44.6%, P=0.002) and grades 2 to 4 vomiting (23.2%vs. 16.7%, P=0.016) were lower in patients with the UGT1A1*28 wild genotype than in those with the non-wild genotype. However, in the herb group, the incidences of grades 2 to 4 diarrhea (22.2% vs. 21.9%, P=0.974) and vomiting (18.5% vs. 13.7%, P=0.777) were not significant between the non-wild-and wild-type groups. Conclusion:Herbs can effectively pre-vent the late diarrhea caused by irinotecan, which is also applicable in UGT1A1*28 non-wild genotype patients. Incidence of diarrhea was obviously higher in the cases with UGT1A1*28 non-wild type than in those with wild genotype. Hence, the UGT1A1*28 gene type should be detected prior to chemotherapy with irinotecan.

Objective To describe a technique of closed reduction and percutaneous internal fixation for the treatment of displaced patellar fractures and evaluate the clinical results. Methods Fifteen cases (nine males and six females with mean age of 35.5 years, ranging from 24 to 65 years) with displaced patellar fractures were treated with closed reduction (or an arthroscopic-assisted reduction) and percutaneous cannulated screw fixation (or Kirschner wire tension band wiring technique) under guidance of fluoroscopy or C-arm X-ray tomography. Controlled passive range of motion exercises started on the first postoperative day. The mean follow-up was 28 months (24-35 months). Results All cases healed successfully with healing time of (1.2?2.2) months and mean Lysholm II score of 86.8 (79-96), except for one patient regained full knee range of motion. Compared with the contralateral side, a mean quadriceps atrophy of 0.8 cm was seen in unilateral cases based on Tandogan measurement. There was no implant failure or postoperative infection. Conclusions The technique of closed reduction and percutaneous internal fixation is appropriate for displaced, transverse, longitudinal or oblique patellar fractures and can facilitate early postoperative range of motion exercises and accelerate rehabilitation of the affected knee with few complications and minor incision without disturbing blood supply of the patella. But, this method is not suitable for severely comminuted fractures.

Objective To establish the sensitive,specific,stable and convenient immunoradio assay for detecting human soluble IL-6R?.Methods The hybridoma cell lines were obtained by fusing spleen cells of BALB/c mice that had been immunized with soluble IL-6R? protein to mouse myeloma cells sp2/0. Ascites were used to produce the monoclonal antibodies (mAbs). The mAbs were purified by protein G immunoaffinity method. The mAb SI10 was used as coating antibody, the other mAb H126 recognized different epitope from SI10 was labeled by 125I. Results The immunoradio assay for detecting soluble IL-6R? was set up. It has high stability and accuracy. The detecting limit is 10 ng/ml. The serum concentration of soluble IL-6R? is (81.96 ? 7.23) ng/ml in healthy donors and (237.58?70.96) ng/ml in patients with multiple myeloma. Significant difference was founded between two groups (P

Objective To investigate the possibility,surgical methods,outcome and surgical indications of minimal invasion dynamic hip plate (MIDHP) through percutaneous limited open reduction in treatment of subtrochanteric femur fractures.Methods All cases underwent percutaneous limited open reduction with MIDHP.Duration of operation,intraoperative bleeding volume,length of incision,incidence of intra-or post-operative complications of all case were recorded.X-ray films were reviewed periodically after operation to analyze aspects of fracture displacement,loosening of intemal fixation,screw cutting femoral neck,screw penetrating out of or withdrawing from femoral head,bending or breaking of internal fixation,and fracture healing.Hip joint function was evaluated according to Huang' s criteria.Results Operation lasted for 45-55 minutes (average 50 minutes),showing the incision length of 4.0-5.0 cm (average 4.5 cm) and blood loss of 50-200 ml (average 150 ml).A total of 21 cases were enrolled in the study and were followed up for 6-28 months (average 18 months).In the follow-up,loosening or bending of internal fixation,fracture displacement,screw cut-out,and screw penetrating or withdrawing from femoral head did not occur.In the meantime,incision,bone,and joint were not infected.All cases had bony fusion within 3 months with the fracture healing rate of 100％.According to Huang' s criteria,hip function was excellent in 19 cases and good in two.Conclusions MIDHP with percutaneous limited open reduction is characterized by less trauma,small incision,less blood loss,less postoperative complications,firm fixation,early functional exercise,free load,and good hip functional recovery and hence is suitable for cases of different subtrochanteric femur fractures,especially for cases combined with osteoporosis.

Pancreatic stellate cell (PSC) activation in islet fibrosis of insulin-resistant rats induced by high-fat diet was investigated. After 20 weeks, the glucose infusion rate and glucose-stimulated insulin secretion in high-fat group were significantly decreased while fasting plasma glucose, fasting serum insulin, free fatty acid and the basal glucagon secretion were significantly increased compared with those parameters of the control rats (P< 0.05 or P<0.01). Activated PSC and collagen fiber ( type Ⅰ and Ⅲ) were found in islets of rats fed with high-fat. The result suggests that PSC activation, proliferation and migration to islet may contribute to islet fibrosis in insulin-resistant rats.

Objective:To investigate the expression of inducible costimulatory ( ICOS) and inducible costimulatory ligand ( ICOSL) on peripheral blood mononuclear cells ( PBMCs ) and their clinical relationship with rheumatoid arthritis ( RA ) patients.Methods:Peripheral blood samples were collected from 85 RA patients and 50 HC in this study.Expression of ICOS and ICOSL on PBMC from the subjects were detected by flow cytometry and real-time polymerase chain reaction( RT-PCR).The alteration of ICOS and ICOSL were observed after hormone therapy in 15 patients with RA and the relationship between their expression level and patients′clinical manifestations were analysed.Results:The ICOS and ICOSL mRNA level of RA patients′PBMCs were significantly higher than that in HC.The expression level of ICOS on CD4+T cells was higher than than that in HC[(7.08±4.72)% vs (3.01+1.39)%,P<0.0001].The expression of ICOSL on monocytes[(5.77±3.45)%vs (3.64±1.43)%,P<0.05] and B cells [(5.78± 4.52)%vs (3.97±1.63)%,P<0.05] were significantly elevated in RA patients.In RA patients with active disease,however,ICOSL expression on monocytes and B cells were increased as compared with those in inactive RA patients [ ( 5.45 ±3.50 )% vs ( 4.04 ± 1.55)%,P=0.036],[(6.59 ±5.74)%vs (5.63±4.30)%,P=0.016].Furthermore,after receiving immunosuppressive therapy, the expressions of ICOS and ICOSL were notably reduced as compared with pre-therapy levels on PBMCs from patients [ ( 5.45 ±3.50)%vs (4.04±1.55)%,P=0.036],[(6.59 ±5.74)%vs (5.63±4.30)%,P=0.016].Conclusion:The high levels of ICOS and ICOSL expression were closely correlated with the degree of disease and therapeutic response,suggesting that ICOS/ICOSL pathway may play a critical role in pathogenesis of RA.

Objective To perform a mechanical test of fresh cadaver specimens and compare the biomechanical properties of the novel minimal invasion dynamic hip plate (MIDHP) and the dynamic condylar screw (DCS) in treatment of subtrochanteric fractures of the femur.Methods All specimens were firstly used to simulate models of Seinsheimer type ⅡA subtrochanteric fractures of the femur,which were later divided into DCS group and MIDHP group.Based on experimental requirements,the femoral head and distal femur were embedded using seff-freezing type dental base acrylic resin powder.Torsion strength test was given in the first place,succeeded by compression strength test.Finally,destructive test was made to record the limit load.All experimental data were analyzed statistically.Results Torsion strength test showed that specimens of both groups were basically stable as the reverse was within 3°.Torque for specimens in DCS and MIDHP groups was (3.16 ± 0.13) N · m and (3.31 ± 0.27) N · m respectively as the reverse was 1.5°.Both torque and torsion stiffness had no statistical significance between the two groups,and the anti-rotation features of the two internal fixations were similar.Compression strength test showed that compression stiffness of specimens in DCS group was (532.27 ±61.02) N/mm and (581.98 ±77.56) N/mm in MIDHP group at a load of 800 N,with evidently higher compression displacement and stiffness in MIDHP group (P ＜ 0.05).Destructive test showed the maximum load of specimens in DCS and MIDHP groups was (2 994.38 ±244.81) N and (3 322.13 ± 141.21) N respectively,far higher in MIDHP group (P ＜ 0.01).Conclusions MIDHP is characterized by reasonable design,strong anti-rotation property and anti-compression property over DCS.In comparison with DCS,MIDHP has biomechanical advantage in treatment of femoral subtrochanteric fractures,for it can be performed minimally invasive and is worthy of further application.