Objectives:To explore the effect of total parenteral nutrition support on immunity funtion in critically ill patients . Metheds:60 Cases of critically ill patients were divided into two group(A and B).Group A was treated with the normal regulation treatment.Group B (30 patients) was treated with the normal regulation treatment and total parenteral nutrition support treatment for 2 weeks. Results:After the treatment,total lymphocyte and T cell population level in the B group were significantly higher than those in the A group ( P 0.05). Conclusions:Total parenteral nutrition support treatment can significantly improve the immunity function in the critically ill patients.

Objective: To explore the effect of parenteral nutrition support on immunity function in severe undernourished patients with chronic obstructive pulmonary disease. Methods: 36 cases of patients with severe chronic obstructive pulmonary disease were randomly assigned into experimental and control group.Control group was treated with normal regulation treatment.Experimental group was treated with normal regulation treatment and parenteral nutrition support for 2 weeks. Results: After the treatment,total lymphocyte,T cell population and OT test level in the experimental group were significantly higher than those in the control group( P

Objective To investigate the diagnostic value of serum MK (Midkine)and total bilirubin (TB)in diabetic retinopathy (DR). Methods A total of 148 patients with type 2 diabetes were divided into three groups:diabetes without retinopathy (NDR group,n = 50),diabetic with non proliferative retinopathy (NPDR group,n = 52 )and diabetic with proliferative retinopathy (PDR group,n = 46 ) according to whether retinal lesions were detected. The diagnostic value of serum MK and TB were investigated. Results Age,gender,body mass index (BMI),FPG,HbA1 c,TG,TC,LDL-C,HDL-C, SBP,DBP were not statistically different among the three groups (P >0.05).Duration,UAlb/Cr,SOD, MDA,AOPP,MK,TB and DB were statistically different among the three groups (P<0.05). Duration, ALB/CR,MDA,AOPP,and MK were higher,SOD,TB,DB were lower in PDR and NPDR group than in NDR group (P<0.05). Duration,UAlb/Cr,MDA,AOPP,and MK were higher,and SOD,TB,DB were lower in PDR group than in NPDR group (P <0.05).Logistic regression analysis showed that duration, ALB/CR,MDA,AOPP,and MK were risk factors (OR =1.36,1.71,1.27,1.65,2.35,P <0.05 )and SOD,TB,DB were protective factors for DR (OR =0.46,0.31,0.46,P <0.05). Diagnosis sensitivity, specificity,positive predictive value,negative predictive value and accuracy of TB combined with MK were higher than TB,MK alone(AUC=0.918,0.735,0.762,P <0.05). Conclusion DR may be associated with increased MK and decreased TB.Diagnostic efficacy of MK combined with TB is better than MK,TB alone.

Objective To study the mutations of Pseudomonas aeruginosa oprD gene in Imipenem-resistant clinical isolates. Methods Random amplified polymorphic DNA typing(RAPD) was carried out to analyse the homology in 10 Imipenem-resistant clinical isolates. Pseudomonas aeruginosa oprD gene in 10 Imipenem-resistant clinical isolates were amplified by polymerase chain reaction and sequenced. Results Ten Imipenem-resistant clinical isolates were divided into four different clones which can not produce metallo ?-lactamase. As compared with sequence X63152, oprD gene of Pseudomonas aeruginosa varied greatly. The aberration rates exceed 50%. There were multiple point mutations within 276～387 bp coding region of 30, 11, 9, 20, 31 strains. Due to the mutations of 308 bp G→C and 344 bp C→A, threonine and diaminocaproic acid were replaced by serine and threonine respectively. The DNA deletion of 393～412 bp in oprD gene contributes to the frame shift mutation in the following nucleotide sequence. The deletion of 264～273 bp in the coding region of oprD gene in 13 and 21 clone strains leads to frame shift mutations forming terminal codon TAA(319～321 bp).Base substitutions and multiple point mutations were obvious in the coding regions of 1 and 22 clone strains. Their aberration rates were 54.03% and 74.89% respectively. Conclusions The mutations of Pseudomonas aeruginosa oprD gene in Imipenem-resistant clinical isolates are various.

Objective To explore the effect of CYP2D6 gene polymorphism on blood concentration,therapeutic efficacy and adverse effects of anti-depression drug venlafaxine.Methods 69 cases of patients with depression were selected randomly from southern region of FuJian,China.The blood concentration of venlafaxine was detected by HPLC,and the CYP2D6 genotype was determined by sequencing with the amplified PCR products from peripheral blood DNA.The therapeutic efficacy and adverse effects of venlafaxine were evaluated by Hamilton depression scale(HAMD) and treatment emergent symptom scale(TESS) respectively.Results Subjects was divided into CC,CT,TT three groups based on rs16947 locus genotyping.The blood concentrations of venlafaxine were (157.35±15.63) ng/ml,(70.17±5.11) ng/ml,(115.72± 10.2) ng/ml respectively and there was no significant difference (F=1.257,P=0.301).The dose-corrected concentrations and normalized concentrations were not significantly different (F=1.683,1.547,P＞ 0.05).Similarly,the reduction rate of HAMD (CC:(40.6 ± 7.23) ％,CT:(51.7±7.09)％,TT:(42.8±14.1)％) and TESS scores (CC:1.3±0.21,CT:1.3±0.36,TT:1.2±0.28) were not significantly different either (P＞0.05).In 69 samples in this study,genotyping of rs3892097 locus only found GG type,and no further examination was performed.Genotyping divided rs1065852 locus into CC,CT,TT three groups.The blood concentrations of venlafaxine were (42.87±9.9) ng/ml,(64.25 ± 13.59) ng/ml,(181.56± 14.15) ng/ml respectively,and there was significant difference among the three groups (F=4.893,P=0.016).The dose-corrected concentrations and normalized concentrations were also significantly different (F=3.985,3.648,P＜0.05).The reduction rate of HAMD (CC:(42.6±8.23) ％,CT:(48.8± 10.8) ％,TT:(63.4±9.15) ％) was not significantly different (F=2.961,P=0.07).The difference of TESS scores was similar to that of HAMD reduction rate.Conclusion Among the 3 loci studied,only rs1065852 locus within CYP2D6 gene can affect its enzyme activity and then influence the therapeutic efficacy and adverse effects of venlafaxine.

OBJECTIVE To study the antimicrobial susceptibility and molecular epidemiology of imipenem-resistant Pseudomonas aeruginosa isolated from patients in burn wards in a hospital of Guangzhou. METHODS A total of 48 imipenem-resistant isolates were collected,antimicrobial susceptibility was tested by KirbyBauer disk diffusion method.Random amplified polymorphic DNA(RAPD) typing was carried out to analyze the homology. RESULTS All isolates were multiresistant,the orders of sensitivity rates of antibiotics were CIP,TOB,AMK,GEN,and FEP.Forty eight strains were classified into types A,B,C,and D based on RAPD pattern,types A and B were the most epidemic clones. CONCLUSIONS The prevalence of imipenemresistant P.aeruginosa in burn wards of the hospital is due to nosocomial infection.The prevalent strains are multiresistant.

OBJECTIVE To analyze homology,antimicrobial susceptibility and metallo-?-lactamase gene type of metallo-?lactamase producing Pseudomonas aeruginosa in burn wards.METHODS Antimicrobial susceptibility tests were performed with E-tests.Using 2-mercaptoethanol disc synergy test to screen metallo-?-lactamase(positive) strains from imipenem-resistant P.aeruginosa in burn wards.Metallo-?-lactamase gene and integrase gene were amplified and sequenced.Resistance plasmid transfer and curing experiments were implemented to study the transfer of imipenem resistance and plasmid DNA was extracted and purified with Qiagen Plasmid Mini Kit.Random amplified polymorphic DNA(RAPD) typing was carried out to analyze the homology of the isolates.(RESULTS) Six strains of P.aeruginosa were suggested to produce metallo-?-(lactamase) by 2(-mercaptoethanol) disc synergy test.Using primers described for bla(VIM),the amplifications were observed among all 6 isolates and a VIM-2 metallo-?-(lactamase) gene was identified by sequencing.All isolates which producing VIM-2 metallo-?-(lactamase) had class 1 integrase gene and derived from a same clonal origin.CONCLUSIONS(VIM-2) metallo-?-(lactamase) producing P.aeruginosa is prevalent in burn wards,all isolates which producing VIM-2 metallo-?-(lactamase) have class 1 integrase gene.

Objective To invcstigate the clinical effect of Bushenxuanfei decoction combined with salmon calcitonin on osteoporosis in COPD patients.Methods 60 COPD patients with osteoporosis were randomly divided into two groups:30 patients as controls were treated with calcium carbonate and vitamin D3 tablets and salmon calcitonin and another 30 patients in the treatment group with salmon calcitonim combined with Bushenxuanfei decoction.The two groups were compared in terms of pain,BMD and calcium concentration.Results The treatment group was significantly better than the control one in terms of indexes of pain BMD and calcium concentration (P＜0.05).Conclusion Bushenxuanfei decoction combined with salmon calcitonin is of significant effect in the treatment of osteoporosis in COPD patients.

ObjectiveTo explore the relationship between the mRNA and protein expressions of NIX and the pulmonary alveolus apoptosis following severe acute lung injury (ALI).Methods Rat models of severe collision injury on the chest were built.The mRNA and protein expressions of NIX in the alveolar cells at 6,12,24,48,72 and 96 hours after injury were detected using immunohistochemistry,immunoblotting and RT-PCR.Meanwhile,apoptosis of the alveolar cells was checked at different time points with Tunel assay.ResultsThe protein expression of NIX in the alveolar cells was observed both in experimental and control groups,which increased at 6 h post injury,peaked at 48 h and then declined till approaching the pre-injury level at 96 h.In the meantime,NIX showed a high expression both in the vascular endothelial cells (VECs) and the renal interstitial fibroblasts.The apoptosis of alveolar cells mainly presented in bronchi,blood vessel endothelium (BVE) and alveolar epithelium at 24 h post injury.The post-injury apoptosis rate of the alveolar cells was significantly higher than the pre-injury rate ( P ＜ 0.01 ),which reached the peak at 72 h and then decreased gradually.The changes of NIX protein in lung tissue showed a positive correlation with the apoptosis rate of alveolar cells after injury (r =0.303,P ＜ 0.01 ).ConclusionsThe up-regulated expression of NIX takes part in the pathophysiological process of apoptosis of the alveolar cells and shows consistency with the apoptosis rate change of the alveolar cells,as may be the molecular basis for apoptosis of the alveolar cells after ALI.