AIM: To investigate lipoprotein lipase gene HindⅢ polymorphism and its relationship with serum lipids and apolipoprotein, serum HDL subclasses in patients with hyperlipoidemia. METHODS: Lipoprotein lipase gene HindⅢ polymorphism was assayed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The subclasses of serum HDL in 152 hyperlipoidemia patients and 128 healthy subjects were determined by two-dimensional gel electrophoresis conjunction with immunodetection method. RESULTS: H+H+ genotype and allele H+ in hyperlipoidemia and control groups were both the highest. In hyperlipidemia group, H+H+ genotypes tended to be higher than that in control group, while H+H- and H-H- genotypes were significantly lower (P

Objective To discuss the clinical effects of hemiarthroplasty for the treatment of intertrochanteric comminuted fracture in aged patients.Methods From June 2006 to June 2010,91 cases with intertrochanteric comminuted fractures were treated by hemiarthroplasty using Zweymtüller long-stem cementless implant.There were 35 males and 56 females,with an average age of 81.2 years (range,75-94 years).There were fresh fractures in 75 cases and old fractures in 16 cases.According to classification of Evans-Jensen,there were 36 cases with type Ⅲ fracture and 55 with type Ⅳ.Osteoporosis was graded by Singh index,and there were 51 cases with level Ⅲ and 40 with level Ⅱ.The interval between injury and operation was 2-10 d (average,3.5 d).Results The surgery lasted 30-50 min (average,39 min).The blood loss was 320-610 ml (average,405 ml).The hospital stay was 14-21 d (average,16.5 d).Two cases who experienced with the infection of the respiratory system after operation,recovered through routine treatment.Thirty-seven cases were followed up for 15 to 38 months (average,24.5 months).According to the Harris score,the overall rate of excellent or good result was 83.8％ (31/37).Conclusion Hemiarthroplasty using Zweymüller long-stem cementless prosthesis is reliable option for intertrochanteric comminuted fracture in the aged patients.

Objective To establish a rat model of coal-burning-borne fluorosis,and to observe the expression changes of bone morphogenetic protein-2 (BMP-2) and bone morphogenetic protein-3 (BMP-3) in the serum of rat treated with different dose of fluoride and different treatment duration.Methods A total of 120 clean grade SD rats(body mass between 80 to 120 g) weaned for 4 weeks were randomly assigned into four groups,which were control,low-dose fluorid,medium-dose fluorid and high-dose fluorid groups,respectively,and 30 rats in each group (female 15,male 15).All of the rats were fed with coal drying corn from fluorosis area.Ten rats were killed by femoral artery bleeding 30 d,90 d and 180 d after exposed to fluoride,respectively.Serum BMP-2 and BMP-3 level was tested by enzyme-linked immunosorbent assay (ELISA).Results ①Results of BMP-2:after exposed to fluoride for 90 d and 180 d,the differences of serum BMP-2 level between groups were statistically significant(F=385.08,173.98,all P ＜ 0.01).In low-dose fluorid,medium-dose fluorid and high-dose fluorid groups,the expression of serum BMP-2 at 90 d[(18.80 ± 0.43),(22.22 ± 0.85),(25.14 ± 0.69)μg/L] and 180 d[(7.98 ± 0.68),(8.97 ± 0.78),(15.04 ± 0.89)μg/L] was higher than that of control group[(12.54 ± 1.29),(7.53 ± 0.97)μg/L,all P ＜ 0.05],and the level of BMP-2 increased with increasing dose of fluoride (all P ＜ 0.05).Within each group,the difference of serum BMP-2 was statistically significant(F =55.42,511.58,686.35,671.64,all P ＜ 0.01).The expression of BMP-2 in each group at 90 d [(12.54 ± 1.29),(18.80 ± 0.43),(22.22 ± 0.85),(25.14 ± 0.69)μg/L] was higher than that at 30 d[(11.75 ± 1.15),(11.42 ± 1.07),(11.38 ± 0.92),(11.15 ±1.03)μg/L,all P ＜ 0.05].The expression of BMP-2 in each group at 180 d[(7.53 ± 0.97),(7.98 ± 0.68),(8.97 ± 0.78),(15.04 ± 0.89) μg/L] was lower than that at 90 d.②Results of BMP-3:the difference between groups was not statistically significant at every experimental stage(F =0.7215,1.2951,0.0964,all P ＞ 0.05).Conclusions Longer excessive fluoride intake stimulates the expression of BMP-2 in rats,but with prolonged fluoride intake,the stimulation becomes weak.The effect of fluoride on BMP-3 is not as sensitive as that on BMP-2.

Objective To evaluate the eradication rate and long-term therapeutic effect of a triple therapy consisted of cla-(rithromycin) (CLA), amoxicillin (AMO)and omeperazole on Hp infection,and explore the alternative therapeutic programs and their effects after first therapeutic failure.Methods A total of 92 children with Hp infection were divided into two groups: 70 children were given the triple therapy for one week (CLA group);Twenty-two children were given another triple therapy composed of metronida-(zoole) (MET), AMO and omeperazole for two weeks (MET group).All of the children were followed up for 1-30 months after the therapies ended.Children of the two groups who were therapeutic failure were given retreatment as follows.CLA triple therapy were given for one week to the children who were failure after MET triple therapy;increased doses of CLA with longer treatment course was given to the children who were failure after CLA triple therapy . A tetra therapy consisted of colloidal bismuth subcitrate (CBS), furazolidone (FUR) ,omeperazole and AMO was given to children in whom the retreatment failed.Results The Hp eradication rate of CLA group was 91.4%(64/70),and the Hp eradication rate of MET group was 72.7%(16/22).There was significant difference between eradication rate of the two groups(?~2=5.16 P

Objective To investigate the correlation between CT perfusion parameters of pulmonary carcinoma and standardized uptake values(SUV)derived from ~(18)F-fluoro-deoxyglucose positron emission tomography(~8F-FDG PET)and tumor microvessel density(MVD),and to determine the validity of CT perfusion in assessing tumor angiagenic activity of pulmonary carcinoma.Methods Fifty patients(mean age 57.5,17 females)with pulmonary carcinoma underwent CT perfusion using 16-slice helical CT.Blood flow(BF,ml?100g~(-1)?min~(-1)),blood volume(BV,ml?100g~(-1)),mean transmit time(MTF,s)and permeability surface area product(PS,ml?100g~(-1)?min~(-1))were analyzed.SUV of PET was calculated in 14 patients.The CD34 immunohistochemical staining was used for tumor microvessel counting.CT perfusion parameters of pulmonary carcinoma were correlatively studied with SUV and tumor MVD.Pearson's correlation analysis was performed to evaluate the association between CT perfusion parameters and SUV and MVD.Results The average values of BF,BV,MTT and PS were 97.30 ml?100g~(-1)?min~(-1), 8.86 ml?100g~(-1),6.75 s and 34.52 ml?100g~(-1)?min~(-1),respectively.The average value of MVD was 61.82/FOV.The mean value of SUV was 5.96.There was positive correlation between BF and SUV(r= 0.727,P

Objective To investigate the effect of low-dose glucocorticoid on prognosis of critical illness-related corticosteroid insufficient (CIRCI) patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods A total of 385 eligible patients met the criteria of AECOPD were admitted from January 2010 to December 2012.The AECOPD patients co-morbid with CIRCI screened by an adrenal corticotrophic hormone test within 12 hours after admission were randomly divided into treatment group (n =32) and control group (n =31) for prospective,randomized (random number) and controlled clinical study.Hydrocortison (150mg/d) for treatment group or normal saline instead for control group was injected intravenously for 7 days.The 28-day mortality,shock-free days,length of ICU stay within 28 days and ventilator-free days were evaluated.And the markers of inflammation C-reactive protein,tumor necrosis factor-α,interleukin 6 and procalcitonin were measured before and 7 days after treatment.The variables were analyzed by Student' s t-test,non-parametric statistical test,Chi-square test or KaplanMeier test with SPSS 18.0 statistic software.P ＜ 0.05 was considered statistically significant.Results A cohort of 385 patients with AECOPD was screened,and the prevalence rate of CIRCI was 16.4％.The shock rate was higher in the AECOPD patients co-morbid with CIRCI than that in the AECOPD patients without CIRCI (23.8％ vs 8.7％,P ＜0.01).Compared with the control group,the 28-day mortality was significantly lower in treatment group (2/32 vs 8/31,P ＜ 0.05),and shock-free days within 28 days longer in the treatment group (18.2 ± 9.5 vs 25.8 ± 4.1,P ＜ 0.05).However,there was no difference in the shock rate,days of ICU stay and ventilator-free days between the two groups.After treatment,the levels of infection markers were decreased and obviously lower than those in control group (P ＜ 0.01),such as Creactive protein (13.2 ± 5.5 mg/L vs 8.3 ± 3.1 mg/L for control group; 13.5 ± 5.9 mg/L vs 5.1 ± 2.3mg/L for treatment group),tumor necrosis factor-α (26.1 ± 16.2 μg/L vs 17.5 ± 11.7 μg/L for control group ; 25.0 ± 14.8 μg/L vs 10.4 ± 7.8 μg/L for treatment group) and procalcitonin [3.88 (0.25,8.5) μg/L vs 2.03 (0.15,5.1) μg/L for control group; 3.77 (0.21,8.0) μg/L vs 1.26 (0.10,3.2) μg/L for treatment group],furthermore,the levels of infection markers were decrease more obviously in the treatment group than those in the control group (P ＜ 0.01).Conclusions There was high prevalence rate of CIRCI in the patients with AECOPD in the department of critical medicine,and low-dose glucocorticoid reduced 28-day mortality,shock days and markers of infection and inflammation.

Objective To explore the care burden and its influencing factors of primary caregiver of patients with spinal cord injury. Methods A total of 120 primary caregiver of spinal cord injury patients were selected as research object. The general information of SCI patients and their primary caregiver were investigated by SCI patient general data questionnaire and primary caregiver in SCI patient general data questionnaire, caregiver burden of spinal cord injury were investigated bycaregiver burden inventory. The relationship between the general information of patients and caregivers and the care burden analyzed. Results Caregiver burden of elderly patients was significantly lower than that of younger ones (F=54.053,P<0.01). The more serious of spinal cord injury, the higher of care burden (F=315.104,P<0.01). The patients with neck and multiple segmental spine injury and postoperative complications had a higher care burden (F=199.203,t=6.462, 32.195,P<0.01). When the caregivers were female, spouses or children, with poor health condition, with higher education degree, and as cadres or workers, caregiver burden was higher (t=6.061,F=22.073-52.392,P<0.01). Multiple linear regression analysis showed that the degree of spinal cord injury, complications, gender, and the relationship between the patients were the main factors that influenced the care burden. Conclusions The main factors influencing the care burden are spinal cord injury degree, complications, gender, and the relationship between the patients. Clinical managers needs to develop appropriate social support system for the factors which affect the caregiver, in order to ease the caregiver′s care burden.

Objective To develop a network system for radiotherapy.Methods Delphi 6.0 lan- guage was used to program the system based on PACS through the model of client-server machine and local network.Data of different facilities were transferred among each other through Dicom 3.0 and Dicom RT pro- tocol.Results The main function of this system was a management software for radiotherapy,a PACS sys- tem,a TPS system and a therapeutic machine system.Conclusion The network system operates steadily with data safe and reliable,and is an important part of the information construction in the department of radio- therapy

Bone turnover is regulated by local concentrations of cytokines such as osteoprotegerin (OPG) and receptor activator of nuclear factor kappaB ligand (RANKL). To explore the in vivo biological function of Opg and the mechanism of osteoporosis due to deficiency of Opg, Opg knockout mice have been generated through homologous recombination. Opg-/- mice exhibit a sharply decrease in bone density and strength as expected. The number of osteoclasts in Opg-/- mice significantly increases. Morphologically, osteoclasts appear more cuboidal in shape in Opg-/- mice than those of wt mice, suggesting that active osteoclastogenesis occurs in the absence of Opg. In consistent with this finding, an increase of osteoblast activity was also observed with accelerated mineral accumulation rate by histomorphometric measurement and elevated serum alkaline phosphatase activity (ALP) in Opg-/- mice. Interestingly, more than 50% of 2-month-old Opg-/- mice manifest medial calcification of aorta with comparable serum concentrations of calcium and phosphorus to wt mice. In conclusion, Opg-/- mice have a high-bone-rurnover type osteoporosis. The aortic calcification in Opg-/- mice is not due to abnormality of calcium and phosphorus metabolism. The mechanism underlying aortic calcification in Opg-/- mice needs to be further investigated.

The gene of mutated TNF-?D4 gene was amplified by overlap PCR and cloned into the prokaryotic expressive vector pBV220.TNF-?D4 contains two changes:substitutions of Pro8Arg,Ser9Lys,Asp10Arg,Ile157Phe,Leu29Ser,Arg31Val and a deletion of the N terminal four amino acids.The recombinant vector pBV220-TNF-?D4 was transformated into E.coli strain DH5?,and the high expression strain was obtained by screening monoclones.The level of expression was about 45% of total cell protein.After purification,the purity of fusion protein was above 90% by HPLC and relative ability was 8 ?107.TNF-?D4 was modificated by mPEG-ButyrALD。After purification,the purity of mPEG-TNF-?D4 was above 85% and relative ability was 8.6?107.The in vivo systemic toxicity of mPEG-TNF-?D4,which is indicated by LD50,is lower than that of rhTNF-?.These results strongly supported for the further study and exploitation of TNF-antitumor drug.