Objective To prepare chitosans of high degree of deacetylation with different molecular weights.Methods A series of chitosan samples of high degree of deacetylation were prepared by different approaches of hydrolysis from commercial chitosan in the presence of strong base.The obtained deacetylchitosans were then degraded into samples with medium or low molecular weight in the system of acetic acid and hydrogen peroxide.Their corresponding molecular weights were further determinied with Ubbelohde viscometer.Results Chitosans of high degree of deacetylation with different molecular weights were successfully prepared under the experiment conditions.Their characteristics were indicated and analysed by IR and 1H-NMR.Conclusion Chitosans of 90%~100% degree of deacetylation can be prepared by the intermittent approach of hydrolysis using 10mol?L-1 NaOH solution at 110℃.Chitosan samples with the viscosity-average molecular weigh between 10,000 ~100,000 Da can be prepared in the system of 0.35 mol?L-1 acetic acid and 0.45 mol?L-1 hydrogen hyperoxide.

AIM:To investigate the effect of Dachengqi decoction(DD)on the acute respiratory distress syndrome(ARDS)in rat model induced by endotoxin "two-hit".METHODS:48 healthy male Wistar rats were randomly divided into 4 groups:control group,ARDS model group,ARDS+DD treatment group and ARDS+dexamethasone treatment group(12 in each group).E.coli lipopolysaccharide(LPS)"two-hit" induced ARDS model in rats was established.The arterial blood gas analysis,lung wet/dry weight(W/D)ratio and lung tissue pathology observation and scoring were measured to evaluate the pharmacological effects of DD on ARDS.The levels of TNF-?,IL-1 and IL-10 were determined by ELISA to explore the immune regulatory mechanism of DD.RESULTS:(1)Treatment with DD significantly improved blood pressure in rats,increased oxygen saturation,decreased lung wet/dry weight ratio and lung injury score,relieved pulmonary edema and the inflammatory responses.(2)DD suppressed the productions of systemic and pulmonary pro-inflammatory mediators and promoted the release of anti-inflammatory mediators in lung.CONCLUSION:The inhibitory effects of DD treatment on pulmonary inflammatory response are not only related to reducing the extent of systemic inflammatory response,but also promote pulmonary anti-inflammatory production and regulate the balance of pulmonary pro-inflammatory mediators and anti-inflammatory cytokines.This specific regulatory effect protects the target organ from excessive inflammatory organ injury,discloses that DD has advantages in the treatment of endotoxic ARDS.

Total 406 community residents entered in fitness improvement program with “management by objectives model of health promotion” from 2009 to 2011.The fitness status was monitored by Xuhui Physical Constitution Center before and after entering the program.The results showed that the level of fitness assessment,the composite score,lung capacity and reaction time were improved with the years (P ＜ 0.01) ; the step index and sitting-and-reach test in 2010 was better than those in 2009(P ＜ 0.01) ; the grip strength in 2010 and 2011 was better than that in 2009 (P ＜ 0.01); the test of single leg-standing with closing eyes in 2011 was better than that in 2009(P ＜ 0.05).There was no difference in body mass index before and after program (P ＞ 0.05).The results indicate that physical fitness and overall health can be improved by management by objectives model for health promotion.

OBJECTIVE To investigate the epidemiological characteristic of lower respiratory infection among the hospitalized patients in Tianlin Community Health Service Center so as to take effective measures to control the infection and reduce the emergence of drug resistant strains.METHODS Totally 6150 cases of patients discharged from our Center during from Jan 2004 to Sept 2006 were collected and among them 141 cases occurred hospital onset of lower respiratory infection and drug resistance was analyzed through contrasting.RESULTS The incidence rate of hospital onset of lower respiratory infection and drug resistance were 2.29% and 58.62%.Among the 141 cases,the incidence rate of ESBLs was 28.36% which mainly produced from Escherichia coli and Klebsiella pneumoniae.CONCLUSIONS Primary affection should actively treated and antibiotics should use rationally according to the drug sensitive cultivation to control the abuse of antibiotics and reduce the emergence of drug resistant strains.

Recent studies have found that peptide therapies tar-geting specific epitopes can avoid nonspecific immune suppres-sion induced by traditional medicines for the treatment of autoim-mune diseases, and have shown great therapeutic effect in ani-mal models of autoimmune diseases and clinical trials. The pa-per summaries the research progress and trends of peptide drugs for the treatment of autoimmune diseases from candidate peptide sources and their suppression mechanisms, which can provide a theoretical basis for the in-depth understanding of immune toler-ance and allow for discovery of new treatment for autoimmune diseases.

Objective To evaluate patient outcomes of sustained low flow oxygen inhalation therapy with humidifying and non-humidifying oxygen.Methods Randomized controlled trial (RCT) about sustained low flow oxygen therapy with humidifying and non-humidifying oxygen were searched from China National Knowledge Infrastructure (CNKI),Wanfang database,VIP database,PubMed on line.Literatures were searched from the database had been established till now.The primary outcome of the rate of unpleasant respiratory symptoms,oxygen humidification cylinder pollution as well as secondary lower respiratory tract infections were attached importance to.Two reviewers evaluated the literatures independently according to the RCT authentic assessment manual of Cochrane Collaboration.Negotiation took as the measure to attach an agreement.RevMan 5.2 was used to analyses the result of the study.Results A total of 15 met the inclusion criteria,Meta-analysis showed that humidifying and non-humidifying oxygen was not statistically significant with the rate of unpleasant respiratory symptoms (P ＞ 0.05).Non-humidifying group was better than humidity group at the rate of oxygen humidification cylinder pollution and the secondary lower respiratory symptoms (Z=2.50,2.44,P ＜ 0.05).Conclusions Low flow nasal oxygen inhalation therapy may not have to use humidifying oxygen.

Objective To evaluate a normative and systematic training mode for teachers of community general practice.Methods A total of 16 general practice teachers,who came from Fenglin community health service centre in Shanghai,participated three-stage training mode during March 2011 to February 2012.The clinical competence evaluation and questionnaire survey were conducted before and after training.Fifty trainees trained by the teachers also received clinical competence evaluation.Results After the three-stage training,the test score in medical knowledge,physical examination and clinical skills of the teachers did not change significantly (P =0.794,0.674 and 0.326).The self assessment questionnaire survey of general practice teachers indicated a significant increase,especially in practice capability (t =-2.840,P =0.015) and overall quality (t =-3.017,P =0.011).After training by the teachers,the medical knowledge (t =-9.200,P =0.000),physical examination (t =-9.947,P =0.000) and clinical skills (t =-14.828,P =0.000) of 50 trainees increased markedly.Conclusions Differed from conventional training courses,the three-stage training enhances teaching ability and overall quality of community general practice teachers,and provides a effective training model.

Objective: To investigate SIN ( Sinomenine) for TLR signal transduction pathway and MyD88 ( MyeloidDifferentiation Factor 88), TRAF-6 ( Tumor necrosis factor receptor associated factor-6) expression, clarifying SIN inhibit RA(Rheumatoid arthritis)-FLS(Fibroblast-like synoviocytes)proliferation leads to joint deformity of RA cartilage and subchondral bonedestruction caused by the role of mechanisms.Methods: RA-FLS cells for vitro were divided into a control group and(0.125,0.25,0.5,1 mmol/L)SIN group,within each group were detected by alkaline phosphatase(ALP)activity,to determine the best concentrationfor vitro drug;detect 0.5 mmol/L SIN group in CCK-8 method to detect cell proliferation rate;fluorescence quantitative PCR methodMyD88 SIN group and control group with 0.5 mmol/L TRAF-6 gene expression;Western blot method to detect MyD88 SIN group andcontrol group with 0.5 mmol/L TRAF-6 protein expression.Results: SIN the ALP activity of the lower than the control group,with theminimum ALP activity of 0.5 mmol/L SIN group(P<0.01).CCK 8 method,0.5 mmol/L RA-FLS cell proliferation rate SIN group wasobviously lower than the control group(P<0.01),SIN induce cell proliferation rate was highest,4 days into the plateau,after cell proliferationrate began to fall.Fluorescence quantitative PCR and Western blot method to detect,0.5 mmol/L SIN group of MyD88 andTRAF-6 gene and protein expression significantly lower than the control group,the difference was statistically significant(P<0.01). Conclusion: The SIN of TLR signalling pathways through effectively suppress the influence of RA-FLS MyD88 in the cell and theexpression of TRAF-6,this could be a treatment of RA prevent cartilage and subchondral bone damage cause joint deformity happened one of the important molecular mechanism.

Considerable attention has been directed toward studying the impact of diabetes on the central nervous system. The current study investigates the biochemical changes in the brain tissue of streptozotocin (STZ)-induced diabetic rat using 31P magnetic resonance spectroscopy (31P MRS). The 31P NMR spectra of the whole brain show no significant changes of phosphomonoesters and phosphodiesters levels one week after STZ induction, suggesting no apparent structural changes in cell membranes. The results identifies the increased level of adenosine diphosphate, negligible changes of phosphocreatine ( PCr ) and adenosine triphosphate ( ATP) , but the decreased ratio of PCr/ATP, indicating that PCr plays a role of balancing the energy. Moreover, the decreased pH value indicates the changes of the intracellular environment in STZ-diabetic brains in rats. After 15 weeks of STZ injection, the metabolism of phospholipid membrane and brain energy metabolism has been obviously disturbed. Our study successfully shows that 31 P MRS can not only study phospholipid and energy metabolism non-invasively, but also measure intracellular pH and other important biochemical information. All of these spectroscopic characterizations contribute significantly to the understanding of pathogenesis and evolution of diabetes, and provide theoretical basis for early diagnosis and clinical treatment in diabetes.

Objective To study the methods and effect of minimally invasive percutaneous plate osteosynthesis(MIPPO) on tibial Pilon fracture.Methods 49 cases of tibial Pilon fracture hospitalized,23 cases(group A) with minimally invasive percutaneous plate osteosynthesis(MIPPO) by indirect reduction and 26 cases(group B) with open restoration internal fixation by prospective contrast investigation.Results Compared with group B,the amount of blood loss and complications in group A markedly decreased,the healing of fracture was faster,the functional rehabilitation of ankle joint was more satisfactory.Conclusion Minimally invasive percutaneous plate osteosynthesis(MIPPO)on tibial Pilon fracture can meet the requirements of biological osteosynthesis,degrade soft tissue operation injury,be beneficial to fracture healing and functional rehabilitation of ankle joint.MIPPO is a safe and effective technique of tibial Pilon fracture.