Objective To investigate the efficacy of early nutrition support combined with glutamine and low molecular hepa‐rin in elderly patients with severe pneumonia and its influence on immune function regulation and RAGE .Methods Totally 148 eld‐erly patients with severe pneumonia in ICU of our hospital from October 2012 to May 2015 were selected and randomly divided into the treatment group 1 (55 cases) ,treatment group 2 (55 cases) and control group(38 cases) according to the randomized digital ta‐ble .The control group was given the routine treatment .Based on the control group ,the treatment group 1 was treated with the early nutrition support combined with glutamine .On the basis of the treatment group 1 ,the treatment group 2 adopted low molecular heparin .The APACHEⅡ score ,PaCO2 ,SaO2 ,and PaO2 before and after treatment were compared among three groups .The levels of PT ,APTT ,FIB and D‐D were detected in three groups .The immune function indexes and RAGE level were compared among three groups .Results The APACHEⅡ score ,PaCO2 and RAGE level after treatment in two treatment groups were lower than those in the control group ,while SaO2 ,PaO2 and immune function indexes levels were higher than those in the control group ,more‐over the APACHEⅡscore ,PaCO2 and RAGE level in the treatment group 2 were lower than those in the treatment group 1 ,while SaO2 ,PaO2 and immune function level were higher than those in the treatment group 1 ,the differences were statistically significant (P<0 .01) .The levels of PT ,APTT ,FIB and D‐D after treatment in the treatment group 2 were lower than those in the treatment group 1 and control group(P<0 .01) .The total effective rates in the treatment group 1 and 2 were 96 .36% and 98 .18% respec‐tively ,which were higher than that in the control group ,moreover the obviously effective rate in the treatment group 2 was 85 . 45% ,which was superior to the control group and treatment group1 ,the differences were statistically significant (P<0 .01 or P<0 . 05) .Conclusion Early nutrition support combined with glutamine and low molecular heparin in treating elderly severe pneumonia can decrease the APACHEⅡscore ,improve the coagulation function ,enhance the immune function and decreases the RAGE level .

Deep vein thrombosis (DVT) is a serious complication of fractures. The incidence of ankle fracture which occurs most frequently intra-articular is 200/100 000, about 3.9%of all fractures. Domestic and foreign reports of ankle fractures and DVT were allocated and analyzed to review their correlation. Furthermore, different methods of rou-tined thromboprophylaxis was discussed. DVT incident after ankle fractures and the necessity of routined thromboprophy-laxis were reviewed. DVT incidence after ankle fractures was low and routine thromboprophylaxis was not necessary to all ankle fracture patients except the ones who had risk factors of thrombosis which could induce DVT.

OBJECTIVE:To provide reference for strengthening the cultural construction and promoting the cultural develop-ment of TCM in Chongqing. METHODS:Questionnaire was adopted to investigate the status quo and cognition of some citizens, staffs in medical and health institutions for the cultural construction of TCM in public TCM medical and health institutions above Grade Two in Chongqing,and the data was statistically analyzed. RESULTS:Totally 45 questionnaires were sent out for TCM med-ical and health institutions,45 were effectively received with effective recovery of 100%;3 500 were sent out for the citizens,2 250 were effectively received with effective recovery of 64.29%;1 100 were sent out for the staffs in TCM medical and health institu-tions,702 were effectively received with effective recovery of 63.82%. In terms of cultural construction in surveyed institutions,or-ganization,principles and unit markings carried out a relatively high proportion in the core cultural soft power construction,the de-velopment of behavioral norms system carried out a relatively low proportion;and the proportion was higher in the hardware envi-ronment construction. In terms of the cognition of surveyed citizens for the TCM culture,62.98% believed in TCM;the first rea-son for choosing TCM was its less side effects(24.76%);89.42% thought it was necessary to keep in good health. In terms of the cognition of surveyed staffs for the cultural construction of TCM,81.91%thought the TCM culture was taken seriously in their hos-pital;60.54% showed great satisfaction with the cultural construction of TCM;only 23.08% was very familiar with the concept of TCM core values;the surveyed staff thought the main problems in the cultural construction of TCM were lack of facilities (69.09%)and talent personals(44.59%). CONCLUSIONS:The organization,principles,unit markings and facilities in Chongq-ing TCM medical and health institutions are taken seriously,while the behavioral norms system needs to be strengthened;the citi-zens’cognition for TCM culture should to be improved,as well as the staffs’TCM cultural awareness in TCM medical and health institutions.

In plant genetic engineering, selectable marker is needed to distinguish transformant. As the commercialization of transgenic plants, people are more and more paying close attention to their safety, among which mainly refers to the safety of selectable marker. In order to increase the safety of transgenic plants, biologists began to search for biosafe selectable marker.Current research progress of taking key enzyme in metabolic pathways were overviewed,which include glycometabolism, amino acid metabolism, hormone metabolism ,nucleotide metabolism and protein metabolism et cetera, as selectable marker in transgenic plants.

We reported a case of rheumatoid arthritis (RA) combined with pigmented villonodular synovitis (PVNS) from Peking University People's Hospital. The clinical data were introduced and the related literature was reviewed. The clinical features, treatment and prognosis of the disease were summarized to improve clinicians' understanding of this rare disease and avoid misdiagnosis and delayed diagnosis. A 45-year-old female, with 15 years of RA history and unregular treatment, was admitted to the hospital with the complaint of aggravating pain and swelling in the right knee for 3 months. The puncture of the right knee was performed and there was a large amount of bloody synovial fluid that could not be explained by her RA history. Moreover, the magnetic resonance imaging (MRI) of the right knee revealed hemosiderin deposition with low-intensity signals on both T1-weighted and T2-weighted images which suggested PVNS to us. Then, the patient underwent knee arthroscopy and biopsy to assist in diagnosis. The arthroscopic appearance and pathology were consistent with PVNS and the hyperplastic synovium was removed during arthroscopy. After the operation, she did active functional exercises and took disease-modifying antirheumatic drugs to control RA. She recovered well and remained asymptomatic after half a year of follow-up. Also, there was no recurrence of the right knee. As we all know, RA is a systemic autoimmune disease characterized by chronic synovitis and joint damage. And PVNS is characterized by synovial proliferation and infiltrative process. Both of them are synovial involvement and the clinical manifestations are quite similar. PVNS has occasionally been reported in association with RA. So it is difficult to make a clear diagnosis of RA combined with PVNS. Literature was searched with RA+PVNS in the WanFang Medical Network Database and China National Knowledge Infrastructure and there were no related Chinese cases. Then we searched literature from PubMed with RA+PVNS. The cases were still rare and eventually 2 related articles were yielded including 2 similar patients. It is necessary to fully understand the disease development, complicated MRI appearance and various pathological morpho-logy. They can contribute to making a correct diagnosis which is effective to guide the proper treatment.
Arthritis, Rheumatoid/diagnosis* ; Arthroscopy ; China ; Female ; Humans ; Knee Joint/diagnostic imaging* ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Recurrence, Local ; Synovitis, Pigmented Villonodular/diagnosis*

Objective To observe the effect of motor relearning program (MRP) on balance function of stroke patients.Methods Sixty stroke patients were randomly divided into the MRP group and control group with 30 cases in each group. The patients of the control group were trained with proprioceptive neuromuscular facilitation (PNF) therapy; those of the MRP group were trained with the MRP therapy. The balance function of all patients was assessed with the Fugl-Meyer Balance Function Assessment before and after training.Results After training, the scores of Fugl-Meyer Assessment of all patients increased ( P<0.05), but scores of the patients of the MRP group were significantly higher than that of the control group ( P<0.05).Conclusion The MRP training can improve the recovery of balance function of stroke patients.

Objective To investigate the expressions of glucagon-like peptide-1 receptors (GLP-1R) and cytokeratin17 (CK17) in papillary thyroid cancer tissue and clinicopathological significance.Methods The immunohistochemistry and immunoblotting method were employed to detect the expressions of GLP-1R and CK17 in normal thyroid tissues (control group,50 cases) and papillary thyroid cancer tissue (observation group,80 cases).Then the correlation between the expressions of GLP-1R and CK17 with pathological factors of thyroid cancer was analyzed.Results Low expression of GLP-1R was found in 22 cases (44.00 ％) of the control group,while GLP-1R was expressed in 77 cases(96.25 ％) of the observation group,and the difference between both groups was statistically significant(P＜0.01).The expression of CK17 was positive in 8 cases(16.00％) of the control group,while 77 cases(96.25 ％) in the observation group were CK17 expression positive,and the difference between both groups was statistically significant(P＜0.01).The difference between GLP-1 positive expression and clinicopathologic factors had no statistical significance(P＞0.05).The difference between CK17 expression with sex and age had no statistical significance (P＞0.05),and was obviously related with the tumor diameter,clinical stages and cervical node metastasis of thyroid neoplasms(P＜0.05).Conclusion GLP-1R and CK17 all are highly expressed in papillary thyroid cancer tissue and CK17 expression is obviously related with the tumor diameter,clinical stages and cervical node metastasis of papillary thyroid cancer.

Objective To investigate effect of folic acid combined with xin funing on CRP, HGF, IL-2,TNF-αof patients with cervical cancer caused by human papillomavirus.Methods 80 cases of cervical cancer patients were randomly divided into control group, 40 cases in the control group were given conventional chemotherapy, 40 cases in the experimental group were on the base of the control with folic acid combined with xin funing.CRP, HGF, TNF-α, IL-2 and T lymphocyte subsets were compared before and after the treatment.Results Compared with the control group, the serum CRP, HGF and TNF-αof the experiment group were lower(P<0.05), IL-2 levels was higher (P<0.05), CD4 +and CD4 +/CD8 +level were higher(P<0.05), level of CD8 +was lower(P<0.05) and the clinical effective rate were higher(P<0.05).Conclusion Folic acid combined with Xin Funing has important significance for the treatment of patients with cervical cancer.It is speculated that the mechanism may be to reduce the level of serum CRP and HGF in patients with cervical cancer, and to increase the level of IL-2, and to regulate immune cells.

Objective To analyze the impact factors and their importance on academic reputation of medical research institutions in China.Methods Seventy medical researchers and 70 medical graduate students were selected by convenience sampling method.Brainstorming and expert consultation were applied to determine the 6 factors affecting the academic reputation of medical research institutions in China.A Face-to-face or e-mail interview was conducted using a designed questionnaire.Six affecting factors were nominated analyzed.Chi-square test was used to cross exam nominated rate and affecting factors;Bonferroni method was also applied to make paired comparisons.Results There is significant difference in nomination rates among 6 impact factors (P ＜ 0.001).Pairwise comparison showed that information obtained by academic exchange (70.49 ％) and the scientific understanding generated from research practice (67.21％) are top 2 impact factors to the medical research institutions;followed by all kinds of ranking list (44.26％),and the celebrity effect (42.62％).Conclusions Scientific communication and research practice are two most important factors affecting the academic reputation of medical research institutions in China.

Objective To clarify the distribution characteristics of serum pepsinogen (PG ) and gastric cancer related tumor markers in the healthy population ,and analyse their value in health examination .Methods The levels of serum tumor markers ,pep‐sinogenⅠ(PGⅠ ) and pepsinogenⅡ(PGⅡ) were detected in 958 subjects who underwent physical examination by using the Lumi‐nex 200 instrument ,and the ratio of PGⅠ /PGⅡ(PGR) was calculated .Meanwhile ,the C13 breath test was carried out ,and relation‐ships among these clinical indicators were analysed .Results In this population ,The serum level of PGⅠ in male subjects was high‐er than that in female subjects ,there was statistically significant difference(P<0 .05) .The levels of serum PGⅠ ,PGⅡ ,carcinoem‐bryonic antigen(CEA) ,carbohydrate antigen 199(CA199) and carbohydrate antigen 242(CA242) were gradually increased with age ,while the PGR was slowly decreased with age .The positive rate of C13 breath test in male subjects was higher than that in fe‐male subjects ,there was statistically significant difference(P<0 .05) .Compared with subjects whose C13 breath test results were negative ,the serum levels of PGⅠ and PGⅡ were higher ,while the PGR was lower in subjects whose C13 breath test results were positive(P<0 .05) .Conclusion The distribution of serum PG might be correlated with age ,gender and the infection of Helicobact‐er pylori in healthy population .It is shown that the effects of tumor markers on gastric cancer screening are limited .