The Strem-1 is a member of the immunoglobulin family,which is recently found to be closely associated with the inflammatory and a sensitive marker of the inflammatory response.Many pathogenic microorganisms infection can make sTREM-1 highly expressed,it is involved in the secretion of pro-inflammatory factors by the role of TOLL receptors,and played an important role in the development of sepsis.It is a more sensitive and reliable indicator in the diagnosis and monitoring of sepsis in recent years.It is necessary to study the characteristics and role of sTREM-1 in the development of sepsis,and it has important significance in preventing the occurrence of sepsis and reasonable treatment or prognosis evaluation.

OBJECTIVE:To investigate the role of clinical pharmacists in the treatment of high paraplegia patient with hospital acquired pneumonia. METHODS:Clinical pharmacists provided suggestions for anti-infective treatment failure of a high paraplegia patient with hospital acquired pneumonia,including anti-infective treatment of imipenem and cilastatin sodi-um 1.0 g,ivgtt,qid,de-escalation anti-infective treatment of cefoperazone sodium and sulbactam sodium 3.0 g,ivgtt,bid+amikacin 0.4 g,ivgtt,bid,and prevention treatment of fluconazole sodium chloride 0.2 g,ivgtt,qd against potential invasive infections with fungi,etc.,assisted physician to improve therapy plan,monitor ADR and guide rational drug use. RE-SULTS:After 3 weeks of treatment,the symptoms had been improved significantly. CONCLUSIONS:Clinical pharmacists provide individual pharmaceutical care to reduce ADR during treatment and improve the effectiveness and safety of clinical treatment.

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.

?Acute retinal necrosis syndrome ( ARN) is a serious eye disease, which caused by Herpes virus mostly, with unknown pathogenesis. Because of the aggressive progression, treatment of ARN is difficult, and the blindness rate is extremely high. Current treatment strategies are the combination of the drug therapy and the operative treatment. Drugs commonly used are antiviral drugs, glucocorticoids, and antiplatelet drugs, and the operative treatment includes laser photocoagulation and vitrectomy.

Glutamine,a coding amino acid in the process of synthesis of protein,could be absorbed by endothelial cells of the small intestine in most cases,or converted from other amino acid and glucose in the assistance of concerned enzyme.This nonessential amino acid maintains homeostasis in rivo.In recent years,a large number of researches reveal that glutamine plays an extremely important role in the tumor metabolism and therefore influences the process and treatment of cancer.In the study,the netabolism of glutamine in normal cells and tumor cells and its effects on tumor therapy were reviewed.

Objective: To determine the changes of upper airway morphology induced by mandible position from central relation to advancement position in patients with obstructive sleep apnea syndrome. Methods: Nineteen patients (17 males and 2 females) suffering from obstructive sleep apnea syndrome were confirmed with polysomnography. Occlusal wax record was made with mandible in advancement position. Helical computed tomography was performed on each patient in central relation and mandibular advancement position with wax record in situ respectively. On each slice, anteroposterior and transverse diameters were obtained. Airway shape was expressed as the anteroposterior/transverse (AP/T) diameter ratio. Paired samples t test was employed to compare the measurements. Results: With mandibular advancement, average and minimal diameters of glossopharynx and hypopharynx were increased significantly. Compared with it, the change of transverse diameter was more prominent. All segments of upper airway were increased significantly except hypophaynx laterally. Moreover, the change of velopharynx shape was observed on axial planes. Ellipse with transversal long axis became more compressed. Conclusion: Upper airway morphology of all segments was influenced by mandibular advancement whether in the sagittal or transverse plane of space, or airway shape. Not only anatomic connection but also regulation of the nerve system and other still unknown mechanism make contribution to the changes of upper airway morphology in patients with obstructive sleep apnea syndrome. The changes of upper airway morphology above mentioned constitute the rationale of treatment of obstructive sleep apnea syndrome with oral appliances.

Objective To investigate the clinical value of the intra-cronary interventional techniquein the treatment of coronary heart disease. Methods The 110 patients with coronary heart disease weretreated with 63 balloon angioplasties and 47 coronary-stent implantations. Results The ballloon angioplasty was made in 94 coronary lesion arteries with success of 88 vessels. In the following up periods of2-72 months, the angina pectoris and acute myocardial infarction were occurred respectively in 11 and2 cases (24.07 % ). The 63 stems were implanted into 59 coronary lesion arteries with success of 58 vessels. All patients were followed up for 2~12 months and the angina pectoris were occurred in 6 cases(13.3 % ). Conclusion The intracoronary intervetional technique was an effective method for treatmentof the coronary heart disease.

Objective:To investigate the protective effect of dimethylsulfoxide(DMSO) on axon degeneration.(Methods: Cultured) rat superior cervical ganglia were treated with DMSO(100%,10 ?l) per well to disconnect axons from the cell bodies.SCGs in DMSO control group were treated with a mixture of DMSO(10 ?l) and medium (2 ml) per well;in positive control group were transfected with herpes simplex virus over-expressing Wld~S protein and the cell body was eliminated;and in blank control group were treated with 10 ?l PBS.The separated axons were fixed with 4% poly formaldehyde at 0,4,8,12 and 24 h after treatment with DMSO for immunostaining with specific antibody to microtubulin.Thus,the changes of axonal structure were investigated.The axonal protein was collected and the degeneration of neurofilament was detected by Western Blotting.Results: In DMSO disconnected group,the axonal morphology and structure showed no obvious change at 12 h post disconnection,but slight degeneration was observed at 24 h post disconnection.The degradation of microtubulin was obviously slowed down and their axonal structures maintained intact 12 h later.The neurofilament could be detected 12 h after disconnection.The above changes in disconnected group were similar to those in positive control group.No obvious protective effects on axonal degeneration were observed in blank and DMSO control groups.Conclusion: Local high concentration of DMSO can delay axonal degeneration,which indicates that DMSO can be used for adjuvant treatment of neurodegenerative diseases.

OSCE is a new method which has strong objectivity for the evaluation of clin-ical skills examination.According to the actual situation of our college,we chose medicine sta-tion of OSCE to assess the level of the clinical skills of the clinical graduates.

Objective To observe the clinical effect of medicated diet of primary hyperuricemia .Methods 80 cases of primary hyperuricemia patients were randomly divided into experimental group and control group , 40 casesin each group.The experimental group used traditional Chinese medicine medicated diet on the basis of conventionaltherapy, and the control group was given conventional treatment .The change of indicators including main, secondaryclinical symptoms, signs and laboratory were observed before and after treatment in the two group patients .Results In the experimental group, the total effective rate was 92.5%; The control group the total effective rate was 82.5%.The experimental group was more efficient than the control group .Two groups of curative effect in the treatment ofsymptom improvement, there was significant difference (p <0.05).Blood uric acid before and after treatment wasimproved in the two groups (p <0.05).Blood uric acid level of experimental group decreased significantly comparedwith the control group (p <0.05).Conclusion The physique of Chinese Medicined Diet as dialectical auxiliary pri -mary hyperuricemia in clinical treatment of the exact effect , has not found adverse reactions.It is worth popularizationand application, and the formula need to be further enriched and perfected .