OBJECTIVE To evaluate the value of blood lactic acid in elder pneumonia patients and indicate its relation with the classification of peverity of patients.METHODS Seventy-five elder patients with pneumonia and 50 younger patients were divided into sepsis group and no sepsis group.The sepsis group was divided into MODS and non-MODS sub groups.The level of blood lactic acid,CRP and PaO2 in them were measured.RESULTS The incidence of sepsis was remarkably higher in the elder pneumonia patients group than in the younger one.There was a significent difference of the blood lactic acid between them((1.74?0.33)mmol/L vs(1.35?0.66)mmol/L,P

OBJECTIVE To investigate pulmonary fungal infection spectrum and its resistance in older COPD patients with mechanical ventilation.METHODS Retrospective study were performed in 67 cases of COPD patients with mechanical ventilation treatment who were admitted to our ICU from Jan 2004 to Doc 2007.Bronchoalveolar lavage fluid was cultured,differentiation and antifungal susceptilibity testing were taken.RESULTS Seventy-eight fungi strains were cultured in 78 cases,among them,41 strains were Candida albicans(52.56%),14 of C.tropicalis,9 of C.krusei,5 of C.parapsilosis,7 of yeast-like fungi and 2 of Aspergillus.CONCLUSIONS There were increasing fungal infection rate in older COPD patients with mechanical ventilation and C.albicans is still the most frequent type.The resistance to triazole antifungal drug is also increasing.

Repeat cervical cytologic testing,human papillomavirus(HPV)testing and immediate colposcopy are currently the most general managements in women with atypical squamous cells of undetermined significance(ASCUS)result.However,the efficacy of these three methods is hampered by strong subjectivity,high false negative and positive rates.With the development of the aetiology of cervical cancer,there is good evidence that biomarkers for persistent HPV infection,HPV integration,instability of host genes and malignancy triage ASCUS more objectively and efficiently.The three-dimensional multiparameter biomarker-based detection may be the predominant method for the triage of women with abnormal cervical cancer screening result.

Objective To explore a new evaluation framework for talented professionals in science and technology, and design an appropriate methodology and management mechanism.Methods Key evaluation indicators were set according to the organization′s strategic objectives and innovation elements.Following the introduction to new concepts of evaluation, methods and steps were designed that could analyze evaluation results using the radar chart to achieve full-dimensional identification of different indicators, scopes or levels.Results and Conclusion A pluggablehierarchical management mechanism was established, and an organic architecture that involved data, evaluation logics and operation management was constructed.A pilot study was carried out in an institution of military medical sciences to verify the applicability of this framework.

Objective To investigate the effects of Metformin on serum proprotein convertase subtilisin/kexin type 9(PCSK9)level in patients with type 2 diabetes(T2DM). Methods 48 healthy people with normal glucose tolerance were selected as the controls (NGT group). 93 newly diagnosed T2DM were randomized to Metformin treated group (Met,n= 47 )and Glipizide treated group (Gli,n=46).Serum PCSK9 was measured by ELISA in all participants. After treatment,the changes of serum PCSK9 were observed in Met group and Gli group. Results Serum PCSK9 levels in Met group and Gli group were higher than NGT group(P<0. 01). PCSK9 level was positively correlated with FPG,HbA1 c, HOMA-IR,FIns,TC,LDL-C,TG,hsC-RP,TNF-αand BMI (r= 0. 578,0. 638,0. 556,0. 610,0. 578, 0. 592,0. 589,0. 638,0. 561,0. 552;P<0. 05 or P<0. 01),and negatively correlated with HDL-C(r=-0. 614,P<0. 01). The levels of PCSK9 significantly decreased after treatment with Metformin(P<0. 05). PCSK9 levels had no significant differences before and after treatment with Glipizide. Multiple regression analysis showed that TNF-αand HOMA-IR were independent related factors of PCSK9. Conclusion T2DM patients have high levels of serum PCSK9 which can be decreased by Metformin.

Objective To evaluate the clinical efficacy of multiple target burst frequency thermocoagulation in treatment of lumbar disc herniation.Methods One hundred and twelve patients suffering from lumbar disc herniation were treated with stepped heating multiple target burst frequency thermocoagulation using of domestic R-2000B radiofrequency ablation machine.The visual analogue scale (VAS) score,Oswestry disability index (ODI) and effect of grade before operation and after operation were compared.Results The VAS score before operation was (7.60 ± 1.12) scores,3 d after operation was (3.10 ± 1.05) scores,6 months after operation was (2.90 ± 0.92) scores,there was significant difference between before operation and 3 d,6 months after operation (P ＜ 0.05).The ODI before operation was 47.6 ± 8.3,3 months after operation was 25.5 ± 6.7,6 months after operation was 23.7 ± 6.2,there was significant difference between before operation and 3,6 months after operation (P ＜0.05).The clinical efficacy:excellent grade was in 66 cases,the good was in 32 cases,the improvement was in 10 cases,the inefficacy was in 4 cases,the excellent and good rate was 87.5％ (98/112).There was no nerve injury,infection or death after operation.Conclusion Multiple target burst frequency thermocoagulation in the treatment of lumbar disc herniation has the advantages of little incision and tissue damage,fast recovery,good clinical outcome,it is worth to clinical practice.

Objective:By observing effects of Dahuang Zhechong Pills on CD44,VEGF and the metastasis suppressor in mice with Lewis Lung carcinoma,to discuss its mechanism of anti-tumor metastasis preliminarily.Methods:The mice were divided randomly into five groups the day after modeling and each group included ten mice.According to the pre-test,high-dose,medium-dose and low-dose were quantitated with 0.18g/ml,0.09 g/ml,0.045g/ml.The model group was intragastric administrated with NS 0.2ml for ten days;the chemotherapy group was Intraperitoneal administrated 50mg/kg CTX on the first day.Observing and numerating the pulmonary metastases with nodules by pulmonary pressure slide film on the 12th day.Based on immunohistochemical method to detect the expression of VEGF and the activity detection by flow cytometry CD44,Its anti-tumor mechanism and the role of target were preliminarily studied.Results:The inhibition rates of lung spontaneous metastasis in experimental groups of high(H),medium(M),low(L)dosages and the chemotherapy group were respectively 57.44 percent, 55.32 percent,38.72 percent,60.00 percent.CD44,respectively,values were 0.59?0.86,0.21?0.28,0.33?0.31,1.36?0.52; the experimental group(M)compared with model group,VEGF expression was significantly reduced,there was a significant difference(P0.05).Conclusion:Dahuang Zhechong Pills reduced the lung metastases incidence of C57BL mice with Lewis lung carcinoma and prolonged their lives.These results were obvious in the medium-dose experimental group.Medium-dose of Dahuang Zhechong Pills had effects on C57BL mice with Lewis lung carcinoma,whose CD44 activity were inhibited and the expression of VEGF was reduced.

OBJECTIVE To investigate the pathogenic causes of community acquired pneumonia(CAP) in the elderly and to guide experience antibiotic therapy.METHODS An etiological study was performed on 204 elder patients with CAP in the Cadres Medical Department of Beijing Shijitan Hospital from May 2005 to Apr 2008.The count scores were by CURB-65 scoring system.RESULTS Pathogens were identified in 204 patients: there were Mycoplasma pneumoniae(42,20.6%),Streptococcus pneumoniae(30,14.7%),Haemophilus influenzae(24,11.8%),Chlamydia pneumoniae(17,8.3%),Klebsiella pneumoniae(14,6.9%),Escherichia coli(7,3.4%),Pseudomonas aeruginosa(5,2.5%),Staphylococcus aureus(4,2.0%),Legionella pneumophila(2,1.0%),and Acinetobacter baumannii(1,0.5%).The score,by CURB-65 scoring system,of mixed infected patients was higher than single infections.CONCLUSIONS Atypical pathogens have important role in elderly CAP,the most common pathogenare Gram-negative bacilli,S.aureusand fungi.Mixed infection couldn′t be ignored.

Objective To study the impact of HBV/C gene G87 mutation on HLA-I expression of host cells. Methods HBV wild-type genome plasmid was reconstructed by site-directed mutagenesis technique and subcloning technique into expression vector of G87 mutant (EBO-G87) and expression vector of wild type (EBO-WT), which were transfected into HepG2 cells via liposome technique,respectively.The transfected cells were stained with murine mAb anti-HLA-ABC conjugated directly to FITC, and HLA-I expression on their membranes was analyzed by flow cytometry. Results The constructed vectors of EBO-WT and EBO-G87 were identified by restriction enzyme digestion and nucleotide sequencing. The mean fluorescence intensity of HLA-I expression on transfected cells with EBO empty vector was at low level(2.3). It was elevated remarkably to 18.8 by EBO-WT, while that of EBO-G87 was increased to 10.5. Conclusion Two strains of HBV may up-regulate the expression of HLA-I, and G87 mutation of C gene may affect the expression level of HLA-I on host cells.

Objective To estimate the effects of nasal continuous positive airway pressure(nCPAP)therapy on patients with OSAS in prethrombotic state.Methods One group of 30 patients with OSAS who were diagnosed from Sep.2003 to Sep.2005,one healthy control group of 30 cases.Blood samples were taken from people in the supine position in the morning immediately after overnight polysomnography and nCPAP theraphy(only in OSAS group).Results Compared with the normal controls,the level of the molecular marker GMP-140 increased in the blood of patients with OSAS,the levels of APTT,AT-Ⅲ decreased,and the level of t-PA decreased as well.The level of PAI increased.Compared with the healthy controls,datum indicated statistical differences between the two groups.Datum of the patients with OSAS were improved after nCPAP therapy:AHI decreased from 63.21?23.23 to 0.56?0.84;the nocturnal lowest of SaO_2 increased from 0.68?0.07 to 0.90?0.02;GMP-140 and PAI decreased to (17.07?7.97)% and (95.83?5.91)% respectively;AT-Ⅲ and t-PA increased to(95.20?6.67)% and (5.45?1.61)?g respectively.Conclusion Prethrombotic state is present in patients with OSAS.nCPAP therapy can decrease OSAS-related thrombotic complications.