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 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 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 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 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 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.

Objective To establish the evaluation methods of individual technology maturity based on SCI-covered papers and patent data using Gartner's Hype Cycle.Methods The SCI-covered papers and patent data were ana-lyzed by nonlinear regression analysis in combination with traditional X-radiography and photo-acoustic tomo-graphy, and represented as the bell-shaped curve and S-shaped curve for judging the technology maturity.Results The individual technology maturity was consistent with the qualitative review of experts.Conclusion The individual technology described in SCI-covered papers and patent data can be used in primary evaluation of its maturity.

Objectives To clarify the differential diagnostic value for iron deficiency anemia (IDA)and anemia of chronic disease(ACD)with analysis method of multiple parameters.Methods The serum concentrations of iron parameters (SI,TIBC,TF,SF and sTfR),inflammatory index(IL-1,IL-6,TNF-β),CRP and hepcidin were detected in patients with IDA and ACD by biochemical method and ELISA respectively.Results In the differential diagnosis of IDA versus ACD,the SF (98.6 versus 6.0,P=0)and sTfR/logSF[(13.1-±-4.4) versus (27.6 ± 16.5),P=0.002] had clinical value for the differential diagnosis.Inflammatory factors level was increased in two groups,only the difference in CRP between IDA and ACD showed a statistical significance.The hepcidin had the clinical value in differential diagnosis for single disease diagnosis of IDA and ACD and for differential diagnosis between IDA and ACD [(144.6 ±-1.9) versus (86.5-±-3.1),P＜ 0.05].Correlation analysis showed that the sTfR/logSF had a significantly negative correlation with SI(P=0.002),a significantly positive correlation with TIBC and TRF,and no significant correlation with inflammatory factors.The hepcidin had significantly positive correlation with IL-6 and TNF-β,and a significantly negative correlation with SI.The positive correlation was observed between sTfR/logSF and Hepcidin(r=0.376,P=0.005).Conclusions Analysis method of multiple parameters could make a differential diagnosis of ACD in the elderly.

OBJECTIVE:To investigate the effects of triptolide(TP)on the proliferation of fibroblast-like synoviocytes(FLS) from patients with rheumatoid arthritis(RA)in vitro. METHODS:5 RA patients received knee arthroplasty or synovectomy to ob-tain synovial tissue. FLS was isolated,cultured and identified,and then incubated in the presence of TP [0 (blank control),50, 100 and 200 nmol/ml] for 24,48 and 72 h. The effects of TP on FLS was evaluated by MTT,and then proliferation inhibitory rate was calculated;flow cytometry was used to detect the apoptosis and cell cycle of FLS. RESULTS:The inhibitory rates of TP(50, 100 and 200 nmol/ml)on the proliferation of FLS were 17.46%-52.56%,which was positively correlated with drug concentration. Compared with blank control group,100 and 200 nmol/ml TP could increase the percentage of cells in G0/G1 phase and decrease the percentage of cells in S phase,with statistical significance(P<0.05);200 nmol/ml TP could induce cell apoptosis. CONCLU-SIONS:TP could inhibit the proliferation and also could induce the apoptosis of FLS in RA patients in vitro,which may be one of its mechanism for treating RA.