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 explore the level of angiopoietin‐like protein 4 (ANGPTL4) in patients with early chronic kidney disease (CKD ) in diabetes and the influence of pioglitazone on the level. Methods 92healthypeoplewithnormalglucosetolerancewereselectedasthecontrols(NCgroup).89 newly diagnosed T2DM were selected (T2DM group ). 90 cases of CKD group were divided into pioglitazone (PGZ) and glimepiride (GLI) treated subgroups ,45 cases in each subgroup. After treatment , serum ANGPTL4 levels were observed in CKD group. Results There were significant differences in serum ANGPTL4 levels among NC ,T2DM and CKD groups [(34.8 ± 4.75) vs (31.1 ± 3.65) vs (27.1 ± 3.52)ng/ml ,P<0.05 or P<0.01]. ANGPTL4 level was positively correlated with SOD ,TG (r=0.635 , 0.526 ,P< 0.05 or P< 0.01) ,and negatively correlated with BMI ,FPG ,HbA1c ,hsC‐RP ,UAlb/Cr , VEGF ,FIns ,HOMA‐IR (r= -0.502 ,-0.624 ,-0.542 ,-0.520 ,-0.538 ,-0.566 ,-0.576 ,-0.509 ,P< 0.05 or P < 0.01 ). In PGZ subgroup after treatment ,ANGPTL4 levels were significantly increased and UAlb/Cr significantly decreased [(31.51 ± 3.87 ) vs (27.60 ± 3.58 )ng/ml ,P < 0.05 ;(88.50 ± 8.90 ) vs (116.20 ± 10.30 )mg/24 h ,P < 0.01 ]. In GLI subgroup after treatment ,there were no significant difference in FPG and HbA1 c as compared with PGZ subgroup but ANGPTL4 levels have no significant differences after treatment ,and UAlb/Cr decreased [(27.20 ± 3.54 ) vs (26.60 ± 3.48 )ng/ml ,P > 0.05 ;(99.70 ± 12.80 ) vs (122.40 ± 13.10 )mg/24 h ,P < 0.05]. HbA1 c ,FIns ,UAlb/Cr were the independent related factors influencing ANGPTL4 of CKD patients. Conclusion Serum ANGPTL4 has a lower level in CKD patients. PGZ is effective in treating CKD. This role is associated with the increase of serum ANGPTL4.

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 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 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 To investigate the changes of serum stromal cell‐derived factor‐1α (SDF‐1α) in patients with diabetic peripheral neuropathy (DPN) and the influence of mouse never growth factor (MNGF) on the levels of serum SDF‐1α. Methods 180 patients with type 2 diabetes (T2DM ) were divided into T2DM with DPN (DPN group ,n=92) and T2DM without DPN (T2DM group ,n=88). 90 healthy people were select as normal control (NC group). DPN group was divided into 47 cases of MNGF treatment (A) subgroup and 45 cases of basic treatment (B) subgroup. The levels of serum SDF‐1αwere measured using ELISA method. The relationships between the levels of serum SDF‐1αand SOD ,TGF‐β1 , hsC‐RP ,and GAP‐43 were analyzed. After treatment ,the levels of serum SDF‐1α in A and B subgroups were compared. Results Compared with NC group [(0.91 ± 0.37)μg/L] ,the levels of serum SDF‐1αin T2DM and DPN group were higher [(2.58 ± 0.58) μg/L and(1.71 ± 0.43)μg/L ,respectively ,P<0.05 or P<0.01]. The levels of SDF‐1αwere positively correlated with FPG ,HbA1 c ,TGF‐β1 and hsC‐RP ,and negatively correlated with SOD in T2DM group. The levels of SDF‐1αwere positively correlated with TG and TGF‐β1 ,and negatively correlated with course of disease ,FPG ,HbA1 c ,SOD ,hsC‐RP ,GAP‐43 , MMCV ,PMCV ,MSCV and PSCV in DPN group. SDF‐1α levels were significantly increased after treatment with MNGF in subgroup A [(1.75 ± 0.39) vs (2.09 ± 0.45)μg/L ,P<0.05]. There were no significant difference of SDF‐1αlevels after treatment in subgroup B [(1.67 ± 0.48) vs (1.71 ± 0.51)μg/L , P>0.05] .Multiple stepwise regression analysis showed that HbA1c ,hsC‐RP and PSCV were the independent factors related with the levels of SDF‐1αin DPN patients. Conclusion The levels of serum SDF‐1αin DPN patients are lower than in T2DM patients without DPN. MNGF may increase the level of serum SDF‐1α.