Obesity is caused by the imbalance between caloric intake and energy expenditure. It is also influenced by genetic factors. Many genes,such as ob gene, ? 3 receptor gene, ucp 1 gene, may involved in the prevalence of obesity. Pharmacologic treatments include anorexigenic agents, lipase inhibitor, ? 3 receptor agonists and many newer antiobesity drugs, which provide prospective ways in treating obesity.

OBJECTIVE　To evaluate the availability and safety of a new carbapenem meropenem.METHODS　The randomized study was conducted in 60 patients with respiratory tract infections.They were divided into two groups:meropenem or imipenem/cilastatin.RESULTS　The cure rate,effective rate and bacterial clearance rate for meropenem were 80.0%,93.3%,92.3%,respectively and for those of imipenem/cilastatin were 76.7%,90.0% and 91.3%,respectively.The rate of adverse reactions for both meropenem/cilastatin was 3.3%.CONCLUSION　Meropenem appeared to be a highly effective and safe agent in treatment of respiratory tract infections.Its efficacy and safety are similar to that of imipenem/cilastatin.

Objective The aim of this study was to evaluate the clinical value and the possibilities of measuring the serum levels of pepsinogen I (PG I ) and careineembryonic antigen (CEA) in 402 patients with gastric ulcer.Methods The patients with gastric ulcer were all confirmed by either operation or gastrofiberscope,and divided into two groups,benign and malignant gastric ulcer.After comparing the relationship between the patients'clinical appearance and the Radioimmunoaasay(RIA) results,(CEA and PG I ).Results There were 73 patients were onfirmed malignant gastric ulee in 402 patients.The positive rate of PG was 52.05% (38/73).The positive rate of CEA was 64.38% (47/73).Both were 30.14% (22/73).Then there were 63(63/73) patients who was positive in the combined determination.Solo determination's positive rate of CEA and PG were significantly different from the combined determination.(P＜0.05 and 0.01) Conclusions Feasibility and the necessity of combined determination were evaluated.Compared with solo determination,for patients with malignant gastric ulcer,it was more sensitive to determine and analysis the serum levels of PG I and CEA sYnthetically.So it is recommended to popularize the combined determination of serum PG I and CEA in clinical distinctive diagnosis of benign and malignant gastric ulcer.

Objective To evaluate the relationship among segmental dyssynchrony indexes, reginal ejection frction(EF) and global EF of left ventricle(LV) in the patients with dilated cardiomyopathy. Methods Standard deviation(SD) and maximal difference (Dif) in the time to minimal systolic volume in user-selected LV segments (Tmsv SeI-SD, Tmsv SeI-DIF) of LV global EF (LV-EF), reginal ejection fraction (REF) were acquired by real-time three-dimensional echocardiography in 27 controls and 24 DCM dyssynehrony patients. Data were grouped separately for 3 levels of the basal, mid and apical segments. Results The values of Tmsv SeI-SD and Tmsv SeI-DIF were linearly negatively correlated with REF in mid segment of DCM (r =-0.6921,-0.6384, P<0.01). It existed exclusive linear regression between Tmsv Sel-SD,Tmsv SeI-DIF and LV-EF only in mid segment's dyssynchrony indexes among three segments(β= -0.7836, -0.7801, P<0.01). Each REF in three segments was linear regression relationship with LV-EF(β= 0.2234,0.7506,0.1880, P <0.05) especially in mid segment. Conclusions The Tmsv SeI-SD, Tmsv SeI-DIF and REF of mid segment are important factors to influence left ventricular function in the patients with dilated cardiomyopathy.

Objective To estimate the clinic features of severe multiple trauma with secondary thrombocytosis as a factor influencing the prognosis.Methods A retrospective single-center study was carried out in 680 patients with severe multiple trauma survived longer than 72 hours in Chongqing Emergency Medical Center from March 2010 through March 2013.The variables including age,gender,ISS (injury severity score),APACHE Ⅱ score,splenectomy and the usages of vasopressors,blood products transfusion,hematopoietic medicines and anticoagulant were analyzed.The prognosis indices including total in-hospital mortality after 72 hours,length of hospital stay and morbidity of thrombo-embolism were explored.The clinic characteristics and prognosis of severe multiple trauma with secondary thrombocytosis (platelet count more than 450 × 109 L-1) were evaluated.T test or rank sum test was used for comparison between measurement data and Chi-square test or Fisher' s exact test was used for comparison between enumeration data.Results Thrombocytosis was identified in 99 (14.56％) patients and it occurred one week after injury with median time of 27 days (ranged from 8 days to 304 days),and maintained for (18.62±4.38) d.The median of platelet count was 584 × 109 L-1 (lowest 478 × 109 L-1,highest 1 072 × 109 L-1) in severe multiple trauma patients with thrombocytosis.The proportions of splenectomy,prolonged use of vasopressors and employment of hematopoietic medicines or anticoagulant were significantly higher in patients with thrombocytosis than those in patients without thrombocytosis (14.14％ vs.7.06％,P=0.03;62.63％ vs.39.07％,P＜0.01; 28.28％ vs.6.71％,P＜0.01; 90.91％ vs.19.45％,P＜ 0.01).The highest D-Dimer level presenting in patients with thrombocytosis during the time of platelet increasing was significantly more common than that in patients of non-thrombocytosis group 7 days after trauma [(11.68 ± 11.90) vs.(5.05 ± 5.11),P =0.004].However,the mortality,length of hospital stay and morbidity of thrombo-embolism were not significantly increased in patients with thrombocytosis compared with patients without thrombocytosis [8.08％ vs.8.78％,P=0.82; 34 d (28.5,54.5) d vs.45 d (23,67) d,P =0.41; 10.10％ vs.10.50％,P =0.91].Conclusion There was a higher rate of secondary thrombocytosis in severe multiple trauma patients.The factors such as splenectomy,vasopressors,hematopoietic medicines and so on might induce the reactive thrombocytosis in trauma patients.Thrombocytosis might increase the incidence of thromboembolism in severe multiple trauma patients without appropriate prophylactic anticoagulation.For the sake of prophylaxis,employment of anti-platelet agent might be the appropriately therapeutic strategy for patients suffering from severe multiple trauma with secondary thrombocytosis accompanying risk factors of arterial thrombo-embolism.

Objective To investigate the effects of aspirin(aspi) on rat cardiac fibroblasts (CFs) proliferation induced by aldosterone(ald) and the underlying molecular mechanisms .Methods Primary CFs from 1-3 day neonatal rats were digested by 0.08%trypsin and then purified by differential adhesion .The rats were divided into four groups:control group, DMEM medium ( free calf serum ) , ald group [ DMEM medium ( free calf serum ) +ald 1 ×10 -8 mol/L ] , aspi group [DMEM medium (free calf serum)+ald 1 ×10 -8 mol/L+aspi 1.11 ×10 -6 mol/L] and spiro group [DMEM medium (free calf serum)+ald 1 ×10 -8 mol/L +spiro 1 ×10 -6 mol/L].The morphology of CFs was assayed by HE staining methods .MTT Methods were used to measure cell proliferation .Western blotting was used to determine protein expression of TGF-β-Smad 2,3,4.Results HE Staining results showed that compared with the control group , ald activated cell proliferation and increased the cell division phase significantly (P<0.01).Compared with ald group, aspi+ald as well as spiro+ald could reduce cell division significantly ( P<0 .05 ) .MTT assay showed that compared with control group , ald could significantly improve the metabolism of MTT in CF (P <0.01).Compared with ald group, aspi +ald as well as spiro+ald could reduce the metabolism of MTT (P<0.01).Western blotting revealed that the expression levels of TGF-β-Smad 2, 3, 4 in CF were significantly increased by the stimulation of ald but were significantly reduced in aspi +ald and spiro+ald groups compared with ald group (P<0.01).Conclusion Aspi can inhibit the proliferation of CFs induced by ald,possibly by down-regulating the expression of Smad 2, Smad3 and Smad4.

Objective To explore the effect of early phase rehabilitation training on the urination function recovery of the patients with paraplegia caused by spinal cord injury (SCI).Methods Sixty-six patients with paraplegia caused by SCI were selected and divided into the rehabilitation and the control group.The rehabilitation group of patients received early phase rehabilitation training on the urination function,the control group received routine training on the urination training and urinary catheter nursing care.The urination function recovery effect was compared between two groups.Results The urination function recovery effect of the rehabilitation group was significantly better than the control group.Conclusions The usage of early phases of urination training measures on the SCI paraplegia patients can help them cast off the catheter,build up regular urination,and reduce complications.

Objective To investigate the characteristics of clinical course and outcome in elderly patients with nonvariceal upper gastrointestinal bleeding (NUGB) Methods The 206 hospitalized patients were devided into elderly group (≥60 yrs, 105 cases) and non elderly growp (

BACKGROUND:Periosteum is considered as a source of seed cels for cel therapydue toits biological features. OBJECTIVE:To seek the optimal way to isolate and culture rabbit periosteal cels and identify their biological features. METHODS:Rabbit periosteum on facies medialis tibiae was taken out under aseptic conditions. Periosteal cels isolated through the digestion of type II colagenase with the explants culture method were cultured in DMEM/F12 complete medium. Cel ultrastructure was observedunderan inverted microscope. Periosteal cel proliferation was determined bycel counting kit-8assay. Cel surface antigensCD90 and CD105 were determined using flow cytometry. Osteogenic andlipogenic induction mediums were applied to induce periosteal cels to differentiate into osteocytes and adipocytes, respectively. After 2 weeks of induction, cels were harvestedfor alizarin red staining and oil red O staining to assay the calciumnodules and lipid droplet. RESULTS AND CONCLUSION:The digestion of type II colagenase with the explants culture method shortened the period of primary cels culture and enhanced the survival rate, which causedhigher purity and stronger reproductive activity of harvested periosteal cels. Primary cultured periosteal cels grew in form of spindle spiral or paralel. Alizarin red andOil red O staining verified the multi-directional differentiation potentiality of periosteal cels. These findings suggest that the periosteal cels with high purity,strong reproductive activity,andmulti-directional differentiation potentialitycanbe harvested in short time using digestion of type II colagenase with the explants culture method.

Objective To estimate the venous thromboembolism (VTE) risk and prevention in critically ill patients admitted to ICU and discuss the appropriate strategy for prevention.Methods A total of 276 critically ill patients staying longer than 48 hours in ICU were enrolled for a retrospective single-center study.VTE risk assessment,methods for mechanical and pharmacological prophylaxis and demographic data were recorded.Simplified Caprini scores for VTE risk were counted in the first day and 7th day after admission to ICU,and were compared among internal medicine,surgery and trauma subgroups.Relationship between VTE risk and the clinic index was analyzed by Pearson test and Spearman test with SPSS 17.0 software.The prophylaxis strategy applied to patients without low risk of VTE was explored.Results Simplified Caprini scores were (8.71 ± 4.90) and (9.24-± 5.30) on the first day and the 7th day after admission respectively.Simplified Caprini score was significantly related to APACHE Ⅱ score (r =0.397,P =0.027).Meanwhile,simplified Caprini score in surgical and traumatic patients was higher than that in medical ill patients (14.02 ±2.01),(14.5 ± 1.29) vs.(6.55 ±3.98),P ＜0.01.The total rate of early prophylaxis measures used with mechanical prevention (13.43％) and pharmacological prophylaxis (5.22％) was only 18.28％ within 48 hours after admissioin of patients with highest riskof VTE.Even on the 7th day after admission to ICU,the total rate of prophylaxis measure employed with mechanical prevention (11.92％) and pharmacological prophylaxis (11.56％) for VTE was 25.83％.Conclusions Critically ill patients in ICU were subjected to extremely high risk of VTE.The VTE risk related closely to the severity of critically illness existed throughout the whole period of the ICU stay.Constant assessment for VTE risk and bleeding risk should be made with frequent assessment for critically ill patients.