Objective To analyze the effect of calcitonin combined with alfacalcidol on clinical outcome,lumbar vertebrae bone mineral density and safety in patients undergoing internal fixation of humeral shaft fracture.Methods 80 patients with humeral shaft fracture treated with internal fixation in Xunwu county people's hospital from June 2010 to June 2016 were selected,and randomly divided into control group and observation group,40 cases in each groups.The control group was given calcium carbonate D3 tablets and functional exercise therapy,the observation group treated calcitonin combined with alfacalcidol on the basis of control group,analysis and comparison the clinical effects,lumbar spine BMD and safety.Results Compared with before treatment,serum calcium level of two groups increased significantly at treatment 2 weeks and 3 weeks(P<0.05);The control group BMD of lumbar spine was significantly increased in treatment 12 weeks(P<0.05),the observation group BMD of lumbar spine was significantly increased in treatment 4 weeks and 12 weeks(P<0.05).Compared with control group,the level of serum calcium in observation group was higher at treatment 2 weeks and 3 weeks (P<0.05),BMD of lumbar spine was higher at treatment 4 weeks and 12 weeks(P<0.05);The total adverse reaction rate of observation group was 10%,the difference was not statistically significant to control group 15%.Conclusion The combination of calcitonin and alfacalcidol treatment of internal fixation of humeral shaft fractures in patients with significant results, can improve serum calcium levels in patients with and improve bone mineral density, and less adverse reactions.

OBJECTIVE To analyze the application of antibacterials in liver transplanted patients of our hospital in order to improve the rational use of antibacterials in perioperative period of liver transplantation.METHODS According to the criteria of DDD and DUI recommended by WHO,a retrospective study of the application of antibacterials in 82 patients with liver transplantation who discharged hospital during from Jun 2003 to Jun 2005 was made.RESULTS Among the 82 patients,100.0% patients had received antibacterials and 48 patients received combined medication,in which 45.10% used two kinds and 13.41% used three kinds.The longest medication time was 49 days while the shortest was 10 days.Nineteen antibacterials′ DUI were all less than one except meropenem whose DUI was 1.03.CONCLUSIONS This study proved that patients with liver transplantation in our hospital received rational antibacterials.

Objective:To identify HLA-A2-restricted CTL epitope of breast cancer differentiation antigen NY-BR-1.Methods:The HLA-A2-restricted CTL epitope of breast cancer differentiation antigen NY-BR-1 is predicted by combination quantitative motif method and the molecular dynamics.The three epitope were assayed their affinity to HLA-A2.Results:The affinity to HLA-A2 of NY-BR-1_ 1043-1051 is a best.Conclusion:NY-BR-1_ 1043-1051 is a HLA-A2 restricted epitope.

To explore the clinical effect of alendronate combined with Jintiange capsules in the treatment of postmeno-pausal osteoporosis ( PMOP) . Methods:Ninety-eight cases of PMOP patients were randomly divided into three groups. The combina-tion treatment group (34 cases) was treated with alendronate tablets combined with Jintiange capsules, while the control group A (32 cases) and the control group B (32 cases) was respectively treated with alendronate tablets and Jintiange capsules, and the treatment course was six months. The changes of the clinical symptom score, bone mineral density ( BMD) , serum calcium, serum phosphorus, AKP, hepatorenal function and so on before and after the treatment were recorded. Results:After the six-month treatment, the clinical symptom score of the treatment group was much better than that in the two control groups(P<0. 05). BMD in the three groups was in-creased after the treatment(P<0. 05), and the increase in the treatment group was more notable than that in the two control groups(P<0. 05). Conclusion:Alendronate combined with Jintiange capsules can effectively improve BMD and relieve clinical symptoms in the patients with PMOP, which is worthy of promoted application.

BACKGROUND: Clinically Alzheimer disease (AD) is characterized by obscurity in onset, decline of intelligence, and dysfunctions of behavior and nerve system. The essence of AD is impairment of memory and cognition.OBJECTIVE: To explore the effective mechanism of tiaoxin recipe (TXR)and bushen recipe (BSR) in treating AD.DESIGN: Randomized controlled study.SETTING: Shanghai Institute of Traditional Chinese Medicine for Geriatrics.PARTICIPANTS: Totally 60 AD patients were selected from Shanghai Institute of Traditional Chinese Medicine for Geriatrics from October 1999to January 2000.METHODS: Sixty patients with AD were divided into 3 groups, with 20in each group. The patients in TXR and BSR group took respectively TXR and BSR 10 mL once, 2 times per day. The patients in donepezil (Dp)group took a Dp capsule once a day, h.s (Dp was produced in England Boots Company, 5 mg per capsule). For a course consisted of 12 weeks.The changes of Mini mental state examination (MMSE) score, Activity of Daily Living Scale (ADL) score, neuropsychological testing (NPT) score,including FULD object-memory evaluation (FOM), rapid verbal retrieval (RVR), digit span test (DS) and block design (BD), as well as the overall operational evaluation before and after treatment were analyzed.MAIN OUTCOME MEASURES: Scores of MMSE, ADL, NPT and the overall operational evaluation.RESULTS: Totally 60 patients entered the final analysis. ① MMSE scores in the 3 groups were decreased after treatment as compared with those before treatment (P ＜ 0.01). Total effective rates were 70%, 65% and 75% respectively (P ＞ 0.05). ② ADL scores in the 3 groups were decreased after treatment as compared with those before treatment (P ＜ 0.05or P ＜ 0.01). Total effective rates were 45%, 45% and 40% respectively (P ＞ 0.05). ③ Total effective rates were 70%, 65% and 75% respectively (P ＞ 0.05). ④ Scores of FOM were increased in the TXR and the Dp group after treatment as compared with those before treatment (P ＜ 0.05). RVR scores in the three groups were increased after treatment as compared with tbose before treatment (P ＜ 0.05); DS scores were increased in TXR group and Dp group after treatment as compared with those before treatment (P ＜ 0.05 or P ＜ 0.01); and BD scores in BSR group were increased after treatment as compared with those before treatment (P ＜ 0.05).CONCLUTION: TXR, BSR and Dp can improve cognitive function and daily living ability of AD patients, and TXR and BSR are effective TCM drugs in treating AD.

BACKGROUND: The study about the multiple differentiation potentials of the mesenchymal stem cells is still on the stage of the animal experimentation. Can mesenchymal stem cells have the ability to differentiate into certain tissues and develop the corresponding functions after they are transplanted into certain tissues?OBJECTIVE: To observe the differentiation of the bone marrow mesenchymal stem cells into the nerve and its effect on the nerve functional recovery after they are transplanted into the peripheral zone of the ischemic infarction focus of the cerebral cortex.DESIGN: A randomized controlled study.SETTING: The Department of Anatomy of the School of Basic Medical College of Sun Yat-sen University; the Department of Neurology of the First Hospital of Sun Yat-sen University; Department of Pathology of the Medical College of Jinan University.MATERIALS: The experiment was conducted at the Medical College of Sun Yat-sen University from November 2002 to November 2003. Forty-eight male SD rats were chosen and randomly divided into two groups, with 32 rats in cerebral infarction model group and 16 in the non-model control group. In the cerebral infarction group, the rats were randomly divided again into two groups: 16 rats in the transplantation group and 16 in the phosphate buffered fluid group. The anterior fontanel taken as the reference point, 5 μL(5 × 104 L-1) of the bone marrow mesenchymal stem cells or the phosphate buffered fluid was respectively transplanted at the site 3 mm away on the caudal side and 1.5 mm aside at the depth of 2. 0 - 3. 0 mm.METHODS: The bone marrow mesenchymal stem cells were obtained through the separation and purification of the bone marrow of the ribs taken away in the thoracic surgery from the patients without the hematological diseases, and then the cells underwent in vitro culture, the amplification and the identification. At the 2nd and 6t1 weekend after the transplantation,the rats of every group were anesthetized, and the samples were taken from the transplantation site and made into the 25 μm of continuous frozen section. Then, the immunohistochemical method was used for the detection of the expressions of neuron specific enolase, neurofibril protein, glial fibrillary acidic protein, and nidogen to evaluate the ability of the bone marrow mesenchymal stem cells to differentiate into neurons and glial cells. Eight rats of the transplantation group and 8 rats of the phosphate buffered fluid group were randomly taken out, and 2 and 6 weeks before and after the transplantation the bar walking test evaluation method was used to identify the general status and reaction ability of the rats. Sixteen rats of the control group were assessed at the same time.enolase, neurofibril protein, glial fibrillary acidic protein and nidogen in the bar walking test.2nd weekend after the transplantation, there were positive expressions of glial fibrillary acidic protein and nidogen at the transplantation site of the bone marrow mesenchymal stem cells. At the 6th weekend there were positive expressions of neuron specific enolase and neurofibril protein at the transplantation site of the bone marrow mesenchymal stem cells. While in the phosphate buffered fluid group, there were negative expressions of neuron specific enolase, neurofibril protein, glial fibrillary acidic protein and nidosymptoms in the control group and the evaluation scores were all 9. 2 weeks after the transplantation, and the evaluation scores of the motor function in the transplantation group were higher than the ones in the phosphate buffered fluid group, [(6.7±0.9), (5.3-±1.0), (P ＜0.05)]. Six weeks after the transplantation, the evaluation scores of the motor function in the transplantation group were also higher than those in the phosphate buffered fluid group[(8.9±1. 1),(7.2±0.8),(P ＜0.05)].CONCLUSION: After their transplantation into the central nervous system,the bone marrow mesenchymal stem cells showed the ability to differentiate into neurons and glial cells, in which the characteristics of some neurons and glial cells were found. Bar walking test found that the evaluation scores of the motor function in the transplantation group were higher than those in the phosphate buffered fluid group, which suggests that the bone marrow mesenchymal stem cells have a significant effect on restoration of the functions of the nerves.

Objective To study deletion mutations and polymorphism of PINK1 gene exons in patients with Parkinson' s disease (PD) in the littoral of Zhejiang Province,and analyze the association between these changes and the etiology of PD.MethodsAll exons of PINK1 gene in 200 PD patients( 112early-onset PD and 88 late-onset PD) and 220 controls (68 young controls and 152 old controls ) were amplified by polymerase chain reaction (PCR). All the positive PCR products were sequenced,and genotypes were detected by dot blot allele and genotype frequencies of PINK1 were compared by the Chisquare test.ResultsNo deletion mutations of the exons were found in all patients and controls.However,a known heterozygote point mutation G12169A in exon 5 was identified in 2 patients with early-onset PD.And G12164A polymorphism and G12101A polymorphism were located on PINK1 gene of exon 5. There were G/G and G/A genotypes in G12164A polymorphism,no A/A genotype.There were G/A and A/A genotypes in G12101A polymorphism,no G/G genotype. The chain relation polymorphism A/A genotype frequency was significantly higher in the PD group 84/200 (42.0％ ) than the control group (52/220,23.6％,x2 =4.034,P =0.045 ).The frequency was also significantly higher in the late-onset PD (40/88,45.5％ ) than the old control (32/152,21.1％,x2 =3.951,P =0.047 ).There were no significant differences in alleles frequencies of other groups.ConclusionThe deletion mutation and point mutation are rare in PD patients in littoral of Zhejiang Province.Chain relation polymorphism at G12164A and G12101A in PINK1 gene might be a susceptible factor for PD patients.

Objective To investigate the clinical significance of BiPAP mechanical ventilation in the treatment of chronic obstructive pulmonary disease(COPD)with type Ⅱ respiratory failure.Methods A total 56 patients suffering from respiratory failure due to exacerbation of COPD were randomly divided into treatment group (BiPAP plus routine therapy)and control group(routine comprehensive therapy).Blood gases,respiratory rates,heart rates,scores of the activity of accessory respiratory muscles,incubation rate,fatality rate were observed.Results In the treatment group,PO2 greatly increased,PCO2 greatly decreased,pH improved significantly,and respiratory rate,heart rate and scores of the activity of accessory respiratory muscles greatly decreased.The incubation rate and the fatality rate were significantly lower in the treatment group than those in the control group(P＜0.05).Conclusion BiPAP mechanical ventilation plus routine therapy on COPD with type Ⅱ respiratory failure can improve the curative effects,lessen respiratory muscle fatigue,and decrease the need for incubation and fatality rate.

Objective To investigate the effects of inhalation of different concentrations of sevoflurane combined anesthesia on somatosensory evoked potentials (SEPs) in the adolescent patients undergoing scoliosis surgery.Methods Forty-five adolescent patients of both sexes,aged 12-17 yr,with body mass index of 15-23 kg/m2,undergoing scoliosis surgery under general anesthesia,were randomly divided into 3 groups ( n =15 each):low concentration sevoflurane group ( group S1 ),moderate concentration sevoflurane group ( group S2 ) and high concentration sevoflurane group (group S3 ).Anesthesia was induced with fentanyl 4 μg/kg,midazolam 0.03 mg/kg,propofol 2.0 mg/kg,and rocuronium 0.6 mg/kg.The patients were endotracheal intubated and mechanically ventilated.Anesthesia was maintained with propofol infusion at 8 mg· kg-1 · h-1 and remifentanil infusion at 0.25 mg· kg-1 ·min-1.After beginning of the surgery,1.8％,4.0％ and 6.0％ sevoflurane were inhaled for 10 min in groups S1-3 respectively,SEPs were measured by stimulating the posterior tibial nerve and significant SEP suppression was detected and recorded.The wave P40 latency,wave P40-N50 amplitude,and time for P40 waveform changes were recorded before sevoflurane inhalation (baseline) and at 10 min of sevoflurane inhalation,and the time for recovery of P40 waveform was recorded after sevoflurane inhalation was stopped.The prolonged percentage of P40 latency and decreased percentage of P40-N50 amplitude were calculated.Results The rates of significant SEP suppression were 80％,100％ and 100％ in groups S1,S2 and S3 respectively ( P ＞ 0.05).Compared with group S1,the prolonged percentage of P40 latency and decreased percentage of P40-N50 amplitude were significantly increased,the time for P40 waveform changes was significantly shortened,and the time for recovery of P40 waveform was significantly prolonged in groups S2 and group S3 ( P ＜ 0.05).Compared with group S2,the decreased percentage of P40-N50 amplitude was significantly increased,the time for P40 waveform changes was significantly shortened,and the time for recovery of P40 waveform was significantly prolonged in group S3 ( P ＜ 0.05).Conclusion 1.8％,4.0％ and 6.0％ sevofiurane combined anesthesia can suppress SEPs in the adolescent patients undergoing scoliosis surgery,and they are not suitable for the surgeries requiring SEP monitoring.

Objective To investigate the different components of Acorus tatarinowii and Polygala tenuifolia(volatile oil, aqueous extract)on the expression of phosphorylated Tau protein at site Ser396 and Tau-5 in the hippocampus of rats with Alzheimer′s disease(AD). Methods Male Sprague Dawley rats were randomly divided into 8 groups:normal control group, model control group,low-,middle-,and high-dose groups of volatile oil of Acorus tatarinowii and Polygala tenuifolia,and low-, middle-,and high-dose groups of aqueous extract of Acorus tatarinowii and Polygala tenuifolia. The subacute aging model was established by intraperitoneal injection of D-galactose( D-gal). Rats were given different components of Acorus tatarinowii and Polygala tenuifolia(crude drug dosage,0.6,1.2,1.8 g·kg-1 )in experimental groups,and 0.9% sodium chloride solution in normal control group and model control group,by gavage for 28 days.The levels of phosphorylated Tau protein at site Ser396 and Tau-5 were detected in hippocampal tissues by Western blotting and immunohistochemistry. Results The levels of phosphorylated Tau protein at site Ser396 were significantly enhanced in the model control group,as compared with those in normal control group (P<0.01).The relative expression levels of Tau protein Ser396 were 3.83±0.10,3.35±0.01,3.11±0.01,2.75±0.03,2.93±0.01,2.55± 0.07,and 2.23±0.08 in model control group,low-,middle-,and high-dose groups of volatile oil of Acorus tatarinowii and Polygala tenuifolia,and low-,middle-,high-dose groups of aqueous extract of Acorus tatarinowii and Polygala tenuifolia,respectively.Two components of Acorus tatarinowii and Polygala tenuifolia could dephosphorylate Tau protein Ser396 to vary degrees in a dose-dependent manner.The aqueous extract component was slightly better than the volatile oil component,especially in the high-dose group(P<0.01).But Tau-5 did not change significantly after treatment with Acorus tatarinowii and Polygala tenuifolia(P>0.05). Conclusion Acorus tatarinowii and Polygala tenuifolia could promote the dephosphorylation of Ser396 site of Tau protein in the hippocampus of AD rats,with the aqueous extract component having better effects.