Volume 88  ·   Issue 38  ·  2008

Translational medicine is an emerging field of multidisciplinary convergence.The main purpose of this field is to promote the transformation of basic medical research into clinical application,and at the same time,it provides a platform for crossing the barrier between traditional basic and clinical research,and builds a bridge between basic researchers and clinicians.Once the concept of translational medicine was proposed, it immediately demonstrated its strong impetus.

Objective To study the expression of cyclooxygenase-2 (COX-2) in bladder transitional cell carcinoma (Tcc) and the clinical significance thereof. Methods Immunohistochemistry was used to detect the expression of COX-2 in 56 specimens of bladder Tcc and 10 specimens of normal bladder tissue, all resected during operation. Results No expression of COX-2 was detected in the 10 specimens of normal bladder tissue and in the 56 specimens of bladder Tcc the positive rate of COX-2 was 55.36%. The expression of COX-2 in bladder Tcc was closely correlated with the grade and stage of tumor (both P<0.01). Conclusion COX-2 expression in bladder Tcc is closely correlated with the grade and stage.

Objective To analyze whether isolated hypertension and metabolic syndrome (Based on the 2005 IDF criteria) have equal risk on stroke in Chinese adults. Methods 25194 subjects (25-75 years old) from Chinese National Health and Nutrition Survey in 2002 were divided into control group,isolated hypertension (I-HTN) group, metabolic syndrome (MS) without hypertension (non-HTN/MS) group, MS with hypertension (HTN/MS) group. The clinical features and risk for stroke (using multiple logistic stepwise regression analysisi) were compared among 4 groups. Results (1) The clinic features in the I-HTN group was non-central obesity, and its plasma glucose, triglyceride(TG), high-density lipoprotein cholesterol (HDL-C) levels were nonnal. (2) The prevalence of stroke in control group, I-HTN group, non HTN/MS group and HI'N/MS group was 0.14%, 1.27%, 1.19% and 2.14%, respectively. (3) After adjustment for age, sex, smoking, hiw-density lipoprotein cholesterol level, logistic regression analysis showed that the I-HTN group, non-HTN/MS group and HTN/MS group had higher risk of stroke compared with the controls, the odd ratio (OR) were 4.18,8.00,8.69(P<0.01), respectively. Compared with I HTN group, OR in HTN/MS group was 2.05, while no difference was found between I-HTN group and non HTN/MS group (P>0.05). (4) Among different components of the MS, hypertension (OR 2.33), central obesity (OR 2.09), low HDL-C (OR 1.69), hyperglycemia (OR 1.66) except hypertriglyeeridemia were all significantly related to stroke (P<0.01). Conclusion (1) MS and hypertension were an independent risk factor for the development of stroke in Chinese adults. (2) Though there was no clinical features of insulin resistance in I-HTN group, it was observed that the I-HTN and non HTN/MS had equal contribution to stroke. The risk of stroke will be further increased if hypertension included in the MS.

Objective To investigate the changes of intrarenal pressure in response to continuous irrigation at different pressures during ureteroseopie lithotripsy. Methods Eleven patients with residual ureteral calculi after pereutaneous nephrolithotomy (PCNL), 8 in the proximal section, 2 in the middle section, 1 in the distal section. And one patient with calculi in the distal ureteral section underwent ureteroscopie lithotripsy. Renal fistula tube was connected with a urine dynamic detector and irrigation was performed continuously through the ureteroscope at different pressures. The baseline intra-pelvic pressure (IPP0) and maximum intra-pelvie pressure (IPPmax) were recorded. Results The average IPP0 was (16.9±3.2) cm H2O. The IPP levels during the ureteroscopic lithotripsy [(172.6±32.2) cm H2O] were all significantly higher than the IPP0(all P<0.01). In response to the irrigation pump pressure of 100 mmHg, the IPPmax during the ureteroscopic lithotripsy in the distal, middle, and proximal ureter were 74.6,93.5, and (110.3±2.4) cm H2O respectively. When the irrigation pump pressure levels were 50, 100, and 200 mm Hg respectively the IPPmax levels during the ureteroscopic lithotripsy in the proximal ureter were (51.0±4.5), (110.3±2.4), and (193.2±5.9) cm H2O respectively (all P<0.01). Conclusion The renal pelvic pressure is signifieanfly increased during ureteroseopic lithotripsy. High renal pelvic pressure is associated with the irrigation pressure and the position of calculi.

Objective To investigate the frequency of intron 1 inversion (inv1) in FⅧ gene in Chinese hemophilia A (HA) patients and to investigate the mechanism of pathogenesis. Methods Peripheral blood samples were collected from 158 unrelated HA patients, aged 20 (1-73), including one female HA patient, aged 5, and several family members of a patient positive in invl. One-stage method was used to assay the FⅧ activity (FⅧ:C). Long distance PCR and multiple PCR in duplex reactions were used to screen for the intron 22 inversion (inv22) and invl of the FⅧ ceding gene (FS). The F8 coding sequence was amplified with PCR and sequenced with an automatic sequencer. Results Two unrelated patients (pedigrees) were detected as invl positive with a positive rate of 1.26%. A rare female HA patient with invl was also discovered in a positive family (3 HA cases were found in this family and regarded as one case in calculating the total detection rate). The full length of FⅧ was sequenced, and no other mutation was detected. Conclusion There frequency of FⅧ inv1 is low in Chinese HA patients compared with other populations. Female HA patients are heterozygous for FⅧ inv1 and that may be resulted from nonrandom inactivation of X chromosome.

Objective To clone the full-length cDNA of a novel gene related to familial acute myelogenous leukemia (AML) and to demonstrate its molecular mechanisms on the gene level. Methods Bone marrow specimen was obtained from a patient of familial AML, male, aged 11, and peripheral blood samples were obtained from 23 AML patients outside this family, 9 normal persons in this family, and 23 normal persons outside this family. Based on the EST sequence zywb87 (GenBank accession number:CV973101) from a subtractive eDNA library of differential expressed genes constructed in familial AML,SMART-rapid amplification of eDNA ends (SMART-RACE) was applied to clone the full-length cDNA of the novel gene, and bioinformatics was used to predict its biological function, the expression of the novel gene in AML was detected by One-Step RT-PCR. Results A full-length cDNA of 2313 bp was obtained from the bone marrow specimen of the familial AML patient with complete open reading frame (ORF) of 249 bp. Localized on lq31.3 of human chromosome, it ceded a 82-amino acid polypeptide with signal peptide, leucine-rieh repeat (LRR_SD22 ), and intrinsic disorder functional domain. BLAST analysis confirmed this gene as a novel gene designated with the accession number: (nucleotide) EF413001 and (protein) ABN58747 by GenBank and was named as Homo sapiens familial acute myelagenous leukemia related factor(FAMLF). The FAMLF expression level of the AML patients outside this family was (2.61±0.66), significantly higher than that of the normal persons outside this family (0.97±0.51, P<0.01).Conclusion A full- length cDNA of the novel gene FAMLF related to familial AML has been obtained. The FAMLF gene is expressed highly in AML and may present biological function on the progress of AML.

Objective To investigate the effects of constant magnetic field (CMF) on proliferation and migration of bone marrow-derived endothelial progenitor cells (EPCs) under rapamycin intervention. Methods EPCs were isolated from rat bone marrow by density gradient centrifugation and cultured on fibronectin-coated dishes. Six days later the attached cells were divided into 5 groups: control group, rapamycin (1 ng/ml) group, and 3 rayamycin + CMF groups (treated with CMF of the doses 0.1 mT, 0.5 mT, and 1.0 mT respectively). Samples were collected 24 hours after incubation. Cell proliferation was measured by MTT chromatometry. EPC migration was detected with modified Boyden chamber assay. Results The EPC proliferation ability of the rapamycin group, expressed by absorbance, was (0.252 ± 0.006),significantly lower than that of the control group [(0.328 ± 0.025) ,P <0.05]. The number of migrating EPC was (31±3) cells, significantly lower than that of the control group [(48±5) ,P <0.05]. The EPC proliferation ability of the rapamycin + CMF 0.5 mT and 1.0 mT groups, expressed by absorbance, were (0.278±0.008) and (0.280±0.010) respectively, both significantly higher than that of the control group (both P<0.05). The migrating EPC number of the rapamycin + CMF 0.5 mT and 1.0 mT groups were (37±3) and (38±4) respectively, both significantly higher than that of the control group (both P<0. 05). Conclusion CMF of the doses of 0.5 mT and 1.0 mT antagonizes the effects of rapamycin on EPCs, increasing the proliferation and migration of EPCs.

Objective To investigate the influence of marrow-derived mesenchymal stem ceils (MSCs) on the lung injury caused by exposure to high oxygen. Methods MSCs were extracted from the femurs of Sprague-Dawley (SD) rat, cultured, amplified, and labeled with 5-bromo-2'-deoxy-uridinel (BrdU). Thirty-two 3-day-old SD rots were randomly divided into 4 equal groups: Group A, exposed to high oxygen (95%) for 7 days and then injected intra-peritoneally with 50 μl phosphate buffered solution (PBS) containing 5×104 MSCs; Group B, exposed to ordinary air for 7 days and then injected intra-peritoneally with PBS containing 5×104 MSCs; Group C, exposed to high oxygen (95%) for 7 days and then injected intra-peritoneally with PBS without MSC; and Group D, exposed to ordinary air for 7 days and then injected intra-peritoneally with PBS without MSC. 72 h later, when the rats were 13 days old they were killed Bronchoalveolar lavage fluid (BALF) was obtained to count the numbers of white blood cells and neutrophils. Lung homogenate was made. ELLSA was used to examine the contents of tumor necrosis factor (TNF)-α and interleukin (IL)-1β. Radial alveolar count (RAC) of the lungs was conducted under light microscope. Double-staining immunocytochemisty was used to detect the expression of surfactant protein A (SP-A) and BrdU. Results (1) The RAC values of Groupe A and C were (11.0±1.0) and (9.6±0. 7) cells/10 fields, both significantly lower than those of Group B and D [(13.9±1.1) and (14.0±1.1)

Objective To investigate the effects of erythropoietin (EPO) on the expression of aquaporin 2 (AQP2) after renal ischemia/reperfusion (IR). Methods Twenty-four Wistar rats were randomly divided into 3 equal groups: IR group undergoing resection of the right kidney, closuring of the left renal artery, vein, and ureter, and un-closuring 40 min later; IR + EPO group undergoing the above mentioned procedures and then intraperitoneal injection of EPO 3000 U/kg on days 1 and 2 after the treatment; and control group undergoing resection of the right kidney only without IR of the left kidney.Urine volume and urine osmotic pressure were measured. Blood samples were collected to detect the serum blood urea nitrogen (BUN) and creatinine (Cr). Three days after the treatment the kidneys were taken out.RT-PCR and Western blotting were used to detect the mRNA and protein expression of AQP2. Results The group was (1508±121) mOsm/kg H2O, significantly higher than that of the IR group [(235±99) mOsm/ kg H2O, P<0.01]. The serum BUN and Cr levels of the IR + EPO group were (12.3±6.0) mmol/L and (51±5)μmol/L respectively, both significantly lower than those of the IR group [(29.9±3.7) mmol/L and (141±5)μmol/L respeetivdy, both P<0.01]. The mRNA and protein expression of AQP2 were highly positive in the control group. The protein expression levels of AQP2 of the IR + EPO group were not significandy different from those of the control group (both P>0.05), and the protein expression levels of AQP2 of the IR group were significandy lower than those of the control group (both P<0.01). Conclusion EPO can inhibit the down-regulation of AQP2 in response to IR and this may take part in the FRO protective mechanism of renal ischemia/reperfusian injury.

Objective To explore the possibility of building tissue-engineered adipose tissue and find a new approach for repairing soft tissue defects. Methods Using enzymatic digestion, adipose tissue derived stem cells (ASCs) were extracted from the lipid part of human liposuction aspirate, cultured, and underwent adipogenie induction or not. The adipegenie-induced and non-adipogenie-induced ASCs were labeled with 3, 3, 3', 3'-tetramcthylindo-carbecyanine perchlorate (DiI), a fluorescent marker, in vitro to be used as seed cells. Then, they were combined with injectable fibrin glue scaffold at 1×107/ml cell density. Six athymic BALB/C mice underwent subcutaneous injection of adipogonie-induced ASCs with fibrin glue scaffold at the density of 1×107 cells/ml into the left side of the low back (induced group), subcutaneous injection of non-adipegenic-inducad ASCs into the right side of the low back (non-induced group), and subcutaneous injection of injectable fibrin glue scaffold into the middle part of the neck (blank control group) ,with 0.2 ml per injection. Twelve weeks later the mice were killed and the implants were taken out. The wet weight was measured. HE and oil red O staining and light and fluorescence microscopy were used for morphological observation. Results Adipose tissue-like new-born tissues were found in the injection sites of the induced and un-induced groups. The average wet-weight of the induced group new-born tissue was (28±15) mg, significantly heavier than that of the un-induced group [(22±16) mg, P< 0.01]. HE staining and oil red O staining confirmed that the new-born tissue of the induced group was mature adipose tissue and DiI fluorescent staining approved its exogenousness. Most part of the new-born tissues of the un-induced group was fibroid tissue with only a few mature adipose tissues. Conclusion ASCs extracted from the lipid part after liposuction can be used as seed cells, mixed, after adipose-induction, with injectable scaffold of fibrin glue, and injected into the body to build mature adipose tissue.

Objective To investigate the effect of double targeting gene therapy by using recombinant adeno-associated virus-thymidine kinase (TK)- internal ribosome entry site (IRES)- endostatin (ES) (Raav-TIE). Methods Bladder cancer cells of the line T24 were cultured and transfected with Raav-ES, Raav-MCS (blank virus), and Raav-TIE respectively. 72 hours later the levels of ES in the supernatants were measured by ELISA and annexin V apoptesis test kit was used to examine the apoptosis.Human umbilical vein endothelial cells (HUVECs) were transJP2fected with Raav-ES, Raav-TIE, and Raav-MCS respectively. MTr method and flow cytometry were used to detect the apoptosis of the HUVECs. Balb/c nude rats were inoculated subcutaneously with T24 cells. Twenty rats with tumor were randomly divided into 4 equal groups to be treated by Raav-MCS, Raav-TK, Raav-ES, or Raav-TIE, and 5 rats were used as control group. Four weeks later, blood samples were collected to detect the ES level by ELISA. The tumors were taken out to undergo microscopy to calculate the mcrovessel density(MVD). Results 72 h after transfection, ES could be detected in the supernatants of the T24 cells transfected with Raav-ES, and Raav-TIE. The apoptotic rates of the T24 cells transfected with Raav-TK and Raav-TIE were 34.12% and 36.91% respectively, significantly higher than those of the T24 cells transfected with Raav-MCS and of the control group (3.08% and 0.84% , all P<0.05). Transfection of Raav-ES and Raav-TIE increased the apoptotic rate of the HUVECs time-dependently. Nine days after the transfetion Raav-ES, Raav-TK, Raav-TIE, the tumor volumes of the Raav-ES, Raav-TK, and Raav-TIE groups were (0.75±0.08), (0.71±0.11), and (0.52±0.09)cm3 respectively, all significantly lower than these of the Raav-MCS group and control group [(1.27±0.13)and (1.24±0.17)cm3 respectively, aLl P<0.05]. Conclusion Raav-TIE effectively inhibits the tumorigenesis and angiogenesis in bladder cancer. Double targeting gene therapy against bladder cancer can be achieved by using Raav.

Objective To investigate the effects of candesartan, an angiotensiou Ⅱ type Ⅰ receptor antagonist, in improvement of insulin resistance (IR) induced by high-fat diet and the possible mechanism thereof. Methods 45 male Wistar rats were randomly divided into 3 groups: normal chow group (NC, n= 15) fed with normal diet, high fat diet group (HF, n=15) fed with high fat diet, and high-fat diet with daily candesartsn treatment group (HF+C, n=15) fed with high fat diet and given orally with candesartan 8 mg/kg per day. Body weight was measured regularly. Four weeks later, oral glucose tolerance test (OGTT) and euglycemic-hyperinsulinemic clamp technique were performed to estimate the insulin sensitivity. After 12 h fasting blood samples were collected from the abdominal aorta to test the contents of blood glucose, and serum triglyceride (TG), total cholesterol (TC), LDL, HDL, and free fatty acid (FFA). Radioimmunoassay was used to detect the serum insulin. Viscera were taken out. Immunohistochemistry was used to examine the expression of peroxisome proliferation activated receptor (PPAR)-γ in hepatic and adipose tissues. Results The body weight 16 weeks later of the HF group was significantly higher than that of the HF + C group (P<0.01). The liver weight and epididymal and peri renal fat weights of the HF group were all significantly higher than those of the HF + C group and NC group (all P<0.01). There was no significant difference in fasting blood sugar among these 3 groups (P> 0.05). The glucose levels 2 h after OGTT in the HF + C group was (6.3±0.5) mmol/L, significantly lower than that of the HF group [(7.3±1.2) mmol/L, P<0.01]. The glucose infusion rate (GIR) of the HF +C group was (22±5) mmol/L, significantly higher than that of the HF group [(14±4) mmol/L, P<0.01]. The PPARγ expression levels in liver and adipose tissue of the HF + C group were up-regulated significantly compared with those of the HF group. Conclusion Candesartan may improve insulin resistance through promoting the expression of PPARγ in liver and adipose tissue.

Objective To explore the impact of advanced glycosylation end products (AGE) modified human serum albumin (AGE-HAS) on keratinocte migration and the mechanism thereof. Methods AGE-HAS was prepared in vitro. Epidermal keratinocytes from Sprague-Dawley rats back were cultured and treated with AGE-HAS of the terminal concentrations of 0, 30, 60, 90, 120, and 150 μg/ml for 1, 3, 5, and 7 days respectively. MTT method was used to detect the keratinocyte adhesion rate, expressed by absorbance. Keratinocyte migration ability was assessed by scratch wound healing assay and TransweU assay. Expression of integrin α3 was determined by flow cytometry. Scanning electron and inverted microscopes were used to observe the pseudopodium and microfilament of the keratinocytes. Immunofluorescence staining was used to detect the form of F-actin in the cells. Results The adhesion rates of the keratinocyte cultured with AGE-HAS for 12 and 24 hours were (0.112±0.022) and (0.173±0.012) respectively, both significantly lower than those of the control group [(0.122±0.004) and (0.267±0.024) respectively, both P<0.05)]. Scratch wound healing assay showed that the amount of migrating cells in the AGE-HAS group was (7±4)/HP, significantly less than that of the control group [(61±11)/HP, P<0.05)], and Transwell assay showed that the amount of migrating cells in the AGE-HAS group was (72±18)/HP, significantly less than that of the control group [(288±52)/HP, P<0.05]. The expression rate of keratinocyte integrin α3 in the AGE-HAS group was (3.2±1.2)%, significantly lower than that in the control group [(36.6±11.2)%, P<0.05]. The spreading of cell body, and the formation of pseudopodium and microfilament of the AGE-HAS group were all depressed in comparison with the control group. Condusion Keratinocyte migration is inhibited by AGE accumulation in high glucose condition. The mechanism may be the abnormality in the integrin inside-out signaling pathway and AGE-RAGE signaling pathway.

Objective To explore the effects of urokinase-type plasminogen activator (Upa) gene modified bone marrow-derived stem cell (BDLSC) transplantation on accumulation of extracellular matrix (ECM) in hepatic tissue in liver fibrosis. Methods BDLSCs obtained from 10 male Fisher344 rats were transfected by adenovims-mediated human Upa (AduPA) in vitro. Twenty-seven female rats were randomly divided into 3 equal groups to undergo subcutaneous injection of carbon tetrachloride to establish liver fibrosis models and then randomly divided into 3 equal groups: model group injected with normal saline via caudal vein, BDLSC group injected with 2×106 BDLSCs via caudal vein, and BDLSC-Upa group injected with 2× 106 AduPA-transfected BDLSCs. Eight weeks later the serum levels of alanine transaminase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), albumin (ALB), and ECM levels, I. E., hyaluronic acid, laminin (LN), and procollagen Ⅲ(PC Ⅲ), were detected. Then the rats were killed with their livers taken out. The hydroxyproline (Hyp) content of the liver was detected by alkaline hydrolysis. RT-PCR was used to examine the expression of collagen Ⅰ and Ⅲ( COL Ⅰ and COL Ⅲ), matrix metalloproteinases-2, 3, and 9 (MMP-2, 3, and 9), and tissue inhibitor of metalloproteinase-1 and2 (TIMP-1 and 2). Results Compared with those of the model group the levels of ALT, AST, and TBIL of the BDLSC-Upa group were all significantly lower, and the ALB level was higher (all P <0.05). The ECM levels of BDLSC-Upa group were all significantly lower than those of the model group or BDLSC group too (all P<0.05). Hyp content of the liver decreased dramatically. The Mrna expression levels of COL Ⅰ and COLⅢ of the liver of the BDLSC-Upa group were significantly lower(38.9±2.7,8.5±1.6), and the Mrna expression levels of MMP-2, -3, and MMP-9 Mbna (157.5±32.6,105.5±14.6,187.5±22.8) were significantly higher than those of the model group or BDLSC group (all P<0.05), but no significant differences were observed in the Mbna expression of TIMP-1 and 2 Mrna between the 3 groups (all P> 0.05). Conclusion Upa gene-modified BDLSC transplantation improves the liver function and suppresses the hepatic fibrosis in liver cirrhosis through up-regulating the expression of MMPs and promoting the degradation of ECM.

Avian influenza is the abbreviation of avian influenza, which is classified as Class A infectious disease by the International Bureau of Animal Diseases. In the case of avian influenza, new strains (variant viruses) of avian influenza virus will appear at any time, resulting in the existing drugs and vaccines losing the original effect, thus making the epidemic difficult to control.

Ventilator-associated pneumonia (VAP) is the most common infection in intensive care unit (ICU), with high mortality, disability and medical expense. The cumulative incidence of VAP is 10% ~25%, accounting for 25% of all infections in ICU, and the total mortality is 20% ~70%. More than 50% antibiotics are used in ICU for VAP. How to reduce the incidence of VAP has been the focus of attention of respiratory and ICU doctors.

In clinic, in order to prevent and treat surgical complications and obtain the best curative effect, suitable jejunostomy is often needed. Therefore, scholars at home and abroad have carried out a lot of research. For surgical patients, doctors often use jejunostomy during surgery, but this method is invasive and may cause complications such as intestinal leakage and intestinal obstruction.

Chyloleakage after axillary lymph node dissection of breast cancer is rare, and only a few cases have been reported at home and abroad [1-4]. From July 2005 to June 2007, 882 cases of axillary lymph node dissection of breast cancer were performed in our hospital, and 11 cases of chyloleakage occurred after operation, all of which were cured by conservative treatment. The diagnosis and treatment experience are summarized as follows.

Budd-Chiari syndrome (BCS) is a syndrome caused by portal and inferior vena cava hypertension caused by occlusion of hepatic vein outflow tract and/or hepatic vein outlet or inferior vena cava segment. Although the understanding and diagnosis level of this disease have improved, there is still a certain misdiagnosis rate due to various clinical manifestations. 71 patients with BSC admitted to Zhongshan Hospital affiliated to Fudan University from 1997 to 2006 were retrospectively analyzed and discussed as follows.

A 60-year-old male was admitted to the hospital mainly for "polydipsia and polyuria with episodic limb weakness for 4 years, repeated palpitations and sweating for more than 1 month". The patient had polydipsia and polyuria without inducement 4 years ago, and repeated limb weakness, which could be relieved after rest, but did not attract attention. 　　

In 2007, the International Diabetes Federation announced that the number of diabetic patients in the world reached 246 million. At present, there are more than 40 million diabetic patients in China, of which type 2 diabetes accounts for 90% ~95%. Therefore, diabetes is becoming one of the most challenging human health problems in the world. Type 2 diabetes has always been considered as a medical disease, and commonly used medical treatment methods are difficult to avoid the appearance and further aggravation of various diabetic complications.

Objective To evaluate the effectiveness and safety of the proton pump inhibitor and levofloxacin based first-hne triple therapy in the eradication of Helicobacter pylori (Hp). Methods Correlated randomized controlled clinical trials (RCTs) evaluating the effectiveness and safety of proton pump inhibitor and levofloxacin based first-line triple therapy to eradicate Hp were searched in Medline, Embase, OVID, Cochrane Library, Clinical evidence online, Socolar searching platform, and National Knowledge Infrastructure (1994 -2008) . The final searching date was 17 May 2008. The quality of trials was assessed according to the Jadad standard. Effective model for calculation was selected according to statistical heterogeneity between the trials evaluated by Stata 9.0. Egger regression model and trim-and-fill method were utilized to evaluate publication bias, and trim and fill method was employed to estimate the outcomes of the articles unpublished. Results Eleven RCTs including 1926 cases were selected for analysis in accordance with the enrollment criteria. As the first line treatment, proton pump inhibitor and levofloxacin based triple therapy was more effective than standard triple therapy (total OR = 1.56, 95% CI = 1.25 - 1.94, P=0.000), had lower side effect rate than standard triple therapy (total OR =0.57, 95% CI = 0.44 - 0.74, P = 0.000), and there was no significant difference in the compliance with the two therapies (totalOR =0.72, 95%CI=0.34-1.49, P =0.374). Conclusion Proton pump inhibitor and levofloxacin based triple therapy is effective in the eradication of Hp, and should be advocated to be the first- line regime in the treatment of Hp.

The patient was a male, 7 years and 6 months old, with patent anterior fontanel and short stature. He went to the doctor on January 8, 2008. The patient was the first child, the first birth, and delivered naturally at full term. Before the age of 2, the growth and development were normal. After the age of 2, the growth was slow and gradually lagged behind the children of the same age. His parents were inbred relatives (the father's grandmother and the mother's grandmother were biological sisters).

A 20-year-old male was admitted to the hospital on February 4, 2004 due to increased blood pressure for 3 years and intermittent headache for 2 years.Physical examination 3 years ago showed that blood pressure was 130/90 mm Hg and heart rate was about 100 beats/min, but no diagnosis and treatment were made. In recent 2 years, he had intermittent bilateral beating pain, especially after strenuous activity, with occasional pale complexion, which relieved after rest.The heart rate was fast when he was consciously calm, but obvious after activity.