Objective To determine the causes and risk factors of antimicrobial treatment failure in patients with community-acquired pneumonia(CAP). Methods Hospitalized adults with CAP from January 2006 to December 2006 were analyzed retrospectively. Treatment failure was defined as appearance of nonresponding pneumonia and progressive pneumonia. Patient's clinical features were analyzed. Results All of 378 patients were involved in this study. Total antimicrobial treatment failure was happened in 50 patients(32 patients with non-responding pneumonia and 18 patients with progressive pneumonia). The causes were infectious (35 patients,70% ), non-infectious (11 patients,22% ) and undetermined (4 patients,8% ).Mortality of antimicrobial treatment failure was 18%(9/50, 8 patients died of infectious cause, 1 patient had no clear cause of death). Stepwise Logistic regression analysis showed that C-reactive protein, multilobar pneumonia,albumin < 30 g/L,renal function lesion,liver function lesion were related with antimicrobial treatment failure. Independent factors of treatment failure were multilobar pneumonia (P= 0.002) ,albumin <30 g/L(P = 0.001 ) and renal function lesion (P = 0.000). Conclusion The major challenge associated with antimicrobial treatment failure in hospitalized patients with CAP is infection, most of which is infection of drug resistant strain.

OBJECTIVE To study the bacteriology of pneumonia and its clinical significance in patients with lung cancer.METHODS The bacteriology and clinical features of patients with lung cancer accompanied with lung infections between 2002 and 2005 in our hospital were analyzed.RESULTS Pneumonia took place in 53.7% of 328 patients with lung cancer,the most of them were elderly people and the chemotherapy receivers,and the rates of pneumonia associated with small cell lung carcinoma(63%) and squamous cell carcinoma(59.7%) were significantly higher than those with adenocarcinoma(44.0%) and alveolar cell carcinoma(40.6%)(P

OBJECTIVE:To establish the method for the determination of oleanolic acid and ursolic acid in different medicinal parts of Tibetan medicine Pteocephalus hookeri,and compare the differences among the different parts. METHODS:The contents of oleanolic acid and ursolic acid from different medicinal parts(whole plant,aerial part,underground part)of P. hookeri were de-termined by UPLC-PDA. The separation was performed on Acquity UPLC HSS T3 column(150 mm×2.1 mm,1.8 μm)with mobile phase consisted of methanol-0.1 mol/L ammonium acetate(88:12,V/V)at the flow rate of 0.2 mL/min. The detection wavelength was set at 210 nm,and column temperature was 30 ℃. The sample size was 5 μL. RESULTS:The linear ranges of oleanolic acid and ursolic acid were 10.65-1065 μg/mL (r=0.9996) and 18.8-1880 μg/mL (r=0.9994),separately. The recoveries were 96.95%(RSD=1.24%,n=9) and 98.12%(RSD=2.13%,n=9),separately. RSDs of precision,stability and reproducibility tests were all less than 3%. The contents of oleanolic acid and ursolic acid from different medicinal parts in P. hookeri were in de-scending order of aerial part>whole plant>underground part;the average total content of oleanolic acid and ursolic acid from whole plants was 0.35%,the aerial part reached 0.56% and underground part was 0.09%. CONCLUSIONS:The method is rapid, accurate and reproducible,and it is suitable for the content determination of oleanolic acid and ursolic acid in different medicinal parts of Tibetan medicine P. hookeri. The contents of oleanolic acid and ursolic acid from aerial part of P. hookeri are higher than whole plant and underground part. It is suggested to use aerial parts of medicine.

OBJECTIVE:To explore the multi-component,multi-target,multi-channel mechanism of Tibetan medicine Ptero-cephalus hookeri in the treatment of rheumatoid arthritis (RA). METHODS:The selected target compounds (10 chemical struc-tures of P. hookeri)were imported and stored by related software;target prediction and filtering were conducted by PharmMapper and DrugBank databases. The pathways of targets were acquired and analyzed by MAS 3.0 database. Finally P. hookeriactive com-ponent-targeting-pathwaynetwork was constructed by Cytoscape 3.4.0 software. RESULTS:The target information obtained in the PharmMapper database were compared with that of the DrugBank database for inflammation-related drugs,26 potential targets for the treatment of RA were obtained,in which MAPK14,RXRA,ALB,PDE4D,VDR may be the main potential target gene group in the treatment of RA. 57 functional pathways were obtained after 26 functional targets were annotated by pathway. In addition to 27 RA-related pathways,30 other pathways such as endocrine regulation and immune were involved. CONCLUSIONS:Base on the study of network pharmacology,P. hookeri plays the role in the treatment of RA by acting on inflammation,immune,endo-crine and related targets and pathways.

This study took geo-authentic medicinal material Rhizoma Coptidis as an example and analyzed soil characteristics of the growing environment of Rhizoma Coptidis . The methods of ISSR, HPLC, 1H-NMR and NIR were respectively used for exploring its genotype and investigating on its chemitype . In the respects of an-ti-endotoxin, anti-bacterial activities and insulin resistance that was related to the treatment of diabetes, the pharmacodynamic type was studied and the relationship was comprehensively analyzed . The quality evaluation of geo-authentic medicinal materials was preliminarily established based on ecotype , genotype chemitype and phar-macodynamic type of Rhizoma Coptidis . Simultaneously, quality standards of Rhizoma Coptidis were set up in combination with genuine character , which provided the scientific basis for establishing Chinese medicine char-acteristic methods of quality evaluation of Rhizoma Coptidis .

This study was aimed to optimize the extraction conditions of polysaccharides from Rhizoma Coptidis.With the R.Coptidis of extraction yield,polysaccharide yield and uronic acid yield as evaluation indexes,the impact of extraction temperature,extraction times,extraction duration and liquid-to-solid ratio on the process of R.Coptidis polysaccharides reflux extraction were investigated by the Box-Behnken design-response surface methodology.The results showed that the optimal extraction conditions were achieved and listed as follows:extraction temperature at 100℃,extracted 3 times with 3.8 h per each time,liquid-to-solid ratio of 1:15.7.It was concluded that the Box-Behnken design-response surface methodology was accurate,rational and feasible to optimize the extraction method of polysaccharides fromR.Coptidis.

OBJECTIVETo study pharmacokinetic effect of Aikeqing Granule (AG) by different medication ways on zidovudine (AZT) in highly active antiretroviral therapy ( HAART) of rats.

METHODSTotally 36 rats were administered with corresponding medications by gastrogavage, group I [HAART: AZT 31.5 mg/kg +3TC 31.5 mg/kg + Efavirenz (EFV) 63.0 mg/kg], group II (HAART+AG525 mg/kg), group III (HAART and AG 525 mg/kg after a 2-h interval). Drug concentrations of AZT were determined by high performance liquid chromatography-mass spectroscopy (HPLC-MS) before HAART, and at 0.5, 1, 2, 3, 4, 6, 8, 10, 12 h after HAART, respectively. Pharmacokinetic parameters [such as t1/2, Tmax, Cmax, AUCo-t, plasma clearance rate (CL)] were calculated by DAS2.0 Software.

RESULTSThe-equation of linear regression of AZT was good, with the precision, coefficient of recovery, and stability definitely confirmed. AUC in group II and III was larger than that of group I. There was no statistical difference in t1/2, Tmax, Cmax, AUC0-12 h, or AUC0-∞ among groups (P > 0.05).

CONCLUSIONAG combined HAART could enhance the Cmax of AZT.

Animals ; Antiretroviral Therapy, Highly Active ; Benzoxazines ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; pharmacokinetics ; pharmacology ; Mass Spectrometry ; Rats ; Zidovudine ; pharmacokinetics ; pharmacology

10.3969/j.issn.1007-3969.2013.05.002

Objective:To investigate any change in the effective connectivity between the bilateral anterior central gyruses after transcranial magnetic stimulation (TMS).Methods:Twenty-one healthy subjects were examined using resting state functional magnetic resonance imaging (rs-fMRI) before and after receiving continuous theta burst stimulation (cTBS). The brain atlas of the Institute of Automation of the Chinese Academy of Sciences was used for fine partitioning of the bilateral anterior central gyruses. Granger causality analysis was used to compare any changes in the effective connectivity between them.Results:After the cTBS inhibited the right M1 area, significant changes in effective connectivity among the sub-regions of the bilateral M1 area were observed. The effective connectivity of the right upper limb to the left upper limb and the left head to face were weakened, while that of the left upper limb to the right head, as well as of the face to the right upper limb was enhanced.Conclusion:For people whose right M1 area has been inhibited by cTBS, the effective connectivity changes in both upper limb functional areas of the M1 region reflect inter-hemispheric inhibition. Opposite changes were found in the trunk and upper limbs.

OBJECTIVETo investigate the effects of low molecular peptide of Mycobacterium tuberculosis heat-resistant antigen (Mtb-HAg-10k) on the production of tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) in peripheral blood T cells and test the feasibility of differential diagnosis between pulmonary tuberculosis (PTB) and latent tuberculosis infection (LTBI) by assessing the number of Mtb-HAg-10k-stimulated IFN-γ-producing T cells.

METHODSPeripheral blood mononuclear cells (PBMCs) were separated from the peripheral blood of 10 healthy adults, 6 individuals with LTBI and 13 patients with PTB. The PBMCs were cultured in the presence of Mtb-HAg-10k obtained by ultrafiltration centrifugation, with Mtb-HAg and phytohaemagglutinin (PHA) as the controls. The proportions of TNF-α- and IFN-γ-producing cells in the T cell subsets were detected by flow cytometry (FCM), and the number of IFN-γ-producing cells from patients with PTB and LTBI was detected with ELISPOT.

RESULTSFlow cytometry showed that Mtb-HAg-10k exposure resulted in a significantly higher proportion of TNF-α-producing γδT cells than that of IFN-γ-producing γδT cells in the PBMCs (P<0.01). Compared with the PBMCs exposed to PHA, the PBMCs exposed to Mtb-HAg-10k exhibited a significantly greater proportion of γδT cells that produced both TNF-α and IFN-γ (P<0.01) but a significantly lower proportion of αβT cells producing both TNF-α and IFN-γ (P<0.01). Mtb-HAg-10k exposure of the PBMCs caused a significant reduction in the number of IFN-γ-producing cells as compared with Mtb-HAg and PHA treatments (P<0.01), and this reduction was more obvious in PBMCs from patients with PTB than in those from individuals with LTBI (P<0.01).

CONCLUSIONMtb-HAg-10k can markedly induce γδT cells in the PBMCs to produce TNF-α and IFN-γ, and detection of the number of IFN-γ-producing cells in the PBMCs following Mtb-HAg-10k stimulation helps in the differential diagnosis between pulmonary tuberculosis and latent tuberculosis infection.