OBJECTIVE To evaluate the clinical efficacy of piperacillin/tazobactam for severe community acquired pneumonia(CAP) among elderly.METHODS Seventy-six elderly cases of severe CAP were randomized into piperacillin/tazobactam group and ceftriazone group,and the sputum culture was underwent for each case before and after treatment.RESULTS The total efficacy rates and bacterial clearance rates in piperacillin/tazobactam group and ceftriazone group were 92.11% and 88.89%,and 73.68% and 58.82%,respectively,and the differences between the two groups were statistically significant.CONCLUSIONS It suggestes that piperacillin/tazobactam be a more effective drug for severe CAP among elderly in old age.

Objective To analysis curative effect of triple therapy and sequential therapy for eradication of Helicobacter pylori in patients with long-term aspirin use.Methods 52 patients with long-term aspirin use who were diagnosed with helicobacter pylori infection were collected.All patients were divided into sequential group and triple group according to different drugs classified, each 26 cases in each group were given corresponding drug treatment, after the end of treatment, the serum pepsinogen, Hp-IgG antibody levels and Helicobacter pylori clearance rate were detected in all patients. Results After treatment, compared with the triple Group, in the sequential group, the levels of serum PG I and PG II were lower, and PGⅠ/PGⅡwas higher, and the differences were statistically significant (P<0.05);the serum Hp-IgG antibody levels were lower in the sequential group (P<0.05);the Hp clearance rate of patients in the sequential group was higher (P<0.05).Conclusion Compared with triple therapy, sequential therapy can lower serum PG, PG II and Hp-IgG levels, and improve the Hp clearance rate and clinical efficacy, have guiding significance to clinical.

To compare the effects of polysaccharide nucleic acid fraction of bacillus calmette guerin (BCG-PSN) and thymopeptides on T-lymphocytes of normal and immunosuppressed mice, CD4+ and CD8+ T-lymphocyte subsets of single nucleic cell in thymus, spleen and peripheral blood were detected successively by flow cytometry after application of BCG-PSN and thymopeptides. Meanwhile, CD4+/CD8+ ratio was also calculated. The results showed that both BCG-PSN and thymopeptides could decrease the proportion of CD4+ CD8+ T-lymphocyte subsets in the thymus, at the same time increase CD4+ T-lymphocyte, CD8+ T-lymphocyte proportion in the three tissues. The fluctuation in amplitude was greater in thymopeptides group than that in BCG-PSN group. It is concluded that acting location of thymopeptides is in thymus, its stimulating action is stronger than that of BCG-PSN, while BCG-PSN not only accelerates the differentiation in thymus, but also has some direct stimulation to peripheral CD4+ T-lymphocytes, and can maintain CD4+/CD8+ ratio within normal range. So, BCG-PSN is safer.
Adjuvants, Immunologic/*pharmacology ; Immunocompromised Host ; Mycobacterium bovis/*chemistry ; Nucleic Acids/pharmacology ; Peptide Fragments/*pharmacology ; Polysaccharides, Bacterial/*pharmacology ; T-Lymphocyte Subsets/*drug effects ; Thymus Gland/chemistry

Objective To study preliminary the accuracy of clinical target volume (CTV) and internal target volume (ITV) automatically generated by an in-house deformable registration software on fourdimensional CT (4DCT),and evaluate its feasibility of clinical application.Methods Clinic treated one lung cancer patient and one liver cancer patient were selected for the study.CTV was delineated by radiation oncologist according to a single respiratory phase image of 4DCT scanning,and then deformed to the other phases and generated the CTVdefm on each phase image.Differences between the CTVdefm and CTVmanu were then compared.A composite ITVcopm was created by overlapping all the CTVdefm of 10 phases and compared with the ITVMIP which was contoured on the maximum intensity projection (MIP) CT images,including the shape,volume and geometric center position of the ITV contour.Results For the tested lung case,average volume difference between the CTVdefm and CTV was (-2.59 ± 5.02)％ for the all 10 phases,and the vector departure of the two ITV centers was (1.04 ± 0.89) mm.The ITVcomp almost completely matched the ITVMIP on the tested liver case with a volume difference smaller the 1％ and only 1.4 mm vector departure between their geometric centers.Conclusion The validity of the CTVdefm and ITVcomp gained from automatic deformation of manual delineation reference based on 4DCT images were preliminary evaluated and proved to be good enough for clinic planning.

BACKGROUND:Retinal diseases are caused by damage or apoptosis of the retinal cel s and lack of ideal treatment. Induced pluripotent stem cel s have self-renewal ability and differentiation potential. A new potential source from which to produce stem cel s as a therapeutic platform for the treatment of retinal diseases and avoid ethics issues is the research focus currently.
OBJECTIVE:To review recent advancement of induced pluripotent stem cel s and the potential utility for retinal diseases.
METHODS:The first author searched related articles published from 2006 to 2011 by computer retrieval in PubMed database using the keywords of“induced pluripotent stem cel s, retinal, photoreceptor, retinal pigment epithelium, retinal ganglion cel”in English. Final y, total y 42 papers were involved.
RESULTS AND CONCLUSION:Induced pluripotent stem cel s can be induced to differentiate into retinal cel s which have a possibility to be used as donor cel s for transplantation therapies. Patient-derived induced pluripotent stem cel s can be used as disease models for mechanistic studies and drug screening. It is a promising therapy for retinal degenerative diseases. However, some problems stil remain, such as risk of teratoma formation and low efficiency of somatic cel s to be successful y induced into induced pluripotent stem cel s. It stil requires further more studies.

OBJECTIVE:To observe the clinical efficacy and safety of different doses of atorvastatin in the treatment of chron-ic subdural hematoma(CSDH). METHODS:One hundred and tweaty-eighie CSDH patients selected from our hospital during Jun. 2013-May 2015 were divided into observation group(n=62)and control group(n=66)in accordance with random number table. Both groups were given conventional treatment of brain cell nutrition. Control group received Atorvastatin tablet 20 mg,po,qd;observation group received Atorvastatin tablet 40 mg,po,qd. Both groups were treated for 6 months. Clinical efficacy,CSS and ADL score,hematoma volume,the levels of serum inflammatory factors (hs-CRP,MMP-9,IL-6,TNF-α) were observed in 2 groups. ADR was recorded during treatment and recurrence rate was also recorded. RESULTS:2 patients withdrew from observa-tion group and 6 from control group. Finally,120 patients met the criteria were included,with 60 cases in each group. Total re-sponse rate of observation group(88.3%)was significantly better than that of control group(73.3%),with statistical significance (P<0.05). After 1,3,6 months of treatment,CSS score,hematoma volume,the serum levels of hs-CRP,MMP-9,IL-6 and TNF-α in 2 groups were significantly decreased,while ADL score was increased significantly;the improvement of above indexes in observation group was significantly better than in control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). The recurrence rate of control group(13.3%)was significantly higher than that of observation group(3.3%),with statistical significance(P<0.05). CONCLUSIONS:Daily dose of shows ator-vastatin 40 mg better therapeutic efficacy and lower recurrence rate in the treatment of CSDH with good safety.

Objective To investigate the expression and significance of β-catenin and peroxisome prolifera-tot-activated receptor-γ,(PPARγ) in bepatocellular carcinoma. Methods Tissue microarrays were established to detect β-catenin and PPARγ expression in 49 cases of hepatocellular carcinoma,49 cases of adjacent nontumoral liv-er tissue and 6 cases of normal liver tissue. The relationships between PPARγ and β-catenin as well as between PPARγ and clinicopathological parameters were observed. Results The aberrant expression rate of β-catenin was 69.39%,48.98 % and 0 respectively (P=0.001). The positive expression rate of PPARγ was 51.02%,30.61% and 0 respectively (P=0.016). Clinicopathological analysis revealed that the increase of PPARγ expression was not associated with age,tumor size,serum alpha fetoprotein (AFP) levels,tumor embolus of portal vein or inferior vena cava,and HBsAg infection(χ2=0.214,3.201,0.046,3.201,P>0.05 for each),but correlated with differentiation grades(χ2=4.693,P<0.05). Aberrant expression of β-catenin was associated with PPARγ expression(χ2= 5.130,P<0.05). Conclusion Aberrant expression of β-catenin may involve in the liver carcinogenesis. The high expression of PPARγ in hepatocellular carcinoma is significantly correlated with the clinicopathological characteris-tics. Detection of PPARγ is valuable for diagnosing hepatocellular carcinoma,and evaluating malignancy extent and prognosis.

Objective To investigate the relationship between urine IgG of the first hospitalized children suffered allergic purpura and recurrence within one year. Methods Used immunoturbidimetry to determine acute-stage and convalescent urine IgG of 43 children suffered allergic purpura in the first hospitalized and no recurrence within one year (no recurrence group), and of 29 children suffered allergic purpura and recurrence within one year (recurrence group), and of 28 hospitalized children suffered primary nephrotic syndrome during the corresponding time period before hormonal therapy (nephrotie syndrome group), and of 30 children done medical examination in out-patient clinic (control group), then analyzed.Results There was no significant difference of the urine IgG level in acute-stage between no recurrence group [(1.391± 0.743) g/L] and recurrence group [(1.474 ±0.658) g/L](P>0.05), while they were all lower than that in recurrence group [(2.808 ± 0.683) g/L] (P < 0.01). The level of convalescent urine IgG in nephrotic syndrome group [(0.202 ± 0.154) g/L] was obviously higher than that in no recurrence group [(0.115 ±0.103) g/L] and control group [(0.109 ±0.098) g/L](P<0.05). Conclusion Urine IgG is a significant index to judge the activity and recurrence and prognosis of pedo-allergie purpura.

Objective To quantitatively assess the left ventricular systolic dyssynchrony in patients with varied degrees of chronic congestive heart failure after old myocardial infarction(OMI) by real-time three-dimensional echocardiography(RT-3DE) and investigate the clinical value of the systolic dyssynchrony index(SDI). Methods Forty patients with congestive heart failure after OMI (infarction group) were divided into the severe dysfunction group (LVEF ≤35 %) and the mild dysfunction group (35 % ＜ LVEF＜50%) ,and 30 normal subjects served as the control. RT-3DE was performed on all subjects to obtain the 17-segmental time-volumetric curves and global systolic function. SDI changes in above groups and the correlation between SDI and LVEF were analyzed. Results The SDI of the infarction group was significantly higher than that of the normal control group ( P ＜0. 01 ). The SDI of the severe dysfunction group was significantly higher than that of the mild group (P＜0.01). SDI and LVEF were negatively correlated ( r = -0.84, P ＜0. 01 ). The dyssynchrony rate in the infarction group was 85 %,in the severe dysfunction group was 100%, in the mild group was 75%. Conclusions Left ventricular systolic dyssynchrony is prevalent in patients with OMI, and it is negatively correlated with the LVEF. SDI is a sensitive indicator in assessing left ventricular systolic dyssynchrony. RT-3DE has a unique advantage in the evaluation of the left ventricular systolic dyssynchrony,especially in the patients with myocardial infarction.

Objective To explore the clinical features, diagnosis, and treatment of neonatal necrotizing pneumonia. Methods The clinical data of two cases of neonatal necrotizing pneumonia were retrospectively analyzed. The clinical features, diagnosis, and treatment of neonatal necrotizing pneumonia in literatures were summarized. Results Two cases were diagnosed of community-acquired Staphylococcus aureus necrotizing pneumonia and had the onset with fever. The chest X-ray showed exudative change with cystic shadow. The chest CT showed multiple cavity changes. The sputum and blood cultures were positive for Staphylococcus aureus. Both of them were effectively treated by vancomycin. The imaging was improved during the follow-up. Searching the database, 4 related literatures were being found, and there were totally 7 cases of neonatal necrotizing pneumonia including current 2 cases. The main features were as follows: The pathogenic bacteria in all cases include Staphylococcus aureus. One case was combined with pseudomonas aeruginosa. Six cases were community-acquired infections. All of them were non-immune deficiency newborn. Six cases were primary necrotizing pneumonia. Six cases were unilateral lung involvement. Five cases got fever, 5 cases had septicemia, 3 cases had pleural effusion, 2 cases had aerothorax, one case had bronchial chest and 2 cases had extrapulmonary infection. The C-reactive protein was increased in all cases. Three cases need mechanical ventilation. Six cases had a good prognosis. Conclusions The main pathogenic bacterium in neonatal necrotizing pneumonia was Staphylococcus aureus. The diagnosis was mainly depends on the typical imaging and pathogenic examination. The treatment is mainly the use of antibiotic for gram positive cocci.