Objective:To investigate the clinical efficacy and safety of antibiotic de-escalation therapy in the treatment of severe pneumonia.Methods:Sixty patients with severe pneumonia who received treatment in The First People's Hospital of Yongkang,China from January 2015 to January 2018 were included in this study.They were randomly assigned to receive either conventional antibiotic therapy (control group, n = 30) or antibiotic de-escalation therapy (observation group, n = 30).The clinical efficacy,symptom relief time,antibiotic treatment time,length of hospital stay,pulmonary ventilation function index,serum levels of inflammatory factors and the incidence of adverse reactions were compared between the control and observation groups. Results:Total effective rate in the observation group was significantly higher than that in the control group [93.33% (28/30) vs.73.33% (22/30), χ2 = 4.320, P < 0.05].The time to disappearance of cough,fever and abnormal lung sounds in the observation group was (2.10 ± 1.25) d,(2.19 ± 1.24) d,(2.01 ± 0.56) d,respectively,which was significantly shorter than that in the control group [(3.73 ± 1.92) d,(3.68 ± 1.70) d,(3.36 ± 0.78) d, t = 3.897,3.878,7.701,all P < 0.05].The antibiotic treatment time and length of hospital stay in the observation group were (2.89 ± 1.06) d and (4.08 ± 1.23) d,respectively,which were shorter those in the control group [(4.27 ± 1.45) d and (5.76 ± 1.69) d, t = 4.208 and 4.402,both P < 0.05].The forced expiratory volume in one second (FEV 1) and the ratio of FEV 1 to forced vital capacity (FVC) in the observation group were (2.09 ± 0.69) L and (58.94 ± 15.67)%,respectively,which were significantly higher than those in the control group [(1.43 ± 0.57) L,(43.12 ± 11.03)%, t = 4.039 and 4.522,both P < 0.05).Serum levels of C-reactive protein,interleukin-6 and procalcitonin in the observation group were (5.84 ± 2.09) mg/L,(20.05 ± 2.76) ng/L,(2.18 ± 0.78) ng/L respectively,which were significantly lower than those in the control group [(8.50 ± 2.67) mg/L,(23.24 ± 3.07) ng/L,(3.11 ± 0.97) ng/L, t = 4.297,4.232,4.092,all P < 0.05].There was no significant difference in the incidence of adverse reactions between the observation and control groups (6.67% vs.10.00%, χ2 = 0.218, P > 0.05). Conclusion:Antibiotic de-escalation therapy for the treatment of severe pneumonia can shorten the time of disappearance of clinical symptoms,improve pulmonary ventilation function,and inhibit systemic inflammatory reaction without increasing adverse reactions.

Objective:To establish a method to determine the residual solvents in salvianolic acid B. Methods: The headspace GC was carried out on an HP-5 capillary column(30 m × 0. 32 mm,0. 6 μm). The inlet temperature was 180℃. The injection volume was 0. 1ml and the separation ratio was 1:10. The column temperature was programmed:the initial temperature was 40℃, malntalned for 6 min, ralsed to 180℃ with a rate of 15 ℃·min-1 , and malntalned for another 5 min. The detector was FID with the temperature of 250℃. The carrier gas was N2 with the flow rate of 1. 7 ml·min-1 . DMSO was used as the solvent for salvianolic acid B. Results:All solvents could be separated completely. The linear range of ethanol, acetone and ethyl acetate was 12. 650-1. 012 × 103 μg·ml-1 (r=0.999 3),12.750-1.012 ×103 μg·ml-1(r=0.999 7) and 12.550-1.004 ×103 μg·ml-1(r=0.999 7), respectively. The average recovery of ethanol, acetone and ethyl acetate was 96. 89% (RSD=3. 81%,n=9), 99. 56% (RSD=4. 05%,n=9) and 97. 21% (RSD=4. 95%,n=9), respectively. Conclusion:The method is simple, reproducible and accurate enough for the determi-nation of residual solvents in salvianolic acid B.

The development of molecular biology techniques makes important contributions to the researches of heritable varia-tion of Schistosoma. In recent years,the molecular genetic analysis in the Schistosoma variation researches mainly includes the re-striction fragment length polymorphism(RFLP),random amplified polymorphism technology(RAPD),microsatellite anchored PCR(SSR-PCR),and polymerase reaction single-strand conformation polymorphism(PCR-SSCP). This article reviews the re-search progress of molecular genetic analysis in Schistosoma variation in recent years.

Thyroid microsomal antigen-antibody(TMAg-Ab)system plays an important role in the pathogenesis of autoimmune thyroid diseases.TMAb are involved in the complementmediated cytotoxicity and antibody-dependent cytotoxicity,resulting in thyroid follicle epithelial cell and basement membrane injury,followed by thyroiditis and hypothyroidism,and they may also cause hyperthyroidism through some unknown mechanisms.In recent years,indirect hemagglutination,radioimmunoassay and enzyme-inked immunosorbent assay have been used to detect TMAb in thyroid disease patients'sera,indicating the incidence as high as 90%.Measurements of T3,T4 and TSH alsoreveal that serum TMAb level is related with the variation of T3,T4 and TSH.It ispostulated that TMAg might be the lipoprotein on smooth endoplasmic reticulum ofthyroid follicle epithelial cell.Due to the difficulties to purify TMAg,its nature stillremains unclear.

The serum thyroid microsomal antibodies (TMAb) and thyroglobulin antibodies (TGAb) were measured in 103 normal persons and 183 patients with different thyroid diseases by enzyme-linked immunosorbent assay (ELISA). The serum T3 and T4 were also tested. The results showed that the incidence of these two autoantibodies were obviously increased in Hashimoto's thyroiditis, hyperthyroidism and hypothyroidism, and normal in simple goiter and thyroid adenoma. The TMAb and TGAb levels in subacute thyroiditis and thyroid cancer were moderately increased. There were also a negative correlation between TMAb and T3, T4, TGAb and T4 in Hashimoto's thyroiditis.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Humans ; Male ; Methotrexate ; administration & dosage ; Middle Aged ; Mutation ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; genetics

Objective To clone human cell division cycle gene 2(CDC2)from human liver cancer tissue and express CDC2 protein in E.coli BL-21(DE3).Methods The total RNA was extracted from liver cancer tissue and amplified by reverse transcription polymerase chain reaction(RT-PCR).The PCR products were cloned into the prokaryotic expression vector pET28a(+)followed by DNA sequencing.The recombinant pET28a(+)/CDC2(rCDC2)plasmid was transformed into E.coli.The rCDC2 was induced with IPTG and characterized by SDS-PAGE.Results The cloned CDC2 gene was composed of 894 nucleotides,and is accordance with that reported in GenBank.The prokaryotic expression vector was constructed successfully.The CDC2 protein was successfully expressed in E.coli.Conclusion The CDC2 cDNA is successfully cloned from human liver cancer tissue,and can express in E.coli.

The study of RunX3 in tumor pathogenesis is a rapidly expanding area of cancer research.Functional inactivation of RunX3 is frequently observed in tumors of diverse origins.RunX3 can bind directly to the TGF-β signaling effectors for synergistic induction,enhancing the growth inhibitory effect of TGF-β signal pathway.Additionally,RunX3 can also bind to the complex TCF4-β-catenin in Wnt signal pathway for inhibiting its tumorigenicity.Through the two signal pathway mentioned above,RunX3 can regulate the epithelial mesenchymal transitions process.Moreover,the transcription of claudin-1 can be directly regulated by RunX3.RunX3 has also been described to have an oncogenic function in a subset of tumors,but how RunX3 switches from tumor suppression to oncogenic activity is yet unknown.This review focuses on summarizing the important findings about the mechanism and relative signal pathway of RunX3 in tumor suppression from the articles published recently.

Based on the background of knowledge economy,factors which have affected the social status of a person can be divided into five levels: physical fitness,technical ability,mental capacity,potential energy and recombination energy.This article analyzes the educational style of medical students by using five-level-ability model which judges a person from the economic angle.It aims at providing constructive opinions on innovation,enhancement and improvement of modern medical education.