The bactericidal mechanism of carbon monoxide (CO) and the feasibility of CO-releasing molecules as anti-infective drugs were summarized by consulting scientific literature, combined with our own research work. Anaerobic bacteria are usually tolerant to high concentration of CO, and some can even grow with CO as sole carbon or energy source, but most pathogenic bacteria are sensitive to CO. In view of the difficulty of gaseous CO in controlling the applying dose and the action site, CO release molecules were synthesized. CO release molecules not only have higher bactericidal activities against common pathogenic bacteria than gaseous CO, but also have the ability to kill antibiotics-resistant bacteria and destroy their biofilms. CO mainly binds with heme-Fe²⁺ in cells, interrupting the electron transfer of respiration chains, which would result in the generation of reactive oxygen species. CO can also disturb intracellular ion balance, which further triggers free radical reactions. Due to its diverse acting targets, uneasy to induce drug resistance, and synergistic effect with other antibiotics, CO is expected to be the next generation of anti-infection drugs.

Objective To discuss the donor site complications and the treatments of the anterolateral thiIgh flap transfer. Methods From July 1988 to July 2007,427 patients treated by anterolateral thish flap surgery were followed up.The donor sites were treated by several methods,including direct closure(49 cases),skin graft transfer(258 cases),anterolateral fascial flap transfer(27 cases),musculocutaneous flap and skin sraft transfer(65 cases), superficial epigastric artery flap transfer(28cases).The area of these flaps ranged from 30 cm×10 cm to 18 cm×7 cm.and the average follow-up was 21 months(ranged from 8 months to 54 months). All the data was analyzed by SPSS for Windows,Version 11.0.1. Results Short-term complications(within 4 weeks)and long-term complications (over 6months)were observed.The former included skin necrosis(5.4%),wound infection(4.0%),and necrosis of rectus femoris(0.5%); and the latter included chronic ulcer(4.9%), aerious scar(6.6%), serious discomfortable(5.9%),and quadriceps femoris disfunction(3.7%).The statistical results showed that there was a close correlation between the donor site morbidity and the surgical methods. Conclusion The complications of the donor site cannot be ignored.Protect the soft-tissue of the donor site carefully,design all appropriate operation plan.Careful preoperative examination and local flap transplantation can effectively decrease the rate of complications.

To introduce peptidoglycan recycling and the β-lactams resistance mechanisms of bacteria, so that some help would be supplied to corresponding scientific workers and university teachers. By searching literatures, combined with our own studies, the bactericidal mechanisms of β-lactams and the resistance mechanisms of bacteria to β-lactams were summarized. The bactericidal activity of β-lactams is resulted from the inhibition of cell wall biosynthesis through combination with penicillin binding proteins such as transpeptidase destruction of peptidoglycan balances between biosynthesis and hydrolysis. The drug resistance of bacteria is resulted from the induction of β-lactamase, expression of out-pumping proteins, increase of outmembrane permeability, and modification of antibiotic target proteins. The proteins related to peptidoglycan recycling, such as transpeptidase and glycosyltransferase, would be potential targets for screening new β-lactams. The proteins related to β-lactams resistance, such as β-lactamase, would be potential targets for screening adjuvant drugs of β-lactams.

OBJECTIVETo explore the relation of phlegm-stasis syndrome with insulin resistance and monocyte peroxisome proliferator activated receptor-gamma messenger ribonucleic acid (PPARgamma mRNA) expression in patients with coronary heart disease (CHD).

METHODSSixty patients with CHD were differentiated into three syndrome types, the non-phlegm non-stasis (NN) type, the phlegm congealing heart vessel (PC) type and the phlegm-stasis cemented (PS) type. Besides, 20 healthy volunteers were selected as the normal control. Levels of fasting plasma glucose (FPG) and fasting insulin (FINS) were determined and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated accordingly. The expression of PPARgamma mRNA in the peripheral monocytes was assessed by reverse transcriptase-polymerase chain reaction (RT-PCR).

RESULTSLevels of FINS, HOMA-IR and PPAR-gamma mRNA expression in all CHD patients were higher than in the normal control (P <0.01, P < 0.05); comparisons of the three indexes between patients of different syndrome types showed that they were higher in PC type and PS type than in NN type (P < 0.05 or P <0.01), and the difference between PC type and PS type was significant (P < 0.05).

CONCLUSIONChanges of insulin resistance and PPARgamma mRNA expression in monocytes are possibly one of the mechanisms for the development of phlegm-stasis syndrome in CHD.

Aged ; Case-Control Studies ; Coronary Disease ; genetics ; metabolism ; Female ; Humans ; Insulin Resistance ; Male ; Middle Aged ; Monocytes ; metabolism ; PPAR gamma ; genetics ; metabolism ; RNA, Messenger ; metabolism

Acupuncture Analgesia ; methods ; Humans ; Medicine, Chinese Traditional ; methods ; Migraine Disorders ; etiology ; prevention & control ; therapy ; Models, Theoretical ; Neuropeptides ; administration & dosage ; therapeutic use ; Professional Practice

Visceral leishmaniasis (VL) is a parasitic disease ,which is still endemic in western China .An earthquake struck south-western China on May 12th ,2008 ,which affected Longnan City of Gansu Province considerably .The objective of this survey is to determine the effect of the Wenchuan earthquake on the Kala-azar epidemic in Longnan City .In this study ,VL cases were collected from 2005 to 2013 and diagnosed on positive test for anti-rK39IgG antibodies by the Kala-azar Detect rK39 dip-stick (InBios ,USA) .The incidence rates were calculated among various counties of Longnan City with SPSS 19 .0 soft-ware .The epidemiological characteristics of the disease were analyzed before and after the Wenchuan earthquake .From 2005 to 2013 ,there were 825 VL cases in Longnan City ,with an annual incidence of 3 .36/100 000 and a significantly higher incidence in males than that in females (P＜ 0 .001) .All age groups were affected .During this period ,there was an obvious upward trend from 2005 to 2008 ,and a distinct downward tendency since 2010 .The incidences of VL between 2008 and 2010 were sig-nificantly different with that in other years (P＜0 .01) .Results revealed that VL was widespread in Longnan City ,which was likely exacerbated by the earthquake in 2008 .Earthquake created diverse natural environment and social circumstances ,w hich may contribute to the spread of the VL epidemic .Together ,our data strongly suggest that the epidemic of VL should be close-ly monitored after earthquake .

Objective To compare the effectiveness of postoperative analgesia and early rehabil-itation between the wound infiltration combined with intravenous analgesia and epidural analgesia after hepatectomy.Methods Forty-eight patients with liver carcinoma,37 males and 1 1 females,aged 40-65 years,ASA physical status Ⅰ or Ⅱ,were randomly divided into two groups.Patients in group T were given 0.375% ropivacaine 30 ml for incision infiltration before closing the abdomen and intrave-nous analgesia.Patients in group E were given 0.2% ropivacaine 100 ml for epidural analgesia. Pareoxib sodium 40 mg was injected intravenously 30 min toward the end of the operation.Pain scores were assessed by VAS at postoperative 2,6,12,24 and 48 h.Postoperative activity distance was re-corded on 1st,2nd,3th day after surgery;the time first getting off bed and hospital stay were recor-ded.Finally,the complications were also recorded.Results Compared with group T,VAS scores at rest and in activity 12,24 and 48 h postoperatively were significantly lower (P <0.05 ).Compared with group E,postoperative activity distance on 1st,2nd and 3th day after surgery in group T were shorter.Furthermore,the time first getting off bed and the hospital stay in group T were shorter than those in group E (P <0.05).The incidence of adverse reactions between the two groups had no sta-tistical significance.Conclusion The wound infiltration combined with intravenous analgesia is benefi-cial to early recovery and shorter hospital stay.

Objective: To observe the morphologic changes of pituitary adrenocorticotrophic hormone (ACTH) cells in Wistar rats at different altitudes, and clarify the mechanism of stress reaction to hypoxia in ACTH cells. Methods: Wistar rats were divided into three groups and moved to different altitudes (1700 m, 3100 m, 4050 m). After 12 days, changes of ACTH cells were observed by using immunohistochemisty, image analysis and electron microscopy. Results:The ratio (R) of immunoreactive cell area to scanned area and mean optical density (A) increased at higher altitude with statistically different R values between groups of 1700 m and 4050 m (P

BACKGROUND:Although coagulopathy can be very common in severe traumatic shock patients, the exact incidence and mechanism remain unclear. In this study, a traumatic shock rabbit model with special abdomen injuries was developed and evaluated by examining indicators of clotting and fibrinolysis. METHODS:Forty New Zealand white rabbits were randomly divided into four groups:group 1 (sham), group 2 (hemorrhage), group 3 (hemorrhage-liver injury), and group 4 (hemorrhage-liver injury/intestinal injury-peritonitis). Coagulation was detected by thromboelastography before trauma (T0), at 1 hour (T1) and 4 hours (T2) after trauma. RESULTS:Rabbits that suffered from hemorrhage alone did not differ in coagulation capacity compared with the sham group. The clot initiations (R times) of group 3 at T1 and T2 were both shorter than those of groups 1, 2, and 4 (P<0.05). In group 4, clot strength was decreased at T1 and T2 compared with those in groups 1, 2, and 3 (P<0.05), whereas the R time and clot polymerization were increased at T2 (P<0.05). The clotting angle significantly decreased in group 4 compared with groups 2 and 3 at T2 (P<0.05). CONCLUSION:This study suggests that different abdominal traumatic shock show diverse coagulopathy in the early phase. Isolated hemorrhagic shock shows no obvious effect on coagulation. In contrast, blunt hepatic injury with hemorrhage shows hypercoagulability, whereas blunt hepatic injury with hemorrhage coupled with peritonitis caused by a ruptured intestine shows a tendency toward hypocoagulability.

Objective To evaluate the in vitro antiviral activity of HB-13,a compound derivant from berberine and its prodrug berberine,against herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). Methods Vero cells were cultured in vitro and infected with HSV.Then,various concentrations of HB-13, berberine,and aciclovir were used to treat these infected cells.The cytopathic effect was observed to deter- mine the antiviral effects and cytotoxicity of HB-13 and berberine.Results For HB-13,berberine and acy- clovir,the half toxicity concentration (TC_(50)) to Vero cells was 31.99,380 and more than 800?g/mL, respectively;the average half inhibitory concentration (IC_(50)) against HSV-1 was 1.328,more than 100,and 0.443?g/mL,respectively,the treatment index (TI) against HSV-1 was 24.09,less than 3.80,and more than 1805.87,respectively;the IC_(50) against HSV-2 was 1.344,more than 100,and 0.679?g/mL,respectively,the TI against HSV-2 was 23.80,less than 3.80 and more than 1178.20,respectively.Conclusion HB-13 possesses marked antiviral activity against HSV-1 and HSV-2 in vitro,while berberine does not.