Objective To compare the clinic effects of gatifloxacin and fleroxacin on respiractory infections.Methods 160 patients of low-moderate respiractory infections were divided into observation group (80 cases) and control group (80 cases).Under common therapy,the observation group accepted gatifloxacin injection while the control group accepted fleroxacin injection.The effective rate,bacterial clearance rate and untoward effect were compared between the two groups.Results The effective rate of observation group was obviously higher than control group (88.8％ vs 72.5％,x2 =3.16,P ＜ 0.05).The bacterial clearance rate of observation group was obviously higher than control group (90.0％ vs 78.8％,x2 =6.28,P ＜ 0.05).There were 5 cases of nausea and vomiting in observation group while 3 cases of nausea and 2 cases of nausea and vomiting in control group.The diverse of untoward effect of two groups had no significance (x2 =0.03,P ＞ 0.05).Conclusion Gatifloxacin has a better clinic effect than fleroxacin.Gatifkoracin doesn't increase the untoward effect on respiractory infections.

Objective To study the relationship between the enhancement of renal cortex and medulla during the conventional CT scans with and without contrast enhancement and the renal glornerular filtration rate (GFR). Methods Thirty five cases with unilateral posternal obstructive hydronephrosis According to GFR, the 70 kidneys were divided into 4 groups: normal, slightly impaired, moderately impaired and severely impaired. In the cortical phase of enhanced CT scan, the enhancing intensity of the renal cortex and medullar was measured and following measures were calculated: CTce - CTcp, CTmc -CTmp,ratio of enhancement of affected and unaffected renal cortex and medullar, and the ratio of those of each case: CTac/CTnc, CTam/CTum, CTac/CTam, CTnc/CTnm, (CTac/CTam) / (CTuc/CTum). The differences of these measures in different groups were analyzed with one-way ANOVA and their correlation with GFR was studied with Pearson test. The best indicator to reflect enhancement of renal cortex was selected from these measures, and all the kidneys were divided into 4 groups accordingly: strong, less strong, medium and weak. Then its consistency with GFR groups were calculated. Result (1) The differences of CTce - CTcp ( 154. 98 ± 28. 70 ), ( 122.67 ± 39. 32 ), ( 81.30 ± 32.94 ) and ( 57.60 ±23.49) HU respectively, CTac/CTuc 0. 97 ±0. 09, 0. 79 ±0. 18, 0. 64 ±0. 24 and 0. 51 ±0. 13 respectively,CTam/CTum 0. 98 ±0. 26, 0. 89 ±0. 18, 0. 86 ±0. 31 and 0. 75 ±0. 28 respectively, CTam/CTum 2. 76 ±0. 35,2. 35 ± 0. 79, 1. 83 ± 0. 68 and 1.73 ± 0. 28 respectively, CTac/CTam and ( CTac/CTam)/( CTuc/CTum) 1.00 ±0. 28,0. 89 ±0. 34, 0. 75 ±0. 17 and 0. 69 ±0. 14 respectively of different GFR groups were evident( P < 0. 05 ) . ( 2 ) Positive correlation was found between GFR and CTce-CTcp ( r = 0. 887, P <0. 01 ), CTac/CTuc ( r = 0. 872, P < 0. 01 ), CTam/CTum ( r = 0. 504, P < 0. 01 ), CTac/CTam ( r =0. 772, P < 0. 01 ), (CTac/CTam) / (CTuc/CTum) ( r = 0. 663, P < 0. 01 ). ( 3 ) Selecting CTac/CTam to reflect enhancement of renal cortex, the diseased kidneys can be divided into groups of strong ( CTac/CTam ≥2. 60); less strong (2. 20 ≤CTac/CTam <2. 60); medium ( 1.80 ≤CTac/CTam <2. 20); and weak ( CTac/CTam < 1. 80). The consistency with GFR grouping was 80. 0%. Conclusions There is significant correlation between renal cortex-related indicators and GFR, especially CTac/CTam, which can be used as the indicator of renal function in patients with unilateral or bilateral postrenal obstructive hydronephrosis. The conventional contrast enhanced CT scan can be taken as a semi-quantitative method of GFR measuring with relative low X-ray dosage compared with CT perfusion.

Objective To analyze the concentration changes of serum hypoxia stress peptide (HSP)and plasma nitrogen monoxidum(NO)in the entering mountain rapidly man and to explore the importance of HSP and NO in adaptation of man to altitude hypoxia.Methods The levels of serum HSP and plasma NO2-/NO3-were measured from 106 entering mountain rapidly men,105 altitude in habitant,105 altitude immigrant and 104 plain healthy controls,respectively by chromatometry and NO2-/NO3-reagent.Furthermore,the content of serum HSP was determined in 106 entering mountain rapidly men,respectively at the time of 24 h,48 h,76 h,l week and 1 month after entering mountain.Results The level of serum HSP was significantly higher in entering mountain rapidly men than in habitant,immigrant and plain controls(P＜0.05),while there was no statistical difference between in habitant,immigrant and plain controls(P＞0.05).At 24h after entering mountain rapidly,the level of serum HSP was significantly increased and reached the peak.At 48h and 76h,it was slightly decreased,but still maintained a high level.At 1 week and 1 month,it gradually and significantly went down,but was still significantly higher than that in plain controls.Similarly,the level of plasma NO2-/NO3-was significantly elevated in entering mountain rapidly man,compared with inhabitant,immigrant and plain controls(P＜0.05).It was lower in inhabitants and immigrants than plain controls,but the difference was not statistically significant(P＞0.05).Conclusion The present results demonstrated that the levels of serum HSP and plasma NO were significantly up-regulated in healthy adults after en tcring mountain rapidly in order to adapt to altitude stress,and restored gradually to the normal level as time went by.

Objective To investigate clinical characteristics and outcome of patients with liver cirrhosis complicated with diabetes,and to explore the differences of clinical characteristics and prognosis between hepatogenous diabetes (HD) and type 2 diabetes mellitus (T2DM).Methods From November 2010 to April 2012,246 patients with liver cirrhosis were collected and divided into liver cirrhosis complicated with diabetes (LC-DM) group (n=72) and liver cirrhosis without diabetes (LC) group (n=174).LC-DM group was then sub-divided into HD group (n=33) and T2DM group (n =39).All the patients were followed up until death or the study endpoint.The clinical characteristics,prognosis and indicators of glucose metabolism were compared and analyzed.Oral glucose tolerance test and insulin C-peptide release test were conducted in part of patients in LC-DM group.Student t test was performed for mean comparison between two groups.Chi-square test was used for count data and rate comparison between two groups.The death related factors of liver cirrhosis were analyzed by Logistic regression analysis.Results The percentage of alcoholic liver cirrhosis of LC-DM group was 18.1 ％ (13/72),which was higher than that of LC group (6.9％,12/ 174) and the difference was statistically significant (x2=6.946,P=0.008).In HD group,the percentage of patients with diabetes family history was 9.1％ (3/33),which was lower than that of T2DM group (30.8％,12/39),the percentage of alcoholic liver cirrhosis was 30.3％ (10/33),which was higher than that of T2DM group (7.7％,3/39),the total bilirubin level ((43.4±57.7) μmol/L) was higher than that of T2DM group ((22.6 ± 13.3) μmol/L),the total cholesterol level ((3.3 ±1.2) mmol/L) was lower than that of T2DM group ((4.0±1.6) mmol/L),and the differences were statistically significant (x2=5.093 and 6.177,t=2.178 and 2.014,P=0.024,0.013,0.033 and 0.048).The duration of hospitalization,Chiid-Pugh score,the incidence of upper gastrointestinal bleeding,the incidence of hepatic encephalopathy,electrolyte disturbances and mortality of LC-DM group were all higher than those of LC group and the differences were statistically significant(t=2.389 and 2.270,x2 =6.496,5.572,5.194,19.646,all P＜0.05),and there was no significant difference between HD group and T2DM group(all P＞0.05).The blood glucose levels of HD group at different time point (0,30,60,120,180 min) were all lower than those of T2DM group and the differences were statistically significant (t=3.175,2.345,3.444,3.090,3.542,all P＜0.05).The fasting insulin level of HD group was close to that of T2DM group,the insulin levels of HD group at other time point (30,60,120,180 min) were all higher than those of T2DM group and the differences were statistically significant (t =3.084,2.881,3.648,2.840,all P＜ 0.05).There was obvious hyperinsulinemia in HD group.At 0,30,60,120,180 min,C-peptide level of HD group was at normal levels,and which of T2DM group was lower than normal.Child-Pugh grade C was an independent predictor factor of death in patients with liver cirrhosis (OR =3.056,95 ％ CI:1.268 ～ 7.346,P=0.013).Conclusions Compared with liver cirrhosis patients without diabetes,the liver function of patients complicated with diabetes was worse,and the incidence of complication and mortality was higher.However there was no significant difference between HD group and T2DM group.

Hepatocyte nuclear factor 4α is a transcription factor of the nuclear hormone receptor superfamily and plays a very important role in the differentiation and development of the digestive system as well as the polarity regulation,which is considered to be a tumor suppressor gene.It also plays a very important role in digestive tumorigenesis,invasion and metastasis of hepatic carcinoma,colon cancer and gastric cancer,which is closely associated with epithelial-to-mesenchymal transition,the regulation of cell proliferation and wnt signaling pathway.HNF4α expression and its regulation mechanism in the digestive system tumors are now the research focus.

To analyze the EBM present situation of the medical staffs and to discuss the measures to raise the ability of EBM so as to promote the performance of EBM.

AIM: To compare the change of visual quality of femtosecond-laser in situ keratomileusis ( FS-LASIK) and laser in situ keratomileusis ( LASIK) for myopia.
METHODS: A retrospective case series. A total of 89 cases 178 eyes were chosen from Jan. 2014 to Dec. 2015. There were 46 cases (92 eyes) in FS-LASIK and 43 cases 86 eyes in LASIK. The visual acuity, refraction state, subjective visual quality score, high order aberration were measured at 6mo after surgery.
RESULTS: All patients underwent operation smoothly, and no complication was observed during and after surgery; there was no statistically significant difference between two groups at visual acuity (P>0. 05). Postoperative diopter compared with preoperative expectations diopter difference is statistically significant between two groups (P<0. 05). Subjective visual quality score was compared statistically significant postoperative 6mo in two groups(P<0. 05). Six months after surgery in the two groups of patients with corneal aberration RMS values, spherical aberration and coma compared with preoperative increases, more than the expansion of the size of the FS-LASIK group low mechanical plate layer knife group, the difference was statistically significant (P<0. 05).
CONCLUSION: Femtosecond laser corneal flap is more accurate and reliable and the discrete degree is smaller. It can make more thin corneal flap. Femtosecond laser disc of LASIK surgery compare with traditional mechanical plate layer knife following LASIK has better visual quality.

Diabetic retinopathy (DR) is a sight-threatening chronic complication of diabetes mellitus and is the leading cause of acquired blindness in adults. Long-term exposure to the hyperglycemia of diabetes patients leads to the development of DR. Several studies have provided evidence that good diabetes control is important to prevent DR. However, emerging evidence suggests that genes are a significant contributor to an individual's risk of retinopathy. This evidence is from evaluations of familial aggregation and different incidence of DR in racial and ethnic groups. Some groups of patients develop DR despite good control and some escape retinopathy despite poor control. This suggests that the genes are involved in the susceptibility to DR. Genes suggested as having a role include those encoding aldose reductase, nitric oxide synthase, receptor for advanced glycation end products, angiotensin converting enzyme, vascular endothelial growth factors and pigment epithelium-derived factor. An understanding of the role of susceptibility genes will ultimately allow the development of novel therapeutic strategies. This article reviews the role of genetic factors in the etiology and progression of DR.

Objective: To synthesize two kinds of amphipathic chitosan (CS) derivatives, self-assembling to polymeric micelles as novel drug delivery system. Methods: N-Trimethyl chitosan (TMC) was synthesized by the reaction between CS and CH3I, and long-chain fatty acid was combined to amino group of TMC so as to synthesize the derivative of N-fatty acyl-N-TMC (FA-TMC). The polymer structure was confirmed by FT-IR, 1H-NMR spectra, and element analysis. Then the hydrophobicity drug of osthole (OST) was used as model drug to evaluate the solubilizing ability on those polymeric micelles. Results: Two kinds of six novel CS derivatives were synthesized, the results indicated that the different degrees of quaternisation (DQ) and degrees of substitution (DS) were important parameters to the micelles properties of FA-TMC. To the OST loaded micelles prepared by ultrasonic method, the best candidate materials of the N-palmitoyl-N-TMC (PA-TMC) was the polyer with DQ of 62.00% and DS of 13.37%, while the N-caprinoyl-N-TMC (CA-TMC) was the polyer with DQ of 43.06% and DS of 22.00%. The entrapment efficiency of PA-TMC and CA-TMC were 76.67% and 79.11%, and the drug-loading rates of PA-TMC and CA-TMC were 19.01% and 19.08%, respectively. The solubility of OST increased up to two orders of magnitude in the OST-loaded micelles. Conclusion: FA-TMC is a potential solubilization carrier, self-assembling to polymeric micelles in water, with obvious solubilization on OST, and lays the foundation for the further research and application of OST preparation.

Objective To investigate the carriage of nuc-mecA gene among different altitudes in high humidity district,provid-ed guiding data for prevention of staphylococcus aureus and drug-resistant bacteria,standardizing the usage for antibiotics. Methods The nose swabs were collected in different altitudes:1 000 m,1 200 m and 1 400 m,nuc-mecAgene was confirmed by multi-channel real-time PCR.Results The carrier of nuc gene in the noses were 4.878%,2.899% and 7.143%,in 1 000 m,1 200 m and 1 400 m respectively,and there were no statistical significant among the altitudes (P>0.05).The carrier of mecA gene were 14.634%,31.884% and 41.837% in the 1 000 m,1 200 m and 1 400 m respectively,the difference showed statistical significe (P<0.05).The carrying rate of mecA gene showed statistically significant differences between 1 000 m and 1 200 m (P<0.05),and showed statistically significant differences between 1 000 m and 1 400 m (P<0.01)also.The carrier of nuc-mecA gene were 0%,1.449% and 3.061% in 1 000 m,1 200 m and 1 400 m respectively,there were no statis-tical significant (P>0.05).Conclusion The carrier of mecA gene in noses was increased with the increasing of the altitude. The residents who living at higher altitude should keep the colonization sites of pathogens clean,and needed timely medical when got sick,shouldn’t abuse the antibiotics without authorization.Medical staff should rational use of antibiotic drugs,a-voided overusing of antibiotics and overtreatment.