OBJECTIVE:To provide reference for clinical rational use of piperacillin sulbactam for the anti-infection of Pseudo-monas aeruginosa. METHODS:105 inpatients with normal liver and kidney functions that the pathogen was diagnosed as P. aerugi-nosa and susceptible to PIP/SBT from Jul. 2013 to Jun. 2014 were chose,dosing regimens were collected,the minimum inhibitory concentration (MIC) of piperacillin sulbactam for P. aeruginosa was 1 mg/L based on a one compartment pharmacokinetic mode, the standard value of the percentage of the duration of plasma concentration more than MIC(T>MIC)to dosing interval time was 45%,T>MIC was calculated with pharmacokinetic formula of both single dose and multiple dose repeated intravenous administra-tion to analyze the situation of reaching the standard of T>MIC;and the dosing interval time of the original scheme was prolonged appropriately to investigate the situation of reaching the standard of the percentage of (T>MIC) to dosing interval time. RE-SULTS:47 patients’dosing regimens were given 3.0 g PIP/SBT once every 8 hours,and the others were given 3.0 g PIP/SBT once every 12 hours;for P. aeruginosa,the percentages of T>MIC to dosing interval time were respectively 99.93% and 73.13% with pharmacokinetic formula of single dose intravenous administration,and 99.98%and 68.08%with pharmacokinetic formula of multi-ple dose repeated intravenous administration;and the percentages of the interval time prolonged to 16 h were respectively 54.84%and 51.06%,both reached the standard value. CONCLUSIONS:Quantitative analysis of PK/PD prediction parameters can be used to evaluate and optimize the clinical dosing regimens and guide the clinical practice.

The present paper is a study on the use of English movies in the teaching of college English,focusing on the design and interactive teaching process of the course "The Appreciation of English Movies".The paper argues that English movies play a positive role in creating an authentic communicative situation and acquainting students with western culture.

On the basis of innovating the talents training idea, integrating the instruction content, conducting medical simulation education, perfecting the Three-Early-Education mode, improving the research abilities of students, exploring the experimental class manage system and various approaches, the Department of Clinical Medicine of Hubei Medical University has established a mode of talent training for clinical medicine majors, which can guarantee the quality of the talent training, suit the actual conditions of our school and meet the needs of the development health undertakings.

Objective: To explore the optimal concentration of Tanreqing injection for acute upper respiratory tract infections. Methods: A retrospective analysis of 531 children with acute upper respiratory tract infection treated with Tanreqing injection was conducted. These children were divided into different groups according to concentration of Tanreqing injection (i.e., the relationship between liquid and solvent, or the dilution ratio of solvent to liquid). Assume that X was the dilution ratio of solvent to liquid and the group was divided by an additional increment of 2.5 dilution units. All the children were divided into six groups as follows, groups of A (1:10≤X<1:12.5), B (1:12.5≤X<1:15), C (1:15≤X<1:17.5), D (1:17.5≤X<1:20), E (1:20≤X<1:22.5) and F (1:22.5≤X<1:25). The clinical effective rate and incidence of adverse reactions in each group were used as clinical indicators related to concentration of Tanreqing injection. Origin 8 was used to establish the relationship between the two indicators and the median of the concentration, and to seek a net benefit index that can combine the two indicators together. Finally, the relationship between the net benefit indicator and the median of the concentration were established, and the optimal concentration was found by judging and picking up the maximum of the net benefit indicator. Results: The relationship between the clinical effective rate and the concentration median were: Y=-0.3+31.58X-203.33X² (R²=0.988 46), and relationship between the incidence of adverse reactions and the concentration median were: Y=-0.27+10.24X-67.85X² (R²=0.982 28), and relationship between the net benefit indicator and the concentration median were: ΔY=-0.03+21.34X-135.48X². The peak value of the net benefit indicator was 0.81, and the corresponding median of the concentration was 0.078 8, and the optimal dilution ratio of liquid to solvent was 1:11.6-1:14.1. Conclusions This article explored the optimum concentration range of Tanreqing injection and gave tips for clinical safety and effective drug use.

Objective To investigate the methylation status of promoter CpG islands of the estrogen receptors (ERs) in leukemia cell lines,including 3 promoters of ER? (ER?-A,-B and -C) and one promoter of ER?,and explore the possible relationship between the mRNA expressions of the promoters and the CpG methylation. Methods With RT-PCR and methylation specific PCR (MSP),the mRNA expressions of above promoters and their status of methylation in leukemia cell lines HL-60,K562,Jurkat,THP-1,U937 and MOLT-410,and health controls with or without treatment of 5-AzA-2′-Deoxycitidine (5-Aza-DC). Results Promoters of ER were all methylated or semi-methylated in the 6 strains of leukemia cells. Only the ER?-A was inactivated in these leukemia cell lines and was unmethylated in all 10 health controls,and the expression was recovered after the treatment of 5′-Aza-DC. Conclusion The CpG islands of ER promoter are hypermethylated in 6 strains of leukemia cells,and this inactivate the expression of ER?-A,which can be activated by the treatment of 5′-Aza-DC.

OBJECTIVE To evaluate the standard of non-invasive diagnosis of Down′s syndrome between the different PCR machines. METHODS Two kinds of PCR machines were used respectively to amplify the homologous genes-the human liver-like phosphofructokinase gene (PFKL) and the human muscle-like phosphofructokinase gene (PFKM). RESULTS The best annealing temperature of the two PCR machines were 64 ℃ and 60 ℃,and only in this reaction conditions PFKL′s and PFKM′s electrophoresis strips had the same optical density value. CONCLUSIONS This approach has proven that the conditions of amplified the PFKL and PFKM are different between the two kinds of PCR machines.

Objective: To investigate the trends in cerebrovascular disease mortality among residents in Hangzhou City from 2006 to 2020, so as to provide insights into the development of cerebrovascular disease control strategy. Methods: The cerebrovascular disease mortality data were collected from residents in Hangzhou City through household registered death cards recorded in county- and city-level hospitals, township-level health centers and community health service centers in Hangzhou City and standardized by the national population census data in China in 2010. The changes in the crude and standardized mortality of cerebrovascular diseases were estimated using annual percent change (APC) in Hangzhou City from 2006 to 2020. Results: A total of 109 891 deaths were reported due to cerebrovascular diseases among residents in Hangzhou City from 2006 to 2020, accounting for 17.72% of all deaths in Hangzhou City during the 15-year period, and the crude and standardized mortality rates were 105.83/105 and 65.15/105, which both appeared a tendency towards a decline (crude mortality: APC=-0.80%, t=-3.832, P=0.002; standardized mortality: APC=-4.69%, t=-24.084, P<0.001). The crude mortality of hemorrhagic stroke showed a tendency towards a decline among residents in Hangzhou City from 2006 to 2020 (APC=-7.97%, t=-30.704, P<0.001), and the crude mortality of both ischemic stroke (APC=5.76%, t=6.106, P<0.001) and sequelae of cerebrovascular disease (APC=13.20%, t=18.103, P<0.001) appeared a tendency towards a rise. The crude mortality of cerebrovascular diseases was significantly higher in men than in women (110.15/105 vs. 101.51/105; χ2=183.078, P<0.001), which both appeared a tendency towards a decline among residents in Hangzhou City from 2006 to 2020 (men: APC=-0.90%, t=-4.669, P<0.001; women: APC=-0.70%, t=-2.658, P=0.020). The crude mortality of cerebrovascular diseases was 101.95/105 and appeared a tendency towards a decline among urban residents in Hangzhou City from 2006 to 2020 (APC=-1.19%, t=-3.655, P=0.003), and was 112.46/105 and showed no remarkable changes among rural residents in Hangzhou City from 2006 to 2020 (t=-0.719, P=0.485). In addition, the crude mortality of cerebrovascular diseases appeared a tendency towards a rise with age among residents in Hangzhou City from 2006 to 2020 (χ2trend=502 711.682, P<0.001), and the crude mortality of cerebrovascular diseases appeared a tendency towards a decline among residents at ages of 35 years and above in Hangzhou City from 2006 to 2020 (P<0.05). Conclusions The cerebrovascular disease mortality appeared a tendency towards a decline among residents in Hangzhou City from 2006 to 2020, and a high mortality rate of cerebrovascular diseases was seen among rural residents, men and the elderly.

Objective To investigate the value of endovascular surgery for the treatment of thromboangitis obliterans (TAO). Methods Sixteen patients (18 limbs) with thromboangitis obliterans were treated by percutaneous transluminal plasty (PTA). Results Angiographic success on the limb basis was achieved in 15 of 18 treated limbs and the initial technical success rate was 83.34%. Doppler anklebrachial index (ABI) increased from 0.33±0.16 to 0.79±0.23 one week after PTA. The follow-up time was 2～24 months, the average time was 10.84 months. The 3-month, 12-month accumulated primary patency rate were 81.33% and 60. 23% respectively. Conclusion PTA is effective primary invasive treatment for thromboangitis obliterans yielding acceptable primary clinical success with a low complication rate and resulting in moderate long-term clinical patency and a high limb salvage rate.

Objective: To analyze the status and trend of fall mortality among the elderly from 2006 to 2018 in Hangzhou, and to provide basis for fall prevention and control. Methods: Through the medical certificate of death in hospitals at the county level and above and community health service centers, the monitoring data of the deaths from fall among the elderly aged 60 years and above in Hangzhou from 2006 to 2018 were collected. The crude motality rate, standardized mortality rate of fall and the annual percentage change ( APC ) were calculated to examine the status and trend of fall mortality in different gender, age and areas. Results: The crude mortality rate of fall among the elderly in Hangzhou was 85.60/100 000 and the standardized mortality rate was 71.42/100 000 from 2006 to 2018. The crude and standardized mortality rate from 2006 to 2018 showed increasing trends and the APCs were 3.46% and 2.33%, respectively ( P<0.05) . The crude mortality rate was 93.01/100 000 in females, which was higher than 77.82/100 000 in males ( P<0.05 ) , the APCs were 3.25% and 3.77%, respectively. The crude mortality rate of rural areas was 129.03/100 000, which was significantly higher than 60.73/100 000 of urban areas ( P<0.05 ) . The mortality rate of urban and rural areas showed increasing trends, the APCs were 5.02% and 2.43%, respectively. The crude mortality rate of fall among the elderly in Hangzhou increased gradually with age ( P<0.05 ) . Conclusion The fall mortality among the elderly in Hangzhou increased from 2006 to 2018. More efforts are needed to reduce fall mortality in females and rural population.

Objective:To evaluate the pregnancy outcomes of fetal tethered cord (TC) prenatally diagnosed by MRI.Methods:Clinical data of 38 fetuses diagnosed as having TC by MRI, including 36 singletons and two fetuses who were both one of dichorionic diamniotic twins, were retrospectively collected and analyzed in the Obstetrics and Gynecology Hospital of Fudan University from January 2015 to August 2019. According to whether conus medullaris was located above the bladder or reached the lower edge of the bladder, all cases were divided into high or low groups. Pregnancy outcomes were compared between the two groups using Fisher's exact test and Student's t-test. Results:(1) The gestational age at MRI was (25.5±4.7) weeks. Among the 38 cases, 14 (36.8%) were isolated TC, 24 (63.2%) were complicated by other anomalies. The meningocele was responsible for the most (39.5%, n=15). The results of the ultrasound were consistent with those of MRI in 24 cases (63.2%). While in the other 14 cases (36.8%), the ultrasound only showed vertebral body's abnormal morphology, after which further MRI examination revealed a tethered cord. (2) Twenty-nine women (76.3%) chose to terminate the pregnancy. One patient (2.6%) underwent fetal reduction at 23 gestational weeks (one normal twin was delivered prematurely), and one (2.6%) was lost to follow-up. Seven (18.4%) cases continued the pregnancies to delivery. The postnatal follow-up period was 8.1 months (4.0 to 54.9 months). Two infants without comorbidities showed normal growth and development. Another three cases underwent surgeries after birth, and two cases died in the neonatal period. (3) The average width of the medullary cone was (2.5±0.8) cm. There was no significant difference in the spinal cord width between the high [(2.5±0.8) cm, n=34] and low group [(2.7±1.1) cm, n=4]. Six pregnancies (17.6%) in the high group was continued to delivery, and one of the neonates died of severe hydrocephalus. One patient in the low group (1/4) was delivered, while the baby died of neonatal asphyxia. Conclusions:Fetuses with isolated TC are prone to have a good prognosis. Further study should focus on the relation between the high or low position of the conus medullaris and pregnancy outcomes.