Objective To study and analyze the efficacy and safety of caspofungin in the treatment of acute exacerbation of chronic obstructive pulmonary disease patients complicated with pulmonary fungal infections.Methods 62 patients of acute exacerbation of chronic obstructive pulmonary disease complicated with pulmonary fungal infec-tions were randomly divided into study group and control group,31 cases in each group.Study group was intravenously given caspofungin,with an initial dose of 70mg/d,follow 50mg/d.The control group was intravenously given liposomal amphotericin B,dose control in 3mg? kg-1 ? d-1 .After treatment lasted symptoms 5d,clinical efficacy and side effects of two groups were recorded.Results The effective rate of the study group was 67.74%,which was signifi-cantly higher than 41.93% of the control group, the difference was statistically significant ( χ2 =2.0251, P =0.0429).The incidence rate of adverse reactions of the study group was 16.13%,which was significantly lower than 48.39% of the control group,the difference was statistically significant(χ2 =2.6948,P =0.0070).After treatment, liver and kidney function parameters in the control group such as ALT,AST,BUN,Cr had significant differences com-pared with before treatment (P <0.05).Conclusion For chronic obstructive pulmonary disease patients complicated with acute exacerbation of pulmonary fungal infection,the treatment efficacy and the incidence of adverse reactions of caspofungin therapy are significantly better than liposomal amphotericin B,and has small renal damage,which is wor-thy of clinical application.

As quantum dots( QDs),an advanced porduct of nanotechnology,have been widely used in bio-medicine due to their unique photoelectric properties. QD safety evaluation has become a hot area of research. So far,some researchers have expressed concern about the neurotoxic potential of QDs because the central nervous system was confirmed to be one of the target organs. Several studies found that QDs could enter the central nervous system by crossing the blood brain barrier and following neural pathways and produce some neurotoxic effects,such as damaging the structure and function of neural cells and impairing synaptic plasticity. The potential toxicity mechanisms could include oxidative stress,inflammation and change of ion channels.

Animals ; Cell Proliferation ; drug effects ; Cells, Cultured ; Collagen ; biosynthesis ; Cricetinae ; Cricetulus ; Fibroblasts ; cytology ; drug effects ; metabolism ; Macrophages ; drug effects ; Nanostructures ; Silicon Dioxide ; pharmacology

Objective:To study the characteristics of the adverse reactions caused by tacrolimus and analyze the risk factors. Methods:Totally 280 cases of renal transplant recipients received standard treatment options were selected from 1997 to 2013 in Wuhan general hospital of Guangzhou military command. The tacrolimus-related adverse reactions and their risk factors were analyzed statistically. Results:Totally 39. 65% of the patients had the tacrolimus-related adverse reactions. The main adverse reactions were hematotoxicity,diabetes mellitus and hyperlipidemia. The univariate analysis showed that age,weight,BMI and treatment course were the suspected risk factors. The multivariate analysis results showed that age,BMI and treatment course were the risk factors of tacrolimus-related adverse reactions. Conclusion:The incidence of tacrolimus-related adverse reactions is relatively high,and if the patient is in advanced age,with poor nutritional status or long-term medication,the probability of adverse reactions will be increased.

Objective To offer a theory that supports the individualized tacrolimus dosage regimen by retrospectively investigating the influences of gene polymorphism and other clinical factors on tacrolimus concentration in renal transplant recipients. Methods A total of 280 renal transplant recipients were genotyped for CYP3A4?5, CYP3A4?6, CYP3A4?18B, CYP3A5?3, MDR1 1236C>T, MDR1 2677G>T/A, MDR1 3435C>T polymorphisms by PCR followed by restriction fragment length polymorphism (RFLP) analysis.PXR 6bp deletions (rs3842689) genotypes were determined by Allelic Special-Touch down PCR.Correlation between gene polymorphisms and tacrolimus concentrations was analyzed. Results The mutation frequency of CYP3A4?18B, CYP3A5?3, MDR1 1236C>T, 2677G>T/A, 3435C>T and PXR rs3842689 in the renal transplant recipients was 29.11%, 69.29%, 43.57%, 49.64%, 36.43% and 26.07%, respectively.Multiple regression analysis showed that, CYP3A5?3 and red blood cell count were associated with the value of C0/D of FK506, the best regression model was:D=C0/(-60.445 +95.777×CYP3A5 +34.938×RBC), and the equation could explain 38.8% of tacrolimus individual differences. Conclusion Gene polymorphism of CYP3A5?3 and red blood cell count may be responsible, in part, for the large interindividual variability of FK506 dose and concentration.

Quantitative structure activity relationship ( QSAR ) study attempts to correlate chemical structure with activity using statistical approaches and is now being applied to high throughput toxicity screening and prediction of nanomaterials. This paper is interded to discuss the present QSAR study methods of nanomaterials based on traditional QSAR study, such as the use of measurement instrument and quantum chemistry methods of structure descriptor selection, evaluation criteria for the quality of published experimental data on nanomaterials, modeling methods such as K-nearest neighbor ( KNN) and support vector machine(SVM), validation methods such as leave-one-out(LOO) and leave-N-out ( LNO) . We also review the problems and challenges existing in this area and predict future development.

Objective To investigate the attitude of medical students towards standardized resident training in Shanghai and to provide references for policy adjustment.Methods Self-made questionnaire was used to investigate the attitude of 267 clinical medical students towards standardized resident training in Shanghai.Reference reviewing and expert consultation were also performed.Results Nearly eighty percent of students believed that they had basic knowledge of the training.Two thirds of students hold objective attitude towards the policy.Conclusions Income and pressure in finding jobs are the main reasons why students object the policy.Standardized resident training program need to improve in aspects of advertisement,incoming,quality of teaching staff,connection between medical education and training.

Physiologically based pharmacokinetic (PBPK) modeling is established based on the information of existing human or other animal anatomy, knowledge of physiology and biochemical data. The model uses mathematical methods to simulate chemicals′process of absorption, distribution, metabolism and excretion in the body, in order to achieve the dose and interspecific extrapolation and to predict the chemical level in the specific organ at the specific time. In studies on toxicology of nanomaterials, the PBPK models in the silver nanoparticles, zinc oxide nanoparticles, titanium dioxide nanoparticles and polymer nanomaterials are gradually established. PBPK modeling can not only provide information on the dynamic change of nanomaterials in the body, but is of great significance for to quantitative evaluation of biological safety of nanomaterials. PBPK modeling will be a hot spot for research in the field of nanotoxicology.

Objective To analyze the differences of coagulation parameters between patients with advanced schistosomiasis cirrhosis and hepatitis B cirrhosis under different degrees of liver function,so as to provide the evidence for further guidance of judging clinical condition and prognosis. Methods Sixty?three patients with advanced schistosomiasis cirrhosis and eighty pa?tients with hepatitis B induced cirrhosis hospitalized in Jingzhou Central Hospital from January 2014 to June 2016 were served as an advanced schistosomiasis cirrhosis group and a hepatitis B cirrhosis group,respectively,and ninety?six gastropathy pa?tients excluded from other diseases that might affect coagulation in the same period were served as a control group. The levels of PT,INR,Fib,TT,APTT,and PLT of the patients among the above 3 groups and the cirrhosis patients with different Child?Pugh classes were detected and compared. Results The differences of the levels of PT,INR,Fib,TT,APTT,and PLT among the 3 groups were statistically significant(F=84.512,81.672,37.612,104.475,52.497,102.233;all P<0.05). The further analysis showed that PT,INR,TT,and APTT of both the advanced schistosomiasis cirrhosis and hepatitis B induced cirrhosis groups were longer than those of the control group,and the PLT levels of both the former 2 groups were lower than that of the con?trol group(all P<0.05). Compared with the advanced schistosomiasis cirrhosis group,PT,INR,TT,and APTT of the hepati?tis B induced cirrhosis group were longer,and the levels of Fib and PLT were lower(all P<0.05). Among those with the liver function of Grade A,the reduced degree of PLT in the patients with hepatitis B induced cirrhosis was more serious,while for those with the liver function of Grade B and C,the difference between the patients with advanced schistosomiasis cirrhosis and hepatitis B induced cirrhosis was not statistically significant(both P > 0.05). Under all the grades of liver function,TT and APTT of the hepatitis B induced cirrhosis group was longer than those of the advanced schistosomiasis cirrhosis group ,and the Fib level of the former was lower than that of the latter. Among those with the liver function of Grade A and B ,PT and INR of the hepatitis B induced cirrhosis group were longer than those of the advanced schistosomiasis cirrhosis group;while for those with the liver function of Grade C,the difference between the two groups was not statistically significant(all P > 0.05). Conclu?sions There exist differences of the damage degrees of coagulation function between the patients with advanced schistosomiasis cirrhosis and hepatitis B cirrhosis. When the damage degree of the liver function is lighter,the coagulation function in the pa?tients with hepatitis B cirrhosis decreases more significantly;when the damage degree becomes more severe,APPT in the pa?tients with hepatitis B cirrhosis extends more significantly,while the differences of PLT and PT between them are little.