Adult ; Aged ; Arthritis, Rheumatoid ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy

Objective To evaluate the efficacy of ambroxol on community acquired pneumonia (CAP) in elderly patients.Methods Totally 120 patients with CAP were selected and divided into 3 groups:low-dose group (patients received ambroxol 15 mg intravenously,3 times per day,n=40),conventional-dose group (patients received ambroxol 30 mg intravenously,3 times per day,n=40)and control group (patients received routine treatment including antibiotic therapy and oxygen inhalation,n=40).All patients were treated for 7 days.The levels of white blood cell (WBC),high sensitivity C-reactive protein (hs-CRP) and procalcitonin (PCT) were determined dynamically during the treatment.Results The markedly efficient rate,efficient rate and inefficient rate were 62.5％ (25/40),15.0％ (6/40) and 22.5％ (9/40) in low-dose group,82.5％ (33/40),15.0％ (6/40) and 2.5％ (1/40) in conventional-dose group,40％ (16/40),15.0％ (6/40) and 45.0％ (18/40) in control group,respectively.The total efficient rates were 77.5％,97.5％ and 55.0％ in low dose,conventional dose and control groups,respectively.The markedly efficient rate was higher in lowdose,conventional-dose groups than in control group (x2 =15.29,P＜0.05).There was a significant difference in markedly efficient rate between low dose and conventional-dose groups (x2 =4.01,P＜ 0.05).The total efficient rate was higher in low-dose,conventional-dose groups than in control group (x2 20.22,P＜0.05).There was a significant difference in total efficient rate between low dose and conventional-dose groups (x2=7.31,P＜0.05).Compared with before treatment,the levels of WBC,hs CRP and PCT were decreased in 3 groups after treatment (all P＜0.05).The levels of WBC,hsCRP and PCT were decreased more remarkably in low dose,conventional-dose groups than in control group (all P＜0.05).There was a significant difference in the decrease of WBC,hs-CRP and PCT levels between low-dose and conventional-dose groups (all P＜0.05).Conclusions Conventional dose ambroxol treatment (30 mg,iv,3 times/d) is an efficient therapy for community acquired pneumonia in elderly patients.

Objective To explore the optimal method of anesthesia in radical resection of gastric cancer by comparing the effects of two anesthesia techniques on the balance of Th1/Th2 in order to provide evidence for clinical anesthesia manage-ment.Methods Forty patients who underwent elective radical resection of gastric cancer were randomized into two groups:in-halation anesthesia group(group S)and total intravenous anesthesia group(group P),in which sevoflurane and propofol were ad-ministered for the induction and maintenance of anesthesia,respectively.The general data of the patients were collected,the tis-sue type of tumors obtained and the fluid infusion and blood loss volumes recoded.The VAS score was obtained 1 h,6 h and 5 d after the surgery.Before the induction of anesthesia,6 h and 5 d after surgery,the blood samples were drawn to determine the serum levels of IL-1β,IFN-γ,TNF-α,IL-2,IL-6 and IL-10.Flow cytometry was used to detect the proportion of CD3+CD8-IFN-γ+ and CD3+CD8-IL-10+ cells and the Th1/Th2 ratio was calculated.Results The level of IL-6 was increased post-sur-gically in groups S and P(P<0.05).There were no significant changes in the levels of IL-1β,IL-2 and IL-10 in groups S and P and in the levels of TNF-αand IFN-γ,and the Th1/Th2 ratio in group S between before the induction of anesthesia and different time points after the surgery(P>0.05).The levels of TNF-αand IFN-γ,and the Th1/Th2 ratio were significantly increased in group P 5 d after the surgery(P<0.05).Conclusion Total intravenous anesthesia with propofol can enhance Th1 response and it is an ideal anesthetic method for radical resection of gastric cancer.

Objective To study the stem development and essential oil distribution in different deve- lopment stages of Pogostemon cablin and to provide theoretical information and practical guidance for reasonable harvest and use of this medicinal plant. Methods Paraffin method, semi-thin sectioning, and histochemical method were used. Results Essential oil was not found in the promeristem of stem; in the primary meristem of stem and the early stage of stem's primary structure, the essential oil was mainly distributed in glandular hairs; in the primary structure of stem, the essential oil was mainly distributed in cortex parenchyma cells; in the secondary structure of stem, the essential oil was mainly distributed in remaining cortex parenchyma cell. Conclusion The essential oil is mainly distributed in the stem bark, so the thickness of a stem bark can be used as a standard of selective breeding index.

Dipeptidyl peptidase-4 (DPP-4) inhibitors, a new kind of oral hypoglycemic drugs, can significantly lower blood glu-cose levels in the patients with type 2 diabetes without common side effects such as body weight gain, hypoglycemia and gastrointestinal disturbances. Therefore, DPP-4 inhibitors play an increasingly important role in the treatment of type 2 diabetes. In this review, the re-search progress in the action mechanism, pharmacokinetics and clinical applications of DPP-4 inhibitors was summarized in order to provide reference for the clinical application.

Objective To investigate the relationship between genetic polymorphism of methylenetetrahydrofolate reductase (MTHFR) and the risk of childhood acute lymphocytic leukemia (ALL).Methods 45 patients with ALL and a cohort of 45 matched healthy children were included,and DNA was extracted from their peripheral blood.PCR-RFLP was used to determine the genotypes of MTHFR C677T and A1298C.The adjusted odds tatio (OR) and 95 ％ confidence interwal (CI) were calculated using unconditional logistic regression model.Results The frequency of MTHFR 677 CC,CT and TT genetypes were 31.1％ (14/45),51.1％ (23/45) and 17.7 ％ (8/45) in controls and 51.1％ (23/45),40.0 ％ (18/45) and 8.9 ％ (4/45)in ALL,respectively (x2 =7.48,P =0.04).The frequency of MTHFR 677 T allele were 69.9 ％ (31/45) in controls and 48.8 ％ (22/45) in ALL.The MTHFR 677 T allele had an decreased risk in ALL compared with CC genetype (OR =0.4,95 ％ CI 0.21-0.83).The frequency of MTHFR 1298 AA,AC and CC genetypes were 57.8 ％,40.0 ％ and 2.2 ％ in controls and 18.8 ％,44.4 ％ and 6.8 ％ in ALL,respectively (x2 =11.23,P=0.23).The frequency of MTHFR 1298 C allele were 51.1％ (23/45) in controls and 42.2 ％ (19/45) in ALL.No significant association between the MTHFR 1298 polymorphism and the risk of ALL (OR =1.3,95 ％ CI 0.21-0.83).Conclusion MTHFR 677 polymorphism could significantly decrease the risk of developing childhood ALL,whereas MTHFR 1298 don' t significantly affect the risk of ALL.

Aim To study the effect of BNIP3 on hy-poxia-induced autophagic cell death in gastric carcino-ma.Methods The protein levels of BNIP3 and LC3-Ⅱ of 1 8 cases of gastric carcinoma were studied with immunocytochemistry and Western blot analysis be-tween normal and tumor tissues.The expression of LC3-Ⅱ in SGC-7901 cells was assessed while knock-down of BNIP3 by siRNA in CoCl2-induced hypoxia, and the effect of 3-MA was also studied.Cell viability in hypoxia treatment for 48 h was estimated with cell counting kit-8 (CCK8).Results Compared with nor-mal tissues,the protein levels of BNIP3 and LC3-Ⅱwere increased in tumor tissues.BNIP3 siRNA could decrease the expression of LC3-Ⅱ and enhance the cell viability,while inhibition of autophagy could also in-crease the cell viability in SGC-7901 cells.Conclu-sions BNIP3 may play a role in hypoxia-induced cell death in gastric carcinoma,and the possible mecha-nism may be related to the regulation of autophagy.

Objective:To establish the competency model for medical representatives in China. Methods:Firstly, the competen-cy elements for medical representatives were defined through the literature research and logic analysis, the importance of each element was then evaluated by a questionnaire, and the survey results were analyzed by a factor analysis approach. Lastly, the weight of each factor was confirmed by analytic hierarchy process. Results & Conclusion: The competency model, which consists of 5 dimensions ( professional quality, professional ethics, knowledge, personal characteristics and relationship management) , 26 competency elements and the weight of each factor, is established successfully.

Objective To find out the hygienic status of rural drinking water in Jianhe County of Guizhou Province.Methods Forty-eight source water and tap water samples from small centralized water supply stations in 12 townships of Jianhe County in dry season and wet period were tested from 2009-2011.The water samples were examined in accordance with the relevant provision of Standard Examination Methods for Drinking Water (B/T5750-2006).The contents included:①sensory indicators:standard color,turbidity,smell and taste and visible objects; ②general chemical indicators:pH,iron,manganese,chloride,sulfate,total dissolved solids,total hardness,oxygen consumption and ammonia; ③toxicological indicators:fluoride,arsenic and nitrate; ④microbial indicators:total number of colonies,with a total population of Escherichia coli and heat-resistant Escherichia coli Outcome evaluation was carried out in accordance with the Drinking Water Health Standards (B/T 5.749-2006).Results A total of 192 rural water samples were collected in 2009-2011,and 18 samples were qualified,accounting for 9.38％.The differences of water passing rate between groups of years were statistically significant (x2 =14.74,P＜ 0.01).Rural drinking water quality in dry season (18.75％,18/96) was better than that in wet season (0.00％,0/96; x2 =19.76,P ＜ 0.01).Passing rate of source water quality (16.67％,16/96) was higher than that of tap water(2.08％,2/96; x2 =11.95,P ＜ 0.01).Sensory indicators and toxicological indicators of 192 water samples were qualified.General chemical indicators:in addition to four water samples with pH exceeded the standard(two copies in 2009 and two copies in 2010),other test indicators were qualified.Microbiological indicators:passing rates of the total number of colonies,Escherichia coli group and heat-resistant Escherichia coli group were 77.08％ (148/192),9.90％ (19/192) and 20.31％ (39/192),respectively.Passing rate of microbes was 18.75％ (18/96) in dry season and 0.00％ (0/96) in wet period,and microbes passing rate was significantly higher in dry season than that of the wet period(x2 =19.76,P ＜ 0.01).Passing rate of microbes was 16.67％(16/96) in source water and 2.08％(2/96) in tap water,and passing rate of the source water was significantly higher than that of the tap water(x2 =11.95,P ＜ 0.01).Conclusions The hygienic status of rural drinking water in rural areas of Jianhe County of Guizhou Province is poor.Microbial pollution is the main reason.