Food Safety ; International Cooperation ; Risk Assessment

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.

Biofilm formation makes bacteria adopt a multicellular lifestyle.Compared to planktonic cells, biofilm-grown cells express an increased resistance to antimicrobial agents.Bacterial biofilm formation is a crucial step in the pathogenesis of many subacute and chronic bacterial infections.In clinical setting, biofilm can cause bacterial biofilm disease and biomaterial associated infection.Understanding the mechanisms involved in biofilm-associated antimicrobial resistance is key to the development of new solutions.

BACKGROUND:The effect of placenta-derived growth factor(PLGF)on promoting vascular regeneration remains uncertain.In studies of models with PLGF deletion,PLGF has been considered to play critical role in inducing angiogenesis.OBJECTIVE:To summarize the research advances in effect of PLGF and its receptor in vascular regeneration and ischemic cerebral disease.METHODS:A computer-based online search of Pubmed and CNKl was performed for relevant articles published between 1990 and 2009 with key words of"PLGF"in Chinese and"PLGF angiogensis"Articles related with biological characteristics of PLGF and its roles in vascular regeneration and articles related with angiogenesis and PLGF expression after cerebral ischemia were selected.Repetitive articles were excludedRESULTS AND CONCLUSION:The role of PLGF and its receptor in vascular regeneration,mechanism of PLGF and its receptor to promote angiogenesis,vascular endothelial growth factor A,and the expression of PLGF and its receptor in brain after cerebral ischemia were introduced.PLGF can promote pathological angiogenesis,arteriogenesis,branch formation and hemopoietic progenitor cell mobilization.PLGF and its receptor play an important role in the angiogenesis of ischemic cerebral disease and display a good clinical prospect in the treatment of ischemic cerebral disease However,the specific role and mechanism require further study.

In the use of antiepileptic drugs in patients with epilepsy,1/3 of the patients with epilepsy can not get effective control,showing resistance to antiepileptic drugs.Now the mechanism of drug resistance is considered to be caused by multiple factors work together.The concept and connotation between drug-resistant epilepsy and refractory epilepsy are different.Since 2010,the international union of antiepileptic proposeddrug-resistant epilepsy expert consensus,different medical centers use the new defition to study different populations and confirm that the new definition is effective and reliable.However,there are some controversier about the drug dosage,drug kinds,judge for determining evaluation index and the treatment judgement in that definition.

Objective To investigate the expression of ICAM-1 and VCAM-1 in colorectal carcinoma and the rela-tionship between ICAM-1, VCAM-1 and the occurrence, the metastasis of colorectal carcinoma, and to analyze the significance. Methods Immunohistochemistry staining(S-P method) was used to detect the expression of ICAM-1 and VCAM-1 on consecutive section in 78 cases of colorectal carcinoma and normal mucosa and 42 cases of colorec-tal adenomas. Plasma was obtained from 78 patients with colorectal carcinoma and 40 healthy volunteers prior sur-gery, by an enzyme-linked immunosorbent assay (ELISA). Results There was significant difference between the high expression of ICAM-1 and VCAM-1 in colorectal carcinoma and the low expression in normal mucosa and ade-noma(P < 0. 01). Serum ICAM-1 and VCAM-1 were significantly higher in patients with colorectal carcinoma than those in normal control group(P < 0. 01). The ICAM-1 and VCAM-1 levels were not related to sex, age, tumor lo-cation and histological grades(P > 0. 05),but had significantly statistical difference between lymph node metastasis and Dukes stage(P < 0. 01). Conclusion The increase expression of ICAM-1 and VCAM-1 in colorectal cancer suggests that the ICAM-1 and VCAM-1 may play an important role in evaluation of malignant degree and judging the progress as well as the mechanism of colorectal cancer.

BACKGROUND:In the elderly patients with a variety of diseases, poor physical and compensatory ability results in a high demand for anesthesia during hip replacement and internal fixation. Lumbar epidural anesthesia with ropivacaine is the commonly used method of narcotic analgesics, but this method of anesthesia has been less studied in elderly hip replacement and internal fixation. OBJECTIVE: To investigate the effects of lumbar epidural anesthesia with ropivacaine in elderly hip replacement and internal fixation. METHODS: Data of fifty elderly patients with hip replacement implants and internal fixation, who were treated in the Department of Orthopedics, Affiliated Hospital of Xizang Minzu University from February 2014 to August 2015, were analyzed. 50 patients were randomly divided into continuous epidural anesthesia group and ropivacaine lumbar epidural anesthesia group, with 25 patients in each group. Anesthetic effect was compared. Self questionnaire on risk factors was used for non-conditional Logistic multivariate analysis between the two groups. RESULTS AND CONCLUSION: (1) Anesthetics onset time, the amount of local anesthesia, the use of trimetaphan camsilate agent number, complete block time, heart rate after anesthesia and complication rate were significantly less in the ropivacaine lumbar epidural anesthesia group than in the continuous epidural anesthesia group (P < 0.05). (2) The highest block level, Bromage score, mean arterial pressure after anesthesia and anesthesia satisfaction rate were significantly higher in the ropivacaine lumbar epidural anesthesia group than in the continuous epidural anesthesia group (P < 0.05). (3) Logistic multivariate analysis on postoperative cognitive dysfunction showed that postoperative cognitive dysfunction was strongly associated with age, education, complications, and hip arthroplasty (P < 0.05). (4) Results verified that lumbar epidural anesthesia with ropivacaine showed ideal effects in hip arthroplasty and internal fixation. Postoperative recovery was rapid, and it is safe and reliable.

From the Government’s fully guarantee stage to the stage of independent organization of medicine, then to the market-oriented reforms and the new health care reform exploration stages, the public hospitals reform fol-lows different institutional logics, but the institutional dilemma have emerged at all stages including the little coupling between the institutional arrangements and environment, the public welfare and benefit wandering, the management system instability, and the breakdown of the financial investment and control costs mechanisms. The Government should elaborate conditions for the spontaneous public hospitals reform on the institutional environment in order to em-bed intrinsic motivation of the induced institutional change into the imposed institutional change. There should be positive interaction between the government and the market in order to form a reasonable and orderly competitive land-scape to the market of medical services. Payment should be reformed which has significant influence on internal medi-cal service system incentives.

Objective To study the extraction process of kendir leaves in compound kendir leaves tablets. Method The optimum extraction process was selected by the orthogonal design L9(34),with the factors of the concentration of ethanol,the volume of ethanol and the time of extraction,the content of quercetin as the evaluating criteria detected by HPLC. Kromasil C18 column (250 mm?4.6 mm,5 ?m) was used. The mobile phase was acetonitrile-0.5% phosphoric acid (27︰73),detection wavelength was 371 nm,the flow rate was 1.0 mL/min,and the column temperature was 30 ℃. Results The best extraction process of kendir leaves was as follows:85% ethanol,30 times volume of ethanol,extracting for 2 hours in boiling water. Quercetin showed a good linearity in the range of 0.963 0～0.080 3 ?g,r =0.999 8 (n =7). The average recovery of quercetin was 99.46%. Conclusion The extraction process was entirely,and the results of determination are satisfactory.