OBJECTIVE:To investigate clinical efficacy and safety of different dosages of bromocriptine in the treatment pro-lactinoma,and its effects on serum prolactin(PRL)and tumor volume. METHODS:A total of 60 patients with prolactinoma were selected from our hospital during Jan.-Dec. 2015 as research objects,and then divided into group A and B according to random number table,with 30 cases in each group. Both groups were given Bromocriptine mesilate tablets orally during meal. Group A was given medicine with initial dose of 2.5 mg/d,increasing to 3.75 mg/d 3 d later,increasing by 2.5 mg every week after 2-3 d,and then recovering to 3.75 mg/d till serum PRL level had been controlled. Group B was given medicine with initial dose of 1.25 mg/d, increasing to 2.5 mg/d 3 d later,increasing by 1.25-2.5 mg every week after 2-3 d,and then recovering to 2.5 mg/d till serum PRL level recovered to normal. Both groups were treated for consecutive 3 months. Clinical efficacies as well as serum level of PRL and tumor size were observed in 2 groups,and the occurrence of ADR was recorded. RESULTS:The total response rate of group A (83.33％) was higher than that of group B (66.67％),without statistical significance (P>0.05). Before treatment,there was no statistical significance in serum level of PRL and tumor size between 2 groups (P>0.05). After 1,2 months of treatment,serum levels of PRL in 2 groups were decreased significantly,and the group A was significantly lower than the group B,with statistical significance(P<0.05). After 3 months of treatment,serum levels of PRL in 2 groups were decreased significantly compared to be-fore treatment,but there was no statistical significance between 2 groups(P>0.05). After treatment,tumor size of 2 groups were decreased significantly,and large adenoma and giant adenoma size in group A were significantly smaller than group B,with statisti-cal significance(P<0.05). There was no statistical significance in microadenoma size between group A and B(P>0.05). The inci-dence of ADR in group A(12 cases,40.00％)was significantly higher than group B(5 cases,16.67％),with statistical signifi-cance(P<0.05). CONCLUSIONS:Increasing dosages of bromocriptine no significant influence on therapeutic effect of prolactino-ma,but it can shorten the time of serum PRL level back to normal,and reduce the tumor size. The incidence of adverse reactions in-crease with the dosage.

Objective To investigate the resistance of multi-drug resistant Acinetobacter baumannii against aminoglycosides and its resistance genes.Methods The minimal inhibitory concentrations (MICs) of seven antimicrobials (gentamicin, amikacin, tobramycine, netilmicin, neomycin, streptomycin and kanamycin) against 20 strains of multi-drug resistant Acinetobacter baumannii were detected by agar dilution method. Meanwhile, two resistance genes of aminoglycoside nucleotidyltransferase were amplified by PCR and vertified by DNA sequencer.Results It was found that MIC50 and MIC90 of gentamicin, amikacin, streptomycin and kanamycin in 20 strains of Acinetobacter baumannii were all above 1 024 mg/L, and their resistant rates were 95%, 95%, 100% and 90% respectively, while the resistant rates of tobramycin, netilmicin and neomycin were 85%, 90% and 40% respectively. Two aminoglycoside-modification genes ant(2″)-Ⅰ and ant(3″)-Ⅰ were detected in 20 strains, with 55% and 80% of positive rate respectively. The double positive rate of two resistance genes was 50%.Conclusion The resistance of multi-drug resistant Acinetobacter baumannii against aminoglycosides was closely associated with ant(2″)-Ⅰ and ant(3″)-Ⅰ genes.

Objective To observe the efifcacy of rosuvastatin in patients with unstable angina and its impact on the levels of lipids, high sensitive C-reactive protein (hs-CRP), homocysteine(Hcy) and troponin I (cTnI). Method 384 patients with unstable angina, from January 2010 to December 2012, were randomly divided into observation group and control group, each group had 192 cases, the control group received simvastatin, the observation group were gave rosuvastatin. The efficacy, and the levels of lipids, hs-CRP, Hcy and cTnI were observed after treatment. Results The total effective rate was 92.19%in observation group which was signiifcantly better than 81.25%in control group (χ2=9.044, P<0.01). Before treatment, the levels of TG , TC, LDL-C, HDL-C, Hcy, hs-CRP and cTnI showed no signiifcant difference, after treatment the levels of TG , TC and LDL-C, Hcy, hs-CRP and cTnI were signiifcantly lower than those before treatment (P<0.01), while, the levels of HDL-C signiifcantly increased than those before treatment (P<0.01), the reducing or increasing levels in observation group were more signiifcant compared with the control group (P<0.01). Conclusion Rosuvastatin treatment in unstable angina not only can reduce plasma lipid, but also reduce their inflammation, and stabilize the arterial plaque for unstable angina, it play an important role in development and prognosis.

Objective To evaluate the sensitizations of Hydroxyethyl Starch 40 Sodium Chloride Injection . Methods Active systemic anaphylaxis ( ASA) test, internal sensitive index ' s determination and screening and Passive Cutaneous Anaphylaxis ( PCA) test are carried out .Observe the allergy safety of the samples .Results We use guinea pigs to carry on ASA test and PCA test with Hydroxyethyl Starch 40 Sodium Chloride Injection from 45 batches of 3 companies and no changes have occurred .Measuring and comparing the sensitive index of HIS ,IgG, IgM and IgE in plasma, IgM and IgE are not obvious variation;HIS and IgG positive group and negative group and sample groups are different .Conclusions It is suggestion that Hydroxyethyl Starch 40 Sodium Chloride Injection safety evaluation should include allergic reactions , HIS and IgG sensitive index monitoring in clinical application of hydroxyethyl starch .

Objective To investigate the effects of dipeptidyl peptidase 4(DPP-4) inhibitor on serum adiponectin (APN) and high sensitivity C-reactive protein (hs-CRP) in patients with type 2 diabetes mellitus.Methods 45 cases were type 2 diabetes were collected from department of endocrinology,wuxi second People's hospital of jiangsu province from January 2015 to April 2015.45 patients with type 2 diabetes mellitus were randomly divided into treatment group (n=23) and control group (n =22) , treatment group was treated with metformin combined with DPP-4 inhibitor and control group was treated without DPP-4 inhibitor.Before and after treatment,fasting plsma glucose(FPG),postprandial 2h glucose(2hPG),adiponectin, hs-CRP and homeostasis model assessment for insulin resistance(HOMA-IR) were measured.Results Adiponectin was significantly higher in treatment group than before(P<0.05),FPG,2hPG,hs-CRP and HOMA-IR were significantly lower than before(P<0.05).Adiponectin in treatment group was significantly higher than control group post-treatment(P<0.05).2hPG,hs-CRP and HOMA-IR in treatment group were siginificantly lower than control group post-treatment (P<0.05).Conclusion DPP-4 inhibitor could improve insulin resistance in type 2 diabetes mellitus by increasing serum adiponectin and decreasing serum Hs-CRP and HOMA-IR.

Objective To evaluate influence of patient-controlled intravenous analgesia (PCIA) and patient-controlled epidural analgesia (PCEA) on expressions of serum inflammatory cytokines in elderly patients with hemi or whole hip replacement using cemented artificial joint. Methods Elderly patients undergoing hip replacement were selected and were divided into PCIA group and PCEA group. VAS scores were calculated at 12 h postoperatively. Patients whose VAS scores were not more than 2 at postoperative 12h were included. 30 cases in each group were finally included. Fifteen cases were randomly chosen in each group and underwent sample blood drawing for assays. Expressions of serum inflammatory cytokines were detected by ELISA , RT-PCR and Western-blot. Results Gene and protein expressions of TNF-a as well as IL-6 in group PCEA were lower and expression of IL-10 was higher than that in group PCIA. Serum level of TGb-β was higher in group PCEA detected by ELISA. There was no significant difference in expression of IL-8 between groups. Conclusions PCEA may better promote expressions of anti-inflammatory cytokines and inhibit expressions of proinflammatory cytokines. PCEA is superior in maintenance of inflammatory cytokine balance.

Objective To summarize the anatomic variations of recurrent laryngeal nerve (RLN during thyroid surgery and to investigate the technical key points for identification and preservation of the nerve.Methods Clinical data of 1548 consecutive patients undergoing thyroid operation with intraoperative routine exposure of RLN from June 2010 to June 2012 was retrospectively analyzed.Results In this series,2620 RLNs at risk were clearly exposed and identified during a total of 1548 thyroid operations,wherein complete dissection was performed on 1886 nerves.Injury occurred in 11 of 2620 (0.42％) nerves.Through the analysis of all 2620 RLNs,conditional variations were found in 64 nerves.Of 1886 RLNs that were completely dissected,421 (22.3％)nerves presented with natural variations of six patterns,including morphological branching variation in 126 (6.68％) nerves,course and location variation in 124 (6.57％)nerves,variation in relationship with inferior thyroid artery (ITA)in 36 (1.91％)nerves,variation at the Berry ligament in 112 (5.94％) nerves,variation at the cricothyroid joint in 17 (0.80％) nerves,and 6 (0.32％)cases of non-recurrent laryngeal nerve (nRLN).Conclusions Variations in RLN found during thyroid surgery are of relatively high incidence,complex and diverse,which can be a potential reason of nerve injury due to visual misidentification.Thus,a thorough knowledge of the normal anatomy of RLN and its anatomic variations ensures a safe and effective thyroid surgery.

Objective To explore the autobiographical memory characteristics of chronic pain patients and its correlators.Methods Autobiographical memory,pain and emotion of 106 chronic pain patients and 106healthy controls were assessed with the Autobiographical Memory Test (AMT), the Short-form McGill Pain Questionnaire (SF-MPQ), the Pain Self-efficacy Questionaire (PSEQ), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI).Results Compared to the control group, the clinical group had less specific memory (3.63 ± 1.53, 2.63 ± 1.68, F (1.416) = 7.233, P ＜ 0.01 ) and more overgeneral memory (2.37 ± 1.53,3.37 ±1.68, F (1.416) =7.069, P＜0.01 ),but the latency to response was not statistically significantly different between the groups.Duration of pain,frequence of pain and pain self-efficacy were the significant predictors of overgeneral memory,and the regression coefficients were significant (P＜0.05 ) ,the multiple regression equation was statistically significant( R = 0.427, R2 = 0.183, F= 2.385, P＜ 0.05 ).Conclusion The autobiographical memory of chronic pain patients was overgeneralized because of the influence of duration, frequence and self-efficacy of pain.

Objective To investigate the relationship between polymorphism of arylamine N-acetyltransferase 2 (NAT2) and hair dye dermatitis in a Chinese population. Methods Polymorphism chain-restriction fragment length polymorphism (PCR-RFLP) was used and the wild-type allele (NAT2 * 4) and three mutant alleles (NAT2 * 5A, 6B and 7A) were determined in 60 patients with hair dye dermatitis and 73 age-matched control subjects in Tianjin region. Results In hair dye dermatitis cases, the frequency of NAT2 * 4, NAT2 * 5A, NAT2 * 6B, NAT2 * 7A was 52. 5 % , 5. 0 % ,26.7 % and 15. 8 %, respectively, and no statistically significant difference of the frequencies was found between the hair dye dermatitis patients and controls (P>0. 05). The frequency of rapid genotype, intermediate genotype and slow genotype was 26. 7 % , 51. 7 % and 21. 7 % in hair dye dermatitis cases, 30. 1 %, 50. 7 % and 19. 2 % in control subjects, respectively, and no statistically significant difference of the frequencies between the two groups (P>0. 05). Conclusions Our study suggests that there might be no relationship between polymorphism of NAT2 and genetic susceptibility to hair dye dermatitis in a Chinese population.

Objective Tyrphostin AG1024(3-Bromo-5-t-butyl-4-hydroxybenzylidenemalonitrile) is a specific insulin like growth factor type Ⅰ receptor tyrosine kinase blocker,this study is to investigate the effect of AG1024 on the proliferation and apoptosis of hepatocellular carcinoma cell lines.Methods Treated with AG1024 on vailed concentrations(0～40 μmol/L),human hepatocellular carcinoma cel lines HepG2 and SMMC-7721 were observed for morphological and molecular biology changes,the effect of AG1024 on the cell lines proliferation invasion ability as well as apoptosis was evaluated. Results MTT showed that AG1024 dose-dependently inhibited the proliferation of hepatocellular carcinoma cells,flow cytometry suggested that AG1024 significantly promoted cell lines apoptosis,the cell invasion assay indieated that AG1024 significantly inhibited cell's invasion ability.RT-PCR showed over-expression of IGF-IR in liver cancer cells.and AG1024 dose-dependently increasedtheexpressionofcytochreme C. According totheresultsof Western, blotting,the phosphor-ERK and procaspase-3 were down-regulated while the total ERK remained unchanged. Conclusion AG1024 as a specific IGF-IR blocker blocks the downstream signaling cascade and thus inhibits the proliferation of hepatocellular carcinoma cells and induces cell's apoptosis.