Targeted cancer therapy is one of the modalities to increase efficiency and decrease adverse effects of chemotherapy,and the selection of drug vector system is of importance for targeted therapy.An ideal adriamycin targeted vector system should have maximal efficacy and minimal adverse effects in inhibiting cancer cells through different mechanisms.This article reviews the recent progress in adriamycin targeted therapy,including the modes of adriamycin administration,the selection of drug vectors,as well as other chemotherapeutic drugs in targeted therapy of liver carcinoma.

BACKGROUND: Diabetic retinopathy is a commonly chronic-vascular complication in a course of diabetes mellitus (DM), and its relation with apoptosis and changes of ion level needs to be proved.OBJECTIVE: To observe apoptosis and changes of Na+ and K+ contents in retinal tissue of DM rats.DESIGN: Randomized controlled study.SETTING: Department of Ophthalmology, Liuzhou Municipal People's Hospital.MATERIALS: The experiment was completed at the Department of Ophthalmology, Liuzhou Municipal People's Hospital. A total of forty adult male Wistar rats, aged 20 months, weighing 320-350 g, were provided by Animal Center of Medical College Affiliated to Sun Yat-sen University.METHODS: Forth Wistar rats were randomly divided into control group and experimental group with 20 in each group. Streptozotocin was used to induce DM in the experimental group. Apoptosis and changes of Na+ and K+ contents in retinal tissue were measured on the 4th, 6th, 12th and 16th weeks after DM onset. Rats in the control group were injected only with the same volume of citrate buffer solution. Then, correlations on the aspect of fasting blood glucose (FBG), hemoglobin glycosylation (HbAlc), Na+ and K+ contents and DM course were analyzed between the two groups.MAIN OUTCOME MEASURES: ① Na+ and K+ contents; ② FBG concentra tion and HbAlc level; ③ changes of apoptosis; ④ correlations among markers.RESULTS: Apoptosis could be detected in retinal tissue in the experimental group at 4 weeks after DM onset, and with course elongating, level of apoptosis was aggravated gradually. Na+ concentration was increased in retinal tissue, but K+ concentration was decreased (P ＜ 0.01 or 0.05). Levels of apoptosis in retinal tissue in the experimental group were positive correlation with FBG concentration, HbAlc level, Na+ content and DM course (r=7.584, 7.844, 7.369, 6.246; P ＜ 0.01); however, they were negative correlation with K+ content in retinal tissue (r=7.658, P ＜ 0.01).CONCLUSION: There are apoptosis and abnormal Na+ and K+ contents in retinal tissue of DM rats. Moreover, these changes may be one of pathological bases of diabetic retinopathy.

OBJECTIVE:To explore the effects of PDCA(plan,do,check,action)cycle theory in the ADR monitoring of our hospital. METHODS:The problems of ADR monitoring in our hospital in 2012 were analyzed and intervened by PDCA cycle. The effects of PDCA cycle were evaluated 1 year later. RESULTS:After implementation of PDCA cycle,we had improved the manage-ment system,brought ADR monitoring into the appraisal of clinical pharmacists,established the networking platform of ADR report-ing,strengthened the training of physicians and nurses,the publicty of ADR information and ADR monitoring of important medi-cine. The number of ADR reports increased by 18.37% in 2013,the proportion of new and serious ADR reports obviously in-creased(increasing from 22.28% to 38.42%);in terms of ADR reporting source,the ADR reporting in wards obviously increased (increasing from 8.16% to 43.84%). The proportion of ADR induced by antibiotics or TCM preparation decreased significantly(re-spetively decreasing from 54.52% to 43.84% and 23.03% to 13.30%);in term of ADR clinical manifestations,the proportion of skin and its appendants involved decreased significantly (decreasing from 53.64% to 39.41%). CONCLUSIONS:The application of PDCA cycle obviously improves the management of ADR monitoring in our hospital.

Obgective To explore the antimicrobial resistance genotypes and molecular epidemic features of Klebsiella pneumoniae (K.pneumoniae) producing extended spectrum 3-lactamases (ESBLs) in the Pediatric Intensive Care Unit (PICU) of Guiyang Children' s Hospital.Methods Disc diffusion technique (Kirby-Bauer method) and automatic microbiology analysis system were employed to determine the antimicrobial resistance,and Double-disk Diffusion was adopted in the phenotype confirmatory test of ESBLs,and PCR was used to determine the antimicrobial resistance genotypes.Results Among 44 straits of non-repetitive-K.pneumoniae,isolated from the children during hospitalization since April to December of 2013,29 straits (65.9％) were detected.The findings of sensitivity tests showed that 29 strains of ESBLs-producing K.pneumoniae presented a higher rate of sensitivity to carbapenems,cephamycin and quinolones,100％ resistance to penicillin and cephalosporins of the first and the second generations.Fifteen non-ESBLs-producing K.pneumoniae presented 100％ resistance to penicillin.The rate of resistance to 9 kinds of antibiotics (Ampicillin/Sulbactam,Cefazolin,Cefuroxime,Cefamandole,Cefiriaxone,Ceftazidime,Cefepime,Gentamicin,Aztreonam) in ESBLs-producing K.pneumoniae strains(79.3％,100.0％,100.0％,100.0％,100.0％,79.3％,65.5％,41.4％,79.3％) was significantly higher than that of non-ESBLs-producing K.pneumoniae trains (13.3％,6.7％,20.0％,20.0％,0,0,0,6.7％,0) (x2 =17.54,35.51,28.00,28.00,44.00,24.93,17.30,4.18,24.93,all P ＜ 0.05).In 29 strains of ESBLs-producing K.pneumoniae,3 genotypes were detected respectively:93.1％ of SHV (27/29 strains),51.7 ％ of TEM (15/29 strains) and 37.9 ％ of CTX-M (11/29 strains).Five forms of genotype distribution were presented:14 (43.8％) strains carrying single ESBLs gene,5 (17.2％) strains carrying 2 types,19 (31.0％) strains carrying 3 types,and 1 strain had not been genotyped.Conclusions ESBLs-producing K.pneumoniae had been epidemic in PICU of Guiyang Children's Hospital,with multiple antimicrobial resistances and diversification of antimicrobial resistance genotypes.

BACKGROUND:Human amniotic membrane-derived mesenchymal stem cells (AMSCs) are considered to be one kind of adult stem cells that can be easily obtained in large quantities without using an invasive method. Because of their low immunogenicity, anti-inflammatory properties, multipotency of differentiation and without ethical issue, human amniotic membrane-derived mesenchymal stem cells have been proposed as a good candidate to be used in celltherapy and regenerative medicine. However, the biological properties and the differentiation capacity of human amniotic membrane-derived mesenchymal stem cells are stil poorly characterized. OBJECTIVE:To establish a practical method for isolation and purification of human amniotic membrane-derived mesenchymal stem cells, and to study the biological characteristics and dopaminergic neural-like celldifferentiation potential of the human amniotic membrane-derived mesenchymal stem cells. METHODS:Human amniotic membrane-derived mesenchymal stem cells were disassociated and isolated from the amniotic membrane by trypsin and col agenase based enzymic digestion, and purified by percol mediated density gradient centrifugation. Expressions of surface antigens and transcription factors of the human amniotic membrane-derived mesenchymal stem cells were determined by flow cytometry and western blot assays. Based on the osteogenic and adipogenic induction, the multipotent differentiation capability of human amniotic membrane-derived mesenchymal stem cells was determined. Induction of neural celldifferentiation of human amniotic membrane-derived mesenchymal stem cells was conducted in Neurabasal conditioning medium with ATRA supplement. Neural cellassociated bio-markers were determined by immunofluoresence staining and confocal microscope. RESULTS AND CONCLUSION:In this study, we performed a practical method to isolate and purify human amniotic membrane-derived mesenchymal stem cells and amniotic epithelial cells simultaneously, with high cells yield. We demonstrated a group of constitutive expressions of neural antigens and embryonic associated transcription factor proteins (OCT-4, SOX-2 and KLF4) in fresh isolated human amniotic membrane-derived mesenchymal stem cells as wel as in human amniotic membrane-derived mesenchymal stem cells after in vitro passage, which suggested that the human amniotic membrane-derived mesenchymal stem cells not only possessed intrinsic tendency to neural celldifferentiation, but also maintained their stem cellcharacteristics after in vitro passage. We stimulated the human amniotic membrane-derived mesenchymal stem cells in the neurobasal-A and B27 based conditioning medium to induce neural celldifferentiation. The induced human amniotic membrane-derived mesenchymal stem cells displayed an up-regulation of expression in panel of neural and dopaminergic associate molecules (β-tubulin III, neuron-specific nuclear protein, tyrosine hydroxylase, glial fibril ary acidic protein, myelin basic protein and nestin) by flow cytometry and immunofluorescence staining, which demonstrated the multipotent differentiation capability and dopaminergic neuron-like differentiation potential of the human amniotic membrane-derived mesenchymal stem cells.

Objective To investigate the protective effects of (-)-epigallocatechin gallate ( EGCG ) on daunorubicin ( DNR)-induced cardiotoxicity in mice. Methods The qualified mice were randomly divided into four groups:normal control group, myocardial injured model control group,high dose group (80 mg·kg-1 ) and low dose group (40 mg·kg-1 ) of EGCG. EGCG was administered intragastrically once daily for 7 days,followed by a single intraperitoneal injection of DNR (15 mg·kg-1 ) except in the normal control group. The electrocardiogram,myocardial enzymes and TNT-Hs in serum,cardiac ultrastructure of mice were detected after 48 h. Results In DNR model control group,the incidence of arrhythmia was 64. 7%. The activity of serum cardic enzymes including CK,CK-MB,LDH,α-HBDH and ALT,AST, level of TNT-Hs were significantly higher than those in the normal control group(P<0. 01),and myocardial ultrastructure was injured remarkably. The incidence of arrhythmia was 44. 4% in mice treated with high dose of EGCG and 31. 6% in mice with low dose of EGCG. Compared to the model control group, the activity of CK,CK-MB,LDH,α-HBDH and ALT,AST, level of TNT-Hs in serum decreased remarkably in EGCG groups( P<0. 05 or P<0. 01). Low can EGCG alleviated the injury to the ultrastructure of myocardium compared to the model control group. Conclusion EGCG can prevent the cardiac toxicity induced by DNR in mice.

Objective To explore the methods of the nutritional support of children with severe sepsis.Methods The biochemical index,nutrition index,blood gas,blood routine and 24 hours urinary urea nitrogen of 198 children with severe sepsis were detected after hospitalization.Enteral nutrition,parenteral nutrition,or enteral and parenteral nutrition at the same time were selected for every children according to patients status.Children with parenteral nutrition were divided into glutamine (Gln) group and non-Gln group.Nutrition and metabolism indexes of survival and dead children were detected,including blood glucose,C-reactive protein,hemoglobin (Hb),pH,blood sodium,blood potassium,alanine transaminase,blood urea nitrogen,creatinine,blood lacticacid,lactate clearance rate,blood triglycerides,blood total cholesterol,serum pre-albumin (PA),retinal-binding protein (RBP),serum albumin (ALB) and 24 hours urinary urea nitrogen.The intake of calories were compared between survival and dead children before nutrition support (0 d),3 d and 7 d after nutrition support.Immunoglobulins of Gln group and non-Gln group were compared.Results The nutrition indexes of the survival group were higher than those of dead group [PA (130.0 ± 30.0) mg/L vs (50.8 ±20.5) mg/L,RBP(22.3 ±10.3) mg/L vs (15.7 ±6.7) mg/L,ALB(35.3 ±8.1) g/L vs (28.7 ±6.2) g/L,Hb(113.2 ±27.7) g/L vs (95.3 ±10.6) g/L,IgA(0.40 ±0.03) g/L vs (0.40 ±0.03) g/L,IgM(0.52 ±0.18) g/L vs (0.49 ±0.03) g/L] (P ＜0.05).The intake calories of survival group in 3 d and 7 d after nutrition support were (50.32 ±2.76) kcal/(kg·d) and (65.70 ±3.25) kcal/(kg·d),which were significantly higher than those of dead group [(32.54 ± 1.72) kcal/(kg·d) and (46.12 ± 1.08) kcal/(kg·d)).Among the survival children with parenteral nutrition,the levels of immunoglobulin in Gln group were higher than non-Gln group [IgG(4.93 ± 2.1) g/L vs (4.01 ± 1.03) g/L,IgA (0.31 ± 0.07) g/L vs (0.19 ±0.03) g/L,IgM(0.52 ±0.08) g/L vs (0.32 ±0.10) g/L] (P ＜0.05).Negative nitrogen balance was better in Gln group as(-2.5 ± 1.4) g/d than non-Gln group as (-5.3 ± 1.3) g/d(P ＜0.05).Conclusion Children with severe sepsis manifeste significantly increased metabolic rate and energy consumption,the protein decomposition utilization is greater than the synthetic with negative nitrogen balance.Children with more severe sepsis have lower metabolic indexes,nutrition indexes,and immunoglobulin.It is necessary for children with severe sepsis to use glutamine while having parenteral nutrition.

Objective To study the neurological prognosis of neonates with ventriculomegaly and its influencing factors.Method A retrospective study was conducted among neonates with ventriculomegaly in Peking University First Hospital from January 2013 to December 2015.A series of cranial ultrasonography were performed after birth and the Gesell development scale was conpleted after six months.x2 test and two-independent-sample t test were used for statistical analysis.Result Among 103 cases of ventriculomegaly,95 cases (92.2％) had mildly enlarged lateral ventricles and 8 cases (7.8％) significantly enlarged.83 cases received serial cranial ultrasound examinations after birth.The lateral ventricles of 9 patients (10.8％) bacame wider and 74 (89.2％) not.The Gesell development scales were completed in 65 cases 6 months after birth.Among them,8 patients with widening lateral ventricles got poor prognosis (100％).Among 57 patients without progressively widening lateral ventricles,6 (10.5％) had poor prognosis.The difference was statistically significant (P ＜ 0.001).No correlation was found between the severity of the lateral ventricle widening and the neurological outcome (P =1.000).There were 2 cases with other abnormalities,and 1 case got poor prognosis on follow-up.Conclusion Most neonatal ventriculomegaly patients have mild and isolated lateral ventricle enlargement.Most of them remain stable or gradually return to normal.The patients with progressively widening lateral ventricles are likely to have adverse neurological prognosis.

Objective To investigate the characteristics of transperineal pelvic ultrasounds among middlelate gestational women and study the the correlation between middle-late gestation and stress urinary incontinence.Methods Seventy-four pregnant women at a gestation of 14-40 weeks were divided into the incontinence group (n =34) and the non-incontinence group (n =40).The bladder neck angle,the bladder neck rotation angle,the bladder neck movement degrees,the posterior urethra-vesical angle,and the urethral rotation angle at both inactivity and maximum Valslva activity were evaluated by pelvic ultrasound.The acquired data were treated and analyzed with t-test and correlation analysis with with P ＜ 0.05 considered statistically significant.Results Compared with the non-incontinence group,the bladder neck rotation angle,BND,bladder neck angle and posterior urethra-vesical angle during the maximum Valsalva activity in the incontinence group were all significantly larger (P ＜ 0.05).A moderate correlation between urethral rotation angle and gestation week in the incontinence was observed (P ＜ 0.05).Conclusion The changes of the supportive structures around bladder urethreal tissues in middle-late gestation women are obvious.The urethral rotation angle becomes larger with the gestation going on.

Objective To explore the prevalence and risk factors of stroke in a population over 40 years in a community in Shenzhen, China. Methods The subjects investigated were a population ≥40 years old in this cross-sectional study. Cluster sampling method was used to conduct the unified questionnaires, physical examination, and laboratory examination in the community residents, and then the survey data were used for online entry analysis. Results A total of 5 308 community residents were screened, and 160 experienced stroke. The crude prevalence of stroke was 3 014. 32/100 000. The prevalence of stroke increased with age, and that in males was significantly higher than that in females (3 721. 37/100 000 vs. 2 552. 93/100 000; χ2 = 5. 923, P = 0. 015). There were significant differences in the proportions of males, obvious overweight, hypertension, diabetes mellitus, atrial fibrillation, lack of physical activity, and family history of stroke, as well as age, systolic blood pressure, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and fasting glucose level between the stroke population and the non-stroke population (all P < 0. 05). Multivariate logistic regression analysis showed that hypertension (odds ratio [OR] 1. 737, 95% confidence interval [CI] 1. 161-2. 600; P = 0. 007), diabetes (OR 1. 917, 95% CI 1. 209-3. 040; P = 0. 006), atrial fibrillation (OR 1. 699, 95% CI 1. 113-2. 592; P = 0. 014), family history of stroke (OR 1. 585, 95% CI 1. 126-2. 231; P = 0. 008), advanced age (OR 4. 645, 95% CI 1. 868-11. 551; P = 0. 001), and physical inactivity (OR 4. 921, 95% CI 3. 552-6. 187; P < 0. 001) were the independent risk factors for stroke, and lack of physical activity was an independent protective factor for stroke. The proportion of smoking in males was more than that in females in all ages(all P < 0. 05). The proportions of hypertension (P < 0. 001) and hyperlipidemia (P < 0. 001) were gradually increased with age, and physical exercise was gradually reduced with age (P = 0. 001, except for subjects > 80 years) in both males and females. The proportions of diabetes (P < 0. 001) and atrial fibrillation (P < 0. 001) in males, and obvious overweight (P = 0. 001) in females were gradually increased with age, and the proportion of smoking in males weas gradually reduced with age. The proportions of hypertension (P < 0. 001) and obvious overweight (P < 0. 001) in males were significantly higher than those in females at the age of 40 to 49 years. The proportions of hypertension (P < 0. 001), diabetes (P < 0. 001) and obvious overweight (P < 0. 001) in males were significantly higher than those in females at the age of 50 to 59 years. The proportion of hypertension in males was significantly higher than that in females at the age of 60 to 69 years (P = 0. 039). The proportions of hypertension (P = 0. 016), atrial fibrillation (P = 0. 028) and hyperlipidemia (P = 0. 023) in females were significantly higher than those in males at the age of 70 to 79 years. The proportion of obvious overweight in females was significantly higher than that in males at the age of ≥80 years (P =0. 001). Conclusions The crude prevalence of stroke is higher among the community residents. The the levels of exposure to stroke risk factors including hypertension, diabetes and atrial fibrillation are higher. It may be important to intervene on these risk factors in community residents, especially in elders and those with family history of stroke.