Objective To observe the therapeutic effect of clarithromycin combined with Cassia Twig-Poria Cocos capsule on patients with chronic pelvic inflammatory disease and its influence on high sensitivity C - reactive protein (hs-CRP). Methods 106 cases of patients with chronic pelvic inflammatory disease were selected to be divided into the observation group and control group with each group of 53 patients. The patients in control group were only given clarithromycin, on the base of control group, patients in observation group were given Cassia Twig-Poria Cocos. Both group were treated for three courses of 7-14 days. Then the therapeutic effect, adverse reactions, hs-CRP, erythrocyte sedimentation rate and hematocrit of patients were investigated. Results The total effective rate of patients in observation group was 90.57%, and the control group was 75.47%. The total effective rate of observation group was higher than control group with statistically significant difference (P<0.05). The hs-CRP, erythrocyte sedimentation rate and hematocrit of two groups both decreased after treatment (P<0.05) and these indexes of observation group was much less than control group (P<0.05). Besides, there was no difference of incidence of adverse reactions between two groups during the treatment. Conclusion Treatment of clarithromycin combined with Cassia Twig-Poria Cocos capsule on patients with chronic pelvic inflammatory disease not only can lessen inflammatory reaction, but also can improve the therapeutic effect effectively.

Objective The aim of this study was to investigate the effect of left-handed pantoprazole sodium on rat models of gastric ulcer generated by pyloric ligation .Methods The rat models induced by pylorus ligation were treated with a single intravenous injection of left-handed pantoprazole sodium .The gastric ulcer inhibition rate , volume of gastric juice, activity of pepsin, and level of serum gastrin were determined and gastric mucosa tissue was examined by pathology . Results The gastric ulcer index , volume of gastric juice , activity of pepsin and level of serum gastrin in the rats pretreated with left-handed pantoprazole sodium (0.9, 1.8, 3.6 mg/kg, i.v.) were significantly lower than those in the model group .The lesions of gastric mucosa were also improved in the pantoprazole-treated groups .Conclusions Left-handed pantoprazole sodium has remarkable protective effects on the gastric mucosa in rat models of gastric ulcer induced by pyloric ligation.

Objective To analyze the clinical value of Guizhi Fuling capsules combined with fosfomycin trometamol power in the treatment of pelvic inflammatory disease and pelvic effusion.Methods A total of 60 patients with pelvic inflammatory disease and pelvic effusion from February 2013 to March 2016 in our hospital were selected and divided into the control group and the observation group , 30 cases in each group.The control group were treated with fosfomycin trometamol power, and the observation group were additionally treated with Guizhi Fuling capsules.The therapeutic effects and changes of TCM syndrome scores were compared between the two groups.The levels of serum C reactive protein ( CRP ) in the two groups were determined before and after treatment and the ultrasound examination was performed and changes of pelvic effusion diameter was determined before and after treatment.Results The total effective rate of the observation group was higher than that of the control group, the difference was statistically significant (P<0.05).There was no significant difference in TCM syndrome scores between the two groups before treatment .After treatment, the TCM symptom scores of both groups were decreased, the difference was statistically significant ( P<0.05 ) .The scores of lumbosacral swelling pain, abdominal pain, morbid leucorrhoea increase, fatigue, low-grade fever and soreness of waist in the observation group were lower than those in the control group, the difference was statistically significant (P<0.05).Before treatment, there was no statistically significant difference in pelvic effusion and CRP levels between the two groups.After treatment, the pelvic effusion diameter and CRP levels were decreased, the difference was statistically significant (P<0.05), and those in the observation group were lower than the control group, the difference was statistically significant (P<0.05). Conclusion Guizhi Fuling capsules combined with the fosfomycin trometamol power is significantly effective in the treatment of pelvic inflammatory disease and pelvic effusion.It can significantly reduce the inflammatory reactions of patients, and improve the TCM syndrome scores.

ObjectiveTo observe the efficacy of maintenance hormonal treatment after response to chemotherapy in advanced breast cancer. Methods8 patients with advanced breast cancer were treated with chemotherapy,maintenance hormonal therapy were given after response to chemotherapy.The efficacy was evaluated every 2 cycles of chemotherapy and 2 months of endocrine therapy according to RECIST standard.Results8 patients received chemotherapy for 2-8 cycles (median 4 cycles). All patients got PR, the duration of chemotherapy was 1-6 months (median 2 months), the time to failure of chemotherapy was 4 months. Until the last follow-up day (31th December 2010), the time to progression was 6-86 months (median 13.5 months).Survival was 6-86 months(median 21.5 months).Seven patients quit the chemotherapy due to severe side effects of hematologic toxicity,fatigue or nausea vomiting.One patient died because of allergy to paclitaxol.Conclusion Maintenance hormonal treatment after patients with metastatic breast cancer response to chemotherapy may prolong the duration of effective therapy and improve the QOL.

Objective To conduct a retrospective study about drug-induced hyperthermia (DIH) based on DIH data obtained in medical practice,and elucidate the relationship between DIH incidence and antibacterials overuse.Methods To investigate successively the medical records of inpatients from orthopaedics department in Fudan university affiliated Jinshan hospital at two different periods,and data of DIH cases were extracted to perform a comparative study.The period for 229 effective cases of group Ⅰ was from Feb.1 to Apr.30,2011,before significant improvement on antibacterials use.The period for 342 effective cases of group Ⅱ was from Jul.1 to Sep.30,2012,after the effective enforcements of regulation on antibacterials use.Inclusion criteria for DIH were:①an oral temperature ≥37.6 ℃ since postoperative day 4,②no evidence of infection,③a time relationship between fever and the administration of causative drugs:a fever occurring with drug administration and disappearing after drug cessation within 3 days,④no other causes for the fever,⑤oral temperature ≤ 37.6 ℃ until leaving hospital.Exclusion criteria for DIH were listed below:①possible pathological fever,e.g.,in cancer,②hospitalization within 3 days,③no surgery,④severe trauma,for example,visceral or central nervous system injury.Results All causative drugs were for injection.By comparison,duration of antibacterial administration is significantly shorter in group Ⅱ than in group Ⅰ (1.7 ± 1.7 vs.4.6-± 1.8days,P ＜ 0.01),and total DIH incidence and antibacterials related DIH incidence were significantly lower in group Ⅱ than in group Ⅰ (7.3％ vs.30.1％,1.5％ vs.25.3％,both P ＜0.01).Conclusion DIH incidence is related with drug type especially with antibacterials overuse,and changed with drug program.DIH was more serious for injection of antibacterials than injection of traditional Chinese medicine.Decrease of antibacterials usage is positively associated with the decreased DIH incidence.Safe medication should begin from safe usage of antibacterials.

Objective To investigate the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) at different intensities on the ultrastructure of an ischemic brain penumbra and the expression of brainderived neurotrophic factor (BDNF) using rats with permanent middle cerebral artery occlusion (MCAO).Methods Forty-two rats were randomly divided into a blank control group,an MCAO model control group,a sham stimulation control group and an rTMS group.The rTMS group was divided further into 3 subgroups:an 80％ of motor threshold (MT) subgroup,a 100％ of MT subgroup and a 120％ of MT subgroup.The cerebral infarction model was established by right MCAO.rTMS treatment was given 24 hours after the MCAO model was successfully established.The rTMS group and sham stimulation control group were given 20 Hz rTMS with the planned intensities.The MCAO model control group was not given any stimulation.After 14 days of treatment,transmission electron microscopy,immunohistochemical and Western blotting ( WB ) methods were used to investigate the ultrastructure of the ischemic penumbra and the expression of BDNF.Results Damage reflected in the ultrastructure in the 3 rTMS subgroups was less than in the model control group and the sham stimulation control group.Expression of BDNF protein increased significantly in 100％ of the MT group and blank control group rats as compared with that in the sham stimulation control group,while the blank control group and the 3 rTMS subgroups had no statistically significant difference in comparison with the MCAO model control group.The expression of BDNF protein had no statistically significant difference between any of the groups.Conclusion 20 Hz rTMS might,especially at 100％ of the MT,promote the recovery of the ultrastructure of neural tissues in the ischemic penumbra after acute cerebral infarction and enhance the expression of BDNF in the ipsilesional hemisphere.This may be one of the important mechanisms of rTMS's effectiveness in the treatment of ischemic stroke.

Objective To compare and evaluate the clinical efficacy and side effect of vinorelbine plus gemcitabine and vinorelbine plus cisplatin combinations in advanced non-small-cell lung cancer(NSCLC). Methods 56 cases with non-treated advanced NSCLC were unrandomly divided into two groups: the GN group (27patients) treated with vinorelbine plus gemcitabine, the NP group (29 patients) treated with vinorelbine plus cisplatin,1/3 weeks×2～6 cycles. Results For the GN group, the overall response rate was 37.7 %, MTTP was 5.1months,one year survival rate (1-ySR) was 40.7 %. There were no significant difference in the response rates and the survival rates for the GN group compared with the NP group (P ＞0.05); But on the side effect of toxicities, WHO grade anemia and nausea/vomiting and tiredness of the GN group was significantly milder than the NP group (P ＜ 0.05). Conclusion Vinorelbine combined Gemcitabine regimen (GN) is active and well-tolerated. It is worth to investigate GN recommended as the first line chemotherapeutic regimen for the treatment of patients with advanced NSCLC.

Objective To study the inhibitory effect of antimicrobial peptide LL-37 on Candida albicans through its ability to promote the secretion of immune factors by vaginal epithelial cells. Methods (1) LL-37 prokaryotic expression vector pET-Duet/LL-37 was constructed and its expression was induced in Escherichia coli M15. The expressed LL-37 fusion protein was purified and identified by western blot. Antifungal activity of the purified protein was initially identified by Kirby-Bauer (K-B) method. (2) Purified LL-37 protein was added to human vaginal epithelial cells co-cultured with Candida, and inhibitory effect on Candida growth was determined by the glucose consumption method. Interferon γ (IFN-γ), interleukin 10 (IL-10) concentration and IFN-γ/IL-10 ratio were measured by ELISA at different time points. Results (1) LL-37 fusion protein was purified to 96% purity at a concentration of 433.92 μg/ml, and was shown to possess anti-fungal activity confirmed by the K-B method. (2) A Candida-vaginal epithelial cells co-culture system was successfully constructed. LL-37 recombinant protein inhibited the growth of Candida with absorbance values significantly higher in the treatment group compared to the control group at all measured time points (12-hour:3.008±0.003 versus 2.967±0.003, 24-hour:2.941±0.003 versus 2.601±0.003, 48-hour:2.893 ± 0.004 versus 2.409 ± 0.003; all P<0.01). Furthermore, the rate of decrease was also much slower compared to the control group. In both control and experimental groups, IFN-γ and IL-10 secretion levels were observed to rise at first peaking at 24 hours and subsequently decrease. For each time period, IFN-γconcentration in the experimental group was significantly higher at 24 hours compared to the control group [(104.00 ± 1.07) versus (85.17 ± 0.28) pg/ml, P<0.01]. In contrast, IL-10 concentrations were significantly lower than the control group at all time points (P<0.01). IFN-γ/IL-10 ratio was also observed to be significantly higher than the control group at all measured time points (P<0.01). Conclusions (1) Recombinant protein LL-37 could significantly inhibit the growth of Candida. (2) By influencing the secretion of immune factors such as IFN-γ, IL-10, etc, recombinant protein LL-37 is able to adjust vaginal epithelial cells local immunity, and enhance resistance to Candida infection.

Objective To investigate the effects of 20 Hz repetitive transcranial magnetic stimulation (rTMS) with different intensities on neurobehavior and expression of glial fibrillary acidic protein (GFAP) in ischemic penumbra of rats with cerebral infarction,so as to explore the probable mechanism. Methods Forty-three rats were randomly divided into a blank control group( n =7 ),a model control group( n =7),a sham stimulation control group(n =8) and a rTMS group (n =21) ; the rTMS group was further subdivided into 3 subgroups:80％ MT subgroup,100％ MT subgroup and 120％ MT subgroup,with 7 rats in each subgroup.The cerebral infarction model was established by right middle cerebral artery occlusion (MCAO) in each group except the blank control group.The 3 rTMS subgroups were given 14 successive blocks of 20 Hz rTMS with corresponding intensity.The sham stimulation control group received sham treatment (without any output).The model control group was given no stimulation,and the blank control group did not receive any special treatment.Functional assessments were performed at 3 different time points.After 14-day treatment,the expression of GFAP proteins in ischemic penumbra were detected by immunohistochemistry technique. Results Functional outcome reflected from 3 behavioral tests in 100％ MT subgroup after 14-day stimulation was better than 1 day after operation,while in the other rTMS subgroups functional outcomes were just better in 2 behavioral tests.The expressions of GFAP in 3 rTMS subgroups were all less than that in model control group. Conclusions The 20 Hz rTMS with 80％ MT and 100％ MT might be safe and effective to improve the functional outcome in rats with acute cerebral infarction,especially 100％ MT.Decrease of expression of GFAP in ischemic penumbra might be one of the mechanisms of beneficial effects of rTMS in ischemia brain injury.

AIM:To observe the effect of plumbagin on the mRNA and protein expression of nicotinamide ade -nine dinucleotidephosphate oxidase 4 ( Nox4 ) , reactive oxygen species ( ROS ) level and protein expression of α-smooth muscle actin (α-SMA) in the HSC-LX2 cells stimulated with transforming growth factor β1 (TGF-β1) in vitro.METH-ODS:HSC-LX2 cells were cultured in vitro and divided into blank group, model group, high-, medium-and low-dose (2, 1.5 and 1 μmol/L) plumbagin groups .After incubated with each drug for 72 h, the mRNA expression of Nox4 was detec-ted by RT-PCR.ROS levels were tested by in situ loading probe method.The protein contents of Nox4 and α-SMA were measured by Western blot .RESULTS:Compared with model group , after treated with plumbagin for 72 h, the mRNA ex-pression of Nox4, ROS level and α-SMA protein were significantly decreased in high-and medium-dose plumbagin groups (P<0.01).CONCLUSION:Plumbagin inhibits the activation of HSC-LX2 cells via decreasing the expression of Nox4, thus decreasing ROS levels .