OBJECTIVE:To investigate the utilization of vancomycin in a hospital,and provide reference for the rational use of vancomycin. METHODS:Retrospective survey was conducted for the medical records of 180 inpatients using vancomycin from Jan. to Jun.,2015 in the hospital. The general information,usage and dosage and pathogenic examination were summarized,do-mestic vancomycin rational use evaluation criteria was conducted to evaluate the medication rationality,summarize and analyze cor-responding inappropriate questions. RESULTS:The vancomycin drug utilization index(DUI)of 180 cases was 0.88(mainly elder-ly patients);the microbial test sample submission rate was 84.44%(152 cases);there were 74 cases (41.11%) about the drug combination;32 cases(17.87%)about unauthorized use;37 cases(20.56%)about inappropriate use,in which inappropriate sol-vent(12 cases,32.43%)and inappropriate drug combination(11 cases,29.73%)were the main types. CONCLUSIONS:The clin-ical application of vancomycin is good with no abusing phenomenon,and the microbial inspection rate is qualified in the hospital. But there still exists some problems or shortcomings when using vancomycin,it is necessary to further standardize the medication monitoring of vancomycin to ensure patients’safety.

BACKGROUND:Core decompression and tantalum rod implantation after core decompression are common methods to repair early and middle stages of necrosis of femoral head, can effectively control and even reverse the progress of necrosis of the femoral head. Comparison of mechanical support and curative effect of femoral head after operation deserves further investigation. OBJECTIVE:To explore the effect of core decompression on mechanical pulp femoral head support by using the finite element analysis and the advantages of tantalum implant treatment in the repair of avascular necrosis of the femoral head. METHODS: The right femur of healthy adults was chosen as the research object, and CT scanning was conducted to get the images of cross-sections. The images were then inputted into computer to get contour of femur and rebuild three-dimensional model. Distal end of femur was completely fixed, the angle of the top of femoral head and the femoral shaft was 25°, and 570 N pressure on the femoral head was applied according to the three-dimensional space distribution of femur force under physiological state. Three-dimensional finite element models were calculated to get the colapse values in different necrotic areas of the femoral head before and after different repair methods. RESULTS AND CONCLUSION:After core decompression, colapse values were apparently increased, especialy in the weight-bearing area. With increased range of necrosis, colapse values also increased. After core decompression, colapse values decreased obviously after porous tantalum rod implantation. Although core decompression could remove dead bone, decompression itself further reduced the mechanical properties of the femoral head and changed the original femoral head support. On the basis of core decompression, porous tantalum rod provided safe and effective mechanical support for femoral head and subchondral bone plate, could effectively prevent colapse and provide conditions for the restoration of bone tissue.

Objective:To investigate the inhibitory effect of small interfering RNA-Yes-associated protein 1 (siRNA-YAP1) on epithelial-mesenchymal transition (EMT) in human lens epithelial cells (LECs) induced by transforming growth factor-β 2 (TGF-β 2). Methods:Human LECs line (HLEB-3) was cultured and divided into normal control group and TGF-β 2 induced group.The cells in the normal control group were treated with serum-free low-glucose medium for 24 hours, and the cells in the TGF-β 2 induced group were treated with additional 10 ng/ml TGF-β 2 for 24 hours.The cultured HLEB-3 cells were divided into siRNA empty vector group, siRNA-YAP1 transfection group, siRNA empty vector+ TGF-β 2 group and siRNA-YAP1+ TGF-β 2 group, and the cells were transfected with plasmid including siRNA empty vector or siRNA-YAP1 sequence according to grouping.The relative expression levels of YAP1 mRNA and protein in various groups were detected and compared by quantitative real-time polymerase chain reaction (PCR), immunofluorescence and Western blot assay, respectively.The relative expression levels of EMT marker proteins (E-cadherin and Vimentin proteins) in various groups were detected by immunofluorescence and Western blot assay. Results:Compared with the normal control group, the expression level of E-cadherin protein was decreased (1.180±0.118 vs.0.830±0.104) and the Vimentin protein was increased (0.797±0.110 vs.1.240±0.110) in the TGF-β 2 induced group, with significant differences between the two groups ( t=3.857, P=0.018; t=-4.933, P=0.008).The relative expression levels of YAP1 mRNA and protein in the TGF-β 2 induced group were significantly increased in comparison with the normal control group (2.200±0.193 vs.1.136±0.123; 1.203±0.121 vs.0.967±0.025), with significant differences between the two groups ( t=-9.288, P<0.01; t=-3.329, P=0.029).Compared with the siRNA empty vector group, the expression levels of YAP1 mRNA and protein in the siRNA-YAP1 transfection group were significantly reduced (both at P<0.01).Compared with the siRNA empty vector+ TGF-β 2 group, the relative expression level of E-cadherin protein was significantly enhanced and the expression level of Vimentin protein was significantly reduced in the siRNA-YAP1+ TGF-β 2 group (both at P<0.01). Conclusions:YAP1 participates in the TGF-β 2 induced EMT in human LECs, and siRNA-YAP1 can suppress the EMT process.

ObjectiveTo evaluate the effect of facial fat tissue grafting and remodeling with SMAS suspension in facial rejuvenation.MethodsThe treatment process of 12 patients with facial fat tissue grafting and SMAS-suspended rhytidectomy were reviewed retrospectively,the surgical operative procedure and treatment results of facial liposuction and autologous fat grafting with SMAS-suspended rhytidectomy were analyzed and evaluated.Results12 patients underwent facial liposuction,SMAS-suspended rhytidectomy and autologous free fat tissue grafting and remodeling.All the followed-up cases obtained good results without complications.ConclusionsCombined surgery of facial fat tissue remodel with SMAS-suspended rhytidectomy not only corrects the soft tissue laxity,but also modifies the faical volume loss.It solves the aging problems in different angles through soft tissue lift and volume restoration.It is a relatively ideal surgical method of facialplasty for those aged patients.

Objective To investigate the relationship of serum levels of human cartilage glycoprotein 39 (YKL-40) and oxidized low density lipoprotein (ox-LDL) with carotid atherosclerotic plaque in patients with cerebral infarction.Methods The levels of serum YKL-40 and ox-LDL were measured by enzyme immunoassay in 35 normal controls and 130 patients with acute cerebral infarction.Patients with acute cerebral infarction were divided into intima media thickness (IMT) of the common carotid group (30 cases),intima media thickened group (30 cases),plaque group (70 cases) according to their carotid artery sonography.Patients in the plaque group were divided into stable plaque group (33 cases) and unstable plaque group (37 cases).The serum levels of YKL-40 and ox-LDL were determined and compared among different groups.Results Serum levels of YKL-40 and ox-LDL in patients with acute cerebral infarction were (53.61 ± 27.63) ng/ml and (526.58 ± 207.39) mg/L,respectively; which were significantly increased compared to normal control subjects [(25.18 ± 12.69) ng/ml and (301.43 ± 107.53) mg/L,P ＜0.01].Among patients with acute cerebral infarction,the serum levels of YKL-40 and ox-LDL in carotid artery atherosclerosis group were (66.75 ± 28.29) ng/ml and (647.05 ± 198.54) mg/L,respectively;which were significantly increased compared to those of IMT of the common carotid group [(33.23 ±13.06) ng/ml and (366.43 ± 77.51) mg/L,P ＜ 0.01].The serum levels of YKL-40 and ox-LDL in unstable plaque group were (94.87 ± 20.86) ng/ml and (812.47 ± 150.12) mg/L,respectively; which were significantly increased compared to stable plaque group [(59.34 ± 19.17)ng/ml and (609.66 ± 112.96)mg/L,P ＜ 0.01].Serum levels of YKL-40 was significantly linearly correlated with those of ox-LDL (r =0.45,P ＜ 0.05).Conclusions The serum levels of YKL-40 and ox-LDL were significantly increased in patients with cerebral infarction compared to the normal the degree of carotid artery atherosclerosis and instability of atherosclerotic plaque.Patients with serious carotid artery atherosclerosis and instable plaque had higher serum levels of YKL-40 and ox-LDL.The serum levels of YKL-40 were positively correlated with oxLDL.

Objective To investigate the clinical significance of brain-derived neurotrophic factor (BDNF) from peripheral serum in patients of vascular cognitive impairment (VCI).Methods Forty VCI subjects (including 10 mild cognitive impairment vascular(MCI-V) and 30 vascular dementia(VD)),and the control group for the same period in 40 healthy persons.Enzyme-linked immunosorbant assay (ELISA) was used to measure the serum levels of BDNF,statistical analysis was performed.Results The peripheral serum levels of BDNF in VCI (0.175 ±0.056) ng/L were lower than those of control group (0.211 ±0.061) ng/L,and there were significant differences (t =-2.752,P ＜ 0.05).The levels of BDNF showed no significant difference between MCI and VD ((0.195 ± 0.067) ng/L vs.(0.168 ± 0.052) ng/L,t =1.310,P ＞ 0.05).But they were both significantly lower than the control group (F =4.590,P =0.013).No significant differences were observed in the levels of BDNF between subcortical small vessel dementia (0.178 ± 0.057) ng/L and big vascular dementia (0.154 ± 0.042) ng/L (t =1.278,P =0.212).Conclusion BDNF participate in pathophysiology of VCI,and the serum levels of BDNF may be a candidate marker for clinical diagnosis of VCI.But serum levels of BDNF could not reflect the severity or the type of the VCI.

Objective To investigate the diagnosis and treatment of mutinous cystadenoma of the pancreas.Method The clinical data of 12 cases with pancreatic mutinous cystadenoma was confirmed by pathology from May 2000 to May 2009 was retrospectively analysed.Results The accuracy rates of ultrasound,CT and MRCP were 50.0%(5/10),66.7%(6/9)and 83.3%(5/6)respectively.Pancreaticoduodenectomy,duodenum-preserving pancreatic head resection,distal pancreatic resection,distal pancreaticresection and splenectomy,segment pancreatic resection were performed according to the site of tumors.Completed resectable rate was 91.7%(11/12),palliative resection in 1 case,postoperative pancreatic leakage in 3 cases.2 cases cured;1 case died of intra-abdominal infection caused by pancake fistula 1 month later;1 case died of tumor recurrence and metastasis 25 months later.Conclusions Pancreatic cystic neoplasms is lack of specific clinical manifestations.Combined with application of imaging methods,can improve the diagnosis rate.Operation is the most effective therapy.The feasible procedures for mucinous cystadenoma of the pancmas should be choiced according to the site of tumors.

BACKGROUND:Establishing a highly successful, safe, reliable standard spinal cord transection model is the precondition of studying spinal cord injury repair. OBJECTIVE:To evaluate the value of preparing spinal cord transection model in rats and the effects of laminectomy on spinal cord. METHODS: We searched the randomized controled trials involving rat models of spinal cord transection in the databases of PubMed, CNKI, VIP and WanFang. RESULTS AND CONCLUSION:11 randomized controled trials (RCTs) met the inclusion criteria (two in English, 9 in Chinese), and a total of 394 rats were included in the study. There were significant differences in the lower limb motor function scores (BBB scores) within 1-6 weeks after injury (WMD=-12.86, 95%CI-16.10 to-9.62,P < 0.01) and electrophysiological indices within 4 weeks after injury (WMD=15.36, 95%CI 11.36 to 19.36,P < 0.01) between spinal cord hemisection group and laminectomy group. The BBB scores after 6 weeks were not significantly different between these two groups (WMD=-10.28; 95%CI-24.20 to 3.64;P=0.15). There were significant differences in the lower limb motor function scores (BBB scores) within 1-6 weeks after injury (WMD=

Objective:To observe lethal effect on liver cancer cells by the DCs transfected with recombinant plasmid pchIL -18-MAGE.Methods:Cultivate dendritic cells in vitro ,and recombinant plasmid pchIL-18-MAGE was constructed which was transfected into DCs.Expression of IL-18 and MAGE-1 on the transfected DCs were detected by RT-PCR and Western blot.The diversity of DCs phenotypes after transfect were analyzed by flow cytometry.Different killing effects to the target cells by lymphocytes which were stimulated by DC and those by non-transfected DC were detected.IFN-γin the cellular supernatant of the transfected DCs was inspected by ELISA.Results:pchIL-18-MAGE transfected DCs expressed higher level of CD 83,CD1a,CD86,CD80,HLA-DR,and expressed as a mature DC phenotype.pchIL-18-MAGE group′s killing activity was the highest ( P<0.05 ) .Conclusion: The DC vaccine pchlL-18-MAGE can induce better killing effect compared with other experimental groups.

Impaired clearance of apoptotic cells is important in the pathogenesis of autoimmune disease.C-reactive protein (CRP) is an acute phase protein that plays a major role in the regulation of the autoimmune and inflammatory response .CRP has a role in the clearance of bacteria and dying and altered cells through binding to phosphocholine and might also have more complex immunomodulatory functions . CRP function as opsonins for pathogens and dying and apoptotic cells through activation of the complement pathway and through binding to Fcγreceptors , and is associated with the clearance of apoptotic cells and nuclear antigen , thus becoming a protective molecule against pathogenic autoimmune responses in general . Measurement of serum CRP level is in widespread clinical use as a sensitive marker of inflammation and autoimmune disease , particularly in relation to the use of the CRP-based disease activity score in the evaluation of rheumatoid disease.