OBJECTIVE To investigate the oropharyngeal bacterial carriage in hospitalized elderly patients without acute infections and the antimicrobial resistance,and the risk factors for the bacterial carriage.METHODS An oropharyngeal swab was taken from each patient after they rinsed their mouths with sterile saline.Bacteria were cultured and identified with routine methods and the antimicrobial susceptibility testing was carried out with disk diffusion method.RESULTS The oropharyngeal bacterial carriage rate was 55.2% in elderly patients.Sixty two pathogens were isolated including 56(90.3%) strains of Gram-negative bacilli,5(8.1%) Gram-positive cocci and 1 Candida albicans.All of 34 strains of Haemophilus spp were susceptible to antimicrobials tested such as ampicillin and cefaclor,a few strains were resistant to gentamicin and ciprofloxacin.Of 10 strains of Klebsiella pneumoniae,4 strains were extended-spectrum ?-lactamases positive and resistant to cefotaxime.Logistic analysis indicated that denture-wearing was the risk factor for the oropharyngeal bacterial carriage in elderly.CONCLUSIONS Oropharyngeal bacterial carriage rate is high in hospitalized elderly patients.The major colonized bacteria are Gram-negative bacilli.Denture-wearing is the risk factor for the oropharyngeal bacterial carriage in elderly.

Chinese medicine prescriptions are the wisdom outcomes of traditional Chinese medicine (TCM) clinical treatment determinations which based on differentiation of symptoms and signs. Chinese medicine prescriptions are also the basis of secondary exploitation of TCM. The study on prescription helps to understand the material basis of its efficacy, pharmacological mechanism, which is an important guarantee for the modernization of traditional Chinese medicine. Currently, there is not yet dissertation n the method and technology system of basic research on the prescription of Chinese medicine. This paper focuses on how to build an effective system of prescription research technology. Based on "component structure" theory, a technology system contained four-step method that "prescription analysis, the material basis screening, the material basis of analysis and optimization and verify" was proposed. The technology system analyzes the material basis of the three levels such as Chinese medicine pieces, constituents and the compounds which could respect the overall efficacy of Chinese medicine. Ideas of prescription optimization, remodeling are introduced into the system. The technology system is the combination of the existing research and associates with new techniques and methods, which used for explore the research thought suitable for material basis research and prescription remodeling. The system provides a reference for the secondary development of traditional Chinese medicine, and industrial upgrading.
Drug Prescriptions ; Medicine, Chinese Traditional

OBJECTIVETo explore the effect of Salvianolate on myosin heavy chain (MHC) in cardiomyocytes of congestive heart failure (CHF) rats.

METHODSSixty male SD rats were divided into 6 groups according to random digit table, i.e., the normal control group (NCG), the model group, the Captopril group (CAG), the low dose Salvianolate group (LSG), the high dose Salvianolate group (HSG), the Captopril and high dose Salvianolate group (CSG), 10 in each group. CHF rat model was established with peritoneal injection of adriamycin in all rats except those in the NCG. Equal volume of normal saline was peritoneally injected to rats in the NCG, once per week for 6 successive weeks. Corresponding medication was started from the 5th week of injecting adriamycin. Rats in the CAG were administered with Captopril solution at the daily dose of 10 mg/kg by gastrogavage. Rats in the LSG and the HSG were administered with Salvianolate solution at the daily dose of 24.219 mg/kg and 48.438 mg/kg respectively by gastrogavage. Salvianolate was dissolved in 2 mL 5% glucose solution and administered by peritoneal injection. Rats in the CSG were peritoneally injected with high dose Salvianolate solution and administered with Captopril solution by gastrogavage. Two mL normal saline was peritoneally injected to rats in the model group, once per day for 8 successive weeks. Eight weeks later, the cardiac function and myocardial hypertrophy indices were detected by biological signal collecting and processing system. mRNA expression levels of alpha-MHC and beta-MHC in cardiac muscle were detected by fluorescence quantitative PCR. Expressions of protein kinase C (PKC) in cardiac muscle were detected by Western blot.

RESULTSCompared with the normal control group, heart mass index (HMI) and left ventricular mass index (LVMI) obviously increased in the model group (P < 0.01). Compared with the model group, HMI and LVMI decreased in HSG, CAG, and CSG groups (P < 0.05, P < 0.01). It was more obviously lowered in the CSG group than in the CAG group (P < 0.05). Compared with the NCG, the mRNA expression level of alpha-MHC in cardiac muscle decreased, the mRNA expression level of p-MHC and the expression of PKC in cardiac muscle increased in the model group (P < 0.01). Compared with the model group, the mRNA expression level of alpha-MHC in cardiac muscle was increased, and the mRNA expression level of beta-MHC and the expression of PKC in cardiac muscle were decreased in HSG, CAG, and CSG groups (P < 0.05, P < 0.01). There was statistical difference between the CSG group and the CAG group (P < 0.05).

CONCLUSIONSSalvianolate could up-regulate the mRNA expression level of alpha-MHC, and down-regulate the mRNA expression level of beta-MHC in cardiac muscle. Its mechanism might be related to decreasing the expression of PKC.

Animals ; Captopril ; Doxorubicin ; Drugs, Chinese Herbal ; Heart Failure ; metabolism ; Male ; Myocardium ; Myocytes, Cardiac ; drug effects ; metabolism ; Myosin Heavy Chains ; metabolism ; Plant Extracts ; pharmacology ; Rats ; Rats, Sprague-Dawley

The purpose of the secondary exploitation of Chinese medicine is to improve the quality of Chinese medicine products, enhance core competitiveness, for better use in clinical practice, and more effectively solve the patient suffering. Herbs, extraction, separation, refreshing, preparation and quality control are all involved in the industry promotion of Chinese medicine secondary exploitation of industrial production. The Chinese medicine quality improvement and industry promotion could be realized with the whole process of process optimization, quality control, overall processes improvement. Based on the "component structure theory", "multi-dimensional structure & process dynamic quality control system" and systematic and holistic character of Chinese medicine, impacts of whole process were discussed. Technology systems of Chinese medicine industry promotion was built to provide theoretical basis for improving the quality and efficacy of the secondary development of traditional Chinese medicine products.
Chemistry, Pharmaceutical ; economics ; standards ; China ; Drug and Narcotic Control ; economics ; Drugs, Chinese Herbal ; chemistry ; economics ; standards ; Humans ; Medicine, Chinese Traditional ; economics ; standards ; Quality Control

Objective:　To report a method and remote therape utic effect of early nerve transposition in treatment of obstetrical brachial pl exus palsy. 　　Methods:　From May 1995 to August 1996, 12 patients who had no r ecovery of biceps 3 months after birth were treated with nerve transposition. Ei ght had neuroma at the upper trunk and 4 had rupture or avulsion of the upper tr unk. Mallet test was used to evaluate the results. 　　Results:　The follow-up of 40-52 months showed that excellent and good recovery in functions was found in 75% of the patients and the excellen t rate of phrenic nerve and accessory nerve transposition was 83.3% and 6 6.7% respectively. A complete recovery in shoulder and elbow joint function wa s in 3 patients and Mallet Ⅳ was in 6 patients. 　　Conclusions:　Satisfactory outcome can be obtained by using earl y nerve transposition in treating obstetrical brachial plexus.Paralysis, obstetric; Peripheral nerves; Nerve trans position

Objective: To investigate the anatomic basis of vascularized ulnar nerve graft by the pedicle of the superior collateral ulnar artery (SCUA).Methods: Twenty-two fresh cadaver upper extremities injected intra-arterially with latex were dissected to study the extrinsic blood supply of the ulnar nerve.Other 6 fresh upper extremities were used to analyze the blood supply range of SCUA inside the ulnar nerve by microangiographic and histological methods,Results: The ulnar nerve was supplied by a branch of the lateral thoracic artery or directly by the axillary artery in the axillary section, by branches of SCUA in the upper arm. And by branches from the anastomosis of the collateral arteries and the posterior branch of the recurrent ulnar artery in the elbow. SCUA could supply the whole ulnar nerve from the axilla to the wrist. Conclusions: The ulnar nerve can be used as a vascularized nerve graft by the pedicle of SCUA in treatment of brachial plexus roots avulsion by C7 transfer from healthy side.

A total of 101 patients undergoing operations for malignant gastrointestinal tumors (stage Ⅱ to Ⅲ) were enrolled and randomly assigned to receive intraperitoneal hyperthermal chemotherapy plus intravenous chemical injection (treatment group, n=51) or routine intravenous chemical injection (control group, n=50). Our results indicated that the recurrence rate and the metastatic rate in the treatment group were significantly lower than those in the control group (25.5% vs. 50.0%, 13.7% vs. 30.0%, both P< 0. 05), although the 3-and 5 year-survival rates were significantly higher (both P < 0. 05). Our data suggest that intraperitaneal hyperthermal chemotherapy plus general chemotherapy after surgery for malignant gastrointestinal tumors could effectively reduce tumor recurrence and metastases and improve long-term survival.

Sixty-one patients with moderate to severe malignant ascites were enrolled and randomly assigned to receive intraperitoneal hyperthermal chemotherapy+intravenous chemical injection (treatment group; n=31) or routine intravenous chemical injection (control group; n=30). Short-term response and reverse effects were observed. Our results indicated that the complete remission rate, part remission rate,and clinical benefit rate in the treatment group was significantly higher than those in the control group (38.71% vs 13.33% ,41.94% vs 16. 67%, and 90.32% vs 66.67%, respectively). No difference in reverse effects was found between the two groups. Our data suggest that intraperitoneal hyperthermal chemotherapy plus general chemotherapy may effectively control the malignant ascites, and the reverse effects might be well tolerated.

BACKGROUNDDelirium is a common and deleterious complication in critically ill patients after surgery. The purpose of this study was to determine the incidence and risk factors of delirium in critically ill patients after non-cardiac surgery, and to investigate the relationship between the serum cortisol level and the occurrence of postoperative delirium.

METHODSIn a prospective cohort study, 164 consecutive patients who were admitted to the surgical intensive care unit after non-cardiac surgery were enrolled. Baseline characteristics and perioperative variables were collected. Blood samples were obtained on the first postoperative day and serum cortisol concentrations were measured. Delirium was assessed using the Nursing Delirium Screening Scale until the seventh postoperative day or the disappearance of delirious symptoms.

RESULTSPostoperative delirium occurred in 44.5% of patients (73 of 164). The median time to first onset of delirium is 0 (range 0 to 5 days) and the median duration of delirium is 3 (1 to 13) days. Independent risk factors of postoperative delirium included increasing age (odds ratio (OR) 2.646, 95% confidence interval (CI) 1.431 to 4.890, P = 0.002), a history of previous stroke (OR 4.499, 95%CI 1.228 to 16.481, P = 0.023), high Acute Physiology and Chronic Health Evaluation II score on surgical intensive care unite admission (OR 1.391, 95%CI 1.201 to 1.612, P < 0.001), and high serum cortisol level on the 1st postoperative day (OR 3.381, 95%CI 1.690 to 6.765, P = 0.001). The development of delirium was linked to higher incidence of postoperative complications (28.8% vs. 7.7%, P < 0.001), and longer duration of hospitalization (18 (7 to 74) days vs. 13 (3 to 48) days, P < 0.001).

CONCLUSIONSDelirium was a frequent complication in critically ill patients after non-cardiac surgery. High serum cortisol level was associated with increased incidence of postoperative delirium.

Aged ; Critical Illness ; Delirium ; epidemiology ; etiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Postoperative Complications ; Prospective Studies ; Risk Factors

OBJECTIVETo study the non-taxoids in the leaves of Taxus mairei.

METHODThe chemical constituents were isolated by chromatography and identified by spectral data.

RESULTFive compounds, taxamairin A (1), taxamairin B (2), sciadopitysin (3), ( - ) matairesinol (4), ponasterone A (5) were isolated and identified.

CONCLUSIONCompounds 3-5 were isolated from this plant for the first time, compounds 1 and 2 were isolated from the leaves of T. mairei for the first time.

Biflavonoids ; chemistry ; isolation & purification ; Diterpenes ; chemistry ; isolation & purification ; Ecdysterone ; analogs & derivatives ; chemistry ; isolation & purification ; Furans ; chemistry ; isolation & purification ; Lignans ; chemistry ; isolation & purification ; Plant Leaves ; chemistry ; Plants, Medicinal ; chemistry ; Taxus ; chemistry