Anti-Infective Agents ; administration & dosage ; Clinical Competence ; Hematologic Diseases ; Hospitals, Special ; manpower ; Humans ; Medical Staff, Hospital

Acupuncture Therapy ; instrumentation ; methods ; Adult ; Aged ; Female ; Hot Temperature ; Humans ; Male ; Middle Aged ; Needles ; Spondylosis ; therapy ; Treatment Outcome ; Young Adult

Objective To investigate distributions and drug resistance of pathogens in cirrhotic ascites comphcated with spontaneous bacterial peritonitis (SBP). Methods Results of bacterial culture and drug sensitivity tests of 117 aacitie specimens from cirrhotic patients with SBP were analyzed retrospectively. Results From the 117 ascitie specimens, 117 bacterial strains were isolated, among which 71 (60.68%)were gram-negative bacteria, 45 (38.46%) were gram-positive bacteria. The isolated strains were highly resistant to antibacterial agents, especially for Escherchia coli and Staphylococcu, the resistances to most antibiotics were above 60%. Conclusions High drug resistances were common for pathogenic bacteria in aacites of liver cirrhosis patients complicated with SBP.

Objective To evaluate the biomechanical characteristics of the long U-shaped hollow pedicle screw system for percutaneous fixation of thoracolumbar fractures.Methods Models of vertebral compression fracture were created by flexion in 8 fresh cadaveric samples of thoracolumbar spine.The models were divided into 2 equal groups according to the fixation system applied.In group A conventional pedicle screws were used while in group B long U-shaped hollow pedicle screws were used.The yield compressive strength,axial compression stiffness,bending stiffness,torque and torsional stiffness of all the fixated spines in the 2 groups were tested by the bio-mechanical electrical measurement and compared as well.Results The conventional pedicle screws and long U-shaped hollow pedicle screws showed no significant differences regarding yield compressive strength (3450.02 ± 110.03 MPa vs.3430.04 ± 102.12 MPa),axial compressionstiffness (407.52 ± 33.02 N/mm vs.395.04 ± 26.46 N/mm),bending stiffness (305.14 ± 26.53 N · cm/Degvs.295.12±23.80 N · cm/Deg),torque (6.45±0.25 N · m vs.6.25±0.21 N · m) or torsional stiffness (0.54±0.04N·cm/Degvs.0.52±0.03N·cm/Deg) (P＞ 0.05).Conclusion The long U-shaped hollow pedicle screw system can satisfy the biomechanical requirements for fixation of thoracolumbar fractures and can function as well as the conventional pedicle screw system.

Objective To investigate the virologic responses to pegylated-interferon alfa-2a (PegIFNα-2a) plus ribavirin therapy for cryoglobulinemia positive chronic hepatitis C in patients with hepatitis C virus (HCV) genotype 1 b.Methods Clinical data on 60 chronic hepatitis C patients with HCV genotype 1b were collected from Huzhou Central Hospital during January 2008 and December 2012.The patients were divided into cryoglobulinemia positive group (n =22) and cryoglobulinemia negative group (n =38),and both received 48-week PegIFNα-2a (180 μg) plus ribavirin treatments.For those who could not tolerate the treatment,PeglFNα-2a was reduced to 135 μg from 12th week.Rapid virologic response (RVR),end of treatment virologic response (ETVR) and sustained virologic response (SVR) in two groups were observed and compared using Chi-square test.Results RVR,ETVR and SVR in cryoglobulinemia positive group were 59.1％ (13/22),81.8％ (18/22) and 31.8％ (7/22),while those in cryoglobulinemia negative group were 55.3％ (21/38),76.3％ (29/38) and 60.5％ (23/38).There was significant difference in SVRs between two groups (x2 =4.674,P ＜ 0.05).For those completed full course of antiviral therapy with 180 μg PegIFNα-2a,the RVR and SVR in cryoglobulinemia negative group tended to be higher than those in cryoglobulinemia positive group,but the differences were not statistically significant (x2 =1.524 and 1.009,P ＞ 0.05).Serious adverse reactions were observed in 9 (40.9％) patients of cryoglobulinemia positive group,while in 11 (28.9％) patients of cryoglobulinemia negative group (x2 =0.887,P ＞ 0.05).Conclusion Cryoglobulinemia may not have considerable impact on virologic responses to PegIFNα-2a plus ribavirin therapy in patients with chronic genotype 1b hepatitis C.

Acute Disease ; Combined Modality Therapy ; Humans ; Pancreatitis ; therapy ; Pancreatitis, Acute Necrotizing ; therapy

Several hot questions such as selection of patients and favorable time of transplantation, design of conditioning regimen, monitoring of chimerism and complication of graft versus host disease (GVHD) in allogeneic hematopoietic stem cell transplantation following reduced intensity regimen (RIC-HSCT) as salvage therapy for refractory leukemia are discussed in this article. More and more investigators began to recognize that it was not a fundamental to undergo transplantation in complete remission for patients with refractory leukemia, since it may expend patients' physical status. RIC-HSCT may be substantially considered as a kind of adoptive immunotherapy, so that immunologic attacking targets and the latency of immunoreactian must be considered when making the decision to use, lacking of attacking targets and rapidly growing diseases seemed to be less susceptible to control. Commonly used reduced intensity regimens differed significantly, but it was clear that dose intensity was very important in refractory leukemia. In fact, many investigators used intermediate dosage between criteria of non-myeloablative and conventional myeloablative regimens. Complete donor chimerism is the hallmark of engraftment but often delayed in RIC-HSCT. Since sustained complete donor chimerism induced persistent graft-versus-leukemia (GVL) effect play an important role in patients' long-term survival, it was recommended that sensitive techniques (eg. STR-PCR) should be used to analysis chimerism and should be measured more frequently (every 2-4 weeks), and lineage-specific chimerism (eg. T cell) analysis was also recommended. As compared with traditional HSCT, the incidences of acute and chronic GVHD are similar and the onset of GVHD is associated with the GVL effect. Decrease or interruption of immunosuppressive drugs early after transplantation and donor lymphocyte infusion may facilitate transformation to complete donor chimerism, so that it may benefit patients with advanced disease at time of transplantation from avoiding disease relapse in one hand, but may induce GVHD in the other hand.

The myelodysplastic syndrome(MDS) comprise a heterogeneous group of clonal disorders.A unique aspect of MDS is the notion that both bone marrow failure and the propensity toward development of acute leukemia coexist. Origin of abnormal clone with MDS occurs at the level of multipotent progenitors or above it. Recently some kinds of MDS were observed the abnormal clone has been potentially originated from normal CD+34 CD-38 Thy-1 + hematopoietic stem cells. The abnormal clones with different chromosomal abnormality have different distribution. With the propotion of abnormal clonality increasing MDS has aggravated. Coherent result will provide new insight into the clinical diagnosis, treatment and prognosis of MDS by strengthening the research of MDS clonality.

Objective To study the changes in the expression of GABA and its receptors in the dorsal horn of rat spinal cord induced by hind paw formalin injection. Methods Twelve healthy male SD rats weighing 300-325 g were randomly divided into two groups: (A) control group (n=6) and (B) peripheral inflammatory hyperalgesia group in which 5% formalin 50?l was injected subcutaneously into the plantar region of right hind paw to produce persistent pain(n=6). The animals were killed 24h after formalin injection. L_(4-6) segment of the spinal cord was removed. The number of GABA immuno-reactive cells was examined by immuno-cytochemistry technique and the exprpession of GABA_(A?3) and GABA_(B1) receptor mRNA in the spinal dorsal horn were determined by in situ hybridization. Results In control group(A), GABA immuno-reactive cells and GABA_(A?3) and GABA_(B1) receptor mRNA were observed throughout the lumbar spinal dorsal horn. The density of GABA immuno-reactive cells and GABA_(B1) receptor mRNA was highest in the superficial laminae Ⅰ-Ⅲ; while the GABA_(A?3) receptor mRNA was evenly distributed in the spinal dorsal horn. In group B, 24h after formalin injection there was a significant increase in the GABA immuno-reactive cells in the ipsilateral spinal dorsal horn. The expression of GABA_(A?3) and GABA_(B1) receptor mRNA were significantly increased in bilateral dorsal horn compared to group A. The three parameters were positively correlated and their locations in the spinal dorsal horn were not significantly different from those in group A. Conchusion GABA and its receptors may play an important role in nociceptive modulation.

Total glucosides of paeony (TGP)is used to treat rheumatoid arthritis(RA)as the first immunoregulatory drug in clinic.The efficacy of TGP in treating RA patients is definite, which is accompanied with mild adverse reaction and slow effects simultaneously.Paeoniflorin (Pae ),the main constituents of TGP,has a bioavailability of 3% ~4%,which may be served as the main reason for its slow effects.Therefore,in this paper,the pharmacokinetics of Pae as well as its influencing factors were re-viewed on basis of pulished papers.In addition,some problems about Pae were also discussed.