OBJECTIVE:To prepare betamethasone gel and establish its quality control method. METHODS: Orthogonal experiment was carried out to optimize the formula of the base material and design the formula technology of betamethasone gel. The content of betamethasone in the gel was determined by UV-spectrophotometry with its stability investigated through centrifugalization,thermostabilization,cold-resistance and long-term tests. RESULTS: The preparation was off-white semitransparent gel,with its property identification in line with the standard specified in Chinese Pharmacopeia (2005 edition). The linear range of betamethasone was 6～36 ?g?ml-1 (r=0.999 9) and its average recovery rate was 98.88% (RSD=0.57%). The stability tests revealed no stratification of the gel. CONCLUSION: The preparation process is simple and the preparation is stable and controllable in quality.

In recent years, the incidence and mortality rate of invasive fungal infection have increased dramatically, and it is of great significance to develop novel antifungal agents with new chemical structure and new mode of action. In this review, novel antifungal lead compounds reported from 2007 to 2009 are reviewed. Moreover, their chemical structures, antifungal activities and structure-activity relationships have been summarized, which can provide useful information for future study of antifungal agents.

Objective: To investigate Fuzhengzhiqiu Granules' effect on ICAM-1(Intercellular adhesion molecule-1) and VCAM-1(Vascular cell adhesion molecule-1) expression in nasal mucosa of experimental allergic rhinitis. Methods: SD rats (n=64) were immunized by intraperitoneal injection of 200?g Ovalbumin (OVA) (1ml OVA-Al[OH] 3-saline suspension) on 1st, 2ed and eleven day. Normal control group rats A (n=16) were treated with the same methods except injecting OVA. 19th day, 0.1 ml of saline containing 10 mg of OVA was instilled into nasal cavity for 7 consecutive days. Normal control group followed by intranasal administration only with saline. The rats challenged into allergic rhinitis (n=64) were randomly divided into four groups: allergic rhinitis model group B (n=16); Fu zhengzhiqiu Granules treated group C (n=16); Fu zhengzhiqiu Granules treated group D (n=16, three times dosage used in group C); Xinqin Granules treated group E (n=16). All animals were treated for 15 days. The nasal mucosa of them were studied by immunohistochemical staining to observe the ICAM-1 and VCAM-1 expression. Results: Animal model of allergic rhinitis was established by using ovalbumin intraperitoneal immunization and nasal challenge. The number of positive immunoreactive cells (ICAM-1 and VCAM-1) was increased significantly in all the groups compared with normal controls. VCAM-1 expression was inhibited by giving with Fuzhengzhiqiu Granules (especially in group D) and Xinqin Granules (P0.05). Conclusion: Fuzhengzhiqiu Granules can decrease the expression of VCAM-1 in nasal mucosa of experimental allergic rhinitis, but no effect on ICAM-1.

Objective To explore the association between maternal methylene tetrahydrofolate reductase (MTHFR) C677T polymorphism and neural tube defects (NTDs). Methods CBM, VIP, CNKI, Wanfang, PubMed and Web of Science databases from set up to March, 2014 were electronically searched to identify case-control studies on the relationship between maternal MTHFR C677T polymorphism and NTDs. The data were quantitatively analyzed by RevMan 5.0 software. Results A total of 25 studies were selected including 2 282 cases and 3 420 controls. Overall, the pooled OR (with 95%CI) under co-dominant model and allele contrast were 2.28(1.60-3.24), 1.25(1.02-1.53) and 1.42(1.21-1.67). Subgroup analysis showed significant association between maternal MTHFR C677T polymorphism and NTDs susceptibility in Asian populations. Conclusion The present meta-analysis suggests that MTHFR C677T polymorphism is significantly associated with maternal risk for NTDs, especially in Asian populations.

Objective To observe the clinical curative effects of transvaginal surgery in treatment of uter -ine prolapse .Methods The clinical data of 301 cases of uterine prolapse in our hospital treated with transvagi-nal surgery were retrospectively analyzed .Results The surgeries of 301 cases were successful .Among the 114 cases with the first degree uterine prolapse,63 cases were cured(55.26%),25 cases were improved(21.93%), 23 cases were relapsed ( 20.18%) , and 3 cases were ineffectively ( 2.63%) .The clinical effective rate was 77.19%.Among the 178 cases with the second degree uterine prolapse ,101 cases were cured(56.74%),67 ca-ses improved(37.64%),and 10 cases were relapsed(5.62%).The clinical effective rate was 94.28%.Among the 9 cases with the third degree uterine prolapse , 1 case was cured ( 11.11%) , 5 cases were improved (55.56%),1 case was relapsed(11.11%),and 2 cases were ineffectively(22.22%).The clinical effective rate was 66.67%.Conclusion Transvaginal surgery is regarded as an good method for the first and second degree u -terine prolase because of its curative effects ,less pain ,low incidence of complications and quick recovery .Howev-er, it is ineffective and has a higher rate of recurrence for some cases of third degree uterine prolapse .

OBJECTIVE To analyze the risk factors and the drug-resistance of nosocomial acquired lung infection by Chryseobacterium meningosepticum.METHODS A retrospective investigation of the clinical correlative data and the drug sensitivity results of 60 cases with nosocomial acquired lung infection by C.meningosepticum from Jan 2004 to Jan 2006 was conducted in local hospital.RESULTS The patients were mainly distributed at ICU,respiration and neurosurgery wards.They had severe underlying diseases(100.0%),tracheal intubation(56.7%),central venous catheter(25.0%) and urine catheter(16.7%) treatments and applications of more than three antibiotics(68.3%).The drug-resistance of C.meningosepticum was serious.The antibiotic drugs which had higher susceptibility ratio were cefoperazone/sulbactam,fluoroquinolones,et al.CONCLUSIONS The main risk factors of nosocomial acquired lung infection by C.meningosepticum are severe underlying diseases,various invasive treatments,long-term hospitalization and inappropriate use of broad spectrum antibiotics.Clinical isolates are multi-drug resistant to many kinds of antibiotics.

Objective To investigate the drug resistant genes against carbapenems,aminoglycosides and quinolones and the molecular epidemiology of clinical isolates of Acinetobacter baumannii.Methods Forty non-duplicate strains of Acinetobacter baumannii were collected from clinical specimens in First Affiliated Hospital of Wenzhou Medical University.The identification of strains was conducted by Vitek 2 Compact system.The susceptibilities to antimicrobials commonly used were determined by agar plate dilution method and broth microdilution method.The presence of class B metalloenzyme-encoding genes (blaIMP,blaVIM,blaNDM,blaSIM,blaGIM),class D cabapenemase-encoding genes (blaOXA-23,blaOXA-48,blaOXA-58),16S rRNA methylase genes (armA,rmtB) and quinolone resistance-determining regions (QRDR) in gyrA and parC were detected by polymerase chain reaction (PCR) and sequenced.Chromosomal or plasmid location of blaOXA-23 and armA genes were assessed by Southern blot.Multiple loci sequence classification (MLST) was performed to analyze the molecular epidemiology of these strains.Results All of the 40 isolates were multi-drug resistant Acinetobacterbaumannii (MDR-AB) and showed high level resistance to all of the tested antimicrobial agents excluding colistin and tigecycline.The positive rates of blaOXA-23 and armA were 90％ and 95％,respectively.All of the 40 isolates carried QRDR mutations in gyrA and parC genes,leading to the Ser83→ Leu and the Ser80→ Leu amino-acid substitutions,respectively.Southern blot showed the chromosomal location of blaOXA-23 and armA genes.Six different ST (ST191,ST381,ST373,ST426,ST208 and ST207) were assigned for these isolates by MLST and the most dominant clones were ST191 (23/40) and ST381 (10/40).Conclusions The predominant cabapenemase-encoding gene and 16S rRNA methylase gene of Acinetobacter baumannii isolates in First Affiliated Hospital of Wenzhou Medical University are blaOXA-23 and armA,respectively,which may be located on the chromosome and vertically transmit the drug resistance.ST191 MDR-AB with blaOXa-23 and armA gene clonally spread in this hospital.

We retrospectively analyzed clinical and imaging data of 26 children with split cord malformations (SCMs). Based on Pang's classification, 14 SCMs were defined as type Ⅰ and 12 as type Ⅱ.Neural function was markedly improved in 20 patients postoperatively. Three of 4 children who did not undergo surgical treatment had neural function deteriorated. Two children lost follow-up. We suggest that Pang's Classification of SCMs may be useful in describing pathological changes and guiding surgical procedure; imaging examine (including MRI, CT and X-ray) would play a significant role in confirmed SCMs diagnosis; and surgical operation should focus on eliminate and prevent spinal cord damnification.

Objective To explore if any rules in electrocardiogram changes after transcatheter closure of perimembranous ventricular septal defects ( PMVSD ) . Methods We included all the 358 patients who have accepted transcatheter closure of PMVSD in our hospital between July 2006 to October 2014 and the electrocardiogram (ECG) done in hospital and during follow up in 1,3, 6 and 12 months after operation were all reviewed. Results No changes were found in heart rates and electrical axis during follow-up as compared to preclosure ECG. PR interval was shorter, the QRS duration and QT interval were longer than preclosure. Incidence rate of arrhythmia was 38. 0% ( 136/358 ) and incidence rate of serious arrhythmias ( including Ⅱ° or Ⅲ° atrioventricular block and complete left bundle branch block) was 5. 0%(18/358). Among the 180 patients who had ECG done in all follow up between the first 12 months post closure, the rates of new developed arrhythmias was 12. 8% ( 23/180 ) and severe arrhythmia was 0. 6%(1/180) during follow-up. Conclusions Incidence rate of serious arrhythmias after transcatheter closure of PMVSD is low and most patients have good clinical outcome.

Objective To evaluate the difference in coronary microcirculation and short term prognosis in patients with different collateral circulation and underwent elective percutaneous coronary intervention ( PCI) with complete occlusion of coronary artery. Methods The study included 42 patients who had been admitted in our hospital for NSTEMI or STEMI between 01/2012 to 12/2015 without receiving revascularization treatment and whose symptoms persisted for over 6 months. According to the results of coronary angiography and the Rentrop grade, the patients were divided into 2 groups: poor collateral circulation formation group (group A, Rentrop=0 -1, n=17) and well established collateral circulation group (group B, Rentrop=2-3, n=25). The basic clinical data and the result of coronary angiography were compared. A pressure-temperature sensor wire was used to measure index of mierocirculatory resistance ( IMR) immediately after PCI. An echocardiograph was used to measure left ventricular end systolic diameter ( LVEDd) and left ventricular ejection fraction ( LVEF) postoperatively and again at 3 months after operation to evaluate the changes in cardiac function. Results The IMR value of group A was significantly higher than group B (P﹤0. 05), the grade of collateral circulation had negative correlation with IMR value (r=-0. 671, P﹤0. 05). The mean changes in LVEDd in 3 months in group B was -0. 28 mm, while in group A was 5. 76 mm (P﹤0. 05). The mean changes in LVEF in 3 mouths in group B was 5. 36% and in group A was -3. 82% (P﹤0. 05). The grading of coronary collateral circulation had negative correlation with the changes of LVEDd in 3 months (r= -0. 669, P﹤0. 05), but had positive correlation with the changes of LVEF (r=0. 657, P ﹤0. 05). The IMR value had positive correlation with the changes of LVEDd in 3 months (r=0. 686, P﹤0. 05), but had negative correlation with the changes of the LVEF (r= -0. 664, P﹤ 0. 05 ) . Conclusions Patients with poor collateral circulation was more prone to coronary microcirculatory injury than patients with good collateral circulation. Patients with good collateral circulation and microcirculation had better prognosis after the revascularization of the infarction-related vessel.