Sepsis should be defined as life-threatening organ dysfunction caused by a dys-regulated host response to infection. Continuous renal replacement therapy (CRRT) is one of the methods for the clinical treatment of sepsis. For patients undergoing CRRT, rational antimicrobial therapy is very important for the control of patient's infection. However, during CRRT, there is no clear guideline for the dose adjustment of antibiotics. In this paper, we analyzed the effect of CRRT combined with antibiotics on sepsis treatment in China and abroad, and discussed its effect on antibiotic clearance, and provided reference for clinical work.

OBJECTIVE:To optimize the extraction technology of Bushen huoxue capsules. METHODS:Central composite de-sign-response surface method was used to optimize the extraction technology with the amount of water and boiling time as main fac-tors using normalized value of the contents of icariin and salvianolic acid B,the yield of dry extract as index. Validation test was al-so conducted. RESULTS:The optimal extraction technology was as follows as 15-fold water,reflux extracting for 75 min,extract-ing for 2 times. The deviation of measured value and predicted value was 0.000 3% in validation test. CONCLUSIONS:The cen-tral composite design-response surface method can be used to optimize the extraction technology of Bushen huoxue capsules with good prediction,and the technology is simple and stable.

【Objective】To investigate the therapeutic effect of Turbidity-resolving and Stasis-removing Prescription(TSP) for the treatment of nonalcoholic fatty liver disease(NFLD).【Methods】One hundred and thirteen NFLD patients were randomized into groups A and B according to their consulting order.Group A(N=61) received oral use of TSP 100 mL,bid,and group B(N=52) received oral use of ursodesoxycholic acid(UDCA) 150 mg,tid.The treatment lasted 2 months.【Results】The total effective rate was 85.2% in group A,superior to 51.9% in group B (P

Objective To construct a short hairpin RNA (shRNA) adenovirus vector targeting Aktl (protein kinase B1, PKBI/Aktl) and cyclooxygenase-2 (COX-2) and study its effects on the invasion and metastasis of SGC-7901 human gastric adenocarcinoma cells. Methods Aktl and COX-2 shRNA expression frames were subcloned to pGSadeno adenovirus vector by homologous recombination technology to construct pGSadeno-Aktl+COX-2 (rAdS-A+C) vector. After screening and amplification, the recombinant adenovirus vector was digested with PacI and transfected into SGC-7901 cells, the titer and transfection efficiency were detected by fluorescent microscopy. Aktl and COX-2 mRNA and protein expression was identified by real-time PCR and Western blot. MMP-2 and MMP-9 contents in control group SGC-7901、rAd5-HK and treatment group rAdS-A+C were detected by ELISA assay and transwell assay analyzed cell invasion and metastasis ability. Results Adenovirus vector rAdS-A+C was successfully constructed and it dramatically down-regulated Aktl and COX-2 mRNA and protein expression in SGC-7901 gastric cancer cells. MMP-2 and MMP-9 contents in treatment group rAd5-A+C were respectively (39.7± 1.7) ng/ml, (31.3±3.6) ng/ml, and they were lower than those in control group SGC-7901 (278.4± 15.5) ng/ml, (225.4±15.1) ng/ml and rAd5-HK (275.5±2.1) ng/ml, (226.0±23.3) ng/ml (P= 0.01, P=0.021). Transwell assay showed treatment group rAd5-A+C significantly inhibited the invasion and metastasis of SGC-7901 gastric adenocacinoma cells. Conclusions Adenovirus-mediated targeting Aktl and COX-2 shRNA can inhibit the invasion and metastasis of SGC-7901 human gastric adenocarcinoma cells.

ObjectiveTo explore the changes of degree attribute values and its significance of post-concussion syndrome (PCS) patients with tinnitus by the brain network research method based on graph theory.Methods34 PCS patients were chosen,including 17 PCS patients with bilateral tinnitus (PCS tinnitus group) and 17 PCS patients without tinnitus (PCS non-tinnitus group).Meanwhile,17 healthy individuals with the matched age,gender and educational background were recruited as the control.Degree attribute values of PCS patients with tinnitus were figured out with the brain network research method based on graph theory.Results(1)The degree attribute values of PCS patients without tinnitus at left orbital middle frontal gyrus (3.13±1.07),left thalamus (2.51±1.03),left superior temporal gyrus (3.67±1.31),right anterior cingulate cortex (3.13±1.25),right posterior cingulate cortex (2.13±1.08) and right supramarginal gyrus (4.46±1.35) were reduced compared with the control group (4.41±1.47,3.71±1.08,5.27±2.13,5.51±0.67,5.63±2.16 and 5.64±1.30) (P<0.05).The degree attribute values of PCS patients without tinnitus at left posterior cingulate cortex (5.87±1.06) and left gyrus lingualis (4.67±1.48) increased compared with the control group (4.41±1.46,3.21±1.27) (P<0.05).(2) The degree attribute values of PCS patients with tinnitus at left posterior cingulate cortex (3.37±1.54),left parahippocampal gyrus (3.41±1.62),left amygdala (2.25±1.43),left angular gyrus (4.17±1.02),left superior temporal gyrus (3.25±1.02),right thalamus (2.35±1.34),right Heschl gyri (3.97±1.62),right superior temporal gyrus (3.26±1.22),right cuneus (3.18±1.32) and right lingular lobe (3.26±1.42) were decreased,compared with the control group (4.41±1.46,5.27±2.13,3.71±1.08,5.63±2.61,5.64±1.30,3.43±1.33,5.63±2.16,5.13±1.64,5.51±0.67,4.24±0.63) (P<0.05).The degree attribute values of PCS patients with tinnitus at right posterior cingulate cortex (5.76±1.83),left MPFC (6.08±1.62) and right precuneus (6.08±1.06) were increased,compared with the control group (4.47±1.26,4.41±1.47,4.81±0.62) (P<0.05).(3)The degree attribute values of PCS patients with tinnitus at left MPFC,left amygdale,left parahippocampal gyrus,right Heschl gyri,right superior temporal gyrus,right cuneus and right lingular lobe were decreased,compared with PCS patients without tinnitus (P<0.05).The degree attribute values of PCS patients with tinnitus at right posterior cingulate cortex and left insular lobe increased,compared with PCS patients without tinnitus (P<0.05).ConclusionsPCS patients with tinnitus present the alteration of degree attribute in related brain network structure.The alteration in degree attribute of relevant brain zones in auditory system,limbic system and default network system may be important factors which result in tinnitus of PCS patients.

Objective To evaluate the effectiveness and safety of Botulinum toxin-A (BTX-A) injection into detrusor to treat neurogenic detrusor overactivity in patients with spinal cord injury (SCI).Methods A total of 78 patients with SCI were treated with transurethral injection of BTX-A (300 IU dissolved in 15 ml of saline) into 30 different points of detrusor with 15 ml in every patients. Urodynamic parameters and voiding diary were assessed at baseline and 3 weeks and 3 months after the injections. Adverse events were recorded after the injection if present.Results After the first injection, 78 patients showed that the mean frequencies of incontinence decreased from 13.5 to 2.7 times per day, the mean volume of intermittent catheterization (IC) increased from 131 ml to 389 ml per time, the mean volume of incontinence decreased from 1 690 ml to 281 ml per day, the mean getting effect time was 7.6 days. 10 patients received second injection at 8.9 months after first injection, the results showed that the mean frequencies of incontinence decreased from 9.7 to 3.7 times per day, the mean IC volume increased from 108 ml to 387 ml. 6 patients received third injection at 5.8 months after second injection, the results showed that the mean frequencies of incontinence decreased from 9.2 to 3.9 times per day, the mean IC volume increased from 116 ml to 364 ml. No side effects were observed during the follow-up.Conclusion BTX-A injection into detrusor to treat neurogenic detrusor overactivity in patients with SCI seems to be an effective, safe and miniinvasive solution.

Objective To construct a short hairpin RNA (shRNA) adenovirus vector targeting P85 and protein kinase B1 (PKB1/Akt1) and study its effects on the growth of SGC-7901 human gastric adenocareinoma cells. Methods P85 and Aktl shRNA expression frames were subcloned to pGSadeno adenovirus vector with homologous recombination technology to construct pGSadeno-P85 + Akt1 (rAd5-P + A) vector. After screening and amplification, the recombinant adenovirus vector was digested with PacI and transfected into SGC-7901 cells and then its titer and transfection efficiency were detected with fluorescent microscope. P85 and Akt1 mRNA protein expression was identified with real-time PCR and Western blot. The proliferative activity of tumor cells was evaluated with MTr assay and flow cytometry in vitro, rAd5-HK and rAd5-P + A mediated by adenovirus were injected into the established subcutancous SGC-7901 gastric adenocarcinoma in nude mice. During the observation period of 21 days, tumor volume was measured every 3 days to further testify the anti-tumor effect of rAd5-P + A on the SGC-7901 gastric adenocarcinoma cells and cell in situ apoptosis was detected with TUNEL assay. Results The adenovirus vector rAd5-P + A was successfully constructed and it dramatically downregulated P85 and Akt1 mRNA expression in SGC-7901 gastric adenocarcinoma cells. Compared with a control group of SGC-7901 cells and cells transfected with general adenovirus rAd5-HK as control, P85 and Akt1 protein expression 48 h and 72 h after rAd5-P + A transfection was decreased by 57.5% and 63. 7%, 67. 8% and 75.6% with statistical significance(P = 0. 005, P = 0. 003). Cell proliferative activity in rAd5-P + A transfected cells was suppressed from the second day (P <0. 001) and the decreased P85 and Akt1 expression was accompanied by 5.9% -7. 1% decrease of S phase fraction and 12. 1% - 13.7% increase of G0/G1 phase. The tumor volume of rAd5-P + A treated group was smaller than that of the control and rAd.5-HK group with statistical significance (F = 9. 871, P = 0. 025) . Moreover, rAd5-P + A could induce cell in situ apoptosis. Conclusions Adenovirus-mediated targeting P85 and Akt1 shRNA can inhibit the growth of SGC-7901 human gastric adenocarcinoma cells and this may provide a new strategy of combination gene therapy in gastric adenocarcinoma.

Objective To investigate the effect of Holmium laser urethrotomy under ureteroscopy on urethral stricture.Methods 30 men with urethral stricture who accepted urethrotomy with Holmium laser under ureteroscopy were observed.Results Operation was performed successfully in 21 cases;7 cases underwent 2～3 endoscopic surgical treatments.Endoscopic surgical treatment failed in 2 cases,and open surgery were performed on them.21 cases were followed up for 3～37 months,and 8 of them need urethral dilatation termly.Conclusion Endoscopic surgery with ureteroscopy and Holmium laser may be effective on urethral stricture with slight trauma.

Objective To evaluate the long-term outcome of reconstruction for urinary conti-nence function by using implantation of artificial urinary sphincter (AUS). Methods From 2002 to 2005,15 incontinent patients (14 men and 1 woman) with age range of 19-75 years treated with im-plantation of AUS were followed up. In 15 eases, there were 5 cases with traumatic urinary inconti-nence, 1 with neurogenic stress incontinence, 1 with neurogenic urgent incontinence,6 with postpros-tatectomy incontinence and 2 with neurogenie voiding dysfunction. Three eases had taken urethro-stenotomy, 3 had sphineterotomy and 1 had enterocystoplasty and ureterovesieostomy before the im-plantation for AUS. The patients were followed up for 13-55 months with mean of 37 months. The information about the continence status and pads usage, also the complications were collected. Results After implantation, 13 cases(87%)used AUS device normally, 12(92%)beeame dry and 1 (8%) got social continence. Eleven cases (85%) got continence depending on the original implanted AUS and 15% did continence by reoperation. There were 4 cases(27%) with complications including erosion of skin and urethral in 1, graft rejection in 1, urethral atrophy in 1, and voiding dysfunction in 1. Durability of 11 cases with original implanted devices was 13-55 months with mean of 38 months.Conclusion The implantation of AUS is a long-term reliable method in reconstruction for lower uri-nary tract function.

Objective To assess clinical and urodynamic results of augmentation enterocystoplasty (AE) in patients with ncurogcnic hladdcr dysfunction (NBD).Methods Retrospectively reviewed our database between 2005-2011 to identify 77 patients who underwent AE ( sigmoid 74 patients,ileum 3 patients).Postoperativc complications,renal function,urodynamics parameters and quality of daily life were evaluated.Results The mean follow-up length was 24 months.Compared with pre-operative condition,the mean bladder capacity significantly increased from (160.6 ± 128.3) to (468.5 ± 60.6) ml (P ＜0.001 ) and the maximum detrusor pressure decreased from ( 31.1 ± 26.4) to ( 10.9 ± 4.5 ) cm H2O ( P =0.002 ).Serum creatinine level decreased from (270.3 ± 113.6 ) to ( 174.4 ± 81.3 ) μmol/(l) ( P =0.00 1 ).There were significant decrease on mean number of incontinence episodes and pads used per day ( P ＜0.01 ).Post-operative complications included metabolic acidosis in two patients (2.6％),adhesive intestinal obstruction in four patients (5.2％),deteriorating renal function in one patients ( 1.2％ ) and recurrence of vesicoureteral reflux in three patients (3.9％).Conclusions The results suggest that AE is safe and effective in treating patients with NBD.Concomitant URI is considerèd on patients with long illness history,vesicoureteral reflux at low intravesical pressures and upper urinary tract dilation.Patients with moderate and severe upper urinary tract deteriorations benefit from this procedure and the benefit can maintain a long time.