Objective To investigate the factors that might influence the effectiveness of treatment for cryptococcal meningitis. Methods Retrospective analysis was conducted for 11 patients with cryptococcal meningitis admitted to Peking Union Medical College (PUMC) Hospital during 1980-1995. Results Seven of 11 patients with cryptococcal meningitis were successfully cured with combination of amphotericin B and flucytosine for 14 to 31 weeks (five months in average), paraventriculostomy was performed in five of them with hydrocephalus complicated with deteriorated mental status and one of them was administered with additional fluconazole for 15 days during its early stage of therapy. Four of the 11 patients died from cryptococcosis during the course of antifungal therapy. The duration of illness varied from three weeks to four and a half months (two months in average) . And four of them had underlying illness with steroids / cytotoxic therapy and another one had AIDS. Factors associated with unfavorable outcomes included more rapidly progress of the illness (2/11), delay in diagnosis and antifungal therapy, severe impairment of host defense mechanisms against infection, underlying illness involving central nervous system, and significantly abnormal cerebrospinal fluid for a sustained period. Conclusions Cryptococcal meningitis could hardly be diagnosed earlier. Combination of antifungal therapy with paraventriculoatomy at adequate time, if necessary, was effective in treatment for it.

0.05).However,there was significant difference in E-selectin expression among each postmortem stability group of which skin samples were kept at 25℃ degree as compared with the wounded skin at 0h after injury(P

OBJECTIVE: To prepare doxycycline hydrochloride microspheres and to establish a method for its quality control.METHODS: O/O emulsion solvent evaporation method was adopted to prepare doxycycline hydrochloride microspheres with poly (lactic-co-glycolic acid) (PLGA) as carrier.Light microscope was used to detect appearance and particle size of microspheres and UV spectrophotometry was applied to determine the loading rate and release rate of drug in vitro.RESULTS: Prepared microspheres are smooth and round with mean particle size of (49?6.9) ?m and span of 0.9.Average drug loading rate was (3.3?0.2) % and encapsulation efficiency was (52.4?3.2) % (n=3).Accumulative drug release reached 28% within 0.5 h with constant drug release lasting more than 30 days.CONCLUSION: Doxycycline hydrochloride microspheres preparation process is available and controllable in quality.

Objective To observe the efficacy of Botulinum toxin type A(BTXA)injection in Meige's syndrome and facial wrinkles and exp lore the method of reducing the side e ffect of BTXAand weaken facial wrink les.Methods Ninety-nine patients were evaluate d on the therapeutic efficacy of single and multiple topical facial in-jection with BTXA.Results The effective rates of patients with blepharospasm were 98.4%,oromandi bular dystonia 90.9%,blepharospasm and o romandibular dystonia 95.8%,respectively.The therapeutic effect for each disease lasted(16.9?8.4)weeks?(12.6?5.4)weeks and(13.5?5.7)weeks,respectively.Facial wrinkl es of all patients has got weakened and seemed much smooth and flattend.The rec overy rate approached to 100%.The local side effects were transient an d mild,and disappeared spontaneously.Conclusions The treatment of Meige's syndrome and facial wrinkles with BTXA could produce a significant impro vement,and is safe.Strictly observ e the procedures of injection,and use adequate dose of BTXA,the side effects o f BTXA can be decreased.

To reduce and avoid the contradiction caused by the right of privacy in nursing practice, the author analyzed problems of patients'privacy in nursing: distance between nursing staffs cognition and practice; doctors' opinion is different from nurses'; the contradiction between privacy and informed consent; problems of privacy relate to bed side teaching; new contents brougth out by science development. Aiming at the problems, the author puts forward corresponding countermeasures: to enhance the study of law; to balance the right to privacy and informed consent; to respect patients'privacy, strengthen communication with patients; and to understand new contents about ethics.

BACKGROUND:Oral insulin iS easy to be degradated by hydrochloric acid in gastric iuice and the enzyme which exists in stomach and intestines,while it is dimcult to through the epithelium cell membrane of gastrointestinal.Even a lasting-long injection iS taken,and it still needs an injection once 36 hours.OBJECTIVE:To prepare oraI insulin sustained-release microspheres.DESIGN,TIME AND SETTING:Contrast observation which was carried out at the Laboratory of Medical Chemistry of Nanjing Information Engineering University from September 2003 to December 2004.MATERIALS:Insulin Was provided bv Nanjing Medicinal Factory of Bio-Chemistry.METHODS:A new method tO prepare the microsphere,I.e.,drying through liquid phase was adopted with the special pH and the acrylic acid polymer which could be dissolved as the medicine'S carrier of the sustained-release microphere.MAIN 0UTCOME MEASURES:The effects of polymer concentration and agitation rates on size of microspheres and drug incorporation efficiency were studied by scanning electronic microscopy(SEM)and ultraviolet-spectrophotometry.RESULTS:The temperature,drug payloads and the content of emulsifier played important effects on microspheres formation.The mean diameter of microspheres decreased with increasing in stirring rate and decreasing in polymer concentration,and drug loading efficiency increased with increasing in stirring rate.CONCLUSION:Insulin-loaded polyacrylate sustained-release microspheres is prepared preferably.

ObjectiveTo explore the diagnosis and treatment of incomplete Kawasaki disease.MethodsA retrospective analysis was applied in 39 children patients clinically diagnosed as Kawasaki disease.ResultsThirtynine cases were found to have a high temperature over 5 days( 100％ ),30 patients with bilateral conjunctival congestion (76.9％),28 cases with cherry pink and chapped lips( 71.8％ ),21 patients with erythema multiforme and erythra(53.8％ ),20 cases with hand-foot scleredema(51.3％ )and 10 patients with cervical lymphatic enlargement (25.6％).In addition to the high temperature,22 cases were found to have three classic clinical diagnostic characterstics(56.4％ ),and 17 patients with two classic characterstics(43.6％ ).During the course of disease,C-reactve protein was observed to increase,and erythrocyte sedimentation rate speed up significantly.Intravenous infusion of gamma globulin and oral administration of aspirin was confirmed to be effective for incomplete Kawasaki disease.ConclusionThe careful observation and complete clinical examination was conducive to early diagnosis of incomplete Kawasaki disease instead of misjudge and missed diagnosis.

Objective To observe if IL-2 gene can express in hepatic carcinoma cells by double targeting of hepatitis B virus envelope (HBVE) and alpha fetoprotein (AFP) promoter.Methods HepG2 cells,L02 cells,and HepG2.2.15 cells were cultured in vitro.HBVE was obtained by PEG8000 concentration assay,and the acquired HBVE was used to pack recombintional gene.Human AFP promoter-IL-2 recombinational gene was obtained by PCR.Then HepG2 cells and L02 cells were transfected by transient transfection and the expression of IL-2 was detected by RT-PCR and Western blot.Results IL-2 was detected in HepG2 cells by RT-PCR and Western blot but not in L02 cells.Conclusion By using HBVE as a gene transporter,human AFP promoter-IL-2 recombinational gene can express in hepatic carcinoma cells,thereby it can increase the safety of exogenous gene transfection of hepatic carcinoma cells.

BACKGROUND:Anterior decompression, bone graft fusion, plate and screw fixation are commonly used in clinic for the treatment of thoracolumbar burst or comminuted fractures. The posterior surgery including decompression laminectomy and pedicle screw internal fixation.
OBJECTIVE:To explore the biomechanical changes of spine after thoracolumbar fracture and dislocation treated with pedicle screw internal fixation.
METHODS:Forty-six patients with thoracolumbar fracture and dislocation were treated with pedicle screw internal fixation, and then the recovery of spinal cord injury and fracture reduction were observed after internal fixation, immediately after internal fixation and 1-year fol ow-up.
RESULTS AND CONCLUSION:Al the 46 cases were fol owed-up. Frankel function classification assessment was used to evaluate the spinal cord injury grade. There was no significant difference in the percentage of A grade between periods (P>0.05), and there were significant differences in the percentage of B-E grades when compared between immediately postoperative period, 1-year fol ow-up period and preoperative period (P<0.05), but there was no significant difference when compared between immediately postoperative period and 1-year-fol ow period (P>0.05). The anterior height percentage, posterior height percentage and Cobb angle indicators were used to assess the fracture reduction, and the results showed there was no significant difference in posterior height between periods (P>0.05), and there was significant difference in Cobb angle when compared between immediately postoperative period, 1-year fol ow-up period and preoperative period (P<0.05), but there was no significant difference between immediately postoperative period and 1-year fol ow-up period (P>0.05). The results indicate that pedicle screw internal fixation system for the treatment of thoracolumbar spinal fracture and dislocation is conducive to the fracture reduction and functional recovery.

BACKGROUND: Local application of sustained-release antimicrobials serve as an adjuvant therapy of periodontitis, and the dosage form, medicine and carrier material have greatly developed. OBJECTIVE: To summarize the currant situation and progression of periodontal local sustained-release antimicrobials at home and abroad.METHODS: A computer-based online search of CNKI and Pubmed (1999-01/2009-10) was performed for the related articles about sustained-ralease antimicrobials, with the key words "periodontitis, treatment, medication, and sustained-ralease". The articles in the same field published recently or in authoritative journals were selected. A total of 143 articles were collected, and 40 related sustained-ralease antimicrobials were included.RESULTS AND CONCLUSION: Application of sustained-release antimicrobials is a well adjuvant therapy for some special clinical periodontitis. It is widely used due to its low dosage, long lasting-time and well target effect. The clinical application of sustained-ralease antimicrobials is promising along with the development of compound medicine and periodontal tissue regeneration.