OBJECTIVE:To evaluate the clinical efficacy of Shuanghuanglian injection in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD),and to observe its effects on the plasma levels of C-reactive protein (CRP),procalcitonin(PCT)and interleukin-6(IL-6). METHODS:A total of 100 AECOPD patients were randomly divided into observation group and control group,with 50 cases in each group. Control group received routine treatment,such as controlled oxygen therapy,intravenous dripping of moxifloxacin,bronchodilator for relieving asthma,mucolytic for eliminating phlegm,nu-tritional support. Observation group was additionally given Shuanghuanglian injection 1 ml/(kg·d)added into 5% Glucose injec-tion 250 ml intravenously,qd,on the basis of control group. Treatment course of 2 groups lasted for 10 d. Clinical efficacies of 2 groups were compared as well as the changes of serum levels of CRP,PCT and IL-6 before and after treatment and the occur-rence of ADR. RESULTS:After treatment,total effective rate of observation group was 96.0%,which was significantly higher than 82.0% of control group,with statistical significance(P<0.05). Before treatment,there was no statistical significance in se-rum levels of CRP,PCT and IL-6 between 2 groups (P>0.05). After treatment,serum levels of CRP,PCT and IL-6 were de-creased significantly in 2 groups,and those of observation group were significantly lower than those of control group,with statis-tical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CON-CLUSIONS:Shuanghuanglian injection can effectively improve serum inflammatory factors of AECOPD patients,and shows good clinical efficacy and safety.

w biomarker to predict the presence of vulnerable plaque.

Objective To explore the relationship between blood pressure variability and different types of stroke.Methods One hundred and twenty-five ischemic stroke subjects,78 hemorrhagic stroke patients and 66 non-stroke individuals,collected in our hospital from January 1,2013 to December 31,2015,were enrolled according to the inclusion and exclusion criteria.All indicators of blood pressure variability were calculated from 24 h ambulatory blood pressure,including nighttime blood pressure fall (BPF),moming surge in blood pressure (MBPS),standard deviation (SD),weighted SD (wSD),and coefficient of variation (CV).Results As compared with non-stroke subjects,ischemic and hemorrhagic stroke individuals had significantly increased systolic MBPS (P＜0.05),and the systolic MBPS of ischemic stroke group was significantly lower than those of hemorrhagic stroke group (P＜0.05).CV,wSD and BPF of systolic blood pressure (SBP) in the ischemic and hemorrhagic groups were significantly higher than those in the non-stroke subjects (P＜0.05);CV and SBPF of diastolic blood pressure in hemorrhagic group were significantly different as compared those in the non-stroke subjects (P＜0.05).The factors which were significantly associated with ischemic stroke in Logistic regression,included high-density lipoprotein,nighttime SBP,wSD of SBP,CV of SBP,while smoking,nighttime SBP,wSD of SBP,MBPS,and CV of SBP were observed as important influence factors for hemorrhagic stoke patients.Conclusion Whether ischemic stroke,or hemorrhagic stroke are associated with short-term blood pressure variability.

Objective To determine the long-term impacts of major pulmonary complications ( MPCs) and identify the in-dependent risk factors in those non-small cell lung cancer(NSCLC)patients who underwent VATS lobectomy.Methods A ret-rospective study was developed to analyze the pulmonary complications of 574 non-small cell lung cancer patients who under-went VATS lobectomy in Peking University Hospital , the complications were graded according to TMM classification criteria . The effects of PCs on the long-term prognosis were analyzed by using the Kaplan-Meier method.Multivariate logistic regression analysis was used to determine the risk factors of MPCs.Results Of 574 patients, 106 had PCs, including 50(8.7％) MPCs, Postoperative pulmonary complications were associated with significantly longer drainage time (P<0.001) and hospital stays(P<0.001).Perioperative mortality was significantly increased in patients with PCs (4.0％ vs 0.6％; P =0.021). Those who develop a MPC had a reduced 3-year DFS and 5-year DFS(61.3％ vs.77.4％、42.2％ vs.69.3％;P=0.003), as well as the reduced 3-year OS and 5-year OS(78.5％vs.88.2％、62.4％ vs.79.2％;P=0.047).MPCs were independ-ent prognostic factors of patients with lung cancer .Multivariate logistic regression analysis showed that the independent risk fac-tors for MPCs were age, male, ASA grade.Conclusion Major pulmonary complications after VATS lobectomy are associated with a poorer long-time outcome.The independent risk factors for MPCs are age, male, and ASA grade.

Global Health ; History, 20th Century ; Humans ; Influenza A Virus, H2N2 Subtype ; genetics ; isolation & purification ; Influenza, Human ; epidemiology ; history ; transmission ; virology

OBJECTIVETo develop a rapid duplex Real-time reverse transcription PCR (rRT-PCR) method to detect E119V mutation on neuraminidase (NA) of influenza A(H3N2) subtype with drug resistance to oseltamivir.

METHODSTwenty-six NA genes of influenza A(H3N2) virus between 2000 and 2012 in GenBank database were selected as the target genes, and specific TaqMan-MGB probe was designed to target the E119V amino acid change in neuraminidase protein. rRT-PCR was then performed and evaluated for the sensitivity, specificity and reproducibility using virus with E119V mutation and clinical samples.

RESULTSThis study described the validation of a highly sensitive and specific duplex rRT-PCR for detection of substitutions leading to the E119V amino acid change in NA protein of influenza A(H3N2). Fluorescence signals could be detected even when diluted a A (H3N2) virus (HA = 8) into 10(-5) and linear correlation between the logarithm of the viral titer with the Ct values was observed. In addition, the assay was highly specific in that there was no cross-react with other respiratory viruses, nor did two TaqMan-MGB probes. E119V substitution in quasispecies with both sensitive and resistant viruses could be detected as well. The limit of detection was 5% for quasispecies with high concentrations and 50% for quasispecies with low concentrations. The average coefficient of variation (CV) for within-run assays was 2.32% and 0.57% for H3N2-119E and H3N2-119V primer/probe sets separately, 1.77% and 0.97% for average CV of between-run assays, which exhibited good repeatability. Sequence analysis of twenty NA genes verified glutamic acid (E) at amino acid site 119, which was in consistent with the results from our rRT-PCR method.

CONCLUSIONThe assay developed in this study is highly sensitive and specific, and easy to operate; thereby it could be used for identification of A(H3N2) virus with E119V amino acid change in NA protein.

Amino Acid Substitution ; Drug Resistance, Viral ; Influenza A Virus, H3N2 Subtype ; drug effects ; enzymology ; genetics ; Mutation ; Neuraminidase ; genetics ; Nucleic Acid Probes ; Reverse Transcriptase Polymerase Chain Reaction ; methods

BACKGROUNDIn recent years, interventional tumor therapy, involving implantation of intra-cholangial metal stents through percutaneous trans-hepatic punctures, has provided a new method for treating cholangiocarcinoma. (103)Pd cholangial radioactive stents can concentrate high radioactive dosages into the malignant tumors and kill tumor cells effectively, in order to prevent re-stenosis of the lumen caused by a relapsed tumor. The aim of the present study was to investigate the efficacy of gamma-rays released by the (103)Pd biliary duct radioactive stent in treating cholangiocarcinoma via induction of biliary cholangiocarcinoma cell apoptosis.

METHODSA group of biliary duct cancer cells was collectively treated with a dose of gamma-rays. Cells were then examined by the 3-(4, 5-dimethyl thiazol-2-yl)-2, 5-diphenyl terazolium-bromide (MTT) technique for determining the inhibition rate of the biliary duct cancer cells, as well as with other methods including electron microscopy, DNA agarose gel electrophoresis, and flow cytometry were applied for the evaluation of their morphological and biochemical characteristics. The growth curve and the growth inhibition rate of the cells were determined, and the changes in the ultrastructure of the cholangiocarcinoma cells and the DNA electrophoresis bands were examined under a UV-lamp.

RESULTSThe gamma-ray released by (103)Pd inhibited cholangiocarcinoma cell growth, as demonstrated when the growth rate of the cells was stunned by a gamma-ray with a dosage larger than 197.321 MBq. Typical features of cholangiocarcinoma cell apoptosis were observed in the 197.321 MBq dosage group, while cell necrosis was observed when irradiated by a dosage above 245.865 MBq. DNA agarose gel electrophoresis results were different between the 197.321 MBq irradiation dosage group, the 245.865 MBq irradiation dosage group, and the control group.

CONCLUSIONS(103)Pd radioactive stents which provide a radioactive dosage of 197.321 MBq are effective in the treatment of cholangiocarcinoma; (103)Pd radioactive stents should be useful for the clinical treatment of cholangiocarcinoma.

Apoptosis ; radiation effects ; Bile Duct Neoplasms ; pathology ; radiotherapy ; ultrastructure ; Bile Ducts, Intrahepatic ; Cell Line, Tumor ; Cell Proliferation ; radiation effects ; Cholangiocarcinoma ; pathology ; radiotherapy ; ultrastructure ; DNA ; analysis ; Flow Cytometry ; Gamma Rays ; therapeutic use ; Humans ; Palladium ; Stents

BACKGROUNDCommunity-acquired pneumonia (CAP) is a common infectious disease throughout the world and the incidence continues to grow as the population ages. Aspiration is an important pathogenic mechanism for pneumonia in the elderly and the management of patients with community-acquired pneumonia with aspiration factors is a major medical problem. Our study aimed to assess whether moxifloxacin in comparison to levofloxacin plus metronidazole are effective and safe in the treatment of community-acquired pneumonia with aspiration factors.

METHODSIn this prospective, multicenter, open-label, randomized controlled trial, 77 patients with mild-to-moderate community-acquired pneumonia with aspiration factors were enrolled and randomly assigned to receive moxifloxacin or levofloxacin plus metronidazole. The primary efficacy variables were clinical outcomes in evaluable patients at a follow-up visit 7 to 14 days after the end of therapy.

RESULTSSeven days after the end of therapy a clinical cure was achieved for 76.7% (23 of 37) of efficacy-evaluable patients in the moxifloxacin group and 51.7% (15 of 40) of patients in the levofloxacin plus metronidazole group. There was a significant difference between the two groups (χ(2) = 4.002, P < 0.05). Bacteriological success rates were similar in the moxifloxacin group (93.3%) and levofloxacin plus metronidazole group (96.4%), there was no significant difference between the two groups (P > 0.05). The overall adverse event rate was 10.8% (4/37) in the moxifloxacin group versus 17.5% (7/40) in the levofloxacin plus metronidazole group, there was no significant difference between the two groups (P > 0.05). No serious adverse events were observed.

CONCLUSIONSMoxifloxacin is effective and safe for treatment of community-acquired pneumonia with aspiration factors. And the regimen of moxifloxacin monotherapy is more convenient compared with levofloxacin plus metronidazole.

Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; therapeutic use ; Community-Acquired Infections ; drug therapy ; Female ; Fluoroquinolones ; therapeutic use ; Humans ; Levofloxacin ; therapeutic use ; Male ; Metronidazole ; therapeutic use ; Middle Aged ; Pneumonia ; drug therapy ; Prospective Studies

OBJECTIVEBenzyl butyl phthalate (BBP) is a plasticizer used in food contact materials. Dietary exposure to BBP might lead to reproduction and developmental damages to human. The present paper was aimed to assess the health risk of BBP dietary exposure in Chinese population.

METHODSThe BBP contents were detected in 7409 food samples from 25 food categories by gas chromatography-mass spectrometry operated in selected ion monitoring (SIM) mode. The dietary exposures of BBP in different age and sex groups were estimated by combining the content data with food consumption data derived from 2002 China National Nutrient and Health Survey, and evaluated according to the tolerable daily intake (TDI) of BBP established by European Food safety Agency.

RESULTSIt was found that BBP was undetectable in most samples and the highest level was 1.69 mg/kg detected in a vegetable oil sample. The average dietary exposure of BBP in people aged ⋝2 years was 1.03 μg/kg bw per day and the highest average exposure was found in 2-6 years old children (1.98 μg/kg bw per day). The BBP exposure in 7-12 months old children excessed 10% of tolerable daily intake (TDI) in worst scenario. .

CONCLUSIONThe health risk of BBP dietary exposure in Chinese population is low and, considering BBP alone, there is no safety concern.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; Diet ; Environmental Exposure ; Environmental Pollutants ; analysis ; Female ; Food Contamination ; analysis ; Food Packaging ; Gas Chromatography-Mass Spectrometry ; Humans ; Male ; Middle Aged ; Phthalic Acids ; analysis ; Plasticizers ; analysis ; Young Adult