Pimavanserin is a selective 5-HT2A receptor inverse agonist approved by FDA on April 29, 2016, and it is the first drug for the treatment of hallucinations and delusions associated with Parkinson' s disease. Pimavanserin is with high safety, good toleration and promising clinical efficiency, which is a timely option to resolve the drug shortage in clinic treatment. This paper summarized its pharmacodynamics, pharmacokinetics, clinical studies, adverse reactions and drug interactions.

Objective To summarise the experience of surgical treatment of invasive pulmonary fungal infection in patients with hematologic malignancies.Methods From Jan.2000 to Dec.2012,78 hematologic patients with invasive pulmonary fungal infections,including 49 males and 29 females with average age of 29.6 years,underwent surgical treatment.Preoperatively,all patients with 1 to 3 courses of chemotherapy had received average 4 weeks antifungal treatment.There were 58 cases received conventional open thoracic surgery and 20 cases received VATS including lobectomy,segmentectomy,wedgectomy.Results The procedures were successful,the average operation time w as(125.3 ± 35.7) min and intraoperative blood loss was(253.1 ± 42.8) nl.There were no severe postoperative complications.The main complications were excessive effusion (10.2％) and persistence airleak (7.7％).The hospital days was(7.8 ± 2.5) days,no reoperation and death case in 30 days after operation.The follow-up was from 6 to 24 months,38 cases(48.7％) received prophylaetic antifungal treatment,no ease with fungi spread and recurrence.Conclusion The surgical treatment is safe and useful for the hematologic patients with invasive pulmonary fungal infections,when internal medicine conservative treatment is invalid.

Forms and Records Control ; methods ; Humans ; Pathology, Clinical ; methods

Cardiac Catheterization ; methods ; Female ; Heart Septal Defects, Ventricular ; etiology ; therapy ; Humans ; Male ; Wounds and Injuries ; complications

Objective To observe the changes of intraocular pressure(IOP)in surgical treatment of Arnold-Chiari malformation.Methods The IOP of 20 patients who underwent surgical treatment of ArnoldChiari malformation were detected by Tono-Pen tonometer at 5 min utes after general anesthesia(T0),5 minutes after prone position(T1),30 minutes after prone position(T2),60 minutes after prone position(T3),prone position before the end of operation(T4),5 minutes after recovery prostration position(Ts)and 30 minutes after prostration position(T6),mean aortic pressure(MAP),heart rate(HR)and partial pressure of carbon dioxide in end tidal(PETCO2)were recorded at the same time.With the prone position,head was fixed bead-holder with skull pin.Results There was no statistical difference in MAP,HR,PEtCO2 at each time point(P＞ 0.05).The IOP significantly increased at T1[(20.9 ±2.5)mm Hg(1 mm Hg =0.133 kPa)],T2[(17.7 ± 1.7)mm Hg],T3[(23.9 ±2.4)mm Hg],T4[(26.3 ± 1.0)mm Hg]compared with IOP at T0 [(9.5 ± 1.5)mm Hg](P ＜ 0.05),there were significant differences between T2 and T3,T3 and T4(P ＜ 0.05).Recovery prostration position,the IOP decreased gradually,IOP at T5[(18.6 ± 1.8)mm Hg]was significantly lower than that at T4(P ＜ 0.05),but T5 was still higher than T0(P ＜ 0.05).The IOP at T6[(10.3 ± 1.7)mm Hg]was no difference compared with T0.Inserting of skull pin might be increase IOP for a moment,the IOP at T; was significantly higher than that at T2(P ＜ 0.05).Conclusion IOP gradually increases as the patients prone position changes in surgical treatment of Arnold-Chiari malformation,and inserting of skull pin maybe increase IOP for a moment.

Objective To explore the significance of mediastinum drainage tube in prevention and treatment of intrathoracic anastomotic leak after esophagectomy. Methods The morbidity and prognosis of intrathoracic anas-tomotic leak after esophagectomy in 180 patients with esophageal or cardia carcinoma (group A) who used mediasti-num drainage tube in operation from 2006 to 2008 was studied retrospectively,and were compare with 154 patients (group B) without mediastinum drainage tube from 2004 to 2006. Results The morbidity of intrathoracic anasto-motic leak after esophagectomy was 1.67% (3/180) in group A,and 4.55% (7/154) in group B,but no difference between them(χ2=1.4807, P>0.05) were found. Compared to group B, the final diagnosis of anastomotic leak in group A was early [(6.7±0.6) vs (10.0±2.1) days after operation (t=2.62, P<0.05)] and the duration of fe-ver was short [(5.3±1.5)vs (43.0±20.9) hours (t=4.39, P<0.01)]. The prognosis of 3 cases in group A was well, who all recovered without operation and had shorten hospital days than group B [(23.7±5.9)d vs (45.3± 5.0)d,t=4.86,P<0.01)]. In 7 cases of group B,there were 5 cases underwent second operation,but only 3 cases recovered, the case fatality rate was 2.60% (4/154), higher than in group A (0, Fisher, P<0.05). Conclusions Although the mediastinum drainage tube used or not used in esophagectomy is unrelated with the occurrence of anas-tomotic leak, and the significance to use it is that it can help to discover anastomotic leak early, and control mediasti-num infection effectively without reoperation,and improve patients' prognosis.

The challenge of the emergence of drug-resistant influenza strains, which is caused by wide spread utilization of direct-acting antivirals (DAAs), accelerates the research and exploration towards host targeted agents. In contrast to DAAs targeting viral replication components, host targeted agents, which regulate host factors and pathways linked to viral replication, can interfere the replication of influenza. Additionally, the innate immune system is activated by influenza during the early stage of infection, so manipulating the innate immune response may prevent the viral infection. However, the excessive inflammatory response induced at the late phase of influenza infection would lead to severe tissue injures. Thus, it is very important to explore drugs with anti-inflammatory actions to suppress these immune imbalances and tissue injures. Here we overview the current progresses about host targets related to anti-influenza drugs.
Anti-Inflammatory Agents ; pharmacology ; Antiviral Agents ; pharmacology ; Humans ; Immunity, Innate ; Influenza, Human ; drug therapy ; Virus Replication

Objective To obtain the Hiwi gene encoding full-length and construct human Hiwi adenoviral vectors carrying green luorescence protein (GFP), and to establish foundation for a further study on Hiwi function and mechanism of inducing leukemia stem cell differentiation and apoptosis.Methods All coding areas of human Hiwi gene full length were amplified using method of overlapping extension PCR technology, and the full length coding aeras were inserted into the vector of Flag-IRES-hrGFP carrying GFP with Gateway technology to construct pDown-Hiwi-3 × flag-IRES-hrGFP. The cloning vector pDown-Hiwi-3 × flag-IRES-hrGFP and expression vector pAV. Des1d were used for homologous recombination reaction to obtain recombinant adenovirus vector pAV.Ex1d-Hiwi-3× flag-IRES-hrGFP.The positive clones were selected by PCR to extract the recombinant adenovirus plasmid and to pack into recombinant Ad-Hiwi-3 × flag-IRES-hrGFP adenovirus. Results The human recombinant Hiwi was successfully cloned and the recombinant adenovirus vector pAV.Ex1d-Hiwi-3×flag-IRES-hrGFP was found to be successfully constructed via restriction enzyme digestion and sequencing methods. The adenovirus vector pAV.Ex1d-Hiwi-3×flag-IRES-hrGFP was transfected into the HEK293A cells using lipofectamine mediated gene transfection method. Under fluorescence microscope, the transfected cells with green fluorescence could be observed.Conclusion The expression plasmid of adenovirus vector pAV.Ex1d-Hiwi-3 × flag-IRES-hrGFP is successfully constructed and it can express in HEK293A cells.

HBx gene is a multifunctional regulator,which has extensive trans-activating effects,and can activate transcription factors,inhibit DNA repair and regulate cell proliferation,differentiation and apoptosis.In recent years,the role of HBx gene in pathogenesis of hepatitis B virus-associated glomemlonephritis (HBV-GN) has been extensively studied,and the results show that HBx can promote glomerular mesangial cell proliferation,and induce damage or apoptosis of podocytes and renal tubular epithelial cells.This paper reviews the research progress on biological characteristics of HBx and its role in pathogenesis of HBV-GN.

Objective To learn current status of health management provided by primary health professionals working in rural areas of Beijing.Methods Health professionals in township hospitals in Beijing were selected by multi-phase random sample method in 2012 and surveyed by a standardized questionnaire to gathering the data on various health management contents,including health checkup,chronic disease management et al,the action location,its collaborative persons and sectors.Statistics description and inference were conducted to describe and compare the distribution of health management implementation across rural areas by descriptive methods and test,respectively.Results Nearly 66.3％ (321/484) of subjects provided health check-up,and 19.1％ (92/481)involved in follow-up study of mental diseases.The main targets population of health management were chronic diseases and the elderly,with response rate of 44.7％ (214/479) and 38.0％ (182/479),respectively.Health check-up,health education and follow-up of chronic diseases were performed in 62.1％ (298/480),52.4％ (251/479) and 42.8％ (206/481) of the township health centers.About 66.1％ (292/442) township health centers had cooperation with general practitioners; however,cooperation with administrative personnels was only 10.6％ (47/443).More than 41.4％ (201/463) township health centers cooperated with community administrative sectors,and cooperation with the propaganda department was only 10.6％ (49/464).The statistical difference across regions shows in the following,including health management action (health checkup,chronic disease patients following-up,et al),the target population covered (youth,elder person,children,and chronic disease patients),health management location(health checkup,education and chronic disease patients following-up in township hospital and village clinic),cooperation with General Practitioner.Conclusions Our results suggest that the actual situation on health management service in Beijing rural areas and the standards of public health equalization of China are still disjoined,even difference exists across regions.In order to improve the health management service quality,we should strengthen the health management personnel training,increase the general practitioner in proportion,establish the performance evaluation mechanism,increase governmental finance to support those service.