China ; Education, Medical ; Occupational Health

Objective:To:investigate the curative effects and cost of sequential treatment of children communityacquired pneumoni(CAP) with azithromycin. Method:118 cases of CAP from this hospital were divided into two groups: sequential azithromycin therapeutic group (Group A) and iv ceftazidime group (Group B). Their clinical effect was observed and cost minimization analysis was carried out. Result:The total costs were 612?7. 3 yuan and 819?8. 2 yuan(P 0.05) in Group A and Group B respectively. Conclusion: The sequential azithromycin scheme is a better one to treat CAP.

Tuberculous meningitis is an important global medical problem which gives rise to high morbidity and mortality. It is the most severe form of extrapulmonary Mycobacterium tuberculosis. Comprehensive prevention effort, prompt diagnosis and rational treatment are all keys to improving treatment outcomes; yet many unsolved problems remain. On the other hand, the new problems, such as HIV co-infection and drug-resistance are posing important challenges. This review outlines the epidemiology, pathogenesis, diagnosis, management and prognosis of tuberculous meningitis. We mainly focus on research carried out in the recent decades, giving special attention to the work done among the Asian populations
Tuberculosis, Meningeal

Animals ; Aorta ; metabolism ; pathology ; Atherosclerosis ; etiology ; metabolism ; pathology ; Cholesterol, Dietary ; Male ; Matrix Metalloproteinase 2 ; metabolism ; PPAR gamma ; agonists ; Rabbits ; Random Allocation

Objective To study the effectiveness and safety of therapeutic mild hypothermia in patients successfully resuscitated from cardiac arrest using a meta-analysis.Methods We searched the MEDLINE (1966-April 2012),OVID (1980 to April 2012),EMBASE (1980 to April 2012),Chinese bio-medical literature & retrieval system (CBM) (1978 to April 2012),Chinese medical current contents (CMCC) (1995 to April 2012),and Chinese medical academic conference (CMAC) (1994 to April 2012).Studies were included (1) the study design was a randomized controlled trial (RCT); (2) the study population included patients successfully resuscitated from cardiac arrest,and received either conventional post-resuscitation care with normothermia or mild hypothermia; (3) the study provided data about good neurologic outcome and survival till hospital discharge.Relative risk (RR) and 95％ corfidence interval (CI) were used to pool the effect.Results The study included four RCTs with a collected total of 417 patients successfully resuscitated from cardiac arrest.Compared to conventional post-resuscitation care with normothermia,patients in the hypothermia group were more likely to have good neurologic outcome (RR =1.43,95％ CI 1.14 ～ 1.80,P =0.002) and were more likely to survive till hospital discharge (RR =1.32,95％ CI 1.08 ～ 1.63,P =0.008).From all over the studies there was no significant difference in reported adverse events between the normothermia and hypothermia group (P ＞ 0.05).There did not exist heterogeneity and publication bias.Conclusions Therapeutic mild hypothermia improves neurologic outcome and survival in patients successfully resuscitated from cardiac arrest.

Objectives:This paper at measuring the inequity and its influencing factors of medical care utiliza-tion of elderly aged above 60 ( inclusive) . Methods:data comes from 2013 China Health and Retirement Longitudinal Study ( CHARLS) where the population aged 60 and above was selected as the research object. Concentration index ( CI) and its decomposition or centralized curve was used to measure the inequity of medical care services utilization of the elderly, and then the influencing factors of inequity were analyzed by means of the centralized index. Results:The concentration index for outpatient and inpatient service utilization for the elderly was 0 . 0619 and 0 . 1050 , re-spectively, and the concentration curves were below the absolute fair line. The top 2 factors that showed positive con-tribution to the outpatient service utilization included annual per capita consumption expenditure and the pension a-mount. The top 2 factors that showed negative contribution and larger contribution rate to the outpatient service utiliza-tion included New Rural Cooperative Medical Insurance (NRCMI), and Physical Ability in Daily Life (PADL). The top 2 factors that positively and highly contributed to the inpatient service utilization included the household per capita consumption expenditure and the Urban Employees' Basic Medical Insurance (UEBMI). The top 2 factors that nega-tively contributed to the inpatient service utilization included the New Rural Cooperative Medical Insurance ( NRCMI) and the Physical Ability in Daily Life ( PADL) . The horizontal inequity of outpatient and inpatient service utilization was 0. 0739 and 0. 1339, respectively, indicating that there was unfairness in the use of outpatient and inpatient services among elderly. Conclusion:There is inequity of medical care service utilization among the elderly in China. The economic status contributes the largest part of inequity, meaning that it is unfair to the first contribution factor;while the Needs-based fac-tors and New Rural Cooperative Medical Insurance (NRCMI) showed an inequity, narrowing the unfair gap.

Objectives:To investigate the effects of zinc supplements on the nutritional state of gut mucosa after major burns. Methods:Weanling rats were fed zinc deficient chows (zinc content: 1.6 ?g/g) for seven days to induce zinc deficient status. Then 20% TBSA deeper second degree scalds were made and the rats were divided into three groups fed on chows different in zinc contents. Zinc contents were 1.6 ?g/g, 24.7 ?g/g, 286.9 ?g/g respectively. A group of rats fed normal zinc content (24.7 ?g/g) diets before and after scalds was designed as control. Rats were killed on the eighth day after burns and certain sections of jejunum and ileum were resected. Vincristine was injected 6 hours before they were killed, which was supposed to block cell division in metaphase. DNA and protein contents as well as crypt cell production rate (CCPR) were calculated. Results: DNA contents and CCPR of jejunal mucosa were markedly improved in the group of zinc supplements. Protein contents were also improved to some extent. The same trend could be seen in ileac mucosa too. Conclusions: Zinc plays an important role on the nutritional states and proliferation of gut mucosal cells. To supplement zinc after major burns in rats with zinc deficent could help to repair the injured intestinal mucosa.

SUMMARY Regenerationofbonetissue,aswellasothertissues,requiresinvolvementandinteraction of cells,scaffolds and relevant growth factors,among which growth factors play a crucial role in maintai-ning the stability of microenvironment.Nel-like-type 1 molecule (NELL-1 ),a novel growth factor in tis-sue engineering,has been studied intensively in recent years.Researches mainly covered gene and pro-tein structure and their expression profiling,biological function,molecular mechanisms and disease rele-vance.NELL-1 expressed in embryonic tissue is essential for growth and development of bone tissue. NELL-1 presents excellent abilities of inducing bone and cartilage regeneration,especially with high spe-cificity to chondrocyte lineage.Compared with classic osteogenic growth factor bone morphogenetic pro-tein 2 (BMP-2),the process of osteogenesis interacted with NELL-1 exhibits stronger specificity,higher bone density and fewerside effects.Furthermore,a recent study shows synergistic effects of NELL-1 and BMP-2.NELL-1 enhances the osteogenic reaction induced by BMP-2 of cells and notably declines in-flammation response caused by BMP-2.This review evaluates the current research progress of the function and application of NELL-1 by the systematic method of evidence-based medicine.

Objective To investigate the protective role of carbon monoxide releasing molecule-2 (CORM-2) in post-resuscitation myocardial dysfunction (PRMD) in rat models of cardiopulmonary resuscitation (CPR).Methods Cardiopulmonary resuscitation model was established after cardiac arrest induced by ventricular fibrillation.Male healthy Sprague-Dawley (SD) rats were randomly (random number) divided into 4 groups according to random number table:control group,CORM-2 group,inactive CORM-2 (iCORM-2) group and Sham group,in which the equal volume (1 mL) of 0.2％ DMSO,50 μmol/kg CORM-2,50 μmol/kg iCORM-2 and 0.2％ DMSO were respectively administered into the rats of these groups after resuscitation.The ejection fraction (EF) of left ventricle and myocardial performance index (MPI) were measured to detect the myocardial function by echocardiography at 12 hours after resuscitation.Mitochondrial respiration was assessed with Clark oxygen electrode at the same time.Western blot was used to determine the ratio of mitochondrial cytochrome c (cyt c) to cytoplasmic cyt c as well as caspase-3 level.Multiple comparisons were made by analysis of variance.Results Compared with the control group,higher EF and MPI,higher state Ⅲ respiration rate and respiratory control rate (RCR) of mitochondria,and decreased ratio of mitochondrial cytc/cytoplasmic cyt c and lower caspase-3 level were observed in the CORM-2 group (P ＜ 0.05).However,there were no significant differences in above biomarkers found between iCORM-2 group and control group (P ＞ 0.05).Conclusions The CO released from CORM-2 might improve mitochondrial respiration and PRMD by inhibition of myocardial apoptosis via a mitochondrial pathway.

Objective To observe the efficacy and safety of tiopronin supplemented with chemotherapy in treating advanced breast cancer.Methods Sixty patients with advanced breast cancer were randomly divided into two groups:treatment group(n = 28) and control group (n = 32).Two groups were treated the same of NVB + DDP,the treatment group was supplemented with tiopronin,given for 10 days.Efficacy,toxicity in two groups were compared.Results The effective rate in the treatment group and the control group were 46.4% and 46.9% respectively, with no significant difference between the two groups ,P > 0.05.But the improved quality of life of patients in the treatment group was higher than that in the control group, P < 0.05.The rate of adverse reaction in liver function damaged (9.4%)and leucocyte lassitude(46.4%) were apparent lower than those in the control group(31.2% ,81.2% ),with significant difference between the two groups(P < 0.05, P < 0.01).Conclusion Tiopronin supplemented with chemotherapy show apparent effect in decreasing the adverse reaction of chemotherapy,improving the quality of life and not influence efficacy in advanced breast cancer.So tiopronln may act as protective drug for chemotherapy and deserve further testing in the clinic.