Objective To investigate the effects and distribution of 4 efflux pumps and correlated mutation of regulatory gene in multi-drug resistance Pseudomonas aeruginosa (Pa) in Hunan province. Methods Forty non-duplicated clinical strains of multiple-drug-resistant Pseudomonas aeruginosa were collected in Hunan in 2008, then the phenotype was screened with efflux pumps inhibitor phenylalanine-L-β-naphthylamide and 4 antimicrobial susceptibility test discs. Genes of the efflux pump membrane fusion protein were amplified by PCR, and correlated efflux pump regulatory genes were amplified and sequenced to analyze the role of efflux pump gene expression in multi-drug resistance compared to that of 18 strains with non-multi-drug resistance. Re-suits The positivity rates of MexAB-OprM, MexCD-OprJ, MexEF-OprN, MexXY-OprM were 45.0% (18/40), 30.0% (12/40), 42.5% (17/40) and 12.5% (5/40) respectively with phenotype screening in multi-drug resistance group. The positivity rates of mexA, mexC, mexE and mexX were 100% (58/58), 22.5% (9/40), 45.0% (18/40) and 22.5% (9/40) with RT-PCR. The overexpressed positivity rates of mexA and mexX were 55.0% (22/40) and 22.5% (9/40) respectively by semi-quantitative analysis with real-time PCR. However, no over-expression of mexA and mexX in non-multi-drug resistance group with real-time PCR. The positive expression rates of mexC and mexE with RT-PCR were 11.1% (2/18), 38.9% (7/18) in non-multi-drug resistance group. The difference of overexpression of mexA and mexX was significant(P<0.001, P=0.045) between two groups. The strain Pa20 with mexA overexpressian displayed gene mutations in mexR(164GTC→GAG) and amino acid substitution(126Val→Glu), the strain Pa34 with overexpression of mexX had 164GCG→GAG,55Ala→GIu. Conclusion Most of Pa with multi-drug resistance contained the resistant mechanism of efflux pumps and most-ly due to the overexpression of MexAB-OprM and MexXY-OprM in Hunan. There are mostly regulatory genes mutation in the strains with overexpression of MexAB-OprM and MexXY-OprM.

Objective To investigate the effect of the abnormally accumulated iron ions in the perihematoma tissue lesions and the impact of deferoxamine intervention. Methods A total of 135 SD rats were randomly assigned to sham-operation (n = 15), intracerebral hemorrhage (n =60) and deferoxamine (n =60) groups. A rat model of intracerebral hemorrhage was induced by the infusion of autologous blood. The neurological deficit score, brain water content (dry/wet weight method), blood-brain barrier permeability (Evans blue extravasation method), DNA fragmentation (TUNEL staining), and the impact of deferoxamine intervention were observed at different time points in all groups.Results One to seven days after intracerebral hemorrhage, the neurological deficit score, perihematomal water content, the blood-brain barrier permeability, and the numbers of TUNEL positive cells in the intracerebral hemorrhage group were significantly higher than those in the sham-operation group (P ＜0.01, P ＜0.05, P ＜0.01, and P ＜0.05). All the observation indexes in the deferoxamine and intracerebral hemorrhage groups showed the same trend, however, the neurological score, perihematomal water content, the blood brain barrier permeability, and the numbers of TUNEL positive cells were significantly lower than those in the intracerebral hemorrhage group (P ＜ 0.05, P ＜ 0.05, P ＜ 0.05, and P ＜ 0.05). Conclusions The abnormal accumulation of iron ions involves in the pathological injury of perihematoma tissue after intracerebral hemorrhage, and deferoxamine may reduce this injury.

Objective To compare the effects of adjustable pressure drainage device, negative pressure ball drainage and drainage bag drainage on patients with the total hip arthroplasty. Methods The silicone drainage ball with negative pressure, the urine collection bag, the infusion set′s regulator were used to make adjustable pressure drainage device. 120 cases of total hip arthroplasties from January to December in 2015 were chosed and divided randomly into 3 groups based on the sequence of operation notifications. In 40 cases, drainage bag were used (control group 1), 40 cases with negative pressure ball drainage (control group 2) and 40 cases with adjustable pressure drainage device (experimental group). Total postoperative bleeding, the blood transfusion amount, swelling (the thickness of hematoma) and the nursing workload of the three groups were compared. Results The total postoperative bleeding, the blood transfusion amount, the thickness of hematoma and the nursing workload in the experimental group were (775.1±130.5) ml, (3.5±1.3) mm, (180.2±29.9) ml, (34.5±5.2) min. The total postoperative bleeding, the blood transfusion amount, the thickness of hematoma and the nursing workload in the control group 1 were (889.4 ± 160.8) ml, (5.2 ± 1.1) mm, (285.9 ± 30.4) ml, (40.6 ± 7.4) min and in the control group 2 were (876.2±156.7) ml, (4.3±1.2) mm,(208.3±33.3) ml, (50.3±8.5) min. Compared the data of the experimental group and the control group 1, the difference was of statistically significance (t=3.49-15.68, P < 0.01). Compared the data of the experimental group and the control group 2, the difference was of statistically significance (t=2.86-10.03, P<0.01). Conclusions The effects of adjustable pressure drainage device are better than the drainage bag and negative pressure drainage ball. It can effectively reduce the postoperative bleeding and the swelling degree, and bring a lot of relief to the patients and lots of convenience to the nursing work. The method is affordable, reliable and safe which should be promoted in the primary hospital.

A new sesquiterpene hydroquinone (1) was isolated from a deep sea sediment derived fungus, Phialocephala sp.. Its structure and stereochemistry were established on the basis of spectroscopic data and optical rotation. This compound was tested for cytotoxicity against P388 (murine leukemia cell) and K562 (human leukemia cell) cell lines, and displayed strong cytotoxic effects with IC50 value of 0.16 and 0.05 micromol x L(-1), separately.

Breviscapine, a flavone glucuronide, is a cardiovascular medicine extracted from a Chinese herb Erigeron breviscapinus. Modern pharmacological research shows breviscapine has a therapeutic effect on cardiovascular diseases such as cerebral thrombus,cerebral ischemia hemiparesis and platelet aggregation et al. However, its poor water solubility and low bioavailability in vivo severely restrict the clinical application. In this article, we reviewed the marketing preparations of breviscapine and its research progress on the new dosage forms.
Biomedical Research ; Brain Ischemia ; drug therapy ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; administration & dosage ; economics ; Flavonoids ; administration & dosage ; economics ; Humans

Objective To evaluate the efficacy of minimally invasive percutaneous intervertebral disc approach for treatment of sympathetic cervical spondylosis. Methods Fifty?six patients diagnosed as having sympathetic cervical spondylosis from January 2009 to August 2014, aged 22-64 yr, with the dis?ease course ranged from 6 months to 15 yr and a follow?up period of 6 months, were enrolled in the study. The related minimally invasive approach was selected according to the height of the diseased intervertebral space. When the ratio of the height of diseased intervertebral space∕normal intervertebral space≤1∕3, per?cutaneous radiofrequency ablation was used ( groupⅠ, n=19); when the ratio within the range of 1∕3-2∕3, percutaneous laser disk decompression was used ( groupⅡ, n=12); when the ratio≥2∕3, low?tem?perature plasma radiofrequency ablation was used ( group Ⅲ, n=25) . Before operation, at 2 weeks after operation, and at 1, 3 and 6 months after operation, the sympathetic symptoms were evaluated using the 20?point score. At 2 weeks and 6 months after operation, the patients′ subjective satisfaction was assessed and graded ( excellent, good, medium and poor ) . Results All the patients were followed up for 6 months. The sympathetic symptom scores were significantly lower at each time point after operation in Ⅰand Ⅲ groups and at 2 weeks and 3 and 6 months after operation in group Ⅱ than those before operation
( P<0.05) . The excellent and good rate of patients′subjective satisfaction was 67.9% at 2 weeks after op?eration, and 76.8% in the last follow?up period at 6 months after operation. Conclusion The minimally invasive percutaneous intervertebral disc approach has a marked short?term effect on sympathetic cervical spondylosis.

Objective To compare the dose distribution of the target and normal tissues in gastric cancers between three-dimension conformal radiation therapy (3DCRT) and intensity modulated radiation therapy (IMRT) plan when respiratory motion factors integrated in the plan. Methods From January 2005to November 2006, 10 patients with post-operatively radiation of gastric cancer were enrolled in this study.Planning CT were acquired conventionally with free-breath mode and the static treatment plans of the 3DCRT and IMRT were designed respectively. Probability distribution functions (PDF) were generated and convoluted with the static dose distributions from 3DCRT and IMRT plans to obtain the integrated plans. The dose distributions of the target and normal tissues were compared between 3DCRT and IMRT integration treatment plans, such as V45 of clinical target volume, V4o of liver and V15, V18 of left and right kidney.Results In the respiratory integrated treatment planning, the target volume coverage and homogeneity with IMRT are superior to those with 3DCRT ( ( V45 98%∶ 87% (t = -3. 35 ,P =0. 010) ,mean dose 46. 81 Gy ±0. 75 Gy∶45.99 Gy ± 1.12 Gy (t = -0. 31 ,P=0. 020) ). The V40 of teh liver in IMRT are smaller than those in 3DCRT ( 12%∶ 16% ;t=3.75,P=0.010). For the left kidney, the V15 and V18 in IMRT are smaller than those in 3DCRT ( (34%∶ 50% (t = 2. 17 ,P = 0. 050) and 27%∶46% (t = 3. 11 ,P = 0. 020) ),but for the right kidney, V15 and V18 in 3DCRT are smaller than those in IMRT ( ( 15%∶ 21% (t = - 2. 42,P=0.040) and 11%∶15% (t= -2.71,P=0.030)). Conclusions When respiratory motion factor integrated in the treatment plan, IMRT showed advantage both in target coverage and normal tissue sparing in the high dose region of liver and left kidney.

Objective To explore the effect and safety of the operationive treatment of calculus incarceration in neck of gallbladder.Methods We analyzed retrospectively the clinical data of 26 cases with calculus in carceration In neck of Gallbladder.Results All 26 cases patients were found to have serious cholecystitis and unclear anatomic site in Calot's trangle.Six patients'operative way had to transform from laparoscopiccholecystectomy to cholecystectomy.Endogenous membrane of gallbladder were excised retrogradely in the operation.In operative process,there were no injury in extrahepatic bile duct,intestinal canal and vascular.The all patients were recovery and discharge after operation.Conclusion It is one kind of good choice to open the gallbladder,aspirate the bile and extract the stones.And then performing endogenous membrane retrograde cholecystectomy.For treatment of the Calot's trangle areas,blunt dissection may used.It is dangerous that using sharp dissection and electrosurgical knife.

Objective To assess the impact of respiratory motion on the displacement of target area and to analyze the discrimination between free breathing and active breathing control (ABC) in patients with gastric cancer treated with post-operative radiotherapy. Methods From January 2005 to November 2006, 22 patients with post-operatively confirmed gastric cancer were enrolled in this study. All diseases were T_3/ N +, staging Ⅱ - Ⅳ. Patients were CT scanned and treated by radiation with the use of ABC. Image J software was used in image processing, motion measurement and data analysis. Surgical clips were implanted as fiducial marks in the tumor bed and lymphatic drainage area. The motion range of each clip was measured in the resultant-projection image. Motions of the clips in superior-inferior (S-I), right-left (R-L) and anterior-posterior (A-P) directions were determined from fluoroscopy movies obtained in the treatment position. Results The motion ranges in S-I, R-L and A-P directions were 11.1 mam, 1.9 mm and 2.5 mm (F = 85.15, P = 0. 000) under free breathing, with 2.2 mm, 1.1 mm and 1.7 nun under ABC (F = 17.64, P = 0. 000), and the reduction of motion ranges was significant in both S-I and A-P directions (t = 4.36, P = 0. 000;t = 3.73,P = 0.000). When compared with under free-breathing, the motion ranges under ABC were kept unchanged in the same breathing phase of the same treatment fraction, while significant increased in different breathing phase in all three directions (t = - 4.36, P = 0. 000; t = - 3.52, P = 0.000; t =-3.79, P = 0. 000), with a numerical value of 3.7 mm, 1.6 mm and 2.8 mm, respectively (F = 19.46, P = 0. 000) . With ABC between different treatment fractions , the maximum displacements were 2.7 mm, 1.7 mm and 2.5 mm for the centre of the clip cluster (F =4.07,P =0. 019), and were 4.6 mm, 3.1 mm and 4.2 mm for the clips (F =5.17 ,P =0.007). The motion ranges were significant increased in all the three directions (t = - 4.09, P=0.000 ; t =-4.46, P = 0.000 ; t = - 3.45, P =0.000). Conclusions In the irradiation of post-operative gastric cancer, the maximum displacement of organ motions induced by respiration is in S-1 direction and the minimum in R-L direction under free breathing. The use of ABC can reduce the motions significantly in S-I and A-P directions, and the same changes exist in both inter-and intra-fraction treatment.

BACKGROUND:Dorsal digital block refers to the commonly used anesthesia for adults in smal or moderate hand injury surgeries, but in recent years, modified transthecal digital block technique is gradualy respected, which is favored with a rapid and good effect and fewer complications.
OBJECTIVE:To evaluate the clinical anesthetic outcomes of modified transthecal digital block and traditional dorsal digital block technique for the treatment of hand injury of adults in emergency by a prospective randomized controled study.
METHODS:Totaly 60 adult patients with hand injury were enroled and divided into two groups of modified transthecal digital block and traditional dorsal digital block randomly. Blocks were performed by one single surgeon. The operation time, local anesthetic dose, onset time of anesthesia, duration of anesthesia, success rate of anesthesia, visual analogue scale scores and complications were recorded.
RESULTS AND CONCLUSION:The anesthesia effects in the two groups were acceptable. There was no significant difference in the onset time of anesthesia, duration of anesthesia, success rate of anesthesia and complications between the two groups (P > 0.05). The operation time of anesthesia, local anesthetic dose, and visual analogue scale scores were significantly different between the two groups (P< 0.05). Modified transthecal digital block is more convenient and has less pain than the traditional root digital block, which is a safe and reliable anesthetic technique.