Pneumococcal meningitis is one of the most common infectious diseases of the central nervous system in pediatric period which is characterized by acute fever,unconvulsions,consciousness,in-creased intracranial pressure and meningeal irritation and cerebrospinal fluid pus changes in clinic. With the advent of antibiotics and pneumococcal vaccination,the morbidity and mortality of the disease decline signifi-cantly. But due to the appearance of drug-resistant bacteria and the relative lag of research and development speed of clinical new antibacterial drugs,it still has high mortality and morbidity which are promoting resear-ches of pathogenesis and adjuvant therapy. In this paper,researches of pathogenesis and adjuvant therapy for preumococcal meningitis were reviewed in recent years.

Objective To investigate the cardio-protective effects of fructose-1,6-diphosphate on myocardium during coronary artery bypass graft.Methods A total of 30 patients were treated with coronary artery bypass graft(CABG) and divided into group A(treated group) and group B(control group) randomly.Each group included 15 patients.In the treated group,patients were treated with FDP three days before CABG and treated with FDP before cardiopulmonary bypass(CPB).FDP was replaced by 0.154mol/L NaCl of the same volume in control group.Blood samples were collected from all patients after induction and at 1h,4h,24h and 48h after aortic declamping to measure the serum concentration of cTnI,CK-MB,SOD and MDA.Results The levels of CK-MB and cTnI at 1h,4h,24h and MDA at 1h,4h after reperfusion were significantly lower in the treated group than those in the control group(P

Objective To establish a simple method for determination the Alkaloids contents from Zanthoxylum nitidum. Methods Adopting nitidunechloride as reference,alkaloids in Zanthoxylum nitidum were by ultraviolet spectrophotometry at 329 nm. Results The liner arrange was 3～8 ?g/mL,regression equation:Y=97.75X -0.025 5,r =0.999 1 (n=6). The mean recovery of Nitidunechloride was 99.46%,RSD=0.93% (n =5). Conclusion The method performed is accurate and simple. The reproducibility and rate of extraction are also desirable.

Farnesoid X receptor (FXR) belongs to the nuclear receptor superfamily. It is highly related to the formation of metabolic syndrome and the glucose homeostasis, and therefore represents an important drug target against metabolic diseases and diabetes. In recent years, great progress has been made in the agonists, antagonists, and crystal structures of FXR. The diverse FXR ligands and their structure-activity relationship are reviewed in this article. The advances in the crystal structures of FXR in complex with different ligands are also introduced.

Objective To investigate the effect of sufentanil preconditioning on the expression of Toll-like receptor 4 (TLR4) in myocardium during myocardial ischemia-reperfusion (I/R) in rats.Methods Thirty-six male Sprague-Dawley rats,weighing 250-300 g,were randomly divided into 3 groups (n =12 each):sham operation group (group S),I/R group and sufentanil preconditioning group (group SPC).Myocardial ischemia was induced by occlusion of anterior descending branch of left coronary artery for 30 min followed by 2 h of reperfusion.In group SPC,the rats were subjected to 3 consecutive cycles of 5 min sufentanil infusion at 0.2 μg· kg-1 ·min-1 via the femoral vein at 5 min interval before ischemia.In groups S and I/R,the rats were subjected to the equal volume of normal saline instead.HR and mean arterial pressure (MAP) were recorded at 30 min before ischemia (T0),immediately before ischemia (T1),at 30 min of ischemia (T2),and at 30 and 120 min of reperfusion (T3-4).At the end of reperfusion,blood samples were obtained to determine the serum concentration of TNF-α.The rats were then sacrificed and hearts were removed for measurement of myocardial infarct size and expression of TLR4 and NF-κB p65 in myocardium (using Western blot).Results There was no significant difference in HR among the three groups (P ＞ 0.05).Compared with group S,MAP was significantly decreased at T2-4,the serum concentration of TNF-α was increased,and the expression of TLR4 and NF-kB p65 protein in myocardium was upregulated in groups I/R and SPC (P ＜ 0.01).Compared with group I/R,no significant difference was found in MAP at all time points (P ＞ 0.05),and myocardial infarct size was significantly decreased,serum concentrations of TNF-α were decreased,and the expression of TLR4 and NF-κB p65 protein in myocardium was down-regulated in group SPC (P ＜ 0.01).Conclusion The mechanism by which sufentanil preconditioning alleviates myocardial I/R injury may be related to down-regulation of TLR4 expression in rat myocardium.

Objective To explore the correlation between postoperative cognitive dysfunction (POCD)and serum level of S100βand NSE in patients undergoing on-pump heart valve replacement. Methods Ninety-eight patients underwent elective heart valve replacement were enrolled and divided into two groups:POCD group (group P)and none POCD group(group NP)by the result of neurocog-nitive testing with MMSE performed preoperatively and on the first postoperative day.Serum S-100βprotein and NSE were measured before operation(T0 ),at the end of operation(T1 ),24 h(T2 )and 48 h(T3 ) postoperatively.Results The incidence of POCD on the first postoperative day was 45 (45.9%).Compared with T0 ,the S100βincreased at T1 in both groups (P <0.05),NSE increased at T1 and T2 in both groups,and NSE increased in group NP at T3 (P <0.05).There was no signifi-cant difference of NSE between groups P and NP.The prolonged recovery time(OR = 1.222,P =0.004)and increased concentration of S100βat the end of operation(OR=1.85,P =0.009)were pre-dictors of POCD on the first postoperative day.Conclusion There was a higher incidence of POCD af-ter on-pump heart valve replacement surgery.The prolonged recovery time and increased concentra-tion of S100βat the end of operation might be predictors of POCD.

Objective To investigate the effects of propofol on the changes in myocardial Toll-like receptor 4 (TLR-4)and TNF-αand NF-κb protein expressions in ischemia-reperfusion injury (I/R).Methods Thirty healthy male SD rats weighing 250-320 g were randomly divided into 3 groups (n=10 for each):Group A,sham operation;Group B,I/R;and Group C,propofol + I/R.In Groups B and C myocardial I/R was induced by occlusion of the left anterior descending artery (LAD)for 30 min,followed by 120 min reperfusion.In Group C propofol was given intravenously 1 0 min before myocardial ischemia,followed by continuous infusion of propofol at 5 mg/(kg·h)until the end of 120 min reperfusion.In Groups A and B normal saline instead of propofol was given. The myocardial tissues were taken at the end of 120 min;ultrastructural changes of myocardial cells were observed under X-ray electron microscope and the expressions of TLR-4 mRNA as well as TNF-αand NF-κb protein were determined.Results Ultrastructural observation under electron microscope showed significantly worsened damage in myocardial tissue structure and mitochondria in Groups B and C compared with Group A.The myocardial expressions of TLR-4 and TNF-αand NF-κb protein were significantly higher in Groups B and C than in control Group A.The myocardial expressions of TLR-4 and TNF-αand NF-κb protein were down-regulated in Group C compared with Group B.Conclusion Intravenous injection of propofol can protect against myocardial damage.Propofol can suppress the increase in myocardial TLR-4 and TNF-αand NF-κb protein expressions induced by I/R.

Objective To observe the effect of fetus distress treated with hyperoxin liquid and to provide evidence for this treatment.Methods A total of 70 lying-in women with fetus distress during cesarean section were randomly divided into two groups: treatment group was given infusion of hyperoxin liquid by vein and control group was given 50g/L glucose.The blood gas was analyzed in the two groups,and the SOD and MAD of fetus ambilical blood were also tested.The blood gas analysis and the Apgar scoring of neonates were carried out.Results The PaO2 in pregnant and lying-in women and SOD,PO2,SaO2,HCO-3 and BE of fetuses in treatment group were obviously higher than those in control group.The MDA and PCO2 were significantly lower than those in control group.The Apgar score in treatment group was better than that in control group.Conclusion Hyperoxin liquid can improve the anoxia status of fetus distress and save time for further clinical treatment.

BACKGROUND:Although there are many studies addressing osteoarthritis in China, population-based epidemiological studies of knee osteoarthritis have been rarely reported. OBJECTIVE:To explore and analyze the clinical efficacy of early ladder-like treatment in knee osteoarthritis patients from Zoucheng city in the southwest of Shandong province based on an epidemiological investigation. METHODS: A total of 3 427 people randomly enroled from Zoucheng city located in the southwest of Shandong province in 2008 were taken as research objects. A self-designed epidemiological survey on knee osteoarthritis was carried out to analyze the sex, age, urban and rural distribution, and incidence of knee osteoarthritis. According to Kelgren Lawrence Grading, 208 patients with levels 0, I, II of knee osteoarthritis were randomly selected and divided into two groups: surgical treatment group was given intraarticular injection, intraarticular rinsing, arthroscopic treatment and functional exercise; oral drug group was only given oral administration of non-steroidal anti-inflammatory drugs and blood circulation drugs. Ninety-eight patients in the surgical treatment group and 87 in the oral drug group were folowed-up for over 1 year. RESULTS AND CONCLUSION:The incidence of knee osteoarthritis showed an increasing trend with aging in Zoucheng city. There were 33.2% patients who did not receive treatment, 53.2% patients who received irregular treatment, and only 13.6 patients who could folow the doctor’s advice. The excelent rate and total effective rate were higher in the surgical treatment group (81% and 99%) than the control group (34% and 87%;P < 0.01). This epidemiological investigation exerts a certain protective role in the occurrence and development of knee osteoarthritis, and active early ladder-like treatment has achieved good outcomes in patients with knee osteoarthritis.