Objective To investigate the distribution and the antibiotic resistance genes carried by classⅠintegron and insertion sequence common region(ISCR1)among clinical isolates of Acinetobacter baumannii. Methods Fifty-one clinical isolates of multidrug-resistant Acinetobacter baumannii were collected. Polymerase chain reaction method was used to detect the classⅠintegrase gene, variable region of classⅠintegron, ISCR1 and genes related to antibiotics resistance lo-cated downstream of ISCR1 in 51 multidrug-resistant Acinetobacter baumannii. Antibiotics resistance genes carried by classⅠintegron and ISCR1 were performed by DNA sequencing. The relationship between classⅠintegron and ISCR1 was detected by PCR-mapping. Results Among 51 multidrug-resistant Acinetobacter baumannii isolates, 45 strains were found con-taining classⅠintegrase genes, 32 strains were found containing variable regions. Sequencing results showed that the gene cassette arrays were aacA4-catB8-aadA1, aacC1-orfA-orf-B-aadA1 and blaPSE-1-aadA2-cmlA1-aadA1. Twenty-two strains were found containing ISCR1 and 5 strains were found containing resistance genes located downstream of ISCR1. DNA sequencing results showed the resistant gene of qnrA1-ampR. The results of PCR-mapping showed that ISCR1 located directly downstream of 3' conserved segment of classⅠintegron in 20 Acinetobacter baumannii strains. Conclusion ClassⅠintegron and ISCR1 play an important role in mechanisms of drug resistance of Acinetobacter baumannii. ClassⅠintegron and ISCR1 could connect in series in Acinetobacter baumannii.

OBJCTIVE To investigate the protective effect of ferulic acid (FA) on lipopolysaccharide (LPS)-induced damage to PC12 cells and hippocampal neurons in Sprague-Dawley (SD) rats and its potential mechanisms. METHODS ① in vitro study:PC12 cells were pretreated with FA 2.5-40 μmol · L-1 for 12 h and treated with LPS for another 8 h. CCK-8 kit was used to test PC12 cell viability. Inflammatory cytokines tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)were de?tected by ELISA kits. Laser scanning confocal microscopy was performed to measure F-actin expres?sion in the cells. ②in vivo study:FA 25,50 and 100 mg · kg-1 was ip given to Sprague-Dawley(SD) rats once a day for 35 d,and from the 29th day,ip co-administered with LPS(0.2 mg · kg-1)for 7 d. Immunohistochemistry method was used to determine protein expression of phophodiestera 4B (PDE4B)in the hippocampus of rats. The protein expression of cAMP response element-binding protein (CREB) and phospho CREB (p-CREB) was determined by Western blotting. RESULTS In the in vitro study,compared with LPS group,cell viability was significantly increased in FA 10,20 and 40μmol·L-1 groups(P<0.05),while the production of inflammatory cytokines TNF-α and IL-1β decreased(P<0.05). The structure and distribution of cytoskeletal protein F-actin were ameliorated markedly in PC12 cells. In the in vivo study,hematoxylin-eosin(HE)staining showed that pretreatment with FA(50 and 100 mg·kg-1) alleviated the damage to the hippocampus induced by LPS in SD rats. Immunohistochemistry showed that FA(50 and 100 mg·kg-1)pretreatment effectively prevented LPS-induced up-regulation of PDE4B expression in the hippocampus of rats(P<0.05). Western blotting analysis showed that the inhibitory effects on the protein expressions of CREB and p-CREB induced by LPS were altered by FA(50 and 100 mg · kg-1)pretreatment(P<0.05). CONCLUSION FA can protect against LPS induced damage to PC12 cells and hippocampal neurons of rats. The resistant effect on neuron-inflammation of FA may be conferred by inhibiting LPS-induced up-regulation of PDE4B and stimulating signaling pathways of cAMP/CREB.

OBJECTIVE:To provide suggestions for the government decision of payment price of medicare drugs. METHODS:Investigation was conducted for the beginning of payment price policy of medicare drugs,effect of the implementation of policy in other countries and the encountered problems. The payment pricing mechanism was explored based on the combination of new medi-cal reform with theoretical analysis and empirical research. RESULTS:The reform of payment pricing mechanism of medicare drugs will have effect on current drug price,especially for R&D oriented pharmaceutical industries. The policy can decrease drug expendi-ture in medicare expenditure,and it is not sure whether it can decrease total medicare expenditure. CONCLUSIONS:It is suggest-ed to notice the related measures and government should keep balance between drug availability and encouraging R&D innovation.

Objective To enhance the understanding of hemophagocytic syndrome(HPS)by analyzing the clinical manifestations, diagnosis and therapy. Methods The clinical data of 12 patients with HPS were retrospectively collected in the People's Hospital of Jiangsu Province from 2000 to 2007. The relevant literature were reviewed. Results Twelve patients were diagnosed as secondary hemophagocytic syndrome most secondary to virus and bacteria infection. Some patients condition was associated with systemic lupus erythematosus or histiocytic necrotizing lympheadenitis. All of the 12 patients had high fever, abnormal liver function and showed a decrease in the number of blood cells in a short time. After antivirus and antibiotic treatment, 11 patients'condition were improved and 1 patient died. Conclusion Hemophagocytic syndrome is not a common clinical condition but with poor prognosis. When patient presents with fever without apparent reasons and pancytopenia, bone marrow examination should be done and sometimes repeated bone marrow examinations are needed. The diagnosis of secondary haemophagocytic syndrome needs multidisciplineary cooperation. Aggressive diagnostic procedures are needed to clarify the diagnosis and prompt treatments are warranted to improve prognosis.

ObjectiveTo investigate the possibility of establishing a model of connective tissue disease-associated pulmonary arterial hypertension (PAH) in rats.MethodsPAH was induced by a single intraperitoneal injection of monocrotaline solution at a dose of 50 mg/kg.The rats of the control group were injected the same volume of 2:8 ethanol saline.After 2 and 4 weeks,a polyvinyl catheter was inserted into the pulmonary artery,and the hemodynamic variables were monitored continuously by Maclab/8 s.The pulmonary vascular pathologic remodelling was examined with hematoxylin and lectin perfusion.Thickness and area indices were calculated.ResultsFour weeks after intra-peritoneal injection of monocrotaline,the systolic,diastolic,and mean pulmonary arterial pressures [(41 ±6),(24.3±3.8),(29.8±4.2) mm Hg] were obviously increased in the experimental group [(23 ±3),(8.5 ±2.4),( 17.1 ±2.5) mm Hg] (P＜0.05) when compared with those of the control groups.Histological examination showed that the thickness of arterial wall increased,the lumen became narrowed,and the thickness and area index(TI:0.723±0.034 vs 0.314±0.023,AI:0.912±0.203 vs 0.414±0.021 ) increased in small pulmonary arteries(P＜0.05).ConclusionThe model of connective tissue disease-associated pulmonary hypertension could be established by intraperitoneal injection of monocrotaline solution.The model has been demonstratedthe characteristic morphologic changes in the pulmonary vasculature.This method may provide an economic,easy,and stable animal model for the study of the mechanisms of pulmonary vascular remodeling in connec-tive tissue disease-associated pulmonary hypertension.

Objective To investigate the association of chlamydia pneumoniae infection with ankylosing spondylitis (AS).MethodsSerum samples were obtained from 33 AS patients and 22 healthy controls.Enzyme-linked immunosorbent assay (ELISA) was applied to mearsure serum anti-Chlamydia pneumoniae antibodies (IgM/IgG),while immunofluorescence assay (IFA) was used to detect Chlamydia pneumoniae LPS antigen,and polymerase chain reaction (PCR) was used to amplify Chlamydia pneumoniae DNA in peripheral blood cells. Immunohistochemistical technique was applied to examine Chlamydia pneumoniae LPS antigen in synovial tissue from another 9 AS patients who received total hip replacement and 13 patients with comminuted femoral fractures.ResultsThe positive rates of Chlamydia pneumoniae IgM,LPS antigen and chlamydia pneumoniae DNA were higher in AS patients than those in healthy controls (78.8％ vs 22.7％,x2 =16.867,P =0.000; 66.7％ vs 31.8％,x2 =6.431,P =0.011; 33.3％ vs 9.1％,x2 =4.298,P =0.038).Chlamydia pneumoniae DNA positive rate was correlated with erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels (Z =-2.774 and -2.829,P =0.004).In synovial tissues,chlamydial LPS-containing inflammatory cells were observed in 77.8％(7/9) AS patients,while those in fracture patients was 30.8％ ( 4/13 ) ( P =0.08 ).Conclusion Chlamydia pneumoniae infection is common in blood circulation and joint cavity of AS patients and may be associated with the pathogenesis of AS.

Objective To compare the clinical curative effect of pedicle screw reduction and fix-ation via or not the injured vertebra in treatment of thoracolumbar fractures. Methods A retrospective study was performed on 27 patients with single thoracolumbar fractures admitted from March 2006 to Feb-ruary 2008. There were 12 patients treated with pedicle screw fixation (Group A) and 15 with traditional two-level fixation (Group B). Group A involved 11 males and 5 females, aged average 43 years (25-56 years); Group B included 10 males and 5 females, aged from 23 to 61 years (mean 42 years). All pa-tients had fresh fractures with intact pedicles on either unilateral or bilateral sides. With body position re-duction under anesthesia, the patients in Group B were treated with posterior routine distraction and lordo-sis restoration, while those in Group A were treated with the methods used in Group B as well as pedicle screw reduction and fixation. The kyphosis (Cobb angle) and recovery of injured vertebral height were observed. Results The mean follow-up period was 9 months (6-22 months). After operation, the op-timal Cobb angle and anterior column restoration were achieved through the ventral reduction from the in-jured vertebral body. The degree in anterior movement of injured vertebrae pre- and post-operatively was (0.089±0.036)° in Group A and (0.023±0.048)° in Group B, with statistical difference (P < 0.01). Cobb angle was (9.88±7.69)° in Group A and (5.19±3.24)° in Group B (P < 0.05). Changes of distance between the anterior- upper edge of the cephalad vertebrae to the anterior - lower edge of the caudal vertebral body was (39.3±5.2) % in Group A and (20.6±6.5)% in Group B (P < 0.05). Over distraction of the contiguous discs was also avoided efficiently. Conclusions Selective pedicle screw fixation into the injured vertebrae can help correct the kyphosis and maintain the reduction and en-hance the stiffness of the posterior short-segment instrumentation in single thoracolumbar fractures.

A rapid resolution liquid chromatography quadruple time-of-flight mass spectrometric ( RRLC-Q-TOF/MS) method combined with multivariate statistical analysis was applied to investigate the changes of endogenous metabolites in murine urine before and after ultraviolet B ( UVB ) irradiation for the purpose of discussing the physiological mechanism of acute injury caused by UVB radiation. A narrow-band UVB ( NB-UVB) (TL-01, peak value 312nm) was used to establish the acute light damage model. The urine samples were centrifuged before four times dilution treatment, subsequently the diluted urine samples were separated on a Supelco Ascentis Express C18 column using water (0. 1% formic acid) and acetonitrile as mobile phase by gradient elution. The differences metabolites with major contribution for grouping were found out based on the metabolic profiling analysis of principal component analysis ( PCA) and cluster analysis ( CA) , which could illustrate their possible mechanism of actions by means of relevant pathways. A prediction model was built to investigate the forecasting ability of the acute photo damage induced by UVB irradiation through the partial least square discriminant analysis ( PLS-DA ) . The results of multivariate statistical analysis showed that the blank control group was separated from UVB model group quite well, 11 endogenous metabolites were identified as the potential biomarkers through comparison with the database, tandem mass spectrum data and standard substance, which indicated the UVB radiation may affect the sphingolipid metabolism, nucleic acid metabolism, linoleic acid metabolism and amino acid metabolism pathways. These different metabolites could be helpful for diagnosing the light damage induced by UVB radiation

OBJECTIVE: To summarize the clinical effect of TPF regimen in the treatment of hypopharyngeal carcinoma and explore various clinical factors affecting treatment efficacy. METHOD: The clinical data of 20 cases with hypopharyngeal carcinoma, who received TPF treatment, were analyzed retrospectively. After two courses of chemotherapy, based on radiographic outcomes, next treatment plan was developed. To sum up the clinical information, including the clinical type, patterns of tumor growth, pathologic type, tumor stage, lymph node metastasis, age and so on. To analyze possible influencing factors affecting curative effect. RESULT: (1) After 20 cases with hypopharyngeal carcinoma received two courses of TPF treatment, the effect was evaluated. Objective response rate was 65%. (2) In patients with hypopharyngeal carcinoma, the efficacy of TPF therapy was significantly related to the clinical type, patterns of tumor growth and pathologic type; there was no statistical significance in tumor stage, lymph node metastasis and age. CONCLUSION According to the clinical type, patterns of tumor growth and pathologic type of hypopharyngeal carcinoma, resistance to chemotherapy in hypopharyngeal carcinoma can be assessed, which provides important basis for designing individualized treatment plan.
Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cisplatin ; therapeutic use ; Fluorouracil ; therapeutic use ; Humans ; Hypopharyngeal Neoplasms ; therapy ; Lymphatic Metastasis ; Retrospective Studies ; Taxoids ; therapeutic use ; Treatment Outcome

Objective:To solve the problems in intensity-modulated radiation therapy (IMRT) planning, such as large labor cost and high dependence on the experience of physicists and great inconsistency in the quality of plan, and to discuss an unsupervised automatic treatment planning procedure of IMRT.Methods:The eclipse scripting application programming interface (ESAPI) within the Eclipse treatment planning system (TPS) 15.6 and optimization parameters tree search algorithm (OPTSA) were used to emulate and realize the whole planning process. Interacted with the TPS through ESAPI, relevant dosimetric parameters were input and output. The OPTSA evaluated the plan qualities based on dosimetric parameters of the targets and organs at risk (OARs) and iteratively adjusted the optimization objective parameters to achieve a progressively improving IMRT plan. In order to verify the effectiveness of the automatic planning, twenty historical rectum cancer cases were selected from the clinical database, and the dose distribution and specific dosimetric parameters were compared between the plans generated by the OPTSA and the manual plans under the same constraints.Results:All the auto plans have met clinical requirements. Furthermore, 90% and 10% of the auto plans were deemed as clinically improved and equally compared with the manual plans, respectively. The average CI for the PTV was 0.88 and 0.80 for the auto and manual plans respectively. Compared with the manual plans, the mean doses of all the OARs in the auto plans were reduced by 11% in average. The average elapsed time of automatic planning and manual planning was (28.15±3.61) and (36.7±4.6) min, respectively.Conclusions:The plans created by the proposed algorithm have been shown to be at least as good as the manual plans. In addition, this method can shorten the labor time in plan designing while ensuring the plan quality and consistency of the plan.