Objective To investigate the effects of levofloxacin,ciprofloxacin,ceftazidime,pip-eracillin,cefoperazone/sulbactam,erythromycin,sulfamethoxazole and gentamycin on the bacterial biofilms of Stenotrophomonas mahophilia.Methotis Biofilm and conventional susceptibilities were determined for S.maltophilia isolates from 42 patients.The model of S.maltophilia biofflms in vitro was developed in the Mueller-Hinton broth--micmtiter inoculator or silica films.After antibiotic challenge plate 20 h,each plate was sonicated and the absorbance value at 620 nm(A620)was measured on a microtiter plate colorimeter be-fore and after incubation for 6 h.Then the biofilm inhibitory concentrations were calculated.Finally,based on the acquired data.the experiments of combinafion effects of erythromycin with the 3 antibiotic agents on the formed biofilms of 5 picked strains were designed and worked out.Results The sensitive rate of 42 S.maltaphilia to levofloxacin.sulfamethoxazole and piperacillin were 83.33%,66.67%and 54.76%,re-spectively.The bilfilm inhibitory concentrations were much higher than the corresponding minimal inhibitory concentrateion after formed biofflms.Conclusion Forty-two S.maltophilia are multi-resistant to antibiotic agent.And levofioxacin may have a better effect against biofilms compared with others.The inhibition effect of combination erythromycin with levofloxacin is more obvious among all the 3 antibiotic agents.

OBJECTIVETo explore the therapeutic effects of amiodarone and metoprolol, either alone or in combination, on chronic heart failure (CHF) complicated by ventricular arrhythmia.

METHODSA total of 110 NYHA class II-III patients with CHF complicated by ventricular arrhythmia were randomly divided into amiodarone group, metoprolol group and amiodarone + metoprolol group. The therapeutic effects was evaluated at the end of the 1-year follow-up.

RESULTSAmiodarone, metoprolol and their combination produced statistically different therapeutic effects (P<0.05). Compared with amiodarone and metoprolol used alone, amiodarone combined with metoprolol resulted in significant cardiac function improvement (P<0.05) and ventricular arrhythmia control (P<0.01). During the 1-year follow-up, the readmission rate and cardiac event rate in the amiodarone + metoprolol group were significantly lower than those in amiodarone group (P<0.01) and metoprolol group (P<0.05). The adverse reaction rates in the 3 groups were similar (P>0.05).

CONCLUSIONThe combination of amiodarone and metoprolol produces better effect than amiodarone or metoprolol alone in the treatment of CHF complicated by ventricular arrhythmia.

Adrenergic beta-Antagonists ; therapeutic use ; Adult ; Amiodarone ; therapeutic use ; Anti-Arrhythmia Agents ; therapeutic use ; Chronic Disease ; Drug Therapy, Combination ; Female ; Heart Failure ; complications ; drug therapy ; physiopathology ; Humans ; Male ; Metoprolol ; therapeutic use ; Tachycardia, Ventricular ; drug therapy ; etiology ; physiopathology ; Treatment Outcome ; Ventricular Premature Complexes ; drug therapy ; etiology

To investigate the clinical features and principles of diagnosis and treatment of early postoperative inflammatory ileus (EPII). The clinical data of 69 patients with EPII treated in this hospital were retrospectively reviewed. EPII mostly occurred in 3-11d after abdominal surgery, and the average time was 5d. Sixty two cases were cured in a mean period of (22±13)d through combination therapy including gastroenteral decompression, somatostatin, dexamethasone and total parenteral nutrition (TPN). Seven cases were cured by operation. EPII is a special type of early intestinal obstruction which often occurs in two weeks after abdominal operation. Its typical symptoms are abdominal distension; conservative therapy is effective for most cases and reoperation is usually contradicted.

ObjectiveTo study the effect of platelet aggregation rate (PAR) level on the prognosis of percutaneous transluminal coronary angioplasty (PCI).MethodsFour hundred and one patients who performed PCI were divided into 4 groups:group 1 (PAR≤30％,103 cases),group 2 (PAR 31％ - 40％,102 cases),group 3 (PAR 41％ - 49％,103 cases ) and group 4 (PAR ＞ 49％,93 cases ).All the patients were followed up.The survival analysis was performed in 4 groups.ResultsThe data of survival table were tested by 3 methods among 4 groups:statistic was 0.612,degree of freedom was 3,P =0.894 in Log-rank (Mantel-Cox) test,statistic was 0.567,degree 9f freedom was 3,P =0.904 in Wilcoxon test and statistic was 0.586,P =0.900 in Tarone-Ware test.There was no significant difference among them.The mean follow-up duration was 2.2 years,and there was no significant difference in survival function among 4 groups (P ＞0.05).ConclusionPreoperative and postoperative measurement of PAR levels may not improve the prognosis.

ObjectiveTo investigate the clinical characteristics of patients with acute coronary syndrome suffering hemorrhage during hospitalization. MethodsThe clinical symptoms,diagnostic and therapeutic characteristics and in-hospital outcome of 3807 inpatients who were recruited into SINO-GRACE study in China due to acute coronary syndrome from March,2001 to December,2007 were collected.Statistical methods were adopted to compare the differences in clinical data between hemorrhage group and non-hemorrhage group.ResultsHemorrhage had happened in 57 out of 3807 inpatients with the incidence of 1.50％. Five patients, which accounted for 9.6％of the overall hemorrhage cases, were fatal hemorrhage.Nine patients were intracranial hemorrhage with the incidence of 0.24％. There were 155 deaths among the 3807 patients,with an overall mortality rate of 4.1％. The mortality of hemorrhage accounted for 3.2％in overall mortality. Patients with one of the following factors were more apt to hemorrhage:＞ 70 years old,previous hemorrhage history,renal failure history,heart failure history and clopidogrel and glycoprotein (GP)Ⅱ b/Ⅲ a receptor antagonist administration for coronary artery bypass grafting.Patients who developed hemorrhage might need prolonged hospitalization and were liable to develop heart-related adverse events,including re-infarction and sustained ventricular tachycardia/fibrillation after they were admitted in hospital over 24 hours. ConclusionPatients with acute coronary syndrome who underwent coronary artery bypass grafting,with advanced age,previous hemorrhage history,renal failure history,heart failure history or treated with clopidogrel and GPⅡ b/Ⅲ a receptor antagonist are more vulnerable to hemorrhage.

OBJECTIVETo observe the therapeutic effect of Hongbeiyegen [the root of Alchornea trewioides(Benth.) Muell.-Arg.] on alcohol-induced liver fibrosis (AF) in rats and explore its mechanism.

METHODSIn rats with AF, the serum levels of transforming growth factor beta1 (TGFbeta1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) were detected along with examination of the changes in serum hyaluronic acid (HA), laminin (LN), procolagen type III (PC III), collagen type IV (C IV), glutamic-pyruvic transaminase (ALT) and glutamic-oxalacetic transaminase (AST) levels.

RESULTSCompared with the control group, Hongbeiyegen could significantly reduce the levels of TGFbeta1, TIMP-1, HA, LN, PC III, CIV, ALT and AST in rats with AF.

CONCLUSIONHongbeiyegen can relieve and ameliorate liver fibrosis possibly by inhibiting the expression of TGFbeta1 and TIMP-1.

Alanine Transaminase ; blood ; Animals ; Aspartate Aminotransferases ; blood ; Collagen Type III ; blood ; Collagen Type IV ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Ethanol ; Euphorbiaceae ; chemistry ; Female ; Hyaluronic Acid ; blood ; Laminin ; blood ; Liver Cirrhosis, Experimental ; blood ; chemically induced ; drug therapy ; Male ; Phytotherapy ; Plant Roots ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tissue Inhibitor of Metalloproteinase-1 ; blood ; Transforming Growth Factor beta1 ; blood

Animals ; Blood-Brain Barrier ; drug effects ; Liver ; pathology ; Male ; Mice ; Mice, Inbred BALB C ; Necrosis ; physiopathology ; Tumor Necrosis Factor-alpha ; pharmacology

OBJECTIVETo explore the mechanism of fulminate hepatic failure (FHF) complicated with spontaneous peritonitis (SBP) through the research of bacteria invading the intestinal mucosa barrier.

METHODS240 BalB/c male mice were divided into four groups as isotonic NS group (n = 40), lipopolysaccharide (LPS) group (n = 40), galactosamine (GalN) group (n = 40) and FHF model group (n = 120). Each mouse received same volume of NS, LPS (10 ug/kg), GalN (800 mg/kg) or LPS (10 ug/kg)/GalN (800 mg/kg) intraperitoneal injection according to its group. 8 mice were executed at 2, 6, 9, 12 and 24 hours after injection, respectively, and the liver and intestinal tissue samples were taken at the same time. ALT was measured by automatic biochemical analyzer and was compared between groups using Mann-Whitney U test. Liver and intestinal tissue received HE staining. The ultrastructure of intestinal mucosa and the method by which bacteria invaded the intestinal mucosa were observed by transmission electron microscopy. All data were analyzed by SPSS13.0 statistic software.

RESULTSALT level, results of hepatic pathology, mortality and clinical manifestations of mice in the FHF model group met the diagnostic criteria of FHF. Intestinal tissue was found with slight edema and little inflammatory cells infiltration through HE staining in all the 4 groups of mice 9 hours after injection. Microvilli were found broken, shed and shorten in the intestinal epithelial cells with incomplete tight junction (TJs) and obviously changed organelles in the FHF model group of mice observed by transmission electron microscope. Mass hemorrhagic necrosis of liver cells with remnant liver cells swelling and many inflammatory cells infiltration by HE staining in the FHF model group. But the changes in hepatic pathology and intestinal mucosa ultrastructure were not so obvious in the mice of NS, LPS and GalN groups. Bacteria penetrated the intestinal wall by pinocytosis 6 to 9 hours after injection in the FHF model group, the microvilli were broken off and TJs turned rupture in the areas that the bacteria penetrated. The bacteria were found in the form of cyst 12 hours after injection.

CONCLUSIONLPS (10 mg/kg)/GalN (800 mg/kg) combined injection was successful in establishing the FHF mice model. The rupture of TJs may provide conditions for intestinal bacteria to penetrate the intestinal mucosa in FHF. Rupture of TJs may be one of the reasons why FHF was complicated with SBP.

Animals ; Disease Models, Animal ; Intestinal Mucosa ; microbiology ; pathology ; Liver ; pathology ; Liver Failure, Acute ; microbiology ; pathology ; Male ; Mice ; Mice, Inbred BALB C ; Tight Junctions ; microbiology ; pathology

OBJECTIVETo study the role of tumor necrosis factor-alpha (TNFalpha) on enterocyte apoptosis in the experimental model of fulminant hepatic failure (FHF).

METHODSLiver damage was induced by lipopolysaccharide (LPS)/TNFalpha in D-galactosamine (GalN) sensitized BALB/c mice. Serum TNFalpha levels were determined by enzyme-linked immunosorbent assays (ELISA). The intestinal tissues were studied micro- and ultra-microscopically at 2 h, 6 h, 9 h, 12 h and 24 h time points in mice with fulminant hepatic failure. Enterocyte apoptosis was determined by TUNEL method. The TNFR I expression in the intestinal tissue was tested by immunohistochemistry.

RESULTS(1) Gut mucosa was morphologically normal at every time point in all groups, but typical apoptotic cells could be seen in the experimental groups under the electron microscope. Apoptosis rate of gut mucosal epithelial cells was significantly increased at 6 h (large intestine: 6.47e(-3)+/-2.91e(-4); small intestine: 6.64e(-3)+/-3.78e(-4)), 9 h (large intestine: 6.81e(+4)+/-7.41e(+3); small intestine: 2.58e(+4)+/-2.28e(+3)) and 12 h (large intestine: 4.92e(+4)+/-9.80e(+3); small intestine: 5.24e(+4)+/-3.01e(+3)), and peaked at 12 h in mice with FHF. (2) TNFalpha induced apoptosis of enterocytes in mice with FHF. Anti-TNFalpha inhibited this effect. (3) The integrated OD (IOD) levels of TNFalpha receptor I protein expressed differently in the intestine of mice with GalN/LPS and GalN/ TNFalpha-induced FHF at 9 h after GalN/LPS and GalN/ TNFalpha administration, in comparison with those of the control groups. IOD level of TNFRI changed significantly at 6 h (large intestine: 2.82e(+4)+/-4.60e(+3); small intestine: 1.14e(+4)+/-2.13e(+3)), 9 h (large intestine: 6.81e(+4)+/-7.41e(+3); small intestine: 2.58e(+4)+/-2.28e(+3)) and 12 (large intestine: 4.92e(+4)+/-9.80e(+3); small intestine: 5.24e(+4)+/-3.01e(+3)) hours after GalN/LPS and GalN/ TNFa administration. The expression of TNFR1 protein was significantly higher at 9 and 12 h after GalN/LPS and GalN/TNFa administration than other time points. Protein expression of TNFR1 was positively correlated with enterocyte apoptosis.

CONCLUSIONTNFa can induce enterocyte apoptosis in mice with FHF. Anti- TNFalpha IgG can inhibit this role. Excessive TNFRI expression of enterocyte in fulminant hepatic failure can be induced by TNFa, which suggests that TNFalpha can induce apoptosis of enterocyte by up-regulation of TNFRI protein expression.

Animals ; Apoptosis ; physiology ; Enterocytes ; pathology ; Galactosamine ; Lipopolysaccharides ; Liver Failure, Acute ; chemically induced ; pathology ; Mice ; Mice, Inbred BALB C ; Tumor Necrosis Factor-alpha ; blood

Objective To study the changes of plasma cystatin C level (PcyC),and evaluate the effects of the joint use of atorvastatin and probucol on PcyC and severity of coronary lesion in patients with borderline lesion of coronary artery.Methods One hundred and thirty consecutive patients with borderline coronary lesion assessed by quantitative coronary angiography were enrolled into borderline coronary lesion group (BCL),and another 136 subjects without coronary lesion were enrolled as controls (CTR).And in the meantime,the subjects in BCL group were randomized (closed envelope method) into routine treatment subgroup ( RTT,n =60),and combined treatment subgroup in which patients were treated with atorvastatin 20 mg plus probucol 1.0 g daily in addition to routine medication ( CBT,n =70) for 6 months.There were no statistical differences in basic clinical features between two subgroups.PcyC,high-sensitive C-reactive protein (hs-CRP),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol ( HDL-C ) and triglycerides (TG) were determined.Of them,104 patients in BCL group rechecked by coronary angiography.Comparison of biomarkers carried out between two groups by using a number of independent-sample t-test and analysis of variance.For enumeration data,chi-square test was used to compare mean values of biomarkers between groups. P ＜ 0.05 was considered statistically significant.Results PcyC levels were significantly higher in BCL group than those in CTR group ( P ＜ 0.05 ).Compared with RTT subgroup,levels of PcyC,TC,LDL-C,TG and hs-CRP were more significantly decreased in CBT subgroup (P ＜ 0.05,P ＜ 0.01 ).Moreover,there was a trend of slight decrease in the mean percent of stenosis (MPS) of coronary artery with borderline lesion in RTT subgroup treated for 6 months,whereas more marked decrease in the MPS of coronary artery with borderline coronary lesion in CBT subgroup treated for 6 months ( P ＞ 0.05 ; P ＜ 0.05 ).Conclusions Cystatin C plays an important role in the pathogenesis of coronary artery,and PcyC is associated with severity of coronary lesion,the combination of atorvastatin and probucol decreases the PcyC level,and it may be the treatment of choice for borderline lesion of coronary artery.