OBJECTIVE:To investigate the application of vancomycin in pediatric patients.METHODS:By reviewing medical histories of 368 pediatric patients who had been treated with vancomycin from 2005 to 2006,the use of vancomycin was investigated in respect of children' general condition,microbiological examination,dosage regimen,adverse drug reactions to evaluate the rationality of drug use.RESULTS:ADR occurred in 17 cases(4.6%).The use of vancomycin was rational or basically rational in 240 cases(65.2%).CONCLUSION:It is necessary to tighten more strict control on the use of vancomycin in pediatric patients.

Objective:To establish a simple HPLC method for the determination of warfarin in human plasma and analyze the re-sults of 100 monitoring reports. Methods:Warfarin was extracted from the plasma samples by acetonitrile. The extract was separated on a ZORBAX Eclipse XDB-C8 column (150 mm × 4. 6 mm, 5 μm)with a mobile phase consisting of methanol and 0. 1% acetic acid (65∶35) at flow rate of 1. 0 ml·min-1 and detected by a diode array detector. The detection wavelength was at 308nm and the sample size was 20 μl. Results:The calibration curve was linear within the range of 0. 1-5. 12μg·ml-1 . The average recovery and RSD was ranged from 85. 0% to 102. 3% and 1. 2% to 3. 9%(n=6), respectively. Inter-and intra-day RSD were 1. 1%-1. 8% and 1. 6%-2. 9%, respectively. Conclusion:The proposed method is rapid, convenient and accurate in the detection of warfarinin concentration in plasma.

Objective To evaluate the clinical significance of the combined determination of serum procalcitonin (PCT),C reactive protein(CRP),prealbumin(PA)and white blood cell(WBC) in curative effect and prognosis of elderly patients with bacterial infection.Methods Serum PCT,CRP,PA and WBC levels and their dynamic changes of 70 patients with bacterial infection from intensive care unit(ICU)were measured.The patients with bacterial infection were classified into serious infection group and local infection group.And the comparison with virus infection group was made.Results The levels of PCT(18.00±3.20)μg/L and CRP(86.17±10.64)mg/L in serious infection group and local infection group[PCT(2.03±0.46)μg/L,CRP(50.24±7.45)mg/L] were increased.The contents of PA were reduced[(3.214±0.88)mg/L,(12.89± 1.03)mg/L].The levels of WBC were increased mildly[(8.89±1.23) × 109/L,(6.54±0.87) × 109/L].The differences were statistically significant between bacterial infection groups(serious infection group and local infection group) and virus infection group [PCT (0.21 ±0.06)μg/L,CRP (5.21 ±0.84) mg/L,PA (20.14 ±2.57)mg/L,WBC (5.30 ± 0.93) × 109/L] (P＜ 0.01).Serum PCT,CRP.PA and WBC showed significant differences between serious infection group and local infection group(P＜0.01).After antibiotic treatment,the levels of PCT (0.5 ± 0.08) μg/L,CRP (10.32 ± 1.65) mg/L and WBC (6.30± 0.91) × 109/L in bacterial infection group were reduced obviously and the concentration of PA (18.19±2.66)mg/L was elevated compared with before treatment [PCT(11.61±8.27)μg/L,CRP (71.80±20.09)mg/L,WBC(7.95± 1.59) × 109/L,PA(7.08±4.87)mg/L] (P＜0.01).Correlative analysis was performed between PCT and others indicators before and after antibiotic treatment in bacterial infection group and virus infection group.There was positive correlation between PCT and CRP,WBC before(r=0.586,0.445) and after treatment (r=0.688,0.463) in bacterial infection group.PCT and WBC(r=0.432) were positively correlated after treatment,while no correlation existed between PCT and others indexes in virus infection group(r＜0.306).When comparing sensitivity and specificity of PCT and CRP for diagnosis of bacterial infection disease,the sensitivity (95.7％) of PCT was similar to that of CRP.The specificity of PCT(86.7％) was remarkably higher than that of CRP(73.3％).Conclusions The combination of serum PCT,CRP.PA and WBC is valuable for early diagnosis of bacterial infection disease.Monitoring PCT level dynamically would assist an evaluation of curative effect and disease outcome of elderly patients.

Objectives This research explored the characteristics of changes in the serum metabolic profile of preeclampsia pregnancy(PE) to establish the disease distinguish model and screen characteristic metabolic markers with potential diagnostic value for preeclampsia.Methods From August 2014 to January 2016,samples in three groups were collected at Tianjin Third Central Hospital.Thirty-one clinically diagnosis patients with preeclampsia,25 normal pregnancy women and 29 healthy volunteers of childbearing age were enrolled.Ultraperformance liquid chromatography-mass spectrometry (UPLC-MS) was used to analyze serum metabolites of PE group (31 patients with preeclampsia),P group (25 normal pregnancy women) and Normal group (29 healthy volunteers of childbearing age).Nonparametric test analyzes were used to analyze the data and find the specific metabolites.Results This research established the principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) disease distinguish model for PE group,P group and Normal group.To distinguish PE group,P group and Normal group,15 characteristic metabolites were identified.Eight kinds of glycerol phospholipid (including 7 kinds of hemolysis phosphatidyl choline and 1 kind of lysophospholipids acid) and 1 kind of sphingomyelin in PE group were higher than that of normal pregnancy group.The difference had statistically significant(Z of the metabolites were 2.32,3.34,3.21,2.60,2.22,3.40,3.58,5.84,2.70 respectively,all P<0.05).1,25-Dihydroxyvitamin D3-26,23-lactone and 24-Oxo-1alpha,23,25-trihydroxyvitamin D3 in PE group were higher than that of P group and Normal group,which had a statistics difference (Z of the metabolites were 2.01,3.89,3.26,2.34 respectively,all P<0.05).Conclusions Metabolomics distinguish model has a good ability to distinguish PE group,P group and Normal group.Serum characteristic metabolites can successfully reflect the status of fat,calcium and phosphorus metabolism of preeclampsia patients and provide high value for prediction,diagnosis and treatment.

AIM: To further investagate the mechanism of thrombus formation and develop a new remedy of anti-thrombus formation. METHODS: The amplified DNA fragment of vWF-A1 domain was inserted into expression vector with 6?his taq (pQE-31), the recombinant expression vect or was transformed into E coli (strain M15) and induced by IPTG. The recombinant fragment, comprising residues 449-728 of mature vWF subunit, designate rvWF-A1. It was purified by Ni-NTA agarose column and renatured by Tris buffer containin g GSH and GSSG. FACS and platelet aggregometer were employed to analyse the rvWF -A1 function of binding to platelet glycoprotein Ib and inhibiting ristocetin-in duced platelet aggregation. RESULTS: The rvWF-A1 was expressed successfully in E coli, comin g up to 30% of total bacterial protein. Its purify was over 95% through Ni-NTA a garose. It was identified to have ability to bind to GPIb, its biologic activity to inhibit ristocetin-induced platelet aggregation was observed, and the inhibi tive rate was 84 7%. CONCLUSION: The above results indicated that high-level expressi on of rvWF-A1 was successfully achieved in E coli and rvWF-A1 may be an effectiv e antithromotic agent in preventing thrombus formation.

Objective To investigate the value in the diagnosis of tumor of the stomach by hypotonic water filling method com-bined with CT multi planar reconstruction (MPR).Methods CT image data of 21 5 cases with gastric tumor confirmed by operation and pathology in our hospital were analysed retrospectively.Conventional CT enhanced scan was obtained in patients with the stom-ach hypotonic water filling condition,and MPR CT characteristics of lesions were observed.Results In the 21 5 cases of gastric be-nign or malignant lesions,MPR showed 5 pathological types in 210 cases.In the conventional CT examination,the tumor diagnosis rate had obvious improvement in different gastric parts and types of the stomach tumors through CT MPR.Conclusion There is high detection rate in the diagnosis of gastric tumors using hypotonic water filling method with MPR,which can accurately display invasion and metastasis,and reduce the misdiagnosis and missed diagnosis in gastric tumor.

AIM:Atherosclerotic calcification is highly linked with plaque instability and cardiovascular events .Adenosine monophosphate-activated protein kinase ( AMPK) has been involved in the pathogenesis of various cardiovascular disease .The contributions of AMPKαsubunits to the development of atherosclerotic calcification in vivo remained unknown .We hypothesized that AMPKαsubunits may play a role in the development of atherosclerotic calcification .METHODS: Atherosclerotic calcification was generated by 24-week fed of western diet in ApoE-/-background mice .Calcification was evaluated in aortic roots and innominate arteries of ApoE-/-mice or in mice with dual deficiencies of ApoE and AMPKαsubunits globally ( AMPKα1 and AMPKα2 ) , or vascular smooth muscle cell ( VSMC)-specific or macrophage-specific knockout of AMPKα1 with atherosclerotic calcification pone diet . The mechanism of AMPKα1 in regulating Runx2 was further explored in human aortic VSMC .RESULTS: Ablation of AMPKα1 but not AMPKα2 in ApoE-/-background promoted atherosclerotic calcification with increased Runt -related transcription factor ( Runx2 ) expression in VSMC compared with ApoE-/-mice.Conversely, chronic administration of metformin, which activated AMPK, markedly reduced ath-erosclerotic calcification and Runx2 expression in ApoE-/-mice but had less effects in ApoE-/-/AMPKα1 -/-mice.Furthermore, VSMC-but not macrophage-specific deficiency of AMPKα1 in ApoE-/-background promoted atherosclerotic calcification in vivo com-pared with the controls .AMPKα1 silencing in human aortic VSMC prevented Runx 2 from proteasome degradation to trigger osteoblastic differentiation of VSMC .Conversely , activation of AMPK led to Runx 2 instability by inducing its small ubiquitin-like modifier modifi-cation (SUMOylation).Protein inhibitor of activated STAT-1 (PIAS1), the SUMO E3-ligase of Runx2, was directly phosphorylated by
AMPKα1 at serine 510, to enhance its SUMO E3-ligase activity.Ablation of PIAS1 serine 510 phosphorylation inhibited metformin-in-duced Runx2 SUMOylation, and subsequently prevented the effect of metformin on reducing oxLDL-triggered Runx2 expression in hu-man aortic VSMC.CONCLUSION:Deficiency of AMPKα1 in VSMC increases Runx2 expression and promotes atherosclerotic calcifi-cation in vivo.AMPKα1 phosphorylates PIAS1 to enhance Runx2 SUMOyalation and subsequent degradation .

Objective To explore the expression feature of long non-coding RNA (lncRNA) 1010001N08Rik in hyperoxia-induced bronchopulmonary dysplasia (BPD) and predict the mechanism that 1010001N08Rik might be involved in the occurrence and development of BPD by a series of bioinformatics analysis.Method The sequence,genomic position and structure characteristics of 1010001N08Rik were acquired from UCSC genome browser,and its target gene was predicted by Ensemble database.We successfully established the animal model of BPD by making newborn C57BL/6J mice exposed to 95％ concentrations of ambient oxygen for seven days.The expression of 1010001N08Rik and Gata 6 were detected using real-time quantitative polymerase chain reaction (PCR).Student's t test was used to compare their expression levels during the BPD process.Result The relative expression of 1010001N08Rik in BPD process at d1,d3,d5,d7 was 1.21 ± 0.33,2.02 ± 0.41,2.95 ± 0.45,4.20-± 0.48 respectively,and there were significant difference between adjacent time points (P ＜ 0.05).The relative expression of Gata 6 mRNA was 0.92 ±0.30,1.10 ± 0.31,0.86 ± 0.24,0.45-± 0.08 respectively,and there was significant difference between d5 and d7 (P ＜0.05).1010001N08Rik had highly conserved property among different species.The chromosomal regions of 1010001N08Rik existed transcriptional factors binding locations and epigenetic regulation clues,and its possible candidate target gene was Gata 6.Conclusion The expression of 1010001N08Rik increased during the formation process of BPD.Bioinformatics analysis and preliminary experiment results suggested that 1010001N08Rik might participate in the process of BPD by down-regulating Gata 6 expression.

In this article, the Chinese Traditional Medicine and Materia Medica Subject Headings, Standards of the People's Republic of China - Classification and Codes of Diseases and Zheng of Traditional Chinese Medicine and the Chinese Terms in Traditional Chinese Medicine and Pharmacy were compared. Three standards were compared from the terminology quantity, content and classification. Each standard has its special feature. The compatibility and consistency are not strong in these standards. More authoritative traditional Chinese medicine terminology standards need to be established for the application in the clinical practice and scientific research.

This article was aimed to study the semantic relationship of clinical terminology of traditional Chinese medicine (TCM) from 3 000 clinical medical records and outpatient medical records from books. The aim was to verify the coverage of semantic relationships of UMLS and SNOMED in medical language system with real medical records. The extraction was from the practical aspect in order to improve the semantic relationships involved in TCM clinical practice processes.