Objective To investigate clinical effects and safety difference of cholesterol absorption inhibitor associated with atorvastatin for high dose on elderly patients with coronary heart disease and poor lipid controlling. Methods 240 elderly patients with coronary heart disease and poor lipid controlling were chosen and randomly divided into 3 groups including group A (80 patients)with atorvastatin for conventional dose,group B (80 patients)with atorvastatin for high dose and group C (80 patients)with atorvastatin for high dose associated with ezetimibe for cholesterol absorption inhibitor;and the compliance rate of total cholesterol (TC)and low density lipoprotein cholesterol (LDL-C),serum lipids before and after treatment and the incidence of adverse reaction of 3 groups were compared. Results The compliance rate of TC of group A,group B and group C were separately 40.00%(32/80),62.50%(50/80)and 96.25%(77/80);the compliance rate of LDL-C of group A,group B and group C were separately 51.25%(41/80),81.25%(65/80)and 98.75%(79/80);the compliance rate of TC and LDL-C of group C was significant better than that of group A and group B (χ2 =58.28,27.83,48.13,13.61,all P<0.05).The levels of TC,TG,LDL-C and HDL-C of group A after treatment were separately (5.35 ±1.26)mmol/L,(2.10 ±0.83) mmol/L,(2.85 ±0.93)mmol/L and (1.23 ±0.67)mmol/L;the levels of TC,TG,LDL-C and HDL-C of group B after treatment were separately (4.97 ±1.02)mmol/L,(2.05 ±0.81)mmol/L,(2.47 ±0.86)mmol/L and (1.20 ± 0.65)mmol/L;the levels of TC,TG,LDL -C and HDL -C of C group after treatment were separately (3.84 ± 0.82)mmol/L,(1.74 ±0.56)mmol/L,(2.06 ±0.71)mmol/L and (1.24 ±0.52)mmol/L.The levels of TC,TG and LDL-C of group C after treatment was significant better than group A and group B (F=3.80,4.94,4.21,all P<0.05).There was no significant difference in level of HDL-C among 3 groups after treatment(P>0.05).The incidences of adverse reaction of group A,group B and group C were separately 1.25%(1/80),3.75%(3/80)and 2.50%(2/80);there was no significant difference in incidence of adverse reaction among 3 groups(χ2 =1.03,P>0.05).Conclusion Cholesterol absorption inhibitor associated with atorvastatin for high dose on elderly patients with coronary heart disease and poor lipid controlling can efficiently control blood lipid levels,improve compliance rate of blood lipids,and did not increase the risk of adverse reaction.

OBJECTIVE To investigate the genes of disinfectant-sulfadiazine and antibiotic resistance of Escherichia coli strains in elderly wards.METHODS Polymerase chain reaction and dilution test were used to detect and analyze the disinfectant-sulfadizane drug resistance gene and drug resistance of the E.coli.RESULTS From 30 E.coli strains isolated from elderly patients,21 were detected carrying disinfectant-sulfadizine drug resistance genes,and the positive rate of qacE△1-sulⅠ was 70.0%.CONCLUSIONS The detection rate of disinfectant-sulfadiazine drug resistance gene from E.coli strains isolated from elderly patients,the bacteria detection rates are relatively high.Most of the isolates were resistant to commonly used antibiotics.It suggests that clinical drug-resistant strains may be resistant to disinfectants.This condition should be paid much attention by disinfection wotkers of our country.

OBJECTIVE To investigate the ?-lactamases in Klebsiella pneumoniae strains isolated from the elderly patients.METHODS We had an observation on 20 strains of Klebsiella pneumoniae about 15 kinds of ?-lactamase gene test(blaTEM,blaSHV,blaLEN,laOKP,blaCTX-M-1 group,blaCTX-M-2 group,blaCTX-M-9 group,blaOXA-1 group,blaOXA-2 group,blaOXA-10 group,blaGES,blaPER,blaVEB,blaDHA,and blaACT-1).RESULTS Six kinds of ?-lactamase genes had been found out from these 20 strains of K.pneumoniae,namely,blaTEM,blaSHV,blaCTX-M-1 group,blaCTX-M-9 group,blaOXA-1 group,and blaDHA.Their positives were 95%,30%,50%,5%,5% and 15%.Among these 20 strains of K.pneumoniae,there were 19 ones of K.pneumoniae which at least contained 1 kind of ?-lactamase genes.Fifteen strains of K.pneumoniae were found containing more than 2 kinds of ?-lactamase genes,at the same time.Some were even tested out having 4 kinds of ?-lactamase genes.CONCLUSIONS The resistance of ?-lactamase antibiotics of these 20 strains of K.pneumoniae has a close relative to the number of ?-lactamase.

OBJECTIVE To investigate the chloramphenicol-resistant gene in Escherichia coli strains isolated from the old patients.METHODS Twenty strains of E.coli were clinically isolated.The resistance genes were analyzed by polymerase chain reaction(PCR) and verified by DNA sequencing.RESULTS The positive rates of catB and cmlA were 20% and 20%,respectively.Two strains of E.coli were found containing catB gene and cmlA gene.CONCLUSIONS The resistance to chloramphenicol in these 20 strains of E.coli has a close relation to antimicrobial-resistance gene existed,and the genes of catB and cmlA in E.coli are all firstly found and reported in China.

OBJECTIVE To investigate the prevalence of sulfamethoxazole/trimethoprim(SXT)-resistance genes and drug resistance in Escherichia coli isolates from the old patients.METHODS Drug resistance of 20 E.coli strains were analyzed.The SXT-resistance genes(sul1,dfrA1,dfrA12 and dfrA17)were detected by polymerase chain reaction(PCR).The PCR products were purified and sequenced.RESULTS In 20 E.coli strains,95.0% were SXT resistant.The positive rate of genes of sul1,dfrA12 and dfrA17 were 80.0%,20.0% and 65.0%.Gene of dfrA1 was not detected out,17 strains of E.coli were found dfrA gene.The SXT-resistance gene dfrA or sul1 was detected in 18 of the 20 strains.CONCLUSIONS The SXT resistance of E.coli can be caused mainly by gene expression of dfrA and sul1,and the genes of sul1,dfrA12 and dfrA17 are all firstly found and reported in China.

OBJECTIVE To investigate the antimicrobial-resistant genes in meticillin-resistant Staphylococcus aureus(MRSA).METHODS Forty strains of MRSA were clinically isolated.Nine kinds of antimicrobial-resistant genes were analyzed by polymerase chain reaction(PCR).RESULTS The positive rates of mecA,aac(6′)/aph(2′)and tetM were all 100.0%.The positive rates of ermA/B/C,aph(3′)-Ⅲ,qacA/B,PVL and ant(4′,4″) were 82.5%,67.5%,45.0%,10.0% and 2.5%,respectively.CONCLUSIONS There are higher positive percentages of relevant resistance genes in MRSA isolates clinically.MRSA can induce clone transmition in hospital which should pay,and attention to the disinfection and isolation.

In this study, the "150-cavity", next to the H5N1 influenza virus neuraminidase activity site, has been used as the target to design and synthesize a structural analogue of chlorogenic acid, N-caffeoyl-GABA, using the flexible docking simulation. The docking study showed that the N-caffeoyl-GABA could be inserted into the "150-cavity" and combined with the Arg156 side chain by hydrogen bond. The best binding free energy of H5N1 NA-N-caffeoyl-GABA complex was -7.70 kcal mol(-1), equivalent that of the NA-oseltamivir. At the same time, using the H5N1 pseudotyping virus-based NA inhibitors screening model, we determined the inhibitory effect of oseltamivir, chlorogenic acid and N-caffeoyl-GABA on the NA. Compared with chlorogenic acid, N-caffeoyl-GABA significantly enhanced the inhibitory effect on NA, but less than oseltamivir. This study showed that the "150-cavity" could possibly be used as a new neuraminidase inhibitors target, and provided a path for the development of new neuraminidase inhibitors.

ObjectiveTo explore the regulation of claudin-4 expression in endometrial adenocarcinoma cell lines by progesterone.Methods Ishikawa cells were treated with various concentrations of megestrol acetate (MA:2,5,10,15,20 mg/L).After cultured for 24,48 and 72 hours,cells growth were measured by methyl thiazolyl tetrazolium (MTT).The group of Ishikawa cells incubated with MA at the 50％ inhibitory concentration ( IC50 ) was selected for cell apoptosis assay by using transmission electron microscopy and flow cytometry method.Real-time PCR and western blot were used for detecting the mRNA and protein expression levels of claudin-4.The localization of claudin-4 was examined by immunofluorescent staining.Results The inhibitory effects of megestrol acetate on the growth of Ishikawa cells were dosedependent and time-dependent.IC50 of MA on Ishikawa cells was 15 mg/L after incubated for 72 hours.After MA treatment,Ishikawa cells showed shrinkage,nuclear chromatin condensation,fractures of nuclear membrane and endoplasmic reticulum expansion,even round apoptotic bodies were found.The apoptosis rate of cells before MA treatment was (0.076 ±0.024)％,and the rate was (3.934 ±0.816)％ by MA treated for 72 hours,in which there were signicant difference( P ＜ 0.05 ).The relative quantification of claudin-4 mRNA and protein of the cells before MA treatment were 0.64 ± 0.20 and 0.94 ± 0.18,while they were 0.47 -0.15 and 0.62 ±0.15 after MA treated.The expression of claudin-4 was significantly decreased after MA treatment ( P ＜ 0.05 ).The localization of claudin-4 transferred from cytomembrane to cytoplasm and nucleus after MA treatment.Conclusions MA could inhibite the growth of Ishikawa cells,in which the mechanism may be decrease the expression of claudin-4 and the apoptosis of cells.The distribution change of claudin-4 may be related to the anti-cancer effect of progesterone.

ObjectiveTo evaluate the significance of the detection of serum C-reactive protein (CRP) in elderly patients with diabetes mellitus and cerebral infarction.MethodsSeventy-two patients with diabetes mellitus and cerebral infarction (diabetic cerebral infarction group),66 patients with cerebral infarction and without diabetes mellitus (non-diabetic cerebral infarction group) and 60 healthy persons (control group) from October 2008 to January 2011 were selected.The level of serum CRP was detceted.ResultsThe level of CRP was ( 3.81 ± 2.23 ) mg/L in diabetic cerebral infarction group,( 2.48 ± 2.24 ) mg/L in non-diabetic cerebral infarction group and (0.68±0.16) mg/L in control group.The levels of CRP in diabetic cerebral infarction group and non-diabetic cerebral infarction group were significantly higher than that in control group (P ＜ 0.05).The level of CRP in diabetic cerebral infarction group was obviously higher than that in non-diabetic cerebral infarction group(P ＜0.05).CRP abnormal rate was 70.8％(51/72) in diabetic cerebral infarction group and 43.9％ (29/66) in non-diabetic cerebral infarction group,which had statistical significance (P ＜ 0.05).ConcluslonCRP has important predictive value to the occurrence and development of diabetic cerebral infarction.

Objective To explore the influence of atorvastatin on the carotid atherosclerotic plaque and prognosis of older apoplexy.Methods 124 patients with carotid atherosclerotic plaque were randomly divided into 2groups,64 cases in the observetion group who had given atorvastatin(20mg) and general,and 60 cases in control group who had given genenal treatment.The relapse rate of apoplexy,the level of blood-fat and live viability condition were compared.Results ( 1 ) In the treatment group,the recurrence rate was 4.7％,and 18.3 ％ in the control group,the difference was statistically significant(x2=5.76,P ＜ 0.05 ).The two groups of adverse events had no significant difference ( x2=0.00,P ＞ 0.05 ).(2) In the treatment group,after treatment compared with before treatment,after the treatment group compared with the control group after treatment,TC,TG,LDL-C,HDL-C levels were statistically different ( all P ＜　0.05 ).(3) The life skills of the treatment group after treatment was signiflcantly better than the control group,the difference was statistically significant( x2 =24.18,P ＜ 0.05 ).Conclusion A torvastatin could significantly reduce the level of blood fat,improve prognosis,and reduce the rate of apoplexy,and had good effect.