Objective To investigate the clinical efficacy of imipenem and cilastatin sodium on the clinical efficacy of elderly patients with severe bacterial infection, and to observe the clearance rate to different floras.MethodsA total of 206 elderly patients with severe bacterial infection as the research object in our hospital outpatient treatment, were divided into control group and observation group, the patients were collected with sputum, blood and urine samples sent for bacterial culture.All patients were given positive treatment and nursing care, the observation group was given imipenem and cilastatin sodium treatment,the control group was given cefotaxime sodium treatment.The clinical efficacy, bacterial clearance and adverse reactions of the two groups were recorded and compared.ResultsThe total efficiency rate was 91.26% in the observation group, and 79.61% in the control group.The number of effective cases was significantly higher in the observation group than in the control group (P<0.05), the number of ineffective cases was significantly lower than that of the control group (P<0.05);The bacterial clearance rate was 85.71% in the observation group, and 43.33% in the control group, the clearance rate of Bauman Acinetobacter, Klebsiella pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus was significantly higher in the observation group than in the control group (P<0.05).Through the detection of adverse reactions showed that the observation group and the control group after treatment, few patients mild symptoms of nausea and vomiting and itching rash, on the occurrence of adverse reactions of the two groups of patients were compared, the difference was not statistically significant.ConclusionFor elderly patients with severe bacterial infection with imipenem and cilastatin sodium for treatment, the effective rate is high and can timely remove a variety of pathogenic bacteria, and rare adverse reactions, high safety, worthy of clinical application.

Objective To compare the clinical outcomes of gefitinib and erlotinib treating non-small-cell lung cancer (NSCLC)with epidermal growth factor receptor (EGFR)mutation in either exon 19 or 21 . Methods A total of 242 patients diagnosed as NSCLC with EGFR mutation in either exon 19 or 21 from May 201 3 to December 2014 in our hospital were chosen in this study.According to age,sex,smoking history,eastern cooperative oncology group performance status and types of EGFR mutation,all the patients were matched to 121 pairs,and randomly divided into group A and B.Patients in group A received gefitinib treatment,and those in group B received erlotinib treatment.Based on the response evaluation criteria in solid tumors (RECIST),overall response rate (ORR),disease control rate (DCR),progression-free survival (PFS)were assessed.To assess the independent risk factors for PFS by univariate and multivariate Cox regression analysis.The subgroup analysis was performed for the 63 NSCLC patients using these two drugs as the first-line treatment.To evaluate the adverse drug reactions and quality of life between A and B groups.Results The median PFS of group A and B were 11 .6 months and 9.5 months,respectively,with no significant difference (HR =0.39,P >0.05).The ORR and DCR in the two groups were 76.9%,74.4% (χ2 =1 .03,P =0.58)and 90.1 %,86.8% (χ2 =1 .46,P =0.31 ). The independent risk factors of poor PFS were ECOG PS≥2 (HR =2.60,95%CI:1 .54 -4.43,P =0.001 )and non-adenocarcinoma (HR =3.61 ,95%CI:1 .54-8.66,P =0.003).For patients receiving these two drugs as the first-line treatment,there was no significant difference between two groups in overall response rates (76.6% vs. 90.2%,χ2 =0.83,P =0.12)and median PFS (11 .6 months vs.14.4 months,HR =0.59,P >0.05).The adverse drug reactions were significant differences in emotion function (F =10.27,P =0.03),diarrhea (F =10.24,P =0.03)and pain (F =9.02,P =0.04).After receiving drug treatment,the quality of life scores were improved,and most of the differences were statistically significant between A and B groups(P <0.05). Conclusion As for NSCLC with EGFR mutation in either exon 1 9 or 21 ,both gefitinib and erlotinib are well tolerated and have similar clinical effectiveness.

Objective To discuss the diagnostic value of dynamic contrast-enhanced MRI in differentiating vertebral metastatic tumors from benign deseases after studying the early changes of signal intensity.Methods Twenty patients were scanned by dynamic contrast-enhanced MRI.The parameters of signal intensity were measured and calculated,and time-intensity cures(TICs)were drawn.Then,they were compared with those of normal verte- braes,the characteristics were analyzed.Results The parameters of vertebral metastatic tumors:peak signal intensi- ty,signal intensity minimum signal intensity of post-peak,peak slope,initial ratio of enhancement,maximum ratio of enhancement was respectively(50.61?11.38),(46.75?10.23),(0.73?0.12),(0.33?0.08),(1.03?0.31); that of normal vertebraes was respectively(40.53?12.12),(34.72?14.06),(0.31?0.11),(-0.25?0.05), (0.69?0.28);and ten normal cases showed negative in initial percent of enhancement,but only two abnormal ver- tebraes showed that.All of the above had significant statistical difference.Four types of TICs were concluded:early rapid rise and early rapid descent followed by steady phase(type A),persistently rise(type B),rise phase followed by steady phase(type C),rise phase followed by rapid descent phase(type D).TICs of abnormal vertebraes were respec- tively 6,5,5,5 cases;types of normal vertebraes were mainly type C,15 cases.Type A and type B and the type with the characteristic of early rapid descent phase were features of abnormal vertebraes;type C was the feature of normal ones.Conclusions Dynamic contrast-enhanced MRI could quantitatively show the characteristics of early changes of signal intensity of vertebral metastatic tumors,which were significant statistically different from those of normal ver- tebraes.Dynamic contrast-enhanced MRI was worth performing in the early diagnosis of vertebral metastatic tu- mors.

BACKGROUND: Herbal wines are an important part of the traditional Chinese medicine. The traditional medicated wine, lishizhen herbal wine,which can strengthen the immune function, has long been used for some chronic diseases. But,its mechanism remains unclear.OBJECTIVE: To explore the immune pharmacodynamics of lishizhen herbal wine and to observe its effect on the immune organs (spleen,pancreas) and lymphocyte transformation rate in mice.DESIGN: A randomized controlled experiment based on the observation of the experimental animals.SETTING: Department of integrated traditional Chinese and western medicine and the department of pharmacology of a university hospital MATERIALS: The experiment was completed at the Central Laboratory of Zhongnain Hospital of Wuhan University from September 2000 to December 2000. A total of 90 healthy Kuming mice were involved in the study.METHODS: Different doses of the herbal wine,cartinellin and the same volume of distilled water were given to the experimental animals. The drug administration was orally injected directly to the stomach of the animals once a day and 10 days consecutively. One hour after the last administration,the animals were put to death. Then,the thymus gland and the spleen were taken out and weighed to calculate the indexes of the thymus gland and the spleen. In the last three days of the administration phytohemagglutinin(PHA)was injected intramuscularly at a dose of 10 mg/kg once per day. Two hours after the last administration, the tails of the mice were cut out, the blood samples were taken to perform the Wright' s staining,and 100 lymphocytes were counted under immersion and the transformation rate was calculated.MAIN OUTCOME MEASURES: Primary results: ① The effect on the immune organs of normal mice; ② The effect of PHA on stimulating the lymphocyte transformation in mice. Secondary results: ③ The death condition of the experimental animalsRESULTS: Different doses of the herbal wine increased the spleen index in different degrees. The effect of medium dose group was obvious[(3.71± 0.78) g/kg] (P <0.05),and the thymus gland index increased a little (P>0.05). The cartinellin in the positive control group increased the spleen index[(3.79±0.91 ) g/kg] and there was no impact on thymus gland index. The transformation rates of the lymphocytes of different groups were increased to a different degree and presented a good quantity-effect relationship,especially the group administered a large dose[(45±14)%] (P<0. 01).CONCLUSION: Lishizhen herbal wine has an effect of increasing cellular immune function.

A fusion protein of glucagons-like peptide-1 and human serum albumin (GLP-1/HSA) was expressed and secreted into the fermentation broth with recombinant Pichia pastoris. The productivity of expressed GLP-1/HSA could reach 63.6mg/L in 10L fermentor. After concentrated with hollow-fiber ultrafiltration membrane, GLP-1/HSA was purified from fermentation broth by hydrophobic chromatography, negative ion exchange chromatography and gel filtration chromatography in turn. The HPLC analysis showed that the purified GLP-1/HSA had an overall purity of 95.8%. Furthermore, the analysis of in vivo activity indicated that GLP-1/HSA had the bioactivity of native GLP-1, and could significantly reduce blood glucose level 4h after intraperitoneal administration. It was concluded that a great deal of GLP-1/HSA with higher purity could be harvested by Pichia pastoris expression system and the established purification methods. Preliminary studies show a new potential for developing the long-acting GLP-1 analogs for clinical applications.

A permeabilization method of Micrococcus cells has been established. The obtained penneabilized cells could be used for several batches and in the mean time the intracellular enzymes still keep high activity. This method will undoubtedly increase the productivity of the cells and cut down the cost; therefore, it will be a promising way in the treha-lose industrialization. The experiment shows: after being treated with 5% (v/v) methylbenzene for 40min, the cells in suspension were converted into permeabilized cells, then the latter acted on 10% liquefied starch to produce trehaloae, the conversion ratio could reach 70%. The penneabilized cells could be used at least for 6 batchs (12h per batch) and the intracellular enzyme activity kept steady.

Objective To investigate the relationship between carotid intima media thickness (IMT) and pulse pressure index (PPI) in elderly hypertensive patients.PPI was defined as 24 h mean pulse pressure(PP)/24 h mean SBP.Methods One hundred and three elderly hypertensive patients were categorized by PPI level:group A (PPI

AIM: To better reveal the changing process of macula area after photodynamic therapy (PDT), the changes of tomographic imaging on macular fovea optical coherence tomography ( OCT ) scan at different follow- up time points after treating age-related macular degeneration ( AMD) by PDT were investigated.
METHODS: This cohort study included 30 eyes of 26 patients diagnosed as AMD. The dosage of verteporfin was calculated according to manufacturer's instruction. All participants got FFA, ICG, OCT scan and best corrected visual acuity before and followed up for 2wk, 1, 2, 3mo after PDT. The standard five lines combined with 6 lines OCT scan covered key parts of lesion and the scan locations before and after were kept the same. The bilaminar foveal thickness (BFT), outer high reflectivity band thickness ( OHRBT ) , and the total area of intraretinal fluid ( IRF ) and subretinal fluid ( SRF ) were measured at different time points. The relationship between the changes and follow up time was analyzed. Statistical analysis of the data was performed using SPSS for windows version 13. 0.
RESULTS: There months after treatment, an improvement of 2 lines or better on the Snellen chart was achieved on 22 eyes, visual acuity of 3 eyes without significant change, 3 eyes got decreased, 2 cases lost follow up. The average macular thickness of improved 22 eyes before treatment was 722. 5±55. 6μm, 2wk after treatment, 708. 3±45. 3μm, 1mo, 584. 4±49. 3μm, 2mo, 430. 7±50. 2μm and 180. 6 ±36. 3μm at 3mo. The OHRBT before and after treatment respectively were 302. 3 ±50-2μm, 277. 5±42. 3μm, 202. 7±40. 1μm, 180. 6±35. 7μm, 100. 8±22. 9μm. The total area of both IRF and SRF was estimated as 0. 34±0. 12mm2 , 0. 25±0. 07mm2 , 0. 10±0-05mm2 , 0. 08±0. 04mm2 , 0. 05±0. 01mm2 .
CONCLUSION:SRF and retinal edema of patients with AMD were absorbed 1mo after PDT, and the BFT, OHRBT were significantly tend to be thin.

Objective: To study the effects of TNFα on wound healing. Methods: The skin lesion and incisions were made on mice and rhTNFα was applied in both skin lesion and incision. Tissue strips were evaluated for tensiometry and histologic features after healing. Results: It was found that rhTNFα markedly improved wound healing both in skin lesion and incision wound model, it also markedly enhanced the breaking strength of treated incision and increased wound cellularity in rh TNF α treated groups. Conclusion: The results suggest that TNFα play an important role in regulating inflammatory reactions of local injured tissues and it may improve the functions of fibroblasts, mononuclear phagocytes and endothelial cells. rhTNFα of suitable doses can promote wound healing. This shows that TNFα, as a wound healing promoter, has the potentials for clinical application.

Background Though nitric oxide (NO) and NO synthase (NOS) have a critical role in angiogenesis,their effects on corneal neovascularization (CNV) and mechanism need to be further explored.Objective The aim of this study was to explore the effects of NOS and its antagonist,Nw-nitro-L-arginine methyl ester (L-NAME) on experimental CNV in mice,and investigate the influence of NOS and L-NAME on the tube formation of human retinal endothelial cells (RECs) in vitro.Methods The CNV models were established in the left eyes of 36 male BALB/c mice aged 7-8 weeks by application of the filter paper with NaOH in the center of corneas.The mice were randomized into two groups.L-NAME of 10 g/L (0.5 ml) was intraperitoneally injected 1 week before induction of CNV three times a week for three weeks in the mice of the L-NAME injection,and PBS was used in the same way in the control group.CNV was examined under the slit lamp biomicroscope 2,4,7,14 days after NaOH burn.The expression of CD31 in the CNV was assayed to calculate the ratio of CNV area and total corneal area using whole mount technique.The expression of NOS mRNA in the corneal tissue was detected by reverse transcriptase polymerase chain reaction (PCR),and VEGF expression in the human RECs was assayed by Western blot.The vessel formation number of cultured human RECs with or without L-NAME was performed by matrigel in vitro.Grouped t test was used to compare the differences of the parameters between the two groups.Results CNV developed and peaked 2 weeks after the application of NaOH on the mice corneas,and the CNV was obviously less in the L-NAME group compared with the control group.The expression of NOS mRNA in the corneas (NOS mRNA/ GAPDH mRNA)was significantly lower in the L-NAME group than that of the control group 2,4,7 days after CNV induction (t =19.481,t=22.059,t=10.961,all at P＜0.01).The ratio of the CD31 positive area in whole corneal area was 0.59± 0.01 in the L-NAME group,and that of the control group was 0.78±0.10,showing a significant difference between the two groups (t =3.078,P＜0.05).Western blot assay showed that the relative expression of VEGF protein in human RECs was declined in the L-NAME group compared with the control group 0,2,4,7 days,with statistically significant differences in 4 days and 7 days after NaOH burn(t=7.696,t=17.953,both at P＜0.01).The number of vessel network was 46.33±1.86 in the L-NAME group and 64.00±4.51 in the control group,with a significant difference between them (t =3.623,P＜0.05).Conclusions NOS participated in the pathogenesis and aggravation of CNV induced by NaOH.L-NAME arrests CNV formation and human RECs tube formation through down regulating the VEGF expression and NOS activity.