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.

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.

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.

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.

OBJECTIVETo investigate the epidemiological factors in the first aid, early management, and treatment of chemical burns.

METHODSMedical records of 615 inpatients with chemical burns out of 2682 burn patients hospitalized from January 2001 to December 2010 were screened to retrospectively analyze the clinical data, including gender, age, burn area and depth, occurrence regularity, injury cause, injury-causing chemicals, wound site, complications, pre-hospital management, treatment and prognosis. Annual number of burn patients and annual number of patients with chemical burns were statistically analyzed with linear trend test.

RESULTS(1) Among all the chemical burn patients, 562 (91.4%) were male and 53 (8.6%) female. The mean age of patients was (32 ± 12) years. Burn area ranged from 1% to 95%, with mean area of (30 ± 25)% TBSA. Full-thickness burn area ranged from 0 to 85%, with mean area of (18 ± 24)% TBSA. (2) The annual number of burn patients showed a slow trend of increase during the last decade (χ(2) = 4.009, P < 0.05). There was no statistically significant difference in the annual number of patients with chemical burns among the last decade (χ(2) = 0.060, P > 0.05). Chemical burns mainly occurred in summer and autumn, and the incidence gradually increased in April, peaked in August, and then gradually decreased. (3) Five hundred and seventy-two cases (93.0%) were injured while working, among these patients 70.8% (405/572) were injured in private enterprises. (4) Acid was the most common injury-causing chemical (299 patients, accounting for 48.6%). (5) The extremities and head were the most involved areas. (6) Among 615 patients with chemical burns, 47 cases (7.6%) were complicated by inhalation injury, 94 cases (15.3%) by ocular burns, 51 cases (8.3%) by combined injury, and 67 cases (10.9%) by poisoning. (7) Most patients did not receive (30.4%, 187/615) or only insufficient (61.1%, 376/615) immediate irrigation after injury in pre-hospital management. (8) Two hundred and twelve patients (34.5%) underwent skin grafting or flap transplantation after early total or tangential excision of eschar within one week post injury. Among all the patients, 599 cases were cured with 11 eyes becoming blind in 8 patients, and sixteen patients died with a mortality rate of 2.6%.

CONCLUSIONSPatients with chemical burns accounted for a high proportion of the burn patients admitted to our unit in the same period, and they were mainly injured while working. Sufficient irrigation and immediate detoxification are key points in the treatment of chemical burns. Early total or tangential excision of eschar of deep wounds could reduce the possibility of poisoning.

Adolescent ; Adult ; Aged ; Burns, Chemical ; epidemiology ; therapy ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Objective Establish an objective and fair evaluation index system for the implementation effectiveness of the National Major New Drug Development Program of China.Methods Based on literature review and Delphi method,the framework of the evaluation index system was built and analytic hierarchy process was applied to determine the priority of each indicator of the system.The objectiveness and validness of the results were assured by determining expert activeness coefficient,authority coefficient,indicator rationality,and by applying consistency check.Results A targeted and systematic evaluation index system was constructed for the National Major New Drug Development Program,and through expert consultation and analytic hierarchy process,the factor of product result was considered of the highest weight of 39.03％,followed by technical result,theoretical result and organization and management result.The evaluation index system suggested that product result and technical result are two relatively more significant factors to be considered during evaluation.Conclu sion After consultation on expert opinions,the evaluation index system for the National Major New Drug Development Program was constructed with each factor been assigned with a scientific and rational weight,and this will provide a guideline for the decision making of program administrators and evaluation practice.

Objective:To prepare a novel dental lithium disilicate glass-ceramic,and to study its properties.Methods:A2 colored novel glass-ceramic was prepared by sintering technique.The flexural strength,density,elastic modulus,hardness,fracture toughness, translucency and microstructure of the novel glass-ceramic and IPS e.max Press (LT A2,MO1 and HO1 )ceramic ingots were studied. Results:The novel glass-ceramic demonstrated a lower flexural strength (31 5 MPa)than MO ceramic ingot(338 MPa)(P <0.05). The other mechanical properties of the novel glass-ceramic were similar to those of LT and MO ceramic ingots(P >0.05).The translu-cency parameter of the novel glass-ceramic(21 .2)was higher than that of HO(1 6.5)but lower than that of LT(27.8)and MO(27.5) ceramic ingots(P <0.05).SEMimages showed an interlocking microstructure of rod-shaped Li2 Si2 O5 crystals in all the glass-ceramics investigated.Conclusion:The mechanical properties,translucency and microstructure of the novel glass-ceramic are similar to those of IPS e.max Press ceramic ingots,which can meet the requirements of clinical application.

The varicela-zoster virus(VZV) infection causes central vasculopathy,and then leads to stroke onset. This article review s the correlation betw een VZV infection and stroke onset in order to conduct a comprehensive assessment of patients w ith VZV infection, thereby reducing the risk of stroke after VZV infection.

Objective: To assess the effect of percutaneous transluminal septal myocardial ablation (PTSMA) on mid- to long-term left ventricular diastolic function in patients with hypertrophic obstructive cardiomyopathy (HOCM) by real-time three-dimensional echocardiography (RT-3DE). Methods: A total of 46 HOCM patients who received 2DE and RT-3DE examination before and after (with the mean of 18.8 months) PTSMA were studied. The ratios of E/A and E/Ea were analyzed, RT-3DE was conducted to collect the images, to obtain 17-segmant volume-time curve and to calculate the parameters of rEDV, rESV, rSV and rPFR respectively. Results: The follow-up echocardiography in all 46 patients indicated that the ratio of E/Ea decreased after the operation (12.04 ± 3.29) vs (15.70 ± 5.68),P<0.001, the rSV of left ventricular anterior wall middle segment and anterior septal middle segment decreased after the operation,P<0.05, while the rPFR of anterior septal middle segment, rear septal middle segment and apical segment increased,P<0.05. Conclusion: PTSMA may improve local left ventricular diastolic function in HOCM patients, RT-3DE provides a new method and viewing angle for HOCM evaluation.