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.

The purpose of this study is to prepare T7 and TAT dual modified liposomes (T7-TAT-LIP) to penetrate through blood brain barrier and target to brain tumor cells. The liposomes were prepared with CFPE, T7 modified PEG-DSPE, TAT modified PEG-DSPE, soybean phospholipid, PEG-DSPE and cholesterol. The CFPE was used to track the cellular uptake efficiency. The density of T7 and TAT and the length of PEG were optimized, and then the liposomes were characterized by particle size, zeta potential, morphology and stability. Afterwards, the cellular uptake by bEnd.3 and C6 cells were evaluated. The results showed that the optimized parameters were 6% of T7, 0.5% of TAT, the molecular weight of PEG for T7 was 2000 and the molecular weight of PEG for TAT was 1000. After optimization, the particle size of T7-TAT-LIP was 118 nm, the zeta potential was -6.32 mV and the particles were spherical. The turbidity and particle size of liposomes were not obviously changed after 24 h incubation in PBS at 37 °C. The particle size and polydispersity index were also stable during 1 month incubation at 4-8 °C. The cellular uptake by both bEnd.3 and C6 cells of T7-TAT-LIP was higher than that of T7 or TAT modified liposomes, suggesting dual modified liposomes possessed better blood brain barrier targeting ability and brain tumor targeting ability than the single ligand modified liposomes.
Biological Transport ; Blood-Brain Barrier ; Brain Neoplasms ; drug therapy ; Cell-Penetrating Peptides ; pharmacology ; Cholesterol ; Liposomes ; Particle Size ; Phosphatidylethanolamines ; Polyethylene Glycols

Adult ; Bone Diseases, Metabolic ; etiology ; Female ; Fractures, Spontaneous ; etiology ; Humans ; Liver Diseases, Alcoholic ; complications

Objective To evaluate the practicability of using flow cytometry analysis for diagnosis of non-hodgkin′s lymphoma ( NHL) among children with serous effusion.Methods Twelve children who were diagnosed with malignant lymphoma from February 2011 to November 2013 at Shanghai Children′s hos-pital were recruited in this study.Pleural effusion and ascites samples were collected from those children who showed serous effusion as initial symptoms and analyzed by using flow cytometry based immunophenotyping. The antibodies used for immunophenotyping included CD45, CD10, CD33, CD7, CD1a, MPO, cCD3, CD79a, CD22, CD19, CD20, CD5, CD3,κ,λ,αβ,γδ,CD56 and other common markers for T, B and NK cells.Anti-CD30 antibody was used when necessary.Results All of the twelve cases with serous effusion were diagnosed with aggressive NHL.Six out of the twelve children including five cases with ascites and one case with pleural effusion showed high expression of CD20 and were classified as NHL-B type by flow cytom-etry.Three children with pleural effusion and one child with both pleural effusion and ascites were typed as NHL-T as characterized by monoclonal expression of αβorγδ.The other two children with pleural effusion were diagnosed with anaplastic large cell lymphoma with positive expression of CD30 and morphological het-erogeneity.Conclusion Flow cytometry analysis based immunophenotyping could be used as an auxiliary method for rapid and accurate diagnosis of lymphoma in children with serous effusions.

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 evaluate the effect of therapeutic communication on negative emotion and quality of life of stoke patients. Methods A total of 120 stroke patients were divided into the control group and the observation group equally. The former received routine nursing and the latter routine nursing plus therapeutic communication. After 4 weeks, they were evaluated by self-rating anxiety scale (SAS), self-rating depressive scale (SDS), trait coping style questionnaire (TCSQ) and the short-form health survey-36 (SF-36). Results After the intervention, the scores on anxiety, depression and negative coping in the observation group were lower than those in the control group (P<0.01), while the scores on positive coping and quality of life were higher in the observation group than those in control group (P<0.01). Conclusion Therapeutic communication can effectively improve stroke patients′negative emotion and quality of life.