New process reported the synthesis of telavancin using decyl alcohol as the starting material.After methanesulfonylation,nucleophilic substitution with ethanolamine,Fmoc protection,and Parikh-Doering oxidation,the intermdiate N-(9-fluorenyl-9-methoxycarbonyl) decylaminoethyl acetaldehyde (5) was obtained.Vancomycin hydrochloride and intermediate 5 were then subject to reductive amination reaction,Fmoc deprotection,and Mannich reaction to give the telavancin product.The process have been deeply studied on the two key reactions of reductive amination and Mannich reaction,and the reaction conditions have been optimized.The overall yield is 46％ based on starting material vancomycin.

Objective To investigate the safety and effectiveness of Glifeet in bowel preparation before colonoscopy.Methods A prospective,single blind,randomized controlled trial of patients undergoing colonos-copy was conducted.A total of 67 inpatients were randomized to the control group,who received a low-residue and semiliquid diet (n =31)and the experimental group,who received Glifeet all day (n =36)before the proce-dure.All patients took polyethylene glycol electrolyte powder 1 000 ml at 7 pm on the day before colonoscopy and 2 000 ml at 8 am on the examination day.Bowel preparation quality was scored using the Boston Bowel Prepara-tion Scale (BBPS).Side effects were also observed.Results The time of the first bowel movement of the experi-mental group was significantly shorter [(77.43 ±54.21)min VS (149.35 ±118.15)min,P =0.002].An in-creased defecating frequency was observed in the experimental group,but there was no significant difference when compared with the control group (11.44 ±6.95 VS 8.74 ±3.58,P =0.055).Patient tolerance and acceptance did not differ.There was no significant difference in BBPS between the two groups.But the bowel preparation quality of the right colon was significantly better in the experimental group (2.56 ±0.50 VS 2.23 ±0.81,P =0.045). Conclusion Glifeet could meet the needs of basic energy in most patients for colonoscopy.Furthermore,Glifeet is well tolerated and can partially improve the quality of bowel preparation.

Objective:To observe the anticaries effects of the vaccine gene pcDNA3- PAc against dental caries in BALB/c mice by different routes. Methods: BALB/c mice were immunized with the recombinant plasmid pcDNA3- PAc by the submandibular gland- target injection,the quadriceps femoris injection and the intranasal irrigation respectively. All the mice were immunized two times. The immune interval was two weeks. Saliva and serum samples were collected respectively at 0, 1, 2, 4 weeks after immunization. The specific antibodies were detected by ELISA. Results:The specific antibodies were up at one week after immunization in different routes. The peak time of the antibodies level appeared at 4 weeks.The level of salivary specific anti- PAc IgA induced by submandibular gland- target injection and that of serum IgG induced by thigh bone muscle injection was the highest, respectively. The differences of antibodies level between in experiment groups and negative control group or vacant comparison group were significant(P<0.01). Conclusion: The vaccine gene pcDNA3- PAc effectively induce local mucosal immune response and systemic immune response.

Objective To study the molecular characters of porA and porB genes which encode outer membrane proteins (OMP), and predominated clonal complex of Neisseria meningitidis isolates from Guangdong province. Methods Eighteen Neisseria meningitidis isolates from Guangdong province during year 1967 to 2007 were recovered and reconfirmed by API NH biochemical system, and serogrouped by antiserum. The characters of porA and porB gene were analyzed by DNA sequencing. The allele profiles and the sequence types (ST) were determined by multilocus sequence typing (MLST). Based on their allelic profiles, the evolution relationship was analyzed by PHYLIP software. The predominant clonal complex was determined through comparing with the information of reference strains from the PubMLST database. Results For porA gene, type 20 was more frequently in the variable region (VR) 1 and type 9 in VR2 before year 2004. However, for porB gene, type 4 was more frequently in VR Ⅰ, type7 in VR Ⅳ, type 11 in VR Ⅴ,and type 10 in VR Ⅵ, respectively. The multi-types character was presented in VR Ⅴ and VR Ⅵ after2004. VR Ⅶ and VR Ⅷ can not be found among all the isolates except for one W135 isolate in 2007. Among the seven housekeeping genes, the polymorphism of abcZ was the lowest one with 4 allele numbers, while pgm was the highest one with 13 allele numbers. The predominant clonal complex was ST-5 before 2004. The ST-4821 clone complex appeared in 2004 and caused cases every year since then. More important, highly invasive ST-11 clonal complex firstly appeared in Guangdong in 2007. Conclusion The molecular characteristic of OMP genes presents polymorphism for the Neisseria meningitidis isolates from patients in Guangdong province during 1967 to 2007. ST-5 is the predominant clonal complex before 2004 and the highly invasive clonal complex is circulating in recent 3 years. It suggests that the surveillance based on laboratory should be further enhanced.

The safety and efficacy of retroperitoneoscopic microwave ablation (MWA) in the treatment of renal hamartoma were evaluated. From July 2007 to July 2009, a total of 16 cases of renal hamartoma were treated with retroperitoneoscopic MWA. Peri- and post-operative findings were observed. Middle-term efficacy was assessed by contrast-enhanced computerized tomography (CT) in follow-up period. All patients received MWA of 1-5 points. The mean operative time was 85 min and the mean blood loss was 65 mL. During a median follow-up of 16 months, no evidence of disease recurrence was observed despite of incomplete ablation in 1 case. Retroperitoneoscopic MWA is a relatively simple procedure with less impact to renal function and less complication. The outcome of middle-term follow-up is satisfactory. Thus, retroperitoneoscopic MWA appears to be a safe and effective technique for renal hamartoma in selected patients.

BACKGROUND: Resistin has been shown to play an important role in the pathogenesis and progression of osteoarthritis. OBJECTIVE: To investigate the correlation between resistin level in serum and synovial fluid and the severity of knee osteoarthritis. METHODS: Seventy-four patients with knee osteoarthritis and 79 healthy individuals were recruited. The Noyes score method was used to assess articular cartilage damage arthroscopically. The severity of knee osteoarthritis was evaluated according to the Western Ontario McMaster University Osteoarthritis (WOMAC) score. The radiographic severity of knee osteoarthritis was assessed by the Kellgren-Lawrence (K-L) grading system. The levels of resistin and cross linked C-telopeptide of type Ⅱ collagen (CTX-Ⅱ) in serum and synovial fluid were determined by ELISA. RESULTS AND CONCLUSION: The resistin level in the synovial fluid was positively correlated with the radiographic severity of knee osteoarthritis, WOMAC pain, WOMAC function, and WOMAC total scores, but showed no correlation with the WOMAC stiffness score. There were no significant correlations between the serum level of resistin and WOMAC total scores, subscale or K-L Grading system in the the osteoarthritis patients. Multiple regression analysis showed that the correlation between the synovial fluid level of resistin and WOMAC scores was of significance after removal of other confounding factors, and the resistin level in the synovial fluid was positively correlated with Noyes scores and CTX-Ⅱ level. These results suggest that the resistin level in the synovial fluid can serve as a potential biomarker reflecting the severity of knee osteoarthritis and cartilage degenerative degree in patients with osteoarthritis.

Objective To analyze the pathological and clinical characteristics of patients with idiopathic IgA nephropathy accompanied by vasculitic/crescentic lesion (IgA-V/C). Methods Data of 222 patients diagnosed as idiopathic IgA nephropathy by renal biopsy, among them 87 cases with vasculitic/crescenlic (V/C)lesion, from our department in 2004 were analyzed retrospectively. Clinical and pathological data from patients with IgA-V/C were compared to those of non-IgA-V/C patients and of lupus nephritis (LN) patients with V/C lesion. Results Vasculitic/crescentic lesion was found in 39.19% (87/222) patients with idiopathic IgA nephropathy.And about( 14.08?12.75)% of the glomeruli was affected. It should be taken into account that there was no significant differences of clinical manifestations including blood pressure, urinary protein excretion between IgA-V/C group and non-IgA-V/C group .except serum creatinine(Scr)level which was significantly higher in IgA-V/C group. In addition, only 37.9% of IgA-V/C patients presented high Scr level,thus the lesion of V/C in idiopathic IgA nephropathy was easily overlooked. Patients with idiopathic IgA nephropathy were found to have higher percentage of glomerular sclerosis (64.86% vs 40.00%) and ratio of sclerostic glomeruli to total glomeruli [ (26.98 ?24.68)% vs (16.10 ?18.80)% ]as compared to LN group, which further predicated the progressing characteristics of IgA nephropathy. Conclusions Vasculitic/crescentic lesion is a quite common finding in idiopathic IgA nephropathy and often associated with no dramatically symptoms. It is possible for vasculitic/crescentic lesion to induce unmarked lose of nephron slowly and continually, so as to accelerate IgA nephropathy progression to end-stage renal failure.

Objective:To study the causes of misdiagnosis of patients with POEMS syndrome and to discuss the clues for its early diagnosis.Methods:The clinical and laboratory data of 26 inpatients with POEMS syndrome,who were treated in Changhai hospital over the last decade,were retrospectively analyzed.Results:The misdiagnosis rate of our group was 100%. The misdiagnosis was made in(3.31?0.97)hospitals and in(3.31?0.93)clinical departments;the misdiagnosis period was (19.42?10.86)months and it had been misdiagnosed as 18 other diseases.The initial symptoms included polyneuropathy in 21 (80.8%)cases,edema of lower extremity in 22(84.6%)cases,and body weight loss in 8(30.8%)cases.The typical clinical symptoms included polyneuropathy in 26(100%)cases and organomegaly in 24(92.3%).Two cases had newly-identified uterine hypertrophy,one had adrenal gland hypertrophy,and one had gastric wall thickening mimicking advanced gastric cancer.Hypothyroidism,impotence,skin pigmentation and sclerosis occurred in 76.9%(20/26),60%(6/10),92.3%(24/ 26)and 65.4%(17/26)cases,respectively.Monoclonal plasma cell proliferation was documented in 18(81.8%);M proteins were positive in 14(63.6%)cases by serum immunofixation,and only 2(9.1%)cases also positive by serum protein electrophoresis.One patient was positive of M protein by urine immunofixation and one had abnormal infiltration of plasma cells in the gastric wall.Lymph node biopsy were performed in 8 patients and 3 were found to have Castleman disease;the other 5 cases had lymphocyte infiltration,with 3 complicated with plasma cell proliferation.Nerve biopsy in 4 cases all revealed axonal degeneration and one patient complicated with demyelination.Bone marrow biopsy in 5 cases revealed plasmacytosis in 2 cases and myeloma in one.Excessive radioactivity resorption was found in 10 of the 16 cases(62.5%)and abnormal plasma cells were detected in 2 cases by bone aspiration guided by radioisotope bone scan.Conclusion:Misdiagnosis of POEMS syndrome is very common.Polyneuropathy,edema of lower extremity and body weight loss are the common early symptoms of POEMS syndrome. Early diagnosis can be made by having an intimate knowledge of the progression of the disease and by detecting M protein through various approaches.

OBJECTIVE: To investigate the personality and mental health of the objects of substance (caffeine, cocaine, hallucinogens and so on) abstinence who got labor education and rehabilitation. METHODS: 258 male objects and 250 female objects of substance abstinence selected randomly from institutions of labor education and rehabilitation were assessed with MMPI and SCL-90. RESULTS: MMPI tests indicated the personality abnormality in the objects. SCL-90 tests manifested the mental health abnormality of them compared with Chinese models, especially in the female objects. CONCLUSION More attention should be paid on the mental health of the objects of substance abstinence.
Adolescent ; Adult ; Female ; Humans ; Hypochondriasis/psychology* ; MMPI ; Male ; Mental Health ; Middle Aged ; Paranoid Behavior/psychology* ; Personality Disorders/psychology* ; Personality Tests ; Psychiatric Status Rating Scales ; Substance Withdrawal Syndrome ; Substance-Related Disorders/rehabilitation* ; Surveys and Questionnaires

Objective:To summarize the experiences of the surgical treatment of tumors in the posterior part of the third ventricle and pineal region. Methods: Twenty-seven patients with tumors in this region treated microsurgically from 1990 to 2000 were analyzed. The surgical indications, approaches, and operative key points were discussed. The prognostic factors were also analyzed. Results:Tumors were removed totally in 11 patients, removed subtotally in 7 and removed partially in 5. Biopsy and ventriculo-peritoneal shunt was performed in 4 patients. Of 17 patients in follow-up, 13 patients survived longer than 5 years. Conclusions: Most tumors in the posterior part of the third ventricle and pineal region can be surgically removed.Sufficient specimen obtained in the operation can confirm pathologic property of the tumor,guiding next chemotherapy and radiotherapy.