OBJECTIVE:To evaluate the relative bioavailability of two products(CLMC 1 ,CLMC 2 )of Clarithromycin in man.METHODS:A single oral500mg dose of CLMC 1 or CLMC 2 was given to20healthy male volunteers in an open randomized crossover study.The plasma concentrations of CLMC 1 and CLMC 2 were measured by microbial assay.The pharmacokinetic parameters were calculated with3p97pharmacokinetic program and the bioequivalence was evaluated.RESULTS:The con?centration-time curves of CLMC 1 and CLMC 2 fitted to a two-compartent open model.C max were(2.23?0.83)?g/ml and(2.14?0.70)?g/ml;T max were(1.95?0.39)h,(1.78?0.41)h;AUC (0～T) were(9.50?2.52)(?g?h)/ml,(9.35?2.54)(?g?h)/ml respectively.The relative bioavailability of CLMC 1 was(101.60?9.35)%.CONCLUSION:The results of two and one-side t tests suggest that the CLMC 1 is bioequivalent with the CLMC 2 .

In order to solve some problems which we are confronted with in new period during the course of practical teaching in surgery,we carried out some teaching reforms and explorations,such as stimulating study interests,reforming teaching process,strengthening practical ability,persisting after-school training and so on,which have got good results and laid a firm foundation for cultivating medical talents with practical competence.

Objective The association between Helicobacter pylori(H.pylori) infection and allergic diseases was controversial.The aim of this study was to investigate the association between H.pylori infection and allergic diseases.Methods A questionnaire survey regarding the general health condition and allergic diseases was carried out in patients who had taken gastroscopy at People's Hospital of Peking University from September 2015 to April 2016.H.pylori infection was detected by the H.pylori antibody,rapid urease test and gastric mucosa pathology.Results There were 1 034 patients were enrolled in this study.The rate of H.pylori infection was 20.5%(212/1 034).The frequencies of contact dermatitis,urticaria,food/drug allergy,allergic rhinitis,bronchial asthma were 6.9%(71/1 034),15.5%(160/1 034),18.0%(186/1 034),20.8%(215/1 034) and 3.4%(35/1 034),respectively.The rate of the food/drug allergy was significantly lower in the H.pylori-positive group than in the H.pylori-negative group(11.8 %(25/212) vs.19.6%(161/822),χ2=6.940,P=0.008).The risk of food/drug allergy in H.pylori-positive group was 0.611(95% CI:0.386-0.966,P=0.035) in the multivariate analysis.When the patients were divided into age-dependent groups,the rate of the food/drug allergy was significantly lower in the H.pylori-positive group than in the H.pylori-negative group(10.9 %(11/101) vs.20.6%(101/490),χ2=5.152,P=0.023) in those patients ≥50 years old.There were not statistically significant differences on contact dermatitis,urticaria,eczema,asthma and allergic rhinitis between helicobacter pylori positive group and negative group(P>0.05).Conclusion H.pylori infection may be a protective factor in food/drug allergy and the protective effect enhanced by infection time.

Objective:To investigate the roles of donor alveolar maerophages and the recipient circulating neutrophils in early-stage reperfusion injury of lung allograft,and to study the interaction between the 2 kinds of cells.Methods:Twenty pairs of size-and weight-matched adult mongrel dogs were randomly assigned to 4 groups:C(control),D(leukocyte-depleted blood reperfusion),M(maerophage inhibition)and DM(leukocyte-depleted plus macropbage inhibition).The 20 cases of left lung transplantations were performed by the same surgeon.All procedures were identical,except that the donors in Group M and DM received the macrophage inhibitor gadolinium chloride(14 mg/kg)intravenously 24 h before operation,and that the recipients in Group D and DM underwent initial 10 min reperfusion with leukocyte-depleted blood collected from donors'inferior vena cava. All lung allografts were reperfused for 2 h.Results:Compared with Group D and C,macrophage inhibition ameliorated PO_2/FiO_2 and mean pulmonary arterial pressure(mPAP)consistently after 30 min reperfusion in Group M and DM;the parameters of lung reperfusion injury(malonaldehyde activity,wet/dry ratio)at 120 min after reperfusion were also significantly improved(P

Objective To investigate the effect of tramadol on the expression of 5-HT1A receptor in the distal'cerebrospinal fluid contacting neurons (CSF-CNs) in mid-brain in a rat model of neuropathic pain. Methods Forty male SPF SD rats weighing 220-280 g were randomly divided into 5 groups (n = 8 each): group Ⅰ normal control (group C); group Ⅱ normal saline (group NS); group Ⅲ tramodol (group T); group Ⅳ neuropathic pain + normal saline (group NP+ NS) and group Ⅴ neuropathic pain + tramadol (group NP + T). Neuropathic pain was induced by chronic constrictive injury (CCI) in group Ⅳ and Ⅴ . Four silk ligatures were placed on the sciatic nerve at 1 mm intervals. In group Ⅱ (NS) and group Ⅲ (T) the sciatic nerve was exposed but not ligated and NS 2 ml/kg and tramadol 10 mg/kg were injected IP respectively, while in group Ⅳ and Ⅴ NS 2 ml/kg and tramadol 10 mg/kg were injected IP respectively on the 7th day after CCI. Paw withdrawal threshold (PWT) to von Frey filament stimulation and paw withdrawal latency (PWL) to noxious thermal stimuli were measured before (T1) and after IP NS or tramadol injection (T2) in group Ⅱ-Ⅴ. The distal CSF-CNs in the mid-brain was labelled with 30% cholera toxin subunit B and horseradish peroxidase compound (CB-HRP) 3 μl injected in left lateral cerebral ventricle. The expression of 5-HT1A receptors was measured by immuno-histochemistry. Results PWT and PWL were significantly decreased after CCI in group Ⅳ (NP + NS) and tramadol significantly inhibited the mechanical and thermal hyperalgesia in group Ⅴ (NP + T). There was no significant difference in the number of distal CSF-CNs among the 5 groups. CCI significantly down-regulated the expression of 5-HT1A in distal CSF-CNs in group Ⅳ(NP+ NS) as compared with group Ⅰ , Ⅱ and Ⅲ and tramadol significantly inhibited the CCI-induced downregulation of 5-HT1A receptor expression. Conclusion Tramadol can ease neuropathic pain by down-regulating the expression of 5-HT1A receptor in distal CSF-CNs in mid-brain.

ObjectiveTo study the significance of the non-invasive hemodynamic monitor system in the differential diagnosis of severe acute pancreatitis (SAP) combined with pulmonary edema. Methods Twenty-nine cases of SAP during fluid resuscitation treatment combined with pulmonary edema were reviewed and the data of the non-invasive hemodynamic monitor system was analysed and summarized.According to the diagnosis on discharge, 18 patients were enrolled in test group (noncardiogenic pulmonary edema group) and 11 patients were enrolled in control group(cardiogenic pulmonary edema group). The data of two groups were determined and compared. ResultsIn control group, cardiac output[(3.34±1.09) L/min], cardiac index [(2.06 ± 0.46) L/ (min·m2)], stroke volume [(41.89 ± 13.72) ml], stroke index[(25.59 ± 7.32) ml/m2], accelerate cardiac index [(59.24 ± 28.41) L/100 s2], left cardiac work index [(2.09 ± 0.67) (kg·m)/m2], left ventricular ejection time[(254.32 ± 27.34) ms], ejection fraction (0.37 ±0.03) and velocity index [(27.11 ± 11.32) L/100 s] were all significantly lower than those in test group [(4.12 ± 1.06) L/min, (2.64 ± 0.48) L/ (min·m2), (46.21 ± 11.81) ml, (28.87 ± 5.32) ml/m2, (79.43 ±29.01) L/100 s2, (3.21 ± 0.84)(kg·m)/m2, (281.29 ± 29.11) ms,0.54 ±0.04, (39.34 ± 12.11) L/100 s,respectively] (P < 0.01); pre-ejectionphase [(116.54 ± 22.37) ms] and systolic time ratio (0.48 ± 0.04) were significantly higher than those in test group[(95.24 ± 21.41) ms,0.36 ± 0.02,respectively] (P < 0.01 or <0.05). ConclusionNon-invasive hemodynamic monitor system is helpful in the early differential diagnosis of SAP combined with pulmonary edema.

Objective To analyze the clinical characteristics and treatment Methods of severe com?plications after percutaneous tracheotomy( PDT) in neurosurgery patients,and to provide reference for the treat?ment and rescue of these patients. Methods A retrospective analysis of 578 cases after PDT was performed in Neurosurgery Intensive Care Unit ( NSICU ) of Xuanwu Hospital of Capital Medical University from 2005 to 2015. The types of complications,treatment method and prognosis were analyzed. Follow?up was 3 months to 1 year. Results Eighteen cases with severe complications,including bleeding,wound infection,asphyxia caused by tracheal mucosa suffocation,airway stenosis caused by granulation tissue,subcutaneous emphysema and neu?momediastinum,etc. After treatment and active rescue,most patients recovered,no patients die directly associated with surgery. Conclusion PDT plays an important role in the treatment of patients in NSICU,but it is still pos?sible to have serious complications,so physicians must understand and be prepared for complications,and pay more attention to prevent poor prognosis.

Objective To investigate the effects of exogenous glial cell derived neurotrophic factor (GDNF)on colon glial cells in slow transit constipation (STC ) rats,and to explore the optimal concentration of GDNF in order to provide evidence for intestinal neurotrophic therapy in the treatment of STC.Methods A total of 132 SD rats were divided into STC group and control group,66 rats in each group.STC rats were established by feeding with rhubarb.Six rats were randomly selected from either groups to verify whether STC model was successfully established.And the left 120 rats of two groups were randomly divided into six subgroups:STC group one to group six and control group one to group six,ten rats in each group,which were untreated,injected through tail vein with saline,and 0.001 ,0.010, 0.050,0.100 μg/L GDNF 2 mL respectively for one week.The expression of Sox-8 at protein level of either group were detected by Western blotting.Independent sample t test was performed for statistical analysis.Results After treated with 0.001 μg/L GDNF (STC group three),there was no significant
difference in expression level of Sox-8 between STC group three and STC group one (13.38 ±0.70 vs 13.39±0.45 ,t = 0.042,P = 0.969 ).After treated with 0.010 μg/L GDNF (STC group four),the difference in expression level of Sox-8 between STC group four and STC group three was significant (21 .11 ±2.56 vs 13.38±0.70,t=5 .040,P <0.01).After treated with 0.050 μg/mL GDNF (STC group five),the expression level of Sox-8 was higher than that in STC group four (31.86±1.57 vs 21.11±2.56,t=-6.198,P <0.01 ).The Sox-8 expression of untreated,saline treated,0.001 and 0.050 μg/L GDNF treated STC rats (STC group one,two,three and five)were lower than those of the corresponding control groups (t= 3.394,12.103,10.302,- 6.120,all P < 0.05 ).Conclusion Exogenous GDNF could increase Sox-8 expression in colon tissue of STC rats,an increase in the number of colon glial cells could repair enteric nervous system,and 0.050 μg/L was the optimal concentration.

Objective To establish a rapid method for the isolation of murine peritoneal macrophages. Methods Abdominal lavage was performed with NS and the peritoneal macrophages was purified from the lavage,which was later transferred into high glucose DMEM cul-ture medium. Cell viability was measured via the typan blue staining. Purity was observed via Wright's stain. Results High purity macropha-ges with typical morphology were obtained. Conclusion A simple and realistic method was set up for the isolation of murine peritoneal mac-rophages.

Objective To investigate the therapeutic role of Xuebijing injection on acute lung injury (ALI) in a rat model of cecal ligation puncture (CLP) and the potential mechanism.Methods A total of 110 SD rats were divided into sham group (n =30),CLP group (n =40) and Xuebijing treatment group (n =40),according to the random number table.Survival was observed up to 7 days.Rats in each group were sacrificed 12 h after the CLP surgery.Blood samples were obtained by abdominal aorta puncture and inflammatory cytokines and blood gas were detected.Samples of the lung tissue were excised to measure mRNA expression of cytokines,activation of signaling molecules,wet to dry ratio and histopathological changes.Peripheral neutrophils were isolated in vitro and divided into negative control group,high-dose Xuebijing (1 ∶ 30 dilution) group,lipopolysaccharide (LPS,100 ng/ml) group,LPS plus low-,middle-and high-dose Xuebijing (1∶ 300,1∶ 100,1∶30 dilution respectively) groups.Supernatant levels of tumor necrosis factor (TNF-α),interleukin (IL)-6 and neutrophil elastase (NE) in each group were detected.Activation of intracellular signaling molecules was measured as well.Results In animal survival observation,the mortality was 65 ％ in CLP model group and reduced to 30％ in Xuebijing treatment group (P ＜ 0.01).Compared to sham group,serum levels of TNF-α,IL-6,PaCO2 and lactate in CLP group were increased markedly to (32.213 ± 9.802) pg/ml,(21.592 ± 5.427) ng/ml,(39.575 ± 5.295) mmHg and (3.438 ± 0.192) mmol/L respectively,mRNA expressions of TNF-α and IL-6 in CLP group were increased to 5.223 ±0.525 and 12.097 ±2.535 respectively,activation of IκB-α,p38,extracellular regulated protein kinases (ERK) and c-Jun N-terminal kinase (JNK)in CLP group were significantly up-regulated,and water content of rat lung tissue in CLP group were significantly increased to (78.226 ±0.894) ％ (all P ＜0.01).Moreover,histopathological appearance of bleeding,exudation and increased infiltration of neutrophils to the alveolar septum were detected in the lung tissue of CLP rats.Compared to CLP group,Xuebijing treatment reduced the serum levels of TNF-α [(21.592 ± 5.427)pg/ml],IL-6 [(2.252 ± 0.905) ng/m],PaCO2 [(34.088 ± 2.260) mmHg] and lactate [(2.563 ± 0.250)mmol/L],suppressed the up-regulation of TNF-α and IL-6 mRNA expressions [6.866 ± 1.604,3.398 ± 0.334],and reduced the water content of rat lung tissue [(77.159 ± 0.626)％] (P ＜0.05 or 0.01).Compared to CLP group,Xuebijing treatment ameliorated the histological appearance of ALI.In vitro study,negative control group and high-dose Xuebijing group showed basal levels of TNF-α,IL-6 and neutrophil elastase (NE).Levels of TNF-α,IL-6 and NE in cell supernatant were elevated in LPS group [(7 102.520 ± 528.026) pg/ml,(3 109.598 ± 191.291) pg/ml and (63.985 ± 2.823) ng/ml respectively],with significant differences from these detected in negative control group (P ＜0.01).While the release of TNF-α,IL-6 and NE was significantly inhibited in LPS plus middle-and high-dose Xuebijing groups,compared to LPS group (P ＜ 0.05 or P ＜0.01).LPS also increased the degradation of IκB-α and phosphorylation of p38 and ERK in neutrophils,and Xuebijing in higher concentration markedly suppressed the degradation of IκB-α and phosphorylation of p38 and ERK.Conclusions CLP surgery results in the appearance of typical ALI in rats.Administration of Xuebijing can effectively inhibit the proinflammatory response in CLP rats and attenuate ALI.And such effects may be attributed to its inhibition on the proinflanunatory activation of neutrophils in lung tissue.