OBJECTIVE:To optimize the preparation technology of Ginkgo biloba extracts-hydroxyprop-?-cyclodextrin(GBE-HP-?-CD) inclusion compounds and to identify this inclusion compound.METHODS:The optimum preparation condition was studied by orthogonal test with encapsulation rate as the index of evaluation.The inclusion compounds were prepared with solution-agitating technique.The inclusion compounds were identified by phase solubility diagra-m,differential scanning calorimetry(DSC) and infrared spectroscopy methods,respectively.RESULTS:The optimum inclusion condition was as follows:the ratio of GBE to HP-?-CD=1.5∶1;agitating time=6 h;inclusion temperature=50 ℃.CONCLUSION:It has been preliminarily proved that it is possible for Ginkgo biloba extracts and hydroxyprop-?-cyclodextrin to be made into inclusion compounds.HP-?-CD has satisfactory solublization on Ginkgo biloba extracts.

Objective To investigate the distribution and drug resistance of pathogens in intensive care unit (ICU) so as to provide scientific basis for antibiotic adoption and the prevention and control of nosocomial infections. Methods The various specimens collected from the patients admitted into ICU in the First People's Hospital of Shunde Affiliated to the South Medical University from January 2007 to December 2014 were used to isolate the pathogens that might cause nosocomial infections and retrospectively analyze their clinical distribution and drug resistance. Kirby-Bauer paper diffusion and minimal inhibitory concentration (MIC) methods were applied to test the drug sensitivity, and according to National Committee for Clinical Laboratory Standards/Clinical and Laboratory Standards Institute (NCCLS/CLSI) standard, the results were identified.Results The sputum was the major specimen source in ICU, accounting for 68.8%, followed by urine (12.4%) and blood (6.8%). All together 557 pathogens in ICU causing nosocomial infections were isolated of which there were 377 gram-negative (G-) bacilli (67.7%), 103 gram-positive (G+) cocci (18.5%), and 77 fungi (13.8%). Among G- bacilli, the top three wereAcinetobacter baumannii (34.5%), Klebsiella pneumonia (17.8%), andPseudomonas aeruginosa (13.0%). Beside carbapenem, the drug resistance rates of Acinetobacterbaumannii to other antibiotics were more than 40%. The main G+ coccus causing nosocomial infection wasSaphylococcus aureus (36.9%) in ICU. The drug resistance rates ofSaphylococcus aureus to penicillin, gentamicin and erythromycin were higher than 50%. In 77 fungus strains,Candida albicans was ranked the first, accounting for 41.6%.Conclusion The main infection site in ICU is primarily respiratory tract, the G- bacilli are the predominate pathogens, and the drug resistance to antibiotics found in this report is serious, so clinically, the antibiotics should be properly used to avoid the occurrence of pathogenic strain with drug tolerance.

Objective:To investigate the characteristics and perioperative management of hemophilia patients with fracture.Methods:Retrospectively, we analyzed 8 patients with hemophilia combined with fracture, who were admittted to our department from 2005 to 2013.Six patients were with hemophilia A and two with hemophilia B;Based on the severity of hemophilia, 2 cases were light, 3 moderate and 3 severe;Based on the location of fracture, 4 cases were femoral neck fractures, 1 femoral intertrochanteric fracture, 1 bilateral distal femur fractures, 1 tibiofibula fracture, and 1 humerus intercondylar fracture. Blood coagulation factor replacement therapy was conducted preoperatively, intraoperatively and postoper-atively, All the patients underwent closed or open reduction and internal fixation or joint replacement. Also, we analyzed the perioperative complications and observed whether the fracture healed.Results:The average age was 33.5 years (14 to 47 years); In 6 cases, fractures occurred at femur, accounting for 75%of all the fractures; Femoral neck fracture was treated by closed reduction and hollow screws fixation;Femoral intertrochanteric fracture, distal femur fracture, and tibiofibula fracture were treated by open reduction and internal fixation with plate;Humerus intercondylar fracture was treated by elbow joint replacement.Intraoperative bleeding was from 50 to 600 mL, an average of 262 mL;Perioperatively, the average use of FⅧ/activated prothrombin complex concentrates ( APCC) was 358 U/kg (125 to 554 U/kg) .Postoperatively, poor wound healing was observed in 2 patients, and the condition improved after symptomatic treatment; In patients with internal fixation, all the fractures united, and the average hea ling time was 14 weeks.No complications such as fixation loosening or rupture occurred after internal fixation.Conclusion:Hemophilia combined with fracture mainly occurred in the young, and the site of fracture was given priority to femur.With perfect preoperative preparation, on the basis of the replace-ment therapy, hemophilia combined with fractures was safe for surgical treatment, and postoperative frac-tures healing wasgood.But the risk of poor wound healing was high.

OBJECTIVETo investigate the genetic variation and typing of hepatitis B virus (HBV) in patients with chronic hepatitis B in relation to HBeAg status.

METHODSFluorescence quantitative polymerase chain reaction (PCR) was employed to detect serum HBV DNA in patients with chronic hepatitis B negative for HBeAg. Real-time fluorescent PCR and PCR-reverse dot blot hybridization were used to detect HBV genotypes and mutations, respectively.

RESULTSOf the 389 patients, 214 (55.01%) were positive and 175 (44.99%) were negative for HBV DNA; 102 (26.22%) had a HBV DNA copy number of 1×10(3), and 41 (10.54%) had a copy number of 1×10(4) (Χ(2)=226.6729, P<0.001). Of the 21 patients with a HBV DNA load of 1×10(5), 15 (71.43%) were found to have precore mutations, and 11 (52.38%) had basic core promoter (BCP) mutations; a higher HBV-DNA load was associated with an increased incidence of HBV mutations. In the 214 patients positive for HBV DNA, HBV genotypes A, B, C, D and the mixed type were found in 6 (2.80%), 84 (39.25%), 106 (49.53%), and 7 (3.27%), and 11 (5.14%) patients, who showed precore mutation rates of 16.67% (1 case), 36.90% (31 cases), 44.34% (47 cases), 0, and 0, and BCP mutation rates of 0, 19.05% ( 16 cases), 26.42% (28 cases), 0, and 0, respectively, demonstrating significant differences in HBV mutations between the genotype groups (P<0.001).

CONCLUSIONHBeAg-negative and HBV DNA-positive patients with chronic hepatitis B have a relatively low HBV replication level, and HBV DNA load is associated with HBV mutations. The B and C genotypes are more likely to have HBV mutations in HBeAg-negative patients.

DNA, Viral ; blood ; Female ; Genotype ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; classification ; genetics ; Hepatitis B, Chronic ; blood ; virology ; Humans ; Male ; Mutation ; Promoter Regions, Genetic ; Viral Core Proteins ; genetics ; Viral Load

Objective:To investigate the effects of escitalopram oxalate combined with low dose olanzapine on negative emotion and neurological function in patients with depression.Methods:From July 2018 to January 2019, 120 depressive patients who admitted to the Affiliated Kangning Hospital of Wengzhou Medical University were prospectively selected and divided into two groups according to random number table method, with 60 cases in each group.The observation group was treated with escitalopram oxalate combined with low dose olanzapine, while the control group was treated with escitalopram oxalate.The clinical efficacy, related scale scores, neurological function indicators and adverse reactions were compared between the two groups.Results:The total effective rate in the observation group was 85.0%(51/60) at 2 months after treatment, which was significantly higher than 63.3%(38/60) in the control group(χ 2=7.350, P=0.007). At 2 months after treatment, the scores of Mini mental state examination, Hamilton anxiety scale and Hamilton depression scale in the observation group were (12.58±1.34)points, (33.27±4.32)points, (36.72±4.93)points, respectively, which were lower than those in the control group [(16.93±1.46)points, (41.82±3.95)points, (47.61±5.09)points] ( t=17.003, 11.304, 11.904, all P<0.001). At 2 months after treatment, the level of brain-derived neurotrophic factor in the observation group was (33.26±3.52)μg/L, which was higher than that in the control group [(28.27±3.43)μg/L]( t=7.864, P<0.001). The S100B protein, myelin basic protein, neuron-specific enolase levels in the observation group were (0.76±0.09)μg/L, (5.16±0.97)μg/L, (4.63±1.21)μg/L, respectively, which were lower than those in the control group [(1.31±0.12)μg/L, (7.36±0.83)μg/L, (7.72±1.69)μg/L]( t=13.348, 11.505, 28.402, all P<0.001). The incidences of adverse reactions in the control group and the observation group were 10.0%(6/60) and 13.3%(8/60), respectively, there was no statistically significant difference between the two groups(χ 2=0.323, P=0.570). Conclusion:Escitalopram oxalate combined with low dose olanzapine is effective in the treatment of depression.It can effectively improve the negative mood and neurological function of patients.

Metastasis and resistance are main causes to affect the outcome of the current anticancer therapies. Heat shock protein 90 (Hsp90) as an ATP-dependent molecular chaperone takes important role in the tumor metastasis and resistance. Targeting Hsp90 and downregulating its expression show promising in inhibiting tumor metastasis and resistance. In this study, a redox-responsive dual-drug nanocarrier was constructed for the effective delivery of a commonly used chemotherapeutic drug PTX, and a COA-modified 4-arm PEG polymer (4PSC) was synthesized. COA, an active component in oleanolic acid that exerts strong antitumor activity by downregulating Hsp90 expression, was used as a structural and functional element to endow 4PSC with redox responsiveness and Hsp90 inhibitory activity. Our results showed that 4PSC/PTX nanomicelles efficiently delivered PTX and COA to tumor locations without inducing systemic toxicity. By blocking the Hsp90 signaling pathway, 4PSC significantly enhanced the antitumor effect of PTX, inhibiting tumor proliferation and invasiveness as well as chemotherapy-induced resistance in vitro. Remarkable results were further confirmed in vivo with two preclinical tumor models. These findings demonstrate that the COA-modified 4PSC drug delivery nanosystem provides a potential platform for enhancing the efficacy of chemotherapies.