Adult ; Anemia, Aplastic ; chemically induced ; immunology ; therapy ; Benzene ; poisoning ; Cyclosporine ; therapeutic use ; Female ; Humans ; Immunity, Cellular ; Immunosuppressive Agents ; therapeutic use ; Male ; Middle Aged

OBJECTIVE To explore the clinical features of Acinetobacter baumannii lung infection and drug resistance situation.METHODS An analysis was conducted on clinical features and risk factors of 79 cases of A.baumannii lung infection in elderly patients from Jan 2005 to Jun 2008.Drug resistance of A.baumannii to 12 kinds of antimicrobial drugs such as ciprofloxacin,ceftazidime,ceftriaxone,imipenem and amikacin was tested.RESULTS An onset of A.baumannii infections in the lungs of elderly patients usually appeared during the critical period of some underlying diseases.More clinical manifestations as fever,lung and wet La-hypoxemia existed.Accepting antibiotic therapy,pulmonary diseases,mechanical ventilation,ICU wards,etc were the risk factors.There was a high mortality rate with multi-drug resistant(MDR) A.baumannii.Bacterial resistance to cefoperazone/sulbactam,piperacillin/tazobactam was lower while its resistance to other antibiotics was higher.The detection rate of MDR was 37.97%.CONCLUSIONS Elderly patients with A.baumannii infection have a high incidence of lung infection,but lacking characteristic clinical signs and symptoms.There is an increasing trend in the detection rate of MDR.It is of great significance to reduce the incidence rate of A.baumannii lung infection and prevent the spread of multi-drug resistant strains by strengthening the monitoring of pathogens and their resistance and choosing antibiotics according to susceptibility testing.

OBJECTIVE To understand the pathogens spectrum of tuberculosis patients with lower respiratory tract infection in hospital and the drug resistance,so as to provide guidance of rational drug use.METHODS 576 pathogens isolated from the sputum samples of TB patients with lower respiratory tract infection in hospital from 2005 to 2007 and the drug resistance were analyzed.ESBLs test was conducted on the Gram-negative bacill.RESULTS Gram-negative bacilli accounted for 73.6 percent.The first six ones were: Pseudomonas aeruginosa(19.4%),Acinetobacter baumannii(12.0%),Klebsiella pneumoniae(11.1%),E.coli(9.9%),Staphylococcus aureus(9.2%),Candida albicans(8.2%).They were highly sensitive to impinem,Cefoperazone-sulbactam.The drug resistance rates of ESBLs produceing P.aeruginosa and A.baumannii were respectively 2.7%-30.3% and 8.7%-30.4%.The resistance of MRSA to B-lactamase,Fluoroquinolone and Aminoglycoside was 64.7%-100.0%.ESBLs produceing E.coli and K.pneumoniae strains accounted for 52.6% and 45.3%.CONCLUSIONS Lower respiratory tract infection of tuberculosis patients was mainly caused by Gram-negative bacilli,most of which was portunistic pathogens.The pathogens resistance to antibiotics are increasing E.coli and K.pneumoniae produce a higher proportion of EBSLs.To delay the formation of pathogen resistance and control the hospital infection,it is important to enhance drug monitoring and rational use of antibiotics.

For the purpose of expanding the analysis scope of medicines,a RPHPLC assay procedure has been established for quantitative analysis of indomethacin in human plasma.Analytical column was YWG C18(?4 6 mm?200mm).Mobile phase was methanol water acetic acid solution(67∶33∶0 1)(v/v) and wavelength of detector was 254nm.The linear relationship,precision,method of extraction and recovery were comparatively investigated by standard blank human plasma spiked with indomethacin.Indomethacin leved in the blood of the healthy volunteers was detected by using this method.The linear range of the method was 0 1～5 0?g?ml -1 .The calibration curve was linear (?=0 9995). The detection limit was 0 02?g?ml -1 (S/N≥3) and the recovery of indomethacin in human blood was between 97 5%～104 2%. Intra and inter day prccision of the mothod were(1 1?0 2)%(n=4) and(2 7?0 6)%(n=4)respectively.The CV% were no more than 3 0% (n=4).The method shows a high sensitivity,precision,fast and excellent selectivity.Thus it is suitable for investigation of the indomethacin in human blood and its toxicological analysis as well as the pharmacokinetic study.

Objective Investigation and analysis of intelligence and psychomotor function in children born after implementingt universal salt iodization(USI). Methods Historical serious illness areas of water iodine below 10μg/L were selected as study sites, water iodine in 50 - 100 μg/L in the historical non-endemic areas were as control points in Henan, 2008. Cluster sampling was used to select children aged 6 - 15 years as observing subjects,IQ were measured with CRT- Man Test(CRT-C2). A "Tianjin Medical psychomotor test battery" (JPB) was carry out to test psychomotor function. Results In IDD regions 230 children were surveyed post-USI and 1284 children preUSI. The IQs post and pre USI were 99.3 and 99.9, respectively, and the proportion of IQ ≤69 were 2.17%(6/230) and 2.80%(36/1284), respectively. In non-IDD regions 650 children were surveyed post-USI and 2079children pre-USI. The IQs post and pre USI were 95.3 and 93.8, respectively, and the proportion of IQ ≤ 69 were 2.31%(15/650) and 3.37%(70/2079), respectively. In IDD regions, the abnormal rate of T scores and damage index post USI were 3.6%(2/56), 5.3%(3/56), respectively, significantly lower than pre USI [18.1%(29/160),18.1%(29/160), x2 = 7.54, 6.86, all P ＜ 0.01]. Conclusions USI could increase the IQs of children and decrease the positive rate of JPB, and significantly improve the quality of whole nation and persistently eliminating IDD.

Drug therapy is one of the efficient methods for prostate cancer treatment. However, drug resistance greatly hindered the treatment of prostate cancer patients. Herein, the mechanisms of drug resistance in prostate cancer have been exhaustively reviewed, and that can provide an alternative strategy and new targets for anti-prostate cancer therapy.
Drug Resistance, Neoplasm ; Humans ; Male ; Prostatic Neoplasms ; drug therapy

OBJECTIVE:To investigate the characteristics and factors of ADR caused by Chinese patent medicine(CPM)and to provide reference for rational drug use and safety evaluation in the clinic. METHODS:158 cases of ADR caused by CPM collect-ed from our hospital during Jan.2009-Dec.2014 were analyzed. RESULTS:The occurrence of ADR caused by CPM was related to patient’s age,route of administration,category of drugs,irrational drug-use and so on. The incidence of ADR in patients over the age of 60 was the highest (31.01%),the largest number of ADR were caused by intravenous injection (79.11%),ADRs were most likely caused by blood-regulating preparation and dissipate blood stasis preparation (79.75%);ADR manifested as lesion of skin and its appendents(43.01%),followed by gastro-intestinal injury(16.06%)and whole-general injury(10.36%). The severe ADR was anaphylactoid reaction;after symptomatic treatment,the prognosis is good. CONCLUSIONS:According to syndrome differentiation and individual difference,CPM should be used rationally,and great importance should be attached to drug use moni-toring to reduce the incidence of ADR.

Objective To investigate the role of p38 mitogen-activated protein kinase (p38MAPK) signaling pathway in reduction of myocardial ischemia-reperfusion (I/R) injury by morphine preconditioning in the rats with chronic heart failure in vitro.Methods Adult male Sprague-Dawley rats,weighing 200-230 g,aged 6-7 weeks,in which doxorubicin 2 mg/kg was injected via the tail vein once a week for 6 consecutive weeks to induce chronic heart failure,were studied.At the end of 8th week,30 rats with chronic heart failure were randomly divided into 5 groups (n =6 each) using a random number table:sham operation group (group Sham),I/R group,morphine preconditioning group (group MPC),SB203580 (p38MAPK inhibitor) + morphine preconditioning group (group SBM),and SB203580 group (group SB).The hearts were quickly excised and passively perfused in a Langendorff apparatus and subjected to 30 min of occlusion of the anterior descending branch of the left coronary artery followed by 120 min of reperfusion to establish the model of myocardial I/R injury.After equilibration,the hearts were subjected to 3 cycles of 5 min perfusion with K-H solution containing morphine 1 μmol/L at 5-min intervals before ischemia in group MPC.In group SBM,the hearts were perfused with K-H solution containing SB203580 (5 μmol/L) for 45 min starting from l0 min before morphine preconditioning until 5 min of ischemia.In group SB,morphine preconditioning was not performed,and the hearts were only perfused with K-H solution containing SB203580 (5 μmol/L) starting from 40 min before ischemia until 5 min of ischemia.At 15 min of equilibration (baseline),5 and 10 min of reperfusion,the coronary effluent was collected to detect the activity of lactate dehydrogenase (LDH) using the chemical colorimetry.At 10 min of reperfusion,the expression of phosphor-p38MAPK (p-p38MAPK) in the myocardium was determined by Western blot in Sham,I/R and MPC groups.At 120 min of reperfusion,the area at risk (AAR),total areas of right and left ventricles (LV+RV),and infarct size (IS) were measured,and the IS/AAR ratio was calculated.Results Compared with group Sham,the LDH activity in coronary effluent during reperfusion and IS/AAR ratio were significantly increased in the other groups,and the expression of p-p38MAPK was significantly up-regulated in I/R and MPC groups (P＜0.05).Compared with group I/R,the LDH activity in coronary effluent during reperfusion was significantly decreased,the expression of p-p38MAPK was significantly up-regulated,and the IS and IS/AAR ratio were significantly decreased in group MPC (P＜0.05),and no significant change was found in the LDH activity in coronary effluent,IS and IS/AAR ratio in SBM and SB groups (P＞0.05).Compared with group MPC,the LDH activity in coronary effluent during reperfusion was significantly increased,and the IS and IS/AAR ratio were significantly increased in group SBM (P＜0.05).Conclusion The mechanism by which morphine preconditioning reduces myocardial I/R injury is related to activation of p38MAPK signaling pathway in the rats with chronic heart failure in vitro.

Objective To access the left internal thoracic artery (LITA) graft late postoperative patency after coronary artery bypass grafting (CABG) by peripheral blood vessel ultrasound combined with color Doppler coronary flow imaging (CDCFI).In contrast with angiography,try to find available flow parameter to access graft patency.MethodsForty-six patients with CABG more than 1 year postoperatively followed-by angiography were detected by ultrasound.The LITA graft and left anterior descending artery were examined.Systolic and diastolic peak velocity(Smax,Dmax),velocity time integral(VTIs,VTId)of each segment were measured separately.The ratio of diastolic and systolic peak velocity (D/S),and diastolic velocity time integral fraction(DVTIF) were calculated.All patients were divided into groups according to angiography results.ResultsThirty -one LITA grafts were patent,11 were dysfunctional,4 were occlusive.According to the angiography results,the flow parameters of the proximal segment of LITA graft were significant.The D/S and DVTIF of patent group was higher than that of dysfunctional group.The diastolic peak velocity of distal segment of LAD of patent group was higher than that of dysfunctional group.ConclusionsPeripheral blood vessel ultrasound combined with CDCFI could provide the evidence to access the patency of the graft.It was an effective method for the clinical follow-up.

Based on the results of oral glucose tolerance test( OGTT )and the levels of 1-h plasma glucose ( 1 hPG),793 subjects were classified into three groups:583 with NGTN ( normal 1 hPG in OGTT),127 with NGT1 H( higher 1 hPG in OGTT) and 83 with IGT( impaired glucose tolerance).NGT1H group had large waist circumference,higher body mass index,fasting plasma glucose( FPG),triglyceride,and lower high density lipoprotein-cholesterol than those of NGTN group.NGT1 H group had higher homeostasis model assessment insulin index ( 1.2 ± 0.6),lower homeostasis model assessment β3 ( HOMA-β ) (4.5 ± 0.7 ) and insulinogenic index (2.1 ±0.7) than those of NGTN group(0.5 ±0.6,4.8 ±0.7,2.7 ±0.9,respectively,all P ＜0.05 ).HOMA-β of NGT1 H group was higher than that of IGT group(4.5 ±0.7 vs.4.4 ±0.6,P ＜0.05 ).The results indicate that 1 hPG in OGTT may identify a condition of glucose metabolic abnormalities characterized by insulin resistance and reduced β-cell function.