Objective To discuss the clinical significance of vancomycin plasma concentration monitoring and its relationship with adverse reactions in treatment of elderly patients. Methods The clinical records of 32 patients aged over 70 years admitted in the Emergency Medical Department of Sichuan Provincial People's Hospital were collected. Based on the diagnosis and laboratory examinations on admission, the patients were treated with cefoperazone+sulbactam or moxifloxacin, while in patients with severe infections, intravenous drip of carbapenem antibacterial drugs were given. After treatment for 3-5 days, when no effective results were obtained, according to the pathogenic results achieved from cultures of blood, sputum, secretions, catheter, etc, the corresponding treatment was given. If the infection was caused by positive bacteria mainly methicillin-resistant Staphylococcus aureus (MRSA) sensitive to vancomycin, the original antibiotic was replaced by vancomycin or vancomycin combined with other antibiotic; intravenous drip of vancomycin 1 g in 250 mL normal saline was given, once in 12 hours, with a speed of 10 mg/min or not over 15 mg/min. The function of liver and kidney, and auditory impairment were observed, and the correlation between vancomycin plasma concentration and adverse reactions was analyzed. Results The total incidence of adverse reactions in elderly patients with different serum vancomycin trough concentrations was 37.50%(12/32) in which the highest incidence was kidney damage 18.75%(6/32) followed by the hearing loss 9.38%(3/32) and liver damage 9.38%(3/32). There were no statistical significant differences in the rates of adverse reactions among the different vancomycin trough concentrations (<10, 10-20,>20 mg/L) and [37.50%(6/16), 38.46%(5/13), 33.33%(1/3), all P>0.05], that meant along with the increase of vancomycin concentration, no tendency of increment of adverse reactions was seen. Of the 32 cases, there were 13 treated by vancomycin combined with other antibiotic, the combination rate being 40.63%. There were 2 cases of hepatic impairment (11.83%), 1 case of renal impairment (7.69%) and none hearing damage in patients treated with combination of antibiotic therapy. Therefore no correlation was concluded between the occurrence of adverse reactions and the combination therapy ( r=0.15, P>0.05). Conclusions In elderly patients over the age of 70 years, there is a higher incidence of kidney damage in the application of vancomycin. Thus, the monitoring of vancomycin plasma concentration in elderly patients has instructive significance in its clinical use.

Adult ; Anemia, Aplastic ; complications ; surgery ; Female ; Hematopoietic Stem Cell Transplantation ; Hemoglobinuria, Paroxysmal ; complications ; surgery ; Humans

Objective of this study is to re-compute the national hospitalization rate in China using the second-hand data and explore the practical use of systematic review in health policy research field.Methods Domestic literatures on hospitalization rate in the last six years were collected and quality assessment was done.Merging analysis was used based upon systematic review approach.Results 25 reported literatures on hospitalization rate of urban and rural residents were included into the study.After merging analysis,the hospitalization rates were 4.70% for the country,5.31% for the urban and 4.26% for the rural.They are higher than the reported hospitalization rate in National Health Services Survey (NHSS)in 2003.After merging with the NHSS data,the hospitalization rate were 4.12%,4.85% and 3.82% respectively.Conclusions Systematic review can be applied in health service and policy research field.Data merging and information processing methods are diversified and could be selected upon research purpose and data attribute.Computation methods in systematic review in health policy research still need to be developed.

OBJECTIVE:To establish the method for the determination of pemetrexed disodium in human plasma. METHODS:The plasma sample was determined by HPLC after protein were precipitated with strong acid. The determination was performed on Xterra?RP 18 column with mobile phase consisted of acetonitrile-50 mmol/L sodium dihydrogen phosphate buffer solution(15∶85) at the flow rate of 1.2 ml/min. The detection wavelength was set at 225 nm. RESULTS:The linear range of pemetrexed disodium were 1.0-32.0 mg/L (r=0.999 9,n=5) with recoveries of 86.35%-87.25%. RSDs of inter-day and intra-day were lower than 4.21%(n=5). Minimum detection concentration of plasma was 0.05 mg/L. The patients with high plasma concentration easily suf-fered from arrest of bone marrow. The plasma concentration was(18.56±4.50)mg/L,which could induce ADR;when the plasma concentration was (14.05 ± 6.72) mg/L,no ADR was found. There was statistical significance after t-test (P<0.05). CONCLU-SIONS:The method is simple,quick,accurate,sensitive and suitable for the plasma concentration determination of pemetrexed di-sodium and human pharmacokinetics study.

Aging is one of dangerous elements in cancer, diabetes, cardiovascular diseases, and neurodegenerative diseases. Qi deficiency and blood stasis is an important syndrome pattern in aging. The treatment methods of nourishing qi and resolving blood stasis is an important way to delay aging. Based on the theory that nourishing qi and resolving blood stasis can delay aging, many scholars have conducted lots of clinical and experimental researches nowadays. This article mainly analyzeds the theory and origin of nourishing qi and resolving blood stasis delaying aging, the current situation of clinical and experimentai researches on age-related diseases. The purpose of this article is providing a basis for anti-aging researches on Chinese herbal medicines that have the efficienoy of nourishing qi and resolving blood stasis, and further revealing aging mechanism.

ObjectiveTo study the transcript atlas of cell immunity-associated genes in 8 liver cell types including hepatocytes, bile duct epithelial cells, oval cells, hepatic stellate cells, sinus endothelial cells, Kupffer cells, pit cells and dendritic cells from the rat regenerating liver. Methods The 8 liver cell types were isolated respectively by Percoll density gradient centrifugation combined with immune magnetic beads separation method. Their expression changes in the regenerating livers were detected by Rat Genome 230 2.0 Array, the expression patterns and the predicted physiological activities of cell immunity-associated genes were analyzed by Cluster program, and the methods of bioinformation and systematic biology. Results A total of 40 cell immunity-associated genes yielded the meaningful expression changes in liver regeneration, the corresponding gene numbers in 8 liver cell types were 19, 19, 9, 19, 19, 21, 22 and 21, respectively. It suggested that the formation of antigen peptide-MHC complexes, the NF-κB kinase activity and the production of cytokines like IL-2 were enhanced at the priming and progressing phases of liver regeneration. The biological activities, such as NF-κB-promoting cell differentiation and caspase-induced T cell apoptosis, were elevated at termination phase.Conclusion The rat liver regeneration is associated with cell immunity.

Objective To study the effects of valsartan and triptergium glycosides on the abnormal expression of connective tissue growth factor(CTGF) in rats with diabetic nephropathy. Methods Sixty male SD rats were randomly divided into normal control group,diabetic nephropathy group(DN group),diabetic nephropathy treated with valsartan group(VAL group) and diabetic nephropathy treated with triptergium glycosides group(TG group).Diabetic nephropathy model was established by intraperitoneal injection of streptozotocin(STZ) in DN group,VAL group and TG group.The rats were sacrificed after 2,4,8 and 12 weeks.The body weight,blood glucose,renal function and urinary albumin excretion rate(UAER) were measured,and the expression of CTGFmRNA in kidney was detected by RT-PCR. Results Compared with control group,the levels of blood glucose,blood urea nitrogen,serum creatinine and UAER were significantly increased in DN group(P

It is rare that large mixed tumors of salivary gland located in the nose and uvula. The patient who had mixed tumors of salivary gland at nose found exophytic growth tumor for half a year. The other patient who had mixed tumors of salivary gland at uvula felt swallowing foreign body sensation for one year, and dysphagia for one month. After surgical resection, the symptoms disappear.
Adenoma, Pleomorphic ; complications ; pathology ; Deglutition ; Deglutition Disorders ; etiology ; Humans ; Nose Neoplasms ; pathology ; Palatal Neoplasms ; pathology ; Salivary Gland Neoplasms ; complications ; pathology ; Uvula ; pathology

The accommodative function before and after laser in situ keratomileusis (LASIK) was observed, and the effect of LASIk on accommodation was investigated. In a prospective clinical trial, 48 myopic patients (96 eyes) subject to bilateral LASIK in Refractive Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (China) from March 2006 to June 2006 were selected and studied. Refractions, accommodative range, amplitude of accommodative response and high frequency component (HFC) of accommodative microfluctuations were measured with NEDIK-730A before and one week and 30 days after operation. Dominant and non-dominant eyes were determined by hole-in-card method. It was found that all of the operative eyes showed an uncorrected visual acuity of 0.8 or better one week postoperatively, and 1.0 or better 30 days postoperatively. Compared with those preoperatively, accommodative range and HFC had no significant difference at first week and 30th day after operation in both dominant eyes and non-dominant eyes (P>0.05), but there was a significant difference in the amplitude of accommodative response/accommodative stimulus ratio (A/S) after operation (P<0.01), and no significant difference was found in accommodation between one week and 30 days postoperation. No ocular dominance's change was noted. There was no significant difference in accommodative function between dominant eyes and non-dominant eyes. It was suggested that LASIK produced no significant effect on accommodation.
Accommodation, Ocular/*physiology ; Keratomileusis, Laser In Situ/*adverse effects ; Myopia/*physiopathology ; Myopia/*surgery ; Postoperative Period ; Prospective Studies ; Young Adult

Objective To determine the perinatal outcomes and its risk factors of fetuses prenatally diagnosed with the double bubble sign on ultrasound scanning.Methods The clinical data of 57 cases of fetal double bubble sign which was prenatally diagnosed by ultrasound in Xin Hua Hospital from January 1,2000 to December 31,2013 were retrospectively analyzed.The neonates survived not less than 42 days were as surviving group,and who survived lower than 42 days were as dead group.The t test,x2 test and Logistic regression were used for statistical analysis of the data.Results Of 57 fetuses with the double bubble sign,the incidence of polyhydramnios,intrauterine fetal death and associated anomalies was 88％ (50/57),4％ (2/57) and 23％ (13/57),respectively.Induced labor to terminate the pregnancy was occurred in eight cases,the other 49 cases had live births but ten neonates abandoned therapy.Thirty-nine live babies accepted surgical treatment with one dead,and the other 38 neonates survived not less than 42 days.The overall 42-day survival rate was 67％ (38/57) and the surgical survival rate was 97％ (38/39).Compared with surviving neonates,the neonates who died had lower gestational age [(35.8±3.0) vs (38.1 ± 1.9) weeks,t=2.859,P＜0.01] and birth weight [(2 229±567) vs (2 830±558) g,t=3.136,P＜0.01],and a higher incidence of prenatally diagnosed structural anomalies [3/11 vs 3％ (1/38),P＜0.05] and karyotype anomalies detected after birth [3/11 vs 3％ (1/38),P＜0.05].Logistic regression analysis showed that the fetuses with the double bubble sign and fetal growth restriction had a higher risk of complications (OR=9.893,95％CI:1.758 55.661,P=0.009).Conclusions Fetuses with double bubble sign have adverse outcome if they complicating preterm delivery,low birth weight,prenatally diagnosed structural anomalies and karyotype anomalies.