AIM:To investigate the relationship of clinical efficacy,blood trough concentration and adverse reavtion,which in the treatment of methicillin-resistant Staphylococcus aureus infection with Vancomycin.METHODS:The clinical data of 82 hospital patients who were infected by methicillin-resistant Staphylococcus aureus and treated with Vancomycin from January 2008 to October 2009 were retrospectively analyzed the clinic efficacy,bacteriological treatment,adverse reaction were observed,and the blook trough concentration was detected.RESULTS:The treatment effective rate of Vancomycin-blood trough concentration which was less than 5 ?g/mL,in the range of 5-10 ?g/mL,and greater than 10 ?g/mL were 68.75%,72.73% and 81.82%.The bacterial clearance rates were 62.50%,68.18% and 72.73%.One case of blood trough concentration of 14.6 ?g/mL in patients with renal toxicity.CONCLUSION:Increasing the blood trough concentration of Vancomycin can improve the treatment of methicillin-resistant Staphylococcus aureus infection in the efficacy and bacterial eradication rates,but the probability of renal toxicity adverse reactions will also increase accordingly.

Objective To evaluate the clinical efficacy of microwave ablation and surgical resection for the treatment of early primary hepatocellular carcinoma (HCC).Methods The Cochrane Library, Medline,PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang database, VIP database were searched with the key words of tumor, liver cancer, primary hepatic carcinoma, hepatocellular carcinoma, HCC,surgery, surgical, surgical resection, liver resection, hepatic resection, thermal ablation, percutaneous thermal ablation, microwave coagulation, microwave ablation, 肝癌, 原发性肝癌, 肝细胞癌, 手术, 切除, 手术切除, 肝切除, 微波, 热消融, 微波治疗, 微波凝固, 微波消融 between the database establishment and February 2015.Chinese and English literatures on microwave ablation and surgical resection for the treatment of early primary HCC were retrieved, and data were extracted and analyzed by 2 independent researchers.All the patients were divided into the microwave ablation group and the surgical resection group.Measurement data were represented by the standardized mean difference (SMD) and 95％ confidence interval (CI), and count data were represented by the odds ratio (OR) and 95％ CI.Heterogeneity of the publication was analyzed using the I2 test.Results Seven literature including 6 retrospective cohort studies and 1 randomized controlled trial were retrieved, and total sample size were 993 patients including 648 in the microwave ablation group and 345 in the surgical resection group.There were significant differences in the volume of blood loss and duration of postoperative hospital stay between the2groups (SMD=-5.03,-1.74, 95％ CI:-6.21-3.85,-2.21--1.28, P＜0.05).There were no significant difference in the incidence of postoperative complications, 1-, 3-year overall survival rates, 1-, 3-year tumor-free survival rates and 1-, 2-, 3-year recurrence rates between the 2 groups (OR =1.57, 1.10, 1.20,0.77, 1.23, 1.32, 2.31, 1.39, 95％CI: 0.25-9.78, 0.43-2.86, 0.70-2.06, 0.19-3.12, 0.54-2.81,0.62-2.80, 0.96-5.55, 0.47-4.14, P ＞ 0.05).Conclusions The safety, feasibility and clinical efficacy of microwave ablation for the treatment of early primary HCC is comparable to surgical resection, and microwave ablation has the advantages of lesser blood loss and shorter duration of hospital stay.

Objective To investigate the effects of over-expression of wild-type PTEN gene and its mutant (G129E) on apoptosis and proliferation of activated hepatic stellate cells (HSC) in vitro and its potential mechanisms. Methods The activated HSC cells were cultured in vitro and transfected with PTEN gene and G129E gene via adenoviral vector. The apoptosis of HSC was measured by MTT , and its proliferation was assessed by TUNEL and flow cytometry (FCM) . Western blotting and real-time fluorescent quantitation PCR were used to detect expression of PTEN in HSC. And the changes of Bcl-2 and Bax expression were tested by Western blotting. Results The wild type PTEN gene and G129E gene were successfully transducted into HSC, which resuted in elevated expression of Bax and reduced expression of Bcl-2 (P<0.01). After transduction, HSC proliferation was markedly inhibited with inhibitory rates of 14.03% and 23.12% at 48 and 72 hours in Ad-PTEN ,respectively, as well as 9.52% and 12.63% in Ad-G129E, respectively. Apoptotic rate of HSC exposed to Ad-PTEN or Ad-G129E for 72 hours increased significantly (P<0.01). Furthermore, wild type PTEN was more powerful than G129E for above-mentioned effects. Conclusions Over-expression of wild type PTEN and its mutant G129E can inhibit the proliferation of activated HSC, and induce HSC apoptosis through the Bcl-2/Bax pathway. In addition, the effect of wild type PTEN is more powerful than that of G129E.

This study was designed to investigate the correlation between autophagy and polarization of macrophages in atherosclerosis (AS) plaque in arteriosclerosis obliterans amputees. Femoral artery specimens from arteriosclerosis obliterans amputees were performed hematoxylin and eosin (HE) staining, oil red O and immunofluorescence staining to observe the morphology of atherosclerotic plaque, phenotype of macrophages and autophagy in plaque; using real-time quantitative RT-PCR technology to detect the mRNA level of M1 and M2 type markers in arterial tissue; to analyze polarized signal pathway and autophagy protein levels in macrophages by Western blotting. Arterial specimens staining showed obvious lipid deposition and obvious infiltration of amount of foam cells and inflammatory cells. Macrophages were mainly expression M1 type in percentage in fibrous plaque. Although both M1 and M2 macrophages were upregulated in atheromatous plaque, the increase was dominant in M2 type in percentage. The level of autophagy was significantly higher in the atheromatous plaque than that of fibrous plaque. The expression of tumor necrosis factor- α (TNF-α), monocyte chemotactic protein-1 (MCP-1), inducible nitric oxide synthase (iNOS), interleukin-6 (IL-6) and interleukin-12 (IL-12) mRNA was significantly higher in fibrous plaque than that of atheromatous plaque (P < 0.01 or 0.05), and arginase-1 (Arg-1), transforming growth factor-β (TGF-β), CD163 and interleukin-10 (IL-10) mRNA was significantly lower than that in atheromatous plaque (P < 0.01). The levels of p-STAT1 and NF-κB were significantly increased in fibrous plaque (P < 0.01), while p-STAT6 expression was significantly increased in atheromatous plaque (P < 0.01). The level of LC3-II was significantly higher in atheromatous plaque than that in fibrous plaque (P < 0.01). Macrophages in early atherosclerotic plaque were induced to M1 type through p-STAT1/NF-κB pathway and expressed moderate levels of autophagy; while macrophages in advanced plaques were induced to polarization of M2 type through p-STAT6 pathway. M2 macrophages expressed a higher level of autophagy than M1 macrophages.

Objective To identify the rate of hepatitis B virus (HBV) reactivation and potential risk factors in hepatitis B surface antigen negative/hepatitis B core antibody positive patients with lung cancer receiving adjuvant chemotherapy without concomitant antiviral prophylaxis.Methods The records of 3280 patients with lung cancer who received adjuvant chemotherapy were retrospectively reviewed from January 2003 to December 2011.Among these patients,367 hepatitis B surface antigen negative/hepatitis B core antibody positive patients were analyzed for the HBV reactivation in this study.The HBV serology marker and biochemical tests of the 367 patients were performed.The data were analyzed by chi square test.Results Among 367 hepatitis B surface antigen negative/hepatitis B core antibody positive patients with lung cancer,14 patients suffered HBV reactivation.Univariate analysis showed that age≥70 years(x2 =13.003,P=0.019),abnormal liver computed tomography findings (x2 =11.225,P =0.026) and the amount of corticost eroids≥ 150 mg(x2 =7.008,P =0.033)were associated with HBV reactivation.However,gender and adjuvant chemotherapy regimens were not related with HBV reactivation.Conclusion HBV reactivation occurs in a proportion of hepatitis B surface antigen negative/hepatitis B core antibody positive patients with lung cancer during adjuvant chemotherapy.

ObjectiveTo explore the expression of N-cadherin and β-catenin mRNA in human brainstem and supratentorial gliomas. MethodsN-cadherin and β-catenin mRNA expression in 18 cases of brainstem gliomas and 18 cases of supratentorial gliomas tissues were detected with PT-PCR. Resultsβ-catenin mRNA expression was more in human brainstem gliomas than in supratentorial gliomas （t=2.255,P<0.05）, but was not significantly different of N-cadherin mRNA (P＞0.05). The expression of N-cadherin mRNA in human brainstem gliomas of grades Ⅰ～Ⅱ were less than those in human gliomas of grades Ⅲ～Ⅳ (t=2.711，P<0.05), but was not of β-catenin mRNA (P＞0.05). N-cadherin mRNA expression was positively correlated with the β-catenin mRNA expression in either brainstem gliomas or supratentorial gliomas （r=0.480，r=0.809 respectively, P<0.05）. ConclusionThe over expressions of N-cadherin and β-catenin may play an important role in the invasion and malignant progress of human brainstem gliomas.

OBJECTIVETo observe the behavioral changes of rats after subchronic exposure to di-(2-ethyl hexyl) phthalate (DEHP).

METHODSTwenty-four healthy male SD rats were randomized equally into 4 groups, namely the solvent control group (sesame oil) and 3 DEHP groups with daily intragastric administration of DEHP at the doses of 150, 450, and 1350 mg/kg for 28 days. The neurobehavioral changes of rats were evaluated by open-field test (OFT) and elevated plus-maze test (EPM), and the body weight and organ coefficients were measured.

RESULTSThe rats showed no significant differences in the performance in OFT or EPM before DEHP exposure. The body weight of the rats increased with the prolonged DEHP exposure, but no significant differences were found between the treatment groups and the control group (P>0.05). From the third week of exposure, the weekly food consumption and the food utilization rate showed significant differences between the treatment groups and the control group (P<0.05 and PP<0.01), and the liver and testis coefficients, but not the kidney coefficient, also differed significantly (PP<0.01, PP<0.01, and P>0.05). In OFT, the total distance of movement was the longest in high dose treatment group (PP<0.05 vs control group), and the durations of stay in the central area, but not the number of times of entry, differed significantly between the 3 treatment groups and the control group (PP<0.05 and P>0.05). In EPM test, however, the performances of the rats was all similar between the 4 groups (P>0.05).

CONCLUSIONDEHP can affect the locomotor activity and exploratory behavior of rats after short-term exposure, suggesting its possible hazard in human being.

Animals ; Behavior, Animal ; Diethylhexyl Phthalate ; toxicity ; Environmental Exposure ; Exploratory Behavior ; Male ; Motor Activity ; Rats ; Rats, Sprague-Dawley

Objective To explore the efficacy and prognostic independent factors of modified island flap(OIF)and urethroplasty(tip)in the treatment of hypospadias in children.Methods The 164 children with hypospadias analyzed retrospectively were treated from February,2013 to February,2021.They were divided into two groups according to the operation method.82 patients in tip group were treated with tip and 82 patients in OIF group were treated with OIF.The treatment effects of the two groups were compared.Then they were divided into two groups according to the cure condition,namely,the good prognosis group(cured by operation,151 case)and the poor prognosis group(not cured by operation,13 case).Independent factors affecting the prognosis of children were analyzed by binary logistic regression.Results The cure rate of OIF group was 96.34％,which was higher than that of the tip group(87.8％),and the incidence of postoperative complications in OIF group was 7.32％,which was lower than that of the tip group(23.17％,P＜0.05).The operation time in tip group(95.95±12.35)min,which was shorter than that of the OIF group(P＜0.05).At the same time,the binary logistic regression analysis showed that the degree of hypospadias and the classification of barcat were the prognostic factors of children with hypospadias.The degree of penis bending,the width of penis head and the method of operation were suspicious factors.Conclusion OIF and tip have good effects in the treatment of hypospadias in children.OIF has a higher success rate,tip has a shorter operation time and fewer postoperative complications.However,the independent factors affecting the prognosis of children are preoperative hypospadias classification and barcat classification.This operation method is not an independent factor affecting the prognosis.

In the past decade,thyroid surgery in China has developed rapidly.With the improvement of thyroid diagnosis technology,the standardization of thyroid surgery,the clinical application of systematic therapy,and the progress in fundamental research,thyroid surgery has achieved all-round development.Patients with thyroid disease have benefited significantly from safer,more standardized,more effective,and more diverse treatments,which results in the remarkable increase in the 5-year survival rate.Moreover,Chinese experts have published a number of guidelines and expert consensus related to thyroid surgery,which promotes the standardization of the diagnosis and treatment of thyroid disease.Additionally,the specialized multidisciplinary teams in cancer centers allow patients to receive more standardized diagnosis and treatment of complex thyroid diseases.In the present article,we summarize the important developments of China's thyroid surgery in the past decade,including preoperative diagnosis technology,surgical methods,operation safety,application of minimally invasive techniques,diagnosis and treatment of special thyroid cancers,multidisciplinary diagnosis and treatment models,and standardized postoperative managements.We expect to popularize the concept of standardized diagnosis and treatment of thyroid diseases,and improve the level of standardized diagnosis and treatment in thyroid surgery.

Recently,the relationship between intestinal flora and its metabolites and tumorigenesis,inflammatory bowel diseasesas well as radiation-induced intestinal injury has captivated widespread attention from researchers.Accumulated evidence derived from nuclear accident investigation,animal model experiment and clinical research has proven the role of intestinal flora and its metabolites as the biomarkers to evaluate the radiation dose and severity of radiation-induced intestinal injury.This article reviews the relationship between intestinal flora and its metabolites and radiation-induced intestinal injury,aiming to provide theoretical reference for assessing the risk of radiation-induced intestinal injury.