AIM: To observe the clinical efficiency of intravitreal conbercept on diabetic macular edema(DME).METHODS: This was a single arm, open-babel prospective study.Twenty eyes from 20 patients (12 males and 8 females) with DME diagnosed by fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) were enrolled.Before the injection, best-corrected visual acuity (BCVA) of early treatment of diabetic retinopathy study (ETDRS), non-contact tonometer, ophthalmoscope, fundus photography, fundus fluoresein angiograph (FFA), and OCT were examined.All affected eyes were treated with intravitreal conbercept 0.05mL (10mg/mL).Patients were followed up for 6 to 11mo, with a mean duration of 8.55±1.96mo.Post-treatment BCVA, CMT, leakage of macular edema and complications were compared with baseline using repeat analysis.RESULTS: The initial average visual acuity (ETDRS letters) were 43.35±17.45, range from 9 to 70.The initial average central macular thickness (CMT) was 576.30±167.92μm, range from 337 to 987μm.The mean BCVA showed significant improvement during 1, 3, 6mo post-treatment and the latest follow up, with a mean increase of 11.2±5.9, 13.8±7.9, 15.7±6.8 and 14.7±8.6, respectively (P<0.01).The changes of BCVA between before and at 1mo after treatment were different compared with the changes between before and at 6mo (P<0.01).During the latest follow up, the mean BCVA was obviously improved in 10 eyes (50%), improved in 7 eyes (35%), stable in 3 eyes (15%).Likewise, the mean CMT significantly decreased during the follow-up period with a mean CMT reduction of 183.8±159.5, 292.9±169.0, 271.4±167.2 and 286.4±166.9μm respectively (P<0.001).The CMT at 1mo were different with that 3, 6mo and final follow-up (P<0.01).During the latest follow up, macula lutea leakage disappeared in 6 eyes (30%), decreased in 12 eyes (60%) and increased in 2 eyes (10%).No adverse events such as secondary retinal detachment or endophthalmitis were found during the follow-up.CONCLUSION: Intravitreal conbercept significantly improve visual acuity and macular edema exudation.

To observe the effect of oxidized low density lipoprotein (OxLDL) on arterial endothelial cells apoptosis in vivo, we established a model in which Sprague-Dawley rats were given intraperitoneal and intravenous injection of unmodified LDL (8 mg/kg every day) via the tail vein. Seven days after the injection, the aortic endothelial cells specimens were prepared by an en face preparation of rat aorta. The apoptotic cells were identified and counted by in situ nick and labelling (TUNEL) method and light microscopy. The numbers of the apoptotic cells were 12.52 +/- 4.71/field in the intraperitoneal injection control group, 11.41 +/- 2.94/field in the intravenous injection control group, 22.98 +/- 8.01/field in the intraperitoneal injection LDL group and 103.8 +/- 11.5/field in the intravenous injection LDL group, respectively. The difference was significant between injection LDL group and control (P < 0.01), and the difference was also significant between two LDL injection groups (P < 0.01). These findings suggest that injection of LDL can induce apoptosis in arterial endothelial cells and the effect is especially significant with intravenous injection LDL. After injection, oxidative modification of LDL may occur in local arteries and causes injury to the endothelial cells.
Aorta ; Apoptosis/*drug effects ; Endothelium, Vascular/*pathology ; In Situ Nick-End Labeling ; Injections, Intraperitoneal ; Injections, Intravenous ; Lipoproteins, LDL/*metabolism ; Lipoproteins, LDL/*pharmacology ; Oxidation-Reduction ; Random Allocation ; Rats, Sprague-Dawley

Objective To observe the curative effect about heavy abdomen type of anaphylactoid pur-pura treated by Methylprednisolone associate with Heparin. Methods Randomly divided eighty three children with heavy abdomen type of anaphylactoid purpura who treated in department of pediatrics of the first hospital affiliated to Kunming medical college from January, 2006 to december, 2007 into group A (treated by Hydro-cortisone) and group B (treated by Methylprednisolone) and group C(treated by Methylprednisolone associate with Heparin). Group A treated by mainline Hydrocortisone dose of 5～8 mg/kg body weight once a day,mixed into 100ml 5% glucose injection, after 7～14 days later, instead of take orally Predisone tablet and de-grees dose by gradually. Group B treated by mainline Methylprednisolone dose of 2～4 mg/kg body weight once a day, mixed into 100ml 5% glucose injection, after 7～14 days later, instead of take orally Predisone tablet, and group C treated by Methylprednisolone by oneself (dose like group B) associate with mainline Hep-arin (dose of 0.25～0.75 mg/kg body weight once a day, mixed into 100ml 5% glucose injection) 7～10 days. Observe clinic symptomatic like as tetter, bellyache, entron hemorrhage when treatment of every group. Contrast reiteration rate of anaphylaetoid purpura, and the period of urine test get hack normal which cases with kidney tamper. Contrast these medication' s side effect such as resort of natrium and water, elec-trolyte turbulence, hemorrhage and so on. Results Group C (treated by Methylprednisolone associate with Heparin) is better then group A (treated by Hydrocortisone) and group B (treated by Methylprednisolone by oneself) in eliminate tetrer and release bellyache. The less period of group C need to treatment entron hemor-rhage and urine test get hack normal. And thereiteration rate is less of group C than group A and group B.Conclusion Methylprednisolone in association with Heparin to treat heavy abdomen type of anaphylactoid purpura is better than hydrocortisone and Methylprednisolone by oneself in controling symptom, reduing reiter-ation rate and more less side effect. So methylprednisolone in association with Heparin to treat of heavy ab-domen type of anaphylactoid purpura is a ideal project.

OBJECTIVE:To facilitate the evolvement of hospital pharmaceutical care.METHODS:The website of pharmacy department of Shanghai No.9People’s Hospital was programmed and exploited,and based on which the hospital pharmaceutical information service was carrying out.RESULTS:The website ran stably and fast;its maintenance was very convenient;pharmaceutical information was rich,the online communication between doctors and patents was available here and the application outcome proved to be satisfactory.CONCLUSION:Establishing hospital pharmaceutical website and carrying out online pharmaceutical care are of significance in the evolvement of hospital pharmacy work.

Objectives To evaluate the influence of cardio-pulmonary bypass (CPB) to the endothelial function and lipid oxidative status of the Coronary Artery Bypass Grafting (CABG) patients. Methods Thirty-five coronary patients (female 5 cases, male 30 cases, mean age 59.5±8. 6 years) who needed CABG operation therapy were included. The control group consisted of 20 health volunteers (female 5 cases, male 15 cases, mean age 49. 5 ± 7.3 years).Blood samples were taken at preoperative, 3 and 7 days postoperative. Serum von Willebrand factor (vWF) level, one of the endothelial dysfunction markers,and oxidized low density lipid (OxLDL) level, one of the lipid oxidization status markers were detected with ELISA kits. Results The levels of vWF and OxLDL in CABG patients' serum were elevated significantly compared with those of control group ( 139.60% ± 34. 39% vs 82. 79% ±13. 89% and 63. 7 ±18. 9U/ml vs 25.4± 15.2U/ml respectively). Three and 7 days after CABG significant increases in the vWF level (194. 30% ±37. 74%; 181.07% ±31.05%vs 139.60% ±34.39% at baseline, P＜0. 0001, respectively) and OxLDL level (79. 3±26. 7U/ml; 72.4±23.1U/ml vs 63.7±18. 9U/ml at baseline, P＜0. 01, respectively) were detected. Conclusion Compared with normal people, the endothelial system of CABG patients is impaired, and their lipids are in a more oxidative status. CABG procedure with CPB can further deteriorate the conditions, which may imply that the patients are predisposed to acute coronary accident shortly are the procedure.

Objective To analyse the detection rates and antibiotic resistance of extended-spectrum β-lactamases (ESBLs) producing Klebsiella pneumonia and Escherichia coli in Intensive Care Unit (ICU) and to guide the clinical administration of treatment Methods Klebsiella pneumonia and Escherichia coli collected from clinical samples from January 2008 to December 2010 were tested by Phenotypic Confirmatory Test and confirmed by the method advised by NCCLs and drug-sensitivity was tested with K-B. Results Among the isolated 90 samples,49 strains were considered ESBLs-producing bacteria (54.4%) .with 52. 5% (31/59)of Klebsiella pneumonia and 58. 1% (18/31) of Escherichia coli respectively; with the specimens of respiratory system having the highest rate of 75. 5% (37/49). ESBLs producing bacteria were highly resistant to penicillins and cephalosporins, multi drug resistant to aminoglycosides and quinolones; low to piperacillin/tazobactam,cefoperazone/sulbactam,cefoxitin and amikacin; and all sensitive to imipenem. When compared to non-ESBLs producing strains, the rates of antibiotic resistance of the producing ESBLs strains were significantly higher. Conclusion The test results showed that the isolation rates of ESBLs-producing Klebsiella pneumoniae and Escherichia coli in ICU were high,which had high resistance to most antimicrobial agents,and the resistance was multiple. Imipenem could be the best choice to control the infection due to ESBLs-producing organisms. Timely detection of ESBLs producing bacteria and drug resistance is essential to guide clinical antibiotic using in ICU.

Aim To investigate the changes in the expression of protein kinase C gamma (PKC?), phosphorylated cAMP response element binding protein(pCREB)and immediate-early gene(c-fos and c-jun) in the spinal cord in formalin-induced inflammatory pain and study the effect of agmatine on the changes of PKC? activation, phosphorylation of CREB and expression of c-fos and c-jun.Methods Rats were decapitated at 10, 20 min or 2 h after intraplantar injection of 50 ?l 5% formalin and L_4, 5 spinal cords were dissected. Immunohistochemistry and western blotting analyses were used to observe the expression of PKC?, pCREB, c-fos and c-jun in the spinal dorsal horn and the effect of agmatine on the changes of their expression. Results Unilateral peripheral inflammation induced PKC? activation and CREB phosphorylation bilaterally while c-fos and c-jun expression ipsilaterally in rat spinal cord. PKC activity increased in membrane fractions with unchanged levels in the cytosolic fractions. Pretreatment intraperitoneally with 160 mg?kg-1 agmatine 15 min before inflammation significantly inhibited the activation of PKC? in the membrane fraction, suppressed the phosphorylation of CREB and the expression of c-fos and c-jun. Conclusion The mechanism of the analgesic effect of agmatine may be associated with inhibiting PKC? activation in the plasma membrane, CREB phosphorylation, c-fos and c-jun up-regulation which play roles in the hyperalgesia with peripheral inflammation.

AIM: To establish a RP-HPLC method to determine the fingerprint of Compound Fufangteng Mixture (Radix Ginseng Rubra, Radix Astragel. etc). METHODS: Chromatographic conditions included Shim-pack CLC ODS column and the mobile phase composed of a mixture of acetonitrile-water (gradient elution), detection wavelength at 203nm. The mobile phase flow rate was 1.0mL?min -1. RESULTS: 19 peaks existed on the HPLC fingerprint of Compound Fufangteng Mixture. CONCLUSION: The method can provide more information for the quality control of Compound Fufangteng Mixture.

Objective This study explored whether EPAS1 gene is involved in the proliferation of pulmonary arterial smooth muscle cells (PASMCs) during hypoxia when EPAS1 gene expression was interfered by small interfering RNA (siRNA).Methods The rat primary pulmonary artery smooth muscle cells were cultured and identified by immunofluorescence.The specific lipidosomes of EPAS1 siRNA were constructed and transfected into PASMCs,and the best targets were selected from the three interfering targets.The transfected PASMCs were cultured in hypoxia (37℃,5％ CO2,2％ O2) or normoxia (37℃,5％ CO2,20％ O2) for 24h,48h and 72h,respectively.The PASMCs proliferation was detected by CCK-8 assay.The protein expression of EPAS 1 and vascular endothelial growth factor (VEGF) were determined by Western blotting to investigate the effect of silencing EPAS1 gene expression on the proliferation of PASMCs under hypoxic condition.Results The specific liposomes ofEPAS1 siRNA were successfully constructed and transfected into PASMCs,and the best interfering target were selected from the three interference targets.The proliferation of PASMCs was increased and the protein expression of VEGF was up-regulated in the PASMCs under hypoxic condition.Under hypoxic or normoxic condition,PASMCs proliferation and VEGF protein expression of PASMCs were suppressed by EPAS 1 siRNA.Conclusion EPAS 1 gene might be involved in the proliferation of rat PASMCs by regulating VEGF protein level under hypoxic condition.

Objective To explore antibiotics resistance profiles and DNA fingerprints of Pseudomonas aeruginosa isolates resistant to imipenem (IRPA). Methods DNA fingerprints of 56 strains isolated from ICU (intensive care unit) were constructed by ERIC-PCR (enterobacter repetitive intergenic consensus-PCR). MICs (minimal inhibitory concentrations) were determined by agar dilution method.Results 33 genotypes were got from 56 strains by ERIC-PCR. Of 8 frequently used antibiotics, 5 of them showed resistance rate higher than 50%. Conclusion It is high time to pay attention to multi-drug resistance of IRPA. The exist of prevalence of IRPA clone in ICU advise us to control of IRPA in hospital effectively.