Objective To compare the clinical analysis of alone or combined with antibiotics on community acquired pneumonia (CAP) in pediatric patients,and provide reference for clinical rational use of antibiotics.Methods The clinical data of 274 cases of CAP children treated by single antibiotic therapy and 271 cases of CAP children treated by bivalent antibiotic therapy were retrospectively analyzed,and the drug efficacy and adverse reactions were compared between the two groups.Results There were no statistical differences on the sex,age distribution and severity between the two groups (all P ＞ 0.05) ; The sputum submission rate in two groups were over 90％,and there were no significant differences on the positive rate and detection rate of multi-resistant bacteria (P ＞ 0.05) ; Treatment efficiency in the two groups of children were 97.45％ (267/274) and 98.15％ (266/271),the difference was not statistically significant (x2 =0.32,P ＞0.05) ; Average hospital inpatient days were (8.76 ± 1.75) d and (8.66 ± 1.62) d in the two groups,the difference was not statistically significant (x2 =0.71,P ＞ 0.05).Adverse reactions in the two groups of children mainly were drug fever,rash,nausea,bloating,hemolytic anemia.Cases of drug fever (50) and hemolytic anemia(32) in single antimicrobial group were significantly less than those in the combined with antibiotic group (51,72,x2 =4.804 and x2 =5.381,all P ＜0.05).Conclusion The effects of alone or combined with antibiotics on community acquired pneumonia in pediatric patients are same,so alone antibiotics is recommended for treating mild CAP to get better efficacy.

The expressions of hepatocyte growth factor (HGF) and its receptor (c-Met) protein were examined by immunohistochemistry in benign and malignant thyroid neoplasms.The results showed that the positive rates of HGF and c-Met protein expressions in thyroid carcinomas were significantly higher than those of thyroid adenomas,and especially the expressions of HGF and c-Met proteins in follicular thyroid carcinomas were significantly higher than those in follicular thyroid adenomas.There existed significantly positive correlation between the expression degrees of HGF and c-Met in follicular thyroid carcinoma.Thus,the expressions of HGF and c-Met may be valuable in predicting prognosis of thyroid carcinomas and differentiating benign from malignant thyroid neoplasms.

Adult ; Aged ; Female ; Gastrointestinal Diseases ; Humans ; Male ; Middle Aged ; Paresthesia ; Pharyngeal Diseases ; Upper Gastrointestinal Tract

Reference materials containing mixed degradation products of amoxicillin and ampicillin were developed after optimization of preparation processes. The target impurities were obtained by controlled stress testing, and each major component was identified with HPLC-MS and compared with single traceable reference standard each. The developed reference materials were applied to system suitability test for verifying HPLC system performed in accordance with set forth in China Pharmacopeia and identification of major impurities in samples based on retention and spectra information, which have advantages over the methods put forth in foreign pharmacopoeias. The development and application of the reference materials offer an effective way for rapid identification of impurities in chromatograms, and provide references for analyzing source of impurities and evaluation of drug quality.
Amoxicillin ; chemistry ; Ampicillin ; chemistry ; China ; Chromatography, High Pressure Liquid ; Drug Contamination ; Mass Spectrometry ; Reference Standards

Eleven C21 steroids were isolated from chloroform extract of roots of Cynanchum otophyllumby silica gel, MCI, ODS columns, and semi-preparative HPLC. Their structures were determined by spectroscopic data analysis as otophylloside B(1), caudatin-3-O-beta-D-cymaropyranosyl-(1-->4)-beta-D-oleandropyranosyl-(1-->4)-beta-D-cymaropyranosyl-(1-->4)-beta-D-cymaropyranoside (2), caudatin-3-O-beta-D-oleandropyranosyl-(1-->4)-beta-D-oleandropyranosyl-(1-->4)-beta-D-cymaropyranosyl-(1-->4)-beta-D-cymaropyranoside (3), caudatin-3-O-beta-D-oleandropyranosyl-(1-->4)-beta-D-digitoxopyranosyl-(1-->4)-beta-D-cymaropyranoside (4), otophylloside O (5), gagamine-3-O-beta-D-oleandropyranosyl-(1-->4)-beta-D-cymaropyranosyl-(1-->4)-beta-D-cymaropyranoside (6), sinomarinoside B (7), mucronatosides C (8), wallicoside J (9), stephanoside H (10), and qinyangshengenin-3-O-beta-D-oleandropyranosyl-(1-->4)-beta-D-cymaropyranosyl-(1-->4)-beta-D-digitoxopyranoside (11). Among them, compounds 2-3, and 6-11 were separated from the roots of this plant for the first time.
Cynanchum ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Plant Roots ; chemistry ; Steroids ; chemistry ; isolation & purification

Objective To explore the value of brainstem auditory evoked potential(BAEP),visual evoked potential(VEP)and Revised Visual Retention Test(VRT)in detecting impairment of central nervous system in patients with acute leukemia(AL).Methods Neuropack-Ml type evoked potential machine(Japan)was used to check brainstem auditory evoked potential(BAEP)and visual evoked potential(VEP).BAEP,VEP and VRT were examined in 30 cases with acute leukemia(group AL)and in 30 age and sex matched healthy subjects as a control(groupC).Indexes of BAEP including peak latency(PL)of waves I ,IB ,V and inter-peak latency(IPL)of waves Ⅰ～Ⅲ,Ⅲ ～Ⅴ,Ⅰ～Ⅴand indexes of VEP(P100PL)were determined.VRT was accomplished meanwhile applying B method with C pattern,C method with D pattern,D method with E pattern.The correct scores and error scores were recorded separately.Results BAEP:the abnormal rate of the group AL was 23.3 %.Compared with control group,we found significant longer latency of wave Ⅲ、Ⅴ(P＜0.05)and significant elongation in the mean inter-peak latencies of Ⅰ～Ⅴ(P＜0.05).VEP:the abnormal rate of the group AL was 26.7% ,the P100 PL of the patients was longer than that in the control group(P＜0.05).VRT:the abnormal rate of the group AL was 33.3%.The results of VRT showed that the score in the group AL in D method with E pattern was lower than that in the control group(P＜0.05).Conclusion BEAP,VEP and VRT could detect the impairment of central nervous system in patients with acute leukemia sensitively,and give clues to early diagnosis of central nervous system leukemia(CNSL).

Objective To compare the cardiac function parameters in gated SPECT determined by filtered back projection (FBP) and OSEM reconstruction methods. Methods One hundred and forty-four patients underwent 99Tcm-MIBI gated-SPECT imaging studies. The parameters LVEF, EDV and ESV, were derived using quantitative gated SPECT (QGS), four-dimensional model SPECT (4D-MSPECT) and emory cardiac toolbox (ECToolbox) softwares. Each image was reconstructed by FBP or OSEM. Bland-Altman analysis and paired t-test were applied to evaluate those parameters. Results Correlation coefficients for LVEF, EDV and ESV between FBP and OSEM methods were all more than 0.93 (all P<0.001). EDV calculated by FBP was lower than that by OSEM using QGS software, but became the opposite when using 4D-MSPECT and ECToolbox softwares. (QGS: (82.2±39.1) ml vs (83.5±40.8) ml, t=-2.53, P<0.05; 4D-MSPECT: (93.5±46.9) ml vs (88.8±45.2) ml, t=5.95, P<0.01; ECToolbox: (106.4±51.1) ml vs (100.8±49.0) ml, t=3.99, P<0.01). ESV calculated by FBP was higher than that by OSEM using 4D-MSPECT software (4D-MSPECT:(37.5±41.4) ml vs (34.8±37.6) ml, t=3.92, P<0.01). LVEF calculated by FBP was lower than that by OSEM using QGS software ((62.1±16.9)% vs (63.1±16.1)%, t=-3.14, P<0.05), but higher than that by OSEM using ECToolbox software ((74.1±18.8)% vs (71.3±17.1)%, t=5.28, P<0.01). Conclusion Generally, cardiac functional parameters based on FBP and OSEM construction methods correlated well, although they might have singnificantly different results.

Objective To explore somatic symptoms of patients with functional dyspepsia (FD) and effects of combined anti somatisation therapy on the quality of life in patients with FD.Methods Two hundred and nineteen patients with FD were enrolled.Patient Health Questionnaire-15 (PHQ-15) and Nepean Dyspepsia Index (NDI) were completed,and the relation between them was analyzed.Lansoprazole,mosapride and flupentixol melitracen (the anti-somatisation medication) were taken for four weeks by 131 FD patients who had poor response to four-week conventional treatment with proton pump inhibitors (PPI) and/or prokinetic medication and who got more than 4 scores in PHQ 15.And then therapeutic effects were observed and the changes of NDI before and after treatment were analyzed.The t test,chi-square test,Spearman's correlation and linear regression were performed for statistical analysis.Results The total PHQ-15 and NDI score of 219 patients with FD were 5.7±3.4 and 42.0± 10.4,and there was positive correlation between them (r=0.493,P＜0.05).Stomach pain,headache,chest pain,dizziness,shortness of breath,fatigue,sleeping disorder,thirst and so on were positively correlated with totalNDIscore (r=0.262,0.230,0.241,0.243,0.352,0.385,0.266,0.281,all P＜0.05).Chest pain,stomach pain,shortness of breath,dizziness and fatigue were the influence factors of NDI (t=2.340,2.488,5.278,2.167,2.443,all P＜0.05).Among 131 patients with FD who received anti somatisation combination therapy,six patients did not complete the therapy because of the side effects,and finally 125 patients were enrolled and analyzed.Before and four weeks after the treatment,the total PHQ-15 scores of 125 patients with FD were 7.3±3.2 and 2.9±2.2,respectively; and the difference was statistically significant (t =12.653,P＜0.01).There were significant differences in the influence of stomach pain,headache,chest pain,dizziness,shortness of breath,fatigue,sleeping disorder and thirst before and after the treatment (not bothered at all,bothered a little,bothered a lot) (x2=39.231,6.796,6.693,15.520,6.698,51.572,44.390 and 16.506,all P＜0.05).The total NDI score before and after the treatment were 44.3 ± 11.7 and 29.2 ± 6.9,and the difference was statistically significant (t=12.503,P＜0.01).Conclusions The quality of life in patients with FD is affected by somatic symptoms such as chest pain,stomach pain,shortness of breath,dizziness,fatigue and so on.For FD patients with poor response to conventional treatment,the quality of life could be improved by the combination of anti-somatisation therapy and the conventional therapy.

Objective To discuss the efficacy of the modified subinguinal approach for the treatment of acetabular anterior column and wall fractures.Methods A clinical retrospective study was performed of the 5 patients who had been treated at our department from January 2011 to April 2015 for acetabular anterior column and wall fractures and conformed to follow-ups.They were 3 males and 2 females,aged from 19 to 45 years (mean,35.6 years).The duration from injury to surgery averaged 7.6 days (range,from 4 to 10 days).The subinguinal ligament approach was adopted in the 5 cases,through which the inguinal ligament was preserved intact after sharp dissection of its insertion at the anterior superior iliac spine and medial-upper advancement,the advantage of expanded exposure of the first window by the Farid sub-ilioinguinal approach was retained,and additional lesions due to iliac osteotomy were avoided.The operation time,intraoperative bleeding,postoperative reduction and time for fracture union were documented.Merle d' Aubigne and Postel scoring system was used to assess the hip joint function of the affected limb at the final follow-ups.Results The operation time ranged from 110 to 150 minutes (mean,125 minutes);the intraoperative bleeding ranged from 415 to 550 mL (mean,450.2 mL).By the Matta's criteria,the postoperative reduction was rated as excellent in 4 cases and good in one.The 5 patients were followed up for an average of 32.4 months (range,from 6 to 43 months).Their fractures united clinically after an average of 4.6 months (range,from 3 to 6 months).The hip joint function was rated as excellent in 2 and good in 3 by the Merle d' Aubigne and Postel scoring system at the final follow-ups.Follow-ups observed no serious complications like inguinal hernia,internal fixation failure,myositis ossificans,or avascular necrosis of the femoral head.Conclusions As the modified subinguinal approach can provide a broad surgical exposure,lead to minimal injury to the inguinal ligament,avoid lesions caused by iliac osteotomy,and decrease operation time and bleeding,it may be a better approach for acetabular anterior column and wall fractures.

Objective To investigate the effect of platelet-rich plasma (PRP) on starting of wnt3 gene and klotho gene of adipose-derived stem cells (ADSCs) of rabbit.Methods Epididymal adipose tissue stem cells were obtained from New Zealand white rabbits,and the cells identified by morphology and inducing differentiation,and the cells were cultured to the fourth generation,PRP and PPP (platelet-poor plasma) were prepared by traditional centrifugal method from abdominal aortic of rabbit; ADSCs were cultured in culture medium containing PRP (experimental group),PPP (control group) and all medium (blank group) for each 5％ for 24h,48h and 72h.Cells of each group were dissociated and total RNA extracted.Effects of the starting of wnt3 gene and klotho gene were detected by RT-PCR.Results Primary ADSCs of rabbit grew in the way of long spindle swirly.The results of oil red O and alizarin red staining of the ADSCs were positive.Expression of wnt3 gene and klotho gene in the experimental group significantly increased from the results of RT-PCR (P＜0.05).Conclusions PRP can promote proliferation of the ADSCs of rabbit and increase the expression of wnt3 gene and klotho gene significantly.