This article briefly introduces how to rationally use antibiotics in patients with strokeassociated pneumonia from the aspects of etiology,disease,and antibiotic use.A great importance should be attached early to the standard pathologic examination,and the initial empiric treatment should be timely and adequate.The complex preparation of broad-spectrum penicillin/β-lactamase inhibitor is generally recommended,on this basis,the etiological examination results should be sought actively.Selecting the highly targeted or sensitive antibiotics improve the efficacy and reduce adverse reactions.

Objective To evaluate the effect of Gamma nail,PFN(proximal femoral nail)and recon-struction nail fixation in treatmen t of intertrochanteric fractures an d problems regarding the operative t echnique.Methods This study reviews the X-ray films an d complications of one hundred forty-five cases of in-tertrochanteric fractures treated with intramedullary nail at Beijing Jishuitan Hospital from March 1998t o October2001.Results All cases healed ,one case died eight months postoperatively.The distal fragment was broken intraoperatively in two cases.Ante roposterior and lateral and rotatio n displacement occured intraoperatively in fifteen cases.Limb discrepancy over one centimeter occurred in five cases.Conclusion Intramedullary nail is a good device to treat intertrochante ric fractures with vartous coxa varu s the common complication.Skillful in-tramedullary nail technique is the k ey to decrease the complications.In cidence of coxa varus in the stable ty peⅡis less than that in the unstable typeⅠafter the treatment.[

Objective To study the effects of IFN-?on expression of B7 molecules in human lung adenocarcinoma cell line cultured in vitro.Methods Human lung adenocarcinoma SPC-A-1 cells were incubated in the medium with IFN-?respectively.Cell proliferation effect was measured by MTT assay;apoptosis was detected with flow cytometry assay;expression of B7-1 and B7-2 mRNA was determined by RT-PCR.Results Compared with those of control group,MTT shows that IFN-?could reduce the SPC-A-1 cell proliferation.FCM shows the apoptosis rate in the IFN-? group was significantly higher,but there is no different changes in each concentration group.Compared with the control group,expression of B7-1 and B7-2 significantly increased in the IFN-?group,and the expression was not correlated with the concentration of IFN-?in each control group.Conclusion IFN-?can inhibit cell proliferation and induce apoptosis in SPC-A-1 cell line.IFN-?markedly enhance the expression of B7-1 and B7-2 in SPC-A-1 line.The apoptosis may be mediated by up-expression of gene B7-1 and B7-2.

0 05).Among them,WT but neither DN, Blank, nor Pio significantly ameliorated the increased concentrations of TGF-a1 and fibro nectin in culture medium induced by HG. Compared with DN and Blank, WT transfect ion significantly attenuated high glucose-caused elevation in c-fos, c-jun and p-ERK expression, reduction in Ⅰ-?B level, and incretio n in nucleus/cytosol ratio of NF-?B, while Pio demonstrated similarly signific ant changes only in p-ERK and NF-?B. No significant difference of GLUT-1 mRN A level was detected between HG groups. Conclusions Overexpressed PPAR?1 can su ppress increased ECM production from glomerular mesangial cells cultured in HG c ondition. Its inhibitory effects on activation of ERK/AP-1 and NF-?B pathways are involved. The further increase of PPAR?activity may have direct anti-fibr otic effect in diabetic kidney.

Objective To investigate the effects of glycyrrhizin on gene expression of transforming growth factor(TGF)-?signaling pathway of hepatic stellate cell(HSC)in mice by gene microarray tech- nique.Methods The HSCs were isolated from mice and cultured in vitro.Then the mice were divided into control group,TGF-?_1 group(5 ng/ml) or TGF-?_1(5 ng/ml)combined with glycyrrhizin(100?mol/L) group.The cells were collected after 10 hours to extract RNA.A cDNA microarray(GEArray~(TM) Q) targeting TGF-?/BMP signal transduction was used to screen the genes which showed significant changes in expression of TGF-?pathway of HSC by glycyrrhizin.Results The microarray analysis showed that 16 genes(16.7%),such as Smad2,Smad3,Smad7,CoL3A1,CoL1A2,and PAI-1,were upregulated by TGF-?_1 and then down-regulated by glycyrrhizin.Five genes(5.2%)(including BMP7,IGFbp3 and etc.)downregulated by TGF-?_1,were then up-regulated by glycyrrhizin.Finally,2 genes upregulated by TGF-?_1 were then up-regulated predominantly by glycyrrhizin in HSC(T?R2,betaglycan).Changes in some genes,such as Smad2 Smad3,Smad7,were further confirmed to be coincided with cDNA microarray by semi-quantitative RT-PCR.Conclusions The anti-fibrosis mechanisms of glycyrrhizin may be through to interference of TGF-?signaling pathway,decrease the synthesis and increase the degradation of collagen.

Objective To observe the curative effectiveness of kidney transplantation on uremic patients complicated with Thalassemia.Methods Forty-six cases of uremic patients complicated with Thalassemia(26 cases of alpha-thalassemia,20 cases of beta-thalassemia)subject to kidney transplan- tation were retrospectively studied as the anemia group.Incidence of delayed graft function restoration, rejection(hyperacute rejection,accelerated rejection and acute rejection)and anemia correction were observed.Time needed for renal function restoration was recorded and creatinine value(Cr)was mea- sured in those patients whose kidney function restored after kidney transplantation.Control group in- cluded 131 cases of kidney transplantation performed concurrently that accompanied with different con- tent of anemia other than thalassemia.Results Incidence of DGF was 26.1% and 23.7% in thalasse- mia group and control group,respectively.Six months after transplantation,39 cases in thalassemia group and 109 cases in control group with follow-up were host and kidney alive.In 6 months,rejection ratio was 30.8% in thalassemia group and 32.1% in control group respectively.Cr value was(121?20)?mol/L and(128?33)?mol/L in thalassemia group and control group,respectively.Ratio of anemia correction in thalassmia and control groups was 79.5% and 76.1%,respectively.No indexes above were found to be statically significantly different between these two groups.Conclusion Uremic patients complicated with thalassemia is suitable for kidney transplantation,with clinical effectiveness similar to those without thalassemia.

Objective To study the inhibitive effect and mechanism of PPAR?1 on the extracellular matrix (ECM) accumulation of mesangial cells induced by Ang Ⅱ .Methods The plasmid of PPAR?1/WT (wild type) was transfected into mesangial cells. After 48 hours of Ang Ⅱ stimulation, the gene expression of TGF-?1, PAI-1, c-fos and c-jun was examined by RT-PCR. Protein levels of p-ERK, I-?B and nucleus/cytosol ratio of NF-?B were estimated by Westen-blot. The concentrations of FN and TGF-?1 were estimated by ELISA. The activity of PPAR?1 was examined by specific PPRE binding activity. Plasmid expressing non-functional dominant negative type of mPPAR?1, pIRES2-EGFP-mPPAR?1/DN (DN), and blank plasmid, pIRES2-EGFP (Blank) were used as controls. Effects of 6 ?mol/L PPAR? agonist pioglitazone (Pio) were also studied. Results The expression of TGF-?1 and PAI-1 mRNA in mesangial cells induced by Ang Ⅱ was inhibited by PPAR?1(P

AIM:To investigate the influence of high-mobility group box 1 (HMGB1) on the proliferation of neural stem cells in peri-infarction cortex of focal cerebral ischemia/reperfusion model rats .METHODS: Male SD rats (n=48) were randomly divided into sham group , ischemia/reperfusion (I/R) group, RNA interference group and nega-tive interference group .The rat middle cerebral artery was blocked to establish focal cerebral I /R model ( ischemia for 1 h and reperfusion for 7 d).Lentivirus vector of HMGB1 shRNA was used to suppress the HMGB1 protein expression in the rat brain.The effect of RNA interference was evaluated by the methods of double-immunofluorescence labeling of HMGB 1/GFAP and Western blotting .The proliferation of neural stem cells in the peri-infarction cortex was assessed by double labe-ling of BrdU/nestin.RESULTS: The protein expression of HMGB1 in I/R group was much higher than those in sham group (P<0.05).RNA interference effectively inhibited the HMGB1 expression (P<0.05).Double labeled BrdU/nestin positive cells in I/R group were more than that in sham group (P<0.05).The double labeled BrdU/nestin positive cells were significantly decreased in RNA interference group (P<0.05).CONCLUSION:Focal cerebral ischemia/reperfusion injury promotes the proliferation of neural stem cells in peri-infarction cortex by increasing HMGB 1 protein level .

Objective To study the clinical efficacy and safety of Bryan-Morrey approach combined with anatomic locking plate fixation for the treatment of type C fractures of distal humerus.Methods Performed a prospective study from from Mar.2011 to Aug.2014.Thirty-three cases of distal humerus fracture were included in our study,and the mean age was (37.3 ±4.1) years old.The fracture type of distal humerus was 13-C according to Mayo classification.All the fractures treated with a Bryan-Morrey approach and anatomic locking plates.In the follow-up,Mayo scores of elbow,measurement of range of motion,elbow flexion and extension muscle strength were recorded and analysed.Results In this study,there were no serious complications,such as nonunion,rupture of triceps tendon and the infection,except partial sensory function injury of ulnar nerve in 5 cases.At the last time of the follow-up,elbow flexion muscle strength and extension muscle strength did not significantly decreased significantly compared with strength of the normal side.The mean flexion of the injured side was (134.5 ± 10.1) degrees,and the mean extension was (-1 1.5 ± 8.1) degrees.According to Mayo elbow performance score,the average scores of elbow was (86.2 ± 7.8),84％ of the patients got excellent or very excellent function results.Conclusion The Bryan-Morrey approach combined with anatomic locking plate fixation is a good choice for the treatment of distal humerus fractures of AO C type.

Objective To explore the diagnosis and treatment of clinical possible organizing pneumonia.Methods The medical records of 31 patients with clinical probable organizing pneumonia were retrospectively analyzed.The clinical presentation,radiographic results and treatment were collected and analyzed.Results Thirty-one patients with non-response to antibiotics were preliminary diagnosed as organizing pneumonia.By percutaneous lung biopsy or transbronchial lung biopsy the tuberculosis,fungi,suppurative inflammation,lung cancer and other diseases were ruled out in 24 patients,and 7 patients were diagnosed by perfect effect of corticosteroids treatment.Twenty-one patients had typical CT findings.All the patients responded rapidly and completely to the administration of corticosteroids.Six patients relapsed after the reduction or stop of corticosteroid in a follow-up time of 6-25 months.Conclusions Non-response to antibiotics,the typical imaging findings and lung biopsy ruling out other diseases are important for diagnosing organizing pneumonia.Rapid response to administration of corticosteroids may be helpful to the diagnosis.Decreasing the dose of corticosteroid too early may cause recurrence of organizing pneumonia.