OBJECTIVE:To establish a method for bacterial endotoxin test of Boric acid rinse.METHODS:According to appendix volumeⅡof Chinese Pharmacopoeia(2005 edition),the tachypleus amebocyte lysate(TAL)method was applied for the pre-inference test and interfence test to investigate non-inference concentration,pH value and sensitivity of TAL.RESULTS:Boric acid did not interfere with TAL and the reaction of bacterial endotoxin at 2 times diluted concentration with pH value adjusted above 6.The sensitivity 0.25 EU?mL-1 of TAL was available.CONCLUSION:The TAL method can control the limit of bacterial endotoxins in Boric acid rinse.

Objective To observe the serum level of the CD62p,CD63 which indicates the platelet activity of the elderly patients treated by different-dose simvastatin after PCI.Methods Sixty-eight patients with acute coronary syndrome post PCI were randomly divided into 20 mg/d simvastatin group(36 patients)and 40 mg/d simvastatin group(32 patients).We examined the patient's blood CD62p,CD63 levels on the day before the treatment of PCI in both groups.Then all of the patients in both groups received different-dose simvastatin treatment(20mg/d or 40 mg/d qn po);we observed the results again after four weeks in both groups,and compared the results.Results The patients' blood CD62p,CD63 levels decreased significantly after the treatment of simvastatin in both groups(P

Objective:To evaluate the utilization of antifungal drugs in Nanjing area, and provide clinical reference for the rational use of antifungal drugs. Methods:According to the sales data of antifungal drugs in 34 hospitals in Nanjing area from 2013 to 2015, the utilization of antifungal drugs was analyzed in respects of consumption sum, DDDs and DDC. Results:The consumption sum and use of antifungal drugs increased year by year. The maximum amount of consumption sum growth rate was 41. 13%. Triazole drugs oc-cupied the top of consumption sum during the past three years, and the sales amount accounted for more than 60% of all. In term of consumption sum, voriconazole, fluconazole, itraconazole and caspofungin ranked top 4 of antifungal drugs. Clotrimazole topical prepa-rations and oral itraconazole ranked top 2 of DDDs, and caspofungin, micafungin and voriconazole ranked top 3 of DDC. Conclusion:The clinical application of antifungal drugs continues to increase during 2013 and 2015. Invasive fungal infection is a lethal factor at high risk. Choosing reasonable, effective, safe and economic of antifungal drugs is the first principle in clinical treatment.

Objective To study the effects on inhibit tumor growth and enhance immune function of Ganoderma lucidum polysaccharide(GLP)combined with low-dose cisplatin in tumor-bearing mice.Methods 2 × 106 Lewis cells in 0.1 mL PBS were injected subcutaneously into the flanks of healthy female BALB/c nude mice (5～6 weeks old).When the tumor volume reached 100 mm3,mice were randomly assigned to 4 groups,control group (Oral gavage of 0.5 ml PBS and intraperitoneal injection of 0.5 ml),GLP group (gavage once every two days,40 mg/kg GLP in 0.5 ml),cisplatin group (intraperitoneal injection once every two days,2 mg/kg cisplatin in 0.5 ml) and the combination group (such as the above dose of cisplatin and GLP).After the treatment regimen was complete,the mice were sacrificed,and the tumors were removed,photographed,weighed,and prepared for histological analysis.The immune cells in spleen and peripheral blood were analyzed by flow cytometry.Results GLP can effectively increase anti-tumor effect of the small dose cisplatin,improve the survival of tumor-bearing mice,promote Th cells convert to Th1 in peripheral blood,increased the expression of CD 11c + on DC cell surface (GLP group 4.59％ VS the control group 1.06％,the combined group 7.21％ VS the cisplatin group 2.8％).Conclusion GLP can improve the immune function of tumor-bearing mice,had synergistic anti-tumor growth with low dose cisplatin,moreover,reduce renal toxic effects of cisplatin.

Objective To study the effects of Ganoderma lucidum polysaccharide (GLP) on PBMCs and the related immune mechanism.Methods PBMCs from cancer patients and healthy donors were isolated and treated with different doses of Ganoderma lucidum polysaccharides (10 ng/ml,50 ng/ml and 100 ng/ml).DC cell costimulatory molecules (HLA-DR,CD83,and CD11 c),Th1 (CD3 + CD8-IFN-γ+) cells,Th2 (CD3 + CD8-IL-4+) cells and NK (CD3-CD56+) were analyzed by FCM.Furthermore,The CD3+ CD4+ Th ceils were separated by immunomagnetic beads and stimulated with Ganoderma lucidum polysaccharides at different concentrations in culture.After 24 h,the cytokine expression levels of Th1 and Th2were detected by RT-PCR.The expressions of Th1 differentiation-related transcription factor,STAT4,were analyzed by Western blot.Results Ganoderma lucidum polysaccharides can significantly stimulate in vitro Thl cell differentiation (P＜0.01) in a dose depend manner.It correlates with an increased expression of STAT4 and the elevated mRNA expression levels of Th1 cytokineincluding IL-12,IFN-γ and TNF-α (P＜0.01).Conclusion Ganoderma lucidum polysaccharides may promote Th1 differentiation and increase the secretion of Th1 cvtokines through the upregulation of STAT4.

OBJECTIVE:To systematically review the effectiveness and safety of olanzapine in the prevention and treatment of chemotherapy-induced nausea and vomiting(CINV),and provide evidence-based reference for clinical treatment. METHODS:Re-trieved from Medline,PubMed,EMBase,Cochrane Library,Clinical Trials.gov,CBM,CJFD,VIP and Wanfang Database,ran-domized controlled trials (RCT) about olanzapine (test group) versus other drugs or conventional antiemetic regimen (control group)in the prevention and treatment of CINV were collected,Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation by modified Jadad. RESULTS:Totally 19 RCTs were included,involving 1 794 patients. Re-sults of Meta-analysis showed,olanzapine can significantly improve the complete control rate of patients with acute CINV [RR=1.12,95%CI(1.06,1.18),P<0.001],delayed CINV[RR=1.26,95%CI(1.14,1.39),P<0.001],overall CINV [RR=1.62,95%CI (1.32,1.99),P<0.001] and breakthrough CINV[RR=2.05,95%CI(1.47,2.86),P<0.001],there were significant differences be-tween 2 groups;there were no significant differences in the incidence of tiredness,dizziness,lethargy and constipation(P>0.05). CONCLUSIONS:Olanzapine is safe and effective in the prevention and treatment of CINV and can be recommended in treating breakthrough and refractory CINV. Besides,olanzapine in the prevention and treatment of CINV belongs to“off-label use”,so the clinicians should have a comprehensive consideration of chemotherapy and patients’consent.

Objective We aimed to investigate the community nurses' awareness of health policy,related behaviors and paths of learning.Methods A total of 150 community nurses were enrolled in this study by answering a self-completion questionnaire.The survey contents included general conditions of nurses,awareness,related behaviors and paths of learning of community health policy.Results 91.7％ of the respondents believed that heahh policy was important or very important,but only 10.4％ of the respondents understood health policy fully.71.5％ said that they would lecture patients health policy actively and 70.8％ would lecture their colleagues actively.51.4％ respondents would like to take part in policy-making if they were allowed.Education background,professional title and the awareness of health policy were factors of community nurses' policy related behaviors.They learned health policy by working meeting,training and documents.Conclusions It is necessary to improve their school record and adjust their professional title,to strengthen the publicity of health policy by broaden channels of publicity.By these,community nurses' awareness of health policy would be improved,their policy related behaviors would be promoted.Further,the health policy would be well delivered and implemented.

Objective To investigate the enlarged perivascular space (EPVS) and its clinical significance in patients with cerebral small vessel disease (CSVD).Methods One hundred seventy-four patients with CSVD and 86 patients without CSVD admitted to Jinling Hospital,Clinical School of Nanjing University School of Medicine from October 2011 to February 2012 were recruited.All patients underwent cranial MRI examination (including diffusion-weighted imaging and fluid attenuated inversion recovery sequences).The numbers of EPVS and anatomic distribution in all the subjects of both groups were analyzed.The receiver operator characteristic (ROC) curve was used to investigate its diagnostic critical value of anatomic distribution.Results Multivariate logistic regression analysis showed that EPVS in basal ganglia region (odds ratio [OR] 1.491,95％ confidence interval [CI] 1.165-1.909; P =0.002) and EPVS in centrum semiovale (OR 1.279,95％ CI 1.022-1.601;P=0.032) were independently associated with CSVD.EPVS in the basal ganglia region and the centrum semiovale in patients with CSVD was significantly more than that in patients with non-CSVD (all P ＜0.001).Its corresponding diagnosis cut-off points of CSVD were 4 and 6 respectively.The area under the ROC curve and the diagnostic sensitivity and specificity were 0.859,72.4％,93.0％ and 0.808,65.5％,95.3％,respectively.Conclusions EPVS contributes to the diagnosis of CSVD.When using EPVS to diagnose CSVD,the anatomical sites need to be distinguished and establish appropriate diagnostic critical value.

Objective To explore the effects of perinatal infection on retinopathy of prematurity (ROP).Methods A retrospective cohort study was performed to analyzed the clinical data of 238 preterm infants at gestational age ≤32 weeks who were delivered in Guangdong Women and Children Hospital from November 2014 to October 2015 and ROP screening examinations.Observation was not terminated until they were 45 weeks of corrected gestational age.Mild ROP was defined as having stage 1 or stage 2 ROP in zone Ⅱ or Ⅲ without additional disease,and severe ROP was defined as stage 3 or higher,any ROP in zone Ⅰ,prethreshold/threshold,with additional disease,and aggressive posterior retinopathy of prematurity (AP-ROP).Medical records of eligible preterm infants were retrospectively reviewed and analyzed.Occurrences of ROP,severe ROP,and clinically significant ROP requiring surgical treatment were assessed.Results The mean gestational age of the cohort was (30.10 ± 1.34) weeks (25.29-32.00 weeks) and the mean birth weight was (1 373 ± 272) g(720 ～2 330 g).ROP was diagnosed in 76 of 238 infants (31.9％),including 39 cases with mild ROP (16.4％) and 37 cases with severe ROP (15.5％).Surgical treatment was performed on 22 infants (9.2％).In the patients with ROP,the time to develop ROP from birth was (35.16 ± 14.26) d and the mean time of its most serious stage was (44.62 ± 18.99) d.In 22 patients with ROP who required surgical treatment,the time of surgical treatment was (50.27 ± 17.24) d.In univariate analysis,maternal perinatal infection disease was found to be associated with ROP occurrence (x2 =7.891,P =0.005) and ROP progression requiring surgical treatment (x2 =4.494,P =0.034).Small gestational age,low birth weight and long-term oxygen therapy were found to be asso ciated with ROP occurrence and severe ROP (gestational age:t =-5.803,P ＜ 0.001;t =-5.290,P ＜ 0.001;t =-4.150,P ＜ 0.001;birth weight:t =-4.942,P ＜ 0.001;t =-4.058,P ＜ 0.001;t =-3.126,P =0.002;the duration of oxygen therapy:t =2.351,P =0.020;t =2.473,P =0.018).Apgar scores ≤ 7 at 1 min and 5 min were found to be associated with severe ROP (x2 =4.803,P =0.028).Neonatal sepsis and neonatal fungal infection were found to be associated with ROP occurrence (x2 =6.071,P =0.014;x2 =4.070,P =0.044).Neonatal fungal infection was also found to be associated with severe ROP (x2 =5.479,P =0.019).Multivariate regression analysis indicated that maternal perinatal infection disease was associated with an increased risk of ROP and ROP progression requiring surgical treatment (OR =2.837,P =0.023;OR =4.087,P =0.012).Maternal preeclampsia was also associated with an increased risk of ROP (OR =2.506,P =0.040).Gestational age was an important risk factor for the development of ROP.The smaller the gestational age was,the higher the rate of occurring ROP and severe ROP (OR =0.518,0.508,0.520,all P ＜ 0.001).Conclusions Both fetal and neonatal exposure to infection appear to contribute to the increase of ROP risk in the preterm infants at gestational age ≤ 32 weeks.Maternal perinatal infection disease and maternal preeclampsia were independently associated with ROP occurrence and ROP progression in the preterm infants at gestational age ≤32 weeks.

BACKGROUND:Repair programs of posterolateral tibial plateau fracture included posterior plate screws, lateral plate screw and anterior and posterior lag screw fixation. To choose which fixation methods depends on clinical experiences of physicians. Study results are mainly clinical reports, and lack of mechanical evidence.
OBJECTIVE:To compare biomechanical changes in three fixed manners (lateral plate screw group, posterior plate screw group and anterior and posterior lag screw group) in the repair of posterolateral fracture of tibial plateau from the angle of biomechanics.
METHODS:A total of tibial specimens of six adult male antisepsis corpses (12 samples) were used for measuring bone mineral density of metaphysis. 1/2 posterolateral tibial plateau fracture model was established by electric pendulum saw. The model was randomly divided into three groups:lateral plate screw group, posterior plate screw group and anterior and posterior lag screw group. Finite element method and biomechanics were used to test axial displacement value and the maximal displacement distribution area under the axial loads of 250, 500, and 1 000 N.
RESULTS AND CONCLUSION:There was no significant difference in average bone density in three groups of metaphysis (P>0.05). The minimum axial displacement of the fracture fragments was in the anterior and posterior lag screw group (0.013 521 mm), fol owed by posterior plate screw group (0.016 991 mm), and the maximum was visible in the lateral plate screw group (0.138 200 mm) under 250 N load. Displacement value was similar to the 250 N under 500 and 1 000 N. According to the results of biomechanics, displacement values of anterior and posterior lag screw was obviously less than the lateral plate screw group and posterior plate screw group (P<0.05). There was no significant difference between the lateral plate screw group and posterior plate screw group (P>0.05). The maximal displacement distribution area was proximal tibiofibular joint border zone in two methods. These data indicated that the biomechanical stability was most advantageous in the anterior and posterior lag screw group, and poorest in the lateral plate screw group. In the clinic, anterior and posterior lag screw fixation can be used as a first choice for repair of posterolateral tibial plateau fracture.