Objective To discuss the efficacy and relative factors that affect the sequential therapy of invasive and non-invasive mechanical ventilation in treating severe respiratory failure.Methods We analyzed the clinical data of the patient who was hospitalized in Respiratory Department of the Sixth Hospital of Luohe on 3th February 2008.Results The patient received invasive mechanical ventilation for 4 days,then changed to mask non-invasive positive pressure ventilation for 10 days,while receiving comprehensive treatment of anti-infection and bronchial expansion,etc.Then the patient was recovered.Conclusion The sequential therapy of invasive and non-invasive mechanical ventilation in treating severe respiratory failure is effective.The efficacy depends on the optimum converting time between invasive and non-invasive mechanical ventilation,the choice of ventilator and the patient′s compliance.

Objective To evaluate the efficacy and safety of prophylactic cefiazidime on early bacterial infection in APBSCT recipients during neutropenia.Methods APBSCT recipients were prospectively randomly assigned to intravenous ceftazidime treatment group and control group (no prophylaxis of antibiotics).The treatment started from the first day until resolution of neutropenia or the appearance of early bacterial infection.Results From March 2010 to January 2013,70 APBSCT recipients were enrolled in the study with 36 in treatment and 34 in control group.Overall,29 (41.4％) patients developed early bacterial infection,among which,9(25.0％) in the treatment group and 20(58.8％) in the control group (P =0.004).The median infection free survival (IFS) was not reached in the treatment group and was 8 days in the control group (P =0.005).Despite whether patients received single high dose melphalan or other conditioning regimes,the early bacterial infection rate was lower in the treatment group than in the control group,and the median IFS was longer in the treatment group than that in the control group.The mean courses of antibiotic administration were (8.08 ± 2.03) days and (3.68 ± 3.56) days respectively in the treatment and control groups (P ＜ 0.001).However,the duration of empirical carbapenems were (1.67 ±3.03) days and (3.68 ±3.56) days respectively (P =0.013).There was no significant difference of antibiotics cost per patient between the two groups.Four patients in the treatment group had a transient elevated serum creatinine.Overall,no infection related mortality was observed in either group.Conclusions Prophylaxis of intravenous ceftazidime for APBSCT recipients is effective in preventing early bacterial infection with an acceptable toxicity and cost profile.However,it doesn't have effect on infection related mortality.Therefore,our results do not support the use of antibiotic prophylaxis for patients undergoing APBSCT.

Objective To confirm the influence on the path of signal transduction of ERK by BaiHui-QuBin Scalp-acupuncture in rats of experimental acute intercerebral hemorrhage.Methods 192 healthy Wistar male rats were selected by examination.The rats were assigned into 4 groups randomly:matched blank group,model group,pin-prick group,excitomotor group.The latter three groups contained 60 rats in each;another 12 rats were assigned as the matched blank group.All rats were made to be the intercerebral hemorrage model.The pinprick group was acupunc-tured on the BaihuipenetratingQubin.We observed the change surrounding the hamatoma of the proteinum expression of p-ERK of each group in deferent time phase point with the method of Western blot.Results All of the rats after being made model appeared the phenomenon of the expression of p-ERK of rat's brain tissue surrounding the hematoma and increased to the peak in 7 days.1 d, 2 d, 3 d, 7 d, compare with the model group [(0.10 ±0.04),(0.17 ±0.02),(0.09 ±0.05),(0.10 ±0.06)],the expressions of p-ERK of the pinprick group [(0.19 ±0.04),(0.23 ±0.07),(0.24 ±0.05),(0.25 ±0.06),q=11.45,P<0.01] and the excitomotor group's were higher obviously[(0.19 ±0.05),(0.20 ±0.05),(0.24 ±0.06),(0.25 ±0.09),(0.26 ±0.09),q=10.07, P<0.01].The pinprick group compared with the excitomotor set,the expressions of p-ERK showed no significant difference(P>0.05).Conclusion The therapy of BaiHui-QuBin Scalp-acupuncture can activate the path of signal transduction of ERK,increase the expression of the proteinum p-ERK and so on,which have the function of protecting the nerve cell.

Objective To investigate the clinical characteristics and prognostic factors in patients with primary gastric non-Hodgkin lymphoma (PG-NHL).Methods The pathological data of 51 PG-NHL patients admitted in our hospital from 2003 to 2013 were analyzed retrospectively.Results In 51 patients with PG-NHL,there were 26 males and 25 females.The patients' age ranged from 18 to 80 years old with median age as 56 years old.The median survival time was 32 months (range from 1 to 114 months).The oneyear overall survival (OS),three-year OS and five-year OS were 90.2 ％,82.4 ％ and 80.4 ％,respectively.The surgery did not significantly improve PG-NHL patients' progress free survival and OS.Only 1 (2.0 ％) patient had gastrointestinal hemorrhage and perforation after chemotherapy.However,6 (46.2 ％) patients suffered from early satiety,gastric emptying disorder,alkaline reflux gastritis and dumping syndrome in surgery group.Conclusions Surgery did not improve the survival of PG-NHL patients.The life quality in chemotherapygroup is better than that in surgical group.

Objective To assess the diagnostic capability of spiral CT for giant pure seminoma in intraabdominal undescended testis.Methods Spiral CT of 6 cases with pure seminoma of inabdominal testes as proved by surgery and pathology were analyzed.All patients were male,and the age ranged from 31 to 45 years old with the mean of 35.2 years old.Results All tumors were located along the path of testicular descent on CT images.The arterial-supply of tumors all came from the testicular artery ipsilaterally.The draining vein could be seen between the mass and inferior vena cava or left renal vein in 5 cases.Isolaterally spermatic cord was absent in the inguinal region.Isolateral kidney was shifted upward.CT scans typically demonstrated a unilateral,mixed solid and cystic mass,with areas of solid located at the lateral aspect and areas of necrosis at the medial aspect.Contrast-enhanced CT scan showed mild enhancement of solid areas and band-like septal enhancement in areas of necrosis.There is no evidence of calcification or fat within the mass.Conclusion Spiral CT proves to be a very useful preoperative imaging modality for the giant intraabdominal seminoma.

Plasmablastic myeloma is a rare pathological classification of multiple myeloma. This condition must be differentially diag-nosed because of lack of a distinctive phenotype. Involvement of the central nervous system is a rare complication of multiple myelo-ma. The choice of treatment is important for plasmablastic myeloma. Thus, this article presents a rare case of plasmablastic myeloma with multiple cranial nerve involvement. We clarify the diagnosis through the multidisciplinary team and select the optimal therapy for the patient.

OBJECTIVE: To explore the antitumor activities of kushen (Sophora flavescens) flavonoids (KS-Fs) in vivo and in vitro. METHODS: Cell proliferation was assayed by using methyl thiazolyl tetrazolium (MTT) method. H22 hepatocellular carcinoma and S180 sarcoma were induced in ICR mice. Lewis lung carcinoma was induced in C57BL/6 mice. H460 and Eca-109 tumor were induced in Balb/c nude mice by injecting 5x10(5) or 5x10(6) tumor cells in the right flank, respectively. RESULTS: KS-Fs could inhibit the growth of a variety of human tumor cell lines (A549, SPC-A-1, NCI-H460, etc.) in vitro. The antitumor efficacies were confirmed in the mice models of H22, S180 and Lewis lung tumors and the nude mice models of human H460 and Eca-109 xenografted tumors. The oral or intravenous maximum tolerated dose of KS-Fs was more than 2.8 g/kg or 750 mg/kg respectively, far more than the oral medial lethal dose of kushen alkaloids (< or = 1.18 g/kg). No adverse reactions were observed. CONCLUSION: These results suggest that KS-Fs or kurarinone may be developed as a novel antitumor agent.

A recombinant strain Escherichia coli DH5alpha(pMD19-glnA) including Bacillus subtilis glnA gene was constructed. Capillary electrophoresis and nuclear magnetic resonance were used to determine qualitatively the product of transformation by recombinant strain, and the relative level of mRNA expression of glnA was also determined by fluorescence quantitative RT-PCR. Subsequently, SDS-PAGE (polyacrylamide gel electrophoresis) was used to analysis the relative level of protein. Surprisingly, there was no increase of glutamine production in this recombinant strain, but an obvious increase in the GABA (gamma-aminobutyric acid ) production. It was showed in the experiment that protein expression of the glutamine synthetase did not increase, although glnA gene can be transcribed normally in this recombined strain. The phenomenon of exogenous glnA gene interfering metabolism of Escherichia coli was worthy of further study.
Bacillus subtilis ; genetics ; Bacterial Proteins ; genetics ; metabolism ; Escherichia coli ; genetics ; metabolism ; Glutamate-Ammonia Ligase ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Recombination, Genetic ; gamma-Aminobutyric Acid ; biosynthesis

BACKGROUND:A few of studies have showed similar efficacy and safety between domestic clopidogrel (Talcom?) and imported clopidogrel (Plavix?) in patients after percutaneous coronary intervention, but there is lack of large-scale, large sample, and prospective clinical comparative study in China.
OBJECTIVE:To compare the efficacy and safety of Talcom?and Plavix?on percutaneous coronary intervention.
METHODS:Total y 1 798 patients with Coronary atherosclerotic heart disease who received percutaneous coronary interventions were divided to two groups:Talcom?group (n=1 104) and Plavix?group (n=694). 300 mg clopidogrel was administrated oral y before percutaneous coronary intervention fol owed by 75 mg/d clopidogrel sequential y for 1 year. Al the patients were fol owed for 3-28 months to observe the incidence rate of stent thrombosis at acute, subacute, late, and very late stage, major adverse cardiac events of combination end point (including myocardial infarction, cardiac death, and stroke), and correlated adverse reactions, such as bleeding.
RESULTS AND CONCLUSION:There were no significant differences in the incidence of stent thrombosis, target vessel revascularization, cardiac death, bleeding, major bleeding and major adverse cardiac events of combination end point between Talcom?group and Plavix?group. In addition, event-free survival also showed no difference between the two groups. After treatment, white blood cellcount, erythrocyte count, hemoglobin, hematocrit, platelet count were significantly decreased in both the two groups (P<0.05). Hemoglobin level in the Talcom?group was fewer than that in the Plavix?group (P<0.05). The results suggest that effects and safety of Talcom?are similar to those of Plavix?for percutaneous coronary interventions.

OBJECTIVE To study the protective effect of tetrahydropalmatine （Thp） on platelet-derived growth factor-BB （PDGF-BB） induced oxidative stress injury in vascular smooth muscle cells （VSMCs） of rats， and to explore its possible mechanism based on the nuclear factor-erythroid 2-related factor 2 （Nrf2）/heme oxygenase （HO-1） signaling pathway. METHODS In the study about Thp inhibiting PDGF-BB-induced oxidative stress injury in VSMCs， VSMCs were divided into control group， PDGF-BB group （25 ng/mL）， and Thp low-concentration， medium-concentration and high-concentration groups （5， 10， 20 mg/mL）. In the Thp mechanism experiment （silencing Nrf2）， VSMCs were divided into PDGF-BB+negative control of siRNA （NC-siNrf2） group （25 ng/mL PDGF-BB+NC-siNrf2）， PDGF-BB+Thp+NC-siNrf2 group （25 ng/mL PDGF-BB+10 mg/mL Thp+NC-siNrf2）， PDGF-BB+Nrf2 small interfering RNA （siNrf2） group （25 ng/mL PDGF-BB+siNrf2） and PDGF-BB+Thp+siNrf2 group （25 ng/mL PDGF-BB+10.0 mg/mL Thp+siNrf2）. The proliferative and migratory capabilities of VSMCs， the level of reactive oxygen species （ROS）， the activities of superoxide dismutase （SOD） and catalase （CAT） as well as the protein expressions of Nrf2 and HO-1 in VSMCs were all detected in two experiments. RESULTS Compared with the control group， the proliferative and migratory capabilities of VSMCs in the PDGF-BB group were significantly enhanced （P＜0.01）， and the level of ROS significantly increased （P＜0.01）， while the activities of SOD and CAT， and the relative expressions of Nrf2 and HO-1 protein significantly decreased （P＜0.01）. Compared with the PDGF-BB group， the proliferative and migratory capabilities of VSMCs in the Thp groups at different concentrations were significantly reduced （P＜0.01）， the levels of ROS were significantly reduced， while the activities of SOD and CAT， and relative expressions of Nrf2 and HO-1 were significantly enhanced （P＜0.01）. Silencing Nrf2 significantly reversed the improvement of Thp on the oxidative stress damage of VSMCs induced by PDGF-BB （P＜0.01）. CONCLUSIONS Thp can reduce the oxidative stress level of VSMCs by activating the Nrf2-mediated antioxidant defense pathway， thereby inhibiting the proliferation and migration of VSMCs.