Objective To study the relationship between changes of contents of serum free-triiodothyronine(FT 3),Free-thyroxine(FT 4) and liver cirrhosis,and analyse it's clinical significanec.Methods The concentration of serum FT 3 and FT 4 were determined by radioimmunoassay in 69 patients with liver cirrhosis,compared with liver function classification(Child-Pugh).Results Contents of serum FT 3,FT 4 in cirrhosis patients were markedly lower than that of controls(P

0.05).There was significant difference in time of treatment and severeness score after three days and seven days(P

Objective To evaluate the efficacy and safety of linezolid in empirical treatment of methicillin-resistant Staphylococcus (MRS) pneumonia. Methods One hundred and thirty-five hospitalized patients with MSR pneumonia receiving linezolid from April 2009 to October 2010 were enrolled in this retrospective cohort study, and all subjects were assigned to two groups: 75 cases with empirical treatment (linezolid 0. 6 g by infusion q12h at admission) , and 60 cases with objective treatment (linezolid after the sputum culture). The severity score, clinical effect and adverse effect were observed, and the therapeutic effects in patients with high risk factors were especially evaluated. SPSS13.0 software was used for statistical analysis. Results The scores were decreased significantly after finishing therapeutic causes for 3 and 7 days in both groups (tempirical =12.29 and 16.53, tobjective =9.36 and 11.49, P<0. 05). There were significant differences in severity scores after 3 and 7 days between empirical and objective treatment groups (t =2. 64 and 3. 08, P < 0. 01). There were significant differences in absorption time, length of ICU and total hospital stay between two groups (t =6. 61 , 4. 39 and 10. 25, P <0. 05). In empirical and objective group, the effective rates were 88.0% (66/75) and 83.3% (50/60) (x2 = 0.60, P > 0.05 ). In the patients with high risk factors, the effective rates of two groups were 86. 8% (33/38) and 63. 6% (14/22) , and the difference was significant (x2 =4.42, P<0.05). The rate of adverse effects were 6.7% (5/75) in empirical group and 5.0% (3/60) in objective group, and the difference was not significant (x2 =0. 17, P > 0. 05). Conclusion Linezolid can be used as empirical treatment for MRS pneumonia with rapid symptoms relieve and high efficacy, especially for patients with high risk.

BACKGROUND:Basic research demonstrated that type Ⅰ collagen exhibited prominent effect on osteogenesis,bone mass and bone fracture,which also participated in the bone fusion.However,few reports concerning the polymorphism of type Ⅰ collagen gene and spinal fusion.OBJECTIVE:To investigate the polymorphism of type Ⅰ collagen and to explore its relationship with the spinal fusion rate following metal implant or autogenous bone transplantation.METHODS:A total of 200 volunteers who need to receive spinal fusion in the Affiliated Hospital of Qingdao University Medical College were selected,including 102 cases received anterior cervical subcorpectomy combined with lilac bone implantation fusion following decompression,and 98 cases received posterior laminectomy for decompression combined with intertransverse process fusion.Meantime,223 normal adults were served as the control group.The peripheral blood was drawn-off and genomic DNA was extracted from white blood cells.The specific fragment which includes the objective gene was amplified by polymerase chain reaction (PCR),with length of 293 bp.The genotypes of Pcol2 site in type Ⅰ collagen were detected by PCR-restriction fragment length polymorphism (PCR-RFLP) method.The PCR product was digested with restriction endonuclease Eco311 and the result was observed by agarose gel electrophoresis.The G gene represented for the presence of the restriction endonuclease site,while the T gene for the absence of the restriction endonuclease site.The fusion rate of the bone graft was evaluated by x-ray film prior to and at months 3,6 and 12 after operation,and the results were compared by stages including quick (＜3 months),middle (3-6 months) and slow (6-12 months).RESULT AND CONCLUSION:There were the-1997G/T polymorphisms of the type Ⅰ collagen gene in 423 cases,including 166cases with GG,232 cases with GT,and 25 cases with TT,in addition,there was some correlation between the GG genotype and the lilac bone implantation fusion (P =0.004).The GG genotype accounted for 50% in the fast group,which was obviously greater than that of the middle and slow groups (33.3% and 16.7%,respectively).However,the-1997G/T polymorphisms had no correlation with the bone graft fusions inter transverse process of lumbar vertebra (P=0.831).The GG genotype in the-1997G/T polymophsim of the type Ⅰ collagen gene may be the essential factor which can promote the C-spine auto-ilium graft fusion.

Objective To explore the effect of combination therapy of aminoglycosides with other antibiotics on reducing the mutant selective window of Acinetobacter baumannii. Methods Three aminoglycoside antibiotics (amikacin, tobramycin, netilmicin)and four frequently used antibiotics against Acinetobacter baumannii in clinical practice (cefoperazone-sulbactam, imipenem-cilastatin,ciprofloxacin and levofloxacin)were studied.The minimum inhibitory concentrations of these antibiotics against Acinetobacter baumannii ATCC1 9606 were determined by E-test.The mutant prevention concentrations of the four antibiotics against Acinetobacter baumannii alone or in combination with aminoglycosides were determined by agar dilution method.The selective index was calculated. The effect of aminoglycosides on mutant selective window of Acinetobacter baumannii was evaluated according to the change of selective index after combination. Results The selective index of cefoperazone-sulbactam,imipenem-cilastatin,ciprofloxacin and levofloxacin against A.baumannii ATCC19606 was 16,>32, 16 and 32.When combined with amikacin,the selective index was 1,2,4 and 4,respectively.When combined with tobramycin,the index was 2,2,8 and 8,respectively.When combined with netilmicin,the index was 2,4,8 and 16, respectively. Conclusions The mutant prevention concentration of the four antibiotics against Acinetobacter baumannii is significantly reduced when combined with any of the three aminoglycosides,which is helpful to decrease the incidence of mutants and control resistant Acinetobacter baumannii. Amikacin-based combination shows the most evident effect on reducing the mutant selective window of Acinetobacterbaumannii.

OBJECTIVE To study whether the ciprofloxacin(CIP)combined with amikacin(AMK)will decrease the drug-resistant mutants of Escherichia coli(ECO)in vitro.METHODS The MIC of CIP and AMK alone was determined by agar plates dilution method,and the combined MIC by checkerboard method.The mutant prevention concentration(MPC)both alone and combined was determined by the method of agar plates dilution method,and then the value of selectiveity index(SI)(MPC/MIC)would be acquired.RESULTS The SI of two antibiotics separatedly were 16(CIP)and 32(AMK).When two antibiotics combined,if the concentration of AMK and CIP reached 2MIC could restrain the mutants.After these two antibiotics combined,the value of SI(MPCcombined/MICcombined)came to be 8(0.008/0.001)and 8(2.0/0.25).CONCLUSIONS Compared with alone,CIP and AMK combined can decrease the MPC and SI to ECO,and have the more effect to AMK.In this way,we can reduce the drug-resistant mutants.

Objective To investigate the efficacy and safety of patients with malignant pleural effusion treated with injecting endostar combined with platinum complexes into pleural cavity.Methods Cochrane systematic review methods were used in the data selection,and data were selected from the PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure (CNKI),WanFang,and VIP database to get all clinical controlled trials.The retrieval time was August 2014.The objects of these randomized controlled trials were malignant pleural effusion patients.Endostar combination with platinum complexes was used for the experimental group.Platinum complexes alone were used for the control group.The efficacy and adverse effects of two groups were compared.The quality of included trials was evaluated by two reviewers independently.The software RevMan 5.3 was used for meta-analyses.Results Nine trials with 488 patients were included according to the including criterion.All trials were randomized controlled trials,one of them had B level in quality and eight had C level.Meta analysis results were as follows:there was significant difference in overall effective rate (OR =3.52,95％ CI =2.37 ～ 5.22),Karnofsky (KPS) score changes rate (OR =2.64,95％ CI =1.67 ～ 4.19),between endostar combination with platinum complexes and platinum complexes alone group.The incidences of severe leucopenia (OR =1.0,95％ CI =0.62 ～ 1.61) and nausea and vomiting (OR =0.77,95％ CI =0.43 ～ 1.38) were similar in the endostar combination with platinum complexes group compared to those in the platinum complexes alone group.Conclusions In the treatment of malignant pleural effusion,injecting endostar in combination with platinum complexes into pleural cavity improves the effective rate without obviously raised side effects.Owing to the small sample size and poor quality of included trials,more well-designed double-blinded randomized controlled trials should be performed.

32,16,16.Combined with azithromycin were8,16,16,8.MEM,CAZ,CIP combined with AMK were 1,4,8.AMK combined with CIP were 4.Conclusion Compared with sole,MEM,CAZ,CIP combined with azithromycin can reduce the MPC and SI of antibiotics alone to pseudomonas aeruginosa and restrain the drug-resistant mutants.But the capacity of preventing mutants arise were weaker than combined with AMK.AMK combined with azithromycin can't reduce the SI.But when combined with CIP,the SI of AMK were reduced greatly.

Objective To explore disease-associated proteins in the serum of patients with inflammatory bowel disease by serum proteomic analysis combined with mixed sampling strategy. Methods The serum proteins from 8 healthy adults and 8 patients with inflammatory bowel disease who had been admitted to the Sixth Affiliated Hospital of Sun Yat-sen University from March 2007 to June 2008 were collected. Two-dimensional differential in-gel electrophoresis (2D-DIGE) was used to define patterns of protein expression after the serum proteins were cross-labeled with cariant CyDye. Proteins that showed differential expressions were analyzed by matrix-assisted laser dcsorption/ionization time of flight mass spectrometry. The 2D-DIGE images were analyzed using DeCyder V6.0 software, and the differences between the groups were analyzed by t-test. Results Maps of 2D-DIGE of patients with inflammatory bowel disease and healthy adults were obtained. Fifty-six spots of proteins with abnormal expression were detected in patients with inflammatory bowel disease, and 30 proteins were identified using mass spectrometry and database retrieval. The 30 proteins included haptoglobin, complement factor B, apelipoprotein A- Ⅱ precursor and GTPase K-ras. Conclusions Serum proteomic analysis combined with mixed sampling strategy can clearly detect the difference in the expression of serum proteins between patients with inflammatory bowel disease and healthy adults. The differentially expressed proteins may provide new biornarkers for investigating the biological behavior of inflammatory bowel disease.

Adding the qualification examination of rural general practicing assistant doctors conforms to the needs of the rural doctors practicing medicine according to law.It benefits to the progress of practicing physician and improves the rural doctors'quality.Meanwhile, it has great significance in standardized management and stabilize the rural doctors.The villages and towns examination of practicing assistant doctors'qualification examination as an exam-ple, current relevant laws and policies provided legal basis.Meanwhile, the object of policy implementation that rural doctors desire the policy.This three aspects make adding the qualification examination of rural general practicing as-sistant doctors is feasible.In order to guarantee the practicing physicians process of rural doctors, we should complete the current laws, regulations and policies.Enhancing general practitioners'training and medical professional training that aims at the examination of practicing doctors'qualifications.Establishing a reasonable compensation, old-age se-curity and other social security mechanism for rural general practicing assistant doctors.