Objective To study the preventive effect of small-dose fluconazol adiministered in low frequency on nosocomial fungal infectoin.Methods The condition of nosocomial fungal infection among 200 patients in pediatric intensive care unit (PICU)were observed,who were suffered with serious infection or basic diseases and underwent broad-spectrum or ultra-broad spectrum antibiotic and steroid hormones treatment.These patients were divided imto treatment and control group.And the patients in treatment group received fluconazol[5 mg/(kg?time)once every 2 days,total 3 times,after that,twice 1 week till improved] to prevent fungal infection .The control group were treated with fluconazol [6-10 mg/(kg?time),once everyday for 10-14 days] after fungal infection.Results The incidence rate of nosocomial fungal infectoin of control group was 58.3%(56 out of 96 cases,which were 44 cases of mouth,5 cases of respiratory tract ,5 cases of digestive tract and 2 cases of urethra ) and that of treatment group was 1.9%(2 out of 104 cases, which were 2 cases of mouth).In control group,37 cases were cured,17 cases improved and 2 cases were not effective.Mouth fungal infection in treatment group was gently and cured with 1 or 2 times of local treatment .The treatment group didn′t occured liver function damage or aggravation.Conclusion For PICU patients, adiministration of small-dose flucomazol in low frequency is an effective and relatively safety method to prevent against nosocomial fungal infectoin.

OBJECTIVE:To improve automatic outpatient pharmacy drug delivery system in our hospital,and to promote the efficiency of automatic drug delivery. METHODS:The outpatient pharmacy automation system of our hospital was introduced in terms of main structure,working process and application. The work efficiency,safety and error were compared between automatic drug delivery mode and manual drug delivery mode. Drug delivery machine was improved to increase the rate of drug delivery. RE-SULTS:The outpatient pharmacy automation system of our hospital included 2 boxed drug delivery machine and 1 drug dispensing machine,etc. Compared with manual drug delivery mode,automatic drug delivery mode improved drug delivery efficiency,health security and use security,and reduced drug delivery error. Through adjusting the time setting and step of drug delivery of gearing in drug delivery machine,idle time of transmission equipment was utilized effectively,and the quantity of delivered prescriptions was increased,increasing from 220 to 320 each hour. CONCLUSIONS:The reasonable improvement of outpatient pharmacy auto-mation system makes outpatient pharmacy automation system play a bigger role,and further optimize resources.

Glioma is the most common intracranial malignant tumor,with high incidence and recurrence rate,high fatality rate and the characteristics of low cure rate.Current treatment is given priority to with surgical treatment,auxiliary comprehensive therapy such as radiotherapy and chemotherapy.Hydrogen peroxide (H2O2) is a intermediate product of the cell oxygen metabolism which is a universal phenomenon in aerobic organisms.H2O2 is indispensable at various stages of tumor cell proliferation,infiltration and metastasis.Studies of the production of H2O2 and its function,the mechanism of apoptosis and the relationship between H2O2 and glioma cells can provide corresponding guidances for looking for a target gene for the treatment of gliomas.

AIM:To observe the change of insulin-like growth factor-2(IGF-2)in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS),and to explore the relationship of IGF-2,OSAHS and cardiovascular disease complicated with it.METHODS:The level of serum IGF-2 in 40 OSAHS patients and 20 healthy controls was measured by enzyme-linked immunosorbent assay(ELISA).The expression of IGF-2 mRNA in peripheral blood mononuclear cells was detected by reverse transcription polymerase chain reaction(RT-PCR).RESULTS:The serum level of IGF-2 and the expression of IGF-2 mRNA in peripheral blood mononuclear cells were significantly higher in OSAHS group than those in control group(P

Objective To observe the effect and safety of the human glucagon-like peptide-1 analogue,liraglutide,versus insulin glargine in patients with type 2 diabetes mellitus inadequately controlled with metformin alone.Method Ninty patients with type 2 diabetes mellitus(aged 18-79 years,HbA1C 7.5％-10.0％,body mass index＜40 kg/m2) who had inadequate glycaemic control on metformin were allocated for the research with an open,randomized,parallel controlled clinical research method.The patients kept the original dose of metformin unchanged and were randomly assigned to the liraglutide group or the insulin glargine group according to a proportion of 1 ∶ 1.Liraglutide group started with a dose of 0.6 mg subcutaneous injection qd,changed to 1.2 mg subcutaneous injection qd after one week and kept unchanged until the end of the research.Insulin glargine group started with a dose of 0.1-0.2 U/kg according to the fingertips peripheral blood glucose level before breakfast on the continuous 3 d before every follow-up.At the baseline,after 4 weeks,12 weeks,20 weeks,and 26 weeks of treatment,HbA1C,blood glucose,lipids weight,blood pressure were arranged to measured.86 patients finally completed the study.Results Mean HbA1C and the success rate of HbA1C ＜7％ were similar between liraglutide group and insulin glargine group [(7.06 ± 0.87) ％ vs (7.25 ± 1.20) ％,47.73 ％ vs 45.23 ％,P＞0.05],while the percentage of subjects reaching the composite endpoint of HbA1C＜7％ with no hypoglycemia and no weight gain was significantly higher in liraglutide group than insulin group(P＜0.05) ; Fasting plasma glucose decreased more markedly in insulin glargine group,2 h postprandial plasma glucose was decreased more markedly in liraglutide group(P＜0.05 or P＜0.01).Liraglutide significantly reduced mean body weight by (3.21 ± 1.18) kg,waist circumference by (3.82 ± 1.21) cm,and body mass index by (1.95 ± 0.61) kg/m2 (P＜0.01 or P＜0.05),while in the insulin glargine group there sere rise of respective figure of(2.86 ± 0.43) kg,(1.52 ± 0.56) cm,and (0.61 ± 0.25) kg/m2 (P＜0.05),systolic blood pressure and serum triglyceride declined.There was no serious adverse affect in both groups,the incidence of mild hypoglycemia was significantly less in liraglutide group and has a statistically significant difference (4.55％ vs 21.43％,P＜0.05).Conclusions Liraglutide showed a good effect on reducing weight,systolic blood pressure,blood lipid and in addition to blood glucose control which is comparable to insulin glargine.What is more,liraglutide had good safety and tolerability,which can be regarded as a good choice for patients with type 2 diabetes mellitus inadequately controlled with metformin alone.

The study aimed to establish a population pharmacokinetic/pharmacodynamic (PPK/PD) model of warfarin. PCR-RFLP technique was used to genotype the CYP2C9 and VKORC1 polymorphisms of 73 patients. RP-HPLC-UV method was used to determine the 190 plasma concentrations of warfarin. Application of NONMEM, the clinical information and 263 international normalized ratio (INR) monitoring data were used to investigate the effect of genetic, physiological, pathological factors, other medication on clearance and anticoagulant response. The final model of warfarin PPK/PD was described as follows: CL = θCL · (WT/60)θWT · θCYP · eηCL (if CYP2C9*1/*1, θCYP = 1; if *1/*3, θCYP = 0.708); EC50 = θEC50 · θVKOR · eηEC50 (if VKORC1- 1639AA, θVKOR = 1; if GA, θVKOR = 2.01; V = θV; K(E0) = θK(E0); Emax = θEmax; E0 = θE0 · eηE0. Among them, the body weight (WT), CYP2C9 and VKORC1 genotype had conspicuous effect on warfarin PK/PD parameters. The goodness diagnosis, Bootstrap, NPDE verification showed that the final model was stable, effective and predictable. It may provide a reference for opitimizing the dose regimen of warfarin.
Anticoagulants ; pharmacology ; Body Weight ; Cytochrome P-450 CYP2C9 ; genetics ; Genotype ; Humans ; International Normalized Ratio ; Nonlinear Dynamics ; Polymorphism, Genetic ; Vitamin K Epoxide Reductases ; genetics ; Warfarin ; pharmacokinetics

Objective To investigate the relationship between recent chlamydia pneumoniae (Cp)infection and active ankylosing spondylitis (AS). Methods Seventy nine AS outpatients and 73 normal controls (NC) were enrolled into this study. Serum anti-Cp antibodies (CpIg) were tested using the enzymelinked immunosorbent assay (ELISA). Clinical and experimental data were collected. Patients with positive CpIgM or CpIgA were considered as having a recent Cp infection. Wilcoxon test, Student's t test, χ2 test and multivariate logistic regression were used for statistical analysis. Results Both AS patients and normal controls had a high prevalence for sero-positive CpIgG, which was 89％(70/79) vs 92％(67/73) respectively,while AS patients had a higher frequency of CpIgA and CpIgM when compared with NC [52％(41/79) vs 32％(23/73), χ2=6.61, P=0.010 for CpIgA; 80％(63/79) vs 21％(15/73), χ2=44.031, P＜0.01 for CpIgM]. The presence of CpIgM or CpIgA favored AS, the OR was 17.1 (95％CI 7.4～39.5), or 3.1 (95％CI 1.3～7.2),respectively. In addition, CpIgM was associated with disease activity parameters including ESR (χ2=2.56, P=0.021), CRP (χ2=7.28, P=0.007) and BASDAI (χ2=6.79, P=0.009). Furthermore, consecutive positive CpIgM favored the persistent active or relapsed disease, while negative CpIgM favored a reduced disease activity.There was no correlation between CpIgM/CpIgA and peripheral joint disease and enthesitis. Conclusion Recent Cp infection is highly associated with AS and CpIgM antibody relates with active AS, which indicates that Cp infections may be a critical triggering factor for active AS.

Objective To explore the relationship between the expression of XRCC1 and glioma. Methods Total of 26 samples of glioma were divided into 4 groups:gradeⅠ,gradeⅡ,gradeⅢand gradeⅣ. The expression of XRCC1 in 26 Gliomas tissues were examined using SP immunohistochemical staining.Results The positive staining of XRCC1 protein was localized in nucleus of tumor cells in Glioma. There was no correlation among them. The difference of XRCC1 expression among gradeⅠ~Ⅳ was not significant ( >0.05) .Conclusion The difference of XRCC1 expression among gradeⅠ~Ⅳ was not significant. The expression of XRCC1 was closely correlated with the effect of radiotherapy.

Objective To investigate the molecular mechanism of retinoic acid in targeted treatment of craniopharyngioma by detecting the expression of RARαand PPARβ/δin craniopharyngioma cells and analyzing the correlation between the expression and effect of retinoic acid. Methods The expression of RARα and PPARβ/δ in craniopharyngioma cells from 31 patients cultured in vitro was quantified by reverse transcription-PCR. The inhibition rates of RA on craniopharyngioma with different expression of RARα and PPARβ/δ were detected by using MTT assay, and the correlation between the expression of RARα and PPARβ/δand the effect of RA was analyzed. Results 1. The RT-PCR results showed that the expression levels of PPARβ/δand RARα mRNA were different. Craniopharyngioma cells from 31 patients in primary culture were divided into three groups according the expression levels of nuclear receptor: PPARβ/δ>RARα group, RARα>PPARβ/δ group and RARα>>PPARβ/δ group. 2.MTT results showed that the inhibition rate of RARα>>PPARβ/δgroup was significantly higher than the other groups under same drug, the differences had statistical significance ( <0.01) . Conclusions The expression of PPARβ/δ, RARα can be used to evaluate the effect of RA in treatment of craniopharyngioma. The craniopharyngioma with low-expression of PPARβ/δ is more sensitive to RA. Targeting higher RARα or targeting lower PPARβ/δ is beneficial to the treatment of craniopharyngiomas.

Coronaviruses (CoVs) are generally associated with respiratory and enteric infections and have long been recognized as important pathogens of livestock and companion animals. Mouse hepatitis virus (MHV) is a widely studied model system for Coronavirus replication and pathogenesis. In this study, we created a MHV-A59 temperature sensitive (ts) mutant Wu"-ts18(cd) using the recombinant vaccinia reverse genetics system. Virus replication assay in 17C1-1 cells showed the plaque phenotype and replication characterization of constructed Wu"-ts18(cd) were indistinguishable from the reported ts mutant Wu"-ts 18. Then we cultured the ts mutant Wu"-ts 18(cd) at non-permissive temperature 39.5℃, which "forced" the ts recombinant virus to use second-site mutation to revert from a ts to a non-ts phenotype. Sequence analysis showed most of the revertants had the same single amino acid mutation at Nsp16 position 43. The single amino acid mutation at Nsp16 position 76 or position 130 could also revert the ts mutant Wu"-ts 18 (cd) to non-ts phenotype, an additional independent mutation in Nsp13 position 115 played an important role on plaque size. The results provided us with genetic information on the functional determinants of Nsp16. This allowed us to build up a more reasonable model of CoVs replication-transcription complex.