OBJECTIVE:To observe the therapeutic effect of Tanreqing injection in combination with Piperacillin sodium and Amikacin sulfate for hospital-acquired pneumonia.METHODS:104 cases of hospital-acquired pneumonia were enrolled and randomly assigned to receive Tanreqing Injection+Piperacillin Sodium+Amikacin Sulfate(treatment group,n=52) or Piperacillin Sodium+Amikacin sulfate(control group,n=52) for 7～10days.The clinical indexes including the total effective effect,cardinal symptoms,physical signs,and chest X-ray film in two groups after treatment were observed.RESULTS:The total effective rate in the treatment group was 86.54% as compared 67.31% in control group(P

The concept of modern medicine in treating chronic heart failure (CHF) has changed markedly in recent years. To improve the quality of life and prolong life, the treatment goal is no longer just temporary improvement of symptoms, more importantly, is to prevent and delay the occurrence and development of ventricular remodeling. Long-term chronic over-activation of sympathetic system, renin-angiotensin-aldosterone system and other neuroendocrine factors promotes myocardial remodeling, increases myocardial injury and deteriorates cardiac function. Despite short-term use can significantly improve the blood flow dynamics, long-term use of beta-adrenergic receptor stimulators and phosphodiesterase inhibitors does not prolong life, but increases the rate of sudden death caused by cardiac arrhythmia. Angiotensin converting enzyme inhibitors and beta-blockers have become the preferred drugs in treating chronic heart failure. In fact, after long-term use, beta-blockers can significantly improve ventricular remodeling, enhance ventricular function and reduce the incidence of sudden death of patients with CHF. In traditional Chinese medicine practice, short-term use of drugs for warming yang and reinforcing qi can improve symptoms of CHF, but long-term use may have adverse effects, for these medicines can stimulate sympathetic system. Early treatment with medicines of cold and cool property may be more favorable to patients with CHF, except the advanced patients who need special intervention. Eliminating heat and nourishing yin may play more active role in controlling the occurrence and development of CHF. Drugs with good efficacy and value in treating CHF may be developed from the Chinese herbal medicines with eliminating heat and nourishing yin property.

Objective To summarize the clinical effect of urethroplasty using acellular dermal matrix patch for the treatment of anterior urethral stricture caused by lichen sclerosus.Methods The clinical data was analyzed retrospectively from 15 patients with anterior urethral stricture caused by lichen sclerosus treated with aeellular dermal matrix patch.Results The patients were followed up for 8-40 months.The urethral silicone stent was removed 4 weeks after operation in 15 cases and all the patients voided well 2 months after operation.The urinary peak flow rates ranged from 17.6 to 41.7 ml/s(mean,28.6ml/s).Urethral stricture occurred in 2 patients 3 months after operation undergoing discontinuous dilatation within 3 to 6 months,the patients voided very well.Conclusion It is feasible,safe and relatively simple to use acellular dermal matrix patch for anterior urethral stricture caused by lichen sclerosus.

Objective To explore the manifestations of chest multi-slice spiral CT in patients with initial infection of swine-origin influenza A (H1N1) virus (S-OIV). Methods The chest multi-slices spirals CT images of 19 firstly diagnosed patients with swine-origin influenza A (H1N1) in our institution were retrospectively studied. CT manifestations were evaluated by three experienced radiologists. Location, appearance of lung abnormalities, abnormal distribution, pleural effusion and others (pericadiaum, lymphadenopathy and pleural thickening) were observed and quantitatively analyzed. The correlation of ground-glass and consolidation CT scores with the fever time was studied. Results The abnormal CT findings were observed bilaterally in 18 of 19 subjects including ground-glass (n= 3), consolidation (n=3 ), consolidation accompanied with ground-glass (n=12). Most of these lesions were distributed diffusively (n=14) while the others located in the middle and low lobes (n= 4). Unilateral (n=3) or bilateral (n=2) pleural effusion were observed. Lymphadenopathy (n=2), effusion of pericadium (n=1), pleural thickening (n=1) and cardiac enlargement (n=2) were also found in patients with H1N1. CT scores of ground-glass were 4. 25(n=2),3.75 (n=1),2.25(n=1),1.75(n=1),1.00(n=6),0.75(n=2), 0.50(n=2),0(n=4).CT scores of consolidation were4.25(n=1),4.00(n=1),3.75 (n=1), 2.75(n=1),1.25(n=3),1.00(n=2),0.75(n=2),0.50(n=1),0.25(n=3),0(n=4). CT scores of ground-glass were significantly correlated with the fever time (r= 0.776, P < 0.01), CT scores of consolidation had no correlation with the fever time(r=0.322,P > 0.01). Conclusions The most common CT findings in patients with S-OIV infection are diffuse distribution of bilateral ground-glass opacities with or without associated focal or multifocal areas of consolidation. The increasing of ground-glass's range could be the marker of progression of H1N1 pulmonary infection at initial stage.

AIM: To investigate the effects of uric acid sodium salt (UANa) as adjuvant on humoral and cellular immune response in BALB/c mice. METHODS: BALB/c mice were immunized with trichosanthin (TCS) as antigen together with UANa suspension as adjuvant. The antibody titers of IgG were detected by enzyme-linked immunosorbent assay. Dendritic cells (DC) were induced in vitro, the phenotypes of DC were analyzed by flow cytometry and the effect of UANa on DC maturity was evaluated. A delayed-type hypersensitivity (DTH) model was used to analyze the effect of UANa on cellular immune responses in vivo. The in vitro proliferation of lymphocytes was determined by ConA stimulation. RESULTS: Freunds adjuvant greatly enhanced the antibody response of mice to TCS, while UANa adjuvant failed to promote the antibody response but significantly reduced the antibody response as compared to TCS only. No effect of UANa on the expression of CD11c and CD83 in DC was observed by flow cytometry analysis. However, UANa significantly enhanced the expression of MHC II molecule. In the DTH model, UANa enhanced the degree of allergen-induced ear swelling and promoted the ability of lymphocyte proliferation in vitro. CONCLUSION: UANa suspension as adjuvant significantly enhances the cellular immune response but inhibits the humoral immune response to a certain degree, suggesting that UANa has potential application in the vaccine research.

AIM:To investigate the effects of uric acid sodium salt (UANa) as adjuvant on humoral and cellular immune response in BALB/c mice. METHODS:BALB/c mice were immunized with trichosanthin (TCS) as antigen together with UANa suspension as adjuvant. The antibody titers of IgG were detected by enzyme-linked immunosorbent assay. Dendritic cells (DC) were induced in vitro,the phenotypes of DC were analyzed by flow cytometry and the effect of UANa on DC maturity was evaluated. A delayed-type hypersensitivity (DTH) model was used to analyze the effect of UANa on cellular immune responses in vivo. The in vitro proliferation of lymphocytes was determined by ConA stimulation. RESULTS:Freund's adjuvant greatly enhanced the antibody response of mice to TCS,while UANa adjuvant failed to promote the antibody response but significantly reduced the antibody response as compared to TCS only. No effect of UANa on the expression of CD11c and CD83 in DC was observed by flow cytometry analysis. However,UANa significantly enhanced the expression of MHC II molecule. In the DTH model,UANa enhanced the degree of allergen-induced ear swelling and promoted the ability of lymphocyte proliferation in vitro. CONCLUSION:UANa suspension as adjuvant significantly enhances the cellular immune response but inhibits the humoral immune response to a certain degree,suggesting that UANa has potential application in the vaccine research.

Objective To investigate the preventive effect of intrarectal application of indomethacin on hyperamylasemia and acute pancreatitis after endoscopic retrograde cholangiopancreatography ( ERCP ) .Methods 180 patients who underwent ERCP were randomly divided into the indomethacin group, somatostatin group and control group.The serum amylase levels were measured before ERCP, 3 and 24 hours after the drug application.The incidences of post-ERCP hyperamylasemia and pancreatitis were observed.Results Serum amylase levels before and 3h after ERCP of three groups had no differences.The serm amylase levels of control group 24 h after ERCP (228.50 ±121.72) U/L was significantly higher than that of indomethacin group (94.09 ±68.45) U/L (P <0.01) and somatostatin group (76.53 ±74.47) U/L (P <0.05), while there was no difference between indomethacin group and somatostatin group.Compared with before ERCP, the serum amylase levels significantly increased in both control group 3 and 24h after ERCP (P <0.01), as well as in both indomethacin group and somatostatin group 3h after ERCP (P <0.05), but there were no apparent differences between pre-ERCP and 24 h after ERCP in both indomethacin group and somatostatin group.The incidences of post-ERCP hyperamylasemia in both indomethacin group and somatostatin group ( 10.00%, 11.67%) respectively was much lower than that in control groups (35.00%, P<0.01).The incidence of post-ERCP pancreatitis in indomethacin group (3.33%) was also lower than that in control group (15.00%, P<0.05), whlie there was no difference between indomethacin group and somatostatin group (5.00%).Conclusion The intrarectal application of indomethacin can effectively prevent acute pancreatitis after ERCP, which has the same effect as intravenous application of somatostatin.It is also convenient, economic and safe.

Objective To evaluate the influence of renal insufficiency (RI) on long-term major adverse cardiac events (MACE) of patients with acute myocardial infarction (AMI) plus metabolic syndrome (MetS) and received percutaneous coronary intervention (PCI). Methods This was a retrospective study. From February, 2011 to Octorber, 2013 , we consecutivly enrolled 223 AMI patients with MetS in the First Affiliated Hospital of China Medical University. There were 88 patients with RI in group A, and 135 patients as the control group (group B). Patients were followed up for major adverse cardiac events (MACE) for 1 year. Results Compared with group B, the incidence of 1-year MACE of patients in group A was increased (36.4% vs. 18.5%, P= 0.003). Result of Cox proportional hazard regression analysis showed that RI was a predictive factor for 1-year MACE (HR = 3.56,95%CI 1.004 ~ 4.170, P = 0.002). Conclusion The incidence of 1-year MACE for AMI patients with RI and MetS post-PCI was high. RI was a risk factor for poor prognosis of AMI patients with MetS.

Objective:To investigate specific cellular immune response to the HPV16E7 prophylactic vaccine in mice.Methods:BALB/c mice were randomly divided into 3 groups:experimental group (treated with pcDNA3.1-HPV16E7),control group Ⅰ(treated with pcDNA3.1) and control group Ⅱ(treated with N.S.).Mice were injected (i.m.) pcDNA3.1-HPV16E7,pcDNA3.1 and N.S. one time per week,respectively.After three immunization,the blood samples from eye sockets and the supernatant cultured of spleen cells were taken for measurement IFN-? and the number of CD4 +?CD8 +T-lymphocyte by ELISA and FACS assay.Antigen-specific splenocyte proliferation assay in vitro was detected by MTT method.Results:The splenocytes actively proliferated,the number of CD4 +T lymphocyte and the quantitation of IFN-? in spleen and serum in the experimental group were significantly higher than the control group Ⅰ and Ⅱ.Conclusion:The pcDNA3.1-HPV16E7 DNA vaccine can induce specific cellular immune response in BALB/c mice.

Objective To analyze CT manifestations of chest wall Askin tumor and to illustrate its CT diagnostic and differentially diagnostic key points.Methods Eleven cases of chest wall Askin tumors were pathologically confirmed in our hospital between May 2006 and November 2014.Of them,10 cases were children and adolescents,and 9 cases had chest pain as the first symptom.All patients received plain CT scan,while 7 cases received contrast enhanced scan.CT signs of this group were retrospectively analyzed,including the location,quantity,shape,size,density,adjacent tissue invasion and distant metastasis of the tumors.Results CT examination showed a single oval mass on the chest wall in all 11 cases.The tumor was located completely within the thoracic cavity in 10 cases,while a tumor's main part was within thoracic cavity.Nine tumors had long diameters of more than 9 cm.All the tumors were heterogeneous without calcification,wherein 10 cases showed necrosis and cystic degeneration.On contrast enhanced scan,7 cases showed heterogeneously mild to moderate enhancement.All tumors invaded adjacent tissues,including 7 cases of bone damage of a single rib,and 7 cases of pleural involvement,wherein 6 cases had pleural effusion.No remote metastases were found in this group.Conclusions CT manifestations of Askin tumors of chest wall have some characteristics,and familiarity with these manifestations is conducive to diagnosis and differential diagnosis of this disease.