OBJECTIVE:To investigate the implementing status of the Guiding Principles of Clinical Application of Antibacterials.METHODS:A total of 60 case histories of patients who had undergone thyroidectomy and discharged from hospital were selected in July 2005 from six third level hospitals(10 from each hospital) in Changsha and Guangzhou for a questionnaire survey and a statistical analysis based on Guiding Principles of Clinical Application of Antibacterials.RESULTS:The average hospital stay was(10.18?3.71) days;the average cost of hospitalization was(7 538.50?631.99) yuan and the average cost on antibacteirals was(705.21?91.10) yuan.The average compliance rates in the choice of drug kinds and medication opportunity were 35% and 80% respectively.The average medication duration was 6.38 days.CONCLUSION:The implementation of the Guiding Principles of Clinical Application of Antibacterials was far from ideal,thus the related department should offer training and tighten control on the use of antibacterials.

Although heterologous biosynthesis of polyketide erythromycin has been successfully achieved in Escherichia coli, the titer remains at a very low level (-10 mg/L). In this study, based on genome-scale metabolic model of E. coli, in silico method flux distribution comparison analysis was used to discover novel potential targets for heterologous 6-dEB biosynthesis. Synthetic small regulatory RNAs (sRNAs) was used to experimentally test 12 down-regulated targets. The results showed that repression of each of these target genes e.g. lsrC and ackA led to significantly improve heterologous 6-dEB biosynthesis. Using co-repression of lsrC and ackA, 6-dEB titer was improved by 59.9% in shake-flask with a maximum yield of 22.8 mg/L. This study indicates that combined flux distribution comparison analysis and synthetic small regulatory RNAs is an effective strategy to improve 6-dEB production in E. coli.
Down-Regulation ; Erythromycin ; biosynthesis ; Escherichia coli ; genetics ; metabolism ; Industrial Microbiology ; methods ; RNA

Objective To review the clinical features,diagnostic work-up,classification,prognosis and treatment of systemic mastocytosis (SM).Methods The clinical data of 3 SM patients admitted to Peking Union Medical College Hospital (PUMCH) were retrospectively analyzed and the review of recent literatures was performed.Results All the 3 cases were pathologically diagnosed.According to WHO 2008 classification criteria,2 cases were diagnosed as aggressive SM (ASM) and the other one was diagnosed as indolent SM (ISM).Case 1 was a 60-year-old female patient who had overt mediator release syndrome manifesting as episodes of flushing,fever,vomiting,palpitation,hypotension and syncope.She was diagnosed as aggressive SM based on significantly increased number of abnormal mast cells (accounting for 6％ of all nucleated cells) in the bone marrow aspiration sample and biopsy specimen which accompanied with decreased other myeloid and erythroid elements.Her disease was refractory to the treatment of H2 antihistamines and led to a fatal outcome eventually.Case 2 was a 72-year-old male patient who underwent extended proximal gastrectomy with esophagogastric anastomosis due to endoscopically detected diffuse thickening of the gastric fundic mucosa.The diagnosis as indolent SM was established according to the dense infiltrate of abnormal mast cells in the surgically resected part of stomach and regional lymph nodes.He had been in complete remission for more than 6 years ever since then.Case 3 was a 41-year-old female patient who presented with fever,urticaria pigmentosa and diffuse bone lesions.A bone biopsy specimen demonstrated a dense infiltrate of mast cells while the assays for KIT-D816V mutation and FIP1L1-PDGFRα fusion gene yielded negative results.She was diagnosed as aggressive SM and a progression-free survival of more than 1 year had been achieved with the treatment of prednisone,interferon-α and pamidronate.Conclusions SM is a rare disease.Diagnosis is primarily dependent on histopathology.There is currently no curative therapy for systemic mastocytosis.Treatment is intended to reduce symptoms and improve quality of life.The prognosis of ISM is much better than that of ASM.

Objectives To investigate the incidence of the heparin-induced thrombocytopenia (HIT) and positivity of anti-heparin/platelet factor 4 complex antibody (HIT-antibody) in inpatients treated with heparin preparations.Methods A total of 197 consecutive patients,including 120 men and 77 women,who were treated with unfractioned heparin (UFH) or low molecular weight heparin (LMWH),were enrolled in this study.HIT-antibody was detected by enzyme-linked immunosorbent assay (ELISA).All patients were classified into subgroups based on 4Ts (Pretest Clinical Scoring System) and types of underlying disorders.The incidence of HIT and positivity of HIT-antibody among different groups were analyzed.Results The overall incidence of HIT was 3.0％ (6/197),and the positivity of HIT antibody was 12.2％ (24/197).The positivity of HIT-antibody was 10.1％ (18/178),7.7％ (1/13) and 83.3％(5/6) in low,moderate and high HIT probability group respectively.There were significant differences of HIT positivity and mean level of HIT-antibody between the high HIT probability group and the low or moderate HIT probability group (P =0.000).Both the incidence of HIT and positivity of HIT-antibody were higher in surgical patients than in medical patients (5.8％ vs 0.9％,P =0.047 and 19.8％ vs 6.3％,P =0.004).Conclusions The incidence of HIT and positivity of HIT-antibody were 3.0％ and 12.2％ respectively,both of which were related with the types of disorders.Detection of HIT-antibody has a better applicable value in patients with high HIT probability.

Recently,there was great development in the field of small bowel transplantation,which has been become effective in clinical research.However,similarly with the transplantations of heart,lung,liver and kidney,chronic rejection was becoming an important factor for the long-term survivals of grafts.With the deepening comprehensions towards the mechanism of chronic rejection,more methods and therapies were tried and tested.

Objective To investigate and analyze the requirement for health education during and after hospitalizadon of patients with cerebral apoplexy.Methods 150 sober patients with cerebral apoplexy from department of neurology were investigated by questionnaires and the results were analyzed. Results The education content that most patients wanted to understand during hospitalization was treatment method and limbs activity(83.6%and 82.2%);The health education style that they prefered was to communicate directly with doctors and nurses(74.0%);The education content after hospitalization that most patients required was self-nursing knowledge.clinical manifestation and first aid when relapse(90.4%,87.7%and 87.7%).The health education style that they most needed after hospitalization Was that Some reference books would he recommended to them (56.2%).The time choice for health education was consultation whenever they had problems.Conclusion Medical workers should supply selective education and instruction according to the health education requirement and style at different stages of patients with cerebral apoplexy.

Objective To investigate the best way for the operation of congenital microtia with deformities of external auditory meatus (EAM) and middle ear. Method To analyze retrospectively 305 cases (332 ears) of auricle reconstruction operated in the Plastic Department of Auricle, Plastic Surgery Hospital, PUMC, CAMS during June to October 2005, and 49 cases (58 ears) of reconstructions of EAM and middle ear operated in the Otolaryngology Department, General hospital of PLA from December 1988 to July 2002. Results The patients/families rested content with the reconstructed auricles operated with the 3-stage way. The hearing was improved obviously after reconstruction of the EAM and ossicle for the patients with normal stapes footplate. In those patients, for whom EAM was reconstructed first, the scar developed around the orifice which affected the skin flap for auricle reconstruction later, while in those patients, for whom the auricle was reconstructed first, wrong location of the EAM orifice happened easily. Conclusions For the patients with congenital deformities of EAM and middle ear and with the requirement of recovering the appearance and hearing function, the EAM orifice should be located first according to the results of temporal CT, then the auricle reconstruction was conducted with 3-stage method. A simultaneous reconstruction of EAM and ossicle at the third stage may ensure the improvement of both outward appearance and hearing function.

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Objective To study the effects and the mechanism of astragalus menbranaceus (AM) on neonatal lymphocyte apoptosis in cord blood. Methods Cord blood mononuclear cells (CBMC) of 30 full-term neonates were cultured with pure phytohemagglutinin (PHA), PHA combined with IL-6 (PHA + IL-6) or AM (PHA + AM) respectively for 48 hours. The apoptosis index (AI) of lymphocytes of CBMC after cultivation were determined by acridine orange-ethidium bromide dying method. The positive expression of CD38 antigen and CD25 antigen were detected by indirect immunofluorescence procedure. The levels of IL-6 in the supernatants of CBMC were detected by ELISA . Results (1) The AI of the PHA + AM group (16. 5?3. 5)% and PHA+IL-6 group (16. 9?4. 0)% was lower than that of the pure PHA group (32.4?2.8)% (P0. 05). (2) The positive expression rates of CD38 of the PHA+AM group and the PHA+IL-6 group were lower than those of the pure PHA group (P0. 05). The positive expression rates of CD25 of the PHA + AM group and the PHA + IL-6 group were higher than those of the pure PHA group (P0. 05). The positive expression of CD38 of CBMC had positive correlation, but CD25 had negative correlation with the AI of CBMC(r=0. 68, -0. 65,P

Objective To explore the best way to deal with infection of expanded skin flap during auricle reconstruction. Methods 12 cases (12 ears) of expanded skin flap infection was analyzed and treated with the method of stretching the expanded skin flap during auricle reconstruction during Jan. 2003 to Dec. 2005. Results In 12 cases (12 ears) the infection was controlled well, auricles were reconstructed smoothly and no obvious difference was detected between the infected and normal skin flaps after the reconstruction of auricles. Conclusion Stretching the expanded skin flap is a good method to deal with its infection during auricle reconstruction.