OBJECTIVE:To evaluate and compare cost-effectiveness of levofloxacin and cefoxitin in the treatment of adult non-severe community-acquired pneumonia(CAP). METHODS:71 cases of adult non-severe CAP were selected and divided into levofloxacin group (group A,33 cases) and cefoxitin group (group B,38 cases). Gronp A received Mesylate levofloxacin injec-tien 200 ml inotraveously,once a day;group B received Cefoxitin for injection 2.0 g intravenously,3 times a day,for 8 days. Clinical efficacy,excellence time and ADR of 2 groups were observed,and cost-effectiveness analysis was conducted. RESULTS:The total effective rate of group A and group B were 87.88% and 65.79%,and excellence time(5.53±2.56)d and(3.87±3.03)d, with statistical significance(P<0.05);there was no statistical significance in the incidence of ADR between 2 groups(χ2=0.47, P>0.05). The total costs were 6 748.93 yuan and 8 110.34 yuan;the cost-effectiveness ratios were 76.80 and 123.28;incremental cost-effectiveness ratio was -61.63%. Results of sensitivity analysis matched results of cost-effectiveness analysis. CONCLU-SIONS:Levofloxacin save more and is economical in the treatment of adult non-severe CAP.

Objective:To investigate the acid resistance of tooth hard tissues irradiated by different power outputs of Er,Cr∶YSGG laser.Methods:Samples in laser groups were irradiated using Er,Cr∶ YSGG laser with the power outputs of 2.5,3.5 and 5 W for enamel and 2 W,3 W and 4 W for dentin,respectively.The calcium and phosphate ion dissolved was measured after decalcification in lactate buffer solution for 24 h.The atomic percentage of calcium and phosphate on the surface of samples was examined by X-ray energy dispersive spectroscopy and the morphological changes were investigated by SEM.Results:In all laser groups of enamel samples except 2.5 W group calcium and phosphate ion dissolved less than in control group and block group (P＜0.05).There's no statistic difference between different power groups.Compared with control group and block group,Ca/P ratio increased(P＜0.05).There's no statistic difference of the atomic percentage of Ca and P on the surface of dentin samples between each 2 groups.SEM observation showed that the surface of the laser irradiated samples was rouph,the space among enamel fibers was increased,the dentin around dentinal tuble orifice was protruded and looked like collar flange.Conclusion:Er,Cr∶YSGG laser irradiation with a range of power is effective in increasing acquired acid resistance of dental hard tissue.There was no relationship between laser power outputs and acid resistance.

OBJECTIVE:To observe the efficacy and safety of domestic cefepime in the treatment of patients with acute exacerbation of chronic obstructive pulmonary diseases (AECOPD) complicated with respiratory failure. METHODS:A total of ninety-six patients with AECOPD complicated with respiratory failure were randomly assigned to receive cefepime 2.0 g bid iv gtt (Group A,n=48) or cefoperazone/sulbactam (Group B,n=48) at a dose of 2.0 g bid iv gtt for 7～14 day. RESULTS:The effective rate was 82% for Group A versus 62% for Group B(P0.05). CONCLUSION:The efficacy of cefepime is higher than that of cefoperazone/sulbactam in the treatment of patients with AECOPD complicated with respiratory failure,but both had good safety.

OBJECTIVE:To evaluate the cough-relieving and sputum-eliminating efficacy and safety of Guaifenesin Pseudoephedrine Hydrochloride-Codeine Phosphate Oral Solution.METHODS:By a randomized control study,a total of 60 patients characterized by nonproductive cough andlittle sputum were randomly assigned to receive Guaifenesin Pseudoephedrine Hydrochloride-Codeine Phosphate Oral Solution(Trial Group)or Ambroxol Hydrochloride Oral Solution(Control Group)l0 mL tid for 5～7 d.RESULTS:Both groups had a significant improvement in symptoms including cough and expectoration after treatment(P0.05).CONCLUSION:Guaifenesin Pseudoephedrine Hydrochloride-Codeine Phosphate Oral Solution is more effective in relieving cough than Ambroxol Oral Solution,and it has certain effect in eliminating phlegm.In addition,it is safe and has little adverse reaction.

To enhance the specificity of anti-TNF-α single chain Fv antibody (TNF-scFv) to inflamed site, we constructed a bispecific antibody BsDb that targets TNF-α and ED-B-containing fibronectin (B-FN) by covalently linking TNF-scFv and the anti-ED-B scFv L19 at the gene level via a flexible peptide linker deriving from human serum albumin. BsDb was successfully secreted from Pichia pastoris as functional protein, identified by immunoblotting, and purified to homogeneity with affinity chromatography. BsDb retained the immunoreactivity of its original antibodies TNF-scFv and L19, and showed a marked gain in antigen-binding affinity and in TNF-α-neutralizing ability, when compared to TNF-scFv and L19 that were produced in Escherichia coli. In the adjuvant-induced arthritis (AIA) mice model, BsDb showed selective accumulation and retention in the inflamed paws but rapid clearance from blood, resulting in high arthritic paw to blood ratios. These data indicate that BsDb is endowed with high specificity to inflamed site and low toxicity to normal tissues and holds great potential for in vivo application for the targeted therapy of RA and other chronic inflammatory diseases.
Animals ; Antibodies, Bispecific ; biosynthesis ; immunology ; Antibodies, Neutralizing ; biosynthesis ; immunology ; Escherichia coli ; Fibronectins ; chemistry ; immunology ; Humans ; Mice ; Single-Chain Antibodies ; biosynthesis ; immunology ; Tumor Necrosis Factor-alpha ; immunology

OBJECTIVE:To observe clinical efficacy and safety of levofloxacin and azithromycin in the treatment of community acquired mycoplasma pneumonia (CAMP).METHODS:A total of 108 patients with CAMP were randomly divided into group A and group B (n=54).Group A received intravenous administration of levofloxacin (0.6 g,qd) and group B intravenous administration of azithromycinin (0.5 g,qd) for 7 days.The clinical efficacy and ADR of 2 groups were observed.RESULTS:The total effective rates of group A and group B were 83% and 56%,there was significant difference between 2 groups (P0.05).CONCLUSION:The clinical efficacy of levofloxacin in the treatment for CAMP is better than that of azithromycin.Levofloxacin and azithromycin have good safety.

Aim To explore the mechanism of E.coli heat-labile enterotoxin B subunit(LTB)as adjuvant by analysis of cellular proteins interacting with LTB. Methods Whole cell proteins were purified from RAW 264.7 cell after treated with LTB or NaCl 12 h, respectively.The cellular proteins were interacted with LTB and the interacting proteins were purified by pull-down assay and identified by mass spectrography.The LTB interaction proteins were conformed with Western blot and immunofluorescence assay.Results 25 LTB interaction proteins were found,and their interaction network was mapped;four proteins (Jup,Dsp,Ddx5 and Vimentin)were indicated to be related with LTB adjuvant activity;immunofluorescence assay indicated that GM130 interacted with LTB,however,Vimentin had no interaction with LTB in vivo.After treated by LTB,the expression of β-actin was upregulated obvi-ously in RAW 264.7 cell,whereras,Hspd1 did not show any change.Conclusions LTB exerts adjuvant activity through binding to GM1 of immune cells,cau-sing endocytosis and transporting to the Golgi apparatus by vesicles.Then LTB might bind to Jup and affect TCF/LEF activity,regulating the expression of Bcl 2, IL-6,and Runx3.The result is promoted T cell and B cell proliferation,differentiation and activation by se-cretion of cytokines and immunoglobulins.

Objective To analyze factors contributing to the quality of life of earthquake victims with nonunion fracture in limbs after medical rehabilitation and to provide a clinical reference for future disasters.Methods Thirty-one wounded who sustained their injuries in the Sichuan earthquake completed the short form-36(SF-36)questionnaire 2 weeks before their amputation,and after 3,6 and 12 months of medical rehabilitation.The SF-36scores were compared with Sichuan population norms.Stepwise multiple linear regression was used to highlight variables which influenced their functional recovery and their physical and mental health.Results The physical and mental health composite scores of the 31 victims were significantly lower than Sichuan population norms before medical rehabilitation,but they had a significant increasing trend after 3,6 and 12 months of treatment.Their scores on all the domains remained significantly lower than Sichuan population norms at a later follow-up.Smoking,external fixations and chronic diseases were related to their recovery of physical function.Age,permanent housing,family income and casualties among family members were related to their mental health recovery.Conclusion The quality of life of patients with nonunion fracture caused by earthquake can be improved significantly through medical rehabilitation.But social factors should be considered in addition to medical rehabilitation after an earthquake.

Objective To analyze the outcomes of clinical management and rehabilitation interventions for earthquake victims with spinal cord injury. Methods Comprehensive rehabilitation intervention was conducted for 3 to 4 months with 51 earthquake victims with spinal cord injuries. The study involved their physical examination and on site interviews during hospitalization, and follow-up by telephone. Etiology, severity, complications and outcomes of rehabilitation and clinical management were analyzed. Results In 9.8% of the patients the spinal cord injury was at C7 or above, 5.9% at C8 to T6 , 68.6% at T7 to L2 , 13.7% at L3 to S2 and 2.0% at S2 or below. There were 22 complete injuries and 29 incomplete. After 4 months of training, 76.5% of the wounded reached wheelchair independence, 78.4% ambulated with an orthosis and 88.2% were partially independent in the activities of daily living.Conclusions The comprehensive rehabilitation intervention allowed most of the victims to resume an independent life. Their long-term care remains a challenge.

OBJECTIVE:To evaluate the efficacy and safety of the application of airway secretions expurgation cluster manage-ment in oxygen-driven aerosol inhalation. METHODS:280 patients with chronic obstructive pulmonary disease in the Respiratory Second Division of our hospital from Mar. 2012 to Dec. 2013 were randomly divided into group A,B,C and D,with 70 cases in each group.Group A and B were treated with compound isopropyl bromide 2 ml+nomal saline 5 ml,10 min/time,twice a day,and 6 L/min oxygen-driven aerosol inhalation for 7 days;group C and Dreceived Ambroxol hydrochloride injection 15 ml+normal saline 5 ml,10 min/time,twice a day,and 6 L/min oxygen-driven aerosol inhalatiom for 7 days. group A and C were treatment groups, group B and D were control groups. Two treatment groups inhaled compound medications while the application of airway secretions expurgation cluster management. Two control groups inhaled compound medications with single effective cough guidance. RE-SULTS:Compared with control groups,the patients in treatment groups eliminated more phlegm,had lower (PaCO2)and higher (PaO2),also had a shorter hospitalization period,with significant difference(P<0.05). CONCLUSIONS:Airway secretions expur-gation cluster management technology is a simple,safe and effective method,especially in patients with chronic obstructive pulmo-nary disease in oxygen-driven inhalation therapy.