ObjectiveTo study the effects of intermittent subglottic secretion drainage(SSD)with an endotracheal tube on incidience of ventilator- associated pneumonia(VAP). MethodsWe searched computerized databases,including Cochrane library,Pubmed,EMbase,CBM,CNKI,Wanfang and some relevant databases from initializing to March 2012,extracting data about subglottic secretion drainage(SSD)with an endotracheal tube on incidence of VAP using RCT.The data had Meta- analysis by software RevMan5,and to those data which could not be conversed or merged,they underwent descriptive analysis. ResultsWeidentifled 5 randomized clinical trials that met the inclusion criteria with a total of 683 randomized patients.In Meta- analysis,the overall risk ratio for ventilator- associated pneumonia was decreased significantly by intermittent subglottic secretion drainage with an endotracheal tube.There was no significant difference on adverse events or on hospital or intensive care unit mortality.Databases,including ICU and hospital LOS,duration of endotracheal catheterization,bacteria concentration,which were difficult to be conversed and obtained full data,they underwent a descriptive research. ConclusionsCompared with the common endotracheal tubes,the use of endotracheal tubes with subglottic secretion drainage is effective for prevention of ventilatorassociated pneumonia.But it has no effect on adverse events or on hospital or intensive care unit mortality.So large sample RCTs with multiply- center should be carried out to assess the effect of the use of SSD.

Objective To assess the diagnostic value of CT-gnided pereutaneous fine-needle aspiration biopsy (FANB) for the space-occupying lesions of the pancreas. Methods The authors retrospectively reviewed the medical records of 68 patients with pancreatic lesions who underwent CT-guided percutaneous fine-needle aspiration biopsy. The lesions were located at the pancreatic head (n = 49), body (n = 12) or tail (n = 7). The maximum diameter of the 68 lesions ranged from 2 cm to 7 cm. The lesion's diameter was < 3 cm in 10 cases and was ≥ 3 cm in 58 cases. A 20-gauge fine-needle was used to puncture and to make the aspiration in all patients. Both plain and contrast-enhanced abdominal CT scanning were performed before the biopsy procedure. The technical key points of aspiration biopsy included selection of the appropriate cross-section, the entry of the needle, and multiple insertions in fan-like fashion with fast manipulation of puncture and aspiration. All biopsy specimens were sent for pathologic evaluation. Results All the lesions were safely and successfully punctured through the anterior approach without major complications. The technical success of needle puncturing was 100%. Of 68 patients, the pathological results obtained from the biopsy included malignant tumor in 46, benign lesion in 17 and no abnormal finding in 5, of which follow-up observation found no abnormality in 2 and malignant process was eventually confirmed in remaining three. The overall accuracy, specificity and sensitivity of the biopsy were 96%, 95% and 100%, respectively. The accuracy of CT-guided biopsy for malignant and benign lesions was 94% and 100% respectively (P > 0.05). The diagnostic accuracy for lesions larger than 3.0 cm (97%) or located at the pancreatic tail (100%) was a little higher than that for lesions smaller than 3.0 cm (90%) or located at the pancreatic head (96%) or body (92%), although the difference was not statistically significant (P > 0.05). No serious complications occurred in our series. Conclusion CT-guided percutaneous fine-needle aspiration biopsy is a safe and effective technique for the diagnosis and differentiation of the space-occupying lesions of the pancreas.

ObjectiveTo investigate the effect of tacrolimus (FK506) on macrophage accumulation,proliferation and activation in the kidney of early diabetic rats and to explore its possible mechanism of renal protection.Methods Rats were randomly divided into control,model and tacrolimus groups.Diabetic model rats were induced with intraperitoneal injection of streptozotocin.Tacrolimus(0.5 or 1.0 mg·kg-1 ·d-1) was orally administered once a day for 4 weeks.Kidney weight index(KWI),24-h urinary albumin excretion rate(UAER) and creatinine clearance rate(Ccr) were measured.Kidney pathology was observed by light microscopy.ED-1,PCNAandiNOSpositivemacrophagesweredetectedbysingleanddoublestainingof immunohistochemistry.Results KWI increased in model group and was significantly reduced by tacrolimus treatment with 1.0 mg·kg-1 ·d-1 (P＜0.05).UAER elevated in model group and was markedly attenuated by tacrolimus treatment with 0.5 and 1.0 mg·kg-1 ·d-1 (P＜0.05).Elevated glomerular volume of model rats was significantly decreased by tacrolimus treatment with 0.5 and 1.0 mg·kg-1·d-1 (P＜0.05),and increased indices of tubulointerstitial injury were only ameliorated by 1.0 mg·kg-1·d-1 tacrolimus(P＜0.01).Marked accumulation of ED-1+ cells in diabetic kidney was found,which was not inhibited by tacrolimus treatment with 0.5 and 1.0 mg·kg-1·d-1.ED-1PCNA+ cells and ED-1+ iNOS+ cells were significantly elevated in kidneys of model group,while they were significantly inhibited by tacrohmus treatment with 0.5 and 1.0 mg·kg-1·d-1 (P＜0.01).Conclusion Tacrolimus can ameliorate early renal injury of diabetic rats and its mechanism may be partly associated with the suppression of increased macrophages activation.

Objective To investigate the characteristics of CD8+ stem memory T cells (CD8+Tscm) in patients with chronic HIV-1 infection before and after antiretroviral therapy (ART) and to analyze their associations with progression of HIV-1 infection.Methods Thirty-six patients with chronic HIV-1 infection and 20 healthy subjects were enrolled in this study.Flow cytometry was performed to detect the percentages and absolute numbers of CD8+Tscm in patients with chronic HIV-1 infection before and after antiretroviral therapy (ART) as well as in healthy subjects.Correlation analysis was used to demonstrate the relationships between CD8+Tscm and markers for progression of HIV-1 infection (CD4+T cell count, HIV-1 viral load and level of activated T cells).Results The percentages and the absolute numbers of CD8+Tscm in patients with chronic HIV-1 infection had no significant change before and after ART.They were respectively positively correlated with the percentages and the absolute numbers of CD4+Tscm.The percentage of CD8+Tscm was proportional to the percentage of CD8+ central memory T cells (CD8+Tcm), but was inversely proportional to the percentage of CD8+ effector memory T cells (CD8+Tem).In addition, the percentages of CD8+Tscm in patients with HIV-1 infection were negatively correlated with the viral loads before ART.Conclusion CD8+Tscm are responsible for maintaining the homeostasis of other CD8+T cell subsets.CD8+Tscm play an important role in inhibiting viral replication.

Objective:Antimicrobial peptides ( AMPs ) are peptides generated in the biological defense system against exogenous pathogens ,which is all important constituent of the non-specific immune system.The immune system can react and sometimes play an important role in tumor control both in animal models and in humans.In this study,CecropinXJ were used in the BALB/c Eca109 cells-bearing mice model.To investigate whether CecropinXJ exert anti-tumor efficiency through regulating immune response when treated with tumor-bearing mice.Methods:The expression of cytokines and DC surface molecules were detected by immunohisto-chemistry and Flow cytometry.Results:The experiment of mice showed that CecropinXJ could significantly inhibit the proliferation of transplanted tumors in dose-dependent manner.There were significant difference between control group and 10mg/kg CecropinXJ group on the volume and weight of tumor ( P<0.05 ).CecropinXJ inhibited Eca 109 cells infiltrating growth in tumor tissue without affecting viscera,and the expressions of VEGF and bFGF proteins were higher than those in the control group .The expression of cytokines and DC surface molecules,the results that,compared with the control group,CecropinXJ could not significantly promote the expression of CD4,IL-4 and IFN-γ,while not involving the expression of surface molecules on DCs in spleen (P>0.05).In CecropinXJ treatment group,TNF-αlevel in serum was significantly higher than the control group ( P<0.01 ).Conclusion: CecropinXJ could significantly inhibit tumor growth in Eca109 cells-bearing mice,and might not be affected anti-tumor efficiency through regulating immune response.

Objective To assess the protective effect of the proteasome inhibitor bortezomib on rat liver subjected to bile duct obstruction. Methods Thirty rats were divided randomly into three groups, which were sham-operation group (SO group), bile duct ligation control group (Con group) and bortezomib group (Bor group). All rats in the Con group underwent ligation of the common bile duct, and rats in the Bor group were given bortezomib intrabominally at-1 d, 4 d post-ligation of the common bile duct. All the rats were sacrificed at 7 d post-surgery. ALT, TB and TBA levels were determined. The expression of NF-κB p65 was assessed using immunohistological staining. RT-PCR was employed to detect TNF-α mRNA levels in liver samples. Results There was no significance in the levels of TB and TBA between Con and Bor groups. The ALT revel in the Bor group [(92.4±21.4)μmol/L]was significantly lower than that in the Con group [(145.7 ±33.5) μmol/L], P＜0.05. The positive staining rate of NF-κB p65 subunit in the Bor group showed significant lower value (11.6% ±2.7 % ) compared to that in the Con group (15.5 %±4.3 % ), P＜0.05. The expression ratio of TNF-α mRNA in the Bor group was 1.0± 0. 2, which also significantly lower than that in the Con group (1.3±0.4), P＜0. 05. Conclusion These data suggest that the proteasome inhibitor bortezomib reduces rat hepatocyte injury in the bile duct ligation by mechanisms associated with the inhibition of NF-κB as well as the attenuation of inflammation.

Objective To study the clinical significance of expression of survivin gene in transitional mucosa(TM) adjacent to rectal carcinoma.Methods Mucinhistochemical methods were used to observe the distribution of TM adjacent to rectal carcinoma, and using immunohistochemical methods to observe the expression of survivin gene product in TM,normal mucosa,atypical dysplasia and cancer tissue.Results The positive expression level of survivin gene product was lowest in normal rectal mucosa,and gradually increase in TM,dysplasia and carcinoma tissue(all P

ObjectiveTo investigate the number of γδT cells in the peripheral blood from patients with systemic lupus erythematosus(SLE) and their correlation to disease activity.MethodsγδT cells were detected in the peripheral blood from 42 SLE patients and 20 normal controls by flow cytometry.Anniex-V/Pl double-staining flow cytometry was employed to observe the proportion of the apoptotic γδ and CD3+ T cells in 6 SLE patients with active disease and 6 normal controls,respectively.The levels of plasma anti-nuclear antibody and anti-dsDNA antibody were determined by using enzyme-linked immunosorbent assay.Data were analyzed with t test and Pearson's correlation test.ResultsThe percentages of γδT cells were remarkably down-regulated in SLE patients [(3.0±1.8)％ ] with active disease compared with that of those patients with inactive[(5.3±3.0)％] disease and normal controls [(6.8±2.8)％](t=-3.071 and -5.913 respectively,both P＜0.01 ).The absolute number of γδT cells decreased significantly in SLE patients with active disease[ ( 1.7± 1.6)× 107/L ] than those with inactive SLE [ (5.3±3.6)× 107/L ] (t=-3.292,P＜0.01 ),and both were lower than the normal controls [ (10.1±5.0)×l 07/L] (t=-7.247 and -2.905 respectively,both P＜0.01 ).There was a negative correlation between systemic lupus erythematosus disease activity index (SLEDAI) andT cell counts in 30 SLE patients with active disease (r=-0.365,P=0.047).γδT cell percentage (r=-0.336,P=0.030) and counts (r=-0.410,P=0.007) were both inversely correlated with the erythrocyte sedimentation rate,but positive correlation were found between hemoglobulln and γδT cell counts (r=0.409,P=0.007).The apoptosis ofγδT cells in SLE patients was more common than in normal controls(t=2.886,P＜0.05 ).The number of apoptotic γδT cells was higher than that of CD3+ T cells in SLE patients (t=2.952,P＜0.05 ).Conclusion γδT cells of the peripheral blood of SLE patients are down-regulated partially due to excessive apoptosis,which may correlate with the disease activity.

OBJECTIVE:To establish the system of curriculum based on working process and occupation ability for pharmacy major in higher vocational colleges. METHODS:Investigation was conducted among medical practitioners from pharmaceutical companies,hospitals,pharmaceutical factories,scientific research institutions and other related professionals. RESULTS:150 ques-tionnaires were sent out,and 141 valid questionnaires were collected with effective recovery rate of 94.00%. Results of investiga-tion showed that respondents most valued graduates with interpersonal and communication skills,followed by professional skills and practical ability. They were mainly clinical application of drugs,pharmacological effects and adverse reactions of drugs in the pharmacology theory teaching,the mechanism of action of drugs were weakened. The ability of prescription distribution,symptoms inquiring and drugs recommending should be strengthened in the pharmacology theory practice teaching. More than half of the re-spondents thought that confirmatory tests were necessary to keep,which helped to train students’practical ability and deepen the understanding of the theory. Meanwhile,it was important to strengthen the students’communication with the patients or their fami-lies and doctors to cultivate the ability of acquiring professional knowledge. CONCLUSIONS:The investigation provides basis for the making of curriculum standards of pharmacology,through which teaching contents are selected,teaching methods are de-signed,and it makes the pharmacology course full of post applicability and provides better decision-making basis to meet the posi-tion requirements.

The skin ulceration syndrome of sea cucumber is a kind of desease induced by bacterium.In order to investigate the bacterium of infected sea cucumber and detect the N-acyl-homoserine lactones(AHLs) se-cretion of the bacterium,7 bacterial strains were isolated from the infected sea cucumber.These strains were identified by physiological-biochemical characteristics and 16S rDNA sequence.Results show that strain C6 belongs to Tenacibaculum,strain 4 belongs to Shewanella putrefaciens group,strain TB belongs to Vibrio,strain BP2,BP3,BP4 and BP6 belong to Pseudoalteromonas,respectively.AHLs were detected with strain Agrobacterium tumefaciens KYC55.Among these bacterial strains,strain C6,4,TB,BP3 and BP4 can se-cret AHLs,while strain BP2 and BP6 can’t.And the AHLs activity differs,from the highest to the lowest are 4,TB,BP4,BP3 and C6.