Obiective To analyze the characteristics of antibacterial drugs caused adverse drug reactions (ADR) and correlation with DDDs in Ezhou Central Hospital,and provide reference for safe and rational use of antibacterial drug in clinic.Methods ADR reports of antibacterial drugs in Ezhou Central Hospital from September 2011 to August 2016 were entered into Microsoft Excel 2000 software,Statistical analysis was performed on the categories of antimicrobials,drug names,clinical manifestations,and DDDs,composition ratio of ADR and ratio ofB/A.Results Involved in 151 ADR cases and 10 kinds of antibacterial drugs,the top 3 antibacterial drugs respectively were Fluoroquinolones,Cephalosporins,and Penicillins,the top 3 DDDs respectively were Cephalosporins,Fluoroquinolones,and Macrolides,and the B/A values of Cephalosporins,Macrolides,and Antifungal agents were over 1.The top 4 ADR composition ratios respectively were Levofloxacin,Moxifloxacin,Cefmetazole,and Cefotiam,and the top 4 DDDs respectively were Levofloxacin,Cefodizime sodium,Azithromycin,and Cefmetazole,and the B/A ratios of Cefodizime sodium,Metronidazole,and Azithromycin were over than 1.Levofloxacin and moxifloxacin had a higher risk of severe ADR,and Levofloxacin and Cefotiadine had a higher risk of new ADR.Conclusion The ADR rate of antibacterial drugs is basic consistent with its DDDs.Clinical should pay more attention to the individual drugs with higher rates of ADR,such as Cefodizime sodium,metronidazole,and azithromycin etc.

ObjectiveTo explore the effects and possible mechanisms of VCR combined with low dose cyclophosphamide(CTX) intermittently to treat severe systemic lupus erythematosus(SLE).It is assumed that this might be a new combination therapy for SLE and expected to improve the overall prognosis and outcome of SLE.MethodsMurine chronic graft-versus-host disease(cGVHD) model were developed for study.They were randomly divided into the control group,vincristine (VCR) pulse therapy group,CTX pulse therapy group,CTX every other day(EOD) group,VCR+CTX combination group.One way ANOVA and repeated measure variance analysis were used for statistical analysis.Results① Six weeks after cGVHD models were set up,the average 24-hour urine protein quantification was(5.02±0.88) mg,anti-dsDNA antibody was positive,and Ⅳ LN pathology could be observed histologically in the model murine.So cGVHD models were successfully developed.② Significantly difference in decreasing of 24-hour urine protein quantification was found in the CTX EOD group,VCR+CTX combination group and other groups (P＜0.01).Significant decrease in Cr,ALT,anti-dsDNA,was found in the CTX EOD group,VCR+CTX combination group,CTX pulse therapy group and other groups(P＜0.05).Decrease in urine MCP-1 and TGF-β1 could be detected,and statistical significant difference in these parameters could be found in the CTX EOD group,CTX pulse therapy group,VCR+CTX combination group and other groups (P＜0.01).MCP-1 and TGF-β1'expression in model kidney were reduced in the CTX EOD group,VCR+CTX combination group and had statistical significant difference in the CTX EOD group,VCR+CTX combination group,VCR pulse therapy group,and CTX pulse therapy group.③ VCRand CTX combination treatment was effectivein 24-hour urine protein quantification,blood Cr,ALT,anti-dsDNA and urine MCP-1,as well as urine TGF-β1 (P＜0.05).Conclusion ① The combination of VCR and CTX is synergistic in decreasing 24-hour urine protein quantification,Cr,and the expression of MCP-1,TGF-β1.② The adverse effect of VCR+CTX combination group is similar to VCR pulse therapy group and CTX pulse therapy group.

Objective To study the use of ultrasound-guided percutaneous transhepatic cholecystostomy (PTGD) followed by selective minilaparotomy cholecystectomy (MC) for acute obstructive cholecystitis in the high-risk elderly.Method A retrospective study was conducted on 120 patients who received ultrasound-guided PTGD followed by selective MC from January 2008 to December 2010.Results PTGD+ MC were performed successfully on 120 patients with acute severe obstructive chole cystitis.In all the patients,the abdominal pain was relieved within 2-3 h of operation,and the temperature decreased to normal from 24- 48 h after operation.The average time of drainage was 10 days.In 97 patients MC was performed 1 week after PTGD,and in 23 patients 2 weeks after PTGD.Bleeding from gallbladder bed occurred in 1 patient.No patient suffered from bile leak.There was no major complication or death after PTGD+ MC.Conclusion PTGD followed by selective MC is a simple,efficacious and minimally invasive treatment for high-risk elderly patients with acute obstructive cholecystitis.

Objective To observe the influence of ATP protection after brachial plexus injuries. Methods A total of 80 female Wistar rats,weighting 280～300 g,were randomly divided into ATP and con- trol groups.The right C_5～T_1 nerve roots were transected and then the intraperitoneal injection of 4m[ of ATP or normal saline was given immediately and once daily to the rats,respectively.The rats were sacrificed on postoperative days 14,28 and 42 respectively.The C_5-T_1 segments of the spinal cord were harvested.NT-3 activity was measured by enzymo-histochemistry method.Four weeks and 6 weeks postoperatively,ultrastruc- ture of the denervated skeletal muscles was observed.Results Compared to the control group,the expres- sions of NT-3 was increased in the treated groups with ATP injection (P

Objective To investigate the alteration of serotonin-producing gastric enterochromaffin (EC)cell in patients with functional dyspepsia(FD).Methods Fifteen healthy volunteers and 33 patients with FD were enrolled.Proximal gastric mucosal EC cells were countered after immunohisto- chemistry staining.The ultrastructure of EC cell was observed by electromicroscope.Results The EC cells in proximal gastric mucosa in patients with FD were significant higher than that in controls(12.5?2.1 vs 8.3?1.4,t=2.353,P＜0.05),and the staining intensity of EC cell in patients with FD was also stronger than that in controls(3.72?0.42 vs 2.61?0.57,t=2.078,P＜0.05).The more sever the gastric mucosal inflammation was,the more number of EC cells and the stronger staining intensity were.Under the electromicroscopy,more Golgi apparatus,mitochondria and endoplasmic reticulum were found in EC cells.Special secreting particles were also found in cytoplasm.Conclusions EC cells may be involved in the pathogenesis of FD.The number of EC cell is related with the severity of gastric mucosal inflammation.

This study tested the effects of the gastrointestinal pulse train electrical stimulation with different parameters and at different locations on the neuronal activities of the lateral hypothalamus area (LHA) in obese rats in order to find the optimal stimulation parameter and location. Eight gastric electrical stimulations (GES) with different parameters were performed and the neuronal activities of gastric-distension responsive (GD-R) neurons in LHA were observed. The effects of stimulations with 8 parameters were compared to find the optimal parameter. Then the optimal parameter was used to perform electrical stimulation at duodenum and ileum, and the effects of the duodenal and ileac stimulation on the GD-R neurons in LHA were compared with the gastric stimulation of optimal parameter. The results showed that GES with the lowest energy parameter (0.3 ms, 3 mA, 20 Hz, 2 s on, 3 s off) activated the least neurons. The effects of GES with other parameters whose pulse width was 0.3 ms were not significantly different from those of the lowest energy parameter. Most gastric stimulations whose pulse width was 3 ms activated more LHA neurons than the smallest energy parameter stimulation, and the effects of those 3 ms gastric stimulations were similar. Accordingly, the lowest energy parameter was recognized as the optimal parameter. The effects of stimulations with the optimal parameter at stomach, duodenum and ileum on the LHA neuronal activities were not different. Collectively, gastrointestinal electrical stimulation (GIES) with relatively large pulse width might have stronger effects to the neuronal activities of GD-R neurons in LHA of obese rats. The effects of the GIES at different locations (stomach, duodenum and ileum) on those neurons are similar, and GES is preferential because of its easy clinical performance and safety.

Toll-like receptors (TLRs) family may play important roles in inflammatory bowel disease. This study examined the expression of TLR2, TLR4 and TLR9 in the colonic tissues of patients with ulcerative colitis (UC) and explored their roles in the pathogenesis of UC. Colonic biopsies were taken from the colon of 30 patients with mild or moderate UC (at active phase) and 10 healthy controls during colonoscopy. TLR2, TLR4 and TLR9 protein expression levels were immunohistochemically detected. The mRNA expression levels of TLR2, TLR4 and TLR9 were assessed by reverse transcription polymerase chain reaction (RT-PCR). The disease activity index (DAI), colonoscopic and histologic grades and fecal microbial flora were determined. Histological examination showed that the intestinal mucous membrane of UC patients underwent acute inflammation changes. Immunohistochemistry exhibited that the expression levels of TLR2, TLR4 and TLR9 in colon epithelia and inflammatory cells were higher in UC patients than in control group (P<0.01). The mRNA expression levels of TLR2, TLR4 and TLR9 were increased in UC patients but were not detected in the normal controls. Expression levels of TLR2, TLR4 and TLR9 were positively correlated, and bore close correlation with DAI, colonoscopic and histologic grades and fecal microbial flora. An important mechanism of UC might be that abnormal activation of mucosal immunity by intestinal dysbacteriosis caused dysregulation of TLRS that mediates innate immunity.

Objective To investigate ideal solution of neoadjuvant hormomal therapy (NHT) for locally advanced prostate cancer.Methods 60 patients diagnosed with locally advanced (T3-4N0M0) prostate cancer were treated with NHT.They were randomly divided into 3 groups of 20 cases.A group:NHT 2 weeks,B group:NHT 3 months,C group:NHT 6 months.Results The median PSA of A,B and C group after NHT were 24.88 (6.62-55.86),0.20 (0.05-12.07) and 0.07 (0.01-2.01) ng/ml,respectively.There was statistically significance compared with those in untreatment ( all P =0.00).There was statistically significant (P =0.00)among groups.The prostate volume of A,B and C group were (49.50+14.19),(47.35±17.99) and (36.15±7.17)ml,respectively.There was statistically significance in the B and C group compared with that in untreatment (P =0.04,0.00).There was statistically significant between A and C group and between B and C group (P =0.00,0.01).The Qmax of A,B and C group were (8.75±2.15),(11.7±2.81) and (14.45±2.61) ml/s,respectively.There was statistically significance in the B and C group compared with untreatment (both P =0.00).There was statistically significance among groups (all P =0.00).Conclusion The NHT time should last at least 3 months in order to reduce PSA and prostate volume and to increase the Qmax.

ObjectiveTo investigate the ideal method of neoadjuvant hormonal therapy (NHT) for locally advanced prostate cancer.MethodsSixty cases of patients diagnosed with locally advanced ( T3 -T4 N0M0) prostate cancer were treated with NHT combined with intensity modulated radiotherapy (IMRT),They were randomly divided into 3 groups with 20 cases in each group.Group A with NHT 2 weeks,Group B with NHT 3 months,Group C with NHT 6 months.Endocrine duration began with NHT until 12 months after the end of IMRT.The PSA and prostate volumes were detected by transrectal ultrasound and Qmax was tested after NHT and every 3 months after IMRT.Results After NHT,the median PSA of different groups were decreased to 24.88,0.20 and 0.07 μg/L,respectively.There was significant difference ( P ＜ 0.05 ).The prostate volume in groups B and C reduced significantly ( P ＜ 0.05 ).The group B reduced 20.8％ and the group C reduced 39.5％.The Qmax of group B and C were ( 11.70 ± 2.81 ) and ( 14.45 ±2.61 ) ml/s respectively.After 12 months of endocrine combined with IMRT:(①)PSA.There was significant difference (P ＜0.01 ) with group C ＜ group B ＜ group A.②The prostate volume.The reducing of groups B and C were more obvious than group A ( P ＜ 0.01 ).There was no significant difference between group B and group C ( P ＞ 0.05).③Qmax.There was significant difference (P ＜ 0.01 ) among the 3 groups with group C ＞ group B ＞ group A.ConclusionsNHT combined with IMRT is an ideal method for locally advanced prostate cancer.The NHT time before IMRT treatment should last at least 3 months.

Objective To observe the clinical effect of MC and LC in treatment of elderly patients with cholelithiasis and dise~s the best treatment in elderly patients with cholelithiasis.Methods Of 798 elderly patients with cholelithiasis,412 patients were divided into MC group with minilaparotomy cholecystectomy treatment,and 386 patients were divided into LC group with laparoseopic cholecystectomy treatment,then compare clinical effect and complications after operation.Results There was no significant differences in incision length,operative time,blood loss,bed time,hospital stay(all P＜0.05);There Was significant statistical significance in cost of treatment,complications after operation(all P＜0.05).Conclusion Minilaparotomy cholecystectomy was suitable for elderly patients with cholelithiasis,and it Was good at cost of treatment,complications after operation.