OBJECTIVE To investigate extended-spectrum ?-lactamases(ESBLs) producing bacteria and daily(defined) doses (DDDs) of the third generation cephalosporins.METHODS The cosumpsion of the third generation cephalosporins in five(hospitals) from 2000 to 2002 and the incidence of ESBLs producing bacteria were(analyzed).RESULTS In these years,the total DDDs were 1.3064 million therapeutic days,0.3335 million in 2000;0.4312 million in 2001;(0.5417) million in 2002.The average ESBLs producing ratio was 33.67%,ie,29.64%,32.58% and(38.45%) in 2000,2001 and 2002.CONCLUSIONS The incidence of ESBLs producing bacteria and DDDs of the third generation cephalosporins are raised gradually. More faster raised DDDs would result in higher incidence of ESBLs producing bacteria.

Objective To study the correlation between small intestinal bacterial overgrowth (SIBO) and plasma endotoxin,platelet-derived growth factor(PDGF)level,and levels of serum hyaluronic acid (HA),laminin(LN),N-terminal procollagen Ⅲ peptide(PⅢNP)and type Ⅳ collagen(Ⅳ.C). Methods Lactulose hydrogen breath test (LHBT) was performed in 64 patients with chronic liver disease. Plasma endotoxin was measured with Limulus test, plasma PDGF was tested with ABC-enzyme-linked immunosorbent assay,serum HA,LN,PⅢNP and Ⅳ.C were tested by radioimmunoassay(RIA) in the patients. The relationship between SIBO and plasma endotoxin, PDGF and HA,LN,PⅢNP and Ⅳ.C levels were analyzed. Results Positive LHBT suggesting the existence of SIBO were observed in 22 patients(34.4%). Plasma endotoxin[(62?19) pg/ml vs.(31?13) pg/ml] and PDGF [(211?77) pg/ml vs.(136?57) pg/ml] levels were significantly higher in patients with SIBO than those in patients without SIBO (P

Objective To observe the effect of EGFR‐TKI combined with chemotherapy on the changes of serum insulin‐like growth factor1(IGF‐1)and anterior gradient‐2(AGR2)levels in the patients with advanced non‐small cell lung cancer(NSCLC) ,and to investigate whether IGF‐1 and AGR2 can serve as a potential indicator of the prognosis and efficacy of chemotherapy in NSCLC . Methods Sixty‐eight patients with advanced NSCLC were selected as the experimental group treated by EGFR‐TKI combined chemotherapy and 30 healthy people served as the healthy control group .(treatment group) .The levels of serum IGF‐1 and AGR2 before chemotherapy and at 3 weeks after chemotherapy were detected by ELISA .The influence of serum IGF‐1 and AGR2 levels on the prognosis was analyzed by using Kanplan‐Meier method .Results (1)The disease control rate(DCR)in the EGFR‐TKI com‐bined chemotherapy was 52 .9% ;(2)the level of serum IGF‐1 before treatment in the experimental group was (329 .35 ± 88 .13)μg/L ,which was significantly higher than (146 .36 ± 41 .27)μg/L in the healthy control group(P<0 .01);the level of serum AGR2 in experimental group was(16 .72 ± 6 .23)ng/mL ,which was significantly higher than (4 .38 ± 2 .17)ng/mL in the healthy control group(P<0 .01);serum levels of IGF‐1 and AGR2 after treatment were(211 .53 ± 52 .31)μg/L and (9 .72 ± 3 .56)ng/mL respec‐tively ,which were significantly lower than those before treatment (P<0 .01);serum IGF‐1 and AGR2 in NSCLC patients were pos‐itively correlated(r=0 .489 ,P<0 .01);(3)serum levels of IGF‐1 and AGR2 after chemotherapy were(128 .62 ± 48 .24)μg/L and (7 .22 ± 4 .27)ng/mL respectively ,which were obviously lower than(334 .23 ± 82 .11)μg/L and(18 .43 ± 6 .17)ng/mL before chem‐otherapy(all P<0 .01) .The Kanplan‐Meier analysis revealed that serum IGF‐1 and AGR2 levels in advanced NSCLC had an obvi‐ous influence on the prognosis .Conclusion Serum IGF‐l and AGR2 levels may have a potential clinical value to assess the therapeu‐tic efficacy of EGFR‐TKI combined chemotherapy and prognosis in advanced NSCLC .

ObjectiveTo observe effects of early rehabilitation and hyperbaric oxygen treatments on stroke patients.Methods80 patients were randomly divided into rehabilitation group (40 cases) and control group (40 cases). Patients in rehabilitation group were treated with rehabilitation and hyperbaric oxygen treatments; patients in control group were treated only with hyperbaric oxygen treatment. The activities of daily living (ADL) were assessed by modified Barthel index (MBI), and the cognition function was measured by mimi-mental state examination (MMSE).ResultsAfter treatment the scores of MMSE and MBI of two groups increased (P<0.05) and scores of rehabilitation group were higher than that of control group (P<0.05); the process of scores in rehabibilitation group were obviously superior to that in control group (P<0.001).ConclusionEarly rehabilitation and hyperbaric oxygen treatments can obviously improve cognition function and ADL of stroke patients.

Objective To investigate the risk factors of upper gastrointestinal injury induced by non-steroidal anti-inflammatory drugs (NSAIDs).Methods A total of 1032 patients which used NSAIDs was selected.Patients were divided into two groups based on the condition of dyspepsia,peptic ulcer or upper gastrointestinal bleeding:the adverse drug reaction group (331 cases) and the control group (701 cases).Data of two groups on clinical presentation,laboratory test,medication and treatment were analyzed.Risk factors for the adverse drug reaction were identified by multivariable Logistic regression.Results The two groups had significant difference in age ＞ 65 years old,Helicobacter pylori (Hp) infection,ulcer history,drug overdose,combination with glucocorticoid,addicted to tobacco and alcohol history,non-specific inhibitor of cyclooxygenase(COX)-2,combination with anticoagulant,concomitant chronic cardiopulmonary disease (P ＜ 0.05).Logistic regression analysis by backward elimination method revealed that following variables retained,such as combination with glucocorticoid (OR =3.104,95％ CI 1.936-4.695),Hp infection (OR =2.768,95％ CI 2.047-3.742),drug overdose (OR =2.411,95％ CI 1.683-3.453),ulcer history (OR =1.781,95％ CI 1.278-2.480),age ＞ 65 years old (OR =1.659,95％ CI 1.237-2.225),non-specific inhibitor of COX-2 (OR =1.470,95％ CI 1.103-2.133),addicted to tobacco and alcohol history (OR =1.459,95％ CI 1.032-2.064),concomitant chronic cardiopulmonary disease (OR =1.357,95％ CI 1.008-2.143),P＜0.05.Conclusion Combination with glucocorticoid,Hp infection,drug overdose,ulcer history,age ＞ 65 years old,non-specific inhibitor of COX-2,addicted to tobacco and alcohol history,concomitant chronic cardiopulmonary disease are risk factors of upper gastrointestinal injury induced bv NSAIDs.

Objective To evaluate the feasibility of bladder extracellular matrix (BACM) seeding with autologous cultured vaginal smooth muscle cells (VSMC) repaired rabbit vaginal defect.Methods This study included 24 female rabbits.BACM and vaginal acellular matrix (VACM) were obtained from 8 rabbits by decellularization process.The other 16 rabbits were randomly divided into experimental and control groups.Vaginal tissue biopsies ( ～ 1 cm2) were harvested from female New Zealand rabbits.VSMC were cultured and stained with a-smooth muscle actin antibodies. Cultured VSMC cells were seeded on BACM ( experimental group) or VACM ( control group) at a cell density of 1 × 107 cells/cm2.The cell-seeded matrixes were cultured for 5days.In experimental group of 8 rabbits,a 2 cm segment of vagina was resected and replaced with BACM seeding with VSMC.Then the regenerative segment was studied with histological technique by hematoxylin-eosin staining after 3,6 and 12 weeks postoperative aud vaginography was performed at 12 weeks postoperative.The 8 rabbits in control group underwent the exact same procedure as above but the vaginal defect was repaired with VACM seeding with VSMC,Results The prepared BACM and VACM were transparent,HE staining and scanning electron microscopy showed the two acellular matrix was both consisted of abundant network of fibers with the regular arrangement,without cellular debris.Primary culture of VSMC was successfully established and passaged,and was uniformly spindle-shaped in the confluent state and showed a characteristic hill and valley'formation.Immunohistochemical staining showed VSMC in culture stained positively with a-smooth muscle actin antibodies.VSMC began to adhere to the BACM 5 hour after implanting and the number of the adhered cells increased with time.Cells gradually expanded and showed the typical morphology of smooth muscle cells.Three weeks after implantation in vivo,the luminal surface of matrix was completely covered by vaginal epithelial tissue,a layer of smooth muscle cells was formed in the outer surface of the matrix.Multilayered vaginal epithelial and improved development of organized muscle bundles was observed after 6 weeks.The regenerative tissue was equivalent to the normal vaginal tissue at 12 weeks postoperatively.Vaginography demonstrated the maintenance of full patency and a wide vaginal caliber without fibrosis and graft rejection.There was no significant difference in all evaluated items between experimental and control groups.Conclusions BACM has the same regenerative process as VACM in the replacement of vaginal defect.Moreover,BACM has wider source and appears to be an suitable material for vaginal replacement.

Adult ; Aminosalicylic Acid ; therapeutic use ; Female ; Humans ; Manganese Poisoning ; drug therapy

Objective To study the function of the nano-molecular polyamide-amine (PAMAM) as microRNA(miR) carrier targeting gastric adenocarcinoma, and the foundation of developing an efficient delivery of small molecule drugs tar-geting gastric cancer thereof. Methods The folic acid (FA)/PAMAM comoles compound was prepared by dialysis method. After transfection of miR-7 or liposomes into SGC-7901 cell line, fluorescence microscope was used to detect the gene trans-fect efficiency. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the miR-7 level. The immu-nocytochemistry assay was used to test the protein expressions of epidermal growth factor receptor (EGFR), protein kinase B (PKB) and proliferating cell nuclearantigen (PCNA). The transwell system was utilized to explore the migration ability of tu-mor cells. Results Compared with liposme, FA/PAMAN complex compound can significantly improve the level of miR-7 in SGC-7901 cells,reduce the protein levels of EGFR, PKB and PCNA in SGC-7901 cells, and also reduce the percentage of cancer cell migration (P<0.05). Conclusion PAMAM can effectively transfect miR into gastric cancer cells, which is expected to become an efficient delivery of small molecule drugs.

AIM: To evaluate the influences of triptolide on serum cytokines, symptoms and pulmonary function in patients with steroid - resistant asthma, so as to investigate if there is therapeutic effect of triptolide on these patients. METHODS: Sixteen patients with steroid - resistant asthma were randomly divided into two groups (A and B, n =8 for each group). All of the patients took procaterol (50 - 100 μg/d) and theophylline (400 mg/d) orally as baseline treatment. Additionally, triptolide was prescribed for group A (33 μg, orally, three times per day for 4 weeks). Asthmatic symptom score calculation, serum cytokines ( interferon - γ, IFN - γ; interleukin - 4, IL - 4; and interleukin - 5, IL - 5)determination and pulmonary function test (FVC%, FEV1%, PEF%, V50% and V25% ) were undertaken before and at the end of the study. RESULTS: At baseline, no significant difference was found between group A and group B with respect to the above mentioned indices. Following the administration of triptolide, group A had significantly increased serum IFN -γlevel, FVC%, FEV1%, PEF%, V50% and V25%, and significantly decreased asthmatic symptom score and serum IL-4, IL-5 levels (P＜0.01 compared with baseline in the same group, and P＜0.05 compared with group B at the end of the study). Compared with baseline, no significant change was observed for group B regarding all the indices at the end of the study. CONCLUSION: Triptolide in combination with procaterol and theophylline may be a novel and effective strategy for the treatment of steroid - resistant asthma.

Objective To observe clinical results and indications of open reduction and internal fixation by bold canal titanium screws for treatment of radial head fractures. Methods From May 2003to February 2007,18 cases of radial head fractures were treated by open reduction and intemal fixation with bold canal titanium screws.There were 12 males and 6 females at age range of 15-53 years(mean 28.6 years).Of all,13 cases had Mason typeⅡ fractures,3 Mason typeⅣ and 2 Mason typeⅣ.Rehabilitation began as early as possible after operation if the internal fixation was secure;otherwise,rehabilitation began 2 weeks after operation.Postoperative plain radiography was made to observe fracture healing and complications. Results After operation,the rehabilitation was done at the first day in 15 cases and at 2 weeks in 3,with mean fracture healing time of 3 months.Function of elbows and rotation of forearnls were excellent except for 2 eases with Mason Ⅳ fractures.No deep branch of radial nerve injury occurred. Conclusion Open reduction and internal fixation with bold titanium canal screws can attain satisfactory clinical results in treatment of Mason type Ⅱ and Mason typeⅢradial head fractures.