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 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.

Considering the core concept of the system theory,the author describes the conception,components and main functions of the subjects,the objects and behavioral factors for the popularization and application of appropriate health technologies.This theoretically built up the system model for transfer and application of the appropriate health technologies in Chinese rural areas.

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.

Background Vascular endothelial growth factor(VEGF) has been shown to be associated with the pathogenesis of age-related macular degeneration (AMD),therefore VEGF is a target for the treatment of wet AMD.However,the mechanism of VEGF in the pathogenesis of AMD is not clearly understood.Studying the correlation between VEGF gene polymorphism and AMD is becoming a new research hotspot,but relevant studies on Han Chinese have not been performed.Objective This study was to investigate the association between the VEGF +936C/T gene polymorphism and AMD in the Chinese population.Methods A pilot prospective and nonrandomized controlled trial was designed.This protocol complied with Declaration of Helsinki and was approved by the Ethic Committee of Chinese PLA Second Artillery General Hospital.Written informed consent was obtained from each subject prior to entering the study.Two hundred AMD patients and 200 age-and gender-matched normal controls were enrolled in this study.The genomic DNA was extracted from the peripheral blood samples of the subjects,and analysis of the VEGF polymorphisms at the +936 position in the promoter and 3＇-untranslated regions was performed by the restriction fragment length polymorphism method.Frequencies of the VEGF+936C/T genotype were compared between the two groups,and the risk of the VEGF+936C/T gene polymorphism in pre-disposing AMD was evaluated.Results No significant differences were seen in the incidence rates of smoking(P ＝ 0.76),hypertension(P ＝ 0.84),hyperlipidemia (P=0.71),diabetes mellitus (P=0.86) and cardiovascular disease(P=0.89) between the AMD group and the normal control group,and BMI was matched between the two groups (P =0.18).The prevalence of the TT genotype was 9.0％ (18/200)in the AMD group,but that in the normal control was 3.5％ (7/200),showing a significant difference between the two groups (P =0.03).The odds ratio (OR) was 2.73 with a 95％ confidence interval(CI) of 1.11 to 6.68 for AMD in this genotype.The CC and CT genotypes were not significantly different between the two groups (P =0.52,P =0.57).The genotype frequency and allele frequency conformed to HardyWeinberg equilibrium law.There were no significant differences found in the CC,CT,TT genotype frequencies among the early AMD,geographic atrophy AMD and choroidal neovascular AMD (all at P＞0.05).Conclusions The VEGF+936TT genotype is associated with AMD in Han Chinese population.

The expression of heat shock proteins(HSPs) can protect against acute lung injury(ALI).However,HSPs are restrained from clinical application due to the toxicity of most of the former inductors.Glutamine,which also has the ability to induce the expression of HSPs,can protect against ALI and sepsis,and may serve as a candidate for clinical application.

Objective To investigate the in vivo effects of glutamine(Gln) on inflammatory cytokine release in murine peritoneal macrophages during sepsis. Methods Sixty Kunming mice were randomly divided into sham-operation group(Sham group,n=20),operation control group(Con group,n=20) and Gln-treatment group(Gln group,n=20).Sepsis was induced by cecal ligation and puncture in Gln group and Con group,and Gln(0.75 g/kg) or saline was immediately administered via single tail vein injection.Serum was collected and macrophages were harvested from peritoneal lavage at 6 h in these three groups.Intracellular and serum cytokines of tumor necrosis factor-?(TNF-?),interleukin(IL)-6 and IL-10 were detected by ELISA.The expression of TNF-? mRNA in macrophages was analyzed by RT-PCR,and the expression of heat shock protein(HSP) 72 in macrophages was evaluated by Western blotting. Results Gln group demonstrated significantly lower intracellular TNF-? and IL-6 levels than Con group(P0.05).The serum TNF-? level was significantly lower in Gln group than in Con group(P