OBJECTIVE: To evaluate the clinical efficacy of Cefepime in treating senile patients with hospital acquired pneumonia(HAP).METHODS: A total of 60 HAP cases were randomly assigned to receive Cefepime(n=30) or Ceftazidime (n=30) for 7～10 days.The effective rate and the bacterial clearance rate of two groups were compared.RESULTS: The effective rate was 86.7% for Cefepime group and 70.0% for Ceftazidime group(P

Objective To observe the efficacy of prophylactic use of gramsetron(Gra) combined with dexamethasone(DEX) on preventing postoperative nausea and vomiting(PONV) after umbilical one-trocar laparoscopic appendectomy(UOTLA)in children.Methods Sixty children requring UOTLA under general anesthesia were allocated randomly into 3 groups,and each of group included 20 children.Group saline(C),group Gra 40 ?g/kg,group Gra 40 mg/kg and group DEX 0.2 mg/kg(Gra+DEX) were respectively injected intravenously after appendectomy performed outside the abdominal cavity during the operation.Results The incidence of PONV decreased significantly in group Gra and group Gra+DEX than that in group C(Pa

Aim To study IL-8 expression of human airway epithelium-like NCI-H292 cells directly induced by Pyocyanin and its mechanism through protein kinase C(PKC) and nuclear factor-kappa B(NF-??).Methods ELISA methods were performed to test the expression of IL-8 in NCI-H292 cells infected by Pyocyanin.Western blot was employed to examine the expression of NF-?B protein.In addition,NCI-H292 cells were cultured together with PKC inhibitor,calphostin C or NF-?? inhibitor,pyrrolidine dithiocarbamate(PDTC),respectively before Pyocyanin infection,then the expression of IL-8 and NF-?? was assayed using the above methods.Results Pyocyanin was able to induce IL-8 protein secretion in NCI-H292 cells and had marked concentration-dependent relations.Pyocyanin could also significantly promote the activation of NF-?B,which peaked at 60~90 min.PDTC and calphostin C could significantly decrease the activation of NF-?? and the expression of IL-8.Conclutions Pyocyanin can induce IL-8 production.The direct induction of Pyocyanin can promote the activation of NF-?B by PKC signal pathway,then cause the expression and secretion of IL-8.

Objective To assess and compare the effectiveness of gadolinium diethylenetriamine pentacetic acid(Gd-DTPA) solution and barium sulfate(BaSO4) suspension with different concentrations in improving the imaging quality of magnetic resonance cholangiopancreatography(MRCP). Methods The phantom study was carried out to determine the optimal concentration of Gd-DTPA and BaSO4 suspension used as an oral negative contrast agent in MRCP.The patients were grouped randomly and performed MRCP before and after using oral contrast agents in combination with intravenous injection of contrast agents.A comparison of the influence of BaSO4 suspension and Gd-DTPA with different concentrations on the signal intensity of the fluid in gastrointestinal tract on MRCP images was made.Results The phantom study showed that the dilution ratio 1∶10 of Gd-DTPA solution and 100%(W/V)BaSO4 suspension were the optimal concentrations in decreasing the signal intensity.In all patients the high signal intensity of the gastrointestinal fluid was completely suppressed after oral administration of Gd-DTPA diluted solution(P

BACKGROUND:The V-ATPase a3 transport system plays a crucial role on bone resorption mechanism of the osteoclasts.
OBJECTIVE:To observe the expression of V-ATPase a3 transport system in fracture repair and the effect of V-ATPase a3 transport system inhibitor on fracture healing.
METHODS:We retrieved related literatures in the periodicals database with the key words, and screen them according to the inclusion criteria. The literatures were included in this study after the evaluation of quality.
RESULTS AND CONCLUSION:V-ATPase a3 transport system widely exists in the cytoplasm membrane and organel e membrane of eukaryotic cells. V-ATPase a3 has two structural domains:V0 and V1. V0 structural domain is the proton transport channel, V1 structural domain is mainly the hydrolysis of ATP. V-ATPase a3 transport system focuses on the fril ed edge of osteoclasts, H+is transported to form a high concentration, dissolves inorganic minerals and provides the acidic environment for hydrolytic enzymes, thus being involved in bone resorption. So V-ATPase a3 transport system is selected as the research target in the fracture repair and reshape.

Objective To determine the optimum dose of nalbuphine prepared for patient-controlled intravenous analgesia (PCIA) after caesarean section.Methods A total of 100 parturients,aged 22-40 yr,weighing 60-90 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,at ≥ 37 weeks of gestation,scheduled for elective caesarean section,were divided into 4 groups (n=25 each) using a random number table:sufentanil 2.0 μ,g/kg group (group S),nalbuphine 1.5 mg/kg group (group N1),nalbuphine 2.0 mg/kggroup (group N2,) and nalbuphine2.5 mg/kggroup (group N3).In S,N1,N2 and N3 groups,sufentanil 2.0 μg/kg and nalbuphine 1.5,2.0 and 2.5 mg/kg were added to PCIA solution,respectively,tropisetron 12 mg was added,and PCIA solution was then diluted to 100 ml in normal saline.The PCA pump was set up to deliver a 1 ml bolus dose with a 10-min lockout interval and background infusion at 2 ml/h after a loading dose of 3 ml.Tramadol 50 mg was intravenously injected as a rescue analgesic to maintain visual analogue scale score at rest ≤ 4 or during activity (cough) ≤ 6.The highest Ramsay sedation score,requirement for rescue analgesics,the number of unsuccessfully delivered doses,the number of attempts and occurrence of nausea and vomiting,pruritus and somnolence within 48 h after operation were recorded.Results Compared with group S,the number of unsuccessfully delivered doses,the number of attempts and requirement for rescue analgesics were significantly decreased in N2 and N3 groups,the incidence of somnolence and the highest Ramsay sedation scores were increased in group N3 (P＜0.05),and no significant change was found in the parameters mentioned above in group N1 (P＞ 0.05).Compared with group N1,the number of unsuccessfully delivered doses,the number of attempts and requirement for rescue analgesics were significantly decreased in N2 and N3 groups,and the incidence of somnolence and the highest Ramnsay sedation scores were increased in group N3 (P＜0.05).Compared with group N2,the incidence of somnolence and the highest Ramsay sedation scores were significantly increased (P＜0.05),and no significant difference was found in the number of unsuccessfully delivered doses,the number of attempts or requirement for rescue analgesics in group N3 (P＞0.05).Conclusion The optimum dose of nalbuphine prepared for PCIA after caesarean section is 2.0 mg/kg.

Objective To evaluate the effects of flurbiprofen axetil administered at different time points on oxygenation in the patients undergoing one-lung ventilation (OLV).Methods Ninety patients of both sexes,aged 45-64 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective thoracoscope-assisted pulmonary lobectomy,were assigned into 3 groups (n =30 each) using a random number table:control group (group C),preoperative administration group (group F1) and intraoperative administration group (group F2).Flurbiprofen axetil (10 mg/ml) and fat emulsion 10 ml were injected intravenously at 15 min before operation in F1 and C groups,respectively.Flurbiprofen axetil 10 ml was intravenously injected immediately after the beginning of OLV in group F2.At 15 min before operation (T1),15 and 30 min of OLV (T2,3),and 15 min after restoration of two-lung ventilation (T4),airway peak pressure (Ppeak) and dynamic lung compliance (Cdyn) were recorded,arterial blood samples were collected for blood gas analysis.The arterial oxygen partial pressure (PaO2) was recorded,and the oxygenation index (OI) and intrapulmonary shunt (Qs/Qt) were calculated.The concentrations of thromboxane B2 (TXB2) and 6-keto-prostaglandin F1α (6-K-PGF1α) in serum were measured by enzyme-linked immunosorbent assay,and TXB2/6-K-PGF1α ratio was calculated.The development of interrupting OLV due to SpO2＜90％ and postoperative dyspnea,pulmonary infection,atelectasis and length of hospital stay were recorded.Results Compared with group C,PaO2 and OI were significantly increased,and Qs/Qt was decreased at T2,3,the serum concentrations of TXB2 and 6-K-PGF1α were decreased,and TXB2/6-K-PGF1α ratio was increased at T2-4,the incidence of interrupting OLV was decreased (P＜0.05),and no significant change was found in the parameters mentioned above in group F2 (P＞0.05).Compared with group F1,PaO2 and OI were significantly decreased at T2,3,Qs/Qt was increased at T2,and the serum concentrations of TXB2 and 6-K-PGF1α were increased,and TXB2/6-K-PGF1α ratio was decreased at T2-4 in group F2 (P＜0.05).There was no significant difference in the incidence of postoperative dyspnea,pulmonary infection and atelectasis and length of hospital stay between the three groups (P＞0.05).Conclusion Flurbiprofen axetil injected at 15 min before operation can significantly improve oxygenation and prevent the development of hyoxemia in the patients undergoing OLV,however,flurbiprofen axetil administered immediately after the beginning of OLV has no such effect.

Diagnostic Imaging ; Humans ; Liver Cirrhosis ; diagnosis ; diagnostic imaging ; Tomography, X-Ray Computed

OBJECTIVETo assess the clinical feasibility of diagnosing and staging liver fibrosis by apparent diffusion coefficient (ADC).

METHODSTotally, 43 patients (mean age 29.3 years) with chronic hepatitis by liver biopsy and 7 healthy controls (mean age 39.9 years) underwent liver diffusion weighted imaging (DWI) with four b values: 0, 200, 500, and 1000 s/mm2 respectively. The liver fibrosis was staged according to Ishak fibrosis stage. The ADC value of liver fibrosis patients and healthy controls was compared. The correlation of ADC value and liver fibrosis staging was analyzed.

RESULTThe histological staging showed 8 stage 1 patients, 10 stage 2 patients, 6 stage 3 patients, 9 stage 4 patients, 8 stage 5 patients and 2 stage 6 patients. The mean ADC value of liver fibrosis patients was significantly lower than that of healthy controls except for stage 1 group (P < 0.05). There was a negative correlation between liver fibrosis staging and ADC value (r = -0.697 with b=500 s/mm2, P < 0.01). Receiver operating characteristic (ROC) curve of ADC value of advanced liver fibrosis (Ishak stage F3 and higher) showed that area under curve = 0.913, 0.825, and 0.794 with b = 500, 1000, and 200 s/mm2, respectively (95% confidence interval: 83.6%-99.0%, 70.7%-94.3%, 66.5%-92.4%; P < 0.05). When b value was 500 s/mm2, the sensitivity (84%) and specificity (80%) of DWI for diagnosis of advanced liver fibrosis were the highest.

CONCLUSIONDWI is proved to be a useful clinical tool in the quantitative evaluation of liver fibrosis and in the prediction of the process of liver fibrosis with the recommendable b value (500 s/mm2).

Adult ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Humans ; Liver Cirrhosis ; diagnosis ; pathology ; Male ; Middle Aged ; ROC Curve ; Young Adult

OBJECTIVETo evaluate the osteogenic ability of the three-dimensional interconnected porous titanium(TDIPT) coated with bonelike apatite, by the test of the culture of osteoblast in vitro.

METHODSThe pure TDIPT was prepared by the high temperature insostatic pressing (HIP) and was divided into two groups. One group of TDIPT was dipped into the 1.5 simulated body fluid (1.5 SBF) and developed the TDIPT coated with bone-like apatite (The test group). Another group was control group (pure TDIPT). The porous titanium of the two groups were all made into standard parts (5 mm x 5 mm x 4 mm) and placed into the 24-hole plates. The osteoblasts were extracted from SD rat. After the primary culture and subculture of the osteoblast in vitro, the osteoblasts were inoculated into the samples in the 24-pole plate and cultured continually. MTT Cell Proliferation Assay was done on the 1st, 3rd, 5th, 7th and 9th day respectively after inoculating. The ALP activity was tested on the 7th, 14th and 21st day, respectively. The collected data were analyzed by use of the student t test.

RESULTSThe MTT value and the ALP activity increased with the increasing of the culture time in the two group, but those of the test group was more significant than those of the control group (P < 0.05). Moreover, the osteoblast tachyauxesis and stable adhesion were observed in test group by SEM at the 7th day after culturing.

CONCLUSIONThe bioactivity of the TDIPT improves significantly after coating with the bone-like apatite onto the surface of the TDIPT.

Alkaline Phosphatase ; metabolism ; Animals ; Cells, Cultured ; Female ; Male ; Microscopy, Electron, Scanning ; Osteoblasts ; physiology ; ultrastructure ; Osteogenesis ; Porosity ; Rats ; Rats, Sprague-Dawley ; Titanium ; chemistry