The paper analyzes the problems in the clinical use of antibiotics, including imperfection in the structure of medical personne's professional knowledge, lack of guidance by pharmaceutical personnel about the use of antibiotics, and lack of effective supervision measures on the part of the hospital. It then points out the various harmful consequences resulting from the abuse of antibiotics. It is necessary to strengthen administrative intervention at various levels, to set up a steering committee for the rational use of antibiotics in medical institutions at various levels, and to incorporate knowledge about the rational use of antibiotics and hospital infection into continuing medical education.

In clinical medical school,disharmony between teaching and learning has been existing which affects the teaching quantity as well as the cultivation of talents.Personal suggestions about the ways to deal with these problems are given in this paper.

Objective: Pemetrexed (PEM) is a multi-targeted chemotherapeutic agent for antifolate drugs. PEM has become the standard agent for the second-line treatment of advanced non-small cell lung cancer (NSCLC). This study aims to review and analyze the clinical efficacy and adverse reactions of PEM combined with carboplatin with respect to NSCLC treatment. Methods: A total of 40 patients suffering from NSCLC were selected and confirmed by pathology. On the first day of treatment, the conventional 500 mg/m2 dose of pemetrexed disodium was infused intravenously. On the second day, a combined therapy with carboplatin was conducted based on the conventional dose for a 21-day cycle with at least two cycles for each patient. The therapeutic efficacy and adverse reactions were evaluated and were compared with the proposed regimen of gemcitabine (GEM) combined with carboplatin. Results: After two cycles of the treatment, the curative effects of the PEM and GEM groups were 50% and 45%, respectively. The main adverse reactions are bone marrow suppression and gastrointestinal reactions. The incidence rates of bone marrow suppression, gastrointestinal reactions, amisulpride/AST, urea nitrogen, rash, and hair loss were obviously lower in the PEM group than in the GEM group. Statistically significant differences in adverse reaction were found between the two groups (P<0.05). Conclusion: The use of the combination regimen of PEM with carboplatin showed significantly more clinical effects and less adverse reactions for NSCLC treatment.

Objective To investigate the effect of hepatitis B virus X protein (HBx) on the induction of eytochrome P450 (CYP) 3A4 by 1α, 25-(OH)2D3 in HepG2 cells in vitro. Methods HepG2 cells were transiently transfected with plasmid pEGFP-N1 (control) or co-transfected with recombinant HBx eukaryotic expression plasmid pcDNA3-X and pEGFP-N1. All HepG2 cells were divided into four groups: control group (without transfection), plasmid pEGFP-N1 transfection group, plasmid pEGFP-N1 transfection plus 1α ,25-(OH)2D3 group, plasmid pcDNA3-X and pEGFP-N1 co-transfection plus 1α ,25-(OH)2D3 group. The expression of CYP3A4 in HepG2 cell was induced by 0.35 μ mol/L 1α ,25-(OH)2D3 for 72 h, and mRNA levels and protein levels of CYP3A4 in the cells were detected by reverse transcriptase-polymerase chain reaction (RT-PCR) assay and Western-blot assay, respectively. The comparison between groups was done by F test. Results CYP3A4 mRNA level in plasmid pcDNA3-X and pEGFP-N1 co-transfection plus 1α ,25-(OH)2D3 group was 1.52 folds of control group, while that in plasmid pEGFP-N1 transfection plus 1α, 25-(OH)2D3 group was 3.97 folds (F= 4.72, P<0. 05). Similarly, intracellular CYP3A4 protein expression in plasmid pcDNA3-X and pEGFP-N1 co-transfection plus 1α , 25-(OH)2D3 group increased to 2.1 folds of control group, while that in plasmid pEGFP-N1 transfection plus 1α,25-(OH)2D3 group increased to 5.9 folds (F=4.68, P<0.05). Conclusion HBx interferes with the induction of CYP3A4 by 1α , 25-(OH)2D3 in HepG2 cell line, which suggests that HBx has suppressive effect on the expression of CYP3A4.

Both of "Medical Microbiology"and "Medical Immunology"are two important basic and required medical courses for college students.There is something worth discussing in some respects,including the composing of teaching materials,designing of curriculum,key points of teaching and practical application.It's necessary to deal with the relationships well between the teaching effects and the issues such as arrangements of class period,selection of teaching material and the design of teaching.Particularly,we should emphasize close connection between the basic and clinical course.

Objective To investigate the effects and mechanism of different doses of rosuvastatin on expression of tissue factor(TF) in cultured human monocyte-macrophage cells which were induced by oxidized low density lipoprotein (ox-LDL).Methods The human monocyte-macrophage cells were divided into seven groups:control group,ox-LDL group,poly-insine monophosphate group,different doses of rosuvastatin group(0.01 μmol/L,0.1 μmol/L,1 μmol/L,5 μmol/L).The expression of LOX-1 mRNA and TF mRNA was assayed by RT-PCR.The enzyme-linked immunosorbent assay was performed to determine the protein concentration of TF.Results Effects of different doses of rosuvastatin on expressions of LOX-1mRNA,TF mRNA and TF in cultured human monocyte-macrophage cells induced by ox-LDL:comparison among seven groups,the difference was statistically significant (F =91.334,58.833,103.552,P ＜0.05).Compared with control group,the expressions of LOX-1 mRNA,TF mRNA and TF were increased in the ox-LDL group[(3.25156 ± 0.15772) vs (1 ±0) ;(2.522451 ±0.138967) vs (1 ±0) ;(207.7233± 1.154701)ng/L vs (184.8467 ± 0.871799)ng/L],and they were in a concentration-dependent manner (P ＜ 0.05).Compared with the PolyⅠ group and the different doses of rosuvastatin group,the expressions of LOX-1 mRNA,TF mRNA and TF were in the ox-LDL group,and the different doses of rosuvastatin were decreased by dose-dependent manner.It was in a concentration dependent manner (P ＜ 0.05).Different doses of rosuvastatin were compared between groups (between each group P ＜ 0.05),the difference between each two groups was statistically significant (P ＜ 0.05).Conclusions LOX-1 may be responsible for the expression of TF in Human monocyte-macrophage cells induced by ox-LDL.Rosuvastatin by dose dependent manner and by means of ox-LDL reduced monocyte-macrophage LOX-1 mRNA and TF mRNA expressions,which reduced expression of TF.

Objective To establish a method for quantitative detection of hepatitis B virus covalently closed circular DNA(HBV cccDNA ) in infected cells. Methods The transfected cell line HepG2.2.15 which can consistently produce Dane particles was maintained in DMEM containing 380 ?g/ml G418 and 10% fetal bovine serum. Cells in the exponential period were harvested from flasks, then intracellular HBV cccDNA was extracted from pellet containing 1?10~6 cells with mini plasmid extraction kit (QIAGEN).The extraction product was further purified by mung bean nuclease to remove HBV relaxed circular DNA possibly remained. HBV cccDNA was quantitatively detected by fluorescent PCR with selective primer set and Taqman MGB probe. Culture medium before exponential period, HBV DNA positive and negative serum samples from patients with chronic hepatitis B (mild) were amplified simultaneously to test the specificity of the fluorescent PCR method. Plasmids containing whole HBV genome were amplified with the same primer set and fluorescent probe to determine the sensitivity of the method. Results HBV cccDNA was detectable in HepG2.2.15, and the average quantity was 18 copies per cell approximately. No detectable fluorescent signal was observed when culture and serum samples were amplified. The detectable HBV cccDNA was as low as 10~3 copies per ml at least by this method. Conclusions This method is convenient, highly specific and highly sensitive. It can be utilized in the quantitative detection of intracellular HBV cccDNA as well as in the screening and evaluation of antiviral agents.

To investigate the short term anti HBV efficacy of foscarnet sodium, sixty seven patients with various types of chronic hepatitis B were randomly divided into two groups. The experimental group (47 cases) was assigned to receive foscarnet sodium 3 0g by intravenous infusion twice daily in addition to general liver protective medicine for 15 days. The control group (20 cases) was treated with regular liver protective medicine only. The quantity of HBV DNA was measured with equivalent competitive PCR combining with DNA hybridization quantitative detection technique before and after treatment (once a week). The HBV markers and liver functions were also tested before and after treatment. In antiviral therapy group, the patients with different types of hepatitis B had their liver functions improved. HBV DNA in 13 patients became negative by PCR. Two of HBeAg positive patients became sero converted. Foscarnet sodium can inhibit HBV efficiently and quickly. The replication of HBV DNA can be greatly suppressed in the first week but without significant change in the second week in some cases. Foscarnet can be one of the drugs of choice in a combined therapy or as the initial drug in a sequential therapeutic regime.

Objective To explore the effect of prenatal inflammation on vascular remolding and blood pressure in mid-aged rats.Methods Time-mated pregnant Sprague-Dawley(SD)rats were randomly divided into 2 groups,received peritoneal injection of 0.79 mg/kg LPS on the gestation days 8,10,and 12,or same volume of the sterile saline at the same time points.Nine pups were randomly selected from each group for the later experiments,and the offspring were named as LPS groups for those having prenatal LPS exposure and control group for those having not.Their blood pressure was determined with a rat tail non-invasive instrument by tail-cuff method from 6 weeks old to 35 weeks old,and then their aortas were taken out for media thickness(MT),diameter of lumen(LD),and the ratios of MT/LD.The expression of proliferating cell nuclear antigen(PCNA)on the vessel was detected by ELISA.The serum level of NO and plasma endothelin-1(ET-1)were measured by nitrate reductase and radioimmunoassay respectively.Results Compared with control group,LPS groups had significantly raised blood pressure,a significantly higher ratio of MT/LD,obviously increased expression of PCNA,and markedly elevated serum ET-1.Conclusion The offspring whose prenatal rats were exposured to LPS result in vascular remolding,vasofunctional disturbances and hypertension.

To investigate causes and clinical picture of fever of unknown origin (FUO), and to sum up the experiences in diagnosis of FUO, the medical records of 107 patients with FUO were reviewed retrospectively. Specific causes were identified in 99. 1% of these patients, including infections in 50 patients(46. 7%) , rheumatic problems in 22(20. 6%) and malignancies in 17(15. 9%). The main pathogens responsible for the infections were pyogenic bacteria(72. 0% , 36/50) and M tuberculosis (18. 0% , 9/50), mostly extrapulmonary. Lymphatic and he-mopoietic tissue neoplasms were the main forms of malignancy (88. 2%, 15/17), including histiocytosis, malignant lymphoma and leukemia. Drug fever was another common cause of FUO, accounting for 8. 4% in our series.