Objective To provide rational use of vancomycin in elderly MRSA-infected patients, compared its pharmacokinetics in the elderly MRSA-infected patients with healthy young subjects.Methods 15 elderly MRSA-infected patients and 15 healthy young subjects were injected with 1.0g vancomycin.Serum concentrations were determined by fluorescence polarization immunoassay(FPIA) in both groups(n infected=15,n healthy =15),then calculated the pharmacokinetic parameters with program 3p97.Results Compared with the healthy group, the elimination half life (t1/2β)were longer, the apparent volume of distribution (Vd)and the area under curve(AUC)were increased,the creatinine clearance(Ccr)were lower in the infected group.The differences of these pharmacokinetic parameters between the two groups were statistically significant(p<0.01) except the peak serum concentrations(p>0.05).Conclusion Vancomycin should be used with decreased dose or increased interval in the elderly MRSA-infected patients, therapeutic drug monitoring and personalized medicine were required.

Objective To explore the change of the total level of lgE and specific allergen for acute exacerbation of bronchial asthma and to offer evidence for the prevention and cure of acute exacerbation of bronchial asthma.Methods The usual inhalant and ingested antigens were chosen in asthma patients,and the allergens were detected by ELISA in sera of acute exacerbation of bronchial asthma patients.Results Total positive rate of lgE was 92％ (48/52),dust mites 61.2％ (25/52),house dust 17％ (9/52),shrimp and crab 15％ (8/52),mould 9％ (5/52).Conclusion The main allergen of acute asthma exacerbation is dust mites.House dust,shrimp and crab,and mould folloo.The rats of pollen or weed are very low.

Background Minocycline possesses neuroprotective effect in a variety of animal models and clinical trials of central nervous system,but whether it works on optic nerve injury remains unclear.Objective This study aimed to observe the protective effects of minocycline on retinal ganglion cells (RGCs) in the early stage of optic nerve crush and explore its mechanism.Methods One hundred and thirty-six clean C57BL/6J mice were randomly divided into normal control group,normal saline solution group and minocycline group.The optic nerve crush injury models were induced in the left eyes of the mice in the normal saline solution group and minocycline group by a cross-action forceps for 3 seconds.Minocycline was injected intraperitoneally in the minocycline group firstly 45 mg/kg(0.4 ml) and followed by 22.5 mg/kg per day after 24 hours until sacrifice of the animals,and the equivalent volume of normal saline solution was injected in the same way in the normal saline solution group.The mice were euthanized at 4,7,11,14 days postoperatively and the left eyeballs were collected.Retinal flat mounts and DAPI staining was used to observe and compare the change of RGCs density among different groups and various time points.Apoptosis of mice RGCs were assessed by TdT-mediated dUTP nick end labeling (TUNEL).Real-time polymerase chain reaction (real-time PCR) was used to detect the expression of CD11b mRNA in retinal microglials.Results DAPI staining in retinal flat mounts showed that the average RGCs density was (77.50±2.38)/0.01 mm2 and (70.00±2.94) /0.01 mm2 in the 4th and 7th day after modeling in the normal saline solution group,and those in the minocycline group were (88.75 ± 2.36) /0.01 mm2 and (81.00 ± 3.92)/0.01 mm2,with significant differences between the two groups (t4d =-6.708,P＜0.01 ;t7d =--4.491,P＜0.01).The apoptotic RGCs were (12±1)/mm and (4±1)/mm in the normal saline solution,which were significantly more than (4±1)/mm and (1±0)/mm in the minocycline group (t4 d =12.832,P＜0.01 ; t7d =3.455,P =0.026).However,no significant difference was found in apoptotic RGCs in postoperative 11 days and 14 days between the normal saline solution group and the minocycline group (P =0.708,0.777).The expressing levels of CD11 b mRNA in the retinal microglials were significantly higher in the 4th and 7th day in the normal saline solution group than those in the minocycline group (t4 d =8.312,P＜0.01 ;t7d=5.407,P＜0.01),but were not significantly different in the 11st and 14th day after modeling between the two groups (P=0.055,0.170).Conclusions Minocycline can play a neuroprotective effect on RGCs in the early stage of optic nerve crush in mice by inhibiting microglia activation and decreasing RGCs apoptosis.

BACKGROUND: Previous studies have proved platelet-rich fibrin (PRF) with osteoinduction ability, and the centrifugal speed and time to prepare rabbit advanced PRF (A-PRF) with the most similar structure to that of human PRF have been determined.OBJECTIVE: To observe the histological changes during A-PRF-induced osteogenesis.METHODS: Thirty Japanese white rabbits were randomly divided into A-PRF and blank control groups (n=15 per group).The full-thickness defect models were established on the rabbit parietal bone, followed by implanted with A-PRF or nothing, respectively. The model rabbits were killed immediately, at 2, 4, 8 and 12 weeks after modeling, to grossly observe the bone formation, and the histological changes in the defect region were observed through hematoxylin-eosin staining, Masson staining and immunohistochemistry.RESULTS AND CONCLUSION: Unhealed defects were observed in the blank control group. Gross and histological observations showed that the speed, amount and maturity of bone formation in the A-PRF group were significantly better than those in the blank control group immediately, 4, 8 and 12 weeks after modeling (P < 0.05). Our findings suggest that the rabbit skull bone defect is successfully established. A-PRF can induce osteogenesis, and more mature newly born bones appear with time. Additionally, osteoclasts can act with osteoblasts synergically under the A-PRF induction to promote the bone formation.

Objective To investigate the roles of phosphatase and tensin homolog deleted on chromosome 10(PTEN),insulin-like growth factor 1(IGF-1),and insulin-like growth factor receptor 1 (IGF-1R) in the tumorigenesis,development,invasion and metastasis,and prognostic value of gastric cancer.Methods Immunohistochemical assay was used to detect the expressions of PTEN,IGF-1,and IGF-1R in gastric cancer tissue samples from 74 gastric cancer patients and in normal gastric mucosa of 20 health individuals.All data of these patients were collected including the grading and differentiation of the tumor.Results In gastric cancer,expression of PTEN was decreased,and expressions of IGF-1,and IGF-1R were enhanced.The expressions of PTEN,IGF-1 and IGF-1R had correlation with the outcome and biological behavior of gastric cancer.PTEN expression was higher in no lymph node metastasis group than lymph node metastasis group,higher in stage Ⅰ–Ⅱgroup than stage Ⅲ–Ⅳgroup.IGF-1 and IGF-1R expressions were higher in progressive group than early gastric cancer group,higher in poor differentiation group than moderate and well differentiation group,higher in lymph node metastasis group than no lymph node metastasis group,higher in stage Ⅰ–Ⅱgroup than stage Ⅲ–Ⅳgroup.PTEN-negatively-expressed patients had poor prognosis compared with positively-expressed ones;so did those who expressed IGF-1 and IGF-1R.Conclusion The changes of PTEN,IGF and IGF-1R play roles in gastric cancer genesis,progression and prognostic evaluation.

Objective: To investigate the effects of different concentrations of vitamin E (VE) on angiogenesis and its possible mechanism. Methods: The rings of rat aorta were embedded in gels of collagen and cultured in a serum free medium for 28 days. Curves of microvessels growth were generated by counting the number of newly formed microvessels every day with an inverted microscope. Photos were taken at the same time. Expression of factor FVIII related antigen (FVIII RAg) in newly formed microvessels was detected by immunohistochemistry. Concentration change of FVIII R in medium was evaluated by ELISA. Results: Both 0.2 g/L and 0.1 g/L VE showed significant inhibitory effect on angiogenesis (P0.05). The inhibitory effect of VE was expressed in the phases of microvessel growth and decline (10-25 d). Conclusion: 1.Three dimensional collagen gels culture of microvessel in serum free medium can be used as a sensitive assay for study of soluble and solid phase angiogenic agonists and antagonists. 2. Both 0.1 g/L and 0.2 g/L VE inhibit angiogenesis, and VE has no toxicity and no drug resistance.

OBJECTIVE To study the situation of nosocomial infection of maintenance hemodialysis of chronic renal failure patients and discuss the risk factors and preventive measures.METHODS Retrospective analysis of our hospital clinical data in hemodialysis patients with nosocomial infection from Jan 2005 to Dec 2006 was taken.RESULTS There were 44 nosocomial infection cases from 89 cases.The infection rate was 49.43%.Hemodialysis patients were high-risk population of the nosocomial infection.The common infection site was the respiratory tract(52.27%),followed by central venous catheter-related infections(25.00%),urinary tract infections(15.91%) and intestinal infections(6.82%).The primary diseases of diabetic nephropathy,serious anemia,low albumin and elderly were the risk factors(P

Objective To investigate the function of CFTR in ApoE-/- mice with HHcy-induced hepato-cellular injury. Methods Thirty six 5-week old ApoE-/- mice were divided into three groups , including the ApoE-/- group, the HHcy group and the intervention group, (n = 12). Twelve normal C57BL/6J mice were fed with regular mouse diet as the normal control (SPF grade). HL-7702 human liver cells were intervened by Hcy (100 μmol/L) and 100 μmol/L Hcy + folic acid (100 μmol/L Hcy + F). The changes of Hcy, ALT and AST in the serum and the expression of CFTR mRNA and protein in liver and liver cells were detected. The concen-trations of ALT and AST in the liver cell intervened by VX-770 agonist and CFTR(inh)-172 inhibitor were mea-sured by ELISA. Results Compared with the control group , the levels of Hcy , ALT and AST were higher and the levels of CFTR mRNA and protein were lower in the Meth group (P < 0. 05 ) , while the reverse result in the Meth + F group (P < 0.05). Compared with the control group, the levels of CFTR mRNA and protein were de-creased and the levels of ALT and AST were increased in the 100 μmol/L Hcy group (P < 0.05). Compared with the 100 μmol/L Hcy group , the levels of CFTR mRNA and protein were increased and the levels of ALT and AST were decreased in the 100 μmol/L Hcy + F group (P < 0.05). Stimulated with VX-770 can reduce the concentrations of ALT and AST and the vice versa in the CFTR (inh)-17 group the concentration was increased in liver cells. Conclusion CFTR plays an important role in the regulation of hepatocellular injury by HHcy.

Objective To explore the genetic etiologies in 2 siblings with different epileptic encephalopathies (EEs) diagnosed as Ohtahara syndrome(OS) and atypical benign partial epilepsy(ABPE) from one family.Methods The 2 brothers were diagnosed at the Pediatric Neurological Clinic of Peking University First Hospital in September 2013,whose clinical data were collected.The coding region of the syntaxin-binding protein 1 gene (STXBP1) and glutamate receptor subunit gene (GRIN2A) were detected by using Sanger sequencing in the 2 siblings.For the elder brother,targeted next-generation sequencing was further performed to detect the genes associated with epilepsy.Results The younger brother manifested focal motor seizures and tonic spasms in cluster at the age of 1 month.Interictal electroencephalogram (EEG) showed suppression-burst pattern.He was diagnosed as OS.The elder brother had seizure onset at age of 6 years old.Focal motor seizure during sleep was his seizure type.His EEG showed interictal discharges in Rolandic area primarily.Electrical status epilepticus during sleep,epileptic negative myoclonus and intellectual disabilities occurred during the course.He was diagnosed as ABPE.Brain magnetic resonance imagines for both of them were normal.Screening of STXBP1 mutations for the younger brother found a de novo heterozygous mutation:c.1672C ＞ T (p.Q558X).Gene detection for the elder brother and the parents showed negative results.Conclusions Coexistence of distinct EEs was reported in 2 brother siblings:the younger brother had OS associated with a novel nonsense mutation in STXBP1,and the elder brother had ABPE without genetic evidence.This study indicated that different pathological mechanisms might exist underlying the two different EEs in a family.

Objective To investigate clinicopathological features,diagnosis and treatment of cutaneous Merkel cell carcinoma (MCC).Methods CNKI,Wanfang,Vip databases were searched for reported domestic cases of MCC from January 1,1986 to October 1,2017,and clinical data were collected,and retrospectively analyzed and summarized.Results During 31 years between 1986 and 2017,a total of 171 domestic cases of MCC were reported.There were 78 males and 93 females,and the ratio of male to female was 1:1.19.Of the 171 patients,136 (79.5％) were aged more than 50 years,and lesions mostly occurred on the head and face or extremities in 139 (81.3％) patients.Clinically,149 (87.1％) patients were misdiagnosed as tumor of unknown origin (89 cases,52％),malignant lymphoma (34 cases,19.9％),benign tumors (15 cases,8.8％) or non-tumor diseases (11 cases,6.4％).As for clinical stage,84 (49.1％) patients had stage Ⅰ MCC,and 49 (28.6％)had stage Ⅱ MCC.One patient received immunotherapy,and 165 patients underwent surgical resection,including 91 patients receiving surgery alone,24 patients treated with postoperative radiotherapy,19 patients treated with postoperative chemotherapy,and 31 patients receiving postoperative chemoradiotherapy.Five patients did not describe the treatment.Among 74 patients who were followed up after the surgery,one-year survival rate and five-year survival rate were 52.7％ and 6.8％ respectively.The five-year survival rate was 6.1％ in the patients with stage Ⅰ MCC,5.6％ in those with stage Ⅱ MCC,and 0 in those with stage Ⅲ and Ⅳ MCC.Conclusions In China,cutaneous MCC mostly occurs on the head,face,neck and extremities of the middle-aged or elderly,with a high misdiagnosis rate.Surgical excision combined with radiotherapy or chemotherapy is a frequently used treatment protocol in China,but the prognosis is always poor.