Objective To evaluate the efficacy and safety of intravenous cefmetazole in the treatment of patients with aspiratory pneumonia. Methods A multicenter, prospective and open-labeled trial was conducted. A total of 1522 patients were enrolled at the beginning, and only 1324 were evaluabled at the endpoint. The duration of treatment was 7-14 days. During the treatment and follow-up periods, we recorded any unexpected symptoms and abnormal laboratory tests. At last,we evaluated its efficacy and safety. Results The total effective rate of cefmetazole was 79. 8% (1056/1324). The total bacterial eradication rate was 75.0% ( 342/456 ) . The bacterial eradication rates of klebsiellar pneumonia, escherichia, staphyloccocus aureus and anaerobic bacteria were 78.2% (97/124), 80.8% (80/99), 89.0% (81/91), 9/11,respectively. Conclusions Cefmetazole is effective and safe in the treatment of aspiratory pneumonia.

Objective To investigate the effect and safety of long-term use of atorvastatin on carotid atherosclerosis in advanced elderly patients.Methods Totally 61 elderly patients with carotid atherosclerosis were permitted into study.They were treated with atorvastatin (20 mg/d) and followed-up for five years.The carotid atherosclerosis parameter and the serum levels of TC,TG,LDL-C,HDL-C,fasting blood glucose (FBG),ALT,AST,STB,CB,Bun,Cr and creatine kinase (CK) were measured before and 5 years after treatment.Results During fellow-up,2 patients died of severe pneumonia and 1 patient died of operation complications of intestinal obstruction,with mortality rate of 4.9％.2 patients (3.4％) gave up treatment because of muscle-related side-effect.Data was collected in 56 patients achieving study end.There was significant decrease in LDL-C (P＜0.05) and increase in HDL-C (P＜0.05),but there was no change in serum levels of TC,TG,FBG,ALT,AST,STB,CB,BUN,Cr and CK (P＜0.05) after 5 years.The total area of carotid atherosclerosis plaque was reduced [(0.63±0.41)cm2 vs.(1.07±0.67)cm2,P＜0.05] and echo of carotid atherosclerosis plaque was enhanced (2.67±0.52 vs.1.53±0.44,P＜0.01),but carotid intima-media thickness(IMT) appeared no change after five years.Conclusions Atorvastatin is safe in the treatment of advanced elderly patients,it can make carotid atherosclerosis plaque smaller and stable after long-term treatment.

Objective To observe the clinical effectiveness of calcium sodium phosphosilicate desensitizer for the treatment of root-dentin hypersensitivity.Methods This was a randomized,single-blind,placebo controlled pilot study.135 subjects,a total of 215 teeth with a confirmed diagnosis of root-dentin hypersensitivity were randomly divided into three groups:group 1 (patients treated with 100％ calcium sodium phosphosilicate powder with 7％ calcium sodium phosphosilicate toothpaste),group 2 (patients treated with a placebo powder with 7 ％ calcium sodium phosphosilicate toothpaste),group 3 (patients treated with a placebo powder vith 0.11％ NaF toothpaste).Two standard test stimuli,cool air and cold water,were applied to sensitive root surfaces.Subjects recorded the intensity of sensitivity in response to each stimulus on a visual analogue scale (VAS) at baseline,immediately after powder application and after 2,4 and 6 weeks of twice-daily product use.Results The VAS values stimulated by cool air immediately,and 2,4 and 6 weeks after the treatment were [[(4.87±1.98),(3.85±1.09),(2.03±1.16),(0.59±0.51),respectivly] in Group 1; [(6.35±1.84),(4.83±0.75),(3.17±1.12),(1.45±0.91),respectively] in Group 2; [(6.83±0.78),(6.73±1.54),(5.441.58),(4.18±0.98),respectively] in Group 3.The VAS values stimulated by cold water immediately,and after 2,4 and 6 of treatment were [(6.43±1.01),(4.95±1.21),(3.06±0.86),(1.38±0.92),respectively] in Group 1; [(7.72±0.56),(5.65±0.69),(3.81±0.41),(2.17±0.58),respectively] inGroup2; [(8.380.89),(8.17±1.02),(7.99±0.74),(6.46±0.77),respectively] in Group 3.Compared with before treatment,there were significant differences in VAS values stimulated by the two tests at all time points in Group 1,and after 2,4 and 6 weeks of treatment in Group 2 (all P ＜0.05).Group 3 had significant differences in VAS values stimulated by cool air after 4 and 6 weeks of treatment,and had a significant difference in VAS values stimulated by cold water after 6 weeks of treatment (all P＜0.05).There were significant differences between group 1 and group 2 in the hypersensitivity reduction over baseline by two stimuli at all time point.Conclusions The 7％ calcium sodium phosphosilicate toothpaste shows a good performance in relieving the root dentin hypersensitivity.Moreover,the 100％ calcium sodium phosphosilicate powder can enhance the effectiveness of the 7％ calcium sodium phosphosilicate toothpaste.

Objective:To investigate the mechanism of lung injury after cardiopulmonary resuscitation(CPR) in rats. Methods: Cardiac arrest was induced by asphyxiation(succinylcholine) and ice-cold 0.5 mol/L KCl in rats and CPR was carried out 5 min after arrest. Sixteen adult male Sprague-Dawley rats were randomly allocated into 2 groups:control group(n=8) and CPR group(n=8). The blood gas analysis,serum level of tumor necrosis factor ?(TNF-?),lung tissue wet mass/dry mass ratio(W/D),lung malondialde-hyde(MDA) content and myeloperoxidase(MPO) activities were measured 3 h after CPR. The histological appearances of the lungs were observed under light and electron microscope. Results: Compared to the control group,the lung W/D,serum TNF-?,pulmonary MDA and MPO activity increased dramatically in CPR group while PaO 2 decreased 3 h after resuscitation(P

ObjectiveTo study the diagnosis and treatment of peripelvic cysts.MethodsA view of the diagnosis and treatment of 14 cases and an evaluation of the different means of diagnosis and treatment were carried out.Results12 cases were followed up for 6～48 months post-operatively.11 cases were well recovered,with no reoccurrence or complication,and in 2 the high blood pressure dropped to normal whereas repeated urinary infection has been noted postoperatively in 1.ConclusionsB supersonic exam,KUB+IVU,CT exam are the most effective means to the diagnosis of this disease,CT exam being the first choice.Open renal cystectomy is indicated.

In recent years, with the application and exploration of fluorescence imaging technology in pancreatic surgery, it has brought new changes and new hope for the intraoperative treatment of pancreatic diseases. Intraoperative fluorescence imaging with indocyanine green (ICG) as probe is increasingly applied in identify neoplasms, real-time margin assessment, tissue perfusion, lymph node detection, anastomotic leakage and so on, which provides a new means for intraoperative decision-making. This article reviewed the progress in the application of ICG fluorescence imaging in pancreatic surgery.

BACKGROUND: Intestinal tract factors, especially intestinal ischemiareperfusion, can induce the injury of remote organ. Chinese herb, rhubarb,can clear oxygen free radical to promote the proliferation of beaker cell in intestinal mucous membrane, inhibit excessive multiplication of bacterium and endotoxin absorption in the intestinal tract, activate blood circulation and remove blood stasis, improve microcirculation and other ways to protect intestinal mucous membrane barrier, so as to prevent and treat pulmonary injury.OBJECTIVE: To observe the preventing and treating effect of rhubarb on intestinal ischemia/reperfusion-induced pulmonary injury and the effect of rhubarb on tumor necrosis factor and phospholipase A2 (PLA2).DESIGN: A randomized controlled observation.SETTING: Department of Emergency, Urumqi General Hospital of Lanzhou Military Area Command of Chinese PLA.MATERIALS: This experiment was carried out in the Second Military Medical University of Chinese PLA from February to July 2003. Totally 80SD rats were selected and randomly divided into intestinal ischemia/reperfusion group (n=24), sham operation group (n=46), treatment group (n=24) and normal saline group (n=16).METHODS: In the intestinal ischemia-reperfusion group, rats were fasted before operation. They were anesthetized and given a median abdominal incision. Superior mesenteric artery was isolated and occluded by vascular clamp without wound, and then the incision was sutured; 45 minutes later,vascular clamp was taken out to recover blood supply. For the treatment group, modeling was the same as that in the intestinal ischemia/reperfusion group, 600 mg/kg suspension of rhubarb extract was gastrointestinally perfused into the rats 30 minutes before recovering blood supply. For the normal saline group, modeling was the same as that in the intestinal ischemia/reperfusion group; same dosage of normal saline was gastrointestinally perfused into the rats 30 minutes before recovering blood supply. For the sham operation group, occlusion of superior mesenteric artery was omitted. Taking pathological change and 125I-labeled bovine serum albumin pulmonary uptake index as the index to evaluate pulmonary injury, TNF content and serum of pulmonary tissue and PLA2 activity of lung and intestinal tissue of animals in each group were measured respectively at different time points.MAIN OUTCOME MEASURES: 125I labeled bovine bovine serum albumin uptake index, tumor necrosis factor content of blood and pulmonary tissue, and PLA2 activity of serum, lung and intestinal tissue RESULTS: ① Pathological and morphological change of pulmonary tissue: There was no obvious abnormality in the sham operation group; In the intestinal ischemia-reperfusion group, 6 hours later, pulmonary interstitial edema, neutrophile infiltration appeared and alveolar edema was also found, and there were a little haemorrhage and exudation of fibrin. Only mild pulmonary interstitial edema and a small quantity of neutrophiles were found in the treatment group. ② Ultramicro-pathological change of pulmonary tissue: There was no obvious change in the sham operation group. In the intestinal ishcemia/reperfusion group, 6 hours later, pulmonary capillary endothelial cells were swelled and neutrophilic granulocyte leaked into pulmonary stroma and alveolar space. There were no above changes in the treatment group. ③ Change of tumor necrosis factor of pulmonary tissue in the sham operation group or treatment group (reperfusion for 30 minutes) was significantly lower than that in the intestinal ischemiareperfusion group (reperfusion for 30 minutes) (0.235±0.114,1.374±0.550,16.315±4.587,P ＜ 0.01). ④125I-BSA pulmonary uptake index in the treatment group was significantly lower than that in the intestinal ischemiareperfusion group and normal saline group (P ＜ 0.01), without significant difference in comparison with sham operation group (P ＞ 0.05).CONCLUSION: Early application of rhubarb is helpful to prevent and treat lung injury following small intestine ischemic reperfusion, so as to inhibit tissue disease course to deve1op multiple organ dysfunction syndrome,which might be implemented through inhibiting the release of TNF and PLA2 and other media.

Objective To observe the effect of two different periodontal therapies on serum levels of C-reactive protein (CRP) and tumor necrosis factor-alpha(TNF-α)in elderly patients with coronary heart disease.Methods Totally 42 elderly patients with severe periodontitis were randomized into two groups:periodontal initial therapy and periodontal flap surgery group.The percentage of bleeding on probing (BOP),probing depth (PD) and serum levels of CRP and TNF-α were recorded at baseline and 12 weeks after treatment.Results The percentage of BOP,PD and serum levels of CRP and TNF-α in all patients were significantly reduced at 12 weeks after treatment as compared with baseline (all P＜0.05).Serum levels of CRP and TNF-α were lower in periodontal flap surgery than in periodontal initial therapy at 12 weeks after treatment [(3.4±9.1) μg/L vs.(2.6 ±7.9)μg/L,(4.4±1.8)mg/L vs.(3.5±2.1)mg/L,both P＜0.05].Conclusions Compared with periodontal initial therapy,periodontal flap surgery maybe better to reduce the levels of serum inflammatory markers.

Objective To observe the effect of icarrin on proliferation and differentiation of rat osteoblasts cultured in vitro as well as the expressions of bone morphogenetic protein-2 (BMP-2) and Osterix in rat osteoblast.Methods Calvarial osteoblasts were obtained from newborn (＜ 24 h) SD rats by trypsin-collagenase digestion.The culture medium with different icarrin concentrations and the second generation osteoblasts were mixed.The mRNA expressions of BMP-2,Osterix,ALP,and Col Ⅰ were detected by semiquantative RT-PCR.Then the second generation osteoblasts were cultured in the medium containing icariin (10 ng/ml) with or without BMP-2 antibody.After48 h,RT-PCR was used to estimate the mRNA expression of Osterix.Results In comparison with the control group,the mRNA expressions of BMP-2,Osterix,ALP,Col Ⅰ were increased in a dose-dependent manner (P＜0.05) with a maximal effect at the concentration of 10 ng/ml.The mRNA expression of Osterix treated with the mixture of icarrin and BMP-2 antibody was significant decreased(P＜0.05),and compared with the group of icarrin,however,the difference between the BMP-2 group and the mixture group was not statistically significant (P ＞ 0.05).Conclusions Icarrin stimulates proliferation and differentiation of cultured osteoblast in vitro by increasing the mRNA expression of ALP and Col Ⅰ.Icarrin could stimulate Osterix gene expression by enchancing BMP-2 gene expression,finally,it could induce bone formation and prevent and/or treat osteoporosis.

Objective To investigate the long-term effect of direct percutaneous coronary intervention (PCI) on left ventricular remodeling in patients aged ≥75 years with acute myocardial infarction (AMI).Methods 108 cases of patients with acute myocardial infarction were collected into the study.Direct PCI were completed in patients in PCI group within 12 hours of onset.Patients in non-PCI group received conventional conservative treatment with drugs.Patients were followed up for 0.5-8.0 years,and cardiac function (NYHA) and the detected ultrasonic cardiogram were evaluated during follow-up.Results The 106 patients received follow-up.Two female patients who were not treated with PCI died during follow-up,one patient died of sudden cardiac death and another patient died of severe pneumonia.Compared with non-PCI group,direct PCI group showed that cardiac function (NYHA) grade was lower(t=3.17,P＜0.05),the end-systolic and end-diastolic volume of left ventricle were less(t=3.50、3.90,all P＜0.01),the left ventricular ejection fraction was increased (t=2.00,P＜0.05),the ventricular wall motion index was smaller (t=2.96,P＜0.01).E/A ratio was higher,E wave deceleration time was shorter,and left ventricular mass index was smaller (t=4.04,4.29,4.70,respectively,all P＜0.01),the left ventricular long and short axis diameter were decreased (t=2.30,t=5.53,P＜0.05 or 0.01),and Spherical index was increased (t=2.97,P＜0.01).Conclusions Direct PCI treatment improves chronic ventricular remodeling in elderly patients with AMI and contributes to long-term improvement in cardiac function.