Objective To compare the clinical efficacy of different trough concentrations of vancomycin in patients.Methods A retrospective study in patients having at least one trough concentration of vancomycin for enrollment between January 2009 and December 2013 was carried out.The eligibility patients were divided into 3 groups according to the level of trough concentrations namely group A (＜ 10 mg/L),Group B (10 ～ 15 mg/L),and Group C (＞ 15 mg/L).The clinical efficacy,clearance of pathogens and in-hospital mortality were analyzed with the help of SPSS Statistics 17.0.The comparison of dosing days,length of hospital stay and time consumed from initial dosing to the appearance of recovery signs of survivors among the 3 groups.Results There were no significant difference among 3 groups in terms of clinical efficacy (55.6％ vs.33.3％ vs.51.7％),clearance of pathogens (38.9％ vs.25％ vs.24.1％) and in-hospital mortality (44.4％ vs.25％ vs.27.6％).After adjusting by age,the in-hospital mortality decreased along with the trough concentrations vancomycin.Along with increase in the trough concentrations vancomycin,the dosing day (14.90 ± 6.44 vs.18.75 ± 7.23 vs.17.93 ± 9.42) and length of hospitalization [(33.70 ± 18.17) vs.(79 ±45.53) vs.(66.20 ±52.48)] increased,and time required from dosageinitial dosing to the appearance of recovery signs of survivors among the 3 groups [(4.82 ± 2.62) vs.(3.75 ± 0.50) vs.(4.07 ± 3.20)] shortened.Conclusions Improving the trough concentrations of vancomycin could not increase clinical efficacy rate or bacterial clearance rate,but could lower in-hospital mortality.However,it might enhance the financial burden on patients as well.

Objective To observe the influence of chlorderazin on the change of L-arginine transport in human erythrocytes induced by oxidized low density lipoprotein. Methods Human erythrocytes were obtained from six healthy donors. The study included three groups: Gr1 (control)? Gr2 (incubated with OX-LDL) and Gr3 (incubated with OX-LDL and chlorderazin, a PLA 2 inhibitor). The 3H-L-arginine transport was measured.Results Compared with Gr1, the Vmax for the total transport of L-arginine in erythrocytes in Gr2 decreased by 33%, and Km value increased. Compared with Gr2, the Vmax for the total transport and the transport via system y+ of L-arginine in erythrocytes in Gr3 increased by 37% and 25% respectively, and Km values decreased for both. But the change of L-arginine transport by system y+L was not statistically significant.Conclusion OX-LDL could inhibit L-arginine transport in human erythrocytes, which could be reversed by chlorderazin, a nonspecific PLA 2 inhibitor.

Objective:To explore feature of clinic and coronary angiography (CAG)of acute myocardial infarction (AMI)for young adults less than 30 years old.Methods:A total of 41 AMI patients,who were under 30 years old and hospitalzed in our hospital from 2004 to 2012,were enrolled as young group.Another 360 AMI patients >50 years were randomly selected as middle-aged group during the same time.Clinical features and CAG results were compared between two groups.Results:Compared with middle-aged group,there were significant rise in percenta-ges of male (68.1% vs.97.6%),smokers (50.6% vs.80.5%)and hypercholesterolemia (59.2% vs.65.9%)and body mass index [(22.3±6.6)kg/m2 vs.(26.3±9.6)kg/m2 ],and significant reduction in percentages of hyper-tension (63.1% vs.24.4%)and diabetes mellitus (30.6% vs.4.9%)in young group,P<0.05 or <0.01;for ex-citing cause,percentages of psychological factors such as tension and anxiety (29.3% vs.3.6%),staying up late (39.0% vs.2.8%)and heavy drinking (14.6% vs.4.7%)in young group were significantly higher than those of middle-aged group,while percentages of agitation (8.3% vs.0)in middle-aged group was significantly higher than that of young group (P<0.05 or <0.01).For CAG results,young group was mainly single vessel coronary disease (56.1%),which were mainly type A (53.7%)and type B1 (29.3%)lesions,while middle-aged group was mainly multi-vessel coronary disease (48.1%),which were mainly type B2 (29.7%)and type C (33.9%)lesions,and there were significant difference between two groups (P<0.05 or <0.01).Conclusion:Smoking,obesity and hy-perlipidemia are the most important risk factors for acute myocardial infarction;the major exciting causes are sta-ying up late,alcohol drinking and high mental stress etc.in young AMI patients;their coronary lesions are mainly single vessel coronary disease,and of type A and type B1 .

Objective To summary the color Doppler imaging feature of localized Castleman disease.Methods From January 1997 to November 2011,32 localized Castleman diseases which were proved by pathology were analyzed.Results Round-like,hypoechoic,hypervascular lesions were showed in 23 hyalinevascular type lesions,2 of them with calcium,3 of them with structure liked lymph node hilum.Round-like,hypoechoic,hypervascular lesions or normal lymph node were showed in 5 plasma- type lesions and 4 mixed type lesions.Conclusions When round like,hypoechoic,hypervascular lesion is found by ultrasonography,Castleman should be considered.Calcium or lymph nod hilum-like structure is special finding in diagnosis of Castleman disease by ultrasonography.

Objective To evaluate the effects of different concentrations of remifentanil on the expression and distribution of gap junction protein connexin 43 (Cx43) in the cardiomyocytes of rabbits.Methods Healthy adult rabbits of both sexes,weighing 2.0-2.5 kg,were anesthetized with pentobarbital sodium.Their hearts were rapidly excised and retrogradely perfused in a Langendorff apparatus with K-H solution saturated with 95％ O2-5％ CO2 at 37 ℃.After 15 min of stabilization with K-H solution,the 24 isolated hearts were randomly divided into 4 groups (n =6 each) using a random number table:control group (group C),and low,medium and high concentrations of remifentanil groups (R1-3 groups).The hearts were continuously perfused with K-H solution at 37 ℃ in group C.The hearts were perfused for 60 min with K-H solution containing remifentanil 12,25 and 50 ng/ml in R1-3 groups,respectively.The myocardial specimens were then obtained from the anterior wall of the left ventricle for detection of the expression and distribution of Cx43 by Western blot and immunohistochemistry,respectively.Results The expression of Cx43 was gradually down-regulated in C and R1-3 groups in turn (P＜0.05).Compared with group C,there was a tendency for the proteins localized at end-to-end contact sites of ventricular cardiomyocytes to localize at side-to-side contact sites in R1-3 groups,and the distribution was messy in R1-3 groups.Conclusion Remifentanil dose-dependently down-regulates the expression of Cx43 and changes the distribution of Cx43,which may be one of the mechanisms of remifentanil-induced arrhythmia in rabbits.

Objective:To study the qualitative identification and quantitative analysis of Paeoniae radix Rubra in Fufang Fuqing lotion. Methods:TLC was used to identify Paeoniae radix Rubra. The content of paeoniflorinl was determined by HPLC. The mobile phase was acetonitrile-0. 01% phosphonic acid (13 ∶87), and the detection wavelength was 230 nm,the flow rate was 1. 0ml·min-1, the column temperature was 40℃,and the sample size was 10μl. Results:The results of TLC showed that the relevant spots were clear without any interference from the negative sample. The calibration curve of paeoniflorinl was linear within the range of 0. 070-4. 500 μg (r=1. 000 0). The average recovery was 98. 36% with RSD of 2. 73%(n=6). Conclusion:The methods are accurate and quick in the qualitative identification and quantitative assay of the preparation, which can be used for the quality control of Fufang Fuqing lo-tion.

Objective To observe the clinical efficacy of point injection at Xialiao point (BL 34) for levator ani syndrome. Methods A hundred levator ani syndrome patients were randomly allocated to a treatment group and a control group, 50 cases each. The treatment group received point injection at Xialiao point (BL 34) and the control group was intervened by biofeedback therapy. The Visual Analogue Scale (VAS), component scores of the MOS 36-item Short-From Health Survey (SF-36), anal resting and squeeze pressures were recorded in the two groups before and after the treatment. The therapeutic effects and therapy costs were compared between the two groups.Results The VAS, component scores of SF-36, anal resting and squeeze pressures were significantly changed after intervention in the two groups (P<0.05). After treatment, the VAS, a part of the SF-36 score [physiological function (PF), body pain (BP), vitality (VT) and social function (SF) scores], anal resting and squeeze pressures in the treatment group were significantly different from that in the control group (P<0.05). The total efficacy rate was 88.0% in the treatment group versus 80.0% in the control group, and the difference was statistically significant (P<0.05). The therapy costs in the treatment group were (327.31±13.42) RMB and (408.45±21.56) RMB in the control group, and the difference was statistically significant (P<0.01).Conclusions Point injection at Xialiao point (BL 34) is an effective method for levator ani syndrome.

Objective: To compare the contents of saikosaponin a, d and total flavonoids in different parts of Hollow bupleurum to provide reference for the clinical use of medicinal parts.Methods: The determination was performed on a SHIMADZU Inertsil C18(250 mm×4.6 mm,5 μm)column.The mobile phase consisted of acetonitrile and water with the ratio of 40∶60, and the flow rate was 1.0 ml·min-1.The detection wavelength was 210nm, the column temperature was 40℃, and the injection volume was 10 μl.A colorimetric method was used to detect total flavonoids with the detection wavelength of 500 nm.Results: The calibration curve of Saikosaponin a, d and total flavonoids showed a good linear relationship respectively over the range of 0.21-1.26 mg·ml-1(r=0.999 6),0.25-1.51 mg·ml-1(r=0.9997) and 4.00-25.00 μg·ml-1(r=0.999 6).The average recovery was 99.27%(RSD=2.15%, n=6),99.4%(RSD=2.14%,n=6)and 99.03%(RSD=1.34%,n=6), respectively.The content of saikosaponin a and d respectively was 0.31% and 0.50% in the root, while that in the other parts was low.The content of total flavonoids was as high as 8.48% in flowers, and that in leaves, stem and root reduced in turn.Conclusion: The aerial parts of Hollow bupleurum are rich in flavonoids, and the content of saikosaponin in root is higher, therefore, the whole plant with root is more reasonable in the clinical use.

With the roaring development of bioscience and its application in medicine, molecular diagnosis specially gene diagnosis shows striking advantages in disease diagnosis, treatment and prognostic assessment.Mo-lecular diagnosis mainly includes prenatal genes diagnosis the children of gene diagnosis and adult genetic diagno-sis.Molecular diagnosis is expounded from the aspects of medical practice in the field of medical ethics problem and how to correct the medical practice of molecular diagnosis of work, designed to guide all the medical workers to form the correct ethics in the field of molecular diagnostics.

Hepatitis C virus (HCV) genome is of high variation,which results in persistent infection of HCV and increases the incidence of liver cirrhosis and hepatocellular carcinoma.Following the successful paradigm established for HIV protease inhibitors,HCV NS3-4A serine protease has been selected as the main target for the development of small molecule antiviral agents.In this article,we review recent progress in the discovery and development of HCV NS3-4A protease inhibitors,and discuss their antiviral activities,pharmacokinetic properties,side effects and resistance profiles.