OBJECTIVE To evaluate the efficacy and safety of meropenem as first choice for hospital acquired pneumonia(HAP) treatment in intensive care units(ICU) in Southwest Hospital. METHODS The usage of meropenem for the patients with HAP in ICU was studied by a prospective,open,and non-comparative trial.Prior to the clinical trial,the preliminary experiment on etiologic investigation was done through bronchoalveolar lavage and blood cultures.In the trial,all patients were treated intravenously with meropenem at a dose of 1g every 8 hours and(3 to 7 days) were established as a treatment duration period. RESULTS After the meropenem therapy,35 patients(66%) showed either cure or improvement.Mortality was 11% at the end of therapy.Clinical complications were observed in 11 patients(21%),with none of them definitely related to the study drug. CONCLUSIONS Meropenem is effective and well-tolerated as monotherapy for most HAP patients in our ICU.The low mortality rate in this study might have been attributed to the first choice use of this drug.

ObjectiveTo investigate the mechanism by which tetracycline inhibits the development of experimental abdominal aortic aneurysms (AAA).MethodsMale Wistar rats underwent intraluminal perfusion of the abdominal aorta with 50 units of porcine pancreatic elastase followed by treatment for 14 days with tetracycline (25?mg/day, subcutaneously; n=10) or with NS alone (n=10). Aortic wall elastin and collagen concentrations were measured with image analysis system and fixed aortic tissues were examined by light microscopy for inflammation. The expression of MMP-2 and MMP-9 were observed in aortic tissues using immunohistochemistry and molecular in situ histohybridization technique. Results AAAs developed in all NS-treated rats, and only 1/10 of tetracycline-treated rats at 14 days(P

Objective:To construct a canine thoracic aortic dissection(TAD) model for later studying. Methods:The soft tube with graduation and the puncture needle were used to produce the appliance for making TAD model.Under X ray, the appliance was placed into the canine thoracic aortic for elastin enzyme perfusion through iliac arteries or abdominal aorta. Results:TAD were showed instantly,2 weeks and 1 month later by angiography. Conclusion:This appliance can construct a canine TAD model.

Humans ; Renal Artery Obstruction ; therapy ; Stents

Objective To explore the characteristics of illness attribution of outpatients with multiple somatic symptoms in Peking Union Medical College Hospital. Methods It was a cross-sectional study conducted from March to October,2012. A total of 150 outpatients were recruited from the departments of Gastroenterology,Traditional Chinese Medicine and Psychological Medicine by convenience sampling. Somatic symptom scale of the Patient Health Questionnaire (PHQ-15) was used to screening each patient in the waiting list. With the cut-off value of 10,patients were divided into the somatic symptom positive (SOM+) group and somatic symptom negative (SOM-) group. Sociodemographic characteristics were compared between these two groups. All the subjects completed interviews including questions about illness attribution. All the answers of illness attribution were concluded into three major groups as physical factors,situational factors and psychological factors. Results The proportion of female was significantly higher in SOM+ group than in SOM-group (69.3% vs. 53.3%;χ=4.048,P=0.044). In SOM+ group,significantly more patients contributed their illness to psychological factors (64.0% vs. 45.0%;χ=5.273,P=0.022). There was no significantly difference between SOM+ group and SOM-group on the phenomenon of multiple illness attribution (41.0% vs. 32.0%;χ=1.407,P=0.236). However,in the Department of Gastroenterology,there were significantly more outpatients in SOM+ group with multiple illness attribution (60.0% vs. 32.0%;χ=3.945,P=0.047).Conclusions The outpatients in general hospital with multiple somatic symptoms are more likely to contribute their illness to psychological factors. The phenomenon of multiple illness attribution is common among patients. Clinicians should increase their awareness and knowledge of illness attribution,so as to provide better holistic health services.

Objective Labial gland biopsy is one of major diagnostic methods for Sj(o)gren's syn-drome(SS).Meanwhile,99TcmO-4 parotid scintigraphy has been proven useful for the clinical evaluation of SS.This study was performed to investigate the correlation between the two examinations and evaluate the semi-quantitative parotid scintigraphy in the early diagnosis and staging for SS patients.Methods There were 135 SS patients and 30 normal subjects as control group in this study.They all underwent 99TcmO-4 pa-rotid scintigraphy.Semi-quantitative analyses of parotid scintigraphy were conducted with parameters inclu-ding maximum accumulation ratio (MAR),maximum secretion ratio(MSR),time interval from stimulation to minimum count(tparotid),prestimulatory oral activity index (PRI) and poststimulatory oral activity index (POI).For comparison, the biopsy of labial gland was performed in each patient and the pathological se-verity was classified into grade 0,1,2,3,4 (also defined as subgroups).One-way ANOVA and q-teat were applied for the correlation analyses between the two examinations.Results There was significant difference between pathological subgroup 3 or subgroup 4 and the control in all the semi-quantitative parame-ters (q=6.79-38.64,P<0.O1).In subgroups 1 and 2,only PRI and POI showed significant changes compared with the control(q=8.33,8.63,all P<0.01).The pathological stages were negatively correla-ted with MAR(r=-0.679,P<0.01),MSR(r=-0.601,P<0.01),PRI(r=-0.724,P<0.01)and POI(r=-0.751,P<0.01),but only positively correlated with tparotid(r=0.364,P<0.01).Con-clusions Most semi-quantitative parameters of 99TcmaO-4 parotid scintigraphy may be well correlated with the pathological severity of labial gland biopsy in SS patients.Further,the semi-quantitative indices espe-eially PRI and POI may be helpful for the early diagnosis and staging of SS patients.

Objective To evaluate the surgical treatment of carotid artery stenosis. MethodAccording to the level and degree of the stenosis, different operations were performed on 120 patients who suffered from the extracranial carotid stenosis. Treatment result was retrospectively reviewed. ResultSurgery was successful in all the patients. We performed carotid endarterectomy on 111 cases and other operations on 9 cases. The incidence of postoperative complications was low, especially for carotid endarterectomy. ConclusionCarotid endarterectomy is still the main therapy for the treatment of carotid artery stenosis with a satisfactory result.

Objective To investigate 13 high-risk types of HPV (HR HPV) infection rates in women with different grades of cervical lesions.Methods A total of 350 women, who were hospitalized in the department of gynecology in Bao′an Maternity & Child health hospital, were enrolled for the study.TCT technology was used to evaluate the cervical epithelium.The group were divided according to the cytology results.Multiplex real time PCR (mRT PCR) was used to detect the viral loads.HR HPV infection rate of different groups were analyzed using χ2 test or Fisher exact test.HR HPV viral loads of patients in different grades of cervical lesion groups were compared using Kruskal-Wallis or Wilcoxon test, and the age distribution of HR HPV positive group and negative group was analyzed by using Wilcoxon test.Results The HR HPV infection rates of NILM, ASCUS, LSIL, HSIL were 3.4% (10/295), 20.0% (7/35), 78.6% (11/14) and 100.0% (6/6), respectively.HR HPV positivity in NILM was lower than ASCUS (χ2=14.43,P<0.01) and LSIL (χ2=107.69,P<0.01), HR HPV positivity in ASCUS was lower than LSIL (χ2=14.76,P<0.01). The median of HR HPV viral loads in NILM, ASCUS, LSIL and HSIL were 4.10 (3.38-6.27), 5.33 (3.63-6.66), 5.77 (4.01-7.01) and 5.58 (4.19-5.85) respectively (copies/ml,lg).Combined ASCUS, LSIL and HSIL groups into cervical lesion group, HR HPV viral load of which was higher than that of NILM (U=43.0, P<0.05).The median Ages of HR HPV positive group and negative group were 36 and 33, respectively.No statistical significance was found between them (U=4 544, P>0.05).Conclusions The present study revealed that HR HPV infection was related to cervical lesion, but there was no correlation between viral load and cervical lesion grade. In additional, no difference in age distribution was found between HR HPV positive group and negative group.

Objective To analyze and determine the clinical, molecular pathology and genetic features of a Chinese family with dystrophinopathy. Methods Clinical data of the proband and his family members were collected. Immunohistochemistry staining was performed on muscular biopsy tissues with antimerosin, emerin and the N, C and central rod domains of dystrophin. Genomic DNA was extracted using standard procedures from the peripheral blood leukocytes. Multiplex ligation-dependent probe amplification (MLPA) was used to test Duchenne muscular dystrophy (DMD) gene to determine the ways and sites of genetic mutation, and analyze the relationships between genotype and phenotype. Results Patients from this family were clinically diagnosed as muscular dystrophy, and they presented serious manifestations although the immunohistochemistry analysis for the proband exhibited partial loss of dystrophin staining, and positive expression with merosin and emerin. Further test with MLPA detected the loss of exons 45--54 in DMD gene in the proband, while his mother had heterozygositic loss in exons 45--54. Conclusions The losses of exons 45--54 in the proband are all derived from his mother, who carries genetic mutation with normal phenotype. He has been diagnosed as dystrophinopathy. At the same time, his partial loss of dystrophin is not parallel to the out-of-frame mutation of the gene and his severe clinical manifestations. Abnormal expression of dystrophin is the pathological basis for dystrophinopathy phenotype. Its clinical outcome depends not only on the degree of the protein expression, but also on the function of the sites where the DMD gene less occurs.

This study was aimed to explore the effect of Periplaneta Americana against alcohol-induced liver injury in mice, in order to provide a theoretical basis for the industrial production of P. Americana. Kunming mice were randomly divided into six groups, which were the normal group, model group, positive group, high-, middle-, low-dose of P. Americana groups. Intragastric administration of Tiopronin Enteric-coated Tablets 100 mg·kg-1 was given to the positive group. Intragastric administrations of whole powder of medicine were given to the high-, middle-, low-dose groups with the dosage of 6.667, 3.333, 1.667 g·kg-1, respectively. The drugs were given daily for 10 con-secutive days. After 3h of the 10th day drug administration, intragastric administration of distilled water was given to the normal group, while 14mL·kg-1 of 56℃ Red Star Liquor was given to other groups. No food was given but water for 12h. Blood was collected from the orbit. The ALT, AST and GGT in blood serum of mice were measured. The liver was dissected and liver coefficient was calculated. Histopathological examination was given on liver tissues. The results showed that compared with the normal group, the level of ALT, AST in blood serum of the model group had obvious enhanced (P< 0.01), the level of GGT had obvious enhanced (P< 0.05). Compared with the model group, the level of GGT, AST of the high-, middle-dose group had obvious enhanced (P< 0.05), the level of ALT activity had obvious enhanced (P< 0.01). There were severe liver histopathological damages in mice of the high-, middle-, low-dose group. It was concluded that P. Americana had some side effects in the treatment of alcohol-induced liver injury.