Objective To investigate the use of antibacterial drugs in tension -free inguinal hernia repair before and after the 2012 National clinical use of antibiotics special management ,providing the basis for the rational use of antimicrobial drugs and standardized management .Methods Retrospectively investigate the antimicrobial ap-plication in patients undergoing tension-free inguinal hernia repair and discharged from July to September in 2011-2013,and analyzed the timing of administration ,usage,type and treatment time of antimicrobial drugs .Results There were respectively 93.24%,47.76%and 27.59%of patients in the three groups administrated prophylaxis antibacte-rial drugs,and respectively 9.19%,65.67%and 85.08%of patients with indications .The first wound healing rates were respectively 94.59%,98.51% and 96.55%.The rates of reasonable choice of medicines 70.60%,96.88%and 91.67%,respectively;the rates of reasonable timing for medication were 71.01%,81.25%and 70.83%,respec-tively;the rates of reasonable courses of prophylaxis therapy were 33.33%,56.25% and 58.33% respectively. Conclusion The principle of no preventive antibiotics use in tension-free inguinal hernia repair is operable .After en-actment of special management of antibacterial drugs ,the level of preventive medication for tension-free inguinal herni-a repair is improved greatly .However ,it still needs to strengthen the management of antimicrobial prophylaxis timing and overall prophylaxis treatment course .

Objective To study the correlation between symptomatic, radiological and etiological classification in acute ischemic stroke. Methods One hundred and twenty five patients with ischemic stroke within 48 hour of onset were prospectively studied with three step diagnosis: (1) symptomatic classification based on the Oxfordshire Community Stroke Project criteria (OCSP), (2) radiological classification(CT or MRI) and (3) etiological classification based on the Lausanne Stroke Registry criteria.Results Most of the patients with symptoms of total anterior circulation infarcts (TACI), partial anterior circulation infarcts (PACI) and posterior circulation infarcts (POCI) according to OCSP classification had corresponding lesions on CT or MRI, while only 67.3% of lacunar infarcts (LACI) patients had small subcortical infarction (SSI). More than 60% of patients with TACI were classified into cardioembolism (CE) in the third diagnosis, while the etiology of PACI was either CE or large artery atherosclerosis (LAA) in equal numbers. Only 57.7% of LACI patients were classified into small artery disease (SAD) and 28.8% of them into LAA, of which 80% patients had lesions other than SSI. The positive predictive value of SAD in the combination of LACI and SSI was 0.78. The etiology of POCI was variable.Conclusion Except for LACI, the symptomatic classification by OCSP corresponds well to the radiological classification. The etiological classification can be predicted in TACI and PACI, but it is hard to make in POCI, a number of LACI are due to LAA.

Cellular senescence is one of the important steps against tumor. This study was to observe the characteristics of boningmycin induced senescence of human tumor cells. MIT method and clone formation assay were used to detect the growth-inhibitory effect. Cellular senescence was detected with senescence-associated beta-galactosidase staining. Cell cycle distribution and accumulation of intracellular reactive oxygen species (ROS) were analyzed with flow cytometry. Protein expression was detected by Western blotting. The results showed that the growth-inhibitory effect of boningmycin was obviously stronger on human oral epithelial carcinoma KB cells than that on non-small cell lung cancer A549 cells. Comparison to the similar action of doxorubicin, that boningmycin induced the features of cellular senescence in both cell lines, its due to the arrest at G2/M phase and an increase of ROS level. The molecular senescence marker P21 increased significantly after boningmycin treatment at a dosage of 0.1 micromol x L(-1), whereas a higher concentration of it induced apoptosis. The results indicated that cellular senescence induced by boningmycin was one of its mechanisms in tumor suppression.

Objective To investigate the follicle development and pregnancy in clomiphene citrate-resistant patients with polycystic ovary syndrome (PCOS) after transvaginal follicular aspiration and gonadotropin administration. Methods Seventeen clomiphene citrate-resistant patients with PCOS failed to gonadotropin treatment associated with ovarian hyperstimulation syndrone(OHSS). They are anovulatory infertility with normal tubal and husbands'sperm condition. In this treatment regimen,all patients was administered with gonadotropin from day 5 of menstrual cycle(or withdrawal bleeding) and were asked to undergo ultrasound-guided transvaginal follicular aspirations for 5 days later. Only one or two follicles for every ovary were remained and gonadotropin administration was continued. A follicle development,ovulation rate,pregnancy rate and sex hormone were monitored. Results Fifteen of the 17 patients experienced dominant follicles development and ovulation. 9 of them with one(52.9%) ,4 with two(23.5%) and 2 with three(11.8%) dominant follicles ovulated and pregnancy occurred in 7 patiends(41.2%). All of pregnancy are singleton. Conclusion A single follicle development and singleton pregnancy can be realized in clomiphene citrate-resistant PCOS patients by combined ultrasound-guided transvaginal follicular asperation with gonadotropin administration.

Object To study the chemical constituents of Dracaena cochinchinensis (Lour.) S. C. Chen. Methods The constituents were isolated on silica gel chromatography, preparative TLC, and spectral data. Results Six compounds were isolated and identified from the resin of D. cochinchinensis as: 1, 2, 4, 5-tetrachloro-3, 6-dimethoxybenzene (Ⅰ), cholest-4?-methyl-7-en-3?-ol (Ⅱ), cholest-4?-methyl-7-en-3-one (Ⅲ), hexacosane (Ⅳ), cholest-7-en-3?-ol (Ⅴ), cholest-7-en-3-one (Ⅵ). Conclusion Compounds Ⅳ-Ⅵ were isolated from D. cochinchinensis for the first time.

Objective To assess the effectiveness of follicular aspiration in selection phase of follicle growth of the patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization-embryo transfer(IVF-ET). Methods Thirteen infertile patients with PCOS who previously failed IVF-ET associated with ovarian hyperstimulation syndrome (OHSS) , served as control group, were asked to undergo new IVF cycles (follicular aspiration group) with ultrasound-guided transvaginal follicular aspirations in the selection phase ( diameter9 - 10 mm) of follicle growth,with a total of 13 cycles both. No more than 10 follicles were selected. Clinical and endocrinological parameters were monitored. Results In follicular aspiration group, the average number of follicle 5; 12 mm in diameter and serum estradiol level were 16 ? 4 and (9899 ? 1431) pmol/L respectively, which were significantly lower than 29 ? 8 ( P

Objective To investigate the effects of alcohol extract of Kunmu decoction on proliferation and apoptosis of rheumatoid arthritis fibroblast-like synoviocytes (RA-FLS). Methods Synovial tissues were obtained from patients with active RA received joint replacement or arthroscopy. The surface antigen and the amount of apoptotic cells were determined by flow cytometry. The inhibitive effect was detected by MTT assay. Results The CD90+surface antigen of synoviocytes was (94.78 ± 0.98)%. The inhibitive effect on the proliferation in all treatment groups were in a time-and dose-dependent manner. The apoptosis rate was increased in a dose-dependent manner among all dosage alcohol extract groups. Conclusion Kunmu decoction might inhibit proliferation and induce apoptosis of RA-FLS.

Objective The aim of this study was to explore the inhibitory effect of alcohol extracts of Narcissus bulb on melanogenesis in zebrafish embryos.Methods Zebrafish embryos were exposed to different concentrations of alcohol extracts of Narcissus (0, 50, 100, 200, and 500 μg/mL), and then the formation of melanin was observed.Furthermore, we measured the enzyme activity of tyrosinase (TYR), which plays a pivotal role in melanogenesis.Meanwhile, the spatial and temporal pattern of melanin-specific marker genes were detected.Arbutin (Ar) was used as a positive control in all these experiments.Results The treatment of alcohol extracts of Narcissus bulb inhibited melanogenesis in the zebrafish embryos in a dose-dependent manner.Furthermore, the mRNA expression levels of melanin-related genes such as tyrosinase (TYR), silver (SILV) and Mitfa were significantly reduced after treatment with different concentrations of Narcissus extracts by in-situ and semi-quantitative PCR.Finally, the enzyme activity of tyrosinase was also gradually decreased with increasing concentrations of the alcohol extracts.Conclusions Narcissus alcohol extracts can effectively inhibit the production of melanin in zebrafish embryos.This study provides potential evidence and approaches for the screening of natural whitening compounds using zebrafish models.

Objective To evaluate clinical effectiveness of transcatheter closure of atrial septal defects ( ASD) with severe pulmonary arterial hyperyension ( sPAH) by fenestrated Amplatzer septal occluders ( ASO) . Methods From September 2002 to April 2013, 17 patients of ASD with sPAH received transcatheter ASD closure using fenestrated occluders. Aged from 18 - 72 years, the diameters of ASDs were 18 - 33 mm. The systolic pulmonary arterial hypertension measured by transthoracic echocardiogram were 80 - 112 (96. 9 ± 8. 9) mmHg. The follow-up study included electrocardiography, chest radiography and echocardiography. All the patients were followed up for 1. 5 - 12 ( mean 6. 4 ± 0. 7) years. Results Systolic pulmonary arterial pressure (sPAP) of 60 - 108 (88. 7 ± 11. 7) mmHg and mean pulmonary artery pressure ( mPAP) of 29. 3 - 60 (51. 0 ± 8. 1) mmHg were measured by cardiac catheterization before ASD closure. Qp/ Qs was 1. 50 - 2. 44 (1. 8 ± 0. 31) and the pulmonary vascular resistance was 3. 1 - 9. 7 (5. 6 ± 1. 5) wood units (wu) . Immediately after the implantation of fenestrated occluders, sPAP decreased to 56 - 99 (70 ± 11. 5) mmHg and mPAP to 27 - 51. 7 (41. 1 ± 7. 1) mmHg. On the 3 d, 3 m and 6 m follow-up exam, RVEDd decreased ( P ﹤ 0. 05), while LVEDd, LVEDV and LVEF increased significantly (P ﹤ 0. 05) . sPAP decreased significantly after transcatheter closure at 3 m and 6 m as compared to pre-closure levels (both P ﹤ 0. 05) . The mean sPAP in long term follow up was (60. 2 ± 13. 3) mmHg which had significant decrease compared to pre-closure level ( P ﹤ 0. 01), but no significant difference found when compared to 6 m follow up (P ﹥ 0. 05). Conclusions ASD closure with fenestrated ASO is a satisfactory approach for ASD with severe PAH.

Objective An analysis was carried out for the reports of traditional Chinese medical syndrome patterns of psoriatic arthritis (PsA) patients in related reports issued in the recent 35 years, thus to explore the characteristics of syndrome patterns of PsA patients and to supply evidence for the syndrome classification. Methods Electronic retrieval was performed in the reports of PsA syndrome analysis issued in the Chinese medical journals from the year of 1979 to 2013. Traditional Chinese medical syndrome information of PsA patients was extracted from the reports, and then was standardized and classified. SPSS 17.0 software was applied for the analysis of occurrence frequency of syndromes, syndrome elements, tongue and pulse states. Results A total of 84 reports were obtained, and 26 reports met the inclusion criteria. In the 26 included reports, 10 kinds of tongue texture, 15 kinds of tongue fur and 22 kinds of pulse states were present. After the standardization of the syndromes, a total of 39 syndrome patterns were obtained. After combination of the similar syndromes, 14 syndromes were included into the analysis. In the 14 included syndrome patterns, the leading 5 patterns were wind-damp heat arthralgia, wind-heat with blood dryness, excessive heat toxin, wind-cold damp arthralgia, and liver-kidney deficiency. Fourteen syndrome elements were extracted from the syndromes, and 9 were included into the analysis after combination of the similar syndrome elements. The top syndrome elements were heat, phlegm-dampness, wind, dryness, deficiency, and blood stasis. Conclusion The syndrome patterns of PsA patients are various, and the syndrome elements of cold, heat, phlegm-dampness, wind, dryness, and blood stasis play an important role in the pathogenesis of PsA.