Objective To determine in vitro susceptibility of itroconazole,voriconazole,caspofungi,and amphotericin B against 82 clinical strains of filamentous fungi.Methods Etest method was used to test the in vitro susceptibilities of itroconazole,voriconazole,caspofungi,and amphoteriin B against aspergillus fumigatus,A.flavus,A.niger,A.terreus,A.nidulans,et al.Results The MIC range of 4 antifungal agents were 0.03~2.00 mg/L and 0.01~32.00 mg/L against A.fumigatus and A.flavus,respectively.But amphotericin B had higher MIC90 value which was 16mg/L against A.flavus than A.terreus(MIC90 3.00 mg/L),A.fumigatus(MIC90 0.75 mg/L),and A.niger(MIC90 0.25 mg/L).Conclusion Itroconazole,voriconazole,caspofungi,and amphotericin B have different susceptibility patterns against various types of filamentous fungi.It's necessary to identify fungi to level of species and perform antifungal susceptibility test in serious patients.

Total glucosides of paeony root ( TGPs ) ( 5 ~40mg/kg, ip ) had a dose-related hypothermal effect in mice and rats, which was related to the environment temperature. But TGPs ( 40mg/kg, ip or iv ) showed no significant hypothermal effect in guinea-pigs or rabbits. TGPs ( 2, 4 mg/kg, icv ) had a potential hypothermal effect in rats. Chlopheniramine had antagonist effect on hypothermal effect of TGPs in mice and rats.

Objective To investigate the impact of the COX-2 specific inhibitor parecoxib on postoperative serum cytokines and early cognitive function in the elderly patients undergoing knee replacement.Methods Seventy-two elderly patients undergoing knee replacement were divided into a control group (group Ⅰ)and parecoxib group (group Ⅱ).MMSE score were compared at preoperative 1 d and postoperative 1 d,3 d,7 d.Before induction of anesthesia (T1 ),postoperative 6 h (T2 ),1 d (T3 ),3 d (T4 ),7 d (T5 ),the serum IL-1β,IL-6 concentrations were measured,meanwhile the serum S-100βwere measured in T2 .Results At postop-erative 1 d,3 d,the MMSE score in group Ⅰ was significantly lower compared with the preoperative (P <0.05).IL-6 in T2 ,IL-1βin T3 increased in both group.In group Ⅱ,three days later,the exaltation of plasma inflammatory factors returned to the preopera-tive level,but this process last untill T5 in group Ⅰ.The plasma concentration of IL-6 in T2 ,T3 ,T4 and IL-1βin T3 ,T4 in group Ⅰwere higher than group II (P <0.05).At T2 ,the serum S-100βin group Ⅰ was (1 625 ± 364)pg/mL higher than group Ⅱ(1 263 ±174)pg/mL(P <0.05).Conclusion The protective effection of COX-2-specific inhibitor parecoxib upon postoperative cognitive decline in elderly patients undergoing orthopedic surgery may be related to inhibition of peripheral cytokine release.

Colorectal cancer(CRC)ranks the third in incidence and mortality rate among human tumors. Tumor relapse,me?tastasis and drug resistance remain the main obstacle to the success of CRC treatments. Compared to traditional chemotherapy ,target therapy seems to treat tumors in more precise and rational fashion with good response and often less toxic side-effect. Although target agents provide hope for more effective therapy,recent clinical studies have shown only modest benefit from target therapy similar to tra?ditional chemotherapy. Primary and secondary resistance to target agents is still observed and contributes to CRC treatment failure. The review summarizes research progress in the mechanism of drug resistance to target therapy in CRC treatment.

BACKGROUND:Tissue-engineered bone in the treatment of large bone defects has obvious advantages especial y when the autologous ilium transplantation is limited, which can effectively fil bone defects.
OBJECTIVE:To investigate the rationality of intramedul ary nailing support and tissue-engineered bone fil ing in the treatment of fibrous dysplasia of the proximal femur and the biocompatibility of the tissue-engineered bone.
METHODS:Seven patients with fibrous dysplasia of the proximal femur were subjected to intramedul ary nailing support and tissue-engineered bone fil ing.
RESULTS AND CONCLUSION:Al of the seven patients underwent more than 8 months of fol ow-up, no rejection reaction and other complications occurred. After 4-6 weeks of fixation, al the seven patients removed hip spica braces, with a good hip mobility. After 10-12 weeks, X-ray review showed no pathological fracture, internal fixation loosening and narrow neck stem angle. Using the Harris hip score evaluation of the hip function, the affected side of the seven patients was optimized. After 16-18 weeks, X-ray films reviewed good creeping substitution in the affected area treated with the intramedul ary nailing support and bone graft. After 24-26 weeks, new bone appeared within the scope of lesions. After 1.0-1.5 years, bone creeping substitution was basical y completed in the intertrochanteric region, and original lesions were invisible on X-ray films. These findings confirmed that intramedul ary nailing support and tissue-engineered bone fil ing for treating fibrous dysplasia of the proximal femur has good effectiveness, exhibiting stable internal fixation and avoiding resection of autogenous iliac bone. Tissue-engineered bone has a good biocompatibility in the medium-term fol ow-up, with good hip function activities.

【Objective】To observe the therapeutic effect of traditional Chinese comprehensive therapy for the treatment of lumbar disc herniation.【Methods】Forty-one lumbar disc herniation patients received oral use of herbal medicine,external application of herbal medicine,fumigation and steaming with herbal medicine as well as pelvis traction.Fifteen days constituted one treatment course.【Results】After treatment,25 were cured,13 effective,3 ineffective and the total effective rate was 92.68%.【Conclusion】Comprehensive therapy including oral use of herbal medicine,external application of herbal medicine,fumigation and steaming with herbal medicine as well as pelvis traction has a good effect on relieving symptoms.

Objective:To explore the relationship between arrival time and the retention in emergency room and the prognosis in patients with severe trauma.Methods:The clinical data of 1 738 emergency trauma patients in emergency intensive care from trauma center information system of the First Affiliated Hospital of Soochow University were extracted. The emergency retention was the time in the emergency room ≥ 4 h. The 24 h of the day was divided into three shifts at 8:00, 15:00 and 22:00. Logistic regression model was used to calculate the crude OR and adjusted OR after adjustment by age, sex and RTS of emergency shifts, and COX regression analysis was performed with emergency death as the endpoint. Results:Among the total of 1 738 patients with severe trauma, there were 852 (49.02%) cases of emergency retention. Taking the morning shift as the reference baseline, the risks of emergency retention in middle shift and night shift were increased gradually. The OR value of night shift was statistically significant ( P<0.01), and the crude OR and adjusted OR were 2.21 (95% CI: 1.71-2.86) and 2.36 (95% CI: 1.76-3.18), respectively. The univariate COX regression model indicated that the crude HR of night shift was statistically significant ( HR=0.26, 95% CI: 0.08-0.90, P=0.033). However, the multivariate COX regression model showed no statistically significant differences in the adjusted HR of middle shift ( HR=0.96, 95% CI: 0.43-2.14, P=0.914) and night shift ( HR=0.40, 95% CI: 0.08-1.85, P=0.238), respectively. Conclusions:The arrival time of emergency trauma patients might be a contributor to the emergency retention, and night shift patients are more likely to encounter retention, but there is no significant effect on patient death.

Increasing the production and secretion of endogenous opioid peptide by immune cell can significantly induce myocardial protective effects against ischemia-reperfusion injury. Gene therapy is promising to increase endogenous enkephalin (ENK). However, classical viral and plasmid vectors for gene delivery are hampered by immunogenicity, gene recombination, oncogene activation, the production of antibacterial antibody and changes in physiological gene expression. Minimalistic immunologically defined gene expression (MIDGE) can overcome all the deficients of viral and plasmid vectors. The exon of rat's preproenkephalin (PPENK) gene was amplified by PCR and the fragments were cloned into pEGFP-N1 plasmids. The recombined plasmids were digested with enzymes to obtain a linear vector contained promoter, preproenkephalin gene, RNA stable sequences and oligodesoxy nucleotides (ODNs) added to both ends of the gene vector to protect gene vector from exonuclease degradation. A nuclear localization sequence (NLS) was attached to an ODN to ensure the effective transport to the nucleus and transgene expression. Flow cytometry, laser confocal microscopy and Western blotting demonstrated that PPENK-MIDGE-NLS can transfect leukocyte of rat in vivo, increase the expression of proenkephalin (PENK) in tissue, and the transfection efficiency depends on gene vector's dosage. These results indicate that PPENK-MIDGE-NLS could be an innovative method to protect and treatment of myocardial ischemia-reperfusion injury.
Animals ; Cloning, Molecular ; Enkephalins ; genetics ; Gene Expression ; Genetic Therapy ; Genetic Vectors ; Leukocytes ; Plasmids ; Promoter Regions, Genetic ; Protein Precursors ; genetics ; Rats ; Transfection ; Transgenes

Background and purpose:miR-17-92 gene cluster overexpression has been observed in various cancers, such as lung cancer, liver cancer, gastric cancer and prostate cancer. In this study, we established the stable cell line overexpressingmiR-17-92 to explore the inlfuence ofmiR-17-92 on the migration, invasion abilities and cisplatin resistance of the prostate cancer DU145 cells.Methods:miR-17-92 overexpression vectors were constructed. DU145 cells were infected with the viral supernatants produced by Phoenix A packaging system. Real-time lfuorescent quanti-tative polymerase chain reaction (RTFQ-PCR) was conducted to detect the expression level of miR-17-92 in the cells. The migration and invasion abilities were measured by a real-time xCELLigence system. The scratch healing assay was carried out to investigate the migration abilities. The expression of integrin β1 was detected by Western blot, and the activities of matrix metalloprotein-2 (MMP-2) and matrix metalloprotein-9 (MMP-9) were measured by gelatin zymography experiment. The cell growth of the two cell lines after the treatment of cisplatin was detected by a real-time xCELLigence system. The mRNA expression ofERCC1 was measured by RTFQ-PCR. Western blot was conducted to investigate the protein expressions of ERCC1, ERK1/2 and pERK1/2.Results:DU145-miR-17-92 cells migrated faster than DU145-control cells during the 24 h continuous monitoring (P<0.01). The scratch healing assay indicated that DU145-miR-17-92 cells migrated from the edge towards the scratch center faster than DU145-control cells. DU145-miR-17-92 cells invaded through matrigel markedly faster than DU145-control cells (P<0.01). The protein expression level of integrin β1 and the MMP-9 activities in DU145-miR-17-92 cells were increased than those in DU145-control cells. After the treatment of cisplatin, DU145-miR-17-92 cells grew faster than DU145-control cells, presenting cisplatin resistance (P<0.01). The phosphorylation of ERK1/2 in DU145-miR-17-92 cells was constantly at a high level regard-less of the treatment of cisplatin. Compared with DU145-control cells, the expression of drug resistance-related gene ERCC1 was dramatically increased in DU145-miR-17-92 cells after the treatment of cisplatin.Conclusion:miR-17-92 overexpression increases the migration and invasion abilities of the prostate cancer DU145 cells, which is associated with the upregulated expression of integrin β1 and the increased activity of MMP-9. Besides,miR-17-92 overexpression enhances the cisplatin resistance of DU145, which is correlated with the increased phosphorylation level of ERK and the upregulated expression of ERCC1 at both the mRNA and protein levels.

Objective To better understand the clinical characteristics and predisposing factors in non-pregnant patients with Listeria monocytogenes (Listeria) sepsis.Methods Clinical data were collected at Peking Union Medical College Hospital between January 2002 and December 2014.A case with non-pregnant Listeria sepsis is defined as a non-pregnant person with clinically compatible illness and from whom Listeria was isolated from his/her blood culture.We define an underlying condition if a patient has been diagnosed of and/or has been treated for a concurrent baseline disease within 1 month prior to the onset of Listeria sepsis.Results A total of 35 patients were enrolled.The age of all patients was (49.1 ± 17.0) years.The male to female ratio was 2∶ 3.Most patients were combined with at least 1 underlying condition (33,94.3％),including 42.9％ patients with an autoimmune disease,34.3％ with malignancies.The majority (91.4％) represented an acute onset (＜ 1 week) with median time of 3 days.Clinical manifestations included fever (34/35,97.1％),central nervous system (CNS) symptoms (17/35,48.6％),gastrointestinal tract symptoms (13/35,37.1％).Fourteen patients had undergone lumber puncture and cerebral spinal fluid (CSF) tests,which revealed abnormalities comparable of Listeria meningitis.Listeria was isolated from CSF in 11 of 14 patients (78.6％).There were 34 patients receiving empiric antibiotics including 54.3％ cephalosporins which are resistant to Listeria.Twenty five (71.4％) patients were switched to the target antimicrobials according to positive blood culture.Of the 35 patients with Listeria sepsis,21 (60.0％) recovered or were cured,however the rest (40.0％) had dismal outcome.Six patients died in hospital,8 critical patients were discharged and died after transferring to local hospitals.Conclusions Listeria sepsis is commonly associated with non-pregnant patients with compromised immune function.Clinical presentations include acute fever,CNS symptoms and gastrointestinal symptoms etc.Empiric antibiotics covering Listeria should be considered when sepsis is suspected among susceptible hosts.