Objective To investigate the therapeutic effect of tripterygium wilfordii and prednisone in old patients with primary nephrotic syndrome. Methods 78 elderly primary nephrotic syndrome patients were randomly divided into two groups. 42 patients in treated-group were treated with tripterygium wilfordii and prednisone while 36 patients in control-group were treated with prednisone only. The curative effect,24 hours urinary protein, serum albumin,plasma lipid and renal function were detemined after six months. The responses of the patients were classified as complete remission(CR) ,partial remission(PR) and NO-response. Results After six months treatment, there were 24 patients got to CR,12 patients to PR,and 6 patients remained refractory to treatment group. While there were 13 patients got to CR,10 to PR,and 13 as refractory in the control group. The general effective rate in the treatment group was 85.7% ,which was markedly higher than that of the control group,which is 66. 67% (P＜0. 05). The recurrence rate in the treatment group and control group were 14. 3% and 36. 1% respectively (P＜0. 05 ). Conclusion The curative effect of tripterygium wilfordii and prednison on elderly primary nephrotic syndrome is markedly better than prednisone only.

This article reported a case of suppurative meningitis caused by Streptococcus suis infection. The patient is an old man who has been engaged in pig breeding. The common symptoms include fever, headache and disturbance of consciousness. According to the results of magnetic resonance imagine and cerebrospinal fluid examination, the patient was considered purulent meningitis caused by Streptococcus suis type 2. After treatment with penicillin anti-infection and dexamethasone inhibition of immune response, the symptoms improved significantly. Three weeks after the onset of the disease, hearing loss occurred, after six months of follow-up, serious hearing impairment was still left.

Objective To investigate the nutritional state in elderly hospitalized patients(≥70 years old)and provide clinical evi-dence for nutritional support in elderly people .Methods From June to December 2012 ,342 elderly hospitalized patients(≥70 years old)in Daping Hospital ,the Third Military Medical University were included .All of these patients were originally screened by resi-dent doctor ,and were revaluated by dietitians in the Department of Nutrition for the nutritional status .The revaluation was conduc-ted by Nutritional Risk Screening 2002(NRS 2002) ,which recommended by ESPEN ,and combined with the laboratory examina-tion .Results In 342 cases ,the nutritional risk rate was 96 .49% ,the incidence of malnutrition was 28 .79% ,and the incidence of a-nemia was 59 .24% .The incidence of low total serum protein ,low albumin ,and low prealbumin were 51 .40% 、93 .18% and 85 . 30% ,respectively .Conclusion Elderly hospitalized patients(≥70 years old)have high nutritional risk ,high incidence of malnutri-tion ,anemia ,and low blood albumin .Clinical nutritional support is necessary for bad nutritional status elderly patients .

ObjectiveTo study the HIF-1α expression in rats with paraquat poisoning (PQP).MethodsNinety-six healthy SD rats were randomly (random number) divided into 2 groups ( n =48 in each group) : PQP group and control group. The PQP group was further divided into six subgroups as per thedifferent intervals after Paraquat intoxication. Samples from 6 PQP subgroups and control group were taken at 0 h, and 2 h, 6 h, 12 h, 24 h, 48 h, 72 h and 120 h after paraquat administration. Aarterial blood wascollected for blood gas analysis, and the sections of lung tissue were stained with hematoxyhn-eosin and masson's trichrome to detect the trichrome positive area, and HIF-1α was detected by immunohistochemistryAll data were processed with one-factor analysis of variance and Pearson correlation analysis. ResultsTwo hours after paraquat poisoning, the levels of HIF-1α protein and the collagen were both significantly upregulated in the lung tissue in rats with paraquat poisoning. However, the hypoxemia existed until 72h.There was correlation between levels of Masson's trichrome positive area and HIF-1α positive area (r =0. 819, P ＜0. 05 ). There was correlation between the levels of lactic acid in blood gas analysis and HIF-1α positive area (r=0. 761, P＜0. 05. But there was no correlation between levels ofPO2 and HIF-1α positive area (r=-5.24, P＞0. 05). ConclusionsThe level of HIF-1α was up-regulated in rats with paraquat poisoning and it was not associated with hypoxemla.

Objective To explore the expression of human epidermal growth factor receptor -3( HER3) in human epidermal growth factor receptor-2(HER2)-positive breast cancer and its relationship with the therapeutic effect of trastuzumab and clinical prognosis .Methods Clinicopathological characteristics of 235 HER2-positive breast cancer patients undergoing surgery in Jiangsu Cancer Hospital from Jan .2007 to Jun.2012 were analyzed retrospectively.The expression of HER3 was detected using immunohistochemisty staining .The expression of HER3 and its correlation with the clinicopathological characteristics were analyzed .All patients were followed-up to find out the impact of HER3 on the disease free survival and the therapeutic effect of trastuzumab .Results The positive rate of HER3 in Luminal B ( HER2 +) and HER2-overexpressing breast cancer was 100/135 (74.1%), and 85/100(85%)respectively.The difference had statistical significance (P<0.05).The histolog-ical grading and the lymph node metastasis were significantly different in Luminal B ( HER2+) breast cancer .The tumor volume , histological grading and lymph node metastasis were significantly different in HER 2-overexpressing breast cancer .The 5-year disease free survival of HER 2-positive breast cancer patients with negative HER 3 was higher than that with positive HER3.The non-relapse survival time was not significantly different between the pos-itive and negative HER 3 expression in Luminal B ( HER2+) breast cancer patients receiving trastuzumab treat-ment , but was significantly different in HER 2-overexpressing breast cancer patients .Conclusions HER3 is cor-related with unfavourable prognosis in HER 2-positive breast cancer .The treatment targeting HER3 may improve the clinical prognosis of both HER 2-positive and HER3-positive breast cancer patients .The HER2-overexpressing breast cancer patients with negative HER 3 may benefit more from trastuzumab treatment .

Histocytochemistry ; methods ; Humans ; Pathology, Clinical ; methods ; Specimen Handling ; methods ; Staining and Labeling ; methods

OBJECTIVETo study the protective effect of hyperoxia solution on acute lung injury caused by phosgene poisoning by observing the changes of PaO2 and malondialdehyde (MDA) contents, superoxide dismutase (SOD) activity in serum and Glutathione (GSH/GSSG) contents in lung tissues.

METHODSThe rabbits were divided into normal control group, hyperoxia solution (H0) and balance salt (BS) groups. Group HO and Group BS inhaled phosgene and the former was given intravenously hyperoxia solution (which was replaced by balance salt solution in Group BS). The content of MDA and the activity of SOD in serum were observed at different time points, the amount of GSH and GSSG in lung tissue were also measured.

RESULTS(1) The serum MDA contents increased and PaO2, SOD activity decreased significantly in Group HO and Group BS along with time increasing as compared with control group. The contents of GSH in lung tissue decreased in two groups compared with that in control group, however the contents of GSSG ascended instead. (2) At 3 and 8 h of the experiment, PaO2 of Group HO [(9.91 +/- 0.49), (9.15 +/- 0.46) mm Hg respectively] were significantly higher than those of Group BS [(9.03 +/- 0.76), (8.11 +/- 0.57) mm Hg respectively] (P < 0.01). The contents of MDA of Group HO (3.66 +/- 0.35), (5.31 +/- 0.15) micromol/L respectively] were lower than those of Group BS [(4.32 +/- 0.26), (7.4 +/- 0.33) micromol/L respectively] (P < 0.01). SOD activity in Group HO [(237.37 +/- 29.96), (208.10 +/- 18.80) NU/ml respectively] were higher than those of Group BS [(195.02 +/- 21.44), (144.87 +/- 21.26) NU/ml respectively] (P < 0.05 or P < 0.01). The content of GSSG lung tissue in Group HO (423.67 +/- 38.21) micromol/L were lower than those of Group BS (523.85 +/- 43.14) mol/L (P < 0.01). There were no significant differences in the content of GSH in lung tissues between Group HO and group BS.

CONCLUSIONHyperoxia solution can reduce acute lung injury of rabbits following phosgene poisoning.

Acute Lung Injury ; etiology ; metabolism ; pathology ; Animals ; Glutathione Peroxidase ; metabolism ; Hyperoxia ; Lung ; drug effects ; metabolism ; pathology ; Malondialdehyde ; analysis ; Oxygen ; administration & dosage ; pharmacology ; Phosgene ; poisoning ; Rabbits ; Superoxide Dismutase ; metabolism

Breast Neoplasms ; metabolism ; Female ; Humans ; Multidrug Resistance-Associated Proteins ; genetics ; metabolism ; Receptor, Epidermal Growth Factor ; metabolism ; Receptors, Progesterone ; metabolism

Objective To evaluate the efficacy of pregabalin on painful radiation-induced brachial plexus injury.Methods A total of forty-five patients with painful radiation-induced brachial plexus injury were assigned to treatment group with pregabalin 150-600 mg/d combined with conventional therapy, and to control group with conventional treatment for 12 weeks.The visual analogue scale (VAS) and neuropathic pain symptom inventory (NPSI) were evaluated.The response rate (proportion of subjects with at least a 30％ to 50％ reduction in visual analogue scale) was evaluated as the primary endpoint.Results The response rate of the pregabalin group(36.4％) was significantly higher than that of the control group (9.1％) (x2 =4.98, P ＜ 0.05).Although hospital anxiety and depression level, clinical global impression of change, and clinical global impression of change (CGIC) did not differ significantly between pregabalin group and control group (P ＞ 0.05), improvements in neuropathic pain symptom inventory (NPSI), patient global impression of change (PGIC) and the sleep interference score(t =-6.62,-5.65,-6.16, P ＜ 0.05)suggested some utility in the management of radiation-induced brachial plexus.Conclusions Pregabalin treatment combined with conventional treatment exerts efficacy on patients with painful radiation-induced brachial plexus and patients are well tolerated.

Obgective To explore the antimicrobial resistance genotypes and molecular epidemic features of Klebsiella pneumoniae (K.pneumoniae) producing extended spectrum 3-lactamases (ESBLs) in the Pediatric Intensive Care Unit (PICU) of Guiyang Children' s Hospital.Methods Disc diffusion technique (Kirby-Bauer method) and automatic microbiology analysis system were employed to determine the antimicrobial resistance,and Double-disk Diffusion was adopted in the phenotype confirmatory test of ESBLs,and PCR was used to determine the antimicrobial resistance genotypes.Results Among 44 straits of non-repetitive-K.pneumoniae,isolated from the children during hospitalization since April to December of 2013,29 straits (65.9％) were detected.The findings of sensitivity tests showed that 29 strains of ESBLs-producing K.pneumoniae presented a higher rate of sensitivity to carbapenems,cephamycin and quinolones,100％ resistance to penicillin and cephalosporins of the first and the second generations.Fifteen non-ESBLs-producing K.pneumoniae presented 100％ resistance to penicillin.The rate of resistance to 9 kinds of antibiotics (Ampicillin/Sulbactam,Cefazolin,Cefuroxime,Cefamandole,Cefiriaxone,Ceftazidime,Cefepime,Gentamicin,Aztreonam) in ESBLs-producing K.pneumoniae strains(79.3％,100.0％,100.0％,100.0％,100.0％,79.3％,65.5％,41.4％,79.3％) was significantly higher than that of non-ESBLs-producing K.pneumoniae trains (13.3％,6.7％,20.0％,20.0％,0,0,0,6.7％,0) (x2 =17.54,35.51,28.00,28.00,44.00,24.93,17.30,4.18,24.93,all P ＜ 0.05).In 29 strains of ESBLs-producing K.pneumoniae,3 genotypes were detected respectively:93.1％ of SHV (27/29 strains),51.7 ％ of TEM (15/29 strains) and 37.9 ％ of CTX-M (11/29 strains).Five forms of genotype distribution were presented:14 (43.8％) strains carrying single ESBLs gene,5 (17.2％) strains carrying 2 types,19 (31.0％) strains carrying 3 types,and 1 strain had not been genotyped.Conclusions ESBLs-producing K.pneumoniae had been epidemic in PICU of Guiyang Children's Hospital,with multiple antimicrobial resistances and diversification of antimicrobial resistance genotypes.