Objective To compare the treatment responses of the inhaled salmeterol and fluticasone (50/500 μg) for three months in the different clinical phenotypes of chronic obstructive pulmonary diseases (COPD) which were chronic bronchitis phenotype and emphysema phenotype and to explore the difference of the treatment responses.Methods To enroll and follow up the stable COPD patients from outpatient department who received the treatment of inhaled salmeterol and fluticasone (50/500 μg).Patients with low attenuation area (LAA,the density on CT scan ＜-950 HU) ≥15％ of the while lung area％ (LAA％) were defined as emphysema group,while patients with LAA％ ＜ 15％ were defined as chronic bronchitis group.All the subjects received lung function test before and after three-month treatment.Results Totally,84 patients (49 male and 35 female patients) with stable COPD were enrolled with an average age (61.04 ±9.23) years old,30 patients in emphysema group and 54 patients in chronic bronchitis group.Before treatment,forced expiratory volume in one second (FEV1) ％ predicted value and residual volume (RV) ％ predicted value in emphysema group were lower than those of chronic bronchitis group (P =0.04 and P =0.01),while inspiratory capacity (IC)％ predicted value was higher than that of chronic bronchitis group (P =0.02).After three-month salmeterol and fluticasone inhalation treatment,FEV1 and RV were improved in both groups,but FEV1 and RV in chronic bronchitis group were improved more significantly than those of emphysema group (P =0.02 and P =0.03).Conclusions The treatment responses of different clinical phenotypes of COPD to inhalation of combination of salmeterol and fluticasone were different,chronic bronchitis phenotype had better treatment response compared to emphysema phenotype.

OBJECTIVE:To investigate the clinical application of warfarin in inpatients of our hospital,and provide reference for standardized application in clinic. METHODS:Totally 267 inpatients records used warfarin in our hospital from Jan. 2013 to Jun. 2014 were investigated to retrospectively analyze the indications,dosage,international normalized ratio(INR)monitoring and bleeding complications of warfarin. RESULTS:Warfarin was mainly used for patients with deep vein thrombosis,cerebral infarc-tion,rheumatic heart disease and pulmonary embolism in our hospital;the dosage of inpatients was in the range of 0.625-6.875 mg with average daily dosage of (2.15 ± 0.72) mg;the INR lower than 1.8 accounted for 52.8%,the INR in the range of 1.8-3.0 (reaching the standard) accounted for 31.8% and INR higher than 3.0 accounted for 15.4%;incidence of adverse reactions was 5.6%,mainly subcutaneous blood spots (petechiae) and urine occult blood,and incidence of severe hemorrhage (intracerebral hemorrhage) was 0.7%. CONCLUSIONS:At present,the clinical application of warfarin is still deficient,and qualified rate of INR is still low. It's important to actively carry out medication intervention and clinical pharmaceutical care.

Objective To evaluate the effect of caffeine citrate on oxygen metabolism in brain and intestine in premature infants with neonatal respiratory distress syndrome (NRDS).Methods Preterm infants aged 30-34 weeks with NRDS admitted in Guangzhou Women and Children's Medical Center during May 2015 and April 2016 were enrolled.They were administrated with maintainance dose of caffeine citrate at the 2nd day after birth.The oxygen metabolism in brain and intestine 1 h before,during and after the administration were recorded by near infrared spectroscopy.Results The cerebral oxygen saturation (ScO2) showed a less significant change before,during and after treatment.While a marked increase was seen in intestinal oxygen saturation (SsO2) during and after caffeine citrate administration,as well as the change of SsO2/ScO2 than before.SsO2/ScO2 was dramatical higher in infants with nasal continuous positive airway pressure (nCPAP) than in those with incubator oxygen supply and mechanical ventilation during and after caffeine citrate treatment than before.Conclusion Caffeine citrate may improve the delivery of oxygen and may increase the oxygenation in local tissues for preterm infants with NRDS,especially for infants with nCPAP.

This study was aimed to explore the impact of activated carbon adsorption modified by different concentrations of nitric acid and ammonia,in order to examine the impact on adsorption of mannotriose by modified activated carbon.The activated carbon was processed by different concentrations of nitric acid and ammonia.And then,the adsorption capacity of benzene,iodine,methylene blue and the purification effects on mannotriose were measured.The results showed that the active carbon modified by nitric acid and ammonia had some changes of adsorptions for methylene blue,iodine and benzene.The purification effect of mannotriose with nitric acid-modified activated carbon was declined.The purification effect of mannotriose with ammonia-modified activated carbon was increased.It was concluded that the pore structure of activated carbon had been changed by nitric acid and ammonia.The adsorption capacity of nitric acid modified active carbon to mannotriose was declined.However,the adsorption capacity of ammonia modified active carbon to mannotriose was increased.It showed that ammonia modified active carbon was suitable for the purification of mannotriose.And the adsorption capacity of iodine reflected the adsorption capacity of mannotriose by active carbon.

This study was aimed to improve the transfer rate of sinomenine in the intermediate product of Caulis Sinomenii in order to optimize the purification process of intermediate product ofCaulis Sinomenii fromTong-An (TA) injection. The transfer rate of sinomenine and the stability of fingerprints in the intermediate product of Caulis Sinomenii were used as indexes for the investigation on the impact from different pH ofCaulis Sinomenii extract before extraction. The transfer rate of sinomenine was used as an index for the investigation on the impact by different pH of hydrochloric acid created to dry extract solution. The transfer rate of sinomenine was used as an index for the investigation of four separation ways, which included the vacuum filtration, plate and frame filters, high-speed tube separator, and flat direct centrifuge, on the liquid separation of sinomenium acutum acid. The results showed that the pH ofCaulis Sinomenii extract before extraction was 10-11; the transfer rate of sinomenine was the highest in the extraction process and the fingerprints of TA injection was stable. The pH of hydrochloric acid was 2.0-2.5; and the highest transfer rate of sinomenine in acid dissolution process was 92.94%. The high-speed tube separator had the best separation to sinomenium acutum acid-dissolving liquid. The highest transfer rate of sinomenine was 93.34%. It was concluded that the optimized process can effectively improve the transfer rate of sinomenine in the intermediate product ofCaulis Sinomenii. Meanwhile, fingerprints of the product were stable. The process was simple with good repeatability.

Objective To investigate the effect of comprehensive nursing intervention and evaluate its role in the entire clinical course of in the treatment of children with severe burns. Methods A total of 60 children with 1-5 years old with clinical diagnosis of severe burns were randomly divided into experimental group and control group by random digits table method, 30 cases in each group. The control group received routine burn care. The experimental group received comprehensive nursing interventions on the basis of routine burn care and the intervention time covered the entire course of treatment. During hospitalization, the recovery and family social system were evaluated by anxiety scales and social support scales combined with the cure rate and hospitalization of children. Results Before intervention, the score of Anxiety Rating Scale was high in both groups of families, while Social Support Scale was lower, the difference was not statistically significant between the two groups (P>0.05). After intervention, the score of Anxiety Rating Scale and was Social Support Scale were (52.31±7.81), (31.52± 5.48)points in the experimental group, and (62.51 ± 6.52), (23.62 ± 5.62) points in the control group, and there were significant differences (t=5.491 3, 5.512 5, P<0.01). The length of stay was (18.34±3.58) d in the experimental group, and (21.82 ± 4.23) d in the control group, and there was significant difference(t=3.439 6, P<0.05). The cure rate was 93.33%(28/30) in the experimental group, and 56.67%(17/30) in the control group, and there was significant difference(χ2=10.755 6, P<0.05). Conclusions The comprehensive nursing intervention can provide comprehensive refinement of the overall care in children and their families, promote physical and psychological rehabilitation of children with severe burns, and repair their family and social support systems. The comprehensive nursing intervention has far-reaching implications for the rehabilitation of children with severe burns.

Mobile learning has the characteristics of mobility,timeliness,network and virtu-ality. We developed virtual hospital suitable for mobile devices and organized students in to a network. Through early training,clinical case screen,learning objective fix,learning process and results evaluation,mobile devices were employed to do problem-based learning,which is conducive to the integration of theory with practice,the shifting from discipline-centered to system-based courses and the improving of utilization rate of learning resource.

Objective To explore the clinical characteristics including the morbidity, clinical manifestation, and pathogens of late-onset sepsis (LOS) in very low birth weight (VLBW) infants in neonatal intensive care unit (NICU). Methods Clinical data of all VLBW infants in NICU from January 2011 to December 2013 were collected. According to the results of blood culture, the VLBW infants diagnosed with LOS were divided into confirmed LOS group and clinical LOS group. The morbidity, clinical manifestations, common pathogens, and drug sensitivity of LOS were retrospectively analyzed. Results In 226 VLBW infants, there were 117 cases of LOS with the morbidity at 51.8%. Forty-five infants were confirmed to have LOS by blood culture, accounting for 19.9% (45/226); another 72 infants were diagnosed with clinical LOS, accounting for 31.9% (72/226). The rates of tachycardia and temperature fluctuation in confirmed LOS group were higher than those in clinical LOS group, and there were significant differences (P<0.05). There were 51 strains of pathogenic bacteria, with 32 Gram-negative bacteria (62.7%), 16 Gram-positive bacteria (31.4%), and 3 fungi (5.9%).The common pathogenic bacteria were Klebsiella pneumoniae and coagulase negative Staphylococcus,the most of which were multidrug-resistant bacteria.Conclusions The incidence of LOS in VLBW infants is high. The main clinical manifestations are sudden changes in breathing, heart rate, mental state, and skin color. Although these manifestations are not specific,they could serve as early warning.The common pathogenic bacteria are Klebsiella pneumoniae and coagulase negative Staphylococcus,and both of them are multidrug resistant.

Objective A series of 4 substituted salidroside derivatives were designed and synthesized .Their anti-fatigue effects were investigated .Methods With five-acetyl glucose and different 4-substituted benzyl tyrosols as the starting materi-als ,salidroside derivatives were synthesized through glycosidation and deacetylation reactions .The exercise exhaustive mice model was used to study the anti-fatigue effects of those synthesized derivatives by comparing the loading swimming time of mice .Results 10 novel salidroside derivatives were synthesized .The loading swimming tests showed that the swimming time of the mice in the positive group (salidroside) and 3a-1 group (phenethyl-β-D-glucoside) was longer than that in the control group with statistically significant difference(P<0 .05) .The swimming times for other groups were similar to control group with no statistically significant difference .Conclusion This synthetic method for salidroside derivatives was convenient and feasible for large production .The 4-hydroxyl groups on the benzene ring of salidroside and its derivatives may be the active site responsible for their anti-fatigue activity .

We constructed a phage-displayed random mutation library of Tat38-61(51N/55N), for studying the molecular evolution screening of HIV-1 Tat38-61 epitope. We used primers containing the random nucleotide sequences, and introduced the random mutations at the sites of 51 and 55 amino acids coding sequences into full-length Tat sequences by overlapping PCR. With the randomly mutated full-length Tat as template, the Tat38-61(51N/55N) mutants which contained recognition sequences for the Xba I in both ends were amplified by PCR using the designed primers. The mutants were cloned into Xba I site in the phagemid vector pCANTAB5S, then the recombinants were transformed into E. coli TG1, a phage-displayed the random mutation library of Tat38-61(51N/55N) was constructed by the rescue of help virus M13KO7. The results showed that the library consisted of about 5.0 x 10(6) colonies and the phage library titer was 2.65 x 10(12) TU/mL. More than 56.50% colonies in the library were positive for insertion. Sequence analysis showed that the nucleotides encoding amino acids at the sites of 51 and 55 distributed randomly. The constructed mutation library could meet the requirements for the following molecular evolution screening, and might prepare the Tat mutants for the further study of new Tat vaccine candidates.
AIDS Vaccines ; immunology ; Escherichia coli ; genetics ; metabolism ; HIV-1 ; genetics ; Humans ; Mutation ; Peptide Fragments ; biosynthesis ; genetics ; immunology ; Peptide Library ; Recombinant Proteins ; biosynthesis ; genetics ; immunology ; tat Gene Products, Human Immunodeficiency Virus ; biosynthesis ; genetics ; immunology