OBJECTIVE To assess the diagnostic and prognostic value of C-reactive protein(CRP) levels,body temperature and white blood cell(WBC)count for hospital-acquired pneumonia(HAP).METHODS Temperature,and concentration of CRP and WBC count of the patients were determined daily,and fixed a day for sequential organ failure assessment(SOFA).Then observed the prognosis be cured,stable out of ICU or death.Patients were divided into death and survival groups according to the prognosis and analyzed retrospectively.RESULTS There were four response modes of CRP ratio after antibacterial treatment:fast response,slow response,nonresponse and biphasic response.All patients with fast response and most patients with slow response survived,whereas all patients with nonresponse and biphasic response were died(P

[Objective]To probe the approach of supplementing Qi and nourishing Yin in the treatment of lung cancer. [Methods] With detailed research into Chinese medicine literature from recent years regarding its application in lung cancer, the basic pathogenesis of lung cancer, and relevant clinical effects and fundamental research of lung cancer are summarized.[Result]Numerous studies have shown that Qi and Yin deficiency is the basic pathogenesis of lung cancer, thus the approach of supplementing Qi and nourishing Yin can reduce the side effects and strengthen the clinical effects of radio-chemotherapy, stim-ulate immune function, improve life quality, and prolong the survival time of the patients.[Conclusion]It is significantly obvious that the approach of supple-menting Qi and nourishing Yin has shown great advantages in the treatment of lung cancer, however further clinical and basic research are expected.

OBJECTIVE: To study the inhibitory effect of Longzhi extracts (extracts from a Chinese herbal compound) on the growth of transplanted hepatoma H22 and sarcoma S180 in mice. METHODS: Certain dosage of Longzhi extracts was dissolved into distilled water to obtain the suspension of definite concentration. The suspension of 0.2 ml was planted on the right forefoot of each mouse. The mice were randomly divided into groups 24 hours later and treated for 7 days. One day after the treatment stopped, the mice were sacrificed and the tumor masses were taken out and weighed. RESULTS: The inhibition rates of Longzhi extracts on the tumor of transplanted H22 and S180 were 63% and 41% respectively. CONCLUSION: Longzhi extracts has antitumor action.

Objective To study the antimicrobial susceptibility of Staphylococcus aureus isolated from children with infectious skin diseases in Beijing area and to investigate the prevalance of community acquired methicillin-resistant S.aureus (MRSA).Methods S.aureus was isolated from 600 outpatients with infectious skin diseases in Beijing Children's ospital.The susceptibility of these isolates to 14 antimi crobial agents was determined by agar dilution method according to the guidelines from Clinical and Laboratory Standards Institute (CLSI).Results Totally，451 S.aureus strains were isolated.Of them,93.8% were resistant to penicillin,87.6% to erythromycin,71.6% to lindamycin,37.3% to etracycline,13.3% to chloramphenicol,6.4% to gentamicin,1.6%to oxacillin,2.2% to ciprofloxacin,0.4% to cefazolin,0.2% to cefuroxime and mupirocin.No resistance was found to vancomycin,ceffriaxone or fusidic acid.Conclusions The results suggest that penicillin and erythromycin are no longer the appropriate agents for the treatment of S.aureus.The prevalance of MRSA iS 1.6% in children with infectious skin diseases in Beijing area.Oxacillin and cephalosporin are recommended for systemic treatment of community acquired MRSA,and mupirocin or fusidic acid for its topical treatment.

Objective:To evaluate the role of autophagy in reduction of high glucose and hypoxia-reoxygenation (HG+ H/R) injury to isolated cardiomyocytes by dexmedetomidine in rats.Methods:The normally cultured rat H9c2 cardiomyocytes at the logarithmic growth phase were seeded in 6-well plates at a density of 1×10 6 cells/ml and divided into 4 groups ( n=15 each) using a random number table method: control group (group C), group HG+ H/R, dexmedetomidine group (group DEX) and dexmedetomidine+ autophagy inhibitor 3-methylpurine group (group 3-MA). The cells were incubated in culture medium with 1% fetal bovine serum + 1% double antibody for 24 h when the cell density reached 50%.To establish HG+ H/R injury model, the cardiomyocytes were cultured in high-glucose culture medium (glucose concentration of 33 mmol/L) for 24 h, and then incubated in a 37 ℃ incubator (95% N 2+ 5%CO 2) for 4 h followed by reoxygenation (90%O 2+ 10%CO 2) for 2 h. Dexmedetomidine was added until the final concentration reached 5 μmol/L at 1 h before hypoxia in DEX and 3-MA groups, and 3-MA was added until the final concentration reached 5 μmol/L at 1 h of incubation with dexmedetomidine.At 2 h after reoxygenation, the cell viability was recorded by the cell counting kit-8 assay, lactate dehydrogenase (LDH) activity was detected by LDH kit, the expression of autophagy-related protein LC3, P62 and Beclin-1 was detected by Western Blot, the ratio of LC3Ⅱ/LC3Ⅰwas calculated, and the expression of P62 and Beclin-1 mRNA was detected by real-time polymerase chain reaction. Results:Compared with group C, the cell viability was significantly decreased in HG+ H/R, DEX and 3-MA groups, LDH activity in the supernatant was increased and expression of P62 was decreased in HG+ H/R and 3-MA groups, ratio of LC3Ⅱ/LC3Ⅰwas decreased in group 3-MA, and the expression of Beclin-1 was down-regulated in group HG+ H/R ( P<0.05). Compared with HG+ H/R group, LDH activity in the supernatant was significantly decreased, expression of Beclin-1, P62 and its mRNA was up-regulated, and ratio of LC3Ⅱ/LC3Ⅰwas increased in DEX group, and LDH activity in the supernatant was increased in group 3-MA ( P<0.05). Compared with DEX group, cell viability were decreased, LDH activity in the supernatant was increased, Beclin-1, P62 and its mRNA was down-regulated, and ratio of LC3Ⅱ/ LC3Ⅰwas decreased in group 3-MA ( P<0.05). Conclusion:Autophagy is involved in the reduction of HG+ H/R injury to isolated cardiomyocytes by dexmedetomidine in rats.

Objective To analyze the feature of B cell epitope of soluble liver antigen(SLA) in autoimmune hepatitis. Methods Twenty-one autoimmune hepatitis(AIH) were enrolled the study. The control groups included 15 primary biliary cirrhosis(PBC) patients, 20 chronic virus hepatitis patients and 20 heaths. The serum incubated with coated one dimension of SLA peptide pools by ELISA for mapping the B cell epitopes. ELISPOT was performed to screen the SLA specific T cell response by observing the secretion of IFN-γ after PBMC simulated. Results Ten serum samples from AIH patients recognized the SLA peptide pools, the frequency was 47.62%, which was higher than PBC group, virus hepatitis group and normal control group, P value was 0.001, <0.001 and <0.001, respectively. The 10 positive serum dominant response to SLA 7 th pool(aa385-441), which laid in the unique no conservative region of the SLA molecular. T cell recognizing regions laid dominantly in first and second pool, the frequency was 30% and 40%, respectively, however the recognized frequency of 7th pool was 10%. Conclusion B cell linear epitopes lie in the sequence aa385-441, which is the unique unconservative region in the high conservative SLA molecular and overlaps with part sequence of T cell epitopes. The results show it is complex and interaction that SLA induced humoral-mediated immunity and cellular immunity to involve in AIH pathogenesis.

ObjectiveTo evaluate the therapeutical effect and toxicity of home-made paclitaxel and cisplatin combination in metastatic breast cancer.Methods Home-made paclitaxel 175 mg/m2,d1 intravenous drip,cisplatin 80 mg/m2,d1-3 intravenous drip,21-28 d was one cycle,all patients continuous course treatment for 2-6 cycles,then the effect was evaluated.ResultsAll the patients received meso-cycle were 4 (2-6) cycles chemotherapy.The total effective rate was 56.60％ (30/53),disease control rate was 81.13％(43/53 ).The rates of internal organ metastasis and non-internal organ metastasis,before menopause and after menopause had no significant difference [56.76％ (21/37) vs.56.25％ (9/16),59.09％ (13/22) vs.54.84％ ( 17/31 ),P ＞ 0.05 ].The median existence time for all the patients was 18.8 ( 12-27 ) months.The survival rate was 56.60％ (30/53) and 30.19％ (16/53) for 1 and 2 years respectively.The major toxieities were gastrointestinal reaction,alopeoia and myelosuppression,the rates of nerve and heart toxicities were less,15.09％ (8/53) and 7.55％ (4/53) respectively.ConclusionThe therapeutic effect of home-made paclitaxel and cisplatin combination in metastatic breast cancer is good,it is to be worth to spread in clinic.

Objective To investigate the effect of blood hemoperfusion with resin adsorption connected in series to continuous veno-venous hemofiltration ( HP + CVVH) on plasma cytokines such as TNF-α,IL-1β,IL-6 as well as cellular immunity and prognosis of patients with multiple organ dysfunction syndromes (MODS). Methods It was a prospective,randomized clinical trial.A total of 30 patients diagnosed as MODS were randomly (random number) divided into routine treatment + HP + CVVH group (treatment group) and routine treatment + CVVH group (control group).In treatment group,patients received blood hemoperfusion with resin adsorption for 2 hours,and then CVVH for 10 hours every day for 3days.In control group,patients received CVVH for 12 hours every day for 3 days.The plasma samples of patients in treatment group were obtained 0 h,2 h,12 h,24 h,26 h,36 h,48 h,50 h,60 h,5 days,7 days and 10 days after renal replacement therapy.The plasma samples of patients in control group were obtained 0 h,12 h,24 h,36 h,48 h,60 h,5 days,7 days and 10 days after renal replacement therapy.All of these patients were monitored with APACHE Ⅱ score,T-lymphocytes subpopulations,blood lactate acid concentration,heart rate,respiration rate and oxygenation index. Results Plasma levels of TNF-α,IL-1β and IL-6 decreased dramatically after HP (P ＜ 0.01 ) and T-lymphocytes subpopulations CD3+,CD4 +,CD8 + and CD4 +/CD8 + increased after both HP + CVVH and CVVH.The differences in plasma levels of TNF-α,IL-1βand IL-6 of patients between two groups were not noticeably obvious at the intervals of 12 h,36 h,and 50 h after renal replacement therapy. But on the 5 th day after renal replacement therapy,plasma levels of TNF-α,IL-1βand IL-6 of patients in HP + CVVH group were lower than those in control group (P ＜ 0. 05 ).There were 5 fatal patients in HP + CVVH group and 6 patients died off in CVVH group during 28 days after treatment.Conclusions Both HP + CVVH and CVVH could lower the levels of plasma TNF-α,IL-1β and IL-6,and improve cellular immunity and clinical symptoms as well as signs.Compared with CVVH,plasma levels of TNF-α,IL- 1β and IL-6 were lower on the 5th day and increase rate of 28-day survival in HP + CVVH group.

Object: To investigate the effects of Huaiqihuang Granule, a compound Chinese herbal medicine, on expressions of nephrin and podocin of slit diaphragm of glomerular podocytes in rats with adriamycin-induced nephrosis and to explore the mechanism in reducing the proteinuria. Methods: Twenty SD rats were randomly divided into five groups: control group, model group, glucocorticoid group, Huaiqihuang Granule group and Huaiqihuang Granule plus glucocorticoid group. The 24-hour urine was collected 7, 14, 21 and 28 days after adriamycin injection respectively to measure 24-hour urinary protein, and all rats were sacrificed after 28-day treatment. Pathological changes in renal tissues were observed under a light microscope and an electron microscope. Expressions of nephrin and podocin mRNAs in renal cortex were determined by real-time polymerase chain reaction, and protein levels of nephrin and podocin were detected by Western blotting. Results: (1) In the model group and the treatment groups, the level of urinary protein increased significantly from the 14th day. (2) Under the light microscope, inflammatory cells and slight fibroplasia were found in renal interstitium of the model group, but there were less inflammatory cells in renal interstitium in the intervention groups than in the model group. Under the electron microscope, 29 days after adriamycin injection, extensive fusion of foot processes was observed. (3) The expressions of nephrin and podocin were higher in treatment groups than in the model group. (4) Proteinuria level was negatively correlated with the expressions of nephrin mRNA and nephrin and podocin proteins. Conclusion: The above results indicate that Huaiqihuang Granule can maintain the integrity of the slid diaphragram in podocyte, alleviate the lesion of glomerular filtration membrane, and decrease the proteinuria by up-regulating the expressions of nephrin and podocin. Huaiqihuang Granule plus glucocorticoid maybe has better effects than glucocorticoid alone.