Objective To investigate the interaction of in vitro antibacterial activity between cefoperazone-sulbactam and imipenem against carbapenem-resistant Acinetobacterbaumannii.Methods The minimum inhibitory concentrations (MIC) of imipenem and cefoperazone-sulbactam against Acinetobacter baumannii were detected and the fractional inhibitory concentration (FIC) index of imipenem/cefoperazone-sulbactam combination was calculated by broth micro-dilution method.The interactions of imipenem and cefoperazone-sulbactam were assayed by K-B agar plate method.Results The MIC50 of cefoperazone-sulbactam and imipenem were both 16 mg/L,and MIC90 of the two drugs were both 64 mg/L.Among the 26 strains of Acinetobacter baumannii,16 strains had FIC indexes ≤0.5,and 10 had FIC indexes≥2.0.K-B agar plate assay showed that the cefoperazone-sulbactam/imipenem combination was synergistic for strains with FIC indexes≤0.5,and antagonistic for strains with FIC indexes ≥ 2.0.Conclusions Imipenem in combination with cefoperazone-sulbactam can be either antagonistic or synergistic against carbapenem-resistant Acinetobacter baumannii.The clinical use of cefoperazone-sulbactam/imipenem combination for the treatment of carbapenem resistance Acinetobacter baumannii infections should be cautious in case of antagonism.

ObjectiveTo study the correlation between essential hypertension and plasma aminopeptidase A.MethodsThe people of the Han nationality in Huainan city received questionnaire investigation and their blood pressure,height and weight were measured.131 individuals suffered from hypertension and 134 healthy individuals belongs to hypertensive pedigree and 127 individuals suffered from hypertension and 132 healthy individuals belongs to non-hypertensive pedigree were reseached.The level of Ang Ⅱ in plasma was detected by RIA,and the level of APA was detected by ELISA.ResultsThe levels of Ang Ⅱ and APA in plasma in HP group was significantly higher than that in NHP group in two pedigrees ( t =10.3398,6.5613,11.7089,6.6683,all P ＜ 0.01 ).Furthermore,the levels of Ang Ⅱ and APA in plasma in HP group in hypertensive pedigree was significantly higher than that in HP group in nonhypertensive pedigree(t =3.6201,6.1091,all P ＜ 0.01 ).There was significantly positive correlation between MAP and the levels of Ang Ⅱ and APA in plasma in HP group in two pedigrees ( r =0.315,0.392,all P ＜ 0.05 in non-hypertensive pedigree,and r =0.412,0.505,all P ＜ 0.01 in hypertensive pedigree ).There was positive correlation between the levels of Ang Ⅱ and APA in plasma in HP group in hypertensive pedigree ( r =0.322,P ＜ 0.05 ).ConclusionThere was significant difference between hypertensive pedigree and non-hypertensive pedigree in the levels of APA;The levels of APA in plasma in HP group was significantly increased in the individuals suffered from hypertension,and was positively correlated with MAP.

Objective To analyze the related factors of relapse of leukemia after transplantation of nonmyeloablative allogeneic hematopoietic stem cells. Methods Among the twenty-nine patients with acute leukemia who received transplantation of nonmyeloablative allogeneic peripheral blood stem cells, relapse of leukemia occurred in 5 patients. The nonmyeloablative protocol included the pretreatment of CD3 monoclonal antibody, cyclosporine A, cyclophosphamide, cytarabine, and fludarabine was added in 3 patients. Results All the 5 patients went through smoothly the hematopoietic suppression stage, and engraftment of the donor cells was successful. Leukemia relapsed in 4 patients with full donor chimerism (full donor chimerism was converted from the mixed chimerism in 2 patients), and relapse occurred in 1 patient with stable mixed chimerism. Except for 1 patient, all of them did not show acute GVHD or chronic GVHD. Second complete remission after double transplant was achieved in one patient, but leakemia relapsed in two months. In other four patients treatment was given up. Conclusion Transplantation of nonmyeloablative allogeneic peripheral blood stem cells is a safe and effective method for the treatment of acute leukemia.

Objective:To observe the clinical efficacy of Jianpiqinghua Particles and Wentong Powder on early stage of diabetic feet adding to basal treatment,and to establish a standardized clinical diabetic foot prevention program of integrated traditional Chinese medicine.Methods:Take a randomized blind placebo-controlled add-on trial:The treatment group of 20 was given with Jianpiqinghua Particle(oral),Wentong Powder(foot washing),the control group of 20 was given placebo by same methods.The course in both groups was16 weeks.The change of total effect body and foot feeling(VAS scale),electro-neurophysiological examination and ankle/brachial ratio were evaluated.Results:The TCM group was superior to the control group in improving the body and feet clinical symptoms,nerve conduction velocity,evoked potential amplitude and the ABI index(P

We investigated the clinical and photographic characteristics of uremic lung and review the associated literature,so as to improve the diagnostic and therapeutic abilities of uremic lung.The clinical symptoms and signs together with the photographic characteristics of the patient who was diagnosed as uremic lung complicated with pulmonary infection and congestive heart failure in our division were analysed and the associated literature was reviewed.The patient was admitted for the complaint of cough,expectoration and dyspnea.He was diagnosed as chronic renal failure with pulmonary infection and congestive heart failure.The symptoms alleviated after adequate hemodialysis and antibiotic therapy.However,mild dyspnea remained with photographic examination still showing consolidation in the lungs.The diagnosis of uremic lung was established after the exclusion of pulmonary infections of other pathogens and tumor.After 8-month maintenance hemodialysis,the pulmonary lesions were thoroughly absorbed.Uremic lung is a common complication of end-stage renal failure.The diagnosis is established after the exclusion of cardiac pulmonary edema,pulmonary infections and tumors.Sufficient hemodialysis is the most adequate treatment for uremic lung.Abstract:SUMM ARY W e investigated the clinical and photographic characteristics of urem ic lung and review the associated literature,so as to improve the d iagnostic and therapeutic abilities of urem ic lung.The clinical symptoms and signs togetherwith the photographic characteristics of the patientwho was d iagnosed as ure-m ic lung complicated with pulmonary infection and congestive heart failure in our d ivision were analysed and the associated literature was reviewed.The patientwas adm itted for the complaint of cough,expecto-ration and dyspnea.He was d iagnosed as chronic renal failure with pulmonary infection and congestive heart failure.The symptoms alleviated after adequate hemod ialysis and antibiotic therapy.However,m ild dyspnea remained with photographic exam ination still showing consolidation in the lungs.The d iagnosis of urem ic lung was established after the exclusion of pulmonary infections of other pathogens and tumor.Af-ter 8-month maintenance hemod ialysis,the pulmonary lesionswere thoroughly absorbed.Urem ic lung is a common complication of end-stage renal failure.The d iagnosis is established after the exclusion of card iac pulmonary edema,pulmonary infections and tumors.Sufficient hemod ialysis is the most adequate treat-ment for urem ic lung.

Controlling serum phosphorus levels is critical in patients with renal failure. Currently phosphate-binding agents are widely used to reduce phosphate absorption in patients with endstage renal disease. If possible,serum phosphorus level should be reduced without disturbing calcium homeostasis or increasing accumulation of potentially toxic elements. Aluminum hydroxide and traditional calcium -based phosphate binders are commonly used to control serum phosphorus level. Aluminum hydroxide can effectively lower serum phosphorus level,but aluminum can accumulates in the body and results in toxic effect. Traditional calcium-based phosphate binders tend to promote hypercalcemia and calcium overloading,and accelerate cardiovascular calcification. Therefore aluminum -free and calcium-free phosphate-binding agents have become the focus of study; however,agents like sevelamer hydrochloride and lanthanum carbonate are not widely used due to high price,although they are effective in controlling serum phosphorus level. New generation of phosphate binders,such as colestilan,nicotinic acid and magnesium salt,are cheaper than their previous counterparts,but their long -term effect still needs to be observed. This article summarizes the progress of non-calcium phosphate binders in treatment of end-stage renal diseases,hoping to help clinical drug usage.

Objective The current study was to investigate the clinical and pathological features of macroscopic hematuria associated acute kideny injury (MH-AKI) in patients with IgA nephropathy (IgAN) and its associated prognostic factors.Methods We performed an analysis on the clinical and pathological features of biopsy-proven IgAN patients diagnosed during 2004 to August of 2007,who had experienced MH associated AKI.The patients enrolled in the study were followed up.The renal lesions were evaluated with Katafuchi pathological scores of IgAN.Results 5 patients with IgAN had experienced at least one episode of MH-AKI,accounting for 1.3% of IgAN diagnosed during the same period and 13.5% of IgAN patients with macroscopic hematuria.High proportion of tubules filled with red blood cell casts and tubular injury were demonstrated in all biopsy specimens.Renal function of 3 patients completely recovered within 14 days.One patient (patient 4) got quick recovery in the first month of the disease but completely recovered 418 days later.The other patients only had an incomplete recovery during the 20-month follow-up.The incompletely recovered one had relatively an older age,longer persistence of MH,more sclerotic glomeruli and a more severe tubule-interstitial damage.Conclusion AKI is commonly seen during episodes of MH in patients with IgAN.Not all patients with MH-AKI showed a complete recovery.Age,duration of MH,proportion of glomerular sclerosis and the severity of tubular necrosis might be the risk factors of an incomplete recovery of renal function.

Objective To evaluate the efficacy of endovenous laser treatment(EVLT) in the treatment of varicose veins in lower limbs. Methods A total of 450 cases of varicose veins in lower limbs(606 limbs) received EVLT with 940 nm diode laser under a continuous mode from October 2003 to February 2006.All the patients were evaluated with color ultrasonography after the operation.Results The follow-up duration was 2～29 months(mean,16 months).Satisfactory effects were achieved in XXX cases,with varicose veins subsided and sense of swelling and heaviness significantly relieved.In 49 cases accompanying active ulcers before operation,the ulcer healed within 10 days after operation in 44 cases and within 16 days in 5 cases.Five cases experiencing a heat injury were dismissed from hospital on the 7th day after operation.Conclusions EVLT is a minimally invasive operation possessing safety,simple performance,and effectiveness,and without leaving any scar.It is an ideal method in the treatment of varicose veins of lower limbs.

Objective To investigate the role of interferon ?on smooth muscle cells proliferation and migration after balloon injury. Methods Animal model of rabbit iliac artery balloon injury was set up, smooth muscle cells derived from injured artery were cultured. Smooth muscle cells were divided into four groups ( control, TGF ? 1, IFN ?, TGF ? 1 and IFN ?).Cells from each group were treated with medium or TGF ? 1 (10 ng/ml) and/or IFN ?(500 u/ml) for 72 h separately. Smooth muscle cell proliferation was determined by cell count and MTT, migration of smooth muscle cells was also detected. Matrix metalloproteinase 2 was also detected by zymography. Results Our results showed that, compared with group control(2.875?0.323?10 5 cells/ml,279.9?8.129 ?m), TGF ? 1 increased cell count (4.188?0.239?10 5 cells/ml, P

Medical has the dual attributes essentially , which is not only a science but also a humanology . Therefore , it needs to be nourished by rich humanistic spirit .At present , the generalization of medical technology , the abnormal development of medicine socialization and the less care from humanities to medical and many other reasons lead to the lack of humanistic spirit of medicine .To correct the phenomenon of the disorder, we should explore the effective means actively to provide powerful support for the returning of the medical humanism .There-fore, using an appropriate method to strengthen the humanities education of medical students and attention in the classroom will be regarded as good path in medical humanities spirit returning .