Objective To explore the treatment of kala-azar with antimonial resistance in children. Method The clinical data of antimony resistant Kala Azar in a child was analyzed retrospectively, and the related literature were reviewed. Results A 2-year- and 5-month-old boy, suffered from fever, pancytopenia and hepatosplenomegaly. He was diagnosed with kala-azar by bone marrow examination, and improved after the treatment of adequate antimonial. Later, he relapsed twice and the treatment of adequate was effective.. This was the third relapse, and was considered as antimonial resistance. Liposomal amphotericin B (1 mg/kg on day 1, 2 mg/kg on day 2, 3mg/kg on day 3~7 and day 10, with accumulated dose of 21 mg/kg) was used and effective. The child improved and no relapse in one-year follow-up. Conclusion Liposomal amphotericin B can be used in the treatment of kala-azar with antimonial resistance in children.

Objective To analyze the prevalence of nosocomial infections among inpatients and its influential factors.Methods The retrospective survey was performed by reviewing and analyzing the clinical data of 7788 inpatients in 2004 in Nankai Hospital of Tianjin.Results Totally 250 nosocomial infection cases were identified,which gave a prevalence of 3.21%.The all-year highest prevalence was found in September.Among all the departments,the highest rate,5.20%,occurred in Department of Gynecology.The inpatients aged more than 60-year-old showed higher prevalence than those under 60 years old.The main infection position was lower respiratory tract(41.60%).Concludes The prevalence of nosocomial infections of Nankai Hospital were within the acceptable standard range defined by Ministry of Health,China.Nevertheless,the prevalence would be reduced if measurements for surveillance and control could be properly applied.

Fine needle aspiration cytopathology of the breast is an effective means of distinguishing malignant from benign,and the aspirated sample collections techniques is the primary and key part of fine needle aspiration.Fine needle aspiration cell block has been improved and used on preoperative breast cancer molecular portraits.This paper will provide an introduction to application of specimens collection techniques,application and development of fine needle aspiration cell block on preoperative breast cancer molecular portraits.

Preliminary research in our laboratory found that compound YZG-330 can reduce mouse body temperature, which could be blocked by adenosine A₁ receptor (A₁R) antagonist DPCPX. Based on the downstream signaling pathway of the A₁R, the mechanism by which YZG-330 lowers body temperature was further studied. The pharmacodynamics of YZG-330 was evaluated by measuring the rectal temperature; expression of the transient receptor potential (TRP) ion channel, the P38 protein and its phosphorylated form in mouse hypothalamic homogenate were detected by Western blotting. A Ca²⁺ fluorescent probe, Fluo-3AM, was added to cells to detect the effect of YZG-330 on the Ca²⁺ content of mouse hypothalamic cells. YZG-330 dose-dependently reduced the body temperature in mice, and the selective P38 inhibitor SB-203580 (20 mg·kg^-1, i.p.) significantly inhibited the hypothermic effect of YZG-330. A TRPM8 antagonist 2 (0.1 μg per mouse, i.c.v.) markedly attenuated the hypothermic effect of YZG-330 (0.25 or 1 mg·kg^-1, i.p.). YZG-330 (2 mg·kg^-1, i.p.) significantly increased the phosphorylation of P38, an effect that could be attenuated by the A₁R antagonist DPCPX (5 mg·kg^-1, i.g.) in mouse hypothalamus. In addition, YZG-330 also prominently enhanced the expression of TRPM8, which could be blocked by SB-203580; YZG-330 (0.1-10 μmol·L^-1) increased intracellular Ca²⁺ concetration in mouse hypothalamic cells in a dose-dependent manner, and was inhibited by the A₁R inhibitor DPCPX (0.5 and 1 μmol·L^-1) and TRPM8 antagonist 2 (1 μmol·L^-1). In conclusion, YZG-330 exerts its hypothermic effect by activating the A₁R to promote the phosphorylation of P38 protein and thereby up-regulating the expression and activity of the TRPM8 ion channel, resulting in increased intracellular Ca²⁺ concentration to stimulate mouse hypothalamus cells to down-regulate body temperature. All animal experiments were approved by the Ethics Committee of the Institute of Materia Medica, Chinese Academy of Medical Sciences.

With the development of natural products, the research activities on the solubilization methods of water-insoluble natural products have been carried out worldwide. Big molecular weight and poor solubility of most natural active ingredients lead to a very poor oral absorption and low bioavailability, which has extremely limited their development in pharmaceutical fields and clinical application. As a result, it is necessary to find out a suitable technique to improve the solubility and enhance the oral bioavailability of insoluble natural drugs. Based on the related references published in these years, this review introduced some new techniques to improve the solubility and bioavailability of natural drugs, including prodrugs, inclusion complex, solid dispersion, cocrystals, osmotic pump, liquisolid compacts, micronization, self-microemulsifying, nanosuspensions, lipsomes, polymeric micelles and so on, and summarized the theory, characteristics, application range, application examples, problems and development direction of each technique.
Administration, Oral ; Biological Availability ; Biological Products ; administration & dosage ; chemistry ; pharmacokinetics ; Chemistry, Pharmaceutical ; methods ; trends ; Solubility ; Technology, Pharmaceutical ; methods ; trends ; Water

The main active components in Ginkgo biloba extracts were Ginkgo biloba flavonoids and lactone compounds. This pa-per reviewed on the kinds and pharmacological effects of the active ingredients in Ginkgo biloba extracts, and focused on four aspects including controlled-release preparations, solubilized solid preparations, nanoparticle formulations and time- and site-specific formula-tions to introduce the development in the new dosage forms of Ginkgo biloba flavonoids and lactone compounds.

OBJECTIVE To analyze the resistance feature and the distribution of Enterococcus species isolated from bile specimens.METHODS Totally 715 samples of bile in intra-operation were cultured,and the drug resistances were tested.RESULTS From them 511 strains in 469 cases were detected out(65.6%),among whith 156 were Enterococcus strains and 159 were strains of Escherichia coli.The mixed infection with two kinds of germs was found in 35 cases.The results of drug susceptibility showed the resistant rates of Enterococcus faecalis to penicillin and high concentration gentamicin were lower than those of E.faecium.None of E.faecalis,and E.faecium resisted to vancomycin.CONCLUSIONS The detective rate of the Enterococcus is high in bile samples.The results reveal a different resistance to common antibiotics,but a high sensistivity to vancomycin and teicoplanin.The result of antibiotic susceptibility testing guides rational use of antibacterial agents.

Objective To investigate the clinical features, diagnosis and treatment of aortic dissection. Methods Clinical data including manifestations,imageology, treatment and turnover in 23 patients with aortic dis-section, hospitalized in our hospital from January 2006 to April 2008, were retrospectively analyzed. Results There were 8,5 and 10 cases classified in type Ⅰ ,type Ⅱ and type Ⅲ,all of them were complicated with hypertension. Typi-cal syndromes were manifested in 20 patients (86.9%) and were not in the others (13.0%). Surgical operation were performed in 6 patients of type Ⅰ and 5 patients of type Ⅱ, and endovascular repairments were performed in Ⅰ patient of type Ⅰ and 10 patients of type Ⅲ. All the patients were recovered except that two patients of type Ⅰ died. Conclusions Most patients with aortic dissection present typical manifestision. CT or MRI is one of the most valua-ble diagnosis. The patients in type Ⅰ and type Ⅱ should be treated with the surgical operation, and the patients in type Ⅲ with endovascular stent-graft repairment.

Medicine, Chinese Traditional ; Translations ; Yin-Yang

Objective To identify the optimal surgical approaches for the resection of adrenal tumors. Methods The choices and effects of surgical approaches in 1 077 patients with adrenal tumors of varying sizes and types were analyzed. Results An 11th or 10th intercostal incision was used for 567 cases of aldosterone producing adrenocortical tumors (APA) and Cushing syndrome (CUS).An 11th or 10th incision was used in 173 cases of pheochromocytomas and 136 cases of incidental tumors.Transabdominal approach was performed in 136 cases of pheochromocytomas and 22 cases of incidental tumors.Twenty five patients receiving thoracoabdominal approach were all those with pheochromocytomas or incidental tumors.Nine patients with adrenal tomors less than 4 cm in diameter received laparoscopic surgery.Surgeries included 1 060 cases of tumor resection and 17 cases of biopsies,and splenectomy was procedured in 9 patients simultaneously. The main complication of 11th or 10th intercostal incision approach was pleural injury,and transabdominal approach had its main complication of spleen injury. Conclusions An 11th or 10th intercostal incision is the best choice for patients with APA,CUS and pheochromocytoma or incidental tumor less than 7 cm in diameter.For tumors greater than 7 cm,transabdominal or thoracoabdominal approach is indicated.Transabdominal approach is also indicated for extra adrenal or multiple pheochromocytomas and bilateral adrenal tumors.The 11th or 10th intercostal incisions or thoracoabdominal incisions provide more chances of renal vessel repair and renal sparing compared with transabdominal approach for pheochromocytomas adjacent to the renal vascular pedicle.Laparoscopic surgery is suitable for patients with adrenal tumors less than 6 cm in diameter.