Objective To establish erythromycin resistance models of Streptococcus pneumoniae for analysis of the mutations in the binding domain of erythromycin. Methods Streptococcus pneumonia tigr4 and two clinical sensitive isolates were induced with erythromycin by minimum inhibitory concentration (MIC) method for antimicrobial susceptibility, and then the rplD, rplV genes, and 23S rRNA in sensitive and resistant strains were amplified by PCR and RT-PCR for sequencing. CPHmodels-2.0 was used to predict the spatial structures of ribosomal protein L4 and L22 coded by rplD and rplV genes. Results MIC of Streptococcus pneumonia tigr4 increased from 0.0312 mg/L to 256mg/L while MICs of the two clinical isolates increased from 0.0312 mg/L to 32 mg/L. Comparison of the pre-and post-induction results showed V32A mutation in ribosomal protein L4, D35G mutation in ribosomal protein L22, and 67QK68 to 67RE68 mutations in ribosomal protein L4. Changes in spatial structure was found in SiThe ribosomal protein L22 and ribosomal protein L4 due to D35G, Q67R, and K68E mutations respectively. Conclusion Streptococcus pneumonia can be induced to resistant to erythromycin in vitro. The mechanisms of resistance may be relate to the new mutations in the binding domain of erythromycin.

BACKGROUND:Open reduction is general y not advocated for the treatment of children clavicle fracture, because the thick and tough periosteum remains intact and attached by the ligament attachment. In clinic, twin-ring external fixation and simple suspension are commonly used, but there is no reliable basis on which method can get better effect.
OBJECTIVE:To compare the stability of twin-ring external fixation and simple suspension for the treatment of children clavicle fracture.
METHODS:The patients with children clavicle fracture and treated by twin-ring external fixation and simple suspension were selected from June 2008 to December 2012, including 17 patients treated with simple suspension and 22 patients treated with twin-ring external fixation. The X-ray film examination was performed regularly to observe the fracture healing and shoulder function.
RESULTS AND CONCLUSION:The 17 patients treated with simple suspension had good healing;three cases had gap between fracture ends at 1 week after treatment, and re-suspension to increase the height and final y two fracture ends contacted in one case;for the other two cases, there was stil gap between fracture ends, and changed for twin-ring external fixation, the fracture ends contacted. Al the 22 patients in the twin-ring external fixation group obtained healing;five cases had performance of upper extremity neurovascular compression on the fracture side after fixation;after releasing, three cases had recovery, and two cases were treated with simple suspension, the fracture ends began to contact;six cases had armpit redness;four cases had early sleep difficulties;two cases had gap between fracture ends at 1 week after treatment, and after re-adjust, the fracture ends contacted in two cases. The results showed both two methods could not cause appearance deformity, and both could get healing. The simple suspension fixation is easy to operate with reliable effect, and it is comfortable which make it easy to accept by the children, it has the advantages of early for functional exercise, less tissue damage, does not affect the blood supply;the twin-ring external fixation is easy to compress the axil ary arteries and nerves on both sides, thus resulting in upper extremity swel ing, numbness and skin redness, and it can cause discomfort night sleeping and poor comfort which is not easy for children to accept. But, no matter what method we take, the review after 1 week, as wel as the line between proximal and distal part and the contact between fracture ends is stil important.

Objective To investigate the relationship between preoperative anemia,low albumin,low body mass index and the prognosis of advanced gastric cancer.Methods Three hundred and seventeen patients diagnosed with advanced gastric cancer as well as complete clinical pathology data from January 2006 to January 2008 were retrospectively analyzed.The clinical pathologic factors including age,gender,tumor size,type of Borrmann,hemoglobin,serum albumin,body mass index,type of histology,blood vessels and lymphatic invasion,infiltration depth,lymph nodes metastasis.The single factor and multiple factors were analyzed.Results Tumor size,type of Borrmann,hemoglobin,serum albumin,body mass index,type of histology,blood vessels and lymphatic invasion,infiltration depth and lymph node metastasis were identified as influencing factors of the prognosis,while independent factors associated with the prognosis of gastric cancer were serum albumin (OR =1.546,95％ CI:1.069-2.237),infiltration depth (OR =1.933,95％ CI:1.182-3.162) and lymph nodes metastasis (OR =1.586,95％ CI:1.358-1.853).Conclusion Anemia and low body mass index are the influence factors but not the independent factors in the prognosis of gastric cancer,while low albumin concentration is the independent factor in the prognosis of gastric cancer.

Objective To observe the effects of intensive training at different intensities on the expressions of semaphorin 3A ( Sema 3A) and its receptor neuropilin ( NP-1 ) and the cell apoptosis in cerebrum after cerebral ischemia-reperfusion in rats,and to investigate the possible mechanism of intensive training in recovery of motor function after cerebral ischemia-reperfusion in rats.Methods To establish animal model of cerebral ischemia-reperfusion in rats,the intraluminal thread method was applied to cause left middle cerebral artery occlusion (MCAO) for 2 h and before reperfusion.After cerebral ischemia-reperfusion model were established for 24 h,60 male model Wistar rats were randomly divided into training group 1 ( swimming for 5 min once a day),training group 2 ( swimming for 10 min once a day),training group 3 (swimming for 10 min twice a day) and control group (no training) ; another 15 rats assigned to the sham-operation group were subject to no MCAO and no training.Neurological function was evaluated by Garcia scores,and terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL) was performed to dectect the cortical cell apoptosis.Expressions of neural growth inhibition factor Sema 3A and its receptor NP-1 were detected by immunohistochemistry.Results The neurological function in sham-operation group was normal.The differences of Garcia scores at different time points beween sham-operation group and control group were significant (P ＜ 0.01 ).Garcia scores in all training groups,were significantly higher than those in controls at the 7th and 14th d after swimming training ( P ＜ 0.01 ),especially in training group 3 the Garcia scores were ( 12.80 ± 0.45 ),( 15.20 ± 0.45 ),( 16.80 ± 0.45 ),respectively,at the 3rd,7th and 14th d after swimming training.The rates of positive cell of Sema 3A,NP-1 and TUNEL indexes in all training groups were lower than those in controls at the 3rd,7th and 14th d after swimming training (P ＜ 0.01 ),especially in the training group 3.At the 3rd,7th and 14th d after swimming training in training group 3,the rates of TUNEL indexes positive apoptosis cells were ( 29.43 ± 1.38 ) ％,( 22.30 ± 1.21 ) ％,( 17.58 ± 1.70) ％,respectively,the positive cell rates of Sema 3A were ( 19.64 ± 1.17) ％,(9.73 ± 3.83)％,(8.24 ± 0.87)％,respectively,the positive cell rates of NP-1 were ( 33.95 ± 6.86) ％,( 27.95 ± 1.29 ) ％,( 18.90 ± 1.44 ) ％,respectively,the reduction of positive cells expressions in training group 3 was significantly more obvious compared with other training groups (P ＜ 0.01 or 0.05).Conclusions Rehabilitation training can reduce the expression of positive cell of Sema 3A,NP-1 and TUNEL indexes in rats after cerebral ischemia-reperfusion and can improve motor function recovery and facilitate neural plasticity.The more intensive the training,the better the effects.

Objective To explore how neutrophil-lymphocyte ratio (NLR) is related with inflammation and atherosclerosis,and the role of NLR in hospitalization in maintenance hemodialysis (MHD) patients.Methods MHD patients treated in hemodialysis center of Sichuan Provincial People's Hospital from June till November 2013 were enrolled.Patients with severe infection,cardiovascular events and malignant carcinoma were excluded.NLR was determined from complete blood count differential.Clinical parameters such as serum albumin,lipids,intact parathormone,ferritin,C-reactive protein (CRP),25-(OH) vitamin D,interleukin-6 (IL-6) and alkaline phosphatase (ALP) were collected.Pulse wave velocity (PWV) and ankle-brachial index (ABI) were used to evaluate the arterial stiffness.Spearman analysis was used to evaluate the relationship between NLR and these parameters.All patients were divided into low NLR group (NLR≤3.25) and high NLR group (NLR ＞3.25) on the median NLR,and their differences in these indexes were analyzed.During the one-year follow-up,the reasons and rates of hospitalization and survival were analyzed.Results One hundred and thirteen MHD patients including 58 males and 55 females were enrolled with (69±49) dialysis age and (54± 15) average age.(1) The NLR was significantly correlated with whole blood count (WBC,r=0.538,P＜ 0.001),ABIL (r=0.201,P=0.033),ABIR (r=0.235,P=0.012) and total cholesterol (TC,r=-0.414,P＜ 0.001) and low-density lipoprotein cholesterol (LDL-C,r=-0.378,P ＜ 0.001).(2) Low NLR patients had increased TC,LDL-C and IL-6 as compare with high NLR patients,however decreased ABIL and ABIR (all P ＜ 0.05).(3) Forty one patients were hospitalized 63 times during the follow-up period.Annual hospitalization rate was 558/1000 and the mortality rate was 17.7/1000.(4)NLR in patients at least hospitalized once a year was significantly lower than in patients without hospitalization,while ALP was higher (all P ＜ 0.05).Compared with those in other patients,NLR and hemoglobin (Hb) were significantly lower in patients with hospitalization due to infection,while ALP was higher (all P ＜ 0.05).Conclusions NLR is related with WBC,ABI,TC and LDL-C in MHDpatients.Lower NLR may indicate high risk for cardiovascular,atherosclerosis and hospitalization,probably different form non-MHD patients,which needs more studies to verify.

In order to realize an individualized and specialized rehabilitation assessment of remoteness and intelligence, we set up a remote intelligent assessment system of upper limb movement function of post-stroke patients during rehabilitation. By using the remote rehabilitation training sensors and client data sampling software, we collected and uploaded the gesture data from a patient's forearm and upper arm during rehabilitation training to database of the server. Then a remote intelligent assessment system, which had been developed based on the extreme learning machine (ELM) algorithm and Brunnstrom stage assessment standard, was used to evaluate the gesture data. To evaluate the reliability of the proposed method, a group of 23 stroke patients, whose upper limb movement functions were in different recovery stages, and 4 healthy people, whose upper limb movement functions were normal, were recruited to finish the same training task. The results showed that, compared to that of the experienced rehabilitation expert who used the Brunnstrom stage standard table, the accuracy of the proposed remote Brunnstrom intelligent assessment system can reach a higher level, as 92.1%. The practical effects of surgery have proved that the proposed system could realize the intelligent assessment of upper limb movement function of post-stroke patients remotely, and it could also make the rehabilitation of the post-stroke patients at home or in a community care center possible.
Algorithms ; Arm ; physiopathology ; Artificial Intelligence ; Humans ; Movement ; Recovery of Function ; Reproducibility of Results ; Software ; Stroke Rehabilitation

Humans ; Medicine, Chinese Traditional ; methods ; Tongue ; metabolism ; pathology

Objective To investigate the expression and location of Matrix metalloproteinase-9 (MMP-9) in human salivary gland tumors and the effect of MMP-9 in soft and neural invasion,and to find whether there will be a rational option to treat saliary gland tumors by inducing MMP-9,especially saliary malignant tumors.Methods A total of 140 cases of human salivary gland tumors,including 32 cases of plemorphic adenoma tissues,28 cases of basal cell,adenoma tissues,40 case of mucoepidermoid carcinoma tissues,16 case of carcinomatous metastasis,24 case of no metastasis,18 cases of neurotropism,22 of case non-neurotropism,adenoid cystic carcinoma tissues of 40 cases and normal human salivary tissues of 10 cases were detected the expression and location of MMP-9 by PV-9000 polymer detection system for immunohistoch emical staining mcthod.The relationship between the expression and clinical pathological behaviors was analyzed.Results The positive rate of MMP-9 expression in salivary gland malignant tumors,salivary gland benign tumors and normal salivary glands was 72.5％,30.0％ and 10.0％ ( x2 =32.12,P ＜ 0.01 ).The positive rate of MMP-9 was 93.75％ (15/16) in the mucoepidermoid carcinoma tissue,which was signicantly different from that of 66.67％ (16/24) in the carcinomatous metastasis group ( x2=4.038,P ＜ 0.05 ).The positive rate of MMP-9 in the normal human salivary tissues,adenoid cystic carcinoma tissues and mucoepidermoid carcinoma tissues was 10.0％ (1/10),67.5％ (27/40) and 77.5(31/40) (x2=16.263,P＜0.005).Significant difference was found between groups of neurotropism and non-neurotropism on the positive rate of MMP-9 expression in adenoid cystic carcinoma(94.44％ vs 63.63％,x2=5.389,P ＜ 0.05 ).Conclusion MMP-9 is correlated with the invasion and metastasis of malignant salivary gland tumors,and can be used as an indicator of potential metastasis.The finding suggests that MMPs suppressor combined with antiangiogenic agents might be a new option to treat saliary gland tumors.

OBJECTIVETo observe therapeutic effects of qi supplementing, yin nourishing, blood stasis dispersing, collateral dredging recipe (QYBCR) on early diabetic nephropathy (DN).

METHODSSeventy-eight early DN patients were randomly assigned to the treatment group (39 cases, treated by QYBCR) and the control group (39 cases, treated by irbesartan). The changes of the therapeutic efficacy, Chinese medicine syndrome scores, urine albumin excretion rate (UAER), serum creatinine (SCr), blood urine nitrogen (BUN), fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), and the occurrence of end-point events were observed after one-year treatment.

RESULTSThe total effective rate in treatment group was 83.8% (31/37 cases), which was obviously higher than that in control group (60.5%, 23/38 cases) (P < 0.05). After treatment the Chinese medicine syndrome scores were reduced significantly in the treatment group (P < 0.05, P < 0.01), and showed significant difference when compared with those in the control group (P < 0.05, P < 0.01). Levels of UAER, SCr, BUN, FBG, TC, and TG were (65. 78 +/- 9.67) microg/min, (93.20 +/- 12.99) micromol/L, (5.69 +/- 1.21) mmol/L, (6.14 +/- 1.47) mmol/L, (4. 85 +/- 0. 83) mmol/L, (1.46 +/- 0.81) mmol/L after treatment in treatment group. All of them decreased more significantly than before treatment [(161.03 +/- 20.01) microg/min, (101.11 +/- 14.33) micromol/L, (6.54 +/- 1.12) mmol/L, (9.27 +/- 2.32) mmol/L, (6. 19 +/- 2.13) mmol/L, (2. 70 +/- 1.86) mmol/L] (P < 0.05, P < 0.01). The aforesaid indices were also improved in the control group after treatment (P < 0.05, P < 0.01). The reduction of TC and TG after treatment in the treatment group was more significant [(5.58 +/- 1.57) mmol/L, (1.99 +/- 1.22) mmol/L] (P < 0.05). Besides, the incidence rate of end-point events (5.4%, 2/37) (1 year after the development of clinical DN) of the treatment group was slightly lower than that of the control group (10.5%, 4/38), but with no statistical difference.

CONCLUSIONQYBCR combined with Western medicine-based treatment showed better therapeutic efficacy on early DN.

Adult ; Aged ; Biphenyl Compounds ; therapeutic use ; Diabetic Nephropathies ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Qi ; Tetrazoles ; therapeutic use

OBJECTIVETo observe the clinical effect of combined treatment with safflor yellow powder injection and benazepril in treating patients with diabetic nephropathy (DN).

METHODSSeventy-six patients with DN were randomly assigned to the treatment group (39 cases) and the control group (37 cases). Conventional treatment for lowering blood glucose was given to both groups, but to the control group 10 mg benazepril was given orally once a day additionally, while to those in the treatment group the same dosage of benazepril po. and 150 mg/d of safflor yellow powder injection by adding in 250 mL 0.9% normal saline for intravenous dripping. The therapeutic course for them all was 15 days, and all patients received two courses with an interval of 5 days. Changes of clinical symptoms, urinary albumin excretion rate (UAER), blood and urinary levels of beta2 -microglobulin (beta2 -MG), urinary level of alpha1-microglobulin (alpha1 -MG), D-dimer (D-D) and plasma fibrinogen (FIB) were observed.

RESULTSThe total effective rate in the treatment group was higher than that in the control group (84.62% vs 59.45 %, P < 0.05). The total score of syndrome in the treatment group was lower than that in the control group (P < 0.05). Levels of UAER, 132-MG in serum and in urine, alpha1-MG in urine were decreased significantly after after 2 courses of treatment in both groups, showing significant difference as compared with before treatment (P < 0.05 or P <0.01), and the decrements were more significant in the treatment group than those in the control group (P <0.05); while decrease of FIB, D-D only happened in the treatment group (P <0.01), so the post-treatment data in the treatment group were significantly lower as compared with those in the control group (P <0.01).

CONCLUSIONCombined therapy with safflor yellow injection and benazepril is superior to benazepril alone in reducing urinary albumin, improving renal function and blood hyperviscosity manner for patients with DN, suggesting the combination of the two could play their respective superiorities and act in cooperation for retarding the progression of DN.

Adult ; Albumins ; analysis ; Benzazepines ; administration & dosage ; Blood Glucose ; Diabetic Nephropathies ; drug therapy ; metabolism ; urine ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Kidney Function Tests ; Male ; Middle Aged