Objective: To reveal if the use of antimicrobi als is rational in the authors hospital.　Methods: 1 025 cases were investigated retrospectively by systematic sampling from all the inp atients of the year 1997.　Results: 77.8% of the subjects were treated with antimicrobials, of whom, 55.2% treated with 2 or more antimicr obials. Yet only 39 cases had microbiological test before the administration of antimicrobials.　Conclusion: Inappropriate use of antimicr obials exists in the hospital. The management of the use of antimicrobials and c ontinuing education of medical doctors should be enhanced so as to make the use of antimicrobials more rational.

BACKGROUND: Mesenchymal stem cells (MSCs) are capable of differentiating into a variety of lineages, including bone, cartilage, or fat, depending on the inducing stimuli, specific growth and differentiation factors.Recombinant human bone morphogenetic protein 2 (rhBMP-2) produced by gene engineering has an obvious osteoinductive activity and can induce undifferentiated mesenchymal cells into cartilage and bone irreversibly, resulting in new bone formation. Basic fibroblast growth factor (bFGF) modulates chondrogenic and osteogenic differentiation of MSCs.OBJECTIVE: To investigate the effect of bFGF and rhBMP-2 on the differentiation and proliferation of cultured rabbit mesenchymal stem cell in order to find out an optimal way of osteogenesis instead of conventional osteogenic supplements (OS).DESIGN: A randomized and controlled trial.SETTING: General Institute of Orthopaedic Oncology, Tangdu Hospital,Fourth Military Medical University of Chinese PLA.MATERIALS: The subjects were rabbit mesenchymal stem cells cultured by the author.METHODS: This experiment was conducted at the Center of Orthopaedic Surgery, General Institute of Orthopaedic Oncology, Tangdu Hospital,Fourth Military Medical University of Chinese PLA from June 2004 to December 2004. ①Rabbit MSCs cultured in vitro were treated with different growth factor (100 μg/L rhBMP-2, 100 μg/L bFGF, 10 μg/L rhBMP-2and 100 μg/L bFGF and OS; ②The proliferation and differentiation of MSCs were observed through activity of MTT, expression of alkaline phosphatase(ALP), and von Kossa staining.MAIN OUTCOME MEASURES: the rate of proliferation and the activity of ALP.RESULTS: ①rhBMP-2 could promote the proliferation and differentiation of MSCs, especially the cell differentiation; ②bFGF could stimulate the proliferation , the cellular proliferation rate increased 100% as compared with control group, and has no effect on differentiation of MSCs , but it could enhance effect on the cell proliferation of rhBMP-2.CONCLUSION: bFGF and rhBMP-2 are effective induction factors for MSCs. Both of them can stimulate the proliferation and differentiation of MSCs in vitro. bFGF and rhBMP-2 exerted a synergetic action in speeding up the pace of osteoinduction and osteogenesis and can be used to differentiate seed cells for tissue engineering bone.

OBJECTIVETo explore the clinical efficacy of moxibustion on rheumatoid arthritis (RA) in the patients and the impacts on the inflammatory indices.

METHODSForty RA patients were randomized into an observation group and a control group, 20 cases in each one. In the control group, diclofenac sodium sustained release tablets were used, 0.3 g each time, twice a day; methotrexate tablets were used, 10 mg each time, once a week; folic acid was used, 5 mg each time, once a week. In the observation group, on the basis of the treatment as the control group, moxibustion was added specially on the swelling and painful joints, once a day, 15-20 min each time till: the local skin turned slightly red. The treatment was given once a day, at the interval of 1 day after every 6 treatments. In the two groups, the efficacy was observed after 30-day treatment. Before and after treatment, the rheumatoid factor (RF), high sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), disease activity score-28 (DAS-28) and the score of joint symptom and physical signs were observed.

RESULTSCompared with those before treatment, the levels of RF, hs-CRP, ESR, DAS-28 and the symptom scale score were all reduced in the RA patients of the two groups after treatment (all P < 0.05). Compared with the control group, the levels of RF, hs-CRP, ESR, DAS-28 and the symptom scale score in the observation group were improved much apparently (all P < 0.05). The total effective rate was 85.0% (17/20) in the observation group and was 80.0% (16/20) in the control group. The total effective rate in the observation group was apparently better than that in the control group (P < 0.05).

CONCLUSIONMoxibustion as supplement relieves the joint symptoms, reduces the inflammatory reactive indices and improves the clinical efficacy in the RA patients.

Adult ; Aged ; Arthritis, Rheumatoid ; blood ; therapy ; C-Reactive Protein ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Rheumatoid Factor ; blood ; Treatment Outcome ; Young Adult

OBJECTIVETo compare the clinical effective differences between pricking blood combined with moxibustion and west medication for acute gouty arthritis.

METHODSForty patients with acute gouty arthritis were randomly divided into a pricking blood combined with moxibustion group (a combination group) and a western medication group, 20 cases in each one. In the combination group, pricking blood was used at the most painful points of the red turgid and painful joint once three days, total 3 times; moxibustion was applied at the same joint for 15-20 min, once a day. The moxibustion was adopted for 10 days. In the western medication group, 0. 3 g ibuprofen was prescribed orally twice a day for 10 days. The changes of uric acid (UA), high sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR) and the joint syndrome and symptom score before and after: treatment were observed. Results In the two groups, the UA, the hs-CRP, the ESR and the joint syndrome and symptom scores were lower than those before treatment (all P<0. 05). After treatment, the UA, the ESR and the joint syndrome and symptom scores in the combination group were declined more apparently than those in the western medication group (all P<0. 05). The total effective rate in the combination group was 85. 0% (17/20) which was better than 75. 0% (15/20) in the western medication group (P<0. 05).

CONCLUSIONPricking blood combined with moxibustion could improve the joint symptoms more effectively and the effect is better than ibuprofen orally.

Adolescent ; Adult ; Aged ; Arthritis, Gouty ; therapy ; Bloodletting ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Treatment Outcome ; Young Adult

Objective To investigate the effect of different time of hypoxia reoxygenation (HR) on cell autophagy and cell viability.Methods According to the different reoxygenation time,H9C2 cells were divided into five groups:normal control group (group A),hypoxia group (group B),reoxygen 2h group (group C),reoxygen 12h group (group D) and reoxygen 24h group (group E).The expression of LC3 Ⅱ/LC3 Ⅰ in each groups was detected by Western Blot,and the activity of myocardial cells was detected by MlT.Results MlT results showed that the viability of the myocardial cells after hypoxia 2h/reoxygenation 2h was significantly lower than that in the normal control group (P＜0.05).The ratio ofLC3 Ⅱ/LC3 Ⅰ of the cells in group B (hypoxia group),group C (reoxygen 2h group),group D (reoxygen 12h group),group E (reoxygen 24h group) was significantly higher than that of group A (normal control group) (P＜0.05).Among them,the ratio of LC3 Ⅱ/LC3 Ⅰ of the cells in group C and D were significantly higher than that of group B (P＜0.05),paticlularly the group D was the highest (P＜0.05).The activity of myocardial cells in group D was the lowest among all groups.Conclusion Culturing in the three gas incubator can obviously decrease the viability of H9C2cells.Hypoxia can activate autophagy,and autophagy increases significantly after reoxygenation.Autophagy may be activated most obviously at 12 hours and decrease to the level of hypoxia group at 24 hours.Cells can be damaged by hypoxia,and further increase of cellular damage may occur after oxygen inhalation.At 12 hours,the cell viability is the lowest,and the cell viability may be improved at 24h.

To evaluate the value of serum human epididymis protein 4(HE4),cancer embryonic antigen(CEA), carbohydrate antigen(CA125,CA19-9,CA153),alpha fetoprotein(AFP) and β-human chorionic gonadotrophin (β-HCG) in ovarian cancer early diagnosis.Methods:Abbott Architect i2000SR was used to detect the levels of preoperative serum tumor markers (n=7) in ovarian cancer group,benign ovarian tumor group and the normal control (each n=60).Results:The levels of serum HE4,CA125, CA199,CEA,CA153,AFP and β-HCG in ovarian cancer group were markedly higher than the benign ovarian tumor group and the control group.There was statistically significant difference ( P<0.05 ).The diagnosis of ovarian cancer tumor markers were high specificity,but sensitivity was not high except HE4 (76.67%) and CA125 (68.33%).With Youden Index,the area under curve of ROC,the HE4 was demonstrated higher specificity ,sensitivity and accuracy.There was also medium diagnostic value of CA 125 ,CA199 and CEA for ovarian cancer.The sensitivity of ovarian cancer diagnosis is raised by combined assay with serum tumor marker ,but the specificity would be reduced accordingly.HE4, CA125, CA199 and CEA combined detection is considered the best.Conclusion:CA153,AFP and β-HCG have lowered diagnosis for ovarian cancer.HE4, CA125, CA199 and CEA combined detection could significantly improve specificity ,sensitivity and accuracy in the early diagnosis of ovarian cancer.

Objective To investigate the prevention efficiency of spanishneedles herb eye drops on rabbit model with dry eye syndrome caused by sex hormones decline in peri-menopause. Methods Totally 26 rabbits ( 26 right eyes) with dry eye model were studied,and divided into two groups:group A ( the control group, n=12) and group B ( the spanishneedles herb eye drops group, n=12) ,another two rabbits were used as normal control.The Schirmer I tests (SIT), and corneal fluorescein ( FL) were detected, and the total protein content in tear, amylase activity, lactoferrin and lysozyme contents were measured and confocal scanning microscopy were performed at pre-therapy and 1 week,2 weeks,1 month,2 months after therapy,respectively. Results There were no significant difference in the total proteins,lysozyme,lactoferrin and amylase activity between two groups at pre-therapy (P>0.05).After 2 months treatment, there were statistical differences in all items of group A(P<0.05), and SIT, FL in group B(P<0.05).There were significant differences in all indexes between group A and B at 1 wk,2wk,1mo,2mo after therapy.After 2 months treatment,the mean numbers of corneal basal cell in the group B were significantly lower(3 452±422)than those in the group A ( 4 104 ± 568 ) ( P<0. 05 ) . The mean numbers of the inflammatory cells in the group B ( 42 ± 18 ) were significantly lower than those in the group A(208±69)( P<0.05). Conclusion Spanishneedles herb eye drops has significant prevention effect on dry eye syndrome caused by sex hormones decline in peri-menopause.

Objective To investigate the value of magnetic resonance sialography (MRS) as a noninvasive tool in evaluating major salivary gland function before and after radiotherapy (RT) for nasopharyngeal carcinoma patients.Methods From August 2009 to June 2010,patients with stage Ⅰ and Ⅱa (AJCC/UICC 2002) nasopharyngeal carcinoma were enrolled.All the patients were treated with intensity modulated radiation therapy alone.MRS with salivary stimulation was performed in patients before and after RT on a 3.0T MR scanner.An MRS categorical scoring system was used to compare the visibility of ducts pre-RT and post-RT.The relationship between MRS score and EORTC Core QOL and EORTC Head and Neck QOL was analyzed.Spearman rank correlation test was performed to analyze the non-stimulated and stimulated MRS findings and the clinical severity of xerostomia.Results All 10 enrolled patients completed planned treatment.The mean dose of the parotid glands and submandibular glands were (37.99 + 3.70) Gy and (55.65 + 2.99) Gy,respectively.Good-quality MRS images were obtained.The visibility scores of both the parotid and submandibular ducts were increased after secretion stimulation.Irradiation decreased the visualization of the salivary ducts and attenuated the response to secretion stimulation.There were specific correlations between post-RT secretion response of the parotid gland and EORTC QLQ scales ( global QOL scale in QLQ-C30 ( rs =0.636,P =0.048 ) and xerostomia scale in QLQ H&N35 ( rs =- 0.694,P =0.026) ).Conclusions MRS can be used as a non-invasive way to evaluated of the functional changes of major salivary glands before and after RT and as a promising approach for investigating radiation-induced xerostomia.

Objective To observe the changes of blood flow density in the macular area of normal eyes,and to analyze its correlation with age.Methods A cross-sectional study.Two hundred and fifty normal healthy subjects (125 males and 125 females,aged 44.76± 14.77) in routine ophthalmologic examination at the Department of Ophtalmology of Guangdong Provincial People's Hospital during June 2017 to June 2018 were enrolled.Among them,20 to 29,30 to 39,40 to 49,50 to 59,and ≥ 60 years old were 50 subjects (50 eyes) in each.BCVA,slit lamp microscope,indirect ophthalmoscope,OCT angiography (OCTA) examinations were conducted for all eyes.The subjects were examined by both eyes,and the data of 1 eye was selected by EXCEL to generate random numbers,including 126 right eyes and 124 left eyes.The range of 6 mm × 6 mm in the macular area was scanned using a frequency domain OCTA instrument.The software automatically divides it into three concentric circles centered on the macular fovea,which were foveal area with a diameter of 1 mm,parafoveal area of 1 to 3 mm,and foveal peripheral area of 3 to 6 mm.The blood flow density of superficial capillary vessel,deep capillary vessel and foveal avascular area (FAZ) within a 300 μm width (FD-300),FAZ area,perimeter (PERIM),non-circularity index,center retinal thickness (CRT) were measured.The relationship between the blood flow density in macula,CRT,FAZ and age was analyzed by Pearson correlation analysis.Results The mean blood flow density of superficial capillary vessel and deep capillary vessel were (51.61 ± 2.54)％ and (54.04± 5.46)％,respectively.The average FD-300,CRT,PERIM and non-circularity index were (285.55 ± 12.13) μm,(2.150 ± 0.367) mm,1.10 ± 0.04,respectively.The relevance of the results showed that the age was negatively correlated with the blood flow density of whole area (r=-0.335,-0.279;P＜0.01),parafoveal area (r=-0.255,-0.368;P＜0.01),foveal peripheral area (r=-0.330,-0.269;P＜0.01) in superficial capillary vessel and deep capillary vessel as well as FD-300 (r=-0.311,P＜0.01),but not correlated with the blood flow density of foveal area (r=-0.071,-0.118;P=0.264,0.064).There was no relationship between the age and the FAZ area,PERIM,non-circularity index (r=-0.070,-0.055,0.074;P=-0.267,0.385,0.142).The age was negatively correlated with the average CRT (r=-0.217,P＜0.01),but not correlated with the CRT in foveal area (r=0.115,P=0.068).The CRT was positively correlated with the blood flow density of superficial capillary vessel and deep capillary vessel in foveal area (r=0.715,0.653;P＜0.01),but negatively correlated with the FAZ area (r=-0.669,P＜0.01).Conclusion The capillary blood flow density ofmacular area in the normal eyes decreases with age.

Objective:To analyze the clinical characteristics and prognosis of patients with primary aldosteronism (PA) associated with subclinical Cushing syndrome (SCS).Methods:This retrospective cohort study was conducted at the First Affiliated Hospital of Chongqing Medical University in China. Patients with PA were included between January 2014 and December 2022. According to the results of 1-mg overnight dexamethasone suppression test, the patients were divided into the PA group and PA associated with SCS (PA/SCS) group. The demographic information, hormone levels, and follow-up results were analyzed. Independent sample t-test, chi-square test and Mann-Whitney U test were used for data comparison. Results:A total of 489 PA patients were enrolled in this study, of which 109 had PA/SCS (22.3%). Patients with SCS were on average older (54.4±10.7 vs . 47.4±11.0, P<0.001); had a larger proportion of women (69.7%, 76/109 vs . 57.4%, 218/380; P=0.020); and a longer duration of hypertension [96 (36, 180) vs . 60 (12, 120) months, P=0.001] than patients without SCS. There were 215 and 51 patients in the PA group and PA/SCS group, who completed adrenalectomy and follow-up, respectively. The remission rate of autonomous cortisol secretion in the PA/SCS group was 85.3% (29/34). There was no significant difference in the remission rate of autonomous aldosterone secretion among patients between the PA/SCS and PA group (94.1%, 48/51 vs. 94.4%, 203/215; P=1.000), while the clinical remission rate in the PA/SCS group was lower than that in the PA group (39.2%, 20/51 vs. 61.9%, 133/215; P=0.003). Conclusions:SCS is common in PA patients (22.3%), and the clinical remission rate is low. Screening using the 1-mg overnight dexamethasone suppression test is recommended for all patients with PA.