Objective The study was designed to evaluate the clinical efficacy of azithromycin in lung function of patients with IPF.Methods Randomized controlled trials were searched in CNKI,data-base of Wanfang and WeiPu,where azithromycin was used to patients with IPF.We extracted all data on lung functions,standardized mean difference (SMD)with 95% confidence intervals (CI )were pooled with Stata 11.0.Results Seven unique trials with 516 participants were identified.Be compared to pred-nisone,the patients with IPF received azithromycin experienced no improvement in FVC% [SMD = -2.00,95% CI =(-2.05,-1.95)],but it was found that azithromycin was superior to prednisone in in-crease the percentage of carbon monoxide diffusing [SMD =1.16,95% CI =(-2.83,5.16)]and de-cline the percentage of residual volume[SMD =3.00,95% CI =(1.04,4.96)].Azithromycin combined with prednisone were statistically superior to prednisone alone in improvement of FEV1 %[SMD =7.80, 95% CI =(5.92,9.67)],FVC%[SMD =7.23,95% CI =(4.89,7.56)]and lung carbon monoxide diffusion function[ml/(min·kpa))][SMD =40.62,95% CI =(38.96,42.28)].Conclusions Our study suggests that azithromycin significantly improvement pulmonary diffusion function in patients with IPF. Azithromycin combined with prednisone were more effective in improvement of FEV1 %,FVC% and lung diffusion function.

OBJECTIVE:To investigate the effects of Wenxin granule on the related indexes of senile patients with primary hy-pertension and acute left cardiac failure. METHODS:160 senile patients with primary hypertension and acute left cardiac failure were randomly divided into control group(80 cases)and observation group(80 cases). Control group received 12.5 mg captopril, orally,twice to 3 times a day (if patients had taken plenty of diuretic drugs,in low sodium and/or low blood volume,patients with normal or low blood pressure,the initial dose was 6.25 mg,3 times a day). Observation group additionally given 9 g of Wenxin granule,3 times a day. The treatment course for both groups was 4 weeks. SBP,DBP,PP,SDANN,SDNN-Index,RMS-SD,PNN50,improvement of cardiac functions before and after treatment,and incidence of adverse reactions in 2 groups were ob-served. RESULTS:After treatment,the SBP,DBP and PP in 2 groups were significantly lower than before,and observation group was lower than control group,SDNN,SDANN,SDNN-Index、RMSSD and PNN 50 were significantly higher than before,and ob-servation group was higher than control group,the differences were statistically significant(P<0.05). And there was no significant difference in the incidence of adverse reactions(P>0.05). CONCLUSIONS:Based on conventional treatment,wenxin granule can significantly reduce the bloop pressure of senile patients with primary hypertension and acute left cardiac failure,improve cardiac functions and inhibit autonomic disorders,with good safety.

Objective To compare and analyze the biochemical detection results of separated se- ra with the separation gel coagulation promoting tubes and the drying tubes. Methods Venous blood samples was collected from identical blood donors and randomly poured into the separation gel vacuum collective tubes (test group) and traditional drying collective tubes (control group). After serum sepa- ration, timely biochemical detection was performed. The detection results were compared and ana- lyzed. The samples of test group were detected once again after storage for 24 h at 4 ℃. The results were compared with those of timely biochemical detection with separation gel separated sera. Results The results from the test group and those from the control group had no significant difference. The most results from the sera storaging for 24 h at 4 ℃ and those from the fresh serum of the test group had good correspondence. Only a few of biochemical indicators had significant difference. Conclusion The biochemical detection with sera obtained by separation gel tubes and those collected by drying tubes has good correspondence. The separation gel tubes provide the clinical laboratory optimal blood samples and more accurate results.

Objective To investigate the multi-resistance to antibiotics of clinical isolated klebsiella pneumoniae.Methods The resistance to antibiotics of clinical isolated klebsiella pneumoniae were monitored.The discconfirmatory test was used to detect extended-spectrum β-lactamases(ESBLs) and cefoxitin three-dimension was used to detect AmpC β-lactamases.Results Among the isolates there were 53 strains of ESBLs-producing bacteria (49.5% ), 30 strains of AmpC-producing bacteria(28.0%), 24 strains of ESBLs + AmpC-producing bacteria (22.46%).They were high resistance to aminoglycosides,quinolones and cephalosporins.Conclusion The multi-resistance to antibiotics of clinical isolated klebsiella pneumoniae were widespread.It is important to control nosocomial infection to strengthen the detection of the epidemiology of ESBLs and AmpC β-lactamases in clinical isolates.

BACKGROUND: Enthesitis is the most important pathologic change and one of the characteristic manifestations of spondyloarthropathy(SpA). However, its clinical manifestations lack specificity, and medical imaging techniques become an important auxiliary means in its diagnosis. Currently, ultrasound has been applied to examine the entheses of patients with SpA abroad, but so far there is no investigation about the ultrasonic manifestations of entheses in healthy volunteers.OBJECTIVE: To comprehend the acoustic imaging manifestations of entheses in healthy volunteers, and primarily investigate the feasibility of ultrasound in detecting entheses and the possible impact factors of acoustic imaging manifestations.DESIGN: A nonrandomized inter-controlled trail.SETTING and PARTICIPANTS: A total of 30 young healthy workers and medical students who worked or studied in the Third Affiliated Hospital of Sun Yat-sen University were included in our study, including 22 male and 8 female. None of them suffered from any arthropathies or chronic low back pain.INTERVENTION: High frequency and Color Doppler ultrasound were adopted to detect 540 entheses of 30 healthy volunteers, the entheseal thicknesses were compared respectively according to left and right sides, as well as the gender. X-ray was used to inspect if there were any abnormal findings at the attaching bones.MAIN OUTCOME MEASURES: The thickness, the echo inside entheses, the entourage, the attaching bone and the entheseal blood flow were detected.RESULTS: In normal entheses, there was a little lower but equal resonance, in which there was clear funicular fibrin resonance but without blood signal. Most entheses had a little higher membrane resonance, which was clearly divided from entourage. The surface of attaching bone was smooth and continuous. The mean thickness of the lower insertion of rectus femoris tendon, the upper insertion of patellar ligament, the lower insertion of patellar ligament, the lower insertion of tibial collateral ligament, the lower insertion of fibular collateral ligament, the insertion of Achilles tendon and plantar aponeurosis in male volunteers were(0.50 ±0.06), (0. 50 ±0. 07),(0.42±0.04), (0.20±0.03), (0.38±0.04), (0.52±0.07)and (0. 32 ±0.03) cm respectively, while the mean thickness of the corresponding insertions in female volunteers were (0.44 ± 0. 04), (0. 46 ± 0. 03 ),(0.39±0.03), (0.19±0.02), (0.32±0.02), (0.41±0.06)and (0. 28 ± 0.03) cm respectively. All entheses except for the lower insertion of tibial collateral ligament were thicker in male than in female( P ＜ 0. 05 ),but there were no significant differences in the thickness between left and right insertions ( P ＞ 0. 05 ). Calcification, erosion and hyperplasia of the attaching bone or increasing blood flow were found in 11 entheses of 8 volunteers(2.0% of all the 540 entheses detected) . There were 15 items of abnormal signs all together. Some of the abnormal sites had traumatic histories.CONCLUSION: The thicknesses are almost the same in the corresponding insertions between left and right sides, but the thicknesses of most insertions in male are thicker than those in female. Stature, body mass and exercise might impact on entheseal thickness. Trauma can cause abnormal acoustic imaging manifestations of entheses. Ultrasound is an available approach to detecting etheses.

Objective Continuous nursing intervention was conducted in patients with chronic hepatitis B by means of Weixin platform. The effect of this intervention on compliance of oral nucleoside (acid) analogues (NA) in patients with chronic hepatitis B was studied and analyzed.Methods A total of 240 patients with chronic hepatitis B treated in the Third People's Hospital of Guangyuan in Sichuan Province from October 2014 to December 2016 were recruited. According to the different nursing methods, all the research subjects were divided into experimental group (n=120) and control group (n=120). For the experimental group, a nursing WeChat team and related WeChat group was established to provide professional counseling, authoritative scientific diagnostic information, appointment registration and other continuous nursing intervention for 6 months. Patients in the control group were given routine nursing. All patients were given oral NA treatment. The score of compliance after 6 months' intervention, the rate of review at 1st, 3rd and 6th month after discharge, and the recurrence rate at 12th month after discharge.Results The score of compliance of the control group was (52.37±7.65), and experimental group (63.85±8.57) after intervention. The difference in compliance was statistically significant (t=10.947,P<0.05). After intervention, the number of high compliance patients was 51 in the experimental group, which was higher than 29 in the control group, and the difference was statistically significant (χ2=9.075,P<0.05). The rates of review at 1st, 3rd and 6th month after discharge of the experimental group were all 100.00％, which were higher than those of the control group (96.67％, 92.50％ and 82.50％). The recurrence rate at 12th month after discharge of the experimental group was 8.33％,which was lower than 20.00％ of the control group, and the difference was statistically significant (P<0.05). Conclusions With the help of WeChat platform, continuous nursing can significantly improve the compliance of oral NA, improve the degree of re-visit and reduce the recurrence rate after 1 years in patients with hepatitis B.

Objective:To evaluate the prediction power of HIV infection risk assessment tool and the applicability in MSM in Guizhou province.Methods:MSM were recruited through snowball sampling method. Questionnaire surveys were conducted among the MSM using HIV infection risk assessment tool, and combined with HIV serologic test results, the risk prediction power of HIV infection risk assessment tool was evaluated.Results:A total of 3 379 MSM were recruited from January 2018 to December 2019 in Guizhou. The HIV infection rate was 3.3%(111/3 379). The mean risk scores of HIV positive and HIV negative MSM were (12.15±3.08) and (12.07±3.07), respectively. The difference in risk score was significant between MSM with different HIV status ( t=8.69, P<0.001). According to the principle of decision tree, individual risk scores were divided into following three categories: ≤11.96, 11.97-14.80 and >14.80, the HIV infection rate was 0.8%, 4.3% and 8.6% respectively, suggesting that the higher the individual risk score was, the higher the HIV infection rate was (trend χ 2=88.18, P<0.001). Multivariate logistic regression analysis showed that the higher the individual risk score was, the higher the risk of HIV infection was. Compared to the total score ≤11.96, the a OR values at total scores of 11.97-14.80 and >14.80 were 6.34 (95% CI: 3.38-11.88) and 14.07(95% CI: 7.44-26.61), respectively. The risk of HIV infection in Miao ethnic group was higher than that in Han ethnic group (a OR=1.83, 95% CI:1.04-3.21), and the risk of HIV infection in those with education level of primary school and below was higher than that in undergraduates or those with education level of junior college and above (a OR=2.50, 95% CI:1.06-5.88), and the risk of HIV infection was higher in those who had bisexual behaviors than in those who had homosexual behaviors (a OR=1.95, 95% CI:1.19-3.19). The risk of HIV infection was higher in those who had never received HIV testing (a OR=1.53, 95% CI:1.01-2.33). The area under the receiver operating characteristic (ROC) curve and area under ROC (AUC) for HIV infection prediction was 0.751 (95% CI:0.710-0.792, P<0.001). The maximum Youden's index was individual risk score of 12.56, and the sensitivity of the risk assessment tool was 0.838, and its specificity was 0.412. Conclusions:The results of HIV infection risk assessment tool in Guizhou indicated that in MSM the higher the individual risk score, the higher the risk of HIV infection is. The tool can be used to evaluate the risk of HIV infection in MSM, but the specificity should be improved.

Objective To detect the apoptosis effects of dioscin in HepG2 cells and its possible anti-hepatocellular carcinoma mechanisms.Methods HepG2 human hepatocellular carcinoma cells were exposed to 0.25,0.5,1,2,4,6,or 8 μmol/L dioscin,and cell proliferation was measured via MTT assay.The half-maximal inhibitory concentration(IC50)was calculated with the software.A scratch test was used to analyze cell migration ability.Western blot was employed to evaluate the expression of apoptosis and Wnt/β-catenin-pathway-related proteins.Results Compared with the control group,the dioscin-treated HepG2 cells'proliferation was significantly more inhibited,and the inhibition increased in a time-and dose-dependent manner(P＜0.01).HepG2 cells showed morphological characteristics of apoptosis after they were treated with 1 μmol/L or 2 μmol/L dioscin.The scratch test indicated that the migration distance of HepG2 cells was remarkably reduced when treated with dioscin.In the Western blot experiment,the expression levels of Caspase-3 and cleaved Caspase-3 were visibility up-regulated,while those of Bcl-2 and β-catenin were significantly down-regulated when the cells were treated with dioscin for 24 h(P＜0.05,P＜0.01).When LiCl reagent was added to the HepG cells to activate the Wnt/β-catenin signaling pathway,the expression levels of Wnt1 and β-catenin were remarkably increased compared with those of the control group(P＜0.01).Compared with the LiCl group,the LiCl+DIO group's expression of Wnt1,β-catenin,and GSK-3β was significantly decreased(P＜0.01).Conclusions DIO can promote the apoptosis of HepG2 cells by inhibiting β-catenin protein expression and thereby down-regulating the Wnt/β-catenin signaling pathway.This inhibits apoptosis-related gene Bcl-2 expression,which leads to the induction of cell apoptosis.Therefore,DIO can have an anti-hepatocellular carcinoma effect.

BACKGROUNDTo evaluate and compare the effects and toxicity of the domestic product of nrhTNF combined with chemotherapy in the trial group and chemotherapy alone in the control group in the treatment of patients with non-small cell lung cancer (NSCLC).

METHODSNinety patients with NSCLC in multicenter were randomly devided into trial group and control group. Each group had 45 patients. Chemotherapy with CAP regimen was given for the patients in the trial group. Meanwhile, nrhTNF injection of 4×10⁶U/m ² was also given from the 1st to 7th days, the 11th to 17th days on the chemotherapy course. Twenty-one days were as a cycle, 2 cycles were given each patients. Chemotherapy alone with CAP regimen was given in the control group. The chemothepeutic effects and toxicity were observed and compared between the two groups after the therapy.

RESULTSOf the 90 patients, 3 cases in each group were out of the trial because of economy. The other 84 cases (each group had 42 patients) could be used to analyze and evaluate the clinical effects and toxicity. The response rate of chemotherapy was 47.62% (20/42) in the trial group and 19.05% (8/42) in the control group (P=0.002) respectively. The KPS was 85.02±10.74 in the trial group, and 81.35±9.63 in the control group (P=0.038). No significant difference of degree III+IV toxicity was observed between the trial group and control group (P > 0.05). The side effects related to nrhTNF included slight fever, cold like symptoms, pain, and red and swelling in injection site. All of them were mild and didn't need any treatment and disappeared after the therapy.

CONCLUSIONSThe results demonstrate that the effects of domestic nrhTNF combined with chemotherapy can remarkably higher than that of chemotherapy alone in the treatment of NSCLC. It is able to increase the sensitivity to chemotherapy and improve the quality of life of the patients. The toxicity is also slight and is worth to expand clinical use, so as to further evaluate its effect and toxicity.

Objective:To investigate the antagonistic and therapeutic effects of Ginkgo biloba on arsenic-induced lung injury in rats and its mechanism.Methods:A total of 42 healthy clean grade Wistar rats, half male and half female, weighing 120 - 130 g, were randomly divided into 7 groups with 6 rats in each group. Two intervention models of Ginkgo biloba antagonism and treatment were established, respectively. The specific treatments were as follows: (1) Experimental study on the antagonism of Ginkgo biloba (4 groups): the control A group was given deionized water; the Ginkgo biloba control (GBE) group was given Ginkgo biloba solution (50 mg·kg -1·bw); the arsenic-treated (As) group was given sodium arsenite solution (10 mg·kg -1·bw); the Ginkgo biloba antagonistic (As + GBE) group was treated with sodium arsenite solution (10 mg·kg -1·bw) and Ginkgo biloba solution (50 mg·kg -1·bw), and the above administration was by gavage for 6 days/week, for 4 months. (2) Experimental study on the treatment of Ginkgo biloba (3 groups): the control B group was given deionized water for 5.5 months; in the arsenism natural recovery (recovery) group, sodium arsenite solution (10 mg·kg -1·bw) was administered by gavage for 4.0 months and deionized water for 1.5 months; the Ginkgo biloba treatment (treatment) group was given sodium arsenite solution (10 mg·kg -1·bw) by gavage for 4.0 months and Ginkgo biloba solution (50 mg·kg -1·bw) for 1.5 months, and the above administration was for 6 days/week. Masson staining was used to evaluate collagen fiber deposition in lung tissue. Western blotting was used to detect the expression level of related proteins in lung tissue homogenates, including inflammatory cytokines matrix metalloproteinase-9 (MMP-9), interleukin (IL)-1β, IL-18; high mobility group box 1 (HMGB1) and receptor for advanced glycation end-products (RAGE) of the HMGB1/RAGE pathway; phosphatidylinositol-4, 5-bisphosphate 3-kinase (PI3K), protein kinase B (AKT), phosphorylated AKT (p-AKT) of the PI3K/AKT pathway; transforming growth factor (TGF)-β1, SMAD2, p-SMAD2, SMAD3, p-SMAD3 and SMAD4 of the TGF-β1/SMAD pathway. Results:(1) Antagonistic effect of Ginkgo biloba: compared with the control A group, there was no significant change in protein expression and collagen fiber deposition in the lung tissue of GBE group ( P > 0.05); the levels of MMP-9, IL-1β and IL-18 protein expression and collagen fiber deposition in the lung tissue of As group were significantly increased ( P < 0.05); and the levels of HMGB1, RAGE, PI3K, p-AKT, TGF-β1, p-SMAD2, p-SMAD3 and SMAD4 protein expression were significantly increased ( P < 0.05). Compared with As group, the levels of MMP-9, IL-1β and IL-18 protein expression and collagen fiber deposition were significantly decreased in As + GBE group ( P < 0.05); and levels of HMGB1, RAGE, PI3K, p-AKT, TGF-β1, p-SMAD2, and p-SMAD3 protein expression were significantly decreased ( P < 0.05). (2) Therapeutic effect of Ginkgo biloba: compared with control B group, the levels of MMP-9, IL-1β, IL-18 protein expression and collagen fiber deposition were significantly increased in recovery group ( P < 0.05); and the levels of HMGB1, RAGE, PI3K, p-AKT, TGF-β1, p-SMAD2, p-SMAD3 and SMAD4 protein expression were significantly increased ( P < 0.05). Compared with recovery group, the levels of MMP-9, IL-1β, IL-18, HMGB1, RAGE, PI3K and p-AKT protein expression were significantly decreased in treatment group ( P < 0.05); and there was no significant change in collagen fiber deposition and TGF-β1, p-SMAD2, p-SMAD3 and SMAD4 protein expression levels in lung tissue ( P > 0.05). In both experiments, there was no significant difference in the protein expression levels of AKT, SMAD2 and SMAD3 between the groups ( P > 0.05). Conclusion:Ginkgo biloba intervention has ameliorated inflammatory injury and collagen fiber deposition in lung tissue of arsenic-treated rats possibly by inhibiting the expression levels of HMGB1/RAGE pathway-related proteins.