Objective To investigate the effect of reserpine,an efflux pumps inhibitor,on the activities of fluoroquinolones (FQNs) against Enterococci,and the distribution of efflux pump genes emeA and its correlation with the resistance of Enterococci.To elucidate the relationship between FQN resistance in Enterococci and active efflux.Methods One hundred isolates of enterococci were identified by VITEK microbe automatic system.The antibacterial agent susceptibility tests were performed by the disc diffusion method (K-B) in accordance with the CLSI standards.The minimum inhibitory concentration (MIC) of each FQN was tested by the agar dilution method,and the MIC changes were detected after adding reserpine.The distribution of emeA in 100 isolates of Enterococci was determined by PCR.Thex2 test was used to compare the differences of statistical results.Results After reserpine was used,three-FQN resistance in Enterococci was reduced.Ciprofloxacin,gatifloxacin and levofloxacin resistance was reduced from 42％ (42/100) to 28％ (28/100),from 30％ (30/100) to 17％ (17/100),and from 33％ (33/100) to 23％ (23/100),respectively.The positive rate of emeA gene in 100 strains of Enterococci was 55％ (55/100).There were 45 positive strains(72.6％) in 62 E.faecalis and 10 positive strains (26.4％) in 38 E.faecium.The positive rate of emeA gene in the resistant strains against ciprofloxacin,gatifloxacin and levofloxacin was 73.8％ (31/42),76.7％ (23/30),75.8％ (25/33),respectively,and the positive rate of emeA gene in the susceptible strains against above 3 antibacterials were 41.4％ (24/58),45.7％ (32/70),44.8％ (30/67).Efflux pump genes emeA in resistant strains is higher than the sensitive strains,with the statistically significant difference(x2 =13.02,8.13 and 8.57,P ＜ 0.005).Conclusions Reserpine could inhibit the active efflux of in FON Enterococci and reduce the MIC for drug-resistant strains in vitro.Multidrug-resistant efflux pump gene emeA was relevant to antimicrobial drug resistance in Enterococci.

Objective To investigate the role of infiltrating inflammatory cells in photoaging process by comparing the type and number of these cells in sun-exposed and-unexposed skin.Methods The expression of CD3,CD45RO and CD68 were detected by immunohistochemieal staining in 46 paraffin-embeded skin samples from the extensor forearms(sun-exposed)and upper-inner arms(sun-unexposed) of 23 healthy female volunteers.The number of positive cells in sun-exposed and -unexposed sites was counted and statistically tested by paired samples t test,and Pearson correlation analysis was performed to assess the relationship between the number of positive cells and age of these volunteers.Results The number of cells positive for CD3,CD45RO and CD68 per square millimetre in sun-exposed skin was significantly higher than that in sun-unexposed skin(48.91±13.173 vs.40.61±11.571,46.83±12.915 vs.38.00±10.109,85.43±22.346 vs.73.48±16.208,respectively,P<0.01 or 0.05).The number of cells positive for CD3 and CD45RO increased significantly with age (r=0.557,0.555,respectively,both P<0.01) in the sun-exposed skin but not in sun-unexposed skin,and the number of CD68-positive cells was uncorrelated with age in either sunexposed or -unexposed skin.Conclusion T lymphocytes and macrophages may play a role in the process of photoaging.

Objective To summarize the experience with adapalene in the treatment of ache vulgaris and to provide a clue to improve the clinical use of adapalene in ache vulgaris. Methods Chinese literature over the past ten years related to the evaluation of efficacy and safety of 0.1% adapalene gel in acne vulgaris were searched and assessed. Results Combination therapy with 0.1% adapalene was more effective than monotherapy with it. The efficacy of adapalene gel was higher than that of non-tretinoin topical agents, but equivalent to that of other tretinoins. Furthermore, the incidence of adverse events was lower for adapalene than for other tretinoin formulations. Conclusions Adapalene is safe and effective for the treatment of mild to moderate acne vulgaris, and can be used as monotherapy, maintenance treatment, or in combination therapy of acne vulgaris.

Objective To study the expression of matrix metalloproteinase(MMP)-1,-3 and-9 in sun-exposed and-unexposed skin as weil as its significance in the mechanism of skin photoaging.Methods Skin samples were resected from the exmnsor side of forearm(sun-exposed area)and flexor side of upper arm(sun-unexposed area)of 23 healthy female volunteers.The expression of MMP-1,-3 and-9 was detected by immunohistochemical staining in 46 skin samples.Immunoreactive intensity distribution index (IRIDI)was calculated to assess the expression of MMP-1,-3 and-9.Wilcoxon signed ranks test,Mann-Whitney U-test and Spearman rank correlation analysis were performed.Results MMP-1,-3 and-9 were expressed in both sun-exposed and -unexposed skin.The average IRIDI value for MMP-1,-3 and-9 was 7.70(range,3 to 12).9.22(range,6 to 12),8.30(range,6 to 12)in sun-exposed skin,and 4.26 (range,2 to 6),5.39(range,2 to 9),4.04(range,1 to 6)in sun-unexposed skin,respectively;significant difierence existed between sun.exposed and-unexposed skin in the three parameters(all P＜0.01).A significant inerease was observed in the average IRIDI value for MMP-1,-3 and-9 in sun-exposed skin vs.sun-unexposed skin in women above 50 years of age (9.17 vs 4.75,10.58 vs 6.42,8.92 vs 4.33,respectively,all P＜0.05).In women younger than 50 years,the average IRIDI value for MMP-1,-3 and-9 was 6.09(range,3 to 8),7.73(range,6 to 9),7.64(range,6 to 12)in sun-exposed skin,significantly higher than that in sun-unexposed skin[3.73(range,2 to 6),4.27(range,2 to 8),3.73(range,1 to 6),all P＜0.05].Increased IRIDI scores of MMP-1,-3 and -9 were noticed in sun-exposed skin in women above 50 years of age vs.those younger than 50 years.but there was no statistical difrerence in MMP-I or MMP-9 between the two aged groups in sun-unexposed skin(all P＞0.05).The IRIDI scores of MMP-1,MMP-3 and MMP-9 were positively correlated with age(r=0.66,0.69,0.74,all P＜0.01)in sun-exposed skin,but the IRIDI scores of MMP-1 and MMP-9 uncorrelated with age in sun-unexposed skin.Conclusions There isan elevated expression of MMP-1,-3 and.9 in sun-exposed skin VS.SUn.unexposed skin.hinting that these three MMPs play a role in the occurrence and development of photoaging,but their biological mechanism may be different.

Objective To study the effects of different stimulators on the production of matrix metalloproteinases (MMPs) by peripheral blood mononuclear cells (PBMCs),and to evaluate the effects of the culture supernatant of activated PBMCs,named conditioned media (CM),on the proliferation of and production of MMPs by cultured human fibroblasts.Methods PBMCs were isolated from the venous blood samples of healthy volunteers and divided into three groups to be stimulated by phytohemagglutinin (PHA group),the combination of antibodies against CD3 and CD28 (double-antibody group),or the RPMI 1640 medium containing 10％ fetal calf serum (control group).After 72-hour stimulation,CM was collected from all the three groups,diluted to several different degrees.Cultured human fibroblasts were classified into several groups to be treated with different dilutions of CM from the three groups for 48 or 24 hours,with the fibroblasts untreated with CM serving as the control group.Methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate cellular proliferative activity,semi-quantitative reverse transcription (RT)-PCR to detect the expressions of MMP-1,MMP-3 and MMP-9 mRNAs in cells,and enzyme-linked immunosorbent assay (ELISA) to measure the levels of interleukin (IL)-6,MMP-1,MMP-3 and MMP-9 proteins in the culture supernatant of cells.Statistical analysis was carried out mainly by using one-way analysis of variance (ANOVA),Tukey HSD test,and GamesHowell test.Results Compared with the control group,the PHA group showed increased cellular proliferative activity,IL-6 and MMP-3 protein levels in the culture supernatant of activated PBMCs (all P ＜ 0.05).Significant differences were observed among the PHA group,double-antibody group and control group in the relative mRNA expression level (expressed as the ratio of target mRNA to β-actin mRNA) of MMP-1 in activated PBMCs (0.083 ± 0.016 vs.0.188 ± 0.030 vs.0.714 ± 0.104,F =85.905,P ＜ 0.05),but neither MMP-3 nor MMP-9 mRNA was expressed by activated PBMCs.MMP-3 protein was detectable in the culture supernatant of fibroblasts after the treatment with CM,and the level of MMP-3 protein was highest in that of fibroblasts treated with undiluted CM,and lowest with 1/10 diluted CM;at the same dilutions,the level of MMP-3 protein was highest in the culture supernatant of fibroblasts treated with CM from the PHA group,but lowest with that from the control group.Neither MMP-1 nor MMP-9 protein was detected in the culture supernatant of activated PBMCs or treated fibroblasts.There were no significant differences in cellular proliferative activity of and mRNA expressions of MMP-1 or MMP-3 in fibroblasts among these groups (all P ＞ 0.05),and MMP-9 mRNA expression was undetected in the treated fibroblasts.Conclusions PBMCs can be induced to express MMP-1 mRNA and secret MMP-3 protein after activation.However,the culture supernatant of activated PBMCs has no capacity to stimulate the expressions of MMP-1,MMP-3 and MMP-9 mRNAs or proteins by fibroblasts,suggesting that inflammatory cells may function through self-production of MMPs.

Polymer hydrogels composed of highly hydrated crosslinked network mimic the composites of the cartilage extracelular matrix and are embedded with articular chondrocytes not only to support chondrocytes growth but also to promote chondrocytes proliferation and division which wil induce the cartilage regeneration and repair. OBJECTIVE:To review several kinds of natural polymer hydrogels and their newest progress and achievements. METHODS:Relative literatures from January 1994 to July 2013 were classified and analyzed by searching the databases through PubMed, Springer, Sciencedirect and Ovid databases using the keywords of “natural polymers, biodegradable polymers, hydrogel scaffold, articular cartilage, regeneration”.RESULTS AND CONCLUSION:Natural proteins (colagen, gelatin) and polysaccharides (chitosan, hyaluronic acid) are widely used as natural polymer hydrogels. The natural polymer hydrogels have not only the physical characters beneficial to articular cartilage regeneration, but also the important biological parameters, such as biocompatibility, low immunological response, low cytotoxicity and degradation. Meanwhile, the polymer hydrogels with natural origin can promote celladhesion, proliferation and division, and enhance the regeneration of new tissue. Moreover, they also can serve as carriers to sustain the release of drugs and growth factors. Al in al, natural polymer hydrogels have a potential application in articular cartilage regeneration and repair.

Eight parameters about iron nutrition were observed longitudinally in eighty pregnant women from the first trimester to delivery. Their nutrients intake were recorded at the same time. It was noted that serum iron store (ferritin) decreased markedly in the course of pregnancy and the incidence of iron deficiency increased. Total iron intake was closely related to the variation of these parameters, the degree of iron deficiency in pregnant women and the content of cord ferritin. Iron in maternal serum is correlated to ferritin in the cord blood. It suggested that natural food abundant in iron, or food fortified with iron should be taken in early pregnancy to prevent iron deficiency of mothers.

Objective To investigate the construction and implementation of the concept of precise sequential therapy for primary liver cancer.Methods The clinical data of 207 patients with resectable liver cancer who were admitted to the Air Force General Hospital from May 2005 to June 2010 were retrospectively analyzed.Of all the patients,81 received conventional therapy (conventional therapy group),and the other 126 patients received precise sequential therapy (precise sequential therapy group).The conditions of the patients in perioperative phase,during postoperative sequential treatment and the period of follow-up between the 2 groups were compared.All data were analyzed by using the covariance analysis,analysis of variance,chi-square test or rank sum test.Results The detection rates of lesions with a diameter less than 1 cm,operation time,liver resection volume,intraoperative blood loss,rate of perioperative blood transfusion,duration of postoperative hospital stay,incidences of postoperative complications were 81％ (22/27),( 186 ± 36) minutes,(75 ± 29) ml,( 189 ± 60) ml,24％(30/126),(21 ± 12)days and 13％ (17/126) in the precise sequential therapy group,and 18％ (2/11),(222 ± 30)minutes,(133 ±88)ml,(327 ±46)ml,51％ (41/81),(26 ± 17)days and 20％ (16/81) in the conventional therapy group,respectively,with significant differences between the 2 groups (F =10.876,7.390,46.996,31.025,14.556,6.315,4.017,P ＜ 0.05).No significant difference was observed on the levels of alanine transaminase,albumin and the Child-Pugh score before and after the intervention in the precise sequential therapy group,but significant differences were observed in the conventional therapy group.The 1-,2-,3-year tumor recurrence rates and the 1-,2-,3-year survival rates were 17％ (21/126),22％ (17/76),26％ (8/31) and 87％ (110/126),87％ (66/76),84％ (26/31) in the precise sequential therapy group,and 31％ (25/81),38％ (27/71),48％(31/65 ) and 77％ (62/81),75％ (53/71 ) and 60％ (39/65) in the conventional therapy group,respectively.There were significant differences in the prognosis of the patients in the 2 groups ( x2 =4.958,4.292,4.168,4.062,3.640,5.470,P ＜ 0.05 ).Conclusion Through accurate assessment of the patients' condition before surgery,precise hepatectomy and precise postoperative intervention,the goal of effective control of tumor recurrence,maximum protection of the liver function and improvement of the survival rate can be achieved.

Objective To analyse the clinical and therapeutic features as well as laboratory findings in bullous pemphigoid with non-bullous lesions as initial manifestation. Methods Clinical data on 34 cases of bullous pemphigoid with non-bullous lesions as initial manifestation were retrospectively analyzed. Results The male to female ratio was 1.83 :1, with a mean age of onset at 59.79±15.63 years. Before typical bullae appeared, patients presented with erythema, papules, papulovesicles' plaques" wheals, nodules,or erythema muitiforme-like lesions, with the most common lesions being erythematous papules and plaques (occumng in 35.29% of these patients). Conclusions Among these patients, nearly 1/3 displayed various skin lesions at the onset; simultaneous erythematous papules and plaques are the most common initial manifestation.

The nutritional status, serum protein, albumin, calcium, zinc, iron, SF, FEP, vitamin A, activity of RBC transketolase, and blood glutathione redu-ctase of 349 normal primigravidas, 30 healthy non-pregnant women and 42 toxemic gravidas were estimated longitudinally from the 1st trimester to delivery. It was noted that serum protein, albumin, Ca, Zn, and Fe decreased markedly in the course of pregnancy. The content of serum vitamin A showed no variation or decrease in the 3rd trimester in 1/3 of the pregnant women observed. Insufficiency of thiamine and riboflavin were noted in 16.7% and 47% of the normal pregnant women respectively. The adequate nutrients intakes in pregnancy were considered to be: Energy, +200 kcal/d; Protein, + 15g/d in the 2nd trimester and +25g/d in the 3rd trimester; Calcium 1000 mg/d in the 2nd trimester and 1500mg/d in the 3rd trimester; Zinc, 20mg/d; Iron 26 or 30 mg/d by supplementation if possible; vitaminA 1000 ?gRE/d; both thiamine and riboflavin 1.8 mg/d.