Objective:To:investigate the curative effects and cost of sequential treatment of children communityacquired pneumoni(CAP) with azithromycin. Method:118 cases of CAP from this hospital were divided into two groups: sequential azithromycin therapeutic group (Group A) and iv ceftazidime group (Group B). Their clinical effect was observed and cost minimization analysis was carried out. Result:The total costs were 612?7. 3 yuan and 819?8. 2 yuan(P 0.05) in Group A and Group B respectively. Conclusion: The sequential azithromycin scheme is a better one to treat CAP.

Service for key subjects is important for medical information institutions nowadays.This paper discusses the necessity of providing subject-oriented service,and proposes three service modes:information transmission mode,information analysis mode and information navigation mode.In addition,the guarantee measures are also discussed,including constructing a security system for subject literature,training high-quality services team,and promoting subject information service brand.

BackgroundThe study of the molecular mechanism of visual plasticity is helpful for the explaining and prevention of strabismus and amblyopia.The effect and significance of NogoA in the strabismus and amblyopia formation are attracting more attention.ObjectiveThe present study was to investigate the expression of NogoA in 21a area of visual cortex in strabismic-induced amblyopia cats and explore the possible molecular mechanism of strabismic-induced amblyopia.MethodsSixteen 4-week old clean cats were randomizedly divided into normal group and strabismic-induced amblyopia group and eight for each group.The strabismic-induced amblyopia models were created by cutting off the external rectus in 8 cats.Pattern visual evoked potentials ( P-VEP ) were recorded 1 week after operation and compared with normal cats,and depression of amplitude and prolongation of implied time of P100 wave were as the successful criterion of model.The 200 ml paraformaldehyde was infused via heart to fax the brain under the deep anesthesia and then the cats were sacrificed and the brain cortex sections were prepared.The morphology of 21a zone of cat visual cortex was examined by haematoxylin and eosin staining,and the expressions of NogoA in 21a area of visual cortex were detected by immunohistochemistry with a monoclonal antiNogoA antibody.The use of the animals complied with the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.ResultsThe implied time and amplitude ratio of VEP P100 wave were (98.10±7.07)ms and (0.83±0.14) in normal group,and those in strabismic-induced amblyopia group were (108.50±6.95 )ms and (0.35 ±0.09 ),showing significant differences between two groups (t=4.450,P=0.005 ; t =5.970,P =0.005 ).The numbers of neurons were similar in 21a area of visual cortex between the two groups,but the volume of the neurons was lessen in strabismic-induced amblyopia group.The positive cell densities for NogoA were ( 387.37±2.01 ) cells/mm2,( 354.58± 1.85 ) cells/mm2 and ( 289.68± 1.81 ) cells/mm2 in layer Ⅱ/Ⅲ,Ⅳ and V/V[ respectively in strabismic-induced amblyopia group,and those in normal group were ( 161.39± 1.98 ) cells/mm2,( 128.93 ± 1.26 ) cells/mm2 and ( 96.25 ± 1.49 ) cells/mm2,indicating a significant increase in model cats ( t =- 160.400,- 201.890,- 164.740,P =0.000 ).Conclusions NogoA may play an important role in the regulation of the sensitive developmental period of visual sense and its plasticity.

Objective To compare the effects of propofol and ketamine on long-term memory and the expression of brain N-methylgroup-D-aspartate receptor 2B(NMDAR2B) and Gamma-aminobutyric acid receptor 1(GABAR1) in aged rats, and preliminary investigate the relation between the long-term memory and expression of neurotransmitter receptors in different cerebral areas. Methods The aged male rats were randomly divided into control group,propofol group and ketamine group. Morris water maze training was performed in all the rats of three groups for 5 days. On the 6th day, intraperitoneal injection of 50 mg?mL-1 propofol was administrated in propofol group,80 mg?mL-1 ketamine was intraperitoneally injected in ketamine group,and blank control group was given the same dose of saline.Seven days after the administration,space exploration experiment and navigation experiment test were performed to test the impact on the learning and memory ability of rats. After that, the expression levels of GABAR1 and NMDAR2B in temporal lobe and hippocampal CA1 region of the rat brain were detected by immunofluorescence and FISH technique. Results The results of Morris water maze showed there was no significant difference between propofol group (9.49±1.24) s and blank control group (8.82±2.22) s.There was statistically significant difference between ketamine group (12.04±2.67) s and blank control group (P<0.05),with longer latency time and less number of times of passing through target as compared with blank control group.By using immunohistochemistry and FISH technique,the expression of GABAR1 in temporal lobe and hippocampal CA1 region of the rat brain was not significantly different between propofol group and blank control group,but it was significantly up-regulated in ketamine group as compared with blank control group ( P<0.05) . The expression of NMDAR2B in temporal lobe and hippocampal CA1 region of the rat brain was not significantly different between propofol group and blank control group,but it was significantly down-regulated in ketamine group as compared with blank control group (P<0.05). Conclusion Propofol anesthesia alone had no effect on long-term learning and memory,but ketamine anesthesia can result in long-term learning and memory impairment. The mechanism may be related with down-regulation of the expression of NMDAR2B receptor and up-regulation of GABAR1 not only in CA1 region hippocampus,but also in temporal lobe.

Objective To observe the change of learning and memory quality and the expression change of GABAR1 and NMDAR2B in aged SD rat cerebral temporal lobe by propofol injection and discuss the influence that may be caused by propofol.Methods Aged male sd rats were randomly divided into three groups,each group of 20.Propofol intraperitoneal injection was implemented to groups P1 and P7 according 50 mg/kg and maintained anesthesia for 3 hours.The same dose of emulsion was given to control group. Morris water maze test was done in the first days and the seventh days after intraperitoneal injection.Then the left temporal lobe was gathered and the mRNA transcription and protein expression of GABAR1 and NMDAR2B were detected by FISH and Immunofluorescence technique.Results Compared with control group,the latent time of group P1 was significantly prolonged and the numbers of passing through the target frequency were decreased significantly (P <0.05).Group P7 had no significant differences.The mRNA transcription and protein expression of GABAR1 in group P1 were increased significantly and the mRNA transcription and protein expression of NMDAR2B in group P1 were decreased significantly (P <0.05 ). Group P7 had no significant differences.Conclusion The short-term memory of brain declined after propofol was used.This may be related to the function of temporal lobe.The mechanism may be related to the up regulation of GABAR1 and the down regulation of NMDAR2B simultaneously.

BACKGROUND: The emphasis for preventing and treating cardiovascular diseases is to detect correlated risk factors. Among those accepted risk factors, whether serum uric acid (SUA) plays an independent role in the development of diseases is unknown.OBJECTIVE: To study SUA distribution and the prevalence of hyperuricemia, in middle-aged and elderly residents from the conjoining area between city and countryside in Guangzhou, and its association with other cardiovascular disease risk factors.DESIGN: Cross-sectional study.SETTING: Department of Cardiovascular internal medicine, Prevention and Health department, the Third Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS: An investigation on the risk factors of cardiovascular diseases was carriedout among total 890 residents living at the conjoining area between city and countryside in Guangzhou in December 2002. A total of 642 persons including 152 men and 490 women who were above 55years and had complete data were involved, and all of them understood and agreed to the investigation.the-spot investigation. Systolic pressure, diastolic pressure, body height and body mass were measured, and then body mass index [body mass (kg)/body height (m)2] was calculated. High-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride and total cholesterol were measured by endpoint method; SUA was measured by uricolase turbidimetric method.were defined as hyperuricemia. Diagnosis of hypertension was made according to the WHO/ISH 1999 Prevention and Cure Guidelines of Hypertension. Various kinds of dyslipidemia were diagnosed based on Prevention and Cure suggestions of dyslipidemia for Chinese (1997). Obesity was defined, according to 2002 International Obesity Special Working Group'skewness distribution and described by Median ± quartile. Spearson correlation analysis was used to determine the dependability between SUA and other selected cardiovascular risk factors. Binary Logistic regression analysis was done for further analysis.SUA and other cardiovascular risk factors.terolemia and hypertriglyceridemia in men and women were 30.3%, 30.8%;were (357.30±66.77) and (299.80±59.64) μmol/L respectively. SUA level was positive correlated with age in women (r=0.18, P ＜ 0.01), but was not of SUA in men were 293.53, 357.30, 427.08 (μmol/L), and in women were 247.60, 299.80, 366.88 (μmol/L). Low-density lipoprotein cholesterol, total cholesterol, triglyceride, blood pressure and body mass index were positively associated with SUA, while high-density lipoprootein cholesteral was negtive correlated with SUA. In both men and women, triglyceride, total cholesterol, systolic blood pressure and body mass index were positively correlated with SUA significantly (r=0.09-0.35, P ＜ 0.05-0.01), but highdensity lipoprotein cholesterol was negatively correlated with SUA significantly (r=-0.21, -0.25, P ＜ 0.05, 0.01); diastolic blood pressure in men and low high-density lipoprotein cholesterol in women were positively correincluded to Logistic regression equation were age, body mass index and triglyceride [OR (95%CI): 1.048 (1.023-1.073), P=0.000; OR (95%CI): 1.156(1.096-1.219), P=0.000; OR (95%CI): 1.436 (1.224-1.684), P=0.000].uricemia is correlated with hypertension and various kinds of dyslipidemia.The elevation of SUA may be an important marker of cardiovascular dismay affect SUA mostly, and increase the risk for hyperuricemia.

Objective To present the development of the Naming test tool ( Huashan Naming Test, HNT)for Chinese cultural and by amnestic mild cognitive impairment ( aMCI ) and mild Alzheimer' s disease (AD) between the detection of memory decline,and to analyze the validity of its trial.Methods 100 normal elders from communities in Shanghai, 100 patients with amnestic mild cognitive impairment (aMCI), and 95 patients with mild Alzheimer's disease (AD) who received an education of junior high school or above and were evaluated by neuropsychological tests including mini mental state examination ( MMSE), auditory verbal memory test, Huashan Naming tests etc.8 cognitive tests.The groups of MCI and AD patients finished cranial MRI.100 items with HNT including 20 animals,10 vegetables,10 fruits ,20 tools ,20 household , 10 vehicles, 10 stationery.Results 1.HNT items to determine: 22 items were excluded due to the completion of the three groups were not significantly different; 8 items were excluded due to the completion of the normal elderly group was lower than 75%; 10 items were excluded from the analysis of variance Fvalue of the minimum value.The remaining 60 items,according to the size of the arrangement and completion rates were divided into two versions of odd and even, respectively HNT-Ⅰ and HNT-Ⅱ.2.HNT characteristics:in normal elderly group age, sex were found to had no significant factors affecting overall scores of HNT-Ⅰ and HNT-Ⅱ but level of education, MMSE score was significantly correlated (P ＜0.05).As cut-off score ≤ 26 for spontaneous naming of HNT,the sensitivities of HNT-Ⅰ for aMCI ,mild AD were 44%, 84% respectively, specificities were all around 84%; the sensitivities of HNT-Ⅱ for aMCI , mild AD were 56% ,83% respectively,specificities were all around 80%.Conclusion HNT is a Chinese cultural background,time-consuming short and good name validity test,and it is worth further promoting the application.

BACKGROUND:Stem cel therapy has been used for prevention and treatment of degenerative disc disease. Considering the special microenvironment in the intervertebral disc, the survival rate and differentiation ability of transplanted cels are decreased, which may lead to the poor efficacy of stem cel therapy. How to improve the survival ability and therapeutic effect of the transplanted cels is the focus of stem cel therapy for degenerative disc disease.
OBJECTIVE: To investigate the effects of cobalt chloride combined with hypertonic solution pretreatment on bone marrow mesenchymal stem cels that wil be transplanted for treatment of degenerative disc disease.
METHODS:(1)In vitro cel experiment: bone marrow mesenchymal stem cels were divided into three groups and subjected to normal culture medium (normal control group), 1% hypertonic mother solution (hypertonic group), 100 μmol/L cobalt chloride (hypoxia group), or 1% hypertonic mother solution plus 100 μmol/L cobalt chloride (combined group) for 1 week. Then, 2% hypertonic solution and 200 μmol/L cobalt chloride cobalt chloride were used to simulate the anaerobic and hypertonic environment intervenes in pretreated and untreated bone marrow mesenchymal stem cels for 24 hours. After that, RT-PCR was used to detect the expression of caspase-3 for apoptosis evaluation. (2)In vivo animal experiment: Sprague-Dawley rats were divided into model, cel transplantation and hypertonic plus hypoxic groups. Rat models of intervertebral disc degeneration were made in these three groups. After modeling, rats in these three groups were given no treatment, bone marrow mesenchymal stem cel transplantation or transplantation of bone marrow mesenchymal stem cels which were subjected to hypertonic and hypoxia pretreatments into the intervertebral disc. Two weeks later, immunohistochemistry and RT-PCR methods were used to detect cel distribution and related gene expression, respectively, thereby to evaluate the therapeutic effect of stem cels.
RESULTS AND CONCLUSION: (1)In vitro cel experiment: caspase-3 mRNA expression was significantly reduced in pretreated bone marrow mesenchymal stem cels compared with the untreated cels (P < 0.05). (2)In vivo animal experiment: compared with the control group, the caspase-3 and interleukin-1β in the intervertebral disc and a number of degenerative indexes were decreased in the cel transplantation. Compared with the cel transplantation group, these indicators had better outcomes in the hypertonic plus hypoxic group (P < 0.05). These findings indicate that bone marrow mesenchymal stem cels have therapeutic potential for degenerative disc disease, and have better adaptability and transplantation effects by hypertonic and hypoxia pretreatments.

Objective To investigate the efficacy of pegylated interferon (PEG-IFN)+ ribavirin (RBV) treatment in patients with chronic hepatitis C (CHC),and to evaluate the predictors of treatment response.Methods One hundred and thirty CHC patients treated with PEG-IFN a-2a 180 μg weekly or PegIFNα-2b 80 μg weekly plus RBV 900-1200 mg/d for 48 weeks in Guangdong Province were enrolled.The clinical data including age,gender,body mass index (BMI),spleen index (SPI),the diameter of portal vein (PV),hepatitis C virus (HCV) genotype,HCV RNA level were collected at baseline,week 4,12,24,48 of treatment and week 24 of follow-up.Patients obtained sustained virological response (SVR) were compared to those with non-sustained virological response (NSVR).The related factors of SVR were analyzed.The data were compared by t test,chi square test or Logistic regression.Results The total SVR rate was 84％ (109/130),among which rapid virological response ( RVR ),early virological response ( EVR ),and end-of-treatment virological response (ETVR) were 21％ (27/130),72％ (94/130) and 93％ (121/130),respectively.HCV genotype was determined in 70 patients and the SVR rate was 82 ％ (45/55) in the genotype 1 patients and 87％ (13/15) in the genotype non-1 patients.Age,baseline HCV RNA,BMI and SPI were all negatively associated with SVR rate (regression coefficient＜0,all OR＜1,all P＜0.05),while EVR and total cumulative treatment dose of RBV were positively associated with SVR rate (regression coefficient＞0,both OR＞ 1,both P＜0.05).However,RVR,PV and total cumulative treatment doses of PEG-IFN were not associated with SVR rate (P＞0.05).Conclusions The SVR rate of PEG-IFN plus RBV combined treatment is high in CHC patients and more than 80％ of patients can be cured.However,the SVR rates are lower in patients elder than 35 years,with previous treatment failure history,baseline HCV RNA＞6 × 105 IU/mL,BMI＞26 kg/m2,SPI＞40 cm2,or the total cumulative treatment doses of RBV less than 80 ％ of standard dose.

Objective To investigate the dynamic changes of serum interleukin(IL)-18,IL-1β and copeptin in acute cerebral infarction(ACI),and analyze the relationship with the serious degree of ACI.Methods The levels of serum IL-18,IL-1β and copeptin were measured by Double-antibody sanduicb enzyme-linked immunosorbent assay(ELISA)in 83 patients with ACI who were admitted to the hospital within 24 h,and neurological impairment were evaluated by European stroke scale(ESS)at the 1st,3rd and 7th day respectively after hospitalization.At the same time,the patients with ACI were compared with 32 normal adults.Results The levels of serum IL-18,IL-1β and copeptin at the 1st,3rd and 7th day after hospitalization were(131.30±31.62),(168.30±28.12),(141.26±24.23)ng/L,(0.35±0.04),(0.82±0.10),(0.52±0.21)μ g/L,and(3.64±0.26),(4.18±0.53),(3.26±2.41)μ g/L respectively.There were significant differences among different times respectively(P＜0.05),furthermore they were higher than those in normal adults[(119.12±27.42)ng/L,(0.21±0.08)μ g/L,(2.63±0.23)μ g/L](P＜0.05).Univariate Logistic regression analysis showed that age,copeptin,IL-18,IL-1β and ESS score was the influencing factor in the serious degree of ACI.There was no significant difference in assessing the serious degree of ACI by receiver operating characteristic(ROC)curve between IL-18 and age,copeptin,IL-1 β,ESS score(P＞0.05).Conclusions The serum levels of IL-18,IL-1β and copeptin are increasing after ACI,indicating that the inflammatory and immune factors may be involved in the development process of ACI.The serum levels of IL-18,IL-1β and copeptin can reflect the serious degree of ACI.