Objective:To investigate the clinical efficacy and safety of antibiotic de-escalation therapy in the treatment of severe pneumonia.Methods:Sixty patients with severe pneumonia who received treatment in The First People's Hospital of Yongkang,China from January 2015 to January 2018 were included in this study.They were randomly assigned to receive either conventional antibiotic therapy (control group, n = 30) or antibiotic de-escalation therapy (observation group, n = 30).The clinical efficacy,symptom relief time,antibiotic treatment time,length of hospital stay,pulmonary ventilation function index,serum levels of inflammatory factors and the incidence of adverse reactions were compared between the control and observation groups. Results:Total effective rate in the observation group was significantly higher than that in the control group [93.33% (28/30) vs.73.33% (22/30), χ2 = 4.320, P < 0.05].The time to disappearance of cough,fever and abnormal lung sounds in the observation group was (2.10 ± 1.25) d,(2.19 ± 1.24) d,(2.01 ± 0.56) d,respectively,which was significantly shorter than that in the control group [(3.73 ± 1.92) d,(3.68 ± 1.70) d,(3.36 ± 0.78) d, t = 3.897,3.878,7.701,all P < 0.05].The antibiotic treatment time and length of hospital stay in the observation group were (2.89 ± 1.06) d and (4.08 ± 1.23) d,respectively,which were shorter those in the control group [(4.27 ± 1.45) d and (5.76 ± 1.69) d, t = 4.208 and 4.402,both P < 0.05].The forced expiratory volume in one second (FEV 1) and the ratio of FEV 1 to forced vital capacity (FVC) in the observation group were (2.09 ± 0.69) L and (58.94 ± 15.67)%,respectively,which were significantly higher than those in the control group [(1.43 ± 0.57) L,(43.12 ± 11.03)%, t = 4.039 and 4.522,both P < 0.05).Serum levels of C-reactive protein,interleukin-6 and procalcitonin in the observation group were (5.84 ± 2.09) mg/L,(20.05 ± 2.76) ng/L,(2.18 ± 0.78) ng/L respectively,which were significantly lower than those in the control group [(8.50 ± 2.67) mg/L,(23.24 ± 3.07) ng/L,(3.11 ± 0.97) ng/L, t = 4.297,4.232,4.092,all P < 0.05].There was no significant difference in the incidence of adverse reactions between the observation and control groups (6.67% vs.10.00%, χ2 = 0.218, P > 0.05). Conclusion:Antibiotic de-escalation therapy for the treatment of severe pneumonia can shorten the time of disappearance of clinical symptoms,improve pulmonary ventilation function,and inhibit systemic inflammatory reaction without increasing adverse reactions.

Objective:To establish a method to determine the residual solvents in salvianolic acid B. Methods: The headspace GC was carried out on an HP-5 capillary column(30 m × 0. 32 mm,0. 6 μm). The inlet temperature was 180℃. The injection volume was 0. 1ml and the separation ratio was 1:10. The column temperature was programmed:the initial temperature was 40℃, malntalned for 6 min, ralsed to 180℃ with a rate of 15 ℃·min-1 , and malntalned for another 5 min. The detector was FID with the temperature of 250℃. The carrier gas was N2 with the flow rate of 1. 7 ml·min-1 . DMSO was used as the solvent for salvianolic acid B. Results:All solvents could be separated completely. The linear range of ethanol, acetone and ethyl acetate was 12. 650-1. 012 × 103 μg·ml-1 (r=0.999 3),12.750-1.012 ×103 μg·ml-1(r=0.999 7) and 12.550-1.004 ×103 μg·ml-1(r=0.999 7), respectively. The average recovery of ethanol, acetone and ethyl acetate was 96. 89% (RSD=3. 81%,n=9), 99. 56% (RSD=4. 05%,n=9) and 97. 21% (RSD=4. 95%,n=9), respectively. Conclusion:The method is simple, reproducible and accurate enough for the determi-nation of residual solvents in salvianolic acid B.

The development of molecular biology techniques makes important contributions to the researches of heritable varia-tion of Schistosoma. In recent years,the molecular genetic analysis in the Schistosoma variation researches mainly includes the re-striction fragment length polymorphism(RFLP),random amplified polymorphism technology(RAPD),microsatellite anchored PCR(SSR-PCR),and polymerase reaction single-strand conformation polymorphism(PCR-SSCP). This article reviews the re-search progress of molecular genetic analysis in Schistosoma variation in recent years.

Thyroid microsomal antigen-antibody(TMAg-Ab)system plays an important role in the pathogenesis of autoimmune thyroid diseases.TMAb are involved in the complementmediated cytotoxicity and antibody-dependent cytotoxicity,resulting in thyroid follicle epithelial cell and basement membrane injury,followed by thyroiditis and hypothyroidism,and they may also cause hyperthyroidism through some unknown mechanisms.In recent years,indirect hemagglutination,radioimmunoassay and enzyme-inked immunosorbent assay have been used to detect TMAb in thyroid disease patients'sera,indicating the incidence as high as 90%.Measurements of T3,T4 and TSH alsoreveal that serum TMAb level is related with the variation of T3,T4 and TSH.It ispostulated that TMAg might be the lipoprotein on smooth endoplasmic reticulum ofthyroid follicle epithelial cell.Due to the difficulties to purify TMAg,its nature stillremains unclear.

The serum thyroid microsomal antibodies (TMAb) and thyroglobulin antibodies (TGAb) were measured in 103 normal persons and 183 patients with different thyroid diseases by enzyme-linked immunosorbent assay (ELISA). The serum T3 and T4 were also tested. The results showed that the incidence of these two autoantibodies were obviously increased in Hashimoto's thyroiditis, hyperthyroidism and hypothyroidism, and normal in simple goiter and thyroid adenoma. The TMAb and TGAb levels in subacute thyroiditis and thyroid cancer were moderately increased. There were also a negative correlation between TMAb and T3, T4, TGAb and T4 in Hashimoto's thyroiditis.

The colorimetric method has been well developed to detect the sensitivity of most antiproliferative drugs with the advantages of objectivity and accuracy. Many parameters including the dosage and the absorbance of crystalline violet, the extraction time of the solvent, plate effect and marginal effect were investigated, then the optimized method was applied further to measure the biological activity during the refolding of recombinant human IFN-? inclusion bodies.

Objective To investigate the clinicopathologic features,the complications of splenectomy and the survival of epithelial ovarian cancer patients with splenic metastasis.Methods A retrospective study was performed of 32 pailents with epithelial ovarian cancer who underwent splenectomy for tumor cytoreduction at Zhejiang Cancer Hospital between Jan 1998 and Jun 2006.Results Of 32 patients,23 patients(72%)were serous adenocarcinoma and 9 were non-serous adenocarcinoma.According to pathological grade,none was of G1,11 were of G2,21 were of G3.Postoperatively,20 patients were left with no residual tumor.7 were with≤2 cm and 5 were with＞2 cm residual tumor.Postoperative complications developed in 8 patients(25%),including subphrenic abscess,wound infection,gastric perforation,gastrorrhagia,phlebothrombosis,and bowel obstruction.The median follow up was 38 months,estimated 2-year and 5-year overall survival were 70%and 36%.Univariate analysis revealed that histological grade,residual tumor and courses of chemotherapy were influencing factors of the survival(P＜0.05),but multivariate analysis indicated that only residual tumor and courses of chemotherapy independently influenced survival(P＜0.05).Conclusions In epithelial ovarian cancer patients with splenic metastasis,low grade serous adenocarcinoma is most common.Splenectomy as part of cytoreductive surgery is associated with modest morbidity and mortality.Residual tumor and courses of chemotherapy are independent factors associated with the prognosis of the patients.

Objective To evaluate cortisol level in experimental frequent febrile seizures model rats.Methods Rats were divided into 3 groups: normal control group(n=10,NC group),hyperthermic control group(n=12,HC group) and febrile seizures group(n=21,FS group).Cortisol level in serum and hippocampus of rats were determined by ELISA.Ultrastructural changes of neurons in hippocampal region CA1 was observed by electron microscop.Results 1.No special ultrastructual findings were observed from neurons in hippocampal CA1 in NC and HC group.In FS group,the neuronal degeneration and edema,the mitochondrial degeneration and edema,the mitochondrion ridge obscured or disappeared.2.Cortisol levels in serum and hippocampus in FS group [(26.57 ? 15.94)?g/L and((4.11)?1.74)?g/L,respectively] were significantly lower than those in HC group [(40.04 ? 15.72)?g/L and(6.70?3.45)?g/L,respectively](P0.05).Positive correlations were demonstrated between serum cortisol level and hippocampus cortisol level(r=0.40 P

Objective To clone human cell division cycle gene 2(CDC2)from human liver cancer tissue and express CDC2 protein in E.coli BL-21(DE3).Methods The total RNA was extracted from liver cancer tissue and amplified by reverse transcription polymerase chain reaction(RT-PCR).The PCR products were cloned into the prokaryotic expression vector pET28a(+)followed by DNA sequencing.The recombinant pET28a(+)/CDC2(rCDC2)plasmid was transformed into E.coli.The rCDC2 was induced with IPTG and characterized by SDS-PAGE.Results The cloned CDC2 gene was composed of 894 nucleotides,and is accordance with that reported in GenBank.The prokaryotic expression vector was constructed successfully.The CDC2 protein was successfully expressed in E.coli.Conclusion The CDC2 cDNA is successfully cloned from human liver cancer tissue,and can express in E.coli.