Objective To compare the efficacy of different antibiotics strategy,introperitoneal (IP) cefazolin plus third-generation cephalosporin versus IP Vancomycin plus thirdgeneration cephalosporin on peritoneal dialysis (PD)-related peritonitis.Methods All episodes of PD -associated peritonitis happened in prevalent PD patients between January 2008 and December 2012 were recruited from the PD Center of Peking University First Hospital.According to their empiric antibiotics scheme,episodes were divided into group A (where IP cefazolin plus third-generation cephalosporins were administrated) and group B (where IP Vancomycin plus third-generation cephalosporins were administrated).Multivariable logistic regression model was used to explore the influence of different emnpiric antibiotics scheme on peritonitis outcome.Results Patients in Group B had significantly lower level of serum albumin (33.5±6.0 vs 35.3±5.2 g/L) and cholesterol (4.6±1.3 vs 4.9± 1.1 mmol/L) than those in group A.In group A,the percentage of gram-positive bacteria was similar to group B (43.2％ vs 43.3％,P =0.96),but gram-negative bacteria was numerically lower (16.9％ vs 24.7％,P =0.08).Different empiric antibiotics strategy was not independent predictor of peritonitis outcome [OR =1.07,95％ CI(0.45,2.56),P=0.87].Conclusion Both cefazolin and vancomycin can be selected as first-line empiric antibiotic covering gram-positive organisms in the treatment of PD related peritonitis.

Objective: To discuss the rational drug application of Kawasaki disease in children with upper respiratory tract infection in order to provide reference for the therapy of Kawasaki disease suspected of bacterial meningitis.Methods: The medical record of a 2-year-old boy with Kawasaki disease was retrospectively analyzed, and the anti-infection treatment was analyzed and evaluated.Meanwhile, the mechanism of elevated leukocyte count in cerebrospinal fluid (CSF)of children with incomplete Kawasaki disease was discussed.The pharmaceutical care and treatment results in the diagnosis and treatment process were analyzed as well.Results: The anti-infective therapy in early stage was reasonable as the early symptoms of respiratory tract infection in the child were obvious, however, the choice of aztreonam was defective.On the premise of the clinical diagnosis of Kawasaki disease and excluding bacterial meningitis, the medication was timely adjusted.Finally, the symptoms of the child were improved.Conclusion: The application of anti-infection drugs should be reasonable in clinics, and the abnormality in cerebrospinal fluid should be paid more attention in children with Kawasaki disease.It is necessary to strengthen clinical observation and pharmaceutical care in order to guarantee the safety of medication for patients.

Adult ; Ethylene Dichlorides ; poisoning ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Neurotoxicity Syndromes ; etiology ; pathology ; Young Adult

Objective By analyzing the clinical and radiographic manifestations of calcium pyrophosphate deposition disease (CPDD) to improve the recognization of the disease.Methods Clinical features,diagnosis and treatment of an old female patient with CPDD was reported with literature review.Results An old female patient presented with swollen and pain on the right knee without obvious causes eight years ago,which was characterized by slightly reddness of joint surface,warm of local skin.Thcn she gradually developed swollen and pain in left knee,right ankle,both wrists,bilateral meta-carpophalangeal (MCPJ) and right elbow joints with few joint symptoms and the joints swollen and pain could relieved spontaneouslyitself in about one week.X-ray showed the thin strip of cartilage calcifications in wrist triangular fibrocartilage disc,meniscus of knee and the pubic symphysis were parallel to the surface of cartilage.Examination of microscopy with refractive filter demonstrated that short rod crystals refraction in joint fluid.CPDD was diagnosed and treated with flushing of joint cavity and injections of betamethasone as well as nonsteroidal anti-inflammatory drug orally.Symptoms relieved after therapy.Conclusion Understanding the disease characteristics of CPDD is beneficial to for accurate diagnosis and treatment.

Objective To investigate the clinical and imaging features of patients with calcium pyrophosphate deposition (CPPD).Methods The clinical data and X-rays material of knee joint of 20 patients with CPPD were retrospectively analyzed.Pearson/Spearman's correlations analysis was used for statistical analysis with software version 15.0.Results The 20 patients with CPPD had demonstrated that the typical accumulation of calcium,which accounted for about 1.5％o(20/13 536) among patients over 55 years old who had knees X-ray at the same period in Chaoyang Hospital.Female patients of CPPD was 80％ (16/20).Seventeen patients completed follow-up visits.The age of onset for CPPD ranged from 44 to 85 years old,the percentage of CPPD patients over 70 years old was 71％(12/17).Among the 17 cases of followed,14 cases (82％) were patients with paroxysmal arthritis with the initial site of knee joint (79％) and ankle joint (21％).Most patients suffered from moderate to severe pain,while some might have local congestion and increased skin temperature.Five patients had more than two different joints attacked by arthritis.The distribution of the affected areas was knee,ankle,hip,elbow,wrist and metacarpophalangeal joints.The median number of attack was 1.5 times a year,and the median duration of attack was 8.5 days.Among the 14 patients,Six cases of them had no recurrence after treatment,but six cases had recurrent attacks within a year.The imaging of lateral articular facet showed that calcium deposit was extended and thickness of calcification was increased.Plus osteophyte formation stage was 100％ with an average of 3.0±1.6 and 85％ sclerosis of articular facet.The rate of attacks of arthritis had a positive correlation with calcium deposition range of lateral articular facet (r=0.663,P=0.010) and a negative correlation with sclerosis of articular facet (r=-0.548,P=0.042).Conclusion Old patients with paroxysmal joint pain,patients with knee joint or other big joints as the initial joints involved,patients with long duration disease,patients who had more than two joints at attack and patients with calcium deposition in imaging,should be suspected for CPPD clinically.Moreover,patients with a wide range of calcium deposition are high likely to suffer from recurrent arthritis attack.

Objective To evaluate the biological safety of 125I-filled carbon nanotubes covered with metallic esophageal stent with regard to the normal esophagus before clinical application.Methods 125I-filled carbon nanotubes covered with metallic esophageal stent was prepared.Eighteen of New Zealand rabbits were randomly divided into three groups with 6 rabbits in each group.Three groups of stents,non-radioactive,low radio-activity ( 3.7 - 5.6 MBq),and high activity ( 11.1 - 13.0 MBq ) were placed in the midpiece of esophagus of rabbits.Esophagus opacification and three-diamensions DSA were performed at 0.5 h,7,14 and 30 d after insertion of the stents,respectively.The rabbits were killed at 30d after insertion of the stents,and histologic examinations of the esophageal walls were performed.Results In non-radioactive and low activity groups,1 of 6 rabbits died of wound infection at 1 and 3 d after surgery due to pulmonary infection,respectively.All specimens were obtained from 16 rabbits.Microscopically,in all rabbits of low activity and high activity groups,there were membrana mucosa necrotic and swell and breakage of the muscle fiber in esophageal submucosa and muscularis,submucosal inflammation,which were more severe in high activity group.In low activity group,one esophagus ectal membrane was involved,however,esophageal perforation did not develop.In high activity group,3 of 6rabbits esophageal perforation had developed,in which one esophagus mediastinum fistula developed,without inflammation.In non-radioactive group,it was almost normal in mucosa layer,a small amount of inflammatory cells were found in submucosal layer,and part of muscle fibers was fractured and no pathological changes of necrosis was found.Conclusions Radioactive 125I carbon nanotubes covered metallic stent with low activity(3.7 -5.6 MBq) can be used as intraluminal palliative brachytherapy,which is safe and effective.

The interaction of drug and target protein is a critical part of new drug discovery. It is the premise for drugs to exert therapeutic effects by targeting specific binding sites of target proteins and thereby affecting its pharmacological activity. Currently, a variety of techniques are exploited to detect the interaction between drug ligands and target proteins. For example, cellular thermal shift assay (CETSA) and differential scanning fluorimetry (DSF) based on thermodynamics, mass spectrometry and nuclear magnetic resonance technology, etc. In addition, high-throughput ligand screening technology provides technical convenience for the search of specific ligand, and is a powerful tool to efficiently identify the interaction between drug ligand and target protein. Here, we summarize the detection techniques of interaction between small molecules and target proteins, and discuss the application of high-throughput ligand screening technology in drug research.

Target identification and verification of natural products is an important and challenging work in the field of chemical biology. It is also an important job for researchers to apply chemical proteomics technology to biomedicine in order to identify target proteins of natural products. Target identification is critical to understanding its mechanisms and developing natural products as molecular probes and potential therapeutic drugs. Traditional approaches of small molecule target identification based on affinity have been shown to be successful, such as click-chemical probes, radioisotope labeling or photosensitized small-molecule probes. Nevertheless, these technologies require purified candidate target proteins, and modified small molecules with probes or linkers, such as adding agarose beads, biotin labels, fluorescent labeling or photo-affinity labeling. Many structure-activity relationship studies should be performed to ensure that the addition of small molecule labels undisturbed the original biological activity of the small molecules. Unfortunately, all these modifications are likely to alter their biological activity or binding specificity. To overcome the bottleneck of "target recognition", researchers have developed a series of new techniques for unmodified drug target identification. In this article, we reviewed the target identification techniques of natural product without structural modification in order to provide reference for the development of natural products.

Adolescent ; Adult ; Aged ; Antitubercular Agents ; administration & dosage ; Bronchitis ; therapy ; Bronchoscopy ; Combined Modality Therapy ; Female ; Humans ; Isoniazid ; administration & dosage ; Male ; Microwaves ; therapeutic use ; Middle Aged ; Streptomycin ; administration & dosage ; Tuberculosis, Pulmonary ; therapy

Objective To observe the expression level of inhibitor of differentiation 2 (Id‐2) and matrix metalloproteinases‐9 (MMP‐9) in rectal cancer ,analysis the correlation of the expression level of them ,to study the relationship between the expression level of them and the clinical pathology indicators of rectal cancer .Methods Rectal cancer tissues and normal tissue adjacent to rec‐tal cancer were obtained from the rectal cancer resection of 56 patients with rectal cancer ,using immunohistochemical method to ob‐serve the expression level of Id‐2 and MMP‐9 in normal tissue adjacent to rectal cancer and rectal cancer and Spearman correlation test to detect the correlation between the expression level of Id‐2 and MMP‐9 ;then we analyzed the relationships between the ex‐pression level of Id‐2 and MMP‐9 and the index of rectal cancer clinical pathology .Results The positive expression rate of Id‐2 in the in rectal cancer tissues is more higher than that of normal tissue of adjacent to rectal cancer (73 .21% vs .48 .21% ,P<0 .05) . The positive expression rate of MMP‐9 in the in rectal cancer tissues is higher than that of normal tissue of adjacent to rectal cancer (71 .43% vs .44 .64% ,P<0 .05) .Spearman correlation test showed that there is the positive correlation between the expression level of Id‐2 and MMP‐9 (r=0 .393 ,P=0 .003) .The expression levels of Id‐2 and MMP‐9 in rectal cancer were correlated with the degree of tumor differentiation ,TNM stage and lymph node metastasis (P<0 .05) ,but had no differences between the elements of age and sex (P>0 .05) .Conclusion There is a close relationship between the expression levels of Id‐2 and MMP‐9 in rectal cancer and the occurrence and development of rectal cancer .Rectal cancer with the higher Id‐2 expression level may be the ways to achieve tumor invasion and metastasis through MMP‐9 as a facilitator .