2.Cohort study of highly active antiretroviral therapy and drug resistant mutation in Henan Province,China
Min ZHANG ; Xiao-xu HAN ; Qing-hai HU ; Bin ZHAO ; Zi-ning ZHANG ; Hong SHANG ;
Chinese Journal of Laboratory Medicine 2008;31(10):1101-1105
Objective To build the cohort of drug resistance and analyze treatment efficiency of AIDS patients and situation of drug resistant mutations among HIV-1 infected individuals.Methods A cohort of 116 HIV-1 infected patients was built and their treatment progress were acquired once every 6 months.At the sanle time CD4+ T cell counts and HIV-1 viral load were measured and genotyping for drug resistance was determined by a home brew nested PCR.Results The CD4+ T cell count(470±251/ml)was higher than that before treatment in patients who were treated by AZT/DDI/NVP or D4T/DDL/NVP.The viral load was lower than that before treatmenL The drug resistant mutation frequency increased gradually along with treatment.The CD4+ T cell count was decreased and viral load was increased and the prevalence of drug resistant mutation was increased in the patients who changed regimens to AZT/3TC/NVP or D41/3TC/NVP.Only one primary mutation that was resistant to non-nucleoside reverse transcriptase inhibitors (NNRTIs)was detected in the naive patients.The cross-resistant mutation was detected in two patients after 6 months treatment. The intermediate resistance to lopinavir(LPV) was detected after 12 months treatment.The prevalence of high-grade resistances to NNRTIs was increased obviously,and the prevalence of multi-resistance and cross-resistance was detected in 5 patients after 36 months treatment.Conclusions The prevalence of primary mutation was rare in naive HIV-1 infected patients.The prevalence of drug resistant mutation was inereased gradually along with treatment.Ahhough few regimens were available,the treatment effect could last relatively long period of time if patients keep taking medicine stably.The regimens could be changed according to the results of drug resistant test.
3.The diagnosis and treatment of ischemic bowel disease,experience in 73 cases
Wei FU ; Chao-Lai MA ; Zi-Shun ZHANG ; Min LYU ; Xue-Song YANG ; Tong-Lin ZHANG
Chinese Journal of General Surgery 1993;0(02):-
Objective To analyze clinical features and sum up experience for the treatment of ischemic bowel disease. Methods Clinical data of 73 patients with the diagnosis of ischemic bowel disease were retrospectively analyzed. ResultsTwenty-eight patients were male and 45 patients were female. The median of age was 65 years (range of 38 to 89 years). Forty-eight patients were associated with hypertension, 23%(17/73) patients had a history of coronary disease and 15% (11/73) had diabetes. Seventy patients presented symptom of abdominal pain and 93% (68/73) had hematochezia. Symptoms relieved by conservative treatment in 96% (63/66) patients. Nine patients underwent a surgery. One patient died of sepsis postoperatively. One suffered from colostomy necrosis and leakage of the rectum segment. Conclusion 1. Elder patients presenting symptoms of abdominal pain and hematochezia, especially with a history of cardio-cerebrovascular disease and diabetes should be considered for the possibility of ischemic bowel disease. 2. Most patients with ischemic bowel disease could be successfully treated by conservative therapy. 3. Surgery for patients with chronic relapsing and nonresponsible symptoms was difficult and patients often suffer from high postoperative complications.
4.Renal protection of Tangke Decoction on rats with diabetes and its effect on the expression of TGF-beta1/Smad4.
Zi-Run WANG ; Hui-Yu ZHANG ; Min-Fang GUO ; Zhi-Xiong GAO ; Jing-Lin LI
Chinese Journal of Integrated Traditional and Western Medicine 2014;34(7):826-832
OBJECTIVETo observe the effect of Tangke Decoction (TD) on the expression of TGF-beta1/Smad4 of rats with early diabetes and to explore the effect and mechanism of TD against the renal injury induced by diabetes.
METHODSSD rats were randomly divided into the normal control group (n = 12), the model group (n = 10), the Chinese herbs prevented group (n =10), the Chinese herbs treated group (n = 10), and the Western medicine control group (n = 10). TD (18 mg/kg) was given by gastrogavage to rats in the Chinese herbs prevented group immediately after successful modeling for 12 weeks, once daily. At the 4th week of successful modeling, rats in the rest 4 groups were administered by gastrogavage. Equal volume of normal saline was given to rats in the model group and the normal control group. Benazepril suspension (1 mg/kg) was administered by gastrogavage to rats in the Western medicine control group for 8 weeks, once daily. TD (18 mg/kg) was given by gastrogavage to rats in the Chinese herbs treated group for 8 weeks, once daily. The body weight, kidney weight, index of kidney weight, fasting blood sugar, 24 h urinary albumin excretion rate were examined after experiment. The pathological changes of the renal tissue were observed by HE staining, Masson staining, and electron microscope. The expression of renal transforming growth factor-beta1, (TGF-beta1) and Smad4 were detected using immunohistochemical assay.
RESULTSCompared with the normal control group, the body weight of rats decreased significantly; the kidney weight, index of kidney weight, blood sugar, 24 h urinary protein excretion, the urinary albumin excretion rate,TGF-beta1 and Smad4 expression increased significantly in the model group (all P < 0.01). Compared with the model group, the aforesaid indices were improved in each treatment group with statistical difference (P < 0.05, P < 0.01). Compared with the Western medicine control group, the kidney weight, index of kidney weight, blood sugar, 24 h urinary protein excretion, and the urinary albumin excretion rate were obviously improved in the Chinese herbs prevented group (P < 0.01). The renal pathological changes were most obvious in the model group significantly, but they were improved in all treatment groups.
CONCLUSIONTD could obviously improve the symptoms of diabetes and down-regulate the expression of renal TGF-beta1 and Smad4 of early diabetic nephropathy rats, which suggested that TD had certain preventive effect on early diabetic nephropathy.
Animals ; Diabetes Mellitus, Experimental ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Kidney ; metabolism ; Male ; Rats ; Rats, Wistar ; Smad4 Protein ; metabolism ; Transforming Growth Factor beta1 ; metabolism
5.Effect of compound bushen recipe on chronic fatigue syndrome in C. elegans: an experimental study.
Li-jin NIE ; Wai-jiao CAI ; Xin-min ZHANG ; Zi-yin SHEN
Chinese Journal of Integrated Traditional and Western Medicine 2014;34(6):728-732
OBJECTIVETo evaluate the effect of compound bushen recipe (CBR) in improving the survival state of stress and the overall life span in C. elegans by simulating chronic fatigue syndrome (CFS) under various stress states.
METHODSThe tolerance and the average survival time of adult larvae against heat stress (35 degrees C), oxidative stress (250 microg/mL juglone), and in vivo Abeta protein toxicity (Abeta(1-42) transgenic mutant CL4176) under the intervention of the high (500 mg/L), middle (250 mg/L), and low (100 mg/L) dose CBR were observed. The effect of CBR on the average live time (at 25 degrees C), movement distance in 20 seconds, the frequency of pharyngeal pump in 30 seconds, and the reproductive capability were assessed.
RESULTSCompared with the control group, the survival time of heat stressed C. elegans could be significantly increased in each CBR group (P < 0.01). The survival time of heat stressed C. elegans could be elongated, the protein toxicity be attenuated, and the live time prolonged in the high and middle dose CBR groups (P < 0.01, P < 0.05).The movement distance and the frequency of pharyngeal pump could also be increased in the high dose CBR group (P < 0.01). There was no statistical difference in the reproductive capability among all groups (P > 0.05).
CONCLUSIONSCBR could significantly enhance the stress capacity of C. elegans against internal and external environment, and prolong their lifespan. It did not interfere their normal production, and also could improve the quality of life, thus laying a foundation for further mechanism studies and pharmacological researches on CBR in preventing and treating CFS.
Animals ; Caenorhabditis elegans ; drug effects ; Disease Models, Animal ; Drugs, Chinese Herbal ; therapeutic use ; Fatigue Syndrome, Chronic ; drug therapy ; Longevity ; Stress, Physiological
6.Is nationwide special campaign on antibiotic stewardship program effective on ameliorating irrational antibiotic use in China? Study on the antibiotic use of specialized hospitals in China in 2011-2012.
Xiao-Xu, ZOU ; Zi, FANG ; Rui, MIN ; Xue, BAI ; Yang, ZHANG ; Dong, XU ; Peng-Qian, FANG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2014;34(3):456-63
With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly overprescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program (ASP) at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children's, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses (DDDs) per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient cases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days (P<0.001). The percentage of antibiotic use in outpatient prescriptions (range: 24.12%-18.71%, P=0.109) and inpatient cases (64.85%-60.10%, P=0.006) also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.
8.Enantioseparation of 38 Racemates on Four Chiral Columns in High Performance Liquid Chromatography
Mei ZHANG ; Wenhui XI ; Min ZI ; Ya PENG ; Shengming XIE ; Liming YUAN
Chinese Journal of Analytical Chemistry 2010;38(2):181-186
The enantioseparations of 38 racemates on Chiralcel OD, Chiralpak AD, Chiralpak IA and(S, S)-Whelk-01 were presented by HPLC. Those enantiomers come from the amines, alcohols, ethers, ketones, aromatic derivatives, heterocyclic compounds, amide acids and medicines etc. With the mobile phase of n-hexane)/isopropanol(90∶ 10, V/V), n-hexane/isopropanol/trifluoracetic acid(90∶ 10∶ 0.2, V/V) or n-hexane/isopropanol/triethylamine(90∶ 10∶ 0.2, V/V), over 70% enantioseparations were obtained for OD, AD and IA columns). The order of enantioseparation selectivity for four columns was OD>AD>IA>(S,S)-Whelk-01, and among those columns there was a big chiral discriminating complementarity. This investigation was useful for choosing chiral columns to separate chiral compounds.
9.Drug Sensitive Analysis of 207 Strains of Staphylococcus Aureus in Children
min, XU ; jian-hua, ZHANG ; liang-xia, WU ; zi-cai, WANG
Journal of Applied Clinical Pediatrics 2003;0(10):-
Objective To analyze the changes of the frequency of staphylococcus aureus (SAU) and methicillin resistant staphylococcus aureus (MRSA) isolated from hospitalized children from 2003 to 2006,and investigate the 21 antimicrobial susceptibility against SAU strains for providing reference for clinical rational use of drug.Methods The SAU strains were isolated from 207 children who were hospitalized in department of pediatrics of the sixth people′s hospital affiliated to Shanghai jiaotong university from Jan.2003 to Dec.2006 during the first 48 h of hospital stay.Strains were isolated from cotton-tipped swab of throat culture 75 strains,sputum culture 57 strains,secretion of bellybutton culture 25 strains,liquor puris culture 23 strains,hemoculture 20 strains,tube thoracostomy culture 3 strains,middle piece urnary culture 3 strains,cerebrospinal fluid culture 1 strain.The strains were identified by latex agglutination test,the in vitro activities of the 21 antimicrobial agents against 207 SAU isolates was tested by disc diffusion test (K-B method) according to the guidelines of the clinical and laboratory standards institute.MRSA was screened by oxacillin disc diffusion test.The data were analyzed by WHONET 5 software,Cochran-Mantel-Haenszel was used to analyze the tendency of SAU isolating rate and MRSA detectable rate.Results Of these SAU,30 strains(14.5 %) isolates were MRSA and 177 strains(85.5 %) were methicillin sensitive staphylococcus aureus.The sensitive rates of SAU to Penicilin,Oxacillin,Cefuroxime Sodium,Cefotaxime,Ceftriaxone,Erythromycin,Clindamycin,Trimethoprim/Sulfamethoxazole,Ciprofloxacin,Fosfomycin and Rifampin were 4.8%,85.5%,84.9%,90.0%,88.3%,37.5%,46.3%,92.7%,74.2%,97.2%,94.0%,respectively.All the strains were sensitive to peptide antibiotic(for instance,vacomycin and teicoplanin) and Levofloxacin.The SAU isolated rate and MRSA detectable rate were 9.6%,19.8%,25.0%,39.5% and 5.0%,5.9%,12.7%,24.7% in 2003-2006,respectively.Conclusions SAU has strong resis-tance to Penicilin and Erythromycin,but relative sensitive to Oxacillin and Cephalosporin.The SAU isolatating rate and MRSA resistant rate is increased in our area,pediatrics should to strengthen the monitoring of SAU is important in pediatrics.
10.Efficacy of neoadjuvant chemotherapy with antracyclines plus paclitaxel or docetaxel regimen in stageⅢbreast cancer patients
Zi-Yi YIN ; Pi-Lin WANG ; Tie ZHANG ; Mao-Min SONG ;
China Oncology 2000;0(06):-
Background and purpose:Antracycline combined with paclitaxel is more widely applied in breast cancer as neoadjuvant chemotherapy.There are differences in applications of different paclita~els.In this research,the efficacy and toxicity of neoadjuvant chemotherapy with ET,ED regimen were compared for the patients with stageⅢbreast cancer.Methods:64 cases of stageⅢbreast cancer patients were divided in two groups.Before surgery,one group had received ET(EPI ivgtt 60 mg/m~2 d_1?21,PTX ivgtt 175 mg/m~2 d_2?21),the other group had received ED(EPI ivgtt 60 mg/m~2 d_2?21,DOC ivgtt 75 mg/m~2 d_2?21)neoadjuvant chemotherapy for three weeks. Curative effect and side effects were evaluated after 2-4 cycles.Results:Total effective rate was 87.5%.Effective rate in ED group was 92.9%,and effective rate in ET group was 83.5%.There was no significant difference(P=0.253).In pCR cases,8 cases in ED group achieved pathologically complete response compared to 3 cases in ET group(P=0.033). The number of patients in ED group(24 cases)hadⅣ-Ⅴgrade pathology evaluation after chemotherapy,it was higher than that in ET patients(21 cases).There was a significant difference(P=0.017).In both groups side effects including hair loss,nausea and vomiting,liver dysfunction were similar.Incidence rate of peripheral neurotoxicity in ET group was higher than that in ED group(P=0.002).Incidence rates of leukopenia,skin rash and phlebitis in ED group were higher than that in ET group.There was a significant difference between two groups in the leukopenia(P=0.034). Conclusions:For the patients with stageⅢbreast cancer patients,both two regimens could achieve better curative effect.ET and ED regimen have similar effect.But in ED regimen,the number ofpCR cases was obviously higher than in ET group.In both groups side effects were similar.There were significant differences in terms of leukopenia and peripheral neurotoxicity,but the side effects could be tolerated.