The bactericidal mechanism of carbon monoxide (CO) and the feasibility of CO-releasing molecules as anti-infective drugs were summarized by consulting scientific literature, combined with our own research work. Anaerobic bacteria are usually tolerant to high concentration of CO, and some can even grow with CO as sole carbon or energy source, but most pathogenic bacteria are sensitive to CO. In view of the difficulty of gaseous CO in controlling the applying dose and the action site, CO release molecules were synthesized. CO release molecules not only have higher bactericidal activities against common pathogenic bacteria than gaseous CO, but also have the ability to kill antibiotics-resistant bacteria and destroy their biofilms. CO mainly binds with heme-Fe²⁺ in cells, interrupting the electron transfer of respiration chains, which would result in the generation of reactive oxygen species. CO can also disturb intracellular ion balance, which further triggers free radical reactions. Due to its diverse acting targets, uneasy to induce drug resistance, and synergistic effect with other antibiotics, CO is expected to be the next generation of anti-infection drugs.

Objective To discuss the donor site complications and the treatments of the anterolateral thiIgh flap transfer. Methods From July 1988 to July 2007,427 patients treated by anterolateral thish flap surgery were followed up.The donor sites were treated by several methods,including direct closure(49 cases),skin graft transfer(258 cases),anterolateral fascial flap transfer(27 cases),musculocutaneous flap and skin sraft transfer(65 cases), superficial epigastric artery flap transfer(28cases).The area of these flaps ranged from 30 cm×10 cm to 18 cm×7 cm.and the average follow-up was 21 months(ranged from 8 months to 54 months). All the data was analyzed by SPSS for Windows,Version 11.0.1. Results Short-term complications(within 4 weeks)and long-term complications (over 6months)were observed.The former included skin necrosis(5.4%),wound infection(4.0%),and necrosis of rectus femoris(0.5%); and the latter included chronic ulcer(4.9%), aerious scar(6.6%), serious discomfortable(5.9%),and quadriceps femoris disfunction(3.7%).The statistical results showed that there was a close correlation between the donor site morbidity and the surgical methods. Conclusion The complications of the donor site cannot be ignored.Protect the soft-tissue of the donor site carefully,design all appropriate operation plan.Careful preoperative examination and local flap transplantation can effectively decrease the rate of complications.

To introduce peptidoglycan recycling and the β-lactams resistance mechanisms of bacteria, so that some help would be supplied to corresponding scientific workers and university teachers. By searching literatures, combined with our own studies, the bactericidal mechanisms of β-lactams and the resistance mechanisms of bacteria to β-lactams were summarized. The bactericidal activity of β-lactams is resulted from the inhibition of cell wall biosynthesis through combination with penicillin binding proteins such as transpeptidase destruction of peptidoglycan balances between biosynthesis and hydrolysis. The drug resistance of bacteria is resulted from the induction of β-lactamase, expression of out-pumping proteins, increase of outmembrane permeability, and modification of antibiotic target proteins. The proteins related to peptidoglycan recycling, such as transpeptidase and glycosyltransferase, would be potential targets for screening new β-lactams. The proteins related to β-lactams resistance, such as β-lactamase, would be potential targets for screening adjuvant drugs of β-lactams.

Objective To observe the effects of Fengshi Bitong Prescription (FSBT) on cytokines in serum and Fas/FasL mRNA expression system in synovium; To discuss relevant mechanism of action. Methods Rats were given foot intradermal injection of bovine type Ⅱ collagen emulsion to establish collagen-induced arthritis (CIA) model. After successful modeling, they were randomly divided into 6 groups: normal control group, CIA model group, tripterygium glycosides group, FSBT high-, medium-, and low-dose groups. Each medication group was given relevant medicine for gavage for 14 d. The weight and arthritis scores of CIA rats were observed. Serum levels of IL-1β, IL-15, and TGF-β1 were detected by ELISA. Expressions of Fas and FasL mRNA in synovium of CIA rats were detected by real-time PCR. Results Compared with model group, the foot arthritis score and serum levels of IL-15 in FSBT high- and medium-dose groups significantly decreased (P<0.01), and the serum level of TGF-β1 significantly increased (P<0.05). Expression of Fas significantly decreased and FasL significantly increased in FSBT high-dose group (P<0.05). Conclusion FSBT may have certain immune regulation effects on rheumatoid arthritis. Its mechanism may be in regulating Fas/FasL apoptosis system, thereby inducing apoptosis of synovial cells and inhibiting synovial hyperplasia.

Objective To evaluate the clinical efficacy of periradicular compound betamethasone injections into the periganglionic space in the treatment of radicular pain.Methods Periganglionic compound betamethasone infiltrations were performed in 76 patients with lumbar radicular pain under MSCT guidance.All patients were divided into two groups including group 1(31 cases of lumbar disc herniation)and group 2(45 cases of lumbar degenerative disorders).The total and two groups scores of VAS were compared after the therapeutic procedure with evaluation of the efficacy.Results 88%(69/76)of patients showed significant pain reduction,with the score of VAS 6.5?2.0(before therapy)dropping to 3.4?1.8(after 1 week)and 3.8?1.9(after 3 month).Differences in improvements before and after the therapy were statistically significant.Differences between one-week and three-month follow-up were not statistically significant.Differences between the two groups demonstrated no statistical significance.Conclusion Periradicular compound betamethasone injection under CT guidance is safe and useful in the treatment of lumbar radicular pain.

Objective To explore a technical modification by transperineal Da- W anorectoplasty (Da WARP) on treating low, intermediate anorectal anomalies(AA) and to evaluate the results of long - term follow up. Methods Forty six cases of AA underwent a Da-W ARP,which involved preservation of the rectal end of the fistula and invagination of the perineal skin flap through the neoanus.The clinical records were reviewed and analyzed retrospectively. Results The median follow - up period was 7 years and 2 months. All of them achieved a good fecal continence exception of 1 patient with intermediate AA and associated anomaly,had fair result. Conclusions The Da - WARP is relatively simple and practical methods for surgical treatment of low, intermediate AA, with good long - term results.

Background Glucocorticoid is a common drug for treatment of thyroid-associated ophthalmopathy (TAO) with good effectiveness.But some adverse reactions of glucocorticoid are inevitable.At recent years,99technetium-methylene bisphosphonate(99Tc-MDP) is being paid more and more attentions in the treatment of TAO,but its effectiveness and safety is worthy of comparison to traditional treatment methods.Objective This study was to evaluate the efficacy of treatment with intravenous injection of 99Tc-MDP for TAO.Methods The Cochrane Library,CNKI,PubMed,Wanfang database,Weipu net were searched in computer and Google Scholar was searched manually.The randomized controlled trail (RCT) of intravenous injection of 99Tc-MDP for TAO were collected from establishment of database through April,2012.The quality of included literature was assessed based on the methodology of the study.The evaluating indexes included the primary treating outcomes,such as total efficacy,exophthalmic extent and recurrence rate as well as secondary outcomes such as adverse effect.RevMan 5.1 software was used for Mate analysis.Results A total of 11 RCTs were identified with 706 patients.Subgroup analysis was carried out based on the outcome measures and intervention.No significant difference was found in the overall effective rate between intravenous injection of 99Tc-MDP and immunosuppressive treatment (RR =0.96,95 ％ CI:0.76 to 1.22,P=0.740).However,the effective rate was significant different between intravenous injection of 99Tc-MDP and oral prednisone (RR =1.25,95 ％ CI:1.06-1.46,P =0.007) or between intravenous injection of 99 Tc-M DP and the blank control group (RR =2.53,95 ％ CI:1.68-3.81,P =0.000).Significant difference also was found in the total effective rate between intravenous injection of 99Tc-MDP with methyprednisone and methyprednisone alone (RR =1.27,95％ CI:1.05-1.53,P =0.010).There were significant differences in the effective rate of proptosis between intravenous injection of 99Tc-MDP and oral prednisone (RR=2.02,95％ CI:1.44-3.56,P=0.020).The recurrence rate of TAO was significant different between intravenous injection of 99Tc-MDP and oral prednisone (RR =0.51,95％ CI:0.33-0.78,P=0.002).Less adverse responses were seen in the intravenous injection of 99Tc-MDP group than the oral prednisone group and immunosuppressive treatment group.Conclusions Intravenous injection of 99Tc-MDP for TAO appears to be of a similar effectiveness to immunosuppressive method.The combination of intravenous injection of 99Tc-MDP with methyprednisone seems to be more effective than methyprednisone alone,with little systemic adverse effect after application.

Visceral leishmaniasis (VL) is a parasitic disease ,which is still endemic in western China .An earthquake struck south-western China on May 12th ,2008 ,which affected Longnan City of Gansu Province considerably .The objective of this survey is to determine the effect of the Wenchuan earthquake on the Kala-azar epidemic in Longnan City .In this study ,VL cases were collected from 2005 to 2013 and diagnosed on positive test for anti-rK39IgG antibodies by the Kala-azar Detect rK39 dip-stick (InBios ,USA) .The incidence rates were calculated among various counties of Longnan City with SPSS 19 .0 soft-ware .The epidemiological characteristics of the disease were analyzed before and after the Wenchuan earthquake .From 2005 to 2013 ,there were 825 VL cases in Longnan City ,with an annual incidence of 3 .36/100 000 and a significantly higher incidence in males than that in females (P＜ 0 .001) .All age groups were affected .During this period ,there was an obvious upward trend from 2005 to 2008 ,and a distinct downward tendency since 2010 .The incidences of VL between 2008 and 2010 were sig-nificantly different with that in other years (P＜0 .01) .Results revealed that VL was widespread in Longnan City ,which was likely exacerbated by the earthquake in 2008 .Earthquake created diverse natural environment and social circumstances ,w hich may contribute to the spread of the VL epidemic .Together ,our data strongly suggest that the epidemic of VL should be close-ly monitored after earthquake .

OBJECTIVETo explore the relation of phlegm-stasis syndrome with insulin resistance and monocyte peroxisome proliferator activated receptor-gamma messenger ribonucleic acid (PPARgamma mRNA) expression in patients with coronary heart disease (CHD).

METHODSSixty patients with CHD were differentiated into three syndrome types, the non-phlegm non-stasis (NN) type, the phlegm congealing heart vessel (PC) type and the phlegm-stasis cemented (PS) type. Besides, 20 healthy volunteers were selected as the normal control. Levels of fasting plasma glucose (FPG) and fasting insulin (FINS) were determined and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated accordingly. The expression of PPARgamma mRNA in the peripheral monocytes was assessed by reverse transcriptase-polymerase chain reaction (RT-PCR).

RESULTSLevels of FINS, HOMA-IR and PPAR-gamma mRNA expression in all CHD patients were higher than in the normal control (P <0.01, P < 0.05); comparisons of the three indexes between patients of different syndrome types showed that they were higher in PC type and PS type than in NN type (P < 0.05 or P <0.01), and the difference between PC type and PS type was significant (P < 0.05).

CONCLUSIONChanges of insulin resistance and PPARgamma mRNA expression in monocytes are possibly one of the mechanisms for the development of phlegm-stasis syndrome in CHD.

Aged ; Case-Control Studies ; Coronary Disease ; genetics ; metabolism ; Female ; Humans ; Insulin Resistance ; Male ; Middle Aged ; Monocytes ; metabolism ; PPAR gamma ; genetics ; metabolism ; RNA, Messenger ; metabolism

Acupuncture Analgesia ; methods ; Humans ; Medicine, Chinese Traditional ; methods ; Migraine Disorders ; etiology ; prevention & control ; therapy ; Models, Theoretical ; Neuropeptides ; administration & dosage ; therapeutic use ; Professional Practice