OBJECTIVE:To observe clinical efficacy and safety of itraconazole in the treatment of invasive fungal infections(IFI) in patients of intensive care unit(ICU).METHODS:21 patients with IFI in ICU of Xinhua Hospital were analyzed retrospectively from Jan.to Sep.in 2009.Clinical efficacy and safety of itraconazole were analyzed.RESULTS:The total clinical cure rate reached 52.3%.Drug sensitivity test of 103 cases of bacterial strain culture showed those bacterial strains was sensitive to itraconazole.Total clearance rate of bacterial was 57.1%.Cure rate of confirmed diagnosis cases,clinical diagnosis cases and suspected cases were 33.3%,56.2% and 50.0%.The clearance rates of bacteria in above cases were 33.3%、62.5% and 50.0%.The incidence of ADR was 14.2%.CONCLUSION:Itraconazole is effective and safe in the treatment of IFI in patients of ICU.However,the patients with cardio dysfunction should be treated carefully with itraconazole.It is necessary to monitor vital sign and observe the change of symptom during medication.

Liposome-mediated nucleic acid delivery has been a focus recently, but in the course of delivering nucleic acid, some hurdles seriously limit the nucleic acid exerting treatment effect. This review refers to a series of problems such as low blood stability, reticuloendothelial system absorption, the lower targeting of liposome and the restriction of endosomal escape which are suffered in liposome-mediated nucleic acid delivery; and gives a detail introduction of strategies such as PEGylation, ligand modification, photochemical internalization, the application of degradation liposome and membrane-lytic peptide, to overcome those problems.

Objective To compare and analyse the esthetic effect of four kinds of the porcelain fused to metal crowns (PFMs) in restoring anterior teeth. Methods Based on single standard, a total of 371 anterior teeth from 110 patients were restored by PFM, in which 206 teeth of 59 patients were restored with Ni-Cr alloy PFM, 105 teeth of 29 patients with full circular procelain shoulder PFM, 35 teeth of 16 patients with titanium metal PFM, and 25 teeth of 6 patients with noble metal PFM. The esthetic effect was examined and analysed by single-blind method in one week and after one year. Results Between three days and one week, there was no difference among four PFMs in shapes and colors, which corresponded with adjacent teeth. The edge suitability was good and no significance was found in them. After one year, there was no difference of four PFMs in shapes and colors, which corresponded with adjacent teeth. The edge suitability of noble metal PFM was better than the other three, and the difference was statistically significant. Conclusion The esthetic effect is the best when noble metal PFM is used to restore anterior teeth and better with full circular procelain shoulder PFM.

Objective To evaluate the treatment effect of sustained low-efficiency diafiltration( SLEDF) on patients with severe acute pancreatitis( SAP). Methods Forty-two patients with SAP were randomly divided into continuous veno-venous hemofiltration( CVVH)group with 22 patients and SLEDF group with 20 patients. In addition to routine treatment,patients in CVVH and SLEDF were administrated to patients respectively in two groups. Mortality,incidence of complication,clinical symptoms,sign and laboratory examination and recovery time were recorded and measured. The scores of acute physiology and chronic health evaluation( APACHE)II and multiple organ dysfunction syndrome( MODS ) were performed. The level of C-reactive protein( CRP ),tumor necrosis factor-α( TNF-α),interleukin( IL )-6 and IL-8 were measured. Results There were no significant differences in terms of the mortality(90. 91% vs. 90. 00%;χ2 =0. 010,P=0. 920),incidence of complication (18. 18% vs. 20. 00%;χ2 =0. 023,P =0. 881)and recovery time of clinical symptoms,sign and laboratory examination in CVVH group and SLEDF( P﹥0. 05 ). There were also no significant differences between CVVH and SLEDF group in terms of scores of APACHE II((12. 1 ± 6. 1)vs.(11. 9 ± 7. 2);t=0. 097,P=0. 920), MODS((4. 3 ± 1. 7)vs.(4. 4 ± 1. 8);t=0. 185,P=0. 850),CRP((161. 7 ± 22. 9)mg/L vs.(157. 6 ± 21. 8) mg/L;t=0. 594,P=0. 550),TNF-α((5. 8 ± 1. 9)ng/L vs.(5. 7 ± 1. 8)ng/L;t=0. 175,P=0. 860),IL-6 ((4. 1 ±1. 2)pg/L vs.(4. 2 ± 1. 1)pg/L;t =0. 282,P =0. 780)and IL-8((3. 3 ± 1. 4)pg/L vs.(3. 2 ± 1. 0)pg/L;t=0. 268,P=0. 790)at 72 h post-treatment. However,the above test indices were decreased at 72 h post-treatment than those at admission(P﹥0. 05). Conclusion SLEDF and CVVH are proved with same treatment effect based on the levels of inflammatory cytokine,alleviating pathogenetic condition and improving prognosis in patients with severe acute pancreatitis.

Toll-like-receptors(TLRs) have been found to play a critical role in immune response of hosts.They can trigger innate immune responses by detecting pathogen-associated molecular patterns(PAMPs).This paper reviews the roles of several toll-like receptors(TLR4,TLR5,and TLR9) in radioprotection and the related mechanisms,so as to provide theoretical evidences for further studying their roles in radioprotection.

Objective To evaluate and analyze the CT imaging of preoperative SOX regimen neoadjuvant chemotherapy in the treatment of advanced gastric cancer.Methods A total of 33 patients with advanced gastric cancer treated in our hospital from January 2010 to February 2015 were enrolled for the study and given tegafur gimeracil oteracil potassium capsule plus oxaliplatin for injection as preoperative adjuvant chemotherapy.And all the patients were given surgery after 3 cycles of SOX regimen chemotherapy, and surgical resection of the tumor was taken as the final pathology gold standard.The CT imaging data of the patients before and after the chemotherapy was counted and then analyzed and compared with the pathological data to clarify the value of CT imaging in the evaluation of SOX regimen neoadjuvant chemotherapy for advanced gastric cancer.Results The effective rate was 33.33% and the ineffective rate was 66.67% in the preoperative SOX regimen neoadjuvant chemotherapy for advanced gastric cancer through clear surgical pathology.The correlation between tumor volume reduction and pathological grading was the strongest(r=0.581, P<0.001).By ROC analysis, the best area value(AUC) of the tumor volume reduction rate was 0.834.When the tumor volume reduction rate with 36.94% was taken as the effective threshold for SOX regimen neoadjuvant chemotherapy, the sensitivity and specificity of the evaluation were the best with 74.62% and 83.01% respectively.Conclusion sCT volume measurement can be used as a reliable clinical data to evaluate the efficacy of preoperative SOX regimen neoadjuvant chemotherapy in the treatment of advanced gastric cancer and have certain guiding significance in the late treatment of patients with advanced gastric cancer.

Objective: To study the efficacy and safety of microscope assisted nasal transsphenoidal pituitary tumor resection. Methods: pituitary tumor patients in our hospital from March 2011 to May 2013 were enrolled and divided into observation group given microscope assisted nasal transsphenoidal pituitary tumor resection and control group given oral-nasal septum-sphenoid sinus pituitary tumor resection according to different operation mode. Then stress level, curative effect related index and complications were observed and compared with existing research. Results: (1) Adrenaline, noradrenaline, rennin, angiotensin Ⅱlevel and operation time, intraoperative bleeding volume, postoperative hospitalization time of observation group were lower than control group, cases of hormone levels return to normal and improve were more than control group, complication cases were less than control group. (2)compared with the existing research on nerve endoscopic surgery, operation time, intraoperative bleeding volume, postoperative hospitalization time and cases of hormone levels return to normal, improve and complications of observation group had no statistical difference. Conclusion:microscope assisted nasal transsphenoidal pituitary tumor resection is helpful to reduce surgery trauma, relieve stress condition and can achieve equal operation effect and complications.

Objective To evaluate the clinical usefulness of manometry of esophgeal varices with endoscopic balloon technique. Methods The variceal pressure was measured by endoscopic balloon technique in 26 patients with portal hypertension, at the same time , laboratory parameters of liver function were determined. ResultsDetermination of variceal pressure was successful in 23/26 patients, while no side effects was observed. The intraobserver coefficient of variation was 7.18% ?2.64%,and there was a significant(P

Objective To investigate the protective effect and its mechanism of edaravone against rat renal tubular epithelial cell injury induced by cisplatin. Methods The rat renal tubular epithelial cells (NRK-52E) were divided into the control, model control (50μmol·mL-1 cisplatin), group A (50μmol·mL-1 cisplatin plus 10μmol·mL-1 edaravone), B (50μmol·mL-1 cisplatin plus 20 μmol·mL-1 edaravone), and C (50 μmol·mL-1 cisplatin plus 40 μmol·mL-1 edaravone). The cell proliferation ability, content of malondialdehyde, activity of superoxide dismutase(SOD), level of reactive oxygen species ( ROS) , rate of apoptosis, express of protein and mRNA of Bax, Bcl-2 and Caspase-3 activation of cell were detected. Results The proliferation and SOD activity in NRK-52E cells declined, malondialdehyde and ROS were elevated upon being co-cultured with cisplatin. Moreover, the rate of apoptosis, express of protein and mRNA of Bax and Bcl-2, and Caspase-3 activation of cells were upregulated compared to the control group. However, edaravone stimulated cell proliferation, SOD activity and protein and mRNA of Bcl-2 and lowered content of malondialdehyde, level of ROS, rate of apoptosis, express of Bax protein and mRNA and Caspase-3 activation of cell(P<0. 05). Conclusion Edaravone can alleviate rat renal tubular epithelial cell injury induced by cisplatin, via inhibiting oxidative stress and down-regulating cell apoptosis.