OBJECTIVE:To evaluate the economics of azithromycin vs. amocillin clavulante in the treatment of lower respirato-ry tract infections. METHODS:System evaluation was adopted to retrieve the randomized controlled trials(RCT)about azithromy-cin(test group)vs. amoxicillin clavulanate(control group)in the treatment of lower respiratory tract infections. Information was col-lected and Meta-analyses were performed. On this basis and short-term decision tree model,cost factors were added to conduct the pharmacoeconomics by the principle of PICO of Treeage Pro 2011 edition software. RESULTS:Totally 18 RCT were enrolled,in-volving 3 365 patients. Results of Meta-analysis showed that there were no significant differences in the effective rate [RR=0.93, 95%CI(0.55,1.55),P=0.77] and incidence of adverse reactions [RR=0.79,95%CI(0.62,1.0),P=0.05] between 2 groups. The av-erage treatment cost in test group and control group was respectively 790.4 yuan and 884.4 yuan,and cost-effectiveness ratio was respectively 216.0 and 245.7,and the incremental cost-effectiveness ratio(ICER)was -1 392.59. CONCLUSIONS:Azithromycin has similar efficacy and safety to amoxicillin clavulanate in the treatment of lower respiratory tract infection,however,azithromy-cin has better cost-effectiveness.

Objective: To identify the active ingredients, potential targets, and mechanism of Rhizoma coptidis by bioinformatics method, and to explore the hypoglycemic effect of Rhizoma coptidis by in vitro experiments. Methods: The chemical components of Rhizoma coptidis were collected through database search, and oral bioavailability and drug-likeness were used for preliminary screening. The targets of Rhizoma coptidis and diabetes-related targets were collected by database retrieval and reverse docking techniques, and the biological process of cross-set proteins was analyzed. The inhibitory effects of Rhizoma coptidis on α-glucosidase, α-amylase activity, and advanced glycation end products (AGEs) were determined via in vitro experiments. In addition, the effects of Rhizoma coptidis on pre-adipocyte differentiation, absorption of glucose by adipocytes, and the level of intracellular triglyceride were investigated using the adipocyte differentiation model. Results: There were 11 potentially active ingredients in Rhizoma coptidis. IL-6, caspase-3, epidermal growth factor receptor (EGFR), MYC, and estrogen receptor 1 were considered as the key genes. The bioinformatics analysis showed that Rhizoma coptidis played an anti-diabetic role mainly via biological processes and signaling pathways including hormone receptor activity, glutathione binding, steroid binding, etc. In vitro experiments showed that the extract of Rhizoma coptidis inhibited the activities of α-glucosidase and α-amylase, and the generation of AGEs; meanwhile, the extract promoted the absorption of glucose by adipocytes. In addition, the extract of Rhizoma coptidis decreased triglyceride level. Conclusions: Our network pharmacology and in vitro experiments demonstrate the anti-diabetic effects and possible underlying mechanisms of Rhizoma coptidis extract.

A flavivirus, Culex flavivirus, was first isolated from Chinese mosquitoes with high sequences similarities to those of flaviviruses found in America and Japan. In this study, a total of 48 pools of field-collected mosquitoes were sampled from Dandong of Liaoning Province, China during July to September of 2011. Six isolated viruses showing cytopathic effect (CPE) in C6/C36 cells were tested by reverse transcription polymerase chain reaction(RT-PCR)using Flavivirus genus--specific primers and Culex flavivirus-specific primers and the positive PCR-product was sequenced and compared with the sequences of 10 isolates from GenBank. Phylogenetic tree of NS5 and enevelop genes of flavivirus were constructed. The GenBank accession numbers of NS5 gene were JQ409188, JQ409186, JQ409187, JQ409191, JQ409189 and JQ409190. The GenBank accession numbers of envelope gene were JQ065883, JQ065882, JQ065881, JQ065879,JQ065877 and JQ065878.
Animals ; Base Sequence ; Cell Line ; China ; Culex ; classification ; virology ; Flavivirus ; classification ; genetics ; isolation & purification ; Insect Vectors ; virology ; Molecular Sequence Data ; Phylogeny ; Viral Proteins ; genetics

Glycoproteins ; genetics ; metabolism ; Herpesviridae ; genetics ; metabolism ; Viral Proteins ; genetics ; metabolism

Objective To analysis the metabolic index among diabetic patients in community in summer and winter,and to provide evidence for disease management.Methods During June and December,119 diabetic patients were seleted from communities living for more than a year by the method of stratified cluster sampling.The metabolic indexes were compared usingpaired t test ,and the rate of biochemical indicators were analyzed by McNemar 's test between two seasons .Results The values of HbA1c,GLU and HDL -C were higher in winter than in summer (P <0.01).The mean values of TC in summer and winter were the same.The detection values of triglyceride and low density lipoprotein were lower in winter than in summer,but the difference was not statistically significant (P >0.05 ).The control rate of HbA1c was 56.36% in summer,and the control rate was 44.54% in winter,the difference was statistically significant (P <0.05).In summer, the control rate was 59.66%,higher than 45.38% in winter,and the difference was statistically significant (P <0.05). The control rate of blood pressure was better than that in winter,while triglyceride and low density lipoprotein control was better than that in summer,but which was not statistically significant (P >0.05).Conclusion The metabolic index of diabetic patients in Zhoushan urban community was significantly affected by seasonal changes.Most indexes were better in summer than that in winter,which suggested that the intervention of diabetics should be enhanced in winter.

In order to determine the amino acid sequence of functionthat play a role of methyltransferase (MTase) activity in duck Tembusu virus (DTMUV),we have made sequence analysis and structure prediction of the MTase in DTMUV by bioin formatics methods,as well as using the sequence and structure of MTase in other flaviviruses which have been reported.The bioinformatical analysis results showed that the MTase and the MTase of other three kinds of flaviviruses had the higher homology in nucleotide sequence and amino acid sequence,for 64.76％,64.55％,67.33％ and 74.71％,68.45％,75.15％ respectively,and the same basic structural characteristics which contained SAM binding site and had a typical of 4 alpha screw and 7 beta folding.At the same time,there were classical conservative sites K-D-K-E of flavivirus MTase in DTMUV MTase sequence.In conclusion,they imply that the MTase of DTMUV might belong to MTase family of flaviviruses.

AIM To investigate the effects of the compatibility of Ephedrae Herba (Mahuang) and Glycyrrhizae Radix et Rhizoma (Gancao) on pharmacokinetic changes of the plasma levels of glycyrrhizic acid,glycyrrhetinic acid and liquiritin by UPLC-MS/MS.METHODS Twelve SD rats were randomly divided into two groups and orally administered with Glycyrrhizae Radix et Rhizoma and Ephedrae Herba-Glycyrrhizae Radix et Rhizoma (2 ∶ 1) Decoction.Blood samples were collected at different time points,and the main pharmacokinetic parameters were calculated by DAS3.2.2 software.RESULTS Compared with Glycyrrhizae Radix et Rhizoma group,the AUC0-t and Cmax were decreased,the MRT0-t and t1/2z were extended,the Vz/F was increased for glycyrrhizic acid,glycyrrhetinic acid and liquiritin;the CLz/F was increased for glycyrrhizic acid and liquiritin;the Tmax of glycyrrhizic acid was shortened and the Tmax of glycyrrhetinic acid was extended.CONCLUSION After combining Glycyrrhizae Radix et Rhizoma and Ephedrae Herba,the bioavailability of glycyrrhizic acid,glycyrrhetinic acid and liquiritin are reduced,the elimination of them delays,and the distribution volume increases.

AIM To investigate the effects of berberine-evodiamine compatibility on expressions of intestinal acyl-CoA:cholesterol acyltransferase 2 (ACAT2),apolipoprotein B48 (ApoB48),and Niemann-Pick C1 Like 1 (NPC1L1) proteins in hypercholesterolemic rats.METHODS Fifty SD rats were assigned to control and model groups.After establishing the hypercholesterolemic rat model by feeding high fat and high cholesterol food,forty SD rats were equally divided into model control group,atorvastatin group,berberine-evodiamine compatibility groups (89.2 mg/kg,178.4 mg/kg).After four weeks treatment,serum triglycerides (TG),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C) were detected.Then the contents of cholesterol and β-sitoesterol in serum were determined by GC.The expressions of ACAT2,ApoB48 and NPC1 L1 proteins in the small intestine were assayed with immunohistochemistry technology.RESULTS Serum TC,TG and liver TC were significantly decreased in 89.2 mg/kg and 178.4 mg/kg berberineevodiamine compatibility groups compared with those in the model control group (P ＜ 0.01).Serum LDL-C and liver TC were also significantly decreased in 89.2 mg/kg berberine-evodiamine compatibility group (P ＜ 0.05).GC analysis indicated that the amount of cholesterol level and β-sitoesterol in serum were decreased in 178.4 mg/kg berberine-evodiamine compatibility group (P ＜ 0.05) and 89.2 mg/kg berberine-evodiamine compatibility group (P ＜ 0.01).Immunohistochemistry analysis manifested that the average luminous density of ACAT2,ApoB48 and NPC1L1 proteins in two dosages of berberine-evodiamine compatibility group were descended markedly compared with those in the model control group (P ＜ 0.05 or P ＜ 0.01).CONCLUSION The mechanisms underlying the cholesterol metabolism activity of berberine-evodiamine compatibility are mediated most likely by down-regulating the expressions of intestinal ACAT2,ApoB48 and NPC1 L1 proteins in hypercholesterolemic rats.

Objective To evaluate the efficacy of infection prevention and control measures on the management of rational use of antimicrobial agents.Methods Patients who were admitted in a hospital from 2011 to 2015 were as the research object,a series of infection prevention and control intervention measure were taken,efficacy of intervention measures were evaluated.Results After the implementation of comprehensive intervention measures,compliance rate of hand hygiene increased year by year,from 38.17 ％ in 2011 to 87.16 ％ in 2015,difference was statistically significant (x2 =48.50,P＜0.05).Incidence of healthcare-associated infection dropped from 1.45％ to 1.06％,difference was statistically significant (x2 =42.50,P＜0.05);antimicrobial use density in 2011-2015 were 63.1,44.4,40.0,40.8,and 40.5 respectively,which showed a decreasing tendency.Conclusion Effective infection prevention and control measures have obvious effect on promoting management of rational use of antimicrobial agents,it is helpful for reducing the clinical use density of antimicrobial agents.

OBJECTIVETo explore targets of Chinese herbal medicine at cellular and molecular leve1s through an experimental study on Yinxingye Capsule (YC) intervening vascular endothelial cell apoptoeis of hyperhornocysteinemia (HHcy) rats.

METHODSThe HHcy model was prepared in male Wistar rats. Totally 42 rats were randomly divided into 4 groups, i.e., the control group (n =10), the model group (n = 11), the YC group (n =11), the folic acid group (n =10). Carboxy methyl cellulose (CMC) solution (1%) was administered to rats in the control group by gastrogavage.3% methionine suspension at 1. 5 g/kg was administered to rats in the model group by gastrogavage. 3% methionine suspension at 1. 5 g/kg and folic acid suspension at 0. 06 g/kg was administered to rats in the folic acid group by gastrogavage. 3% methionine suspension at 1. 5 g/kg and YC at 0. 02 g/kg was administered to rats in the YC group by gastrogavage. Morphological changes of aortic tissue were observed by hematoxylin eosin (HE) staining. The plasma homocysteine (Hcy) level was detected in each group. The endothelium-dependent diastolic functions of the thoracic aorta on different concentrations of sodium nitroprusside (SNP) and acetylcholine (Ach) were detected. Gene expressions of Bcl-2-associated X protein (BAX), inducible nitric oxide synthase (iNOS), c-Fos, cellular inhibitor of apoptosis protein 2 (c-IAP2) were detected by real time polymerase chain reaction (RT-PCR).

RESULTSPathological results showed that thickening aortic endothelium, swollen and desquamated endothelial cells. Few foam cells could be seen in the model group. Myoma-like proliferation of smooth muscle cells in tunica media could also be seen. These pathological changes were milder in the YC group and the folic acid group. Compared with the control group, plasma Hcy levels increased in the model group (P <0. 05). The endothelium-dependent diastolic rates at 10(-6) and 10(-4)mol/L Ach and 10(-7) -10(-3)mol/L SNP all decreased in the model group (P <0. 01, P <0. 05). Gene expressions of Bax, c-Fos, and iNOS increased, but c-IAP2 gene expressions decreased in the model group (all P <0. 05). Compared with the model group, plasma Hcy levels decreased in the YC group and the folic acid group (P <0. 05). The endothelium-dependent diastolic rates increased in the YC group and the folic acid group at various SNP concentrations except 10(-6) mol/L SNP in the folic acid group. The endothelium-dependent diastolic rates increased in the YC group and the folic acid group at 10(-6) and 10(-4)mol/L Ach (all P <0. 05). Gene expressions of Bax, c-Fos, and iNOS decreased in the YC group and the folic acid group, but c-IAP2 gene expression increased in the folic acid group (all P <0. 05).

CONCLUSIONYC could reduce plasma Hcy levels, down-regulate gene expressions of Bax, c-Fos, and iNOS, thereby reducing apoptosis of vascular endothelial cells, improving vascular endothelial function, and delaying atherosclerotic process.

Acetylcholine ; Animals ; Aorta ; Aorta, Thoracic ; Apoptosis ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Endothelial Cells ; Endothelium, Vascular ; Hyperhomocysteinemia ; drug therapy ; Male ; Nitric Oxide Synthase Type II ; Nitroprusside ; Proto-Oncogene Proteins c-fos ; Rats ; Rats, Wistar ; bcl-2-Associated X Protein