Objective To evaluate the relationship between ceftazidime-avibactam(CAZ-AVI)blood concentrations and efficacy in critically ill patients and to investigate the factors influencing blood levels.Methods The CAZ-AVI trough concentrations(Cmin)were detected in 29 patients who received CAZ-AVI treatment for at least 48 hours.The clinical materials of the patients were collected together for retrospective analysis.Results The Cmin of ceftazidime(CAZ)and avibactam(AVI)were(50.95±5.17)and(7.52±0.96)mg·L-1 in the effective group and(31.16±7.03)and(5.37±1.32)mg·L-1 in the ineffective group,respectively.The Cmin of CAZ in the effective group was significantly higher than in the ineffective group(P<0.05),and there was no significant difference in AVI Cmin between the two groups(P>0.05).Spearman's correlation analysis showed that CAZ Cmin was positively correlated with clinical efficacy(P<0.05),and no correlation between AVI Cmin and clinical efficacy(P>0.05).The optimal CAZ Cmin threshold was 24.59 mg·L-1.Multiple linear regression analysis showed that age and creatinine clearance was significantly correlated with the Cmin of CAZ,and creatinine clearance was significantly correlated with AVI Cmin(P<0.05).Conclusions The Cmin of CAZ correlates with efficacy,and it may be more beneficial for clinical treatment to keep the concentration of CAZ-AVI always greater than the minimum inhibitory concentration during the dosing interval.The creatinine clearance should be fully considered when optimizing CAZ-AVI dosage in critically ill patients.

Adverse drug reaction(ADR)reports are acting as primary sources for post-marketing drug safety evaluation, which have important reference value for drug safety evaluation. In this article, bidirectional gated recurrent unit, a kind of deep learning method, was applied as the model for relation extraction of drugs and adverse reactions in free-text section of ADR descriptions in Chinese ADR reports, with attention as well as character embedding and word segmentation embedding added into the network. The experimental results showed that our model achieved good performance in the classification task of confirming the relationship of “Drug-ADR” pair(denial, likely, direct and post-therapy)in the ADR description, and the final model achieved an F-value of 87. 52%. The extracted information can assist in evaluating ADR reports and at the same time be utilized in tasks like statistical analysis of certain drugs and adverse events and ADR knowledge base construction to provide more research techniques for drug safety researches.

Objective:To explore the clinical outcomes of anatomical double-bundle medial patellofemoral ligament (MPFL) reconstruction with double suture anchor technique in treating patellofemoral instability in adolescent.Methods:Twenty-five young people with patellofemoral instability (25 knees) in our department from January 2013 to December 2014 were enrolled for this study.All patients were performed anatomical double-bundle MPFL reconstruction with arthroscopic-assisted suture anchors technique in the patella,and fixed in the femoral socket with absorbable interference screw.All patients are evaluated by different methods,including patient's satisfaction,patellar apprehension test,recurrent subluxation/dislocation,CT assessment of bone tunnel and patellar tilt angle.Lysholm scores,Tegner scores and Kujala scores were recorded at the final follow-up.Results:The mean follow-up was 24 (range 20-40) months.All cases were observed in negative patellar apprehension test.Infection,recurrent subluxation/dislocation and patellar fracture were not found at the last follow-up.CT results demonstrated that the tunnel position were good.The patellar tilt angle was decreased from 21.6°±2.3° to 10.5°±1.6° (P＜0.05);the Lysholm scores was increased from 51.7±5.3 to 93.8±6.5 (P＜0.05).Tegner scores was increased from 4.1± 1.1 to 5.5±0.6 (P＜0.05).Kujala scores was increased from 53.5±6.4 to 94.6±4.3 (P＜0.05).Conclusion:Arthroscopic-assisted anatomical double-bundle MPFL reconstruction with the suture anchors technique is a safe,minimal invasive and effective surgical option for treating patellofemoral instability in adolescent.

Objective:To explore the effectiveness and safety of pie-crusting the medial collateral ligament release (MCL) in treating posterior horn of medial meniscus (PHMM) tear in tight medial tibiofemoral compartment of knee joint.Methods:Thirty-two consecutive patients with PHMM tear in tight medial tibiofemoral compartment of knee joint were admitted to our department from January,2013 to December,2014.All patients were performed pie-crusting the MCL release at its tibial insertion with 18-gauge intravenous needle.All patients were evaluated by valgus stress test and bilateral valgus stress radiograph at postoperative 1st day,4th week and 12th week.Visual Analogue Scales (VAS),Lysholm scores,Tegner scores and International Knee Documentation Committee (IKDC) scores were recorded at the 1st,3th,6th month follow-up,then follow-up every 6 months.Results:The mean follow-up was 28 (24-36) months.All cases were negative in valgus stress test.MCL rupture,femoral fracture,articular cartilage lesion and neurovascular injury were not found at the last follow-up.The median medial joint space width of affected side and unaffected side for valgus stress radiographs were 6.8 mm and 4.3 mm (P＜0.05) at the 1st day,5.5 mm and 4.2 mm (P＜0.05) in the 4th week and 4.8 mm and 4.3 mm (P＞0.05) at the 12th week,respectively.VAS scores was changed from 4.5±1.5 preoperatively to 1.7±1.0 at the final follow-up (t=16.561,P＜0.05).Lysholm scores was changed from 52.3±5.8 preoperatively to 93.2±6.3 at the final followup (t=-41.353,P＜0.05).Tegner scores was changed from 4.1±1.1 preoperatively to 5.5±0.6 at the final follow-up (t=-18.792,P＜0.05).IKDC scores was changed from 54.5±6.2 preoperative to 93.8±4.5 at the final follow-up (t=-38.253,P＜0.05).Conclusion:Pie-crusting the medial collateral ligament release is a safe,minimal invasive and effective surgical option for posterior horn of medial meniscus tear in tight medial tibiofemoral compartment of knee joint.

Objective To investigate the causes for death in rats after spinal cord injury.Methods A total of 120 adult Wister rats were selected for the study. The animal model with acute spinal injury at T10 was established by using Allen' s combat (25 g · cm). The dissection analysis was performed in death rats. Results Of all, 25 patients died, with mortality rate of 21%. Of death rats, five rats were died before awakening, with no abnormal anatomy; 12 rats died within three days after injury and three died of injuries 3-7days injury. Anatomy found pulmonary bleeding and edema, even hematocele bladder in some rats. There were three rats died within 1-2 weeks, one died of injury only after 2-3 weeks, with lung infection and urinary tract infection. There was no death after three weeks. Conclusions The early causes for death of rats with spinal cord injury is mainly due to lung congestion and pulmonary edema, whereas the leading cause of late death of rats is pulmonary and urinary tract infection.

BACKGROUND: The regeneration and repair of skeletal muscle after injury relies on the new nucleus formed through muscle satellite cell proliferation. However, there are few reports on the relationship between the skeletal muscle cell proliferation and the vimentin expression.OBJECTIVE: To explore the relationship between the skeletal muscle cell proliferation and the vimentin expression, as well as the mechanism underlying the repair of exercise-induced skeletal muscle micro-injury. DESIGN, TIME AND SETTING: A randomized controlled animal experiment was done at the Sports Human Science Experimental Center in Hunan Normal University between December 2007 and September 2008. MATERIALS: A total of 50 male SD rats, aged 8 weeks, were randomly divided into a control group and a training group which were subdivided in to four groups at the time points of immediate post-exercise, hour 3, hour 24 and hour 48 post-exercise, with 10 ones in each of the five groups.METHODS: Rats in the training group underwent 3 days of repetitive exhausting eccentric exercise on a treadmill of-16° slope at the speed of 16 m/min. Rats in the control group underwent no running. MAIN OUTCOME MEASURES: Rats in the training group was taken for measurement immediate, 3 hours, 24 hours and 48 hours post-exercise respectively. Immunohistochemistry was adopted to determine the proliferating coil nuclear antigen (PCNA) A expression and the vimentin expression in medial head of triceps brachii muscle cells in each group at different phases of repair.RESULTS: The skeletal muscle cell showed sequentially-changed proliferation. The proliferation index of the training group was significantly higher than that of the control group immediately post-exercise. At hour 24 post-exercise, it reached the peak. Hour 48 post-exercise saw the decreased proliferation. The expression of vimentin also exhibits a sequential change after exercise. Moreover, its immunoreaction score changed with time in the same direction with the proliferation index, but there is no correlation between the two.CONCLUSION: Three days of repeated exhausting eccentric exercise can induce the sequential changes of skeletal muscle cell proliferation and vimentin expressions. Vimentin expression has some kinds of correlations with skeletal muscle cell proliferation, but it is not the only factor that matters.

Objective To observe biological effect of cardiotrophin-1(Adv-CT1)gene transfection mediated by adnovims on traumatic brain iniuries(TBI)in-vivo and discuss the role and mechanism of Adv-CT1 on TBI. Metheds A rat TBI model was established bv Allen method.After Adv-CT1 was transfefred into the iniured brain by adnovims,the effect of CT-1 on apoptosis and survival of neurons after TBI was determined by means of Nissl staining,TUNEL and flow cytometry apoptosis assay. Resuits Apoptotic cells were increased but the survived cells decreased in the injured cortical brain and hippocampus from 12 hours to 14 days after TBI in the control group.As compared with control group,Adv-CT1 treatment reversed this situation to some degrees. Conclusion CT-1 has neuropmtective effect on neurons after TBI by reducing apoptosis of neurons.

Objective To probe the mechanism of anticonvulsant by melatonin from the angle of neurotransmitter.Methods Rat status epilepticus(SE) model was induced by pilocarpine(PILO).?-aminobutyric acid(GABA) content and glutamin acid decarboxylase(GAD)67 mRNA expression was detected at 6,48,72 h,and 7 d in the hippocampus of post-SE rats.The effect of melatonin on these changes was observed.Results GABA content was significantly lower in the hippocampus than in control(P

Objective To compare the gene expression changes in astrocytes before and after injury. Methods The total RNA from the scratched spinal cord astrocytes two days after injury (injury group) and from the unscratched astrocytes (control group) were extracted for construction of cDNA difference library by means of Switching Mechanism At 5’ end of the RNA Transcript (SMART) and suppression subtractive hybridization (SSH) techniques. The change of the gene expression was identified in astrocytes two days after trauma and the sequences of different expressed segments were analyzed for searching their homology in NCBI BLAST database so as to know the whole change trend of the genes two days after scratch injury of rat spinal cord astrocytes. Results At day 2 after scratch injury of spinal cord astrocytes in newborn rats, expressions of 17 genes including heat shock protein 70, acidic fibroblast growth factor and calmodulin II were up-regulated but those of genes such as ?-actin down-regulated. Conclusion The gene expression is either up-regulated in proteins like heat shock protein 70 or down-regulated in proteins like ?-actin in the reactive astrocytosis after scratch injury of spinal cord astrocytes in rats.

Objective To construct human cardiotrophin 1(huCT 1) adenovirus vector for central nervous system(CNS) gene therapy in vivo . Methods The huCT 1 and eGFP genes were cloned into shuttle plasmid pDC316 to construct pDC316 huCT 1 and pDC316 eGFP. Virus genome plasmids pBHGloxdeltaE1,3Cre and pHG140 were purified by CsCl banding certification. Recombinant replication defective adenovirus vectors AdCMV huCT1 and AdCMV eGFP were rescued in 293 packaging cells by co transfection and Cre mediated recombination of both plasmids pDC316 huCT1 and pBHGloxdelta1,3Cre. The insert gene and its expression were identified by PCR, RT PCR and immunohistochemistry after recombinant adenovirus transfected 293 cells and NIH 3T3 cells. Recombinant adenovirus vectors were purified by CsCl banding and titrated by plaque forming test. AdCMV huCT1 expression in vivo was analyzed by RT PCR and immunohistochemistry after transfection of the cervical spinal cord in adult rats. Results We have constructed two recombinant adenoviral vectors: AdCMV huCT1 and AdCMV eGFP, containing MCMV promoter, foreign DNA and SV40 PolyA with deletions of E1 and E3 regions. The positive huCT 1 mRNA and protein were identified in AdCMV huCT1 transfected NIH 3T3 cells and rat cervical spinal cord. The titer of virus stocks was generally up to 3.0?10 10 plaque forming units(pfu) per milliliter. Conclusion Recombinant purified AdCMV huCT1 vectors can be highly expressed in vitro and in vivo and is suitable for CNS gene therapy in vivo .