BACKGROUNDErtapenem has been demonstrated to be highly effective for the treatment of complicated infections. The aim of this study was to compare the efficacy and safety of ertapenem with ceftriaxone.

METHODSWe searched the PubMed, EMBASE, and the Cochrane Library for published randomized controlled trials (RCTs) that compared the efficacy and safety of ertapenem with ceftriaxone for the treatment of complicated infections including community-acquired pneumonia (CAP), complicated urinary tract infections (cUTIs), and complicated intra-abdominal infections (cIAIs). Meta-analysis was performed by RevMan 5.0.

RESULTSEight RCTs, involving 2 883 patients, were included in our meta-analysis. Ertapenem was associated with similar clinical treatment success with ceftriaxone for complicated infections (1 326 patients, fixed-effect model, OR: 1.13, 95% CI: 0.75-1.71). There was no difference between the compared treatment groups with regard to the microbiological treatment success, and no difference was found with regard to the incidence of clinical and laboratory drug-related adverse events between ertapenem and ceftriaxone groups. As to local tolerability, overall, there was no difference between the compared groups; however, in the subgroup analysis, local reaction was significantly less in the ertapenem subgroup than the ceftriaxone plus ceftriaxone subgroup.

CONCLUSIONSErtapenem can be used as effectively and safely as ceftriaxone for the treatment of complicated infections. It is an appealing option for the treatment of these complicated infections.

Anti-Bacterial Agents ; therapeutic use ; Ceftriaxone ; therapeutic use ; Humans ; Intraabdominal Infections ; drug therapy ; Pneumonia ; drug therapy ; Randomized Controlled Trials as Topic ; Urinary Tract Infections ; drug therapy ; beta-Lactams ; therapeutic use

Objective To analyze the worldwide advances on bacterial quantitative proteomics over the past fifteen years with bibliometric approach.Methods Literature retrieval was conducted throughout the databases of Pubmed,Embase and Science citation index (SCI),using bacterium and quantitative proteomics as the key words.The deadline is July 2013.We sorted and analyzed these articles with Endnote X6 from the aspects of published year,the first author,name of journal,published institution,cited frequency and publication type.Results 932 English articles were included in our research after deleting the duplicates.The first article on bacterial quantitative proteomics was reported in 1999.The maximal publications were 163 related articles in 2012.Up till July 2013,authors from more than 23 countries and regions have published articles in this field.China ranks the fourth.The main publication type is original articles.The most frequently cited article is entitled with Absolute quantification of proteins by LCMSE:a virtue of parallel MS acquisition by Silva JC,Gorenstein MV,Li GZ,et al in Mol Cell Proteomics 2006.The most productive author is Smith RD from Biological Sciences Division,Pac.Northwest National Laboratory.The top journal publishing bacterial quantitative proteomics is Proteomics.Conclusion More and more researchers pay attention to quantitative proteomics which will be widely used in bacteriology.

Objective To investigate the effect of combined traditional chinese medicine and western medicine in treatment old men with femoral trochanteric fracture. Methods120 patients with femoral trochanteric fracture were separated into two groups.Patients in the experiment group were managed by traditional Chinese treatment besides the operations and patients in the control group received only operation treatment.We observed the patients' time of fracture healing and the life quality of them. ResultsThe cure effect of observe group was higher than that of control group(P＜0.05)and the fracture healing time in the observe group was shorter than that of control group(P＜0.01). ConclusionCombined treatment of traditional Chinese medicine and western medicine was more effective in promoting the physical reconstruction of patients with femoral trochanteric fracture.

Objective To develop a diagnosis model for active pulmonary tuberculosis. Methods The proteomic fingerprinting of 264 sera from active tuberculosis patients and controls were analyzed using the surface-enhanced laser desorption ionization time of flight mass spectrometry (SELDI-TOF-MS) and protein-chip technology. The peaks were detected and filtrated by Ciphergen PrnteinChip(R) Software (version 3.1.1). Using the Biomarker Pattern 5.0 software, a diagnostic model was developed for diagnosis of active tuberculosis. Re-sults Fifty protein peaks were significantly different between the patients with active pulmonary tuberculosis and the controls with overlapping clinical features (P<0.01). Five protein peaks at 4360, 3311, 8160, 5723, 15173 m/z were chosen for the system classifier and the development of diagnosis model 1. The model differenti-ated the patients with active pulmonary tuberculosis from the controls with a sensitivity of 83.0%, and a speci-ficity of 89.6%. The diagnostic accuracy was up to 86.4%. Three protein peaks at 5643, 4486, 4360 m/z were chosen for the system classifier and the development of diagnosis model 2. The model differentiated the pa-tients with active pulmonary tuberculosis from the controls with a sensitivity of 96.9%, and a specificity of 97.8%. The diagnostic accuracy was up to 97.3%. Conclusion It might be a new diagnostic test for the de-tection of sera from the patients with active pulmonary tuberculosis using SELDI-TOF-MS and protein chip.

BACKGROUND: Lung protective ventilation strategies and positive endexpiratory pressure (PEEP) have been widely used as an effective ventilation pattern in clinical practice of administration of acute respiratory distress syndrome (ARDS) in recent years, but there arestill great arguments on the therapeutic effects.OBJECTIVE: To observe the changes of oxygenation index and inflammatory transmitters in peripheral blood and bronchoalveolar lavage fluid(BALF) of different lung areas [superior area of lung (upper lobe), ventral side of inferior lung (heart lobe), and dorsalis inferior lung (diaphragm lobe)] of ARDS dogs caused by pulmonary and extrapulmonary insults under lung protective ventilation treatment.DESIGN: A randomized control animal study.SETTING: Department of Respiratory Medicine, the General Hospital of Chinese PLA.MATERIALS: Twenty-four adult healthy male mongrel dogs were randomly divided into four groups with 6 dogs in each: pulmonary ARDS experimental group, pulmonary ARDS control group, extrapulmonary ARDS experimental group and extrapulmonary ARDS control group.METHODS: Models of extrapulmonary ARDS were induced by intravenous injection of oleic acid (0.1-0.15 mg/kg), and the pulmonary ARDS models were established by intratracheal administration of diocty sulfosuccinate sodium salt. After lung injury, the experimental groups received lung protective ventilation treatment (tidal volume: 8 mL/kg, PEEP: 0.981 kPa)for 3 hours, and the control groups also received ventilation of large tidal volume (tidal volume: 14-17 mL/kg, PEEP: 0 kPa).MAIN OUTCOME MEASURES: ① changes of oxygenation index in each group; ② dynamically observed the changes of the inflammatory transmitters [tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL1β) and interleukin-6 (IL-6)] in pe. Ripheral blood and BALF of different lung areas (upper lobe, heart lobe and diaphragm lobe) of ARDS dogs under lung protective ventilation treatment.RESULTS: All the 24 dogs were involved in the analysis of results. ①After lung injury, the oxygenation indexes were significantly decreased in all the groups, and the oxygenation indexes after lung protective ventilation in the experimental groups were obviously higher than those in the control groups (P ＜ 0.05). At 2 and 3 hours after lung protective ventilation, the oxygenation indexes in the extrapulmonary ARDS experimental group were markedly higher than those in the pulmonary ARDS experimental group (P＜ 0.05). ② After lung injury, the levels of the inflammatory transmitters in peripheral blood were all obviously increased in all the groups, which were decreased to different extent after the lung protective ventilation treatment,but the therapeutic effect in the pulmonary ARDS experimental group was not as good as that in the extrapulmonary ARDS experimental group. ③The levels of inflammatory transmitters in BALF of lung upper lobe and heart lobe were obviously higher in pulmonary ARDS dogs than in extrapulmonary ARDS dogs.CONCLUSION: The ameliorations of the release of inflammatory transmitters and oxygenation index at different areas are obviously different between ARDS dogs caused by pulmonary and extrapulmonary insults, and lung protective ventilation has good effect on extrapulmonary ARDS dogs,but has bad effect on pulmonary ARDS ones.

BACKGROUNDTelomerase expresses in many cancers and may contribute to drug-resistance. The aim of this study is to observe the effect of telomerase reverse transcriptase (hTERT) DNAzyme on growth of A549/DDP cells and to explore the possibility of telomerase as a new target in treatment of drug resistance for lung cancer.

METHODSAn hTERT DNAzyme was composed. Telomerase activity was measured by telomeric repeat amplification protocol (TRAP) modified from Kim's method. MTT was used to show the influence of hTERT DNAzyme and cisplatin on A549/DDP cells.

RESULTSThe telomerase activity of A549/DDP cells was down-regulated by hTERT DNAzyme in a dose-dependent manner. The growth inhibition rate of A549/DDP cells was 32.9% by hTERT DNAzyme of 0.25μmol/L, and 60.5% by hTERT DNAzyme combined with 3mg/L cisplatin. The CDI of hTERT DNAzyme and cisplatin was 0.9.

CONCLUSIONShTERT DNAzyme can inhibit the growth of A549/DDP cells and has a synergistic effect with cisplatin. It is suggested that telomerase may be a new target in treatment of drug-resistant lung cancer cells.

OBJECTIVE To study the synergism of imipenem(IMP) combined with azithromyicn(AZM) in the treatment of infection associated with Pseudomonas aeruginosa biofilm.METHODS The inhibitory activity of AZM to glycocalyx(GLX) production was detected with the L-tryptophan method.Viable counts in biofilms treated with AZM combined with IMP were detected with the methyl thiazolyl diphenyltetrazolium(MTT) method in vitro.The tissue cage method was used to establish the animal model of local P.aeruginosa biofilm infection and the synergism of IMP combined with AZM was also studied in vivo.RESULTS AZM could inhibit the production of GLX.When IMP was combined with 1/4MIC or 1/16MIC of AZM viable counts in biofilms were less than they were when IMP was given alone in vitro.When AZM and IMP were administered at the same time viable counts in tissue cage fluids were also less than they were when IMP was administered alone in vivo.CONCLUSIONS AZM could enhance the antibacterial activity of IMP in the treatment of infection associated with biofilm.

OBJECTIVE To establish a rat model of pulmonary infection by inoculating Pseudomonas aeruginosa to Sprague-Dawley(SD) rats and evaluate it.METHODS Two hundred SD rats were divided into 2 groups: the P.aeruginosa group and the control group,P.aeruginosa was embedded in minute seaweed alginate beads by an ejection set with an acuminate hole.Then the beads were inoculated into the rats′ lung through tracheal intubation.RESULTS The bacteriological values: P.aeruginosa was detected from rats of infected groups.Bacterial number was higher than 105CFU/g 3 and 7 days after infection and higher than 103CFU/g 14 and 28 days after infection.The pathological changes showed: 3 and 7 days after infection,lung abscess,edema,and consolidation could be seen from lungs of infected groups.At optical microscopy,alginateP.aeruginosa caused a pronounced inflammatory reaction with polymorphonuclear cells surrounding a bead.Fourteen and 28 days after infection,fibrinous adhesions and granulomas became the major pathological changes.CONCLUSIONS The animal model of pulmonary infection can be established by inoculating P.aeruginosa embedded in minute seaweed alginate beads made by an ejection set with an acuminate hole to SD rats.

OBJECTIVE To study the prevalence of atypical pathogens in patients with community acquired pneumonia(CAP) and the distribution of serotypes of Legionella pneumophilia.METHODS A prospective study was performed on 257 consecutive adult patients with CAP between Dec 2003 and Nov 2004.Antibodies of the paired serum samples to Mycoplasma pneumoniae,Chlamydia pneumoniae and Legionella pneumophilia serotypes 1 to 14 were detected.RESULTS The etiology of CAP was identified in 82(31.9%) patients.The distribution of causal agents was as follows:M.pneumoniae 63(24.5%),C.pneumoniae 17(6.6%),and L.pneumophilia 11(4.28%).Serotype 12 of L.pneumophilia was the predominant one,responsible for 21.8%(56/257).CONCLUSIONS Atypical pathogens especially M.pneumoniae have an important role in CAP;serotype 12 of L.pneumophilia is the predominant one in northern area of China.

OBJECTIVE To study the treatment effect of macrolides on nontypeable Haemophilus influenzae biofilm formation.METHODS Two strains of H.influenzae were isolated from sputum specimens from patients with acute exacerbation of chronic obstructive pulmonary diseases.Formation of bacterial biofilm was examined by crystal violet assay and scanning electron microscope.The biofilms were measured under varying concentrations of macrolides in vitro.RESULTS Biofilm synthesis was observed at subMIC and became thicker in roxithromycin and erythromycin at 1/8 MIC,Disruption of mature biofilms could be achieved at relatively higher concentration,Azithromycin displayed more powerful activity.CONCLUSIONS H.influenzae is capable to form biofilm in vitro,especially in subconcentration.Sufficient antibiotics dosage might affact early formation of biofilms.Azithromycin exerts better effects on biofilm formation than other macrolides.