Bacterial resistance to antibiotics is currently a serious health concern.According to the data from the surveillance of bacterial resistance in China (CHINET),the isolation rates of gram-negative bacteria have been rising annually.Among the gram-negative organisms,the isolation rate of Carbapenem-resistant enterobacteriaceae,especially extensive drug-resistant strains,has been increasing rapidly.The isolation rate of extensive drug-resistant or pandrug-resistant non-fermenting bacteria,especially Acinetobacter baumanii,is still relatively high.These extensive drug-resistant gram-negative bacteria cause high mortality,which has drawn great attention in clinical settings.On the part of multidrug-assistant gram-positive bacteria,the isolation rate of vancomycin-resistant enterococci remains stable but rates of methicillin-resistant Staphylococcus aureus and coagulase-negative staphylococci are still high.Staphylococcal strains have not yet been found resistant to vancomycin in China.Understanding the epidemiology of local drug-resistant bacteria facilitates the development of appropriate antibiotic strategies.The mortality of patients with severe infection may be improved by early use of antibiotics and appropriate de-escalation therapy.Rational use of antibiotics and recognition of the influence factors,such as antibiotic-induced endotoxin release,may maximize the efficacy of antibiotics and minimize the adverse reactions.
Objective To examine the effects of Shenqi Bufei Tang decoction on the expression of histone deacetylase-2 (HDAC2) and nuclear factor-κB p65 (NF-κB p65) in the airway smooth muscle tissues of COPD rats with lung-qi deficiency syndrome. Methods A total of 40 male rats were randomly divided into normal control group,model control group,Shenqi Bufei Tang decoction group,and aminophylline group.The COPD rat model with lung-qi deficiency syndrome was established by intratracheal instillation of lipopolysaccharide (LPS) and passive smoking for 28 days.Pathological changes of lung tissues were observed under the light microscope and the thickness of the small airway wall and airway smooth muscle (ASM) layer analyzed by the image analysis.Immunohistochemistry,real-time PCR and Western blotting were used to detect the expressions of NF-κB p65 and HDAC2 in ASM. Results The thickness of the airway wall and ASM,and the expression levels of NF-κB p65 mRNA and protein were significantly increased in the model control group when compared with those in the normal control group (P<0.05).They were significantly reduced and the expression levels of HDAC2 mRNA and protein were markedly increased in Shenqi Bufei Tang decoction group and aminophylline group,which were compared with those in the model group (P<0.05).There were no significant differences in these indices between Shenqi Bufei Tang decoction group and aminophylline group (P>0.05). Condusion Shenqi Bufei Tang decoction can inhibit the proliferation of ASM in COPD rats with lung-qi deficiency syndrome,which may be associated with the increased expression of HDAC2 and decreased expression of NF-κB p65.
Objective To observe the effect of external use of Curcuma oil on the hyperplasia of mammary glands in rats and explore the mechanism. Methods Sixty female Wistar rats were randomly divided into following groups: normal control group, model control group, Sanjierubi plaster group, low-, medium- and high-dose curcuma oil emulsion groups (n=10 each).The models of hyperplasia of mammary glands were established by intramuscular injection of estradiol benzoate and progesterone into the medial part of the rat hind limb.Different doses of medicines were given for 4 consecutive weeks.Enzyme-linked immunosorbent assay, HE staining and immunohistochemistry were used to investigate the action mechanism of curcuma oil emulsion against mammary gland hyperplasia. Results Curcuma oil emulsion had preventive and therapeutic effects on the hyperplasia of mammary glands.The diameter of breasts was significantly reduced, the body weight restored, serum estradiol, follicle-stimulating hormone and prolactin levels profoundly decreased, progesterone, testosterone and luteinizing hormone levels markedly increased and the number and diameter of lobular acini obviously reduced in high-dose curcuma oil emulsion group when compared with those in model control group (P<0.05 or P<0.01). Conclusion Curcuma oil emulsion can remarkably improve the disturbance of serum hormones and inhibit the occurrence of hyperplasia of mammary glands.
Objective To observe the analgesic and anti-inflammatory effects of the water extract of Glycosmis citrifolia (Willd.) Lindl.on mice and explore the mechanism. Methods The analgesic and anti-inflammatory effects were evaluated by 0.7% acetic acid-induced writhing test,the hot plate test,tests of dimethylbenzene-induced ear swelling,1% carrageenan-induced paw edema,determination of PGE2 in inflammatory feet,0.6% acetic acid-induced increase in peritoneal capillary permeability and cotton ball granuloma. Results The water extract of Glycosmis citrifolia (Willd.) Lindl.at low,medium and high doses can reduce the acetic acid-induced writhing times (P<0.01 or P<0.05),increase the pain threshold of mice (P<0.01 or P<0.05),inhibit dimethylbenzene-induced ear swelling (P<0.01 or P<0.05),1% carrageenan-induced paw edema (P<0.01 or P<0.05) and PGE2 production (P<0.01),0.6% acetic acid-induced increase of peritoneal capillary permeability (P<0.05),and the development of cotton ball granuloma (P<0.01 or P<0.05). Condusion The water extract of Glycosmis citrifolia (Willd.) Lindl.shows analgesic and anti-inflammatory effects on mice.
Objective To explore the improving effect of L-leucine on memory impairment in plateau and the mechanism. Methods After successfully trained in the 8-arm radial maze,50 male Kunming mice were selected and randomly divided into normoxic control group (NC group),model group,and L-leucine (low,medium and high dose) groups.Animals in L-leucine groups were intragastrically given 0.473 g·kg-1,0.945 g·kg-1and 1.89 g·kg-1 L-leucine for 7 days and those in NC and model control groups were administered the same volume of purified water for the same period of time.At the 4th day of the treatment,the mice in the model control group and L-leucine groups were placed in a large low-pressure and low-oxygen chamber to simulate low-pressure hypoxic environment of the plateau (7 500 m,3 d).The 8-arm radial maze was used to measure the spatial learning and memory ability of mice and dry-wet method to measure the water content of brain tissue.HE staining was employed to observe the cell morphological changes in CA1 region of the hippocampus.The expression levels of mTOR,P70S6K and 4E-BP1 mRNA in the hippocampus were detected by SYBR Green real-time PCR. Results The reference memory error (RME),total error (TE),testing time (TT),and water content of brain tissue were significantly increased,the neuron injury was exacerbated in CA1 region of the hippocampus,and the expression levels of mTOR and P70S6K mRNA were markedly decreased in model control group when compared with those in NC group (P<0.05 or P<0.01).These indexes,however,were significantly improved in L-leucine groups,especially in high-dose group. Condusion L-leucine can improve memory impairment in plateau,and the mechanism may involve the activation of mTOR and its downstream substrates (4E-BP1 and P70S6K).
Objective To investigate the protective effects of ethanol extracts of Tadehagi triquetrum (TTOE) on carbon tetrachloride (CCl4)-induced acute liver injury in mice. Methods Kunming mice were randomly divided into six groups: normal control group (NC group),model control group,bifendate dropping pill group,low-,medium-and high-dose TTOE groups.The liver injury model was established by administration of CCl4 in all the groups except the NC group.The indexes of the liver,spleen and thymus were obtained.The activities of serum ALT,AST,ALP,LDH, albumin and T-AOC were measured.The activities of SOD and GSH-PX and the contents of MDA,NO and GSH and Cyt P450 were also detected in hepatic tissues. Results TTOE at different doses could obviously reduce the indexes of the liver,thymus and spleen,which were (57.13±0.71),(32.44±0.24),and (27.78±0.16),respectively,in high-dose TTOE group,and there were significant differences between the TTOE groups and model control group (P<0.01).The activities of ALT,AST,ALP and LDH were obviously decreased in high-dose TTOE groups,which were (65.59±8.23),(141.38±15.52),(2 462.4±253.6),(172.51±20.64),respectively,in the TTOE high-dose group (P<0.01).The serum levels of Alb and T-AOC were obviously increased,the contents of NO and MDA significantly decreased and the activities of SOD and GSH-PX and the contents of GSH Cyt P450 in liver tissues profoundly increased in TTOE groups when compared with those in model control group (P<0.05 or P<0.01). Condusion TTOE could protect against acute hepatic injury induced by CCl4 in mice,which may be associated with the decrease in the activities of liver enzymes,anti-oxide free radical effect,decreased NO content and inhibited lipid peroxidation.
Objective To investigate the protective effect of total flavones of Artemisia capillaris Thunb.on acute hepatic injury in rats. Methods Rats were randomly divided into blank control group,model control group, Yinzhihuang group,and groups of total flavones of Artemisia capillaris Thunb.(low,medium and high dose) in terms of 7-day different treatments.All rats except those in the blank control group were administrated with D-galactosamine hydrochloride (500 mg·g-1,ip) once at the sixth day.Then,concentrations of ALT and AST were detected 48 h later,and the liver samples were collected from each group for pathological examination. Results The serum ALT and AST in high-dose group of total flavones of Artemisia capillaris Thunb.was [(189.2±112.9) and (231.7±149.9) U·L-1],respectively,significantly lower than those in model control group ALT [(391.9±181.3) U·L-1] and AST [(403.9±133.8) U·L-1].Fragmented necrosis,fatty degeneration,inflammatory cells infiltration and acidophilic degeneration of hepatic cells were improved to varying degrees in groups of total flavones of Artemisia capillaris Thunb.compared with model control group.Fragmented necrosis of liver cells and steatosis occurred in 20 and 19 rats,respectively,in the model control group,while those appeared in 1 and 2 rats,respectively,in high-dose group of total flavones of Artemisia capillaris Thunb.. Condusion Total flavones of Artemisia capillaris Thunb.are effective in protecting D-galactosamine hydrochloride-induced acute hepatic injury in rats.
Objective To explore the preventive effects of different extracts from Aspidopterys obcordata on renal tubular epithelial cells injury induced by sodium oxalate in vitro,and initially identify the effective part for treating urolithiasis. Methods The injury model of HK-2 cells induced by sodium oxalate was established to screen the active parts of Aspidopterys obcordata by testing the protective effects of different polarity extracts on HK-2 injury cells through MTT method. Results Different extracts from Aspidopterys obcordata improved the activity of HK-2 injury cells, which were elevated to 86.17% and 95.42% by 0.5 mg·mL-1 and 1 mg·mL-1 aqueous extract, respectively.And the activity reached to 93.59% and 84.77% by 0.5 mg·mL-1 and 1 mg·mL-1 50% alcohol extracts, reached above 81.56% by 95% alcohol extracts,all of which showed significant difference compared with the model group.The HK-2 cells viability were elevated to 82.53% and 91.58% by 0.5 mg·mL-1 and 1 mg·mL-1 95% alcohol extracted ethyl acetate parts,and increased to 77.24% and 87.22% by 0.5 mg·mL-1and 1 mg·mL-1 of 95% alcohol isolated n-butanol extracts, approached to 95.46% and 81.36% by 0.5 mg·mL-1 and 1 mg·mL-1 water extracts, all of which showed significant difference compared with the model control group. Condusion The aqueous extracts and alcohol extracts from Aspidopterys obcordata have obvious preventive effects on HK-2 cells injury,among which the ethyl acetate extracts, n-butanol extracts and water extracts present the remarkable effects, which are supposed to be the active parts for inhibiting calcium oxalate stone formation in vitro.
Objective To explore the characteristics of childhood tuberculosis and recent advances in the diagnosis and treatment of this disease in order to improve its diagnosis and treatment. Methods Key words “child”“tuberculosis”“diagnosis” and “treatment” were used to retrieve relevant literatures from Pubmed,Web of Science,CNKI and Wanfang databases.The literatures were reviewed and clinical experience summarized. Results Disseminated tuberculosis and extrapulmonary tuberculosis were common in children with tuberculosis.It was difficult to collect with samples of diagnostic value for detection.There counterparts were no systematic diagnosis and treatment programs available for children with drug-resistant tuberculosis,and pharmaceutical dosage forms tailored for children were lacking. Condusion Tuberculosis in children is more complex to diagnose and treat than in adult counterpart.Diagnosis of this disease relies on a variety of diagnostic methods.It's still challenging to control childhood tuberculosis.
Objective To investigate the myocardial protection effect of dexmedetomidine hydrochloride during off-pump coronary artery bypass graft surgery. Methods Forty patients undergoing off-pump coronary artery bypass grafting were randomly divided into two groups: control group (group C) and dexmedetomidine group (group D).Dexmedetomidine hydrochloride was given at a loading dose of 0.5 μg·kg-1 to patients in group D,and then infused continuously at a rate of 0.5 μg·kg-1·h-1.The same amount of saline was given to patients in group C. After loading dosing,general anesthesia was performed with TCI technique.Trans-esophagus Doppler monitoring was conducted to monitor the blood volume and heart function,and close monitoring of fluid infusion to maintain stable circulation.Invasive blood pressure and heart rate were recorded every 5 min.Blood samples were taken for detection of cTnI,CK-MB,TNF-α and IL-6 contents at the following time points: after induction (t0),before operation (t1),after operation (t2),12 h postoperation (t3) and 24 h postoperation (t4). Results The blood pressure and heart rate decreased significantly at t0 and t1 in group D compared with group C,and there were no significant differences in the two indexes at other time points between the two groups.Blood CK-MB,cTnI and inflammation factors TNF-α,IL-6 were much higher at t2,t3,t4 than at t0 and t1 in both groups(P<0.05).They were significantly decreased at t2,t3,t4 in group D relative to group C (P<0.05).Vessel active medicines were less given after the operation in group D (P<0.05). Condusion Dexmedetomidine hydrochloride can mitigate the inflammation responses caused by off-pump coronary artery bypass grafting,reduce the myocardial injury and improve the cardiac function of the patients.
Objective To investigate the clinical efficacy and safety of escitalopram in the treatment of chronic subjective dizziness (CSD). Methods A total of 90 CSD patients randomly divided into medication group (n=32),vestibular rehabilitation group (n=27) and psychological intervention group (n=31).Patients in the medication group treated with escitalopram (10-20 mg·d-1,PO),those in the vestibular rehabilitation group were underwent vestibular rehabilitation training and those in the psychological intervention group were given cognitive behavioral therapy.The treatment course lasted six weeks.All patients were evaluated by zDHI,HAMA and HAMD before and after the treatments. Results The total scores of HAMA,HAMD,DHI and the respective factor scores of DHI were significantly decreased in each group after 6-week treatment when compared with those before the treatment (P<0.01).The total scores of DHI was (30.45±15.84) in medication group and (36.15±13.07) in vestibular rehabilitation group,the physical factor score was (10.06±4.49) in medication group and (10.23±4.64) in vestibular rehabilitation group,and the functional factor score was (10.71±5.95) in medication group and (11.23±5.03) in vestibular rehabilitation group,respectively.There were no significant differences in the three indices between medication group and vestibular rehabilitation group.But they were significantly lower than those in psychological intervention group [(43.86±12.48),(14.43±4.37),and (17.57±4.37) for total scores of DHI,physical factor scores and functional factor scores,respectively] (P<0.05,or P<0.01).The emotional factor scores of DHI were (9.68±5.68) and (11.86±4.74),HAMA scores (9.97±4.72) and (12.18±4.16),HAMD scores (10.26±4.91) and (12.32±4.53) in medication group and psychological intervention group(P>0.05),respectively.They were significantly lower in the two groups than in vestibular rehabilitation group [ (14.69±4.76),(14.96±4.77) and (14.88±4.65) for the emotional factor score,HAMA score and HAMD score,respectively,P<0.05 for all]. Condusion Escitalopram can improve the symptoms of CSD involving the body,emotion and function.The vestibular rehabilitation training and cognitive behavioral therapy have their respective advantages.
To evaluate the effects of doxofyline on intraoperative pulmonary function in patients receiving double lumen endotracheal intubation for one-lung ventilation.Methods
Fifty patients who underwent elective pulmonary lobectomy under general anesthesia using double lumen endotracheal intubation were randomly divided into two groups (n=25 each): control group (group C) and doxofyline group (group D).Doxofyline (4 mg&#x000b7;kg-1) was injected intravenously after double lumen endotracheal intubation in group D,while equal volume of 0.9% sodium chloride was intravenously given in group C.Total intravenous anesthesia with target controlled infusion was performed during the operation.Two milliliter blood samples were taken from the radial artery for blood gas analysis immediately before administration (t0),at 30 min (t1),60 min (t2) after one-lung ventilation and at the moment of two-lung ventilation after chest closing (t3).The PaCO2,PaO2,peak airway pressure (Ppeak),airway plateau pressure (Pplat),airway resistance (Raw) and lung compliance (Compl) were recorded at t0-3.Results
The Ppeak,Pplat and Raw were significantly decreased and the Compl and PaO2 significantly increased at t1-t3 in group D when compared with those in group C (P&#x0003C;0.05).The Ppeak,Pplat and Raw were significantly increased and Compl and PaO2 significantly decreased at t3 as compared with those at t0 in group C (P&#x0003C;0.05).Conclusion
Doxofyline can improve intraoperative pulmonary function in patients who undergo double lumen endotracheal intubation for one-lung ventilation.
Objective To establish the quality standard for Yanyan syrup. Methods Thin layer chromatography (TLC) was used for the qualitative identification of Puerariae Lobatae Radix and Scrophulariae Radix.High performance liquid chromatography (HPLC) was used to determine the content of puerarin on Diamonsil C18 (200 mm×4.6 mm,5 μm) column with mobile phase consisting of methanol-0.5% acetic acid (25:75) at a flow rate of 1.0 mL·min-1.The detection wavelength was set at 250 nm. Results TLC spots were clear and well-separated without negative interference.The linear range of puerarin was 3-120 μg·mL-1 (r=0.999 7) with an average recovery of 97.44% (RSD=2.07%,n=6). Condusion The method for quality and quantity of Yanyan syrup is simple, specific, accurate and reliable.It can be used for the quality control of Yanyan syrup.
Objective To evaluate the efficacy and safety of bortezomib combined with dexamethasone and thalidomide in the treatment of autologous stem cell transplantation (ASCT) in multiple myeloma (MM). Methods The randomized controlled trials (RCTs) on combined therapy with bortezomib,dexamethasone and thalidomide for ASCT in MM were retrieved from Pubmed,Medline,the Cochrane Library,CNKI,VIP and Wanfang databases (published until December 2014).The method of the Cochrane systematic review was used to evaluate the quality of the included RCTs and the Review Manager 5.3.5 software was employed for Meta-analysis. Results Five RCTs involving 1 271 patients were included.The meta analysis results showed that the complete remission (CR) rate,near-CR rate and total effective rate were significantly higher after combined treatment with bortezomib,dexamethasone and thalidomide when compared with those in other combination therapies [CR+nCR, RR=1.50,95%CI (1.16,1.94),P=0.002;the total effective rate,RR=1.13,95%CI (1.03,1.24),P=0.009].In terms of safety,the grade 3/4 adverse events were significantly increased in the group of combined therapy with bortezomib,dexamethasone and thalidomide [RR=1.29,95%CI (1.05,1.59),P=0.02]. Conclusion Bortezomib combined with thalidomide and dexamethasone for the treatment of ASCT in MM can significantly improve the CR+nCR and the total effective rate,but it also increases the incidence of the overall adverse events at the same time.
Objective To reveal the evolution, research hotspots and research fronts of clinical pharmacy services. Methods Documents related to "clinical pharmacy services" from 2000 to 2015 in Web of Science Core Collection database are included.Documents are visually analyzed through a number of co-citation maps, which identified the critical node documents in the revolution of clinical pharmacy services research by knowledge visualization tool, CiteSpace.Its functions of clustering and burst terms detection were also applied to analyze the research hotspots and research fronts. Results This paper determined the distribution of documents on time period, journals, countries and research institutions.Critical node documents perfectly showed the evolution pathway of clinical pharmacy services, main cluster groups and burst terms and documents, indicating the research hotspots and research fronts. Conclusion The research hotspots focus on 3 aspects.1 .Practice, including the service model and content of clinical pharmacy services;its interventions in diseases of emergency, organ transplantation, cardiovascular diseases and diabetes;surveys on developing clinical pharmacy services;genotype-guided individualized dosing;remote pharmacy services.2.Evaluation, including the assessment of the effects of pharmacists' interventions, service quality evaluation, and pharmacoeconomic evaluation.3.Pharmacists' career development, including Pharmacists' training pattern, qualification, pharmacy residency programs and job satisfaction.