Research progress of necrotizing otitis externa / 临床耳鼻咽喉头颈外科杂志

Necrotizing otitis externa is a progressive infectious disease involving the external auditory canal and even the skull base, which can lead to serious complications and even death if not treated in time. In this paper, the latest advances in etiology, pathogenesis, clinical manifestations, diagnosis and treatment were reviewed based on previous literature, providing reference for clinical diagnosis, treatment and future research.

Impact of antimicrobial stewardship program on antimicrobial usage and detection rate of multidrug-resistant gram-negative bacteria / 中华儿科杂志

Objective@#Analyze the changes of indicator of antimicrobial usage and detection rate of multidrug-resistant gram-negative bacteria (MDR-GNB), in order to evaluate the impact of antimicrobial stewardship program (ASP).@*Methods@#The antimicrobial stewardship program was implemented since December 2011 at the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University. Intensified effort was made from 2014 to 2017. We divided the program into four stages, one before ASP (2010-2011) and three after ASP (2012-2013 as the first, 2014-2015 as the second and 2016-2017 as the third post-ASP stages). The usage rates in outpatient,emergency department and inpatient, along with the antibiotic use density (AUD, defined as daily doses/per 100 patient-days), the AUD of the third-generation cephalosporins and carbapenems in inpatient were reviewed retrospectively. The detection rates of extended-spectrum β-lactamases (ESBLs)-producing Escherichia coli, ESBLs-producing Klebsiella pneumonia, carbapenem-resistant E. coli, carbapenem-resistant Klebsiella pneumonia, carbapenem-resistant Acinetobacter baumannii and carbapenem-resistant Pseudomonas aeruginosa were also analyzed at the same time. The correlation analysis between the detection rate of MDR-GNB and the indicator of antimicrobial usage was made.@*Result@#Among four stages, the usage rates were 55.2% (560 578/1 015 540) , 38.1% (493 554/1 296 336) , 26.8% (378 602/1 411 595) and 23.1% (347 817/1 502 817) in outpatient, 75.6% (429 582/568 230) , 61.4% (382 558/623 138) , 43.6% (265 102/608 071) and 35.1% (218 484/622 397) in emergency department, and 76.0% (30 568/40 221) , 53.7% (30 437/56 636) , 49.9% (37 395/74 895) and 50.3% (35 493/70 544) in inpatient, respectively. All indicators decreased significantly (χ2=297 811.798, 3 155 704.783, 5 592.037, P<0.01). The AUD in inpatient was 38.4,31.8,21.7 and 19.41,and the AUD of the third-generation cephalosporins were 13.83, 11.21, 6.20 and 6.84, respectively, which decreased significantly after ASP (r=-0.878, -0.781, P<0.05). The AUD of carbapenems were 1.94,1.77,1.87 and 1.93, respectively (r=0.123, P>0.05). A total of 11 289 strains of bacteria were collected, including 5 589 strains of E. coli, 2 823 strains of K.pneumoniae, 1 637 strains of A. baumandii, and 1 240 strains of P. aeruginosa.The detection rates of ESBLs-producing E.coli and ESBLs -producing K. pneumoniae in four stages were 75.4% (1 034/1 371) , 66.6% (893/1 341) , 57.8% (834/1 443) , 46.7% (670/1 434) and 78.7% (547/695) , 67.5% (455/674) , 49.3% (421/854) , 32.5% (195/600) , respectively,both decreased significantly (χ2=266.204; 328.805, P<0.01). The detection rates of Carbapenem-resistant A. baumannii were 28.2% (115/408) , 26.7% (126/472) , 24.3% (125/515) and 12.0% (29/242) respectively,and showed significant decreasing trend after ASP (χ2=18.112, P<0.01). The detection rates of carbapenem-resistant P. aeruginosa were 11.3% (40/355) , 18.5% (58/313) , 13.4% (46/343) and 7.0% (16/229) , respectively,with the most obvious decrease in the third stage after ASP. The detection rates of carbapenem-resistant E. coli and carbapenem-resistant K. pneumonia were continuously lower (<5%). There were positive correlations between the detection rates of ESBLs-producing E. coli and K. pneumoniae and all usage indicators (r1=0.930, 0.974, 0.746, 0.958, 0.842; r2=0.910, 0.960, 0.765, 0.963, 0.898, P<0.05).@*Conclusion@#The antimicrobial stewardship program can effectively reduce both the usage of antimicrobial and the production of MDR-GNB, which has great value to promote rational clinical use of antimicrobials and reduce bacterial resistance.

Expression profiles analysis of gene chip of salvianolatelyophilized injection in treatment of stroke in diabetic rats / 中国药理学通报

Aim To investigate the effect of salvianolate syophilized injection on brain tissue gene expression profiles in stroke of diabetic rats.Methods T1DM was induced in adult male Wistar rats by injecting streptozotocin.T1DM rats were then subjected to 90 minutes of middle cerebral artery occlusion(MCAO).The rats were randomly assigned to sham group(DM+Sham),ischemia-reperfusion group(DM+ MCAO/R),edaravone group(6 mg·kg-1,ED)and salvianolate lyophilized injection treatment group(5.25,10.5,21 mg·kg-1,SLI)with 13 rats in each group.Drugs were administered by tail vein injection 3 hours after MCAO/R,daily and lasting for 14 days.Infarct volume and gene expression in the brain tissue were detected by TTC staining and the gene chip technique.Results Compared with DM+Sham group,67 differential expressed genes were detected in the DM+MCAO/R group,among which 41 genes were up-regulated and 26 genes were down-regulated.Compared with DM+MCAO/R group,59 differential expressed genes were detected in the SLI(21 mg·kg-1)group,among which 45 genes were up-regulated and 14 genes were down-regulated.Hierarchical cluster results suggested that a number of genes were significantly changed in T1DM rats,such as Ly6i,Pax7 and Irx2.Effects of SLI on the stroke in T1DM rats were majorly related to coagulation and hemostasis system,inflammatory cytokines,oxidative stress,substance metabolism,angiogenesis and signal transduction.Conclusion Salvianolate lyophilized injection protects against focal cerebral ischemia/reperfusion injury in type 1 diabetic rats through regulation of the coagulation and hemostasis system,inflammatory cytokines,oxidative stress,substance metabolism,angiogenesis and signal transduction.

Antimicrobial resistance profile of the clinical isolates in Fuzhou First People's Hospital, Jiangxi during 2015 / 中国感染与化疗杂志

Objective To investigate the antimicrobial resistance profile of clinical isolates in Fuzhou First People's Hospital during 2015. Methods? The?bacterial?isolates?were?identified?using?ATB?Reader?semi-automatic?equipment?via?colorimetric?method.?The antimicrobial susceptibility was tested by disk diffusion method. The results were interpreted according to the CLSI breakpoints issued in 2015. All data were analyzed by WHONET 5.5 software. Results A total of 1215 non-duplicate clinical isolates were collected during 2015, including gram negative bacteria (70.6%) and gram positive bacteria (29.4%). The prevalence of MRSA was 50.0 % in S. aureus and the prevalence of MRCNS was 84.1 % in coagulase-negative Staphylococcus. Most MRSA strains (80.3?%)?were?resistant?to?erythromycin,?tetracycline?and?norfloxacin.?No?staphylococcal?isolate?was?found?resistant?to?vancomycin?or teicoplanin. The prevalence of ESBLs was 52.5% in E. coli and 34.7% in K. pneumoniae. Ten strains of Enterobacteriaceae were resistant to carbapenems. Less than10% of the P. aeruginosa isolates were resistant to amikacin, cefoperazone-sulbactam, meropenem and tobramycin. About 2.4% and 51.8% of the Acinetobacter isolates were resistant to polymyxin E and cefoperazone-sulbactam, respectively, while more than 75% of these strains were resistant to other commonly used antimicrobial agents. Conclusions Most of the clinical isolates are gram-negative bacilli in our hospital during 2015. Antimicrobial resistance remains an important clinical concern, which should be addressed seriously.

Effects of salvianolate lyophilized injection on neural functional recovery and the expression of microtubule associated protein-2 after focal cerebral ischemia-reperfusion injury in diabetic rats / 中华行为医学与脑科学杂志

Objective To investigate the effects of salvianolate lyophilized injection(SLI) on neural functional recovery and the expression of microtubule associated protein-2(MAP2) after focal cerebral ischemia-reperfusion injury in the diabetic rats.Methods Diabetes model was made by intraperitoneal injection of streptozotocin (STZ) and cerebral ischemia-reperfusion model was developed by Longa suture occluded method in the middle cerebral artery of diabetic rats.The rats were randomly divided into five groups: sham operation group, model group, SLI (21.0 mg.kg-1,10.5 mg.kg-1) treatment groups, and edaravone (6 mg.kg-1) treatment group.3 hours after ischemia,rats were respectively given normal saline or drugs followed by the injection once a day for 14 days and the neurological impairment was assessed.2 h after the last injection,the rats were decapitated and the brains were collected.The expression of MAP2 protein and mRNA in the bilateral hippocampal ischemia and infarcted area was detected with immunohistochemistry and RT-PCR.Results Severe neurological dysfunction was found in diabetic rats that had been subjected to cerebral ischemic injury (1.850±0.457).A significant improvement on neurological function was found in the SLI treatment groups (1.581 ± 0.314, 1.345 ± 0.425) compared with model group(P＜0.01, P＜0.05).Moreover,the expression of MAP2 in ischemia bilateral hippocampal CA1 and penumbra was represented by the average optical density value respectively (0.743±0.250,0.561± 0.224).In the hippocampal CA1 region, the number of MAP2-positive cells (0.781 ± 0.420 , 0.851 ± 0.136) in the treatment group showed significant increase than those in model group (P＜0.01, P＜0.05).In the ischemic penumbra region,the number of MAP2-positive cells (0.753±0.235,1.203±0.326) in the treatment group showed significant increase than those in model group (P＜0.01, P＜0.05).Conclusion The SLI can promote the post-injury neurocognitive function in diabetic rats.The increase of MAP2 expression may be involved in the mechanisms.

Nasal cavity supernumerary tooth and maxillary sinusitis: one case reported / 临床耳鼻咽喉头颈外科杂志

Supernumerary tooth is a rare case. This report described a case of nasal cavity supernumerary tooth association with maxillary sinusitis. A 28-year-old male patient reported with the chief complaint of nasal obstruction, headache and purulent secretion for the past three months. Clinic examination and CT examination showed that there was a supernumerary tooth in the right nasal bottom, and maxillary sinus was infected in the same side. This patient was performed supernumerary tooth removing and given antibiotics for 3 days. Ten days after the operation, there was no clinical symptoms, and nasal bottom mucosa was normal. After 3 months of follow-up, reexamination of coronal CT scan appeared normal.

Preparation and quality control of compound quercetin creams / 重庆医学

Objective To study the preparation of quercetin compound cream and establish its standard of quality control. Methods The composition of recipe and manufacturing technique were designed.The content of components were determined by HPLC,and its stability tests were carried out.Results The product was a kind of yellow smooth cream.The linear ranges were 0.053-1.696 μg for quercetin(r=0.999 9),0.053-1.696 μg for 8-methoxypsoralen(r=0.999 8)and 0.100-1.000 μg for beta-methasone(r=0.999 9).The average recovery rate were 99.83%,99.52%,and 99.74% of quercetin,8-methoxypsoralen,and beta-methasone(n=9).After 12 months′long term stability test,all the 3 batches of sample preparations were in line with relevant regu-lations.Conclusion The designed recipe was reasonable,and the manufacturing technique was feasible,with stable and controllable quality.

Simultaneous Determination of Spironolactone and Erythromycin in Compound Spironolactone Gel by HPLC / 中国药房

OBJECTIVE:To establish a method for simultaneous determination of spironolactone and erythromycin in Com-pound spironolactone gel. METHODS:HPLC was performed on the column of Thermo-Hypersil ODS2-C18 with mobile phase of 0.1 mol/L ammonium dihydrogen phosphate solution (pH was adjusted to 7.0 by triethylamine)-acetonitrile (60∶40,V/V) at flow rate of 1.0 ml/min,detection wavelength was 215 nm and 238 nm,column temperature was 30℃,and injection volume was 5 μl. RESULTS:The linear range was 0.251 6-5.032 μg/ml for spironolactone and 0.577 2-11.544 μg/ml(r=0.999 9) for erythromycin (r=0.999 9);RSDs of precision,stability and reproducibility tests were no more than 0.83%;average recoveries were 97.8%(RSD=0.74%,n=9)and 96.7%(RSD=2.60%,n=9),respectively. CONCLUSIONS:The method is simple,reproducible,ac-curate and reliable,and can be used for the quality control of Compound spironolactone gel.

Regulation effects on abnormal glucose and lipid metabolism of TZQ-F, a new kind of Traditional Chinese Medicine.

AIM OF THE STUDY: Based on the recipe of the traditional anti-diabetic formula TZQ, we developed TZQ-F, a new formula including 8 fractions isolated from Red Paeony root, Mulberry leaf, Lotus leaf, Danshen root and Hawthorn leaf with a good quality assurance. The study was aimed at fraction preparation and effects of the fractions on abnormal glucose and lipid metabolism. MATERIALS AND METHODS: The active fractions were obtained by macroporous resin, ion-exchange resin and polyamide resin column chromatographies. HPLC analyses were used for quality control. In vitro mechanism study included DPPH radical scavenging, AGEs formation inhibition, alpha-glucosidase inhibition and lipase inhibition, and rats on high-fat diet were used for in vivo study. RESULTS: In vitro mechanism study showed that among the 8 fractions, three of them had inhibition effects on intestinal disaccharase, three with inhibition effects on lipase, and five with effects of free radical scavenging. In vivo study showed that after 4 weeks of treatment, TZQ-F significantly decreased the levels of serum total cholesterol, TG, glucose, LDL-C and HDL-C in rats on high-fat diet. Consistent with the in vitro and in vivo results, histology study demonstrated that TZQ-F alleviated hepatic steatosis induced by high-fat diet. CONCLUSIONS: TZQ-F possesses the potential regulation effects on abnormal glucose and lipid metabolism.

Investigation and analysis of application of syndrome- differentiated nursing care in the hospitals of TCM in Hunan Province / 中国实用护理杂志

Objective To investigate and analyze application of syndrome-differentiated nursing care in the hospitals of TCM in Hunan. Methods A self-designed questionnaire was used to investigate and analyze 485 nurses-in-charge or higher positions in 116 hospitals of TCM in Hunan. Results 90.93% of nursing staff hold that syndrome-differentiated nursing care benefits patients' health; 32.37% of nurses were not familiar with syndrome-differentiated nursing care, and the rate of familiarity was higher among the nurses in municipal and provincial hospitals of TCM than those in county and district hospitals of TCM; hospitals of TCM that carry out syndrome-differentiated nursing care exceeding 70% accounted for 12.37%, with municipal and provincial hospitals of TCM higher than county and district hospitals of TCM. Conclusions Application of syndrome-differentiated nursing care in the hospitals of TCM is of concern. Reform of management model, training system, regulations and laws is needed to encourage nurses' application of syndromedifferentiated nursing care.

Complex traditional Chinese medicine for poststroke motor dysfunction: a systematic review.

BACKGROUND AND PURPOSE: For its current dimensions, stroke represents the world's primary health challenge. In China stroke is the second most common cause of death. Traditional Chinese Medicine (TCM) has for many centuries been used, and it is still widely used today in countries of south and east Asia for the treatment of people with stroke. The objective of this systematic review was to evaluate whether complex Traditional Chinese Medicine (cTCM) improves poststroke motor recovery. In particular, we defined cTCM as intervention that included at least acupuncture and Chinese herbal medicine. METHODS: An extensive search including PubMed, EMBASE, CBM, and the Cochrane Library was performed up to December 2007. Randomized clinical trials (RCTs) about cTCM for motor dysfunction of poststroke were searched irrespective of any language. The quality of each trial was assessed according to the Cochrane Reviewers' Handbook 4.2.6. RESULTS: After selection of 11 234 articles, 34 RCTs and quasi-RCTs were included. All these trials were conducted in China and published on Chinese journals. All trials but one reported results in favor of cTCM treatments suggesting a strong publication bias. Because of the significant clinical and methodological heterogeneity, no meta-analysis was performed and thus no cumulative result was obtained pooling data of RCTs. CONCLUSIONS: What appears from this systematic review is that scant data are available to evaluate efficacy of cTCM for poststroke motor dysfunction. Most of the primary studies available for this review were inadequately designed trials characterized by unknown dropout rates and definitional vagueness in outcomes measures. None of the studies approached important end points like death, survival times, rate of dependency, reduction in length of stay in hospital, etc. The key to lead to evidence-based practices is establishing a consensus on standardized relevant outcome measures and then designing and conducting appropriate RCTs that adopt those standards.

Advance in study of the culture of brain microvascular endothelial cells / 中国药理学通报

Blood-brain barrier(BBB)is mainly composed of brain microvascular endothelial cells(BMECs).According to the special cell membrane transport system and the extensive tight junctions,the brain microvascular endothelial cells play an important role in the CNS.Also,there is a close relationship between BMECs and the cerebrovascular diseases,such as cerebral ischemia,cerebral edema,and so on.Therefore,the culture of brain microvascular endothelial cells provides a new tool for studying the cerebrovascular diseases in vitro.The researches in recent years have been reviewed in this test,approaching the cultivation of the rat brain microvascular endothelial cell from the segregation,purification and culture in turns,in order to provide a foundation for the studies of the brain microvascular endothelial cell;in vitro.

A Comparative Study on the Mutagenicity of Natural Borneol and Synthetic Borneol / 中药新药与临床药理

Objective&Methods The mutagenicity of natural Borneol and synthetic Borneol was studied by using Ames test.Results Natural Borneol and Synthetic Borneol in the dose range of 0.4～250.0 ?g/plate had no effect in reducing the reversion frequencies of Salmonella Typhimurium histidine auxotrophic mutant(TA97,TA98,TA100,TA102)whether if metabolic activation system(S9mix)existed or not.Moreover,the backward mutant colony had normal background.Conclusion Natural Borneol and Synthetic Borneol do not possess evident mutagenicity under experimental condition.