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OBJECTIVE： To study the efficacy and economics of cefoperazone/sulbactam combined with moxifloxacin and amikacin versus cefoperazone/sulbactam combined with tigecycline in the treatment of pneumonia with multidrug-resistant Acinetobacter baumannii （MDRAB）. METHODS： By prospective study， 150 MDRAB pneumonia patients were selected from Jingmen Second People’s Hospital during Jan. 1st， 2016-Aug. 31st， 2019， and then randomly divided into control group and observation group， with 75 cases in each group. Control group was given Cefoperazone/sulbactam sodium for injection （3 g， q8 h， ivgtt） combined with Tigecycline for injection （first dose 100 mg， maintenance dose 50 mg， q12 h， ivgtt）. Observation group was give Cefoperazone/sulbactam sodium for injection （3 g， q8 h， ivgtt） combined with Moxifloxacin hydrochloride and sodium chloride injection （400 mg， qd， ivgtt） and Amikacin sulfate injection （0.6 g， qd， ivgtt）. The treatment lasted for 14 days in both groups. The time for body temperature to return to normal， lung rales disappearance， WBC to return to normal and PCT to return to normal， clinical efficacy， bacterial clearance rate and the occurrence of ADR were compared between 2 groups. Cost-effectiveness analysis was used to evaluate the cost- effectiveness ratio （C/E） and incremental cost-effectiveness ratio （ΔC/ΔE） of 2 groups using antibiotics cost as cost. Sensitivity analysis was performed by reducing drug cost by 15％. RESULTS： There was no statistical significance in the time for body temperature to return to normal， lung rales disappearance， WBC to return to normal and PCT to return to normal between control group and observation group （P＞0.05）. Clinical response rates of 2 groups were 85.33％ and 81.33％， and bacterial clearance rate were 89.33％ and 82.67％， with statistical significance （P＞0.05）. No serious ADR occurred in either group. The antibacterial cost of control group and observation group were 32 371.49 yuan/person and 9 367.82 yuan/person. C/E of clinical response rate were 379.37 and 115.18， and C/E of bacterial clearance rate were 362.38 and 113.32 in 2 groups， respectively. ΔC/ΔE of clinical response rate and bacterial clearance rate between control group and observation group were 5 750.92 and 3 454.00. Sensitivity analysis supported cost-effectiveness analysis results. CONCLUSIONS： Cefoperazone/sulbactam combined with moxifloxacin and amikacin versus cefoperazone/sulbactam combined with tigecycline in the treatment of pneumonia with MDRAB has similar efficacy， but cefoperazone/sulbactam combined with moxifloxacin and amikacin has economic and social benefits.
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Objective To investigate the relationship between multi-slice spiral CT perfusion imaging and tumor angiogenesis and cell cycle protein D1 (cyclinD1) expression in patients with peripheral lung cancer. Methods Seventy-three patients with peripheral lung cancer underwent 16-slice spiral CTperfusion imaging. The CT perfusion imaging were analyzed for time density curve (TDC), perfusion parametric maps and the respective perfusion parameters (BF, BV, PS, PH, and PHpm/PHa). Correlation between the respective perfusion parameters and immunohistochemical findings of MVD measurement and cyclinD1 expression were evaluated. Statistical method used one factor analysis of variance (One-wayANOVA) and Pearson correlation analysis. Results The shape of TDC of three groups of peripheral lung cancers (adenocarcinoma, squamous cell carcinoma, and other type of cancer) was similar. They showed a steeper slope, was obvious increase of nodular HU value [ peak height of TDC is respectively (44. 87±6. 83), (34. 91 ± 8.05), (40. 66±5. 87) HU ], changed little after reaching peak height, became flat at peak, had a platform. Forty-four patients were cyclinD1 positive expression, the peripheral lung cancers with cyclinD1 positive expression showed significantly higher MVD value than that of the peripheral lung cancers with cyclinD1 negative expression [ respectively (33.88± 14. 81), (23. 17±11.66) band/high magnification, P < 0. 01]. The cancers with cyclinD1 positive expression showed significantly higher PH,PHpm/PHa, BF,BV, PS value than those of the cancers with cyelinD1 negative expression[respectively P <0. 05]. MVD was positively correlated with PH, PHpm/PHa, BF, BV, and PS of the three groups ofcancers with cyclinD1 positive expression. Among, the correlation coefficient (r value) of BV, PS, BF was0. 409, 0. 517,0. 503 respectively(all P < 0. 01). MVD was significantly correlated with them. The r valueof PH, PHpm/PHa is 0. 319,0. 324 respectively(all P < 0. 05). MVD was less correlated with them. MVDwas not correlated with PH, PHpm/PHa, BF, BV, and PS of the three groups of cancers with cyclinD1 negative expression. Conclusions Multi-slice spiral CT perfusion imaging moderately correlated with tumorangiogenesis and reflected MVD measurement and cyclinD1 expression. It provided not only a noninvasive method of quantitative assessment for blood flow patterns of peripheral lung cancer but also an applicable diagnostic method for peripheral lung cancer.
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Objective:To study on effect of Jiantai Liquid on progesterone receptor(PR)in the uterus at the nidation stage in the mouse with disturbance of blastocyst nidation.Methods:The gestational mice were randomly divided into a normal group,a model group and a Chinese drug group.Mifepristone was used for inducing disturbance of blastocyst nidation in the mice,which were interfered with Jiantai Liquid.At the eighth week of pregnancy,the mice were killed and morphological changes of the endometrium were observed,and PR expression in the uterus was detected with immunohistochemical method and PR and PRmRNA expressions were detected with Western blot and PT-PCR methods.Results:The endometrium showed maldevelopment in the model group and normal development in the Chinese drug group,similar to the normal group;the gland,the PR expression range and intensity of PR expression in the interstitial substance in the Chinese drug group increased as compared with the model group(P0.05);expressions of PR protein and gene in the Chinese drug group were significantly higher than those in the model group(P0.05).Conclusion:Jiantai Liquid can promote development of the endometrium and improves blastocyst nidation via regulating expressions of PR and PRmRNA in the uterus in the mice with disturbance of blastocyst nidation.
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AIM: To explore the therapeutic strategies of heat-clearing and detoxifying (HCDT) and Yin-invigorating and fluid-supplementing (YIFS), the method of Chinese medicine, on the high density lipoprotein (HDL) and alkaline phosphatase (ALP) molecules, which are associated with endotoxin-degradation. METHODS: The animal model of endotoxemia was established by the injection of E. Coli lipopolysaccharides through rabbits ear vein. The endotoxemic rabbits were treated respectively with two representative herbal preparations of therapeutic principles against febrile diseases: HCDT or YIFS preparations. The serum levels of interleukin-1 (IL-1), tumor necrosis factor ? (TNF-?) and HDL, the ALP activity, the expression of ALP mRNA in liver and kidney tissues were observed. RESULTS: The serum levels of IL-1 and TNF-? in HCDT group were significantly decreased, while the serum ALP activity and the expression of ALP mRNA in liver and kidney tissues were obviously increased, as compared with those in model group. Meanwhile, the serum levels of IL-1 and TNF-? in YIFS group were significantly reduced, and its plasma HDL level was elevated. CONCLUSIONS: Both the herbal preparations, HCDT and YIFS, have the scavenging effects on the overproduction of inflammatory cytokines such as IL-1 and TNF-? induced by endotoxin, but their effects on the endotoxin-degrading molecules might be different. HCDT principally increases ALP activity and enhances ALP expression in liver and kidney tissues, while YIFS might preferably facilitate the elevation of plasma HDL level.