The clinical characteristics of community-acquired pneumonia patients with aspiration risk factors / 医学研究生学报

Objective　By now, there is no unified definition of aspiration pneumonia. However, patients with community-acquired pneumonia (CAP) often have aspiration risk factors. The aims of our study is to explore the clinical characteristics and outcomes of CAP patients with aspiration risk factors.　Methods　Cases data of all patients hospitalized with CAP in 5 teaching hospitals in Beijing, Shandong Province and Yunnan Province from January 1, 2013 to December 31, 2015 were collected. Data from patients with (AR-CAP) and without (non AR-CAP) aspiration risk factors were compared, including demographic features, clinical and radiologic findings and outcomes. A Cox proportional hazard model was used to determine the impact of aspiration risk factors on the 30-day mortality in CAP patients. Receiver operating characteristic curves (ROCs) was performed to verify the accuracy of CURB-65 score and PSI risk classification as 30-day mortality predictors in AR-CAP patients.　Results　Totally, 3561 CAP cases were entered into the final analysis. AR-CAP cases accounted for 5.1% (180/3561), who showed older age [78.0 yrs (M1,M3: 70.0 yrs, 85.0 yrs) vs 63.0 yrs (M1,M3: 52.0 yrs, 77.0 yrs), P < 0.001), more underlying diseases (91.1% vs 71.3%, P < 0.001), more frequently classified as CURB-65 score ≥ 3 (13.3% vs 1.5%, P < 0.001) and PSI risk classification ≥ Ⅳ (53.7% vs 17.0%，P< 0.001), and higher 30-day mortality (10.0% vs 1.8%, P < 0.001). Adjusted for age, sex, comorbidities and CURB-65/PSI score, aspiration risk factors were associated with increased 30-day mortality of CAP patients (HR 2.844, 95% CI 1.331~6.078, P = 0.007). The area under the ROC curve for predicting 30-day mortality in AR-CAP patients by PSI risk class was 0.716, which was higher than CURB-65 score (AUC=0.518, P = 0.019). The difference was statistically significant.　Conclusion　AR-CAP is a distinctive pneumonia phenotype with unique clinical characteristics, which shows more illness severity and worsen outcomes.

Incidence and risk factors for cardiovascular events in patients hospitalized with community-acquired pneumonia / 中华心血管病杂志

Objective: To explore the incidence, risk factors of cardiovascular events (CVE) and their impact on 30-day mortality in patients hospitalized with community-acquired pneumonia (CAP). Methods: This is a multicenter, retrospective study. Patients hospitalized with CAP from 5 teaching hospitals in Beijing, Shandong and Yunnan provinces during 1 January 2013 to 31 December 2015 were included and clinical data were retrieved from the Hospital Information System (HIS), and patients were divided into CVE group and non-CVE group. Age, sex, comorbidities, pneumonia severity index(PSI)/CURB-65 score, routine blood test, biochemical examinations, radiological findings on admission and mortality on 30-day after admission were analyzed. The primary endpoint was acute CVE during hospitalization, the secondary endpoint was 30-day death after admission. Multivariate Cox regression analysis was used to explore the risk factors for CVE. Kaplan-Meier survival curve was used to compare the difference on 30-day mortality between CVE patients and non-CVE patients by Log-rank test. Multivariate Cox regression model was used to assess the impact of CVE on the 30-day mortality among CAP patients after adjustment with age, sex, comorbidities, PSI/CURB-65 score. Results: A total of 3 561 CAP patients were included into the final analysis, including 210 (5.9%) patients in CVE group and 3 351 (94.1%) patients in non-CVE group. Compared with patients in non-CVE group, patients in CVE group were older (P<0.001), prevalence of hypertension, coronary heart disease, chronic heart failure, cerebrovascular disease, chronic obstructive pulmonary disease, chronic kidney disease, aspiration risk and bedrid were significantly higher (all P<0.001); prevalence of CURB-65 score 3-5 and PSI risk class Ⅳ/Ⅴ were also significantly higher (both P<0.001). The proportion of axillary temperature<36 ℃, respiratory rate≥30 beats/minutes, confusion, leukocytes>10×10(9)/L, hemoglobin<100 g/L, platelets>300×10(9)/L, albumin<35 g/L, blood urea nitrogen>7 mmol/L, fasting blood glucose>11 mmol/L, serum C-reaction protein>100 mg/L, serum procalcitonin≥2 μg/L, arterial pH<7.35, arterial PO(2)/FiO(2)≤300 mmHg (1 mmHg=0.133 kPa), and multilobar infiltrates and pleural effusion on chest X-ray or CT scan were significantly higher in CVE group than in non-CVE group(all P<0.05); the 30-day mortality was significantly higher in CVE group than in non-CVE group(P<0.001). The incidence of CVE was significantly higher in patients with cardiovascular and cerebrovascular disease(CVD) than in patients without CVD (13.9%(150/1 079) vs. 2.4%(60/2 482), χ(2)=178.737, P<0.001). Meanwhile, the incidence of CVE increased with PSI in patients with Ⅰ/Ⅱ, Ⅲ and Ⅳ/Ⅴ class, respectively(χ(2)=228.350, P<0.001); and CURB-65 score 0-1, 2 and 3-5, respectively (χ(2)=387.154, P<0.001). Cox regression analysis revealed that age (HR=1.05, 95%CI 1.02-1.09, P=0.002), coronary heart disease (HR=1.88, 95%CI 1.01-3.51, P=0.048), chronic heart failure (HR=4.25, 95%CI 1.89-9.52, P<0.001), PSI risk class (HR=1.66, 95%CI 1.50-2.62, P=0.029) and serum procalcitonin≥ 2 μg/L (HR=3.72, 95%CI 1.60-8.66, P=0.002) were independent risk factors for CVE in CAP patients. Kaplan-Meier curve showed that the survival probability of patients with CVE was significantly lower than patients without CVE (P<0.001). After adjustment for age, sex, comorbidities and PSI/CURB-65 score, Cox regression model showed that CVE was associated with increased 30-day mortality in CAP patients (HR=6.05, 95%CI 3.11-11.76, P<0.001). Conclusions: Although the incidence of CVE is not high in Chinese patients hospitalized with CAP, CVE is common in patients with severe pneumonia and in patients with CVD. Age, cardiovascular disease, PSI risk class and serum procalcitonin are the risk factors for CVE in this patient cohort. CVE is related to increased 30-day mortality in CAP patients.

Impact of Prior Use of Inhaled Corticosteroids on the Clinical Outcomes of Obstructive Pulmonary Disease Patients Hospitalised with Community-Acquired Pneumonia / 中山大学学报(医学科学版)

@#【Objective】To evaluate the impact of prior use of inhaled corticosteroids（IC）on the clinical outcomes of chronic obstructive pulmonary disease patients hospitalised with community- acquired pneumonia （COPD- CAP）. 【Methods】This was a multicenter，retrospective study. Data of COPD-CAP patients from five teaching hospitals in Beijing，Shandong and Yunnan Provinces during 1st January 2013 through 31th December 2016 were reviewed. The patients with and without prior use of IC were compared，including demographic characteristics，clinical and radiologic features， and outcomes. A logistic regression model was conducted to explore the impact of prior IC use on the clinical outcomes of COPD-CAP patients. 【Results】Of 725 patients included in the study，13.9%（101/725）were prior IC users. Compared with no-IC users，IC users showed higher frequency of cardiovascular comorbidity（19.8% vs 12.7%）and a CAP history in the last year（20.8% vs 11.2%）；lower occurrence of pleural effusion（13.9% vs 23.7%）；more often classified in Global Initiative for Chronic Obstructive Lung Disease（GOLD）stage 3（35.1% vs 22.9%）and GOLD 4 stage（51.9% vs 21.8%），less often in GOLD 2 stage（10.4% vs 51.0%）. Adjusted by age，gender，underlying diseases，PSI/CURB-65 score and GOLD stage，logistic regression analysis confirmed prior IC use was associated with decreased risk for noninvasive ventilation［OR = 0.220，95% CI（0.052，0.926），P = 0.029］，but not with invasive ventilation［OR = 0.290，95% CI（0.068，1.236），P = 0.094］，needing vasopressor use［OR = 1.261，95% CI（0.456，3.485），P = 0.655］，ICU admission［OR = 1.455，95% CI（0.638，3.320），P = 0.373］and 30-day mortality［OR = 1.650，95% CI（0.575，2.838）， P = 0.352］.【Conclusion】Previous IC use has no major impact on the clinical outcomes of COPD-CAP patients.

Clinical application evaluation of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for uncomplicated lower urinary tract infection / 中国中药杂志

A questionnaire survey of 1 000 clinicians having experience in treating uncomplicated lower urinary tract infections from different levels of hospitals was conducted to mainly evaluate the applicability and effectiveness of clinical application of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for uncomplicated lower urinary tract infection(hereinafter referred to as Guideline). The research was conducted with the three-level quality control strictly throughout the process, and the data was real and reliable. The survey's results showed that: most clinicians considered that the Guideline had good clinical applicability. The availability and price of the recommended medicine were moderate. Traditional Chinese medicine had obvious features and advantages in treating lower urinary tract infection for it could reduce the usage of antibiotics and shorten the course of antibiotic application. In the recommendation section, clinicians proposed increasing medication guidance, updating the Guideline timely, as well as increasing treating methods and techniques, strengthen propaganda and promotion, and improve the use of evidence-based methods. In the evaluation of effectiveness, the majority of clinicians agreed that the definition in both traditional Chinese medicine (TCM) and Western medicine and differential diagnosis in the Guideline were accurately described and the basic principle of treatment as well as the treating method of TCM were recommended appropriately. The TCM formulas and Chinese patent medicine had good effect. Some clinicians suggested refining the syndrome differentiation of stranguria. Some clinicians considered that the formulas and herbs recommended in Guideline didn't have obvious effect and some had doubts about the manipulation of fumigation and washing in the part of other methods recommended in Guideline. Moreover, specification and procedure of manipulation of fumigation and washing using herbs and the acupuncture included in characteristic TCM therapy treating uncomplicated lower urinary tract infection remained to be developed.

Inhibitory effect of bone marrow mesenchymal stem cells on early stage of inflammation in mice exposed to silica dust / 中国职业医学

OBJECTIVE: To study the effects of bone marrow mesenchymal stem cell( BMSC) transplantation on early stage of inflammation in mice exposed to silica dust. METHODS: Specific pathogen free healthy male C57 BL /6 mice were used.Five mice were used to isolate BMSCs using bone marrow adherent method. Thirty mice were randomly divided into 3groups: control group,silica group and BMSCs transplantation group. The mice of the control group were given 20. 0 μL of0. 90% sodium chloride solution by one time intratracheal injection. The mice of silica group and the BMSCs transplantation group first received 20. 0 μL( 250 g / L mass concentration) of silicosis dust suspension by one time intratracheal injection; followed by 500. 0 μL of 0. 90% sodium chloride solution in the silica group,and 500. 0 μL of BMSCs suspension( cell density 1 × 109/ L) by tail vein infusion in the BMSCs transplantation group 6 hours later. Mice were euthanized on the 7th day of the experiments. The histopathology changes in lung tissues were examined. The serum levels of interleukin( IL)-1β, IL-6 and IL-10 were detected by enzyme linked immunosorbent assay. Real-time quantitative polymerase chain reaction was used to detect the mRNA relative expression levels of above cytokines in the lung tissues. RESULTS: The positive rates of BMSCs surface molecules cluster differentiation( CD) 29,CD34,CD90,CD105 and CD106 were 67. 70%,0. 12%,39. 00%,37. 10% and 20. 10%,respectively. Histopathology examination showed the thickened alveolar walls,broadening alveolar septum and the damaged alveolar structure in silica group. In the BMSCs transplantation group,there was no obvious damage found in the lung tissue. There was no change in the alveolar cavity and alveolar structure was complete. The IL-1β and IL-6 levels in serum and mRNA relative expression of IL-1β and IL-6in lung tissue in the silica group were higher than those of the control group and BMSCs transplantation group( P < 0. 05).The IL-1β level in serum and mRNA relative expression of IL-1β in lung tissue in the BMSCs group were higher than those of the control group( P < 0. 05). The IL-10 level in serum and mRNA relative expression of IL-10 in lung tissue in all groups showed no statistical difference( P > 0. 05). CONCLUSION: The BMSCs can alleviate pulmonary inflammatory damage at early stage by down-regulating the expression of proinflammatory factors of IL-1β and IL-6.

Impact of the waist circumference change on new onset of diabetes in the population with impaired fasting glucose / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the impact of the waist circumference change on new onset diabetes (NOD) in the impaired fasting glucose (IFG) population.</p><p><b>METHODS</b>A total of 12 657 subjects who took part in the health examination from 2006 to 2007 and from 2010 to 2011 from the employees of Kailuan Group and met the inclusion criteria were selected as the observation cohort.Of the 12 657 subjects, 10 697 were male, 1960 were female, with age of (49.9 ± 11.3) years old. According to the baseline waist circumference (WC) measurements and its quartile in the health examinations during 2006 to 2007, the observation population was divided into four groups (first, second, third and the fourth quartile groups) . Multiple logistic regression analysis was used to test the relation between the increasing of WC and NOD.</p><p><b>RESULTS</b>The incidences in the IFG population of NOD were 4.27% (1884/12 657) in the total population;4.25% (1581/10 697) in male and 4.44% (303/1960) in females, respectively (P < 0.05) . Along with increasing WC in the 4 quartile groups, the incidences of NOD was progressively increased, which were 2.19% (235/3083) , 3.07% (333/3114) , 4.47% (473/3037) and 7.08% (843/3423) , respectively;2.34% (213/2626) , 3.06% (282/2645) , 4.37% (393/2582), 7.00% (693/2844) in males and 1.38% (22/457) , 3.12% (51/469) , 5.05% (80/455) , 7.45% (150/579) in female (P < 0.05) . Multiple logistic regression analysis showed that compared with the first quartile group, the second, third and fourth quartile group had increased risk of NOD after adjusting for age, gender and other risk factors, the OR (95%CI) values were 1.38(1.13-1.68), 1.79 (1.47-2.09) and 3.10 (2.57-3.75), respectively.</p><p><b>CONCLUSION</b>The incidence of NOD in the IFG population increased as the WC increased.</p>

Investigate circulating levels of chemokines and evaluate the correlation between these chemokines and liver function indicators in autoimmune hepatitis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>This study investigated circulation levels of chemokines (CCL2, CCL5, CXCL8, CXCL9, CXCL10) in autoimmune hepatitis(AIH) patients and evaluated the correlation between these chemokines and liver function indicators.</p><p><b>METHODS</b>A total of 5 chemokines (CCL2, CCL5, CXCL8, CXCL9, CXCL10) were measured simultaneously by cytokine beads assay(CBA) in the sera of 46 patients with AIH and 12 cases of healthy control.</p><p><b>RESULTS</b>In this study we found that serum levels of CCL2 , CXCL9 and CXCL10 in AIH patients and healthy controls were 11.79:8.39 pg/ml, 11.31:2.69 pg/ml, 15.85:4.64 pg/ml, respectively , which implied these chemokines were significantly higher in AIH patients when compared to healthy control (Z=-1.958, P=0.05; Z=-4.527, P less than 0.0001; Z=-3.84, P less than 0.0001, respectively). And circulation levels of CCL2 , CXCL8 , CXCL9 and CXCL10 in pretreatment and remission stages of patients with AIH were 29.69:11.16 pg/ml, 7.2:5.38 pg/ml, 16.02:5.47 pg/ml, 90.01:13.24 pg/ml, respectively, which showed these chemokines decreased during remission from pretreatment stage levels (t=2.985, P=0.005; Z=-2.547, P=0.0112; Z=-3.187, P=0.001; t=2.12, P=0.0015, respectively). Among AIH , CXCL8 was correlated positively with lgG(r2=0.291, P=0.0039); CXCL9 was associated positively with ALT and AST(r2=0.5324 , P less than 0.0001; r2=0.3352, P less than 0.0001); CXCL10 showed a positive correlation with ALT , AST and GGT(r2=0.9551, P less than 0.0001; r2=0.8960, P less than 0.0001; r2=0.8271, P less than 0.0001).</p><p><b>CONCLUSION</b>Serum levels of CCL2, CXCL8, CXCL9 and CXCL10 are significantly higher in patients with AIH, but decrease to levels in healthy controls after successful treatment , and circulation levels of CXCL9 and CXCL10 are associated positively with liver function indicators which can react inflammation activity of liver, all these may imply that chemokines can reflect the degree of liver inflammation and may be one of the main culprits in AIH pathological damage.</p>

Design and implementation of Geographical Information System on prevention and control of cholera / 中华流行病学杂志

To build the Geographical Information System (GIS) database for prevention and control of cholera programs as well as using management analysis and function demonstration to show the spatial attribute of cholera.Data from case reporting system regarding diarrhoea,vibrio cholerae,serotypes of vibrio cholerae at the surveillance spots and seafoods,as well as surveillance data on ambient environment and climate were collected.All the data were imported to system database to show the incidence of vibrio cholerae in different provinces,regions and counties to supoport the spatial analysis through the spatial analysis of GIS.The epidemic trends of cholera,seasonal characteristies of the cholera and the variation of the vibrio cholerae with times were better understood.Information on hotspots,regions and time of epidemics was collected,and helpful in providing risk prediction on the incidence of vibrio cholerae.The exploitation of the software can predict and simulate the spatio-temporal risks,so as to provide guidance for the prevention and control of the disease.

New advances of epigenetic study in tumors of lymphatic system---review / 中国实验血液学杂志

Epigenetics is aimed to study the heritable changes in gene expression patterns independent of alterations in genomic DNA sequence structure, and the mechanisms of translation from genotype to phenotype. In recent years, compelling evidence gathered supports a role of epigenetic alterations in the pathogenesis of lymphatic system tumors. For example, recent data from multiple laboratories indicate that several hundred genes, involving dozens of critical molecular pathways, are epigenetically suppressed in acute lymphocytic leukemia; a panel of methylation markers can be used for additional risk stratification of chronic lymphocytic leukemia patients; based on the epigenetic profiles, the class prediction models in gray zone lymphoma can be established; the epigenetic silencing of microRNAs in multiple myeloma generally appears to have intact P53 function; epigenetic therapies have broader implication and high potential for the development of immunotherapeutic strategies and so on. In this review, the latest advances of epigenetic study and the prospect of epigenetic therapy for tumors in lymphatic system are summarized.

Mutation analysis of keratin 9 gene in a family with epidermolytic palmoplantar keratoderma / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze potential mutation of keration 9 gene (KRT9) in a Chinese family affected with epidermolytic palmoplantar keratoderma (EPPK) and to correlate genotype with the phenotype.</p><p><b>METHODS</b>Genomic DNA was extracted from peripheral blood samples of 12 patients and 13 healthy individuals from the family and 100 unrelated individuals. Polymerase chain reaction (PCR) was used to amplify exons 1 and 6 of KRT9 gene. PCR products were sequenced bidirectionally in order to identify potential mutations.</p><p><b>RESULTS</b>A heterozygous transversional mutation, 488G→A, was identified in exon 1 of KRT9 gene in all patients, which has resulted in substitution of a glutamine residue for arginine acid at position 163 (R163Q) of the KRT9 protein. The same mutation was not found in the 13 healthy members from the family and 100 unrelated individuals.</p><p><b>CONCLUSION</b>The 488G→A mutation of KRT9 gene is probably the cause of EPPK in this Chinese family.</p>

Study on the quantization diagnostic method for immunoglobulin A nephropathy of qi-yin deficiency syndrome / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the method for establishing a quantization diagnostic standard for immunoglobulin A (IgA) nephropathy of qi-yin deficiency syndrome (QYDS).</p><p><b>METHODS</b>1,016 patients with primary IgA nephropathy were recruited in this study. They were randomly assigned to the training sample group (344 cases of QYDS and 456 cases of non-QYDS) and the testing sample group (77 cases of QYDS and 139 cases of non-QYDS) using SPSS software. On the basis of epidemiological survey, the typing standards for QYDS and common clinical symptoms were taken as candidate correlated factors. The correlated factors were selected using binary Logistic stepwise regression. The correlated factors were scored using conditional probability conversion method. The threshold value of the quantization diagnostics was determined using maximum likelihood method. The receiver operating characteristic (ROC) curve was drawn to calculate the area under curve (AUC), sensitivity, specificity, and accuracy rating. The retrospective and prospective tests were performed on the established quantization diagnostic standard for QYDS.</p><p><b>RESULTS</b>The quantization diagnosis threshold value of IgA nephropathy of QYDS was 12 points. The sensitivity, specificity, and accuracy rating of the quantization diagnostic standard were 75.3%, 68.0%, and 71.1% in the retrospective test, as well as 60.4%, 84.4%, and 69.0% in the prospective tests. The AUC was 0.80 and 0.78 respectively.</p><p><b>CONCLUSIONS</b>It was a feasible method to set up a quantization diagnostic standard for IgA nephropathy of QYDS by taking the occurrence frequency of symptoms. But this method failed to cover the strength information of symptoms.</p>

Inhibition of cell growth by rapamycin through targeting mammalian target of rapamycin signaling pathway in nasopharyngeal carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the effects of rapamycin on cell growth and cell cycle in CNE-1 and CNE-2 cells.</p><p><b>METHODS</b>Growth inhibition effect of rapamycin on CNE-1 and CNE-2 cells were assessed by cell counting kit-8 (CCK-8) assay. Morphological alterations of the cells were observed by microscope. Cell cycle and cell apoptosis were analyzed by FCM. The expression of mammalian target of rapamycin (mTOR) was analyzed by reverse transcription-polymerase chain reaction (RT-PCR).</p><p><b>RESULTS</b>The growth of CNE-1 and CNE-2 cells was inhibited significantly by rapamycin dose-dependently. FCM showed that CNE-1 and CNE-2 cells at 48 hours after rapamycin (150 nmol/L) treatment were arrested in the G0/G1 phase of cell cycle. However rapamycin treatment did not significantly induce apoptosis of CNE-1 and CNE-2 cells (P > 0.05). RT-PCR showed that rapamycin significantly inhibited mRNA expression of mTOR in CNE-2 cells (t = 10.625, P < 0.01).</p><p><b>CONCLUSIONS</b>Rapamycin inhibits the growth of CNE-1 and CNE-2 cells by inhibiting the progression of cell cycle, which could be achieved through decreasing the expression of mTOR.</p>

A clinical experimental study on the relationship between primary glaucoma and retinal blood perfusion due to blood viscosity / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the relationship between levels of blood viscosity and ocular hemodynamic changes in patients of primary glaucoma (PG).METHODS: The blood rheology indices (including whole blood, plasma, packed cell, relative blood visco-sities and yield stress) were determined in primary open angle glaucoma (POAG) patients, primary acute angle closure glaucoma (PAACG) patients, primary chronic angle closure glaucoma (PCACG) patients and normal control group (patients with senile cataract), 20 cases each group. The peak systolic velocity (PSV), end diastolic velocity (EDV), resistant index (RI), shape of spectra and frequency of monitor of ophthalmic artery (OA) and central artery of retina (CRA) were detected with color Doppler imaging (CDI) simultaneously. Comparing to the differences of each group with t test and giving a linear relational analysis to targets between the blood viscosity and hemodynamic of primary glaucoma patients.RESULTS: The blood rheology targets in PG groups were significantly higher than those in control group except fibrinogen. Comparing to control group, PSV and EDV in PG groups were significantly decreased but RI was remarkably increased. All targets of blood viscosity in PG patients were significantly negatively correlated with the PSV, EDV of both OA and CRA, but were significantly positively correlated with RI of OA and CRA. There were no significant correlations between the blood viscosity and ocular hemodynamics in the normal control.CONCLUSION: There are ocular blood circulation obstacles in and high level of blood viscosity PG patients, CDI has an important reference value in early diagnosis and prognosis of glaucoma.

Improvement of xylanase production by Aspergillus niger XY-1 using response surface methodology for optimizing the medium composition / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To study the optimal medium composition for xylanase production by Aspergillus niger XY-1 in solid-state fermentation (SSF).</p><p><b>METHODS</b>Statistical methodology including the Plackett-Burman design (PBD) and the central composite design (CCD) was employed to investigate the individual crucial component of the medium that significantly affected the enzyme yield.</p><p><b>RESULTS</b>Firstly, NaNO(3), yeast extract, urea, Na(2)CO(3), MgSO(4), peptone and (NH(4))(2)SO(4) were screened as the significant factors positively affecting the xylanase production by PBD. Secondly, by valuating the nitrogen sources effect, urea was proved to be the most effective and economic nitrogen source for xylanase production and used for further optimization. Finally, the CCD and response surface methodology (RSM) were applied to determine the optimal concentration of each significant variable, which included urea, Na(2)CO(3) and MgSO(4). Subsequently a second-order polynomial was determined by multiple regression analysis. The optimum values of the critical components for maximum xylanase production were obtained as follows: x(1) (urea)=0.163 (41.63 g/L), x(2) (Na(2)CO(3))=-1.68 (2.64 g/L), x(3) (MgSO(4))=1.338 (10.68 g/L) and the predicted xylanase value was 14374.6 U/g dry substrate. Using the optimized condition, xylanase production by Aspergillus niger XY-1 after 48 h fermentation reached 14637 U/g dry substrate with wheat bran in the shake flask.</p><p><b>CONCLUSION</b>By using PBD and CCD, we obtained the optimal composition for xylanase production by Aspergillus niger XY-1 in SSF, and the results of no additional expensive medium and shortened fermentation time for higher xylanase production show the potential for industrial utilization.</p>

Multi-central clinical evaluation of ginger-partitioned moxibustion for treatment of leukopenia induced by chemotherapy / 中国针灸

<p><b>OBJECTIVE</b>To prove the therapeutic effect of ginger-partitioned moxibustion on leukopenia induced by chemotherapy and effect on life quality of the patient with tumor after chemotherapy.</p><p><b>METHODS</b>Randomized, controlled, multi-central cooperative method was used and the patients confirmed to the enrolled criteria were divided in-to two groups. The test group were treated with ginger-partitioned moxibustion at Dazhui (GV 14), Geshu (BL 17), Pishu (BL 20), etc.; and the control group with oral administration of Chinese patent medicine.</p><p><b>RESULTS</b>Out of the 221 cases confirmed to program analysis, 113 cases were in the test group and 108 cases in the control group. After 10 days, the cured rate and the effective rate were 84.1% and 66.4% in the test group and 35.2% and 33.3% in the control group, respectively, with very significant differences between the two groups (both P < 0.01); fifteen days later, the therapeutic effects in the two groups were maintained. The two methods could improve clinical symptoms, with the test group being better than the control group. Any adverse response was not found in the two groups, and the injuries of functions of the heart, lung and kidney induced by chemotherapy had some improvement.</p><p><b>CONCLUSION</b>The therapeutic effect of ginger-partitioned moxibustion on luekopenia induced by chemotherapy is reliable and is better than oral administration of Chinese patent medicine, with a better duplication.</p>

Flash Visual Evoked Potential Used to Monitor Hydrocephalus Induced by Large Area Cerebral Infraction / 中国康复理论与实践

@#ObjectiveTo explore the relationship between flash visual evoked potentials (fVEP) and intracranial pressure (ICP), and the effect of fVEP on monitoring ICP treatment.MethodsICPs of 37 patients with large area cerebral infarction and intracranial hypertension were measured before and at 10 min, 20 min, 30 min, 40 min, 50 min and 60 min after mannitol treatment.ResultsThe mannitol effect to cure the large area cerebral was not well.ConclusionfVEP can monitor ICP exactly and harmless, and has importance value to instruct therapy of ICP in clinic.