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Objective To understand the empiric antimicrobial use in patients with pyelonephritis in a hospital,and pro-vide reference for clinical rational antimicrobial use.Methods Data of 620 patients with pyelonephritis admitted to the nephrology department of a hospital between January 2011 and September 2014 were collected,application of antimicrobial agents,coincidence between empiric antimicrobial use and antimicrobial susceptibility testing results in patients with different diseases and different ages were analyzed.Results Before antimicrobial susceptibility testing results were reported,620 pa-tients use 625 times of antimicrobial agents,5 of whom used two kinds of antimicrobial agents at the same time,8 varieties in 15 types of antimicrobial agents were involved,the most frequently used antimicrobial agents were third generation ceph-alosporins,cephamycins,and fluoroquinolones.The overall,partial,and non-coincidence rate between antimicrobial use and antimicrobial susceptibility testing results were 64.32%(n=402),8.32%(n=52),and 27.36%(n=171)respective-ly.The overall coincidence rate in patients with acute pyelonephritis was higher than those with chronic pyelonephritis (77.61% [n=357]vs 58.79%[n=97],P <0.05).The overall coincidence rate in patients <50 years old and ≥50 years old were 68.12%(156/229)and 75.25%(298/396)respectively,there was no significant different between two groups (χ2 =2.93,P =0.09).Conclusion The non-coincidence rate between empiric antimicrobial use and antimicrobial suscepti-bility testing results is high,measures needs to be taken to improve the empiric antimicrobials use.
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Objective To evaluate PBL teaching results in medical virology experiment course. Methods Medical students of class 2011 were randomized assigned into PBL group (n=45, 20 five-academic-year students and 25 seven-academic year students) and control group (n=63, 38 five-academic-year students and 25 seven-academic year students). Teaching effectiveness was evaluated by scores of experiment, medical virology examination and final examination. PBL group was surveyed with questionnaire. SPSS statistical software was used and t test was employed to do analysis. Results Scores in medical virology examination were higher in seven-academic-year students in PBL group than in control group and there was no difference in other two examination scores between the two groups. Survey showed that interest motivation, case analysis, experiment design and knowledge grasp-ing in PBL group were highly satisfied. However, evidence-based and generalization ability among seven-academic-year students as well as autonomous learning ability and ability to deduce material among five-academic-year students were not completed satisfied. Conclusions PBL with public health events in medical virology experiment course can develop students' intrinsic motivation, knowledge grasping and public health awareness. However, PBL methods should be adjusted to suit different academic students.
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<p><b>OBJECTIVE</b>To evaluate the safety and immunogenicity of seasonal inactivated influenza vaccine (split virion) and to analyze its cross-reactive antibody responses to H7N9 avian influenza virus.</p><p><b>METHODS</b>An open-labeled clinical trial was carried out in infants aged 6-35 months, adults aged 18-60 years and the elderly aged >60 years. After vaccinations (one dose for adults and the elderly and two doses for infants), adverse events were observed. Serum samples were obtained before vaccination and 21 days after vaccination from adults and elderly subjects. Three types of antibody against seasonal influenza virus and antibody against H7N9 avian influenza virus were tested using microhemagglutination inhibition (HI) assay. Immunogenicity of the vaccine was evaluated based on the immunogenicity criteria for adults and the elderly, set by the Committee for Medicinal Products for Human Use (CHMP) for the European Medicines Agency.</p><p><b>RESULTS</b>A total of 202 subjects (65 infants, 69 adults and 68 elderly) were enrolled and injected for at least one dose. The overall rate of adverse events was 12.4% (25/202) and most of them were under systemic reaction. No serious adverse event was reported. Pre- and post-vaccination serum samples were collected from 124 subjects (64 adults, 60 elderly). After 21 days of vaccination, the sero-conversion rate, sero-protection rate, and geometric mean titer (GMT) ratio (post-/pre-vaccination) of antibody against seasonal influenza virus were 78.1%-90.6%, 92.2%-100.0% and 7.9-41.0 among adults while 66.7%-83.3%, 86.7%-100.0% and 5.7-20.4 among the elderly, respectively. However, after vaccination, both sero-conversion rate and sero-protection rate of antibody against H7N9 avian influenza virus among adults and the elderly became zero, with GMT ratio between 1.2 and 1.4.</p><p><b>CONCLUSION</b>This trial vaccine appeared to have good safety and immunogenicity but inducing no cross-reactive antibody response to H7N9 avian influenza virus.</p>
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Adult , Aged , Aged, 80 and over , Child, Preschool , Humans , Infant , Middle Aged , Young Adult , Antibodies, Viral , Blood , Antibody Formation , Cross Reactions , Hemagglutination Inhibition Tests , Influenza A Virus, H7N9 Subtype , Influenza Vaccines , Allergy and Immunology , Therapeutic Uses , Vaccines, Inactivated , Allergy and Immunology , Therapeutic UsesABSTRACT
Objective To investigate the expression of RGC32 gene in pulmonary adenocarcinoma tissue and to explore the influence on proliferation and apoptosis of A549 cells.Methods Real-time PCR was applied to detect the expression of RGC32 gene in 36 cases of pulmonary adenocarcinoma and pericancerous tissues.RNA interference was used to inhibit the expression of RGC32 gene.After RNA interference,the expression of RGC32 gene was detected by real-time PCR,the apoptosis of the transfected cells was detected by flow cytometry and the inhibition ratio of cell proliferation was detected by methyl thiazolyl tetrazolium (MTT).Results The expression of RGC32 gene was upgraded in pulmonary adenocarcinomas tissues(1:2.2736,t=-29.185,P=0.01).After RNA interference,the expression of RGC32 gene transfected A549 cells was down-regulated significantly[(2.47±0.17)％ vs(4.65±0.26)％,t=-202.868,P=0.000].Comparing to the control cells,the apoptosis of experimental group cells increased significantly (2.9 ％ vs 45.4 ％,t=-37.915,P=0.01),and the inhibition ratio of cell proliferation increased significantly.Conclusion The expression of RGC32 gene shows an obvious upgraded in pulmonary adenocarcinoma.The low expression of RGC32 gene can induce apoptosis and inhibit proliferation of A549 cells.
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Determining the approach to spread the knowledge and technology for preventing birth defects using the diffusion of innovations theory.Identifying the target group,orientation messages and promotion guidelines based on related literature,laws and clinical epidemiology studies.Pathways integrating both inter-personal communication and IT have pushed the adoption percentage of innovative knowledge for preventing birth defects up from 0％ to 97 ％ in almost no time,helping the region ranking the first in China.The innovation diffusion model has caught attention of both the government and all the community.Prevention measures against birth defects are accepted community wide,while medical workers are regulated by law in their behaviors of mothers and children healthcare services to set a model for prevention of other diseases.
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Objective To investigate the role of BMSCg on enhancing the implant survival and bacheal epithelium regeneration. Methods After transplanted with cryopreserved 2 weeks and 6 weeks allocraft, PHK-26 labeled 3-5 passage BMSCs were injected into the recipient rats via tail vein. Rats in the control groups were injected with the same amount of PBS.We observed the histology of the transplanted trachea including epithelium growth and regeneration, and the PKH-26 fluorescence levels at the para-anastomotic trachea to evaluate the role of BMSC transplantation on the epithelium regeneration. Results Rats from BMSCs injection group survived a long period. Histological observation showed that the tracheal lumen was covered by psudo-striated ciliated columnar epithelium. The cartilage structure was intact. There are no signs of denaturation and necrosis. In the PBS injection group, epithelium regeneration is better in PBS-6-week group than PBS-2-week group. The longest survival time in PBS-6-week group was 32 days, whereas it was 10 days in PBS-2-week group. In BMSCs injection group, rats in BMSC-6-week groups survived longer than 8-week group(12 rats were terminated at 1 week, 4 weeks and 8weeks as planned). There was one rat who survived and were terminated at the designated 8 weeks time point (there were 8regenerated epithelium was similar in the two BMSC transplanted groups. PKH-26 labeled BMSCs migrated to the implant site and showed red fluorescence, with most red fluorescence shown at the anastomotic part. Conclusion BMSCs can migrate to the impaired tissue to repair it. BMSCs may exert their reparation function via enhancing epithelium regeneration.
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Objective To explore the value of 18F-fluorodeoxyglucose（18F-FDG）PET-CT and CT in diagnosing bronchioloalveolar carcinoma （BAC）.Methods The PET-CT and CT findings of 15 patients with BAC pathologically confirmed were retrospectively analyzed.Results According to 18F-FDG PET-CT,there was definite diagnosis of malignant in 8 cases（53.3 %）,no exclusion of malignancies in 2 cases （13.3%）,definite diagnosis of benign tumors in 5 cases（33.3%）.The misdiagnosis rate of 18F-FDG PET-CT is higher.According to CT,there was definite diagnosis of malignant tumors in 11 cases（73.3 %）,no exclusion of malignancies in 2 cases（13.3%）,definite diagnosis of benign tumors in 2 cases（13.3%）.Conclusion The false negative rate and the misdiagnosis rate are high when SUVmax as 2.5 was employed as criteria in the diagnosis of BAC.To improve diagnosis accuracy and decrease misdiagnosis of BAC,we should be familiar with the CT images of different BACs and adjust the SUVmax as a diagnosis value.
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BACKGROUND: Chitosan is commonly prepared using emulsion freeze-drying methods, which is complexly operated. OBJECTIVE: To introduce a simple methods for the preparation of chitosan and analyze its biological characteristic. DESIGN, TIME AND SETTING: Controlled observation experiments were carried out in the Central Laboratory, the Second Affiliated Hospital of Chinese Medical University (Shenyang, Liaoning, China) from April to December in 2007. MATERIALS: Ten Wistar rats of 8 weeks old and SPF grade were adopted. Chitosan powder in separated packs, with 99% purity and 99% deacetylation degree were the product of Shandong Jinan Ocean Bio-Product Co., Ltd. (China). METHODS: Acetic acid solution was added into chitosan to prepare 8% chitosan acetic acid hydrosol, which was then stayed for one day. Flowing the immersion into the hydrosol and immediate dislodgement, plastic tube was soaked in 1 mol/L sodium hydroxide for 3 minutes. Hydrosol out of the tube etiolated and coagulated into jells, the tube was removed when the jells were semi-dried. Subsequent to complete drying, chitosan tubes were prepared as an internal diameter of 5 mm, and were cut into many segmentations (length 2 mm). The prepared tubes were subcutaneously implanted into rat muscular tissues at right McBurney point, while rat left muscular tissues were only incised and sutured, taking as controls. MAIN OUTCOME MEASURES: Gross observation of chitosan tube, degradation percentage of chitosan tubes in rat muscular tissue, and tissue inflammation change around chitosan tube detected by hematoxylin-eosin stain. RESULTS: The surface of chitosan tube was smooth and the tenacity was good. Intramuscular implantation test showed that 50% and 90% chitosan tubes were absorbed by tissues in 4 weeks and 8 weeks postoperatively. Inflammatory reaction surrounding tubes was decreased gradually. CONCLUSION: It gives a new kind of way to prepare chitosan tube, with few materials, low cost, simple operation and short time. The prepared chitosan tubes approve the good histocompatibility and biological degradation.
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Objective:To investigate the chemical composition changes in vitreous humor of rabbits at different times after the death of acute acidosis. Methods: 30% Sodium Dihydrogen Phosphate were used in rabbits to induce the animal model of acute acidosis,and we observed the ionic concentration changes in vitreous humor at different times. Results:72 hours after the death of acute acidosis,the concentration of Potassium,Magnesium,Phosphorus in vitreous humor were gradually increased and Calcium were decreased gradually with the time of death. Sodium performance instability,the change of chlorinity firstly decreased and then increased.Potassium ions was closely related to death time (R2=0.976 1). Conclusion:After the death of acute acidosis,the concentration of Potassium in the vitreous humor of rabbits can be used to infer PMI in the death of acute acidosis.
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BACKGROUND: Esophageal replacement or reconstruction should be performed after esophageal resection. There are still no suitable substitutes for esophagus if the conventional esophageal substitutes cannot be used.OBJECTIVE : To investigate the feasibility of applying a pulmonary tissue with vascular pedicle to repair the intrathoracic esophageal defect.DESIGN: A prospective animal investigation.SETTING: Department of Thoracic Surgery, Second Hospital Affiliated to China Medical University.MATERIALS: This trial was carried out in the laboratory of Department of Thoracic Surgery, Second Hospital Affiliated to China Medical University during January 2003 to June 2004. Fourteen adult mongrel dogs of either gender, with body mass of 12 to 18 kg, were provided by Animal Room, Second Hospital Affiliated to China Medical University (License No.SYXK (Liao) 2003-0019).METHODS: Of 14 anesthetized dogs, the middle lobe of right lung was dissected and its right middle lobar bronchus was ligated without damaging pulmonary and bronchial vessels in order to make pulmonary flap. A part of full-layer intrathoracic esophageal wall was resected, which was 4 cm long and 1/2 to 2/3 circled esophageal wall. The defect was patched by pulmonary tissue with vascular pedicle which was inosculated with esophageal cross section. On the 3rd day after operation, intravenous transfusion was performed to maintain nutrition. Qn the 7th day after operation, the dogs were given oral liquid soft food gradually 2 weeks after the operation. The access to the food and the survival of dogs were observed. Every 2 dogs were sacrificed respectively at the 2nd, 4th, 6th, 8th and 10th postoperative weeks. To observe the healing of esophageal defect, light microscope, transmission electron microscope, esophagography and endoscope were used in this study.MArN OUTCOME MEASURES: ①Survival situation and access to food of dogs after operation. ② The healing of esophageal defect of dogs.RESULTS: Three of fourteen dogs died within one week after operation. Eleven dogs survived. ① The survival and access to food of experimental dogs after operation: One dog was alive without problems for more than 170 weeks. The living dogs could be fed orally on the 7th day after operation. ② The healing at esophageal defect of experimental dogs:At the 2nd week after operation, the esophageal defect was covered with collagen layer and inflammatory exudation. A little epithelization was observered at free edge of the anastomosis, which was 1 to 2 layers of stratified squamous epithelium cells. At the 4th to 6th weeks after operation, the internal surface of the defect was covered with 3 to 5 layers of stratified epithelium cells. At the 8th to 10th weeks after operation, the luminal surface of the defect was covered with 6 to 8 layers of stratified epithelium cells. The pathological changs of pulmonary flap mainly included pulmonary alveoli atelectasis and pulmonary fibrosis, and some inflammatory cells without infective focus were observed. In the transmission electron microscope examination, newborn stratified squamous epithelium cells were. found on the surface of pulmonary tissue flap at esophageal defect.CONCLUSION: It is feasible to repair the partial irregular intrathoracic esophageal defect with the autologous pulmonary flap in dogs.
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Objective: The purpose of our experiment is to use new type esophageal prosthesis, which is pulmonary tissue with vascular pedicle, to repair the partial esophageal defect. Methods: Twelve adult mongrel dogs were used for the study. Middle lobar bronchus of right lung was ligated and incised, so the pulmonary tissue with vascular pedicle was made. A 4 cm long and 1/2～2/3 circled esophageal wall, and full-thickness defect was created. The defect was patched by pulmonary tissue with vascular pedicle. Results: Seven dogs were put to death at planned times after the reconstructive operation. One dog is still alive without any problems for more than 12 months. One dog survived 38 days and then died of chronic empyema. The other three dogs died of anastomotic leak at 5～7 days after operation. The living dogs could be fed orally at seventh day after operation. Epithelization was found in the luminal surface of the defect. Conclusion: It was feasible that the partial esophageal defect was replaced by pulmonary tissue with vascular pedicle.
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<p><b>OBJECTIVE</b>To demonstrate the side effects of malariotherapy and to explore safe procedures in conduct of malariotherapy for human immunodeficiency virus (HIV) infected patients.</p><p><b>METHODS</b>Twenty HIV/acquired immunodeficiency syndrome (AIDS) patients were selected for the study of malariotherapy and were intravenously infected with Plasmodia vivax to induce therapeutic malaria. Malaria was terminated with chloroquine after 10 - 20 malarial febrile episodes. Clinical assessments were made before (baseline), during (malarial phase) and after (post) termination of malaria. The density of Plasmodia in peripheral blood from the HIV/AIDS patients were compared to that from HIV-negative naturally infected malarial patients who donated the blood for the therapeutically induced malaria. CD(4) cell baseline levels were correlated to the severity of malarial symptoms and parasitemia.</p><p><b>RESULTS</b>There were no significant differences of Plasmodium density between the HIV/AIDS patients injected with P. vivax and the HIV-negative blood donors. However, it was found that the HIV-positive patients had milder malarial symptoms and parasitemia with progressively lower CD(4) cell baseline levels. All patients developed every day or every other day fever episodes with headache and shaking chill. These symptoms were well tolerated with the aid of anti-pyretic medications. Spleen and liver enlargement were seen in 15 of 20 and 4 of 20 patients respectively. Transitory liver effects with increase of serum glutamic-pyruvic transaminase were seen in 2 of 20 during malarial phase. Most patients experienced mild to medium anemia and 6 of 20 patients developed thrombocytopenia during malarial phase. All these side effects disappeared after termination of malaria or within one month thereafter. No complications occurred in these patients.</p><p><b>CONCLUSIONS</b>Therapeutically induced acute vivax malaria was well tolerated in 20 HIV-positive subjects who represented a range of CD(4) cell levels from 1868/ micro l to 15/ micro l. Malariotherapy did not induce complications while increasing CD(4) cell levels in most treated HIV/AIDS patients (results published elsewhere).</p>
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Adult , Animals , Female , Humans , Male , CD4-Positive T-Lymphocytes , HIV Infections , Therapeutics , Immunotherapy , Methods , Lymphocyte Count , Malaria, Vivax , Allergy and Immunology , Plasmodium vivax , Allergy and ImmunologyABSTRACT
<p><b>OBJECTIVE</b>To explore the mechanisms of malariotherapy for human immunodeficiency virus (HIV)-infected patients and to identify which stage(s) of HIV infection is suitable for the treatment of malariotherapy.</p><p><b>METHODS</b>Therapeutic acute vivax malaria was induced and terminated after 10 fever episodes in 12 HIV-1-infected subjects: Group 1 (G1) had 5 patients with CD(4) T-cell counts >or=500/ micro l at baseline, Group 2 (G2) had 5 patients with CD4 at 499 - 200/ micro l and Group 3 had 2 patients with CD(4) < 200/ micro l (not included in statistical analysis). Enzyme-Linked-Immuno-Sorbent Assay (ELISA) was used to measure plasma levels of cytokines and soluble activation markers. Flow cytometry was used to measure levels of lymphocyte subsets and phenotypes and CD(4) cell apoptosis. Bayer bDNA assay was used to test plasma levels of HIV-1 RNA (viral load). Samples were taken and tested twice before malaria (baselines), three times during malaria and seven times after termination of malaria (at day 10 and 1, 3, 6, 12, 18 and 24 months).</p><p><b>RESULTS</b>Levels of plasma tumor necrosis factor-alpha (TNF-alpha), soluble TNF-alpha receptor-2 (sTNF-RII), neopterin (NPT) and soluble IL-2 receptor (sIL-2R) significantly increased during malaria and sharply reduced to baselines post malaria in all groups. Stronger responses of the aforementioned factors were seen in G2 than in G1 during malaria (P = 0.081, 0.001, 0.013, 0.020). CD4 count and percentage; CD(4)/CD(8) ratio and CD(25)(+) and CD(4)(+)CD(25)(+) percentages increased but HLA-DR+ percentage decreased either during or post malaria in G2. Most G2 patients experienced sustained increase but most G1 patients underwent natural history decline of CD(4) counts and percentages during 2-year follow-up. Percentage of apoptotic CD(4) cells decreased post malaria in all groups. G3 patients had weaker immune responses, however, one advanced AIDS patient in this group experienced clinical improvement after malariotherapy. Most of the 12 patients experienced increase of HIV viral load during malaria but the viral load returned to baseline levels 1 - 3 months after cure of malaria and remained near baseline levels for up to two years.</p><p><b>CONCLUSIONS</b>Part of the mechanisms of malariotherapy is to induce high levels of cytokine activities and subsequently the changes of T-lymphocyte subsets and phenotypes in HIV-infected patients. These findings suggest that malariotherapy may treat HIV-1-infected patients whose CD4 baselines are in the range of 500 - 200/ micro l.</p>
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Adult , Female , Humans , Male , Acute Disease , CD4 Lymphocyte Count , Cytokines , Blood , HIV Seropositivity , Allergy and Immunology , Therapeutics , Virology , HIV-1 , Malaria, Vivax , Allergy and Immunology , Viral LoadABSTRACT
5.70log copies/mL)were determined.All patients received a treatment regimen consisting of indinavir plus combivir(AZT+3TC)for12months.During the treatment,changes in CD4 + T cell counts were monitored using a MultiSET flow cytometric assay while changes in HIV-1viral load were determined by bDNA method(range of detection1.70~5.70log RNA copies/mL).The treatment-related adverse events were clinically evaluated.Results Twelve months after the initiation of HAART,CD4 + T cell counts increased by a mean of267?10 6 cells/L(P
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500?10 6/L), case 6～10 as sub-group2(SG2, CD4 at 499～200?10 6/L), case 11～12 (CD4