Comparison of different susceptibility testing methods of tigecycline against imipenem-resistant Acinetobacter baumannii / 实用医学杂志

Objective To evaluate the susceptibilities of different testing methods of tigecycline against IRAB. Methods MIC and inhibitory zone diameters of 32 strains of IRAB for tigecyclinc were determined by different testing methods.Data were analyzed by comparing the results from each method to those produced by the reference macro broth dilution method. Results The rates of sensitivity intermediate resistance detected by macro broth dilution method , agardilution , MTS and Vitek-2 instrument , disk diffusion method were as follows , 34.375%, 65.625%, 0%, 3.125%, 81.25%, 15.625%, 75%, 25%, 0%, 78.125%, 21.875%, 0%, 3.125%, 81.25%, 15.625%. Compared with macro broth dilution method ,the key major error rate of other methods was 0% by FDA breakpoints , but the CA and EA rates were less than 90%. Conclusions Tigecycline has good activity against the IRAB, with significant difference in susceptible rate among the different methods.

Differential diagnosis of malignant and benign peripheral pulmonary lesions based on two characteristic echo features of endobronchial ultrasonography / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the feasibility of endobronchial ultrasonography (EBUS) in the differential diagnosis of malignant and benign lesions based on the two characteristic echo features of malignancy.</p><p><b>METHODS</b>EBUS images from 102 patients undergoing bronchoscopy for peripheral lung lesions were analyzed. The sensitivity and specificity were determined for each echo feature, namely the halo sign and low-level echoes that indicated malignancy, or their combination in diagnosing malignant and benign lesions.</p><p><b>RESULTS</b>Low-level echoes showed a sensitivity of 89.46% and a specificity of 83% in the diagnosis of malignancy, both higher than those of the halo sign (69.51% and 65%, respectively). The presence of either of the two echo features had a diagnostic sensitivity of 94.6% for malignant lesions, and the coexistence of the two features had a specificity of 93% for a diagnosis of malignant lesions.</p><p><b>CONCLUSION</b>EBUS is a useful adjunctive modality for lung cancer diagnosis, especially in cases where peripheral lung lesions are invisible in conventional bronchoscopy.</p>

Preparation of a monoclonal antibody against polyhedrin of Ectropis obliqua nucleopolyhedrovirus / 生物工程学报

To develop a method based on immunoreactions for detection of Ectropis obliqua Nucleopolyhedrovirus (EoNPV), the polyhedra of the virus were purified and used to immunize the mouse BALB/c. The spleen cells from the immunized mice were then fused with the myeloma cell line Sp2/0. A hybridoma cell line which can stably secrete the monoclonal antibody against EoNPV was achieved by using indirect ELISA screening and cloning methods, and was named as 7D3. Meanwhile, the polyhedrin gene was cloned from EoNPV and expressed in E. coli. Western blotting analysis showed that the monoclonal antibody prepared from 7D3 could specifically react with the recombinant polyhedrin. An indirect ELISA method based on this monoclonal antibody for detecting EoNPV in infected tea looper was developed.

Pathological basis of air bronchogram examined by endobronchial ultrasound in patients with peripheral lung cancer / 中国肺癌杂志

<p><b>BACKGROUND AND OBJECTIVE</b>Air bronchogram were visible in endobronchial ultrasound images of benign and malignant lesions. The aim of this study is to analyze the endobronchial ultrasound images of different characteristics of air bronchogram and clinical significance combined with pathologic section.</p><p><b>METHODS</b>From June 1, 2005 to December 30, 2008, 92 patients were found pulmonary peripheral lesions by X-ray and CT examinations, and confirmed that lesions were located lower to the segmental bronchial orifice by flexible bronchoscopy examinations. These patients were examined by radial endobronchial ultrasound probe afterwards.</p><p><b>RESULTS</b>Seventy-eight patients clarified with benign or malignant diagnosis of lesions were analyzed, among whom, 22 of 47 (46.8%) were of malignant lesion without air bronchogram, 22 patients in 25 of lesions without air bronchogram were confirmed malignant (88%), among whom, 66.7% (2/3), were of small cell lung cancer, 43.9% (18/41) were of non-small cell lung cancer, and 50% (5/10) were of poorly differentiated adenocarcinoma, no sign of air bronchogram was found in corresponding pathological sections. Among those patients with malignant lesion, 51.1% (24/47) were of irregular air bronchogram. For patients with malignant lesions, irregular air bronchogram was most commonly found in adenocarcinoma, 55.2% (16/29) of pathological sections showed signs of air bronchogram, similar sign was also found in 2 patients with moderately differentiated adenocarcinoma and 1 patient with poorly differentiated adenocarcinoma. The total percentage of patients without air bronchogram and with irregular air bronchogram was 97.9% (46/47), only one of them (with medium differentiated adenocarcinoma) showed regular air bronchogram (1.3%). 80.6% (25/31) patients with benign lesion showed regular sign of air bronchogram distributed in the shape of concentric circles, the percentage of patients without air bronchogram or with irregular air bronchogram was both 3.8% (3/31).</p><p><b>CONCLUSION</b>When there's no air bronchogram, or irregular air bronchogram sign found by endobronchial ultrasound examination, it is highly indicated that there is a malignant lesion, while there's regular sign of air bronchogram distributed in the shape of concentric circles, it is likely to be a benign lesion.</p>

Morphology and edge analysis of endobronchial ultrasound images in 47 patients with pulmonary malignant lesions / 中国肺癌杂志

<p><b>BACKGROUND AND OBJECTIVE</b>By analyzing morpholoy and edge of endobronchial ultrasound (EBUS) images in 47 patients with pulmonary malignant lesions. The aim of this study is to explore the role of EBUS in the diagnosis of pulmonary malignant lesions.</p><p><b>METHODS</b>From June 1, 2005 to June 30, 2006, EBUS analysis was performed in a proportion of patients with malignant or benign lesions.</p><p><b>RESULTS</b>In total 78 patients of confirmed diagnosis, 47 cases were confirmed malignant lesions, and 31 were benign lesions, male 56 cases, female 22 cases, age span from 21-80 years (58.01 +/- 13.20). The statistics of the lesion edge imaging in 78 patients showed that different position and angle did not affect the morphous of the edge; analysis of the relationship between the size of the lesion and the morphous of the edge shows that the size of the lesion does not affect the morphous of the edge; the comparison between lesions of benign and malignant shows that a clear edge is the major feature of malignant lesions, indicating certain value in diagnosis; comparison between the shape of the lesion and the property of the lesion shows no relationship between them; compared to conventional bronchoscopy operations, the EBUS operation consumes approximately 10 min, and no related complication was found.</p><p><b>CONCLUSION</b>Clear morphous of the edge in EBUS is a feature of the malignant lesion, and EBUS has certain value in the diagnosis of the malignant lesions.</p>

Clinical analysis of four cases of pulmonary actinomycosis misdiagnosed as peripheral lung cancer / 中国综合临床

Objective To investigate the clinical characteristics of pulmonary actinomycosis and to improve the understanding of the clinical misdiagnosis of pulmonary actinomycosis. Method Clinical data of 4 pulmonary actinomycosis patients were analized and related literatures were reviewed. Results All the 4 pulmonary actinomy-eosis cases were misdiaguosed as lung cancer. Pulmonary actinomycosis can be correctly diagnosed through lung bi-opsy by CT-guided percutaneous paracentesis,fiberoptic,bronchoscopy,or pathological examination of the resected pulmonary lobe. Conclusions Pulmonary actinomycosis is a rare lung infection caused by fungus,and is liable to be misdiagnosed as peripheral lung cancer. The capacity of distinguishing pulmonary actinomycosis from peripheral lung cancer needs to be improved.

An analysis of treatment for invasive pulmonary infections with Candida species / 中国实用内科杂志

Objective To evaluate the diagnosis and treatment for the patients infected with Candida species.Methods A total of 47 patients with persistent fever,pathology of pulmonary infection,no response to the antibiotic therapy,Candida species found in sputum after long time hospitalization were retrospectively analyzed.Results The 47 patients were 24 males and 23 females.The mean age was 57.0?16.1.The mean temperature was(38.4?0.6)℃ and all lasted for over 6 days.Pulmonary infections with Candida species was diagnosed at the(17.7?5.2)th day after admission.The species isolated were 38 strains Candida albicans,5 strains Candida glabrata,2 strains Candida kruseic,1 strain Candida tropicalis,and 1 strain Candida lusitaniae.Fluconazole was given to 28 patients(2 with voriconazole as sequential therapy),itraconazole to 9(2 with voriconazole too),voriconazole in 7(including the 4 patients mentioned above),Casfungin aceate to 7,Amphotericin B to 1(Casfungin aceate was given alone later for serious adverse reactions).Results two patients infected with C.albicans and Candida glabrata separately had no improvement in the 28 patients treated with fluconazole,but voriconazole showed good effect on the 2 patients.Two patients infected with C.albicans and Candida glabrata separately had no improvement to itraconazole in the 9 patients treated with Itraconazole,but voriconazole showed good effect on them too.The 7 patients treated with voriconazole all had good effect,including 3 infected with Candida glabrata,1 with Candida lusitaniae,3 with C.albicans.Conclusion Candida albicans is the main pathogen in this group of invasive pulmonary infections with Candida species.All the patients have fever and long-time hospitalization.The currently used antifungal drugs,such as voriconazole,Casfungin aceate,are reliable.Caspofungin is generally better tolerated than other antifungal drugs.

Clinical application of endobronchial ultrasound examination through fiberoptic bronchoscope / 中国实用内科杂志

Objective To evaluate the clinical value of endobrochial ultrasound (EBUS) examination,a new ultrasound technique.Method 15 patients with space occupying lesions in lung or doubted obstructive pneumonia or atelectasis were examined by EBUS.The procedure was performed with ultrasound catheters,which were introduced into bronchi through the operating channel of fiberoptic bronchoscope and a full 360℃ cross-sectional image was obtained.Result The bronchial wall was highly echogenic and laminated.The lung parenchyma appeared echo rich and patchy.Pulmonary vessels can be identified by the echo free lumen and the pulsatile changes.Echo poor bronchial carcinomas proved in pathology destructed bronchial wall in different extent were detected in 10 patients.1 patient with nodule in right apical segment who had intact bronchial wall was with tuberculosis proved by operation.1 patient with pleural effusion and atelectasis was detected by EBUS and found no abnormal echo,showing that the reason for atelectasis was compression instead of obstruction.Among the 3 patients who were suspected to have obstructive pneumonia,in 1 case ultrasound scanning showed enlarged lymph node outside the bronchus compressing the wall caused the channel mild narrow;as to the other 2 cases,because bronchial wall was complete and no tumor like echo were found,the obstructive factor was excluded.The ultrasound examination had no particular risk and caused little discomfort.Conclusion Endobronchial ultrasound scan can clearly demonstrate the adjacent extraluminal lesion or structure within the brochial wall itself,which is safe and effective.

The influeuce of IL-2 on the immunologic function of the NPC patients treated with radiotherapy and chemotherapy / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the combining therapy which not only have cured effect but also can uphold and improve the NPC patient′s immunity function after radiotherrapy and chemotherapy.Method:90 cases randomly divided into 3 groups ①Local group (local injected with IL-2 +radiotherapy+chemotherapy);②General group(ivdrip with IL-2+radiotherapy+chemotherapy);③convention group(radiotherapy+chemotherapy).Checked and observed the immunity function around the immunotherapy and after the radiotherapy and chemotherapy.Result:Cellular immunity of 3 groups are lower and humoral immunity are hypetuntion than normal person.After treated with IL-2 the cellular immunity improves but there′s no great change of the humoral immunity. The immune status of the immune groups have not obvious change than before radiotherapy,at the same time,the cellular immunity of the convention group cut down and the humoral immunity doesn′t change obviously.Conclusion:①It has some effect to uphold and improve the NPC patient′s immunity function to treat with small dosage of IL-2 before radiotherapy and chemotherapy,general treatment is better than local injection;②The three therapies have not great influence on the patient′s humoral immunity.

Infection after cardiac-lung transplantation in ICU / 中国实用内科杂志

Objective To explore the characteristics of infection after cardiac-lung transplantation.Methods March 23th 2006,one patient received orthotopic heart-lung transplantation,the clinical data were observed and analyzed.Results Depend on etiology,antibioti and antifungul were selected,the patient recoved.Conclusion It is very important to early etiology diagnosis and reasonable selection of antibiotic.

Self-expanding metallic stents for treatment of benign tracheobronchial stenosis / 中华放射学杂志

Objective To report the use of self expanding metallic stents in treatment of benign tracheobronchial stenosis. Methods Nineteen patients with benign tracheobronchial stenosis were treated with implantation of self expanding stents (Ultraflex, Microvasive). Results Stents produced immediate improvement in clinical pulmonary sign and symptoms. Pulmonary function tests in 10 patients demonstrated a mean improvement in FEV1of 45%, FVC of 38%. Following up duration ranged from 10-18 months. Complications included recurrent pneumonia in 3 patients, airway obstruction due to granuloma formation in 2 patients, and stent migration in 1 patient. They were treated successfully with antibiotic therapy, laser therapy, and stent reimplantation, respectively. Conclusion Self expanding metallic stent implantation is a feasible and effective method of treating benign tracheobronchial stenosis.