Objective To analyze and compare the clinical features of community-acquired pneumonia caused by Legionella in elderly (age≥60 years) and younger patients. Methods The epidemiological, clinical, laboratory data and the outcomes of 80 cases with community-acquired Legionella pneumonia (CALP) from January 2001 to October 2009 were studied retrospectively, and the differences between elderly and younger group were compared using univariate and multivariate analysis. Results (1) Underlying diseases, such as cerebrovascular diseases, chronic obstructive pulmonary diseases, diabetes mellitus and immunosuppressive therapy were significantly more frequent in elderly group than in younger group (all P＜0. 05). (2) No significant differences were observed between the two groups in legionella serotype. (3) Malaise, hyponatremia and hypophosphatemia were all more frequent in elderly group than in younger group (x2=5. 300, 5. 520, 4. 470; P=0. 021,0. 019, 0. 034, respectively). And elderly versus younger group had higher creatinine levels [(108.55±56.57) μmmol/L vs. (75.42±17.62) μmmol/L, t= -3. 062, P=0. 002], lower PaO2/FiO2 (＜300) (57.7% vs. 29.2%, x2=4. 120, P=0.042), less leucocyte counts [(8.34±3.65)×109/Lvs. (10.63±5.02)×109/L, t=-2.287, P=0.022]. (4) Elderly patients more likely complicated with congestive heart failure (P=0.037) and their length of staying in hospital was also longer (Z=-2.194, P=0.028). No significant differences were observed between the two groups in mortality, intensive care unit admission, and the need for corticosteroids or mechanical ventilation.Conclusions Elderly patients with CALP have a higher frequency of underlying comorbidities and more organs involvement than younger patients, although greater severity of illness at onset and outcome are not significantly different between the two groups.

Objective To evaluate the value of the peripheral capillary fasting plasma glucose examined by glucometer on screening of type 2 diabetes.Methods With the proportion stratified group sampling,all residents aged 15-75 years in Wuqing district were selected and detected on their capillary fasting plasma glucose(CFPG) by clucometer,and those whose CFPG was higher than 5.0mmol/L should have a 2-hour postprandial glucose(2 h PG) test.Data were analyzed by SPSS 11.5 software.Results The detection rates of diabetes,impaired glucose tolerance and impaired fasting blood glucose were 42.83%,27.88% and 3.74%,respectively.Making two ROC curve with test variable(FPG) and state variables(2 h PG≥11.1 mmol/L and 7.8 mmol/L≤2 h PG≤11.0 mmol/L),the areas under the curve were 0.862 and 0.405,respectively.Conclusion It is suggested to use the sensitivity standard that nears to 99% FPG≥5.0 mmol/L to screen diabetes.

The article presents an analysis of clinical signs, pathological findings and results of laboratory examinations of 10 cases of insulinoma. Diagnostic procedures such as blood sugar and serum insulin determinations, elective arteriography and CT scanning are evaluated. Besides, the relationship between the clinical signs and pathological findings were studied. The results of the study showed that the ratio of blood sugar to insulin and elective ateriography were valuable significant in diagnosing insulinoma, and that the diagnostic efficiency of CT left much to be desired. They also showed that duration of the disease had remarkable effects on patients with insulinoma.

Objective To analyze the clinical,radiologic and pathological features of endobronchial metastasis from prostate cancer, and its diagnosis and treatment. Methods Ten cases of endobronchial metastasis from prostate cancer with pathological evidence in our hospital were retrospectively analyzed.The clinical, radiologie andpathological features and the diagnostic procedures and treatment of the cases were reported and analyzed while combined with literature. ResultsAn average age at diagnosis of advanced prostate cancer was 65.5 years. Emoptysis(5/10), cough (4/10), dyspnea (4/10) and weight loss (5/10) were the common symptoms.Chest X-ray disclosed hilar and mediastinal lymphadenopathy (4/10), hilar mass (3/10) or atelectasis (2/10) . Bronchoscopic examination revealed that most of lesion located in single lobar or segmental bronchus (6/10). Bilateral upper lobe were most susceptibly involved(7/10). Polypoid lesions or mass in lumen of bronchi(8/10)were more frequent than infiltrative lesion(2/10), which could obstruct the orifice of the bronchi in different extent. Immunohistochemical staining for prostate specific antigen or prostatic acid phosphatase was positive, and most patients responded well to endocrine therapy. Conclusions Clin.ical and radiologic features of endobronchial metastasis from prostate cancer are similar to those of primary bronchogenic carcinoma. Immunohistoehemical study is helpful for differential diagnosis and the short-term efficacy of endocrine therapy is significant.

Objective To compare the differences of self-imposed delay of gratification and the characteristics of delay strategy between aggressive children and normal children, in order to provide evidence-based basis for aggressive children's education and behavior modification. Methods Using the classical self-imposed delay of gratification task to compare the ability of delay of gratification between 24 aggressive children and 24 class-, age-, gender-matched normal controls. Recording children' s delay behavior coding to compare their differences of delay strategy by using the time sampling observation method. The differences of purpose of delay of gratification was analyzed with χ2 test. The differences of their delay strategy was analyzed with the independent sample t -test. Results A significant difference was found between two groups on delay of gratification(χ2 = 13. 50, P ＜0.01). The controls showed more purpose during the waiting process than the aggressive children whose waiting was mostly without purpose or they simply gave up. The problem-solving strategy was hightlighted in the use of delay strategy for both the aggressive children(22. 38 ±11. 29) and the controls( 28. 21 ± 3. 05). The control group children used more problem-solving strategy(28.21 ±3.05) and self-control strategy(0. 71 ± 1.08) during the waiting task. Their level of delay strategy was higher than the aggressive groups ( (22. 38 ± 11. 29), (0. 13 ± 0. 45) ) (P ＜ 0. 05). Conclusion The aggressive children are less capable of self-imposed delay of gratification,the purpose of behavior is weaker and the level of delay strategy is lower than normal children.

Objective: To investigate the tendency and correlation between connective tissue growth factor (CTGF) and low density lipoprotein receptor-related protein (LRP) in human pulmonary fibroblasts-1 (HPF-1) induced by transforming growth factor beta1 (TGF-?_1) at different times. Methods: After the HPF-1 cells were stimulated with TGF-?_1 (5 ?g/L) at different times (0 h, 3 h,6 h,12 h and 24 h),CTGF and LRP mRNA expressions were analyzed by RT-PCR. The same preparation steps of cell culture were repeated, then, the protein expressions were determined by Western Blot, co-immunoprecipitation Western Blot and immunocytochemistry. Results: The expressions of CTGF and LRP mRNA had similar tendency, and LRP (224.87?7.00) correlated with CTGF (131.53?2.86) positively (r= 0.8402, P

Objective: To investigate the changes of gastric intramucosal pH(pHi)and the association with hemody namics and oxygen utilization during cardiopulmonary bypass (CPB). Method: Adults (n=15)free of hepatic, pulmonary,and renal diseases undergoing nonemergent heart surgery,were selected. After induction of general anesthesia and endotracheal intubation,a tonometer nasogastric tube was positioned in the stomach to determine the intramucosal pH. Hemodynamics and oxygen utilization data and phi were measured at four times:30 minutes after induction of anesthesia; 15 minutes after termination of cardiopulmonary bypass; at the terminal of the surgery;and 1 day after the surgery. Result: Cardiac index significantly increased(P

Objective To describe the clinical and radiological characteristics, diagnosis, and treatment of bronchobiliary fistula (BBF). Methods From December 1975 to June 2007, 6 patients with BBF were successfully diagnosed and treated in this hospital. A retrospective analysis was performed and literatures on the disease were reviewed. Results All the cases were acquired BBF. The etiologies included liver abscess (3 cases), trauma (2 cases), and postoperative complication of hepatic carcinoma (1 case). The main symptoms the patients complained of were fever (6 cases), cough (6 cases), biliptysis (6 cases), dyspnea (4 cases), abdominal pain in right quadrant (4 cases) and pleuritic chest pain (2 cases). On physical examination, tenderness in the right upper quadrant (4 cases), dull percussion (3 cases), abnormal breath sounds (3 cases), percussion tenderness over hepatic region (2 cases) were main abnormalities. All the 6 patients underwent antibiotics treatment and percutaneous transhepatic biliary/abscess drainage. One of them underwent radiological coil embolization of the fistula. All the patients showed clinical improvement. Follow-up survey showed 1 case of cure, 1 case of long-term drainage until death of biliary tract bleeding one year later, and 4 cases of lost in follow-up. Conclusion Bronchobiliary fistula is characterized by biliptysis. Minimally invasive treatment should be the first therapeutic option.

Objective To evaluate the usefulness of MR cisternography in epidermoids of the cerebellopontine angle (C-P angle).Methods The findings of MR cisternography of epidermoids of the C-P angle in 19 cases confirmed by surgery were analysed retrospectirey.The signal intensity of tumors,the effect on nerves and vessels by tumor were evaluated.Results MR cisternography depicted tumors as slight-medium hypointense (n=19) to CSF. 84% of patients had involvement of the trigeminal nerves (n=16); 42% of patients had involvement of the facial nerve and the acoustic nerve (n=8); 26% of patients had involvement of the internal carotid artery (n=5); 21% of patients had involvement of the vertebral-base artery (n=4). Conclusion MR cisternography contributes to show the anatomic details of the C-P angle and clearly depicte the relationship between tumors and nerves as well as vessels. Thus it can provide useful informations for the presurgical planning and approach of C-P angle epidermoids.

Objective To evaluate the effect of lidocaine on B cell lymphoma 2 gene (Bcl 2) and CPP32 protein expressions of hippocampus CA1 neurons after transient global cerebral ischemia Both genes are closely related to the development of apoptosis Methods Twenty four healthy adult rabbits weighing (3 0?0 2)kg were randomly divided into three groups: sham operative group (SH group, n=6); ischemia group (IS group, n=9) received normal saline 1 5ml I V 5min before ischemia and lidocaine group (LI group, n=9) received 2% lidocaine 10 ml/kg I V 5 min before ischemia Global cerebral ischemia was induced by the occlusions of bilateral common carotid and vertebral arteries All the rabbits were decapitated 24 h after ischemia and brain tissue was removed immediately Expressions of Bcl 2 and CPP32 proteins of hippocampus CA1 neurons were detected by immunoblotting Results Expression of Bcl 2 in IS group and LI group increased significantly as compared with that in SH group (P