Objective To observe the distribution and drug resistance of pathogens cultured from the sputum of hospitalized patients with lower respiratory infection in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) .Methods To i‐dentify the germiculture and test the drug susceptibility of the sputum or respiratory secretion isolated from the bronchial brush of 262 hospitalized AECOPD patients in People′s Hospital of Jiangxi Province from Janurary 2013 to December 2014 and analyze the results .Results Among all the AECOPD patients ,215 cases with positive sputum culture ,281 sputum pathogens were isolated . Gram‐negative bacilli were found in 190(67 .6% ) .Gram‐positive aureus were detected in 76(27 .1% ) .Fungus pathogens occurred in 15(5 .3% ) .The top six pathogenic bacteria were acinetobacter baumannii ,escherichia coli ,klebsiella pneumonia ,pseudomonas aeruginosa ,staphylococcus aureus ,streptococcus pneumonia .Drug susceptibility results showed that the drug resistance of acineto‐bacter baumannii was the strongest .Except that the drug resistance rate of cefoperazone/sulbactam and levofloxacin were less than 50 .0% ,the others were no less than 75 .0% .The drug resistance rate of escherichia coli and klebsiella pneumoniae to ampicillin , ampicillin sulbactam ,cefazolin ,ceftriaxone ,cefotetan ,gentamycin ,ofloxacin ,ciprofloxacin ,and compound sulfamethoxazole trime‐thoprim were no less than 70 .0% .The drug resistance rate of staphylococcus aureus to penicillin G ,oxacillin ,erythromycin ,clinda‐mycin were 100% .The drug resistance rate of streptococcus pneumoniae to erythromycin ,clindamycin ,tetracycline ,sulfamethox‐azole trimethoprim were greater than 75 .0% .Conclusion Gram‐negative bacilli are the main pathogenic bacterium in the AECOPD patients with lower respiratory infection .The key of treatment is to pay more attention to the bacterial culture and drug sensitive test ,use antibiotics reasonably according to the results of drug sensitive experiment .

Background Heideberg retina tomography Ⅱ(HRTⅡ) can offer the quantitative description of optic disc topography and optic nerve fiber layer thickness.The normal optic disc parameter by HRT Ⅱ from Chinese has been reported,but the comparisons between males and females or the left and right eyes are lack.ObjectiveThe goal of this study is to measure the optic disc topography of healthy people with HRT-Ⅱ.Methods Four hundreds eyes from 108 healthy male subjects and 92 healthy female subjects aged 10-72 years were measured with HRT Ⅱ in this study.The parameters of optic disc including disc area,cup area,rim area,cup/disc area ratio,rim/disc area ratio,cup volume,rim volume,cup depth,maximal cup depth,height variation,mean RNFL thickness,and RNFL cross-sectional area were analyzed and compared between the gender or left and right eyes.Oral informed consent was obtained from all of the subjects before this procedure.Results There were no significant differences in measuring parameters by HRTⅡ between female and male subjects (P＞0.05) or between right eye and left eye (P＞0.05).Conclusion The results can be used as a normal reference of optic disc parameters of HRT Ⅱ.

AIM: To construct lentiviral vector carrying the angiopoietin-1(Ang-1) gene,and make it express Ang-1 in the rat mesenchymal stem cells(rMSCs).METHODS: The cDNA encoding the CDS of Ang-1 gene was obtained from the placenta of the adult Fisher 344 rats with RT-PCR.After digestion with restrication endonuclease,the Ang-1 gene was recombined to construct the transfer plasmid PNL-Ang1-IRES2-EGFP.The three-plasmid system of lentiviral vector was consisted of PNL-Ang1-IRES2-EGFP,the packaging plasmid HELPER,and the envelope plasmid VSVG,which were co-transfected to 293T cells mediated by lipofectamin2000 to produce lentiviral particles.The rMSCs were infected by obtained lentiviral particles.The insertion of Ang-1 gene was detected by PCR,the mRNA expression of Ang-1 in rMSCs was detected with RT-PCR,the protein expression of Ang-1 was observed with immunocytochemistry and Western blotting methods.RESULTS: The result of sequencing showed that the cloned Ang-1 gene was consistent with the sequence reported in GenBank.After digestion with restrication endonuclease,the 1 512 bp fragment of Ang-1 gene and the 10.5 kb vector fragment of PNL-IRES2-EGFP were observed with gel electrophoresis.The insertion of Ang-1 gene in viral genome was confirmed.The EGFP expression was observed with the fluorescent microscope.In infected rMSCs,the mRNA and protein expressions of Ang-1 were confirmed.CONCLUSION: Lentiviral vector carrying Ang-1 gene has been successfully constructed.The infected rMSCs are able to express the Ang-1 mRNA and Ang-1 abundantly.This will facilitate the following exploratory development of Ang-1 gene-modified rMSCs.

OBJECTIVE To investigate the pathogenic bacteria distribution and susceptibility of lower respiratory tract infection in patients in our respiratory ward.METHODS All the clinical isolates from sputum or secretion of lower respiratory tract from 2003 to 2007 were analyzed retrospectively.RESULTS A total of 1529 clinical isolates were collected,including 1326 strains of Gram-negative bacilli(86.7%) and 203 strains of Gram-positive cocci(13.3%).The proportion of Gram-negative bacilli was higher in lung underlying diseases group when compared with non-lung underlying diseases.Haemophilus parainfluenzae and H.influenzae were susceptible to spectinonycin,doxycycline and third-generation cephalosporins.Pseudomonas aeruginosa and Acinetobacter baumanni were susceptible to meropenem,cefoperazone/sulbactam and cefepime.Klebsiella pneumoniae and Escherichia coli were susceptible to meropenem,cefoperazone/sulbactam and amikacin.The major Gram-positive isolates were highly resistant to azithromycin,erythromycin,penicillin.All Staphylococcus aureus isolates were susceptible to vancomycin.Streptococcus pneumoniae isolates were highly susceptible to meropenem,levofloxacin,cefazolin and vancomycin.CONCLUSIONS Infection caused by Gram-negative bacilli are predominant in lower respiratory tract infection patients,especially in the patients with lung underlying diseases.Antibiotics resistance of some pathogens become increasingly severe.Therefore,the rational use of antibiotics is important for the containment of bacterial resistance.

Objective To investigate the clinical manifestations, imaging features, diagnosis and management of pulmonary mycosis.Methods Fifty-four patients were identified with pulmonary mycosis by pathological examination in our hospital from January 2002 to June 2008. Data of clinical manifestations, imaging features, diagnosis and management were retrospectively reviewed.Results Of the 54 cases, 30 (55.6%) were pulmonary aspergillosis, 15 (27.8%) were pulmonary cryptococcosis. Underlying disease was reported in 42 of 54 (77.8%) cases. The diagnosis of all the patients was confirmed by pathological exami-nation. Lung or bronchi tissue was obtained by operation in 30 (55.6%) cases, by bronchofibroscope in 12 (22.2%) cases, by CT-guided percutaneous needle biopsy in 9 (16.7%) cases, and by lymphoid node biopsy in 4 cases. Main symptoms included cough (41, 75.9%), expectoration (30, 55.6%), hemoptysis (20, 37.0%), fever (16, 29.6%), and asymptomatic (6, 11.1%). The X-ray and chest CT showed masses or nodule lesions (41, 75.9%), patchy lesions (8, 14.8%), cavity (12, 22.2%), diffuse milliary nodules (1 case). Bilateral lungs were involved in 7 cases (13.0%);right lung alone in 26 cases (48.1%);left lung alone in 21 cases (38.9%). Among the 54 cases, 41 (75.9%) were misdiagnosed before pathological examination. Thirty (55.6%) cases underwent surgical resection of pulmonary lesions. One patient suffered from cryptococcal meningitis after operation. Twenty (37.0%) patients received systemic anti-fugal therapy. Cure or significant improvement was found in 16 cases. Conclusions The most frequently isolated fungi were Aspergillus, followed by Cryptococcus. Final diagnosis is mainly dependent on pathological examination. Clinical manifestations, imaging features, diagnostic procedures and management are different due to the difference of pathogenic fungi. Satisfactory Results can be obtained by anti-fungal therapy combined with surgical management.

Objective The aim of this study was to assess the value of △Np63α in predicting tumor recurrence after curative resection in esophageal squamous cell carcinoma (ESCC) patients.Methods We analyzed △Np63α protein cxpression in 304 clinicopathologically characterized ESCC cases by immunohistochemistry.Results We found △Np63α expression was positive in 122 (40％) of 304 cases.△Np63α expression was higher in the cancer tissue than in non-tumorous control tissue at protein level(P =0.034).There was a significant difference of △Np63α expression in patients categorized according to invasive depth (P =0.001),tumor position (P =0.001) and lymph nodes metastasis condition (P =0.001).Multivariate analyses showed that △Np63α was an independent prognostic marker for ESCC recurrence.Conclusion △Np63α is associated with outcome of ESCC and can be a novel predictor for poor prognosis of ESCC patients after curative resection.

0.05).Conclusions The local cell-mediated immunity of PTC is in the status of obviously suppressed.But the local impaired immune response against carcinoma is not associated with lymph node metastasis of PTC.

ObjectiveTo assess the balance between regulatory T (Treg) cells and T helper 17 (Th17) cells in patients with serofast syphilis.MethodsBlood samples were collected from 26 patients with serofast syphilis and 23 normal human controls.Flow cytometry was performed to determine the proportion of Treg and Th17 cells in peripheral blood and to quantify the expression of specific transcription factors Foxp3 and ROR-γt in CD4+ T cells of these subjects.Correlation analysis was carried out.ResultsThe proportion of Treg cells in CD4+ T cells in the patients with serofast syphilis was 33.28％ ± 11.84％,significantly higher than that in the normal controls(22.13％ ± 7.79％,P ＜ 0.01 ),while the proportion of Th17 cells was significantly lower in the patients than in the normal controls(3.17％ ± 2.32％ vs.8.87％ ± 2.00％,P ＜ 0.01 ).Enhanced expression of Foxp3 and attenuated expression of ROR-γt were observed in CD4+ T cells from the patients compared with the controls(2994.86 ± 1099.18 vs.2539.72 ± 1086.96,P ＜ 0.05; 1473.12 ± 752.20 vs.1778.34 ± 388.13,P ＜0.05).There was a negative correlation between the expression of Foxp3 and ROR-γt in CD4+ T cells from all the subjects (r =-0.481,P ＜ 0.01 ).ConclusionThe Treg/Th17 cell balance is abnormal in peripheral blood of patients with serofast syphilis.

Objective To investigate the humoral and cellular immune responses in patients with acute brucellosis, and evaluate dynamic changes of regulatory T-lymphocytes (Foxp3+ Treg) in the peripheral blood of patients during treatment, in order to clarify the relationship between immunosuppression and the therapeutic effect in human brucellosis.Methods Sixty-five patients with brucellosis hospitalized at the Third Department of Infectious Diseases, Heilongjiang Agriculture and Reclamation Bureau General Hospital between July 2015 and November 2015 were included.Twenty-eight patients were treated with conventional therapy (group A: patients received 3 courses of treatment.Each lasted for 20 days with one-week interval), and 37 patients were treated with conventional therapy in combination with immunopotentiator (group B).Thirty healthy volunteers were enrolled as the controlled group.The ratio of CD3+CD4+ Foxp3+ Treg cells in the peripheral blood of brucellosis patients were measured by flow cytometry (FCM) at the end of each course of treatment.Data in accordance with normal distribution were described as mean±standard deviation.Comparison between two groups was done by two sample t test.Comparison among multiple groups was performed by analysis of variance and SNK test.Data that did not fit the normal distribution were analyzed by multiple-sample nonparametric test.Results After the first (20 d), second (50 d) and third course of treatment (80 d), the ratios of Foxp3+Treg in the peripheral blood of 65 acute brucellosis patients were 2.83%, 3.77% and 4.03%, respectively, which were all significantly higher than control group (1.69%;t=5.97, 9.05 and 5.66, respectively, all P<0.01).At the end of the first course of treatment, the ratios of Foxp3+Treg in group A and B showed no statistically difference (t=0.33, P>0.05), while those were both higher than control group (t=7.09 and 4.94, respectively;both P<0.01).At the end of the second course, the ratio of Foxp3+ Treg in group B was higher than group A (t=2.22, P<0.01), and both of them were higher than control group (t=10.79 and 7.25, respectively;both P<0.01).At the end of treatment, Foxp3+ Treg in group A was also significantly higher than the other two groups (t=6.02 and 6.45, respectively;both P<0.01).Conclusions In patients with acute brucellosis treated with the standard antibiosis treatment in combination with immunopotentiator, the ratio of Foxp3+Tregs significantly increases and maintains at a high level, which suggests that extra immunopotentiator may be not helpful for the treatment of brucellosis at the very early stage.

Objective To establish a surgical risk prediction model for in-hospital mortality of adult rheumatic heart disease.Methods The study sample comprised of 3 889 patients with adult (is, or older than 18 years) rheumatic heart valve surgery only.All patients were divided into three subgroups according to the surgery site of left atrioventricular valve: mitral valve surgery group;aortic valve surgery group;and mitral and aortic valve surgery group.The data was splited into development(60％) and validation(40％) data sets, and then the risk model was developed by using a logistic regression model according to the data in development data set.Model calibration was analyzed by Hosmer-Lemeshow goodness-of-fit statistic, and model discrimination was tested by calculating the area under the receiver operating characteristic(ROC) curve.Risk score was finally set up according to the coefficient β and rank of variables in logistic regression model.Results The general in-hospital mortality of the whole group is 4.2％ (165/3 889).We established a risk prediction model and found seven risk factors: heart function in NYHA functional class ≥ Ⅱ grade (OR =3.36, 95％ CI: 2.42-4.67) , preoperative creatinine ＞ 110 mmoL/L (OR =2.69, 95％ CI: 1.51-4.79) , history of previous chest pain(OR =2.33, 95％ CI: 1.07-5.11) , surgical status(OR =2.32, 95 ％ CI: 0.94-5.73) , previous history of hypertension (OR =2.24, 95 ％ CI: 1.19-4.23), preoperative critical state (OR =2.14, 95％ CI: 1.27-3.60) and age ＞ 50 years (OR =1.57, 95 ％ CI: 1.18-2.09).Our risk model showed good calibration and discriminative power for the development data set, validation data set, and three subgroup in which Hosmer-Leme-show test' s P value were greater than 0.05 and the area under the ROC curve were greater than 0.70.Scoring methods: age 51-60years: 1 point, age 61-70 yeas: 2 points, age ＞70 years: 3 points;history of hypertension: 1 point;creatinine ＞ 110 umol/L: 4 points;NYHA class stage Ⅱ : 2 points, NYHA class stage Ⅲ: 4 points;NYHA class stage Ⅳ: 6 points;history of previous chest pain: 1point;preoperative critical condition: 2 points;urgent surgery: 2 points: emergency surgery: 4 points.Conclusion We have created a new risk prediction model and risk score, which can accurately predicts outcomes in patients undergoing heart valve surgery for our center.Furthermore, our risk model can also enable benchmarking and comparisons between multicenter in a meaningful way in the future.