Objective To evaluate the comprehensive application of the CT guided transbronchial lung biopsy (CT TBLB) and CT guided percutaneous needle lung biopsy (CT_NLB) in pulmonary peripheral lesions.Methods According to the lesion location in lung field,51 patients were selected to CT TBLB and 46 patients to CT NLB.Results In the comprehensive application of the two lung biopsy methods,the comphensive biopsy success rate was 100%,pathological diagnostic positive rate 87.6% and diagnostic correct rate 97.9% (of them 100% in CT TBLB).The complications of pneumothorax and haemoptysis were decreased significantly.The positive rate and diagnostic correct rate seem higher,but there was no significant difference between the two methods (P

Objective:To systematically review the effects of statins in the treatment of the patients with pneumonia or sepsis, and to provide evidence-based basis for the using of statin in treatment of pneumonia or sepsis.Methods:PubMed, Embase, The Cochrane Library, CNKI, WanFang Data and VIP were searched for randomized placebo-controlled trials of statins published from the establishment time of datebases to January 31, 2015.The qualities of the included studies were independently assessed by two reviewers and the relevant data was extracted for analysis using Review Manager 5.3. Results:Nine trails involving a total of 1 227 patients were included.①A total of 6 studies about the mortality of hospitalized patients were included in the Meta-analysis;compared with placebo group, statins didn’t improve the mortality of hospitalized patients with pneumonia or sepsis;risk ratio (RR)= 0.83,95%CI (0.63,1.08),P=0.17.②A total of 7 studies about the rates of mechanical ventilation usage or ICU admission of the patients were included in the Meta-analysis. Compared with placebo group,statins didn’t improve the rates of mechanical ventilation usage or ICU admission of the patients with bacteria infection;RR= 0.99,95% CI (0.96,1.03),P=0.62.③A total of 4 studies about the levels of C reaction protein (CRP)were included in the Meta-analysis. Compared with placebo group, statins significantly reduced the levels of CRP;mean differences (MD)=-8.30 mg·L-1,95%CI (-12.13,-4.47),P<0.0001. Conclusion:Statins can not significantly reduce both the in-hospital mortality and the rates of mechanical ventilation usage or ICU admission, but can significantly reduce the plasma CRP levels, and reduce the inflammation.

Objective To investigate the effects of HBx on proliferation and apoptosis of human hepatocellular carcinoma cell line HepGz in vitro and in vivo. Methods The expression plasmids of pHA-HBx encoding full length of HBx gene was transfected into HepG2 cells with Lipofectamine 2000. The proliferation activity of transformed cells was measured by calculating the growth curve,population doubling time and by the 3H-TdR incorporation rate assay. The nude mouse model of HepG2 expressing HBX gene was established and the apoptosis rate of tumor cells was detected with TUNEL assay. Results RT-PCR indicated that the HBx gene was integrated into the genome DNA of HepG2 cells and transcripted. The growth curve and population doubling time manifested that the proliferation activity of transformed cells was much higher than that of control group cells. The apoptosis rate of tumor cells expressing HBx gene was much lower than that of control group cells. ConclusionHBx facilitates the proliferation activity of hepatoma cells in vitro and in vivo and inhibits the apoptosis of hepatoma cells induced by adriamycin in nude mice.

Objective To investigate the mechanism by which HBx facilitates the proliferation of hepatoma cells. Methods The expression of plasmid pHA-HBx encoding full length of HBx was transfected into HepG2 cell lines and the transformed cells were identified by RT-PCR. The nude mouse model of transplanted human hepatoma HBx-transfected HepG2 cells was established. The expression of VEGF both in HepG2 cell-formed tumors and HBx-transfected cell-formed tumors in nude mice was examined immunohistochemically. Results RT-PCR showed that HBx gene was integrated into the genome DNA of HepG2 cells and amplified; The rate of tumor formation in nude mice both of HepG2 cells and HBxtransfected HepG2 cells was 100%; The growth speed of HBx-transfected tumors was much faster than that in control group; The average volume of HBx-transfected tumors and non-transfected tumors was 2. 86?0. 34 cm3 and 2.48?0.22 cm3 respectively after 8 weeks(t=1.905 ,P

Objective To evaluate the impact of chemotherapy compliance on the therapeutic efficacy of induction chemotherapy plus concurrent chemoradiotherapy versus induction chemotherapy plus radiotherapy alone for patients with locally advanced nasopharyngeal carcinoma (NPC). Methods Based on intention to treat analysis (ITT) for 400 patients, 314 patients were analyzed by per protocol (PP) analysis. The patients were divided into induction chemotherapy plus concurrent chemoradiotherapy group (IC/CCRT, 127 patients) or induction chemotherapy plus radiotherapy group (IC/RT, 187 patients). The patients who completed 2 cycles of induction chemotherapy and at least 2 cycles of concurrent chemotherapy in the IC/CCRT group and the patients who completed 2 cycles of induction chemotherapy in the IC/RT group were analyzed. Radiotherapy was given by two-dimensional technique with γ-ray, X-ray and electron beams. The chemotherapy regimen was FUDR plus carboplatin for induction chemotherapy and carboplatin alone for concurrent chemotherapy. Results The follow-up rate was 96.2%. 295 patients were followed to at 3 years. Based on PP analysis, Grade 3/4 toxicity was found in 23.6% of the patients in IC/CCRT group and 13.4% in the IC/RT group (χ~2 =5,50,P=0.019). No grade 4 toxicity was found in the IC/RT group. The median follow-up time was 3.9 years, and no significant difference was found between the two groups in 3-year overall survival (78.1% : 84.6% ;χ~2 = 0. 61, P =0. 435), disease-free survival (74.3 % : 70.1% ;χ~2= 0. 12, P= 0.731), Iocoregional relapse-free survival (89.7% : 89.5% ; χ~2= 0. 10, P= 0.748), or distant metastasis-free survival (78.9%:76.5% ;χ~2=0.05,P=0.825). Conclusions With more severe toxicities, the IC/CCRT regimen does not improve the overall survival in locally advanced NPC patients compared with the IC/RT regimen.

OBJECTIVE To investigate the prevalence,antibiotic resistance and genotype of the extended-spectrum ?-lactamases(ESBLs)-producing clinical isolates of Klebsiella pneumoniae.METHODS A total of 104 isolates of K.pneumoniae were examined for the ESBLs production and the susceptibilities of the bacteria to 15 antimicrobial agents.PCR was performed to detect the genes encoding the ESBLs belonging to SHV and TEM families as well as CTX-M-1 and CTX-M-9 groups.RESULTS The ESBLs-producers of K.pneumoniae were 54.0% in the total of 104 isolates.Almost all of the ESBLs-producing isolates were resistant to the antibiotics commonly used,and only remained susceptible to carbapenems and the combination of cefoperazone with sulbactam.The genes of SHV,CTX-M-1 and TEM groups were detected in the ESBLs-producing isolates by 64.3%,46.4%,and 32.1%,respectively,and 35.7% and 8.9% of ESBLs-producing K.pneumoniae strains carried two and three genes.CONCLUSIONS The clinical isolates of K.pneumoniae in Tianjin Nankai Hospital are shown a high rate of ESBLs-producing and antibiotic resistance.SHV and CTX-M-1 groups of ESBLs are the dominant genotypes in the isolates of ESBLs-producing K.pneumoniae.

Objective To analyze the therapeutic effect and prognosis of peritoneal dialysis in patients with end-stage polycystic kidney disease.Methods A retrospective analysis was performed on patients with polycystic kidney disease who were treated with peritoneal dialysis for more than 3 months between July 2007 and September 2016 in the Second Hospital Affiliated to Soochow University.A total of 45 patients were enrolled in this study.Another 45 patients of non-diabetic nephropathy were selected as the control group matched by gender,age,and time of PD initiation.The information of the two groups such as general data,dialysis related complications,incidence of peritonitis,prognosis was recorded.Survival analysis was performed using the Kaplan-Meier method and Log-rank test.The risk factors affecting patients' survival were analyzed with Cox regression model.Results There were no significant difference in pre-dialysis age,sex ratio,blood pressure,urine volume,body weight,eGFR,biochemical data,and the proportion of hypertension and diabetes mellitus in the polycystic kidney group and control group.24 h ultra-filtration volume,4 h D/Pcr,Kt/V and Ccr between the two groups showed no significant difference (all P ＞ 0.05).The incidence of peritonitis and the time of the first peritonitis in the two groups respectively as one episode per 82.4 months vs one episode per 81.5 months,(35.8±22.8) months vs (34.5±20.9) months had no statistical difference.The ratio of hernia (6.6％ vs 2.2％),thoracic and abdominal leakage (4.4％ vs 2.2％),dialysate leakage (0 vs 0),catheter dysfunction (4.4％ vs 6.6％),exit-site infections (11.1％ vs 6.6％),tunnel infections (4.4％ vs 2.2％) and non PD related infections (11.1％ vs 13.3％) had no significant difference.The 1-year,3-year,5-year patient survival of two groups respectively were 95.2％ vs 93.3％,78.9％ vs 75.0％,67.6％ vs 64.9％ (P=0.475),and 5-year technique survival was 78.7％ vs 76.7％ (P=0.623),demonstrating no obvious difference.Cox regression analysis showed that age and serum albumin were risk factors for the survival of patients.Conclusions The effect and prognosis of peritoneal dialysis in patients with polyeystic kidney and non polyeystic kidney were similar.Peritoneal dialysis is not the contraindication of polycystic kidney.Peritoneal dialysis can be used as a routine renal replacement therapy in patients with polycystic kidney disease.

Objective To clone,express and characterize a tegument protein gene of Schistosoma japonicum(Sj29),and investigate the immune protection of the recombinant protein against S.japonicum in mice.Methods The gene coding for Sj29 protein was amplified by PCR,and the sequence was analyzed by bioinformatics tools.Partial fragment of Sj29 gene was subcloned into the prokaryotic expression vector pET28c(+).The recombinant plasmid was transformed into E.coli BL21(DE3) and induced the recombinant with IPTG.The recombinant protein(rSj29) was purified by His-binding-resin affinity chromatography and characterized by Western blotting.Three groups each with 10 BALB/c mice were immunized subcutaneously three times(two weeks interval) respectively with 100 ?l recombinant rSj29(0.1 mg/ml),adjuvant or PBS.At the 15th day after the final inoculation,each mouse was challenged by 40 ?2 cercariae of S.japonicum.At the 53th day after infection,the mice were sacrificed to obtain the number of adult worms,number of eggs in liver and feces.Serum samples were collected at pre-immunization and certain time after immuniza-tion,and were analyzed for IgG by ELISA.The localization of rSj29 in worms of different developmental stages was demonstrated by immunofluorescent technique.mRNA expression level of Sj29 gene in worms of different developmental stages and three groups after infection was detected by quantitative real-time PCR.Results A 576 bp Sj29 gene fragment was obtained.The recombinant protein rSj29 with Mr 22 900 was expressed in the form of inclusion body.The recombinant rSj29 can be recognized by sera of mice immunized with rSj29 and sera of infected mice.The number of adult worms(15.4?5.9),number of hepatic eggs(40 143.3?2 995.9) and number of fecal eggs(3 803.9?110.9) in re-combinant protein group were significantly higher than those of PBS control group(20?3.4,49 318.1?6 648.3,5 238.1? 303.5,respectively)(P

OBJECTIVETo study the relationships among pathological and immunohistochemical changes in liver tissues, and the HBeAg, HBV DNA, ALT level in the patients with chronic hepatitis B.

METHODSPathological and immunohistochemical examinations of liver tissue liver function tests, serum HBV and HBV DNA detection were performed in 194 patients with chronic hepatitis B.

RESULTSThere was significant difference between the serum HBeAg positive group and the negative group in G2, G3-4 S2, S3-4 in liver tissues; The serum HBV DNA level of the groups S0 and S1-4, and the hepatic activity index between the groups G0-1 and G2-4 were significantly different. And the hepatic HBcAg positive group and HBcAg negative group were significantly different too. There was no significant difference between the HBsAg level in liver tissues as "+" group and the "++ - +++" group. The pathological diagnosis as S1 or (and) G2 is respectively 28.57%, 53.33%, 80.15%, 77.88% among the four groups with normal-mild-moderate-severe elevated serum ALT level.

CONCLUSIONSerum HBV DNA correlated with HBcAg expression in liver tissue; the HBsAg level in liver tissues have no relationship with the serum HBV DNA level. The patients with low serum HBV DNA level may have high index of hepatic activity and hepatic fibrosis. Asymptomatic carriers and patients with low serum ALT level should be encouraged to accept liver biopsy. It can determine the degree of liver inflammation and fibrosis and timing of treatment.

Adolescent ; Adult ; Alanine Transaminase ; blood ; DNA, Viral ; blood ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; genetics ; immunology ; physiology ; Hepatitis B, Chronic ; blood ; pathology ; virology ; Host-Pathogen Interactions ; Humans ; Liver ; pathology ; virology ; Male ; Middle Aged ; Young Adult

Background: Gut microbiota is closely related to the occurrence and development of diabetes and affects the prognosis of diabetic complications, and the underlying mechanisms are only partially understood. We aimed to explore the possible link between the gut microbiota and vascular inflammation of diabetic mice. Methods: The db/db diabetic and wild-type (WT) mice were used in this study. We profiled gut microbiota and examined the and vascular function in both db/db group and WT group. Gut microbiota was analyzed by 16s rRNA sequencing. Vascular function was examined by ultrasonographic hemodynamics and histological staining. Clostridium butyricum (CB) was orally administered to diabetic mice by intragastric gavage every 2 days for 2 consecutive months. Reactive oxygen species (ROS) and expression of nuclear factor erythroid-derived 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) were detected by fluorescence microscopy. The mRNA expression of inflammatory cytokines was tested by quantitative polymerase chain reaction. Results: Compared with WT mice, CB abundance was significantly decreased in the gut of db/db mice, together with compromised vascular function and activated inflammation in the arterial tissue. Meanwhile, ROS in the vascular tissue of db/db mice was also significantly increased. Oral administration of CB restored the protective microbiota, and protected the vascular function in the db/db mice via activating the Nrf2/HO-1 pathway. Conclusion This study identified the potential link between decreased CB abundance in gut microbiota and vascular inflammation in diabetes. Therapeutic delivery of CB by gut transplantation alleviates the vascular lesions of diabetes mellitus by activating the Nrf2/HO-1 pathway.