Objective To evaluate the effect of the de-escalation therapy of antimicrobial agents combined bronchoalveolar lavage on the treatment of acute stroke complicate pulmonary infection.Methods 80 patients of acute stroke complicated pulmonary infection were randomized into two groups.The method of the de-escalation therapy of antimicrobial agents combined bronchoalveolar lavage was used in therapeutic group(n=40)while the patients in control group(n=42)received routine therapy of antimicrobial agents.The effective rate,the bacteria1 eradication rat,the average time of pneumonia absorption and the average time NICU stay between two groups were compared and analyzed.Results The effective rate and the bacteria1 eradication rat in therapeutic group were significantly higher than those in control group(P

Objective To learn the domestic investigation into pulmonary cryptococcosis in the 22 years.Methods We retrieved the literature about pulmonary cryptococcosis included in CMCC,and summarized the clinical data of 67 patients suffering from pulmonary cryptococcosis.Results The clinical situation and radiological manifestation of pulmonary cryptococcosis were diverse and nonspecific.Cryptococcal meningitis was the commonest complication(31.34%).Almost all patients with pulmonary cryptococcosis were once misdiagnosed.Final diagnosis mainly depended on the smear,culture or pathological examination of various clinical specimens.Therapeutic tool involved resection with operation and the application of anti-fungi drugs.Conclusion To increase the cognition to the disease is the key to increase the final diagnosis rate.Therapeutical effect of anti-fungi drugs should be emphasized,especially the application in preoperation and postoperation can decrease the dissemination of cryptococcus after operation,which might result in cryptococcal meningitis.

Objective To explore the changes of the peripheral blood soluble Fas (sFas) and soluble FasL (sFasL) in patients of diabetes complicated with tuberculosis,in order to provide the basis for condition judgment and intervention.Methods The patients of diabetes complicated with tuberculosis (diabetes comphcated with tuberculosis group,25 cases),simple diabetes (diabetes group,25 cases),simple tuberculosis (tuberculosis group,25 cases) and healthy person (control group,25 cases) were selected.The peripheral blood sFas,sFasL and T-lymphocyte subsets were examined by enzyme-linked immunosorbent test.Results The peripheral blood sFas,sFasL in diabetes complicated with tuberculosis group,diabetes group,tuberculosis group was higher than that in control group[(7.91 ± 1.93),(8.74 ± 2.12),(7.86 ± 1.61)mg/L vs.(2.10 ±0.88) mg/L and (562.37 ± 196.38),(1512.32 ±303.48),(607.48 ± 102.53) ng/L vs.(263.18 ±46.32) ng/L](P＜ 0.05).The peripheral blood sFas,sFasL in diabetes group was higher than that in diabetes complicated with tuberculosis group and tuberculosis group (P ＜ 0.05).With sFasL 1000 ng/L as boundary value,the diagnostic coincidence rate of diabetes complicated with tuberculosis group and diabetes group was 90.00％ (45/50).CD3 +,CD4+ T-lymphocyte subsets in diabetes complicated with tuberculosis group,diabetes group,tuberculosis group was lower than that in control group (0.3376 ± 0.0712,0.2368 ± 0.0803,0.4801 ± 0.0896 vs.0.5849 ± 0.0487 and 0.1798 ± 0.0401,0.2100 ± 0.0679,0.2312 ± 0.0487 vs.0.2811 ± 0.0348) (P ＜ 0.05).CD3 + T-lymphocyte subsets in diabetes complicated with tuberculosis group was higher than that in diabetes group and lower than that in tuberculosis group (P ＜ 0.05).CD4+ T-lymphocyte subsets in diabetes complicated with tuberculosis group was lower than that in diabetes group,tuberculosis group(P ＜ 0.05).CD8+ T-lymphocyte subsets in diabetes complicated with tuberculosis group,diabetes group was higher than that in control group (0.3209 ± 0.0707,0.2831 ± 0.0794 vs.0.2086 ± 0.0589)(P ＜ 0.05).CD8+ T-lymphocyte subsets in diabetes complicated with tuberculosis group was higher than that in diabetes group and tuberculosis group (0.2287 ± 0.0690)(P ＜ 0.05).C D3 +,CD4+,CD8+ T-lymphocyte apoptotic rate in diabetes complicated with tuberculosis group,diabetes group,tuberculosis group was higher than that in control group [(4.34 ± 2.08)％,(3.22 ± 2.12)％,(2.59 ± 1.41)％ vs.(1.01 ± 0.38)％,(5.12 ± 1.58)％,(4.82 ± 1.98)％,(3.21 ± 1.19)％ vs.(1.78 ±0.53)％ and (1.45 ±0.52)％,(2.31 ±2.01)％,(1.62 ± 1.33)％ vs.(1.07 ± 0.38)％] (P ＜ 0.05).CD3 +,CD4+ T-lymphocyte apoptotic rate in diabetes complicated with tuberculosis group,diabetes group was higher than that in tuberculosis group (P ＜0.05).CD8+ Tlymphocyte apoptotic rate in diabetes group was higher than that in tuberculosis group (P ＜ 0.05).Conclusions The peripheral blood sFas and sFasL exists abnormal increase in patients of diabetes complicated with tuberculosis.CD3+,CD4+ T-lymphocyte decreasing shows that the patients exist immune function disorder.sFas and sFasL may be involved development process of disease,and the peripheral blood sFasL content can also be used as auxiliary indicators for identifying diabetes patients with tuberculosis.

Objective To investigate antibiotic resistance of Klebsiella pneumoniae and Escherichia coli in old patients with lower respiratory tract infections. Methods Kirby Bauer agar diffusion method was used to evaluate the drug sensitivity in 240 strains of Klebsiella pneumoniae and Escherichia coli isolated from patients with lower respiratory tract infection. Phenotypic confirmatory test recommended by NCCLS1999 was used to detect extended spectrum beta lactamases(ESBLs). Results The resistant rates of Klebsiella pneumoniae and Escherichia coli to 14 antibiotics in old patients and in non old patients with lower respiratory tract infections were amoxicillin 93 2% vs 87 3%, piperacillin 57 1% and 42 9%, cefuroxime 51 4% and 33 3%, cefotaxime 40 1% and 17 5%, ceftazidime 13 6% and 3 2%, ceftriaxone 39 0% and 17 5%, cefoperazone 37 3% and 15 9%, cefepime 10 2% and 3 2%, amikacin 47 5% and 34 9%, ciprofloxacin 54 2% and 38 1%, imipenem 0, cefoperazone/sulbactam 0, piperacillin/tazobactam 1 1% vs 0, and cefmetazole 9 6% and 4 8% respectively. Out of 240 clinical strains of Klebsiella pneumoniae and Escherichia coli, 78(32 5%) were considered ESBLs producers by phenotypic confirmatory test. The prevalence of ESBLs in old patients was 38 4%, which was much higher than that in non old patients(15 9%). The resistant rate of ESBLs producing strains to imipinem, cefoperazone/sulbactam, piperacillin/tazobactam and cefmetazole was the lowest, being 0, 0, 2 6% and 12 8%. Conclusions The resistant rates of Klebsiella pneumoniae and Escherichia coli to most antibiotics and the prevalence of ESBLs in old patients with lower respiratory tract infection were higher than that in non old patients. Imipinem, cefoperazone/sulbactam, piperacillin/tazobactam and cefmetazole were the effective antibiotics to infections caused by ESBLs producing strains.

BACKGROUND: Anterior and lateral columns of the femoral head integrity and stability have been reported to present a positive correlation with the prognosis of the osteonecrosis of the femoral head (ONFH) and efficacy of hip preserving. China-Japan Friendship Hospital Classification stressed that the retention of the anterior and lateral columns of the femoral head was of great importance to avoid the femoral head collapse, but there is little reported on its three-dimensional (3D) digital model.OBJECTIVE: To explore the method of establishing highly-simulated 3D model of China-Japan Friendship Hospital Classification for ONFH.METHODS: 3D reconstruction of normal and necrotic femoral head was established according to the CT and MRI of individuals with normal femoral head. A healthy adult male volunteer was selected and his CT image was collected; three adult male patients with types L1, L2 and L3 ONFH were selected, whose MRI images were obtained, respectively. 3D solid models were established based on CT and MRI data on Mimics 15.0, Geomagic Studio 13, Geomagic Design X, Solidworks2014 and Abauqus6.14 software. RESULTS AND CONCLUSION: A highly-simulated 3D model of L type ONFH was established, including the corticaland cancellous bones of ilium and proximal femur, articular cartilage, necrotic articular cartilage, muscles, joint capsuleand ligaments. It clearly showed the spatial structures of L type ONFH, by which different surgical programs could be compared in a virtual environment for selecting an appropriate treatment strategy to improve the success rate of hip preserving. The highly-simulated 3D model paves ways for surgical simulation and biomechanical analysis.

0.05). In the improvement of irregular menstruation, lumbosacral discomfort and morbid leucorrhea, the effect of the treatment group was significantly superior to that of the control group (P0.05). The hemodynamic indices of uterine arteries in the treatment group was significantly improved after treatment (P

Objective To evaluate the immediate and short term therapeutic efficacy of percutaneous transluminal septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy (HOCM) and to investigate the prevention of the related complications. Methods PTSMA was conducted in 3 patients with HOCM refractory to medication. The immediate effect was evaluated by pressure monitor, but the follow up effect by observation of the clinical symptoms and ultrasonic cardiogram. Results The left ventricular outflow tract gradients triggered by ventricular premature beats decreased from 143 mmHg (ranging from 70 to 180 mmHg) to 53 mmHg (ranging from 30 to 80 mmHg). Complete atrioventricular block (Ⅲ?AVB) with atrioventricular node rhythm was found in 1 case, and complete right branch bundle block (CRBBB) in another one. Follow up of the 3 cases at 6 months after operation revealed remarkable improvement of the patients' cardiac function (NYHA), disappearance of angina pectoris, and obvious attenuation of ventricular septal hypertrophy and SAM (systolic anterior motion of mitral) phenomenon. Conclusion PTSMA is an effective method with satisfactory short term effect for the patients with HOCM refractory to medication.

BACKGROUNDPathology is the "gold standard" of the diagnosis of lung cancer, but at present there are few articles about evaluating the value of cytopathological check. The aim of this study is to evaluate the value of cytopathological check in the diagnosis of primary bronchogenic carcinoma of the lung.

METHODSA total of 552 samples' cytopathological results of 248 patients from January 2003 to May 2005 in this hospital were retrospectively analyzed. The samples included pleural fluids (110 for 68 patients), materials from lung puncture (33 for 31 patients), smears of transcatheter bronchial brushing (152 for 138 patients), bronchoalveolar lavage fluids (30 for 26 patients) and sputa (227 for 118 patients).

RESULTSThe positive results of different specimens were as follow: the pleural fluids was 69.12%, the materials from lung puncture 67.74%, the smears of transcatheter bronchial brushing 65.22%, the bronchoalveolar lavage fluids 23.08% and sputa 21.19% respectively. The positive rates of the pleural fluids, the materials from lung puncture and the smears of transcatheter bronchial brushing were higher than that of the bronchoalveolar lavage fluids and sputa (P < 0.01). There was no significant difference among the positive rates of the pleural fluids, the materials from lung puncture and the smears of transcatheter bronchial brushing, and between the positive rates of the bronchoalveolar lavage fluids and sputa (P > 0.05).

CONCLUSIONSThe cytopathological examination is helpful for the diagnosis of primary bronchogenic carcinoma of the lung, and is one of the important ways to the diagnosis of primary bronchogenic carcinoma of the lung.

OBJECTIVETo study the status of oral pharyngeal carriage and characteristics of Haemophilus influenzae (Hi) in healthy preschool children in Fuzhou.

METHODSSix hundred and three healthy children in two representative kindergartens in Fuzhou were studied as research subjects, and the rates of oral pharyngeal carriage of Hi were studied in four seasons. All Hi strains were serotyped and biotyped.

RESULTSThe oral pharyngeal carriage of Hi in day care nursery healthy children were 36.7% in winter, 18.0% in autumn, 12.4% in summer and 10.9% in spring respectively. Serotype Hib was preponderant in autumn (6.9%). In winter, the carriage rates of NTHi and Hib were 17.1%, 5.4% respectively. The carriage rates of other serotypes were low. Biotype VII and VIII were preponderant in autumn, spring and summer but biotype VII and VIII were decreasing evidently in winter.

CONCLUSIONThere was evident seasonal difference in the rates of oral pharyngeal carriage and type of Hi in healthy preschool children. The carriage rate of Hi strains was high in autumn and winter. Results suggested that while the inoculation of Hib-binding bacterial vaccine was expanded the study on new bacterial vaccine of Hi still needs to be augmented.

Carrier State ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Haemophilus influenzae ; classification ; isolation & purification ; Humans ; Male ; Pharynx ; microbiology ; Seasons ; Serotyping

Objective To study the effects of carpesium abrotanoides petroleum ether fraction on phagocytic function of macrophages and antibody forming cell in mice.Methods The extract carpesium abrotanoides petroleum ether fraction,forty five mice were divided into the control group and low and high dose groups of carpesium abrotanoides petroleum ether fraction by random number table method,15 mices in each group.The low-dose and high-dose groups of carpesium abrotanoides petroleum ether fraction were given 50 mg/kg and 100 mg/kg respectively by gavage for 10 days.The spleen weight,growth index,the phagocytosis of macrophages and the number of antibody-forming cells in peritoneal macrophages of mice were detected by chicken erythrocyte phagocytosis test and hemolytic plaque test.Results Compared with the control group,the spleen weight (192.4 ± 11.49 mg,204.6 4 10.59 mg vs.117.6 ± 10.89 mg),the growth index (6.04 ± 0.54,6.06 ± 0.40 vs.3.89 ± 0.14),antibody forming (1 216.4 ± 94.1,1 548.8 ± 86.4 vs.361.0 ± 11.7),phagocytosis percentage of macrophages (58.60％ ± 2.60％,72.0％ ± 3.08％ vs.35.49％ ± 1.64％),and Phagocytosis index (2.01 ± 0.10,2.69 ± 0.15 vs.0.37 ± 0.06) of the groups of low doses and high doses of Carpesium abrotanoides Petroleum ether fraction significantly increased (P＜0.05).Conclusions The low doses and high doses of Carpesium abrotanoides Petroleum ether fraction can enhance the mice's specific and nonspecific immune function,and protect the immune system of mice.