Abstract: Objective　To investigate the diagnostic value of joint detection of Mycobacterium tuberculosis rifampicin resistance gene (Xpert MTB/RIF), Mycobacterium tuberculosis ribonucleic acid (TB-RNA) and Mycobacterium tuberculosis deoxyribonucleic acid (TB-DNA) in bronchoalveolar lavage fluid for smear-negative pulmonary tuberculosis. Methods A total of 806 patients with suspected smear-negative pulmonary tuberculosis admitted to our hospital from May 2020 to July 2022 were selected, 506 patients diagnosed as bacterial negative pulmonary tuberculosis by clinical, X-ray and sputum samples were classified as bacterial negative pulmonary tuberculosis group, and the other 300 patients with non-tuberculous pulmonary disease were classified as non-tuberculous pulmonary disease group. XpertMTB/RIF, TB-RNA and TB-DNA in bronchoalveolar lavage fluid of all patients were detected. With clinical, X-ray and sputum specimen examination of mycobacterium tuberculosis as the gold standard, the diagnostic efficacy of alveolar lavage solution Xpert MTB/RIF, TB-RNA and TB-DNA alone and in combination was analyzed. Results The positive detection rates of Xpert MTB/RIF, TB-RNA and TB-DNA in bronchoalveolar lavage fluid of the smear-negative pulmonary tuberculosis group and the non-tuberculosis pulmonary disease group were 69.96% (354/506) and 2.67% (8/300), 61.46% (311/506) and 5.00% (15/300), and 63.64% (322/506) and 8.00% (24/300), respectively. The rates in the smear-negative pulmonary tuberculosis group were higher than those in the non-tuberculosis lung disease group, and the differences were statistically significant (χ2=342.005, 246.930, 235.687, P<0.01). Compared with the gold standard, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of Xpert MTB/RIF in the diagnosis of smear-negative pulmonary tuberculosis were 69.96%, 97.33%, 80.15%, 97.79% and 65.77%, respectively; those values of TB-RNA were 61.46%, 95.00%, 73.95%, 95.40% and 59.38%, respectively; those values of TB-DNA were 63.64%, 92.00%, 74.19%, 93.06% and 60.00%, respectively; those values of combined diagnosis with Xpert MTB/RIF, TB-RNA and TB-DNA were 61.26%, 100.00%, 75.68%, 100.00% and 60.48%, respectively; the specificity and positive predictive value of combined detection were higher than those of single detection (P<0.05). Conclusions The joint detection of Xpert MTB/RIF, TB-RNA and TB-DNA in bronchoalveolar lavage fluid can improve the diagnostic efficacy of smear-negative pulmonary tuberculosis and is worthy of clinical promotion and application.

Objective To investigate the prevalence, clinical characteristics and antibiotic resistance of Haemophilus influenzae (HI) in children with acute respiratory tract infection in Suzhou. Methods Data of sputum culture of 3 167 hospitalized childhood patients with acute respiratory tract infection from January 2006 to December 2007 were collected. The incidence of positive HI and the rate of resistance to different antibiotics were calculated and beta-lactamases of the strains were detected. Results About 4.4% of total 3 167 eases were infected with HI. The infection rate was related with season and sex, more frequent between February and June, more common in boys than girls. Children younger than three years old were likely to be infected by HI, eompared with other age groups. The beta-lactamase positive rate of HI was 31.4%. The resistance rates to ampicillin, SMZ + TMP, chloramphenicol, cefaclor, ceftazidime, tetracycline and ampicillin/sulbactam were 29.6% ～ 31.9%, 66.2% -73.9%, 19.7% ～ 15.9%, 2.8% ～ 14.5%, 2.8% ～0、 28.2% ～ 2.9% and 4.2% ～ 1.4% respectively. Isolates resistance to cefuroxime、 ceftriaxone、 imipenem、azithromycin and ciprofloxacin were not found. Conclusions The infection of HI in children with actue respiratory tract infection is closely related with season and sex in Suzhou. Children younger than three years old are at high risk. The beta-lactamase positive rate of HI was high and increased rapidly. Resistance rate to azithromycin, SMZ + TMP and chloramphenicol was high, some isolates were resistant to the second, third generation of cephalosporin. Monitoring the antibiotic resistance of H! should be emphasized.

Objective To investigate the complications and outcomes of the treatments in the early time of posterior chamber phakic in-traocular contact lens ( ICL) implantation for the treatment of high myopia, and to analyze the causes. Methods Forty-six patients ( 92 eyes) who underwent ICL/TICL implantations were enrolled in this study. The intraoperative and the postoperative complications in 6 months were observed,at the same time also the treatments and the outcomes were observed. Results None of the patients had a pupillary block. Only 8 eyes in all the patients had an elevated IOP after peripheral iridectomy ( PI) ,and 7 eyes after the ICL implantation,the highest IOP in which was 28 mmHg. No medication was given for treatment. In the YAG PI group,the incidence rate of iris bleeding and pigment dispersion were all higher than that in the YAG PI group (P<0. 05);2 crystalline lens of different patient were damaged intraoperation. Rotation of TICL was observed in 2 eyes. Only 2 individuals of all the patients in this study had complained visual disturbances,which was shadows and glare. Visual psychological change occurred in 1 patient. Conclusion The complications in the early time after ICL implantation for treat-ment of high myopia can prevent and control,the satisfaction of the patients is high.

Objective To assess the clinical outcomes about the visual qulitity of toric implantable contact lens ( TICL) implantation for high myopia with astigmatism. Methods Fifty-two eyes of 27 patients that underwent TICL implantation were examined. Uncorrected visual acuity( UCVA) ,best corrected visual acuity( BCVA) ,refraction,contrast sensitivity ( CS) with and without glare were evaluated before and after the treatment. Results Significant improvement in UCVA and BCVA were found at 1 month and 6 months after treatment (P<0. 05). The refraction at 1 month ( -0. 56 ± 0. 42)D and 6 months ( -0. 58 ± 0. 22)D after treatment were of no significant difference (P>0. 05), and the astigmatism at 1 month ( -0. 35 ± 0. 60)D and 6 months ( -0. 31 ± 0. 42)D after treatment were of no significant difference either (P>0. 05). The CS with and without glare were all significantly better than results before operation for 6. 0,12. 0 and 18. 0 cycles/degree (P<0. 05),but there were no significant difference between 1 month and 6 months after treatment (P>0. 05). No significant difference were found preoperatively,1 month after treatment and 6 months after treatment in terms of CS with and without glare (P>0. 05). The satisfaction of this investigation was 100%. Conclusion The TICL performed well in correcting high myopia with astigmatism,and it is a good surgical option for the treatment.

Objective:To determine the relationship between injury risk and alcohol drinking. Methods:Totally 531 patients (age≥18 years) who were treated for the ifrst time and came to the emergency room within 6 h atfer the injury were included. hTe American National Institute of Health questionnaire was used to investigate the trauma type, intentional injury, drinking before the injury, drinking volume, and drinking history in the past years and so on. hTe case-crossover method was used to analyze the data and relationship between alcohol drinking and injury.Results:Compared with the non-drinkers, subjects who drank alcohol 6 h before the injury had a higher risk of intentional injury (OR=2.79, 95%CI: 1.61–4.84). Male, drunken, patients with positive alcohol test results were more likely to suffer from intentional injury. Compared with the non-drinkers, victims who drank alcohol 6 h before injury had a higher risk of injury in traffc accidents (OR=2.41, 95%CI: 1.29–4.51). Compared with the non-drinkers, subjects who drank alcohol 6 h before injury had a higher risk of injury (OR=11.86, 95%CI: 5.48–25.65). Subjects who drank more than 6 standard drinks of alcohol 6 h before injury had much higher risks than non-drinkers (OR=24.52, 95%CI: 5.84–102.86). Conclusion:Alcohol drinking before injury is associated with increased the risk of trauma, intentional injury and injury related to traffc accidents.

Objective To analyze clinical effects of gastric tube operation for treatment of esophageal cancer in elderly patients and evaluate its clinical efficacy and safety.Methods A total of 171 patients aged 60-72 years with esophageal cancer in our hospital were selected.They were randomly divided into treatment group and control group.Treatment group was treated with gastric tube operation,and control group was traditionally treated with complete replacement of esophagus with stomach.The quality of life,patient satisfaction and safety of operation were evaluated after 3 weeks,6 months and 12 months after operation,respectively.Results The operation for esophageal cancer in 171 patients were successful.At 3 weeks after the operation,the score of life quality in treatment group and control group were both low [(67.3±9.6) vs.(65.3±8.4)],and there were no significant differences between the two groups (P＞0.05).At 6 months and 12 months after operation,the scores of life quality were (89.2±8.3) and (90.3±9.6) in treatment group,and (66.5± 10.4) and (60.5 ± 11.2) in contol group,respectively.There were statistical differences between the two groups after 6 months and 12 months of operation (P＜0.05).The complication rate in treatment group (6.9％) was much lower than that in control group (30.6％),and there were significant differences between the two groups (x2 =18.43,P＜0.01).The patient satisfaction was in no differences between the two groups at 3 weeks after operation (P＞ 0.05),while there were statistically significant differences at 6 and 12 weeks after the operation (P＜0.05).Conclusions Gastric tube operation in treatment of elderly patients with esophageal cancer,can effectively improve the life quality,and prevent the occurrence of postoperative complications,which is worthy of clinical application.

OBJECTIVE TNF- related apoptosis- inducing ligand(TRAIL)is a promising cancer therapeutic agent due to its minimal toxicity to normal tissues and remarkable apoptotic activity in tumors. However, most breast cancer cells are resistant to TRAIL- induced apoptosis. Our objectives are to investigate the underlying molecular mechanisms and to develop strategies to overcome such resistance. METHODS To identify modulators of TRAIL-induced apoptosis, we carried out a genome wide siRNA screen. To validate the screening result, we either silenced or overexpressed the identified genes in various breast cancer cells and changes in growth and TRAIL-induced cell apoptosis were determined in vitro and in an orthotopic xenograft mouse model. Finally, we investigated whether small molecules targeting the identified genes improve the effectiveness of TRAIL-therapy. RESULTS We unexpectedly identified androgen receptor (AR) to be responsible for TRAIL resistance. While AR is classically viewed as the key factor in prostate cancer progression, we found that AR expression levels were markedly elevated in human invasive breast cancer specimens including triple- negative breast cancers (TNBC) that are highly aggressive with poor prognosis. Importantly, breast cancer cell lines express different levels of AR that correlated with their TRAIL resistance. AR overexpression in MDA- MB- 231 and MDA- MB- 436 cells suppressed the TRAIL sensitivity whereas knockdown of AR rendered MCF-7 and MDA-MB-453 cells sensitive to TRAIL-induced apoptosis. AR overexpression also induced TRAIL resistance in breast tumors in vivo. Further, we observed an upregulation of the TRAIL receptor, death receptor 5 (DR5) in breast cancer cells, following the removal or inhibition of AR by its antagonists Casodex and MDV3100. Treatment with AR antagonists also enhanced TRAIL- induced breast cancer cell apoptosis. CONCLUSION AR signaling suppresses TRAIL-induced breast cancer cell apoptosis, in part, by suppressing DR5 expression, and a combination of AR antagonists together with TRAIL may be a novel and effective therapy for TNBC.

Six kinds of saponins (I, II, VII, PA, H) content of 22 samples of Paris polyphylla var. yunnanensis collected from different regions of Yunnan province were determined by HPLC, data was analyzed by SPSS 17. The results showed that the effect of altitude on saponin content was not significant, and the effect of growth area of saponins in P. polyphylla var. yunnanensis was significant, saponin content in sample from west Yunnan was significantly higher than that of samples from other regions.
Altitude ; China ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; analysis ; Liliaceae ; chemistry ; Saponins ; analysis

PurposeTo investigate the correlation between iodine concentration and clinical severity of acute pancreatitis (AP) through the quantitative evaluation with dual-energy spectral computed tomography (DESCT), so as to find out an effective imaging technology in the evaluation of clinical severity of AP.Materials and Methods Sixty patients with AP confirmed clinically (AP group) and 30 patients with normal pancreas (control group) were retrospectively analyzed. All the patients underwent enhanced CT scan in the spectral imaging mode. Iodine concentration and normalized iodine concentration (NIC) were respectively measured during arterial phase and portal phase in the material-decomposition images by using a spectral imaging viewer (GSI Viewer). Results Iodine concentration and NIC were significantly higher in the control group than in the AP group (P<0.05,P<0.001). In the AP group, according to Ranson grading, 24 patients were in the mild grade, 20 patients were moderate, and 16 patients were severe. Iodine concentration and NIC decreased along with the increase of their Ranson grade. There were significant difference in iodine concentration and NIC among the three subgroups (iodine concentration on arterial phase:F=8.776,P<0.01; iodine concentration on portal phase:F=4.019,P<0.05; NIC on arterial phase:F=12.700,P<0.001; NIC on portal phase:F=8.732,P<0.01). Iodine concentration and NIC on arterial and portal phases in the mild grade group were both significantly higher than those in the moderate grade group (P<0.05); however, iodine concentration on arterial and portal phases, and NIC on arterial phase in the severe grade group were significantly lower than those in the moderate grade group (P<0.05).Conclusion DESCT can analyze hemodynamic changes in AP quantitatively, which is of great value in evaluating changes in AP of each grade.

ObjectiveTo investigate and compare the behavioral changes, neuron loss of hippocampus and mossy fiber sprouting between pilocarpine-induced status epilepticus (SE) model and pentylenetetrazole (PTZ) kindling model in rats.MethodsAfter two different epilepsy models were made, Vedio was adopted to observe the behavioral changes. Nissl staining and Neo-timms' staining were separately used to observe and compare the neuron loss of hippocampus and mossy fiber sprouting in the dentate gyrus (DG) at different time points during epileptogenisis.ResultsNo recurrent spontaneous seizure, no neuron loss and no mossy fiber sprouting were found in PTZ kindling model; whereas obvious neuron loss was found in CA1, CA3 of hippocampus and hilus of DG, and mossy fiber sprouting were found in pilocarpine model in parallel with recurrent spontaneous seizures. ConclusionPTZ kindling model resembles absence epilepsy in human, while pilocarpine-induced status epilepticus model resembles chronic temporal epilepsy in human. Neuron loss and mossy fiber sprouting may play an important role in epileptogenisis. Pilocarpine-induced epilepsy model can be regarded as an ideal chronic temporal epilepsy model.