OBJECTIVE:To understand the distribution and drug resistance of the pathogens by sputum culture in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in our hospital so as to provide reference for rational use of antibiotics. METHODS:From Dec. 2010 to Dec. 2014,the sputum specimens were collected from the AECOPD patients,then the identification of 307 strains of pathogens and drug susceptibility test were carried out,and the data were analyzed statistically by using SPSS 17.0 software. RESULTS:A total of 307 strains of pathogens were collected,of which 17 cases of gram-positive ba-cillus accounted (5.54%),247 cases of gram negative cocci (80.46%),43 cases of fungi accounted (14.00%). The most com-mon isolates from sputum specimens were Pseudomonas aeruginosa (33.22%),Acinetobacter baumannii (19.54%),Stenotroph-omonas maltophilia(9.77%),Klebsiella pneumoniae(7.82%),Candida albicans(6.84%),etc. P. aeruginosa and A. baumannii were highly multidrug-resistant. There were 10 strains of ESBLs-producing K. pneumonia isolated, with the isolation rate of 41.67%. No Staphylococcus aureus strain was found resistant to vancomycin,teicoplanin or linezolid. Methicillin resistant strains in S. aureus(MRSA)accounted for 50.00%. CONCLUSIONS:Gram-negative bacilli are the most common pathogens in the AE-COPD patients. The common species of pathogens are highly resistant. More attention should be paid to the drug resistance monitor-ing of pathogens and rational use of antibiotics according to the results of susceptibility test.

Objective To explore the relationship among emotional resilience,stress and school adjustment.Methods Adolescent life events check-list,adolescent emotional resilience scale and school adjustment scale of middle school students were conducted among 394 junior high school students.Results (1)The emotional resilience score and emotion recovery score of male junior high school students(46.07±8.56,24.43±5.80) were higher than that of female ones(44.39±8.39,23.27±5.37),and the differences were statistically significant(t=1.97,2.05,P＜0.05).The total score of emotional resilience(45.46±8.50,44.83±8.56) was not statistically related with whether they were the only children(t=0.68,P=0.50).The emotional resilience score and positive emotion score of rural junior high school students(44.04±8.53,20.63±5.35)were lower than that of urban ones (46.46± 8.34,22.15 ±4.72),and the differences were statistically significant(t=-2.86,-2.99,P＜0.01).The total score of emotional resilience (47.23±7.82,44.63±8.45,43.00±8.97) in different grades was statistically significant (F=8.86,P=0.00),and the first grade students were higher than the second and third year students.(2)Psychological stress was negatively related with emotional resilience and school adjustment(r=-0.23～-0.35,P＜0.01),and emotional resilience was positively correlated with school adjustment(r=0.12 ～ 0.29,P＜0.01).The relationship between stress and school adjustment were mediated by positive emotion and emotional recovery (the mediating effect were 11.11％,21.15％).Conclusion Frotional resilience plays a mediating role between psychological stress and school adjustment.

Objective:To investigate the prognostic values of tumor–stroma ratio and tumor-infiltrating lymphocytes in colorec-tal cancer. Methods:A total of 218 stageⅡorⅢprimary colorectal cancer patients were analyzed for the tumor–stroma ratio (TSR) and tumor-infiltrating lymphocytes (TIL) by using HE stained histological sections. The relationship between TSR and clinicopatholog-ic variables and the difference in clinical outcomes of different groups were also analyzed. Results:Overall survival rates for the stro-ma-low group were significantly higher than the stroma-high group in stagesⅡandⅢcolorectal cancer (P＜0.05). However, the differ-ences in TSR were not correlated with clinicopathologic features such as gender and age (P>0.05). Overall survival rates of patients with high TIL were significantly higher than patients with low TIL (P＜0.05). Patients with high TIL had notable better prognosis than patients with low TIL (P＜0.05) in the stroma-low group. Conclusion:TSR and TIL are independent prognostic factors for stagesⅡandⅢcolorectal cancer. The combined estimates of TSR and TIL in routine pathology diagnoses may provide more evidence to predict the prognosis of stagesⅡandⅢcolorectal cancer.

Objective To evaluate the repeatability and accuracy of semi-automated software OsiriX in the assessment of cartilage volume in normal knees on 3.0T MR. Methods Thirty right knees of healthy subjects were scanned twice with 3.0T MR using 3D-FLASH sequence with selective water excitation. Cartilage volume of the patellar compartment was determined with a validated open-source software OsiriX and manual segmentation separately by 3 observers using MRI data sets. After calculating the cartilage volumes, the segmentation processing times, the repeatability and volume results were compared between two segmentations. Results ①Compared with the manual segmentation, a time saving of at least 50% for cartilage volume measurement was achieved with OsiriX software segmentation. ②The interobserver repeatability error was 4.88% and 9.82% with OsiriX software segmentation and manual segmentation, respectively;the intraobserver repeatability error of high experienced observer was 0.77% and 1.29%, the interindividual repeatability range were 0.14%-1.11% and 0.52%-1.61%, respectively. The repeatability error of OsiriX software segmentaion was proved to be significantly smaller than manual segmentation (P＜0.05). ③System difference between results obtained with OsiriX software measurement and manual measurement was (-3.80±3.93)% and absolute pairwise difference was (4.68±2.70)%. There was no statistical difference between the volume results measured using two techniques (t=0.92, P=0.36). Conclusion Compared to manual segmentation, cartilage volume measurement with OsiriX semi-automated segmentation is faster and has higher inter- and intraobserver repeatability with relatively fixed standard. This technique may therefore be used for clinical and multi-center trials of large sample.

Objective To evaluate the feasibility of using single lumen tube intubation technique in bronchial intubation with Robertshaw double-lumen tube .Methods 80 patients with ASA Ⅰ - Ⅱ level who need to accept bronchial intubation were ran-domly divided into two groups .Group A(n=40) accepted bronchial intubation using single lumen tube intubation technique .Group B(n=40) accepted bronchial intubation using traditional intubation technique .The single success rates and intubation complication rates were observed .Results The single success rates of group A was obviously higher than group B (P< 0 .05) ,the intubation complication rates of group A was lower than group B ,but with no statistical significance(P>0 .05) .Conclusion The single suc-cess rates of single lumen tube intubation technique in bronchial intubation with Robertshaw double-lumen tube is higher than tradi-tional intubation technique ,at the same time ,the complication rate of intubation is low ,safe and feasible .

Objective: To study the propagation and phenotypes changes of killer cell (CD3AK cell activated by CD3 mAb in vitro. Methods: Lymph nodes taken from lung cancer patient is dissociated into single cell suspension by mechanical method and cultured in culture medium added CD3 mAb and a little dose IL-2. We analyze cell immunophenotype by flow cytometry and proliferation by trypan blue exclusion test per 2 days. Results: Immunophenotypic analysis showed that CD3AK expressing CD3, CD8, CD56, CD25 increased, and reached a peak value which is 2.33 times than before culturing in the 8 th day. Conclusion: CD3 mAb added to the culture medium can obviously activate CD3AK cell and stimulate proliferation and keep its killer activity.

Objective To study the validity and reliability of the simplified Chinese version of Loewenstein Occupational Therapy Cognitive Assessment (LOTCA). MethodsThe English version of LOTCA was translated into the simplified Chinese first and then translated back to English to ensure its reliability in Chinese version.The we recruited two groups of volunteers to participate in the study. One group consisted of 36 patients with brain disorders (patient group), The other group consisted of 43 subjects without neurological disorders (control group). All the subjects were assessed with LOTCA and Mini-Mental State Examination (MMSE) within one session and on different days, respectively by two independent raters. Scores of LOTCA and MMSE were analyzed with Spearman correlation coefficient to test the validity of LOTCA. Intra-class coefficients (ICCs) were used to examine the intra-rater and inter-rater reliability of LOTCA. And Mann-Whitney test of non-parameters analysis was used to detect the sensitivity of LOTCA. ResultsThere was high correlation between the scores of LOTCA and that of MMSE ( r =0.9852- 0.9939 ). ICCs of LOTCA were 0.9923( P

Objective To investigate the accuracy and reproducibility of multi echo data imagine combination (MEDIC) sequence with water excitation at 3. 0 T in swine knee cartilage. Methods Sagittal MEDIC sequences (0.6 mm slice thickness, isotropic) were acquired twice at 3. 0 T MRI in 30 swine knees. The knee cartilage was then removed and the volume was directly measured with water substitution method. The cartilage volume was also determined with a validated open source image software OsiriX by two observers ( A and B). The cartilage volumes obtained by two methods were compared. The reproducibility of MEDIC for quantitative measurement was accessed by the root-mean-square (RMS) of variation coefficient. Interobserver and intraobserver precision errors were compared using a paired students t-test. The accuracy of MEDIC for quantitative measurement was determined by the random pairwise differences, systematic pairwise differences and the Pearson correlation coefficients. Time of semiautomatic and manual segmentation were recorded. Results Time was saved about 75% by using semiautomatic segmentation methods [(4.0 ±1.5) min] versus manual segmentation [(16.0 ±0.9) min]. Interobserver precision errors (RMS CV%for paired analysis) between A and B for cartilage volume measurement were (2. 66 ±0. 82) ml and(2. 61 ±0.81) ml, t=0.24, P=0. 81 (patella); (2.40 ±0.69) ml and(2.49 ±0. 85) ml, t= -0.45,P =0. 65 (medial femoral condyle) ;(2. 28 ±0.74) ml and(2.41 ±0. 78) ml, t = -0. 66, P = 0. 51 (lateral femoral condyle);(3.43±1.28) ml and(3. 51 ±1. 08) ml, t= -0.26, P=0.79 (femora trochlea) with sagittal MEDIC. Intraobserver precision errors ( RMS CV% for paired analysis) of observer A for the first and second cartilage volume measurement were(2. 64 ±0. 62) ml and(2. 67 ±0. 60) ml, t = -0.19, P =0. 85(patella); (2.43 ±0.60) ml and(2. 39 ±0.59) ml, t =0.26, P = 0. 80 (medial femoral condyle);(2. 26 ±0. 56) ml and (2. 30 ±0. 57) ml, t = - 0.27, P = 0. 78 (lateral femoral condyle); (3.40 ±1.20) ml and(3.47 ±1. 11) ml, t = -0.23, P = 0. 82 (femora trochlea) with sagittal MEDIC. The cartilage volume of direct measurement were (2.73 ±0.97 ) ml ( patella ) , (2. 28 ±0. 66 ) ml ( medial femoral condyle) ,(2. 18 ±0. 55) ml (lateral femoral condyle) and (3. 39 ±1.31) ml (femora trochlea).Correlation coefficients between MEDIC and direct measurement for cartilage volume measurement were high [r = 0.95, t = 16. 10, P<0.05 ( patella); r=0.92, t = 12.42, P<0.05 (medial femoral condyle); r =0.94, t = 14.58, P < 0.05 (lateral femoral condyle) and r = 0.98, t = 26.06, P < 0. 05 (femora trochlea) ]. Conclusion Using image software OsiriX, sagittal MEDIC sequence permits accurate and precise measurement of cartilage volume at reasonable acquisition and segmentation time at 3.0 T MRI in swine knee.

Objective:To investigate the effect of human interferon-α-2b(IFN-α-2b) in the treatment of endometriosis by detecting the levels of CA125 and endometrial antibody(EMAb). Methods: Forty-five cases with endometriosis were divided into three groups. Fifteen cases in test group (operation+IFN-α-2b), 20 cases in control group A (operation+Diphereline), 10 cases in control group B(only operation). The blood serum level of CA125 was detected by microparticle enzyme immunochemiluminescent at pre-operation, the first month, second month and third month of the post-operation; and the EMAb level was measured by enzyme linked immunosorbent assay (ELISA). The follow-up of patients was carried out after operation to evaluate the clinical appearances and record the adverse effects of the human IFN-α-2b. Results: Compared with pre-operation, the levels of CA125 and EMAb were obviously degraded in the first to third months after surgery in test group and control group A(P < 0.05). There were no significant difference in the levels of CA125 and EMAb were at pre-operation,the first month,second month and third month of the post-operation between the test group and control group A(P > 0.05). There were no significant difference in the levels of CA125 and EMAb at pre-operation between the test group and control group B(P > 0.05). However, the level of EMAb was lower the first month after operation in the test group than that of control group B. In the follow-up, the adverse effects of the human interferon-α-2b were observed including low-grade fever, articular muscle soreness and gastrointestinal tract complaints. These appearances completely disappeared after drug withdrawal. It had less impact on the menstruation. Conclusion: The levels of CA125 and EMAb were similar in treatment of endometriosis with human IFN-α-2b and with Diphereline. Both of the treatments are better than the pure surgery. It has less impact on the menstruation and can avoid menostasia.

Objective To investigate the expression and prognostic significance of P-JAK2, P-STAT3 and mutant p53 in cervical lesions. Methods A total of 153 cervical biopsies of patients from Gynecology Department, The Second Hospital of Tianjin Medical University were recruited during December 2013 to June 2015. Fifty-seven cases of squamous carcinoma of cervix (SCC), 36 cases of low grade intraepithelial neoplasia (LSIL), 30 patients with high grade intraepithelial neoplasia (HSIL) and 30 cases of normal cervix (NC) were included in the study. Gene chip method was used to detect high-risk hu-man papillpmavirus(HR-HPV)infection. Hematoxylin-eosin staining was used to make pathological diagnosis. Immunohis-tochemical assay was used for the detection of P-JAK2, P-STAT3 and mutant type p53 protein expression in cervical le-sions. Results (1) HR-HPV infection rate and P-JAK2 expression were significantly higher in SCC group than those of HSIL group, LSIL group and NC group (P<0.05). (2) The expression of P-STAT3 and mutant type p53 were significantly higher in SCC group than those of LSIL group and NC group (P<0.05). However, there was no significant difference between SCC group and HSIL group. (3) The positive expressions of P-JAK2 and P-STAT3 showed significant differences in different FIGO stages, histopathological grade, lymph node metastasis and HR-HPV infection in SCC group, respectively ( P<0.05). There were significant differences in the positive expression of mutant type p53 between different FIGO stages and HR-HPV infection (P<0.05). (4) There was positive correlation between P-JAK2, P-STAT3, positive expression of mutant type p53 and HR-HPV infection in SCC tissues (P<0.05). There was a positive correlation between P-STAT3, p53 expression and HR-HPV infection (P<0.05). There was a positive correlation between mutant p53 expression and HR-HPV infection (P<0.05). Conclusion P-JAK2, P-STAT3 and mutant p53 protein expression rates are high in SCC group than those of NC and SIL groups, which may be associated with HR-HPV infection, cervical cancer occurrence and progression.