Objective To observe the correlation between lipoprotein-associated phospholipase A2(Lp-PLA2) levels and coronary artery disease (CAD), extent of angiographic coronary artery lesions and risk factors of CAD in the elderly. Methods Plasma levels of Lp-PLA2, triglyceride (TG), total cholesterol(TC), low density lipoprotein(LDL-C), high density lipoprotein cholesterol (HDL-C) and high sensitivity C-reactive protein(hs-CRP) were measured in 67 elderly patients with angiographic CAD meanwhile in 23 normal controls without angiographic coronary artery lesions. The extent of coronary artery lesions was evaluated according to the number of vessel lesions (divided into single, double and triple-vessel lesions) and Gensini scoring system. Then the relationship between Lp-PLA2 and CAD was assessed. Results The plasma levels of Lp-PLA2 were significantly higher in the CAD group than in the controls [(352.7 ± 129.0) vs. (204.0 ± 59. 7) μg/L, P < 0. 01]. Lp-PLA2 levels increased with the number of coronary artery lesions and Gensini score, then were positively correlated with age(r= 0. 25, P<0. 05) ,TC(r=0. 33, P<0. 01) ,LDL-C(r=0.27, P< 0. 05),apoB(r=0. 36, P<0. 01). The levels of LP-PLA2 and LP(a) were associated with CAD by using stepwise regression analysis. Conclusions In the eldly, the levels of LP-PLA2 are much higher in angiographic CAD, and these may reflect the severity of CAD. LP-PLA2 is a risk factor for CAD.

OBJECTIVE To study the constituent ratio of the pathogenic fungi of blood culture in recent 24 months and their resistance in our hospital.METHODS Blood culture of patients in our hospital was performed by BacT/AlerT120 and the isolated pathogenic fungi were identified by API identified tests(API Inc,France).In(addition) antibiotics sensitivity test was by K-B.RESULTS Of the specimens in 4135 cases,there were 110 strains((2.7%)) with Candida albicans(29%).C.tropicalis(21%) and C.portugal(9%).The(specimens) come from(hepatobilliary)(25%),neurosurgery(24%) and emergency(10%) departments.CONCLUSIONS It is important and necessary to monitor the circumstance of fungal(infection) and resistance of the pathogenic fungi due to its(morbidity) increased.

0.05) . Compared with group B, serum content of Cu2+ was markedly increased (P

Objective To investigate the relationship between retinal nerve fiber layer thickness and peripheral neuropathy in elderly patients with type 2 diabetes.Methods Clinical data of elderly patients with T2DM in Endocrinology Department in Beijing Hospital were retrospectively collected.Global and sectorial retinal nerve fiber layer(RNFL)thicknesses were measured by using optical coherence tomography(OCT),and never conduction velocity measurements were performed in all patients.Diabetic peripheral neuropathy was diagnosed by the criteria in diabetic neuropathies update(2010,American Diabetes Association).RNFL thickness was compared between diabetic nonperipheral neuropathy group (control group,n =30)and diabetic peripheral neuropathy group (DPN group,n=17)and between different sub-groups.Results The RNFL thicknesses of temporal,nasal,superior and inferior visual fields and the mean RNFL thickness were less in DPN group than in control group,among which there were significant differences in the RNFL thicknesses of superior,inferior visual fields and the mean RNFL thickness [(107.7±27.4)μm vs.(128.1±17.3)μm,(112.9 ±20.8)μm vs.(130.8±21.8)μm,(88.2±15.5)μm vs.(100.5± 11.3)μm,F=7.446,7.468,7.988,respectively,P=0.009,0.009 and 0.007].RNFL thickness was decreased along with the aggravation of DPN from the control group,the subclinical DPN group to the DPN group successively(all P＜ 0.05).Conclusions Retinal nerve fiber layer thickness is associated with diabetic peripheral neuropathy in elderly patients with type 2 diabetes,and the relationship is more significant in patients with serious DPN.

Objective To explore the therapeutic effects of pure collagenase injection and collagenase combined with herniation injection of ozone on the treatment of lumbar disc herniation(LDH).Methods According to the principle of randomized controlled double blind, 100 patients with LDH were divided into 2 groups:pure collagenase group and combined treatment group.Changes of NRS value and Macnab score were observed and recorded at multiple time points after operation.The difference of the effect of the two kinds of operation was analyzed.Results Among the 50 patients in the simple treatment group,3 patients were lost to follow-up.Among the 50 patients in the combined treatment group,2 patients were lost to follow-up,and open surgery in 2 patients because of poor efficacy after the injection of 3 months and 6 months respectively.By analyzing the change of NRS value and Macnab score of 2 groups patients,there was no significant difference in the short-term and long-term efficacy between the 2 groups(P>0.05);The symptoms of the 2 groups were improved after operation.The curative effect was positively correlated with the recovery time, and the difference was statistically significant (P<0.05).Conclusion The curative effect of pure collagenase injection and the combined with herniation injection of ozone are both significant, and there is no significant difference in the clinical efficacy between the 2 kinds of operations.

Objective To examine the distribution and antibiotic resistance proifle of the bacterial isolates from lower respiratory tract of hospitalized patients for better empirical therapy.Methods A total of 3 155 lower respiratory tract specimens were collected from Respiratory Department of the First Afifliated Hospital of Chongqing Medical University in 2013 to identify bacterial pathogens for susceptibility testing. The results were compared with the data of 2011 and 2012.Results The top three bacterial species from lower respiratory tract in the period from 2011 to 2013 wereA. baumannii,P. aeruginosa, andK. pneumoniae. The prevalence ofS. aureusincreased, while the prevalence ofS. maltophilia andS. pneumoniae was still low.A. baumannii isolates were highly resistant to antibiotics. Not more than 40% of these strains were susceptible to the antimicrobial agents except minocycline, which was active against more than 60% of the ICU and non-ICU strains. More than 70% of theP. aeruginosa strains from non-ICU were susceptible to cefepime, meropenem, imipenem, levofloxacin, and ciprofloxacin in the three years, 50%-70% of the strains from ICU were susceptible to the antimicrobial agents tested. Carbapenem-resistantA. baumannii andP. aeruginosa strains were identiifed.S. maltophilia strains were relatively susceptible to minocycline and levolfoxacin. All the S. aureus isolates were susceptible to vancomycin, linezolid, and tigecycline. The prevalence of MRSA increased year by
year. More than 80% of theK. pneumoniae andE. coli strains were susceptible to imipenem, piperacillin-tazobactam, and cefepime. ESBLs-producingK. pneumoniae was identified. More than 85% of theH. influenzae strains were susceptible to meropenem, ceftazidime, cefuroxime, ciprolfoxacin, levolfoxacin, and amoxicillin-clavulanate potassium. All theS. pneumoniae isolates were susceptible to vancomycin, and 80%-96% of these strains were susceptible to levofloxacin and penicillin.ConclusionsA. baumannii,P. aeruginosa, andK. pneumoniae are the top three bacterial species isolated from lower respiratory tract. Carbapenem-resistantA. baumannii,P. aeruginosa and ESBLs-producingK. pneumoniaeare emerging. The prevalence of MRSA is increasing year by year, which poses a challenge to antimicrobial therapy. It is urgent to contain and control the growing antibiotic resistance.

This study developed a novel approach of targeting malignant glioma with pMAGE-A1(278-286)-specific cytotoxic T lymphocytes (CTLs) induced from the peripheral blood mononuclear cells of healthy donors by multiple stimulations with human leukocyte antigen (HLA)-A2-restricted pMAGE-A1(278-286) peptide-pulsed dentritic cells. Cytotoxic assays were performed by the colorimetric CytoTox 96 assay to analyze cytotoxic activity of the induced CTLs against various target cells. The induced CTLs showed approximately 45% specific lysis against T2pMAGE-A1(278-286) (pMAGE-A1(278-286) peptide pulsed T2 cells) and U251 (HLA-A2(+), MAGE-A1(+)) at an effector:target ratio of 40:1, and approximately 5% cytolysis against T2pHIV, A172 (HLA-A2(-), MAGE-A1(+)), K562 and T2 cells without being pulsed with peptide at any effector:target ratio. The specific killing activity of the induced CTLs against T2pMAGE-A1(278-286) and U251 was much more obvious than in any other control group (P<0.05). The cytotoxic activity against the T2pMAGE-A1(278-286) and U251 was significantly eliminated by anti-HLA class I mAb W6/32. These results suggest that pMAGE-A1(278-286) epitope may serve as a surrogate tumor antigen target of specific immunotherapy for treating HLA-A2 patients with malignant glioma.

Objective To isolate the dedifferentiation-derived epidermal stem cells (DDESCs)to further investigate their phenotypic characteristics. Methods The sheets of human foreskin were digested overnight after removal of adipose tissues and then the epidermis was separated from the dermis.The epidermis sheets which eliminated basal stem cells by repeated adhesion to type Ⅳ collagen and flushing were transplanted onto the full-thickness skin wounds on the back of BALB/c nude mice. After five days, the sheets were collected and digested into single cells, after which the percentages of positive cells of CK10, CK19 and β1 integrin were detected by flow cytometric analysis. DDESCs were isolated by rapid adhesion to type Ⅳ collagen. The expressions of CK19, β1 integrin, Oct4 and Nanog in the cells were examined using immunofluorescence and quantitative real-time polymerase chain reaction (RTPCR). Results The percentages of positive cells of CK19 and 31 integrin were increased (P ＜0.01 )and those of CK10 in the transplanted sheets decreased ( P ＜0.01 ) five days after transplantation. Isolation of DDESCs by repeated adhesion to type Ⅳ collagen showed 4.56% adhering cells in the transplantation group within 10 minutes. The in vitro phenotypic assays showed that the expressions of CK19, β1 integrin, Oct4 and Nanog in DDESCs were similar to those of original epidermal stem cells ( P ＞0.05 ) but remarkably higher than those in the control group ( P ＜ 0.01 ). Conclusion The phenotypic characteristics of DDESCs cultured in vitro are similar to those of epidermal stem cells, indicating a new approach for wound repair and regeneration.

Objective To discuss the diagnosis and management options of fetal nuchal cystic hygroma(NCH). Methods Ten cases of fetal nuchal cystic hygroma from Mar 1996 to Mar 2003 were retrospectively analyzed. The sonographic images, fetal karyotype examination after amniocentesis, TORCH results and pathology were reviewed. Results The sonogram detected a large cystic mass around the posterior of the neck. The smallest one was 5.3 cm?4.8 cm?4.0 cm in size and the biggest 12.6 cm?6.6 cm?4.0 cm. The nuchal ligament could be seen inside the mass. Four cases complicated with pleural effusions and 4 with pleural effusions, ascites and skin edema. One case was deliveried in full term and the other 9 cases were induced (including 4 fetal death). Seven cases were examined for TORCH of amniotic fluid among which only one TOX PCR positive. The karyotype examination was performed in 6 cases. The results were 45XO(3 cases), 45XO/46XX (60:40) and 45XX,-21,-22,+t(21;22). The only alive baby is 46XX. Conclusions Ultrasound and invasive amniocentesis to detect the fetal karyotype have an important role in early diagnosis and management of nuchal cystic hygroma. Nuchal cystic hygromas are associated with Turner’s syndrome and other chromosomal abnormalities.

Objective To evaluate the effect of domestic wire-reinforced epidural catheter on the occurrence of adverse events during epidural block.Methods Three hundred ASA Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,weighing 41-78 kg,scheduled for elective operations under combined spinal-epidural anesthesia,were randomly divided into 3 groups (n =100 each):polyvinyl chloride epidural catheter group (group A),imported wire-reinforced epidural catheter group (group B) and domestic wire-reinforced epidural catheter group (group C).Combined spinal-epidural anesthesia was performed routinely.The corresponding epidural catheter was inserted in each group.The catheterization without difficulty,paresthesia during catheterization,the number of patients in whom blood or cerebrospinal fluid was withdrawn from the epidural catheter,intravascular catheter insertion,injection obstruction,easiness during removal of the catheter,bleeding after removal,postoperative paresthesia and epidural hematoma within 1 week after operation were recorded.Results Compared with A group,the incidences of paresthesia during catheterization,the number of patients in whom blood or cerebrospinal fluid was withdrawn from the epidural catheter,injection obstruction and postoperative paresthesia were significantly decreased (P ＜ 0.05),and no significant change was found in the other parameters in B and C groups (P ＞ 0.05).There was no significant difference in all the parameters between B group and C group (P ＞ 0.05).Conclusion Domestic wire-reinforced epidural catheter can decrease the occurrence of catheterization-induced damage to the nerve and blood vessels and the efficacy is comparable with that of imported wire-reinforced epidural catheter.