An investigation on pathogens was performed on 219 consecutive adult inpatients with community-acquired pneumonia (CAP) from November 2008 to August 2009 in Hebei Province.Sputum samples from all patients in acute phase were collected for multiplex polymerase chain reaction (PCR) detection. Pathogens were identified in 125 patients. Streptococcus pneumoniae was the most common pathogen isolated in 75 cases (60％) ; influenza A virus was the most common virus isolated in 32 cases (26％) ; and mixed infection were found in 31 patients (25％). Streptococcus pneumoniae species were more frequent among patients aged ≤30 and 51 -70; Haemophilus influenzae species were more frequent among patients with coexisting disease; the percent of Mycoplasma pneumoniae species infections in the lowrisk groups( Ⅰ - Ⅱ ) was higher than patients in the high-risk groups ( Ⅲ - V ).The percent of virus pneumoniae species infections in patients with coexisting disease trended to higher than patients without coexisting disease,but the difference was not statistically significant ( P ＞ 0.05 ).The results indicate that Streptococcus pneumoniae remains the major bacteria,Viruses are frequently detected in CAP with influenza A virus being the most common one; and mixed infection should not be ignored.The age and underlying diseases are important factors influencing the distribution of pathogens.

AIM: To explore the cytokines level and the discrepancy of reaction to dexamethasone (Dex) in ALI rats induced by hydrochloric acid (HCl) and lipopolysaccharide (LPS). METHODS: Ninety-six SD rats were divided into six groups at random (n=16 in each group): NS group, HCl group, LPS group, NS+Dex group, HCl+Dex group and LPS+Dex group. Every group was divided into two subgroups: the bronchoalveolar lavage (BAL) subgroup and no bronchoalveolar lavage (NBAL) subgroup. The total leukocytes, PMN%, macrophage%, lymphocyte%, total protein in BALF and the wet/dry of the lung weight were measured. The concentrations of TNF-?, IL-1?, IL-4 and IL-10 in serum and BALF in every group were compared. RESULTS: (1) In the groups of LPS and HCl, the total leukocytes, PMN numbers, the protein concentration in the BALF and W/D were higher than those in control group (P

Objective To study the relationship between viral infection and chronic obstructive pulmonary disease (COPD),and the effect of viral infections on the changes of Th1/Th2 in COPD patients. Methods The se-ra from 81 patients with acute exacerbations of COPD,25 patients with stable COPD and 22 healthy subjects were tested for specific IgM of respiratary syncytial virus(RSV) ,herpes simplex virus type 1 (HSV-1), parainfluenza vi-rus (PIV), adenovirus (ADV) and cytomegalovirus (CMV) by indirect enzyme-linked immunosorbent assay (ELISA). Supernatant INF-γ and IL-4 cultured with PHA were determined. Results The positive rates of IgM in patients with acute exacerbations of COPD compared with those in patients with stable COPD and healthy subjects were significantly different(P <0.001 ). The level of INF-γ, and IL-4 in patients with acute exacerbations of COPD and stable COPD compared with normal control group;the level of INF-γ (242±43) and the of IL-4(42±9) in pa-tients with acute exacerbations of COPD was not significantly different as compared with the level of INF-γ( 198±32) and the level of IL-4(56±11 ) in patients with stable COPD (P<0.05), but the level of INF-γ was increased (90±18)and IL-4 was decreased (141±24) in control group (P<0.05). Compared with those in IgM negative group, the levels of INF-γ were significantly higher and the levels of IL-4 were significantly lowerIL-4 in lgM positive group( P<0.01 ). Conclusion Virus infection is a rather important factor in acute exacerbations of COPD, and COPD is characterized by a predominance of Th1-type response,and there is more significant Th1 response predomi-nance in COPD with virus infection.

AIM:To look for a better method to deal with interstitial lung disease,interferon-gamma(IFN-?)combined with methylprednisolone(M-pred)to influence human embryonic lung fibroblast on proliferation,collagen synthesis and the expression of transforming growth factor-?1(TGF-?1)protein and mRNA were investigated.METHODS:Exponentially growing cells were preincubated for 48 h before harvested.The microculture tetrazolium(MTT)assay was used to measure the inhibition ratios of M-pred combined with different concentrations of IFN-?.The expression of proliferation cell nuclear antigen(PCNA)was detected by immunocytochemical analysis.Hydroxyproline kit was adopted to detect collagen synthesis.The expressions of TGF-?1 mRNA and protein were detected respectively by RT-PCR and Western blotting.RESULTS:Methylprednisolone,IFN-? as well as the combination of methylprednisolone and IFN-? inhibited the proliferation of HELF and the expression of PCNA in comparison with control group(P

Objective To evaluate the effect of high-frequency chest well oscillation expectoration system on ventilator-associated pneumonia (VAP) and time for withdrawing mechanical ventilation (MV) system in ICU patients with invasive mechanical ventilation (IMV). Methods 100 ICU patients with IMV were divided into observationgroup (n = 50) and control group (n = 50). The high-frequency chest well oscillation expectoration was used in the former group and the mechanical vibration expectoration was used in the latter. The two groups were compared in terms of amount of sputum, vital signs (heart rate, breathing, systolic blood pressure and blood oxygen saturation), time for withdrawing MV system and VAP rate. Results On days 1, 2, 3, 4 and 5, the amount of sputum in the observationgroup was (33.5 ± 4.2)mL/d, (41.1 ± 3.0)mL/d, (38.2± 3 .5) mL/d, (34.8 ± 2.5) mL/d and (31.1 ± 2.1) mL/d, and those of the control group respectively was (27.4 ± 3.1) mL/d, (30.3 ± 3.6) mL/d, (28.1 ± 2.2) mL/d, (25.7±1.8)mL/d and (20.8 ± 1.7)mL/d. The differences between the two groups were statistically significant (P < 0.05). After sputum expectoration, the blood oxygen saturation of the observationgroup was significantly higher than the control group [(97.5 ± 0.9) vs. (95.2 ± 1.0)] (P <0.05), but there were no statistical differences in heart rate, breathing and systolic blood pressure (P > 0.05). The time for withdrawing MV system in the observationgroup and the control group respectively was (5.8 ± 2.2)d and (9.5 ± 1.8)d, (P < 0.05). The rates of VAP in the observationgroup and the control group respectively was 30.0% (15/50) and 52.0% (26/50), with significant difference between them (P < 0.05). Conclusion The high-frequency chest well oscillation expectoration for ICU patients with invasive mechanical ventilation can promote sputum expectoration , improve blood oxygen saturation , shorten the time for withdrawing the ventilator, and prevent the incidence of VAP.

Objective To understand the awareness status of malaria control knowledge of primary and secondary school stu-dents in malaria endemic areas of Shandong Province,so as to provide the baseline information for formulating the malaria control strategy. Methods A cross-sectional survey was conducted in 5 TypeⅡmalaria-endemic counties in Shandong Province. A struc-tured questionnaire survey was administrated to students in primary and secondary schools. Results A total of 1 884 students were completed with the questionnaires and all were effective. The total awareness rate of malaria control knowledge was 65.9%, and 54.7% of the students knew the transmission route of malaria and only 31.5% of the students were aware of the preventive methods of malaria. There were significant differences of the awareness scores of malaria control knowledge among different malar-ia endemic areas but there were no significant differences between the awareness rates of male and female students and between two different education levels. Conclusions The awareness of malaria control knowledge of primary and secondary school stu-dents in Shandong Province is poor;therefore,the health education of malaria control knowledge for primary and secondary school students should be strengthened.

Objective To understand the malaria situation of Shandong Province in 2013,so as to provide the evidence for formulating targeted prevention and control strategy and measures. Methods The data of malaria cases of Shandong Province in 2013 were collected from the Information Management System for Infectious Diseases Report and Information Management Sys-tem for Parasitic Diseases Control and Prevention. The data of epidemiological characteristics of malaria situation and the diagno-sis and treatment of malaria cases were analyzed by Microsoft Excell2007. Results There were 131 malaria cases reported in 2013,all of them were imported cases,and 127 cases(96.95%)were imported from African countries. A total of 116 cases (88.55%)were falciparum malaria cases. Totally 97.71%of the cases were male and the average age of malaria cases was 39 years. A total of 61.83%of the cases were peasants and 65.65%of the cases only received junior high school education. The dis-tribution of malaria cases was concentrated in Tai’an City(32 cases),Yantai City(19 cases)and Weihai City(17 cases),total-ly acounting for 53.13%. There was no significant seasonal variation in the reporting time of the cases. The median time from on-set to seeing doctor was four days and the median time from seeing doctor to being diagnosed was one day. Totally 35.88%of the cases were misdiagnosed when the first visit to a doctor. All of the cases were laboratory confirmed and 100%of them received the standard treatment after diagnosis. Conclusions All of the malaria cases were imported cases in Shandong Province in 2013. To control the imported malaria in Shandong Province,it is necessary to further strengthen the multi-sectoral cooperation, health education,malaria screening and professional training.

This paper reports one case of atypical falciparum malaria imported from Africa,whose blood smear contains many large trophozoites,with punctiform or massive brown pigment granules,the body shape of the plasmodium is similar to that of Plas-modium vivax and Plasmodium ovale. After the gene detection by PCR,the case was diagnosed as falciparum malaria. As large tro-phozoites were rarely seen in the peripheral blood of non-severe falciparum malaria cases,much attention should be paid to the identification of Plasmodium falciparum and other plasmodia in microscopic examinations.

Objective To understand the infection status of intestinal parasites and related knowledge and behavior factors of the residents in north-west Shandong Province,so as to provide the evidence for taking targeted preventive measures. Meth-ods Eighteen villages were randomly selected as survey spots by the stratified multi-stage sample method. The Kato-Katz tech-nique was used to detect intestinal parasite eggs among the residents and the cellophane tape anus test was used to detect Entero-bius vermicularis eggs among 3-12 years old children. Questionnaires were applied to investigate related knowledge and behavior factors about the intestinal parasite infections in the residents. Results Totally 6 366 residents were detected for intestinal para-sites and the infection rate was 0.28%(18 cases). Totally 895 children were detected for E. vermicularis and the infection rate was 5.70%(51 cases). Totally 2 915 residents were investigated by questionnaires and the awareness rate of knowledge about preventing parasitic diseases was 26.72%. The formation rates of washing hands before meal and after WC,washing fruit and vegetable before eating,never drinking unboiled water were 55.42%,42.87%,43.54%and 83.04%respectively. The aware-ness rate of knowledge about preventing parasitic diseases of 3-12 years old children was 12.24%;and the formation rates of washing hands before meal and after WC were 47.04%and 30.44%respectively. Conclusions The total infection rate of intesti-nal parasites is low but the E. vermicularis infection rate is high among children in north-west Shandong Province. The awareness rate of knowledge about preventing parasitic diseases and the formation rates of healthy behaviors are all low. Therefore ,the tar-geted health education should be taken to increase the awareness rate and guide the residents to develop their healthy behaviors.

Objective To explore the association between malaria epidemic situation and some natural and social factors in high?incidence areas of Shandong Province,so as to provide evidences for malaria elimination in these areas. Methods Twenty towns of 10 counties(cities,districts,)in the high incidence areas of malaria in Shandong Province were selected as the study sites,and the residents in the study sites were investigated by questionnaires with one household as a unit,so as to understand the related natural and social factors. In addition,the malaria epidemic data in the study sites from 2006 to 2010 were collected, and the correlation between these factors and the epidemic situation of malaria was analyzed by Spearman rank correlation and multiple stepwise regression. Results The square root of malaria incidence rate(Y)was negatively related to the rate of house?holds using insecticide(X3),and the rate of households using screen doors and windows(X4)(both P<0.05),but was positive?ly related to the rate of housing surrounding water environment and exposure ratio(X6)(both P<0.05). The regression equa?tion established was Y=0.032X5+0.048X6-0.495,R2=0.973. Conclusions Malaria incidence is obviously associated with some natural and social factors. The measures such as clearing the breeding place of mosquito,protecting the exposure popula?tion at nightfall,as well as using door?window screen and repellents correctly,can effectively control malaria.