Objective To investigate the clinical manifestations, auxiliary examination, diagnosis and therapy of Aspergillus tracheobronchitis (ATB).Methods Clinical data of 4 ATB patients treated in Qingdao Municipal Hospital from June 2012 to September 2015 were analyzed retrospectively. The related literature was also reviewed.Results The main clinical manifestations were cough, sputum production, short of breath, fever and hemoptysis. All the four patients had predisposing factors. The ifndings of CT scan mainly included bronchial wall thickening, obstruction of bronchial lumen or no significant abnormality. Bronchoscopy showed mucosal erosion, necrosis, tracheal stenosis and obstruction of airway by pseudo-membrane. The diagnosis was confirmed by histopathology in all the four cases. They were treated with anti-Aspergillus therapy. The two patients with airway stenosis were treated with interventional therapy via bronchoscope. As for the outcome, one patient was improved after therapy. Another was cured. The remaining two patients died.Conclusions The clinical manifestations and chest imaging of ATB are nonspecific. Bronchoscopy is an important tool for diagnosis of ATB. Early diagnosis and proper anti-Aspergillus treatment are critical for improving prognosis.

Objective: To assay minimal biofilm eradication concentration (MBEC) of various extraction compounds from Galla Chinensis to 5 oral bacterial biofilms, and then to set up traditional Chinese medicine empirical study methods of pharmacodynamic susceptibility. Methods:5 cariogenic bacteria strains were selected (Streptococcus mutans ATCC25175, Streptococcus sanguis ATCC10556, Lactobacillus rhamnosus AC413, Actinomyces naeslundii WVU627, Actinomyces viscosus ATCC19246) in present study. Various extraction compounds of Galla Chinensis were GCE (aqueous extract), GCE-B(300 ml/L alcohol extract), GCE-C(500 ml/L acetone extract),GCE-D(1 000 ml/L acetone extract), gallic acid and methyl gallate. ①Observed oral bacterial biofilm formation in MBECTM-Device at different-time-stages. ②MBECTM -HTP-Assay:The minimal inhibitory concentration (MIC) and minimal biofilm eradication concentration (MBEC) of various extraction compounds of Galla Chinensis on 5 oral bacteria strains were determined. Results:5 oral bacterial biofilm were readily formed on the lid of MBECTM-Device under selected condition (observed by SEM). 5 oral cariogenic bacteria growing as planktonic populations were sensitive to 6 extraction compounds of Galla Chinensis. When compared to 6 extraction compounds of Galla Chinensis, 5 oral cariogenic bacterial biofilm were 2-16 times less susceptible than growing planktonic bacteria. GCE and GCE-B are the most effective medicine against 5 oral cariogenic bacterial biofilm. GCE-C and GCE-D were effective in killing oral-bacterial biofilm at relatively high concentration, but gallic acid and methyl gallate were less effective.Conclusion:GCE and GCE-B are the most effective medicine against 5 oral cariogenic bacterial biofilm of 6 extraction compounds from Galla Chinensis. MBEC can provide a relatively accurate medicine concentration for clinical test.

Objective To investigate the clinical characteristics and risk factors of non-premature STEMI patients underwentprimaryPCI with multivessel disease.Methods Data of clinic and coronary angiographic features were retrospectively compared between group of 371 younger STEMI patients (male age ＜ 55 years,female ＜ 65 years) and group of 662 older STEMI patients.All patients were admitted to hospital from January 2005 to January 2015 and treated with primary PCI.The patients' gender,smoking history,family history of coronary heart disease (CHD),hypertension,type 2 diabetes mellitus,previous myocardial infarction and revascularization,stroke history,serum uric acid,lipids etc.were documented.The comparison of coronary artery disease characteristics and the incidence of adverse events during hospitalization were also carried out between two groups.Results (1) Prevalence of males (88.4％ vs.76.9％),smokers (74.9％ vs.51.5％),family history of CHD (21.0％ vs.9.7％) and levels of diastolic blood pressure,total cholesterol,low density lipoprotein cholesterol (LDL-c),triglycefides,and low cholesterol were significantly higher in the non-prematuregroup than in the premature group (all P ＜ 0.01),while high density lipoprotein cholesterol (HDL-c) was lower in non-prematuregroup (P ＜ 0.01).(2) The incidence of in-hospital events in both groups were low.There was less ventricular tachycardia in the non-premature group (1.5％ vs.0.3％) (P＜0.05).(3) There were no statistically significant differences in the number of infarct vessels,site ofinfarctbetween two groups.(4) Logistic regression analysis showed that smoking (OR =2.22,95％ CI:1.588-3.108) (P ＜ 0.05),family history of CHD (OR=2.12,95％CI:1.431-3.140) (P＜0.05),triglyceride concentration (OR=1.971,95％CI:1.475-2.635) (P＜0.05),LDL-c (OR=1.193,95％CI:1.008-1.413) (P=0.04) were independent risk factors fornon-premature STEMI withmultivessel disease.Conclusion Smoking,family history of CHD,triglyceride concentration,LDL are main risk factors of younger age STEMI patients with multiple vessel disease;Compared with younger age patients,older age patients during hospitalization are more likely to occur ventricular tachycardia.Regardless of age difference,the characteristics of coronary artery lesions show no significant difference.

OBJECTIVE:To prepare Baicalin proliposomes (PBA) containing sodium deoxycholate (SD) with optimized for-mulation,and to study pharmacokinetics of it in rats in vivo. METHODS:PBA were prepared by spray drying method. Response surface method based on Box-behnken design was adopted to optimize the formulation of PBA with the amount of HSPC,cholester-ol and SD as factors using entrapment efficiency of PBA as index. The particle size,morphology,leakage rate and stability of the optimal PBA were evaluated along with the pharmacokinetics of it(compared to raw materials)in rats after ig administration of 15 mg/kg. RESULTS:The optimal formulation of PBA was that the amounts of baicalin,HSPC,cholesterol and SD were 100,214, 68 and 53 mg,respectively;the predicted and practical values of entrapment efficiency were 86.42% and 84.32%,respectively, and particle size of the optimal PBA was 358.4 nm. The leakage rate of reconstituted liposomes was low and the stability of PBA was good. Compared with baicalin raw material,t1/2,tmax,MRT,cmax and AUC0-t of PBA were all increased significantly(P<0.05 or P<0.01 or P<0.001). CONCLUSIONS:PBA were prepared successfully using the spray drying method. This method is simple and easy,and the optimized formulation is feasible and can improve the oral bioavailability of baicalin.

Background The present study investigated the prognostic value of medical comorbidities at admission for 30-day in-hospital mortality in patients with acute myocardial infarction (AMI). Methods A total of 5161 patients with AMI were admitted in Chinese PLA General Hospital between January 1,1993 and December 31,2007. Medical comorbidities including hypertension, diabetes mellitus, previous myocardial infarction, valvular heart disease, chronic obstructive pulmonary disease (COPD), renal insufficiency, previous stroke, atrial fibrillation and anemia, were identified at admission. The patients were divided into 4 groups based on the number of medical comorbidities at admission (0, 1, 2, and ≥ 3). Cox regression analysis was used to calculate relative risk (RR) and 95% confidence intervals (CI), with adjustment for age, sex, heart failure and percutaneous coronary intervention (PCI). Results The mean age of the studied population was 63.9 ± 13.6 years, and 80.1% of the patients were male. In 74.6% of the patients at least one comorbidity were identified. Hypertension (50.7%), diabetes mellitus (24.0%) and previous myocardial infarction (12%) were the leading common comorbidities at admission. The 30-day in-hospital mortality in patients with 0, 1, 2, and ≥ 3 comorbidities at admission (7.2%) was 4.9%, 7.2%, 11.1%, and 20.3%, respectively. The presence of 2 or more comorbidities was associated with higher 30-day in-hospital mortality compared with patients without comorbidity (RR: 1.41, 95% CI: 1.13-1.77, P = 0.003, and RR: 1.95, 95% CI: 1.59-2.39, P = 0.000, respectively).Conclusions Medical comorbidities were frequently found in patients with AMI. AMI patients with more comorbidities had a higher 30-day in-hospital mortality might be predictive of early poor outcome in patients with AMI.

Objective To investigate the clinical characteristics and prognosis in the patients with type 2 diabetes mellitus and invasive pulmonary aspergillosis(IPA) for better management of the disease .Methods Clinical data of 9 cases of type 2 diabetes associated with IPA treated in Qingdao Municipal Hospital from January 2008 to December 2013 were analyzed retrospectively . Results The diagnosis of IPA was proven in 5 and probable in 4 of the 9 patients .The main clinical manifestations were fever , cough and expectoration .The findings of CT scan mainly showed pulmonary nodules along the bronchovascular bundle and cavity signs .Bronchoscopy showed congestion ,edema ,and erosion of bronchial mucosa covered with yellow‐white or brown pus ,partially or completely blocking the lumen .Antifungal treatment was effective for 4 patients .The other five patients died . Conclusions Type 2 diabetes mellitus is a risk factor for developing invasive pulmonary aspergillosis .Early diagnosis and proper treatment are critical for improved prognosis .

Objective To evaluate the diagnostic value of the multislice spiral computed tomography angiography (MSCTA) in the diagnosis of moyamoya disease and explore its future application. Method The image data of 10 patients with moyamoya disease undertaken MSCTA and digital subtraction angiography (DSA) were reviewed analysis. Results MSCTA could clearly show stenosis, multiple occlusion or abnormalities of the cerebral vessels. Volume-rendering helped to show the relationship between the abnormal vessels and the surrounding tissues. Combined maximum intensity projection (MIP) and multiplsnar reconstruction (MPB) images could clearly show abnormally increased vessels (moyamoya disease vessels). The rate of occlusion and stenosis showed by MSCTA were 66.2%(53/80)and 67.5%(54/80)by DSA. There was no significant difference between the two methods (P>0.05). The images of MSCTA were basically same as those of DSA. Conclusions MSCTA is sensitive in diagnosing moyamoya disease, which is an important basis for early diagnosis. Early diagnosis and treatment is effective in improving prognosis of moyamoya disease.

ObjectiveTo investigate the efficacy and advantages through the combination of transurethral resectoscope outer sheath and ueteroscopy for treatment of bladder stones.MethodsThe Wolf F24 transurethral resectoscope was first placed in bladder to observe the lesions in 68 patients with bladder stones.With the moving out of the body and inner sheath,F8 ureteroscopy sheath was sent into the bladder through outer sheath,then,holmium laser lithotripsy was performed.ResultsSixty-eight patients got successful operations without postoperative stones residual,significant postoperative bleeding,urethral tear,bladder injury and infection complications. The gravel rate reached 100％ 20 - 60 minutes ( 36.7 ± 5 ) min.ConclusionThe combination of transurethral resectoscope outer sheath and ueteroscopy is effective and safe for treatment of bladder stones.

Objective To observe the changes of the peripheral blood T helper (Th)17 cells/regulatory T cells (Treg) ratio in patients with anti‐tuberculosis drug‐induced liver injury ,and to explore the relationship between Th17/Treg ratio and liver function . Methods Ninety inpatients with the diagnosis of secondary pulmonary tuberculosis (TB) from Affiliated Hospital of Zunyi Medical College from Feb .2013 to Mar .2015 were included in this study .All these patients had normal base line liver function .After 2 weeks of anti‐TB chemotherapy ,21 patients with alanine transaminase (ALT) and/or aspartate aminotransferase (AST) ≥2 × upper limit of normal (ULN) were defined as TB with liver injure group ,the other 69 patients with ALT and/or AST<2 × ULN were defined as TB with non‐liver injured group .Before treatment and two weeks after anti‐TB therapy ,the peripheral blood Th17/Treg ratios and liver functions of all patients in both groups were detected in order to compare the changes of Th17/Treg ratios pre and post anti‐TB chemotherapy and to explore the relationship between Th17/Treg ratio and ALT/AST levels .Student′s t test was used for statistical analysis ,and Pearson correlation analysis was used for correlation test .Results Before treatment ,there was no statistical significance of Th17 ,Treg and Th17/Treg ratio between groups (P> 0 .05) .The Th17 levels in TB with liver injured group ([2 .522 ± 0 .388]/mL vs [2 .075 ± 0 .369]/mL ,t=3 .633 ,P<0 .01) and TB with non‐liver injured group ([2 .326 ± 0 .348]/mL vs [1 .929 ± 0 .402]/mL ,t= 6 .468 , P< 0 .01) ,and Th17/Treg ratios in both groups(0.618±0.104vs0.489±0.107,t=3.553,P<0.01 ;0.554±0.108vs0.450±0.098,t=6 .353 ,P<0 .01) were all increased after anti‐TB chemotherapy ,with statistically significant differences . However ,there was no statistical significance of Treg levels pre and post anti‐treatment in both groups (both P>0 .05) .The Th17 level and Th17/Treg ratio in TB with liver injured group were significantly higher than those in TB with non‐liver injured group (t= 2 .203 , P< 0 .05 and t= 2 .345 , P< 0 .05 , respectively) .In liver injured group ,the Th17/Treg ratio was positively correlated with ALT level (r=0 .849 ,P=0 .044) ,but not with AST level (P>0 .05) .Conclusion The changes of Th17/Treg ratio are related with anti‐TB drug‐induced liver injury in patients with secondary pulmonary tuberculosis .

Objective To research the special manifestations of magnetic resonance cholangiopancreatography(MRCP) in carcinoma of pancreatic head.Methods MRCP in 22 cases with pancreatic head carcinoma confirmed by operation and pathology (including SE sequences with T1WI and fat saturation,FSE with T2WI and fat saturation and MRCP in coronal sectior) were performed before operations.Additional CE MRA on abdominal vessels including abdominal ateries, portal veins and superior mesenteric arteries and their veins in 16 cases also examined before operations. Results Carcinomas of the pancreatic head were diagnosed correctly by MRCP in 21 cases, and 1 case was misdiagnosed as chronic pancreatitis. MRCP all demonstrated abrupt interruption at pancreatic head segments of dilated left common bile duct and main pancreatic duct at the pancreatic head ones, their left segments were dilate with higher signal and both didn't cross each other, because they were destroyed by carcinomas of pancreatic head. Destruction and no cross each other of pancreatic head segments of choledochus and main pancreas duct,it was called "no cross sign". CE MRA demonstrated destruction of abdominal ateries in 3 cases, portal vein in 3 cases and superior mesenteric vein in 4 cases and not being resected.Conclusion "No cross sign"on MRCP examination is of important value in diagnosis of carcinoma of the pancreatic head.