Objective To analyze the clinical features,curative effect and prognosis of extra-pulmonary infections by mycoplasma pneumoniae(MP).Methods ELISA was used to detect anti-MP IgM and IgG.Case histories of 226 patients,whose nasopharyneal lotione and respiratory secretions were positive of virus and bacteria respectively,was analysed retrospectively.Results One hundred and eighteen of the 226 (52.2%) cases suffered from extra-pulmonary infection.Of these infections 38.98%,33.89%,21.11% and 17.79% were found in digestive, urinary, cardiovascular systems and serous membrane respectively.All of the cases were improved after treatment with macrolides antibiotics.All cases were MP IgM positive,35.5% cases were IgG positive.Spatum MP positive rate was 32.2%.Positive rate of cold-agglutination test was 47.46%.Conclusions MP infection may cause many extra-pulmonary complications.When multi-organ infections can not be explained with bacterial and viral infections,MP infection should be considered.

Adult ; Female ; Humans ; Maxillary Sinus Neoplasms ; Middle Aged ; Neoplasms, Muscle Tissue

0.05).Compared with I/R group,N group showed significantly better recovery of hemodynamic function.At the same time,the size of myocardial infarction and the number of AI were lowered(vs I/R,P

Objective To construct human phage antibody library against hepatoma carcinoma.Methods Peripheral blood mononuclear cells(PBMCs) of patients with liver cancer were sensitized in vitro and transformed by Epstein-Barr virus(EBV).The genes of light chain and Fd of antibodies were amplified by RT-PCR.Fab genes were cloned into vector pComb3 and transformed into E.coli XLI-Blue by electroporation to construct the Fab-displaying phage antibody library.Results ELISA detection showed that 4 liver cancer patients' B cells transformed by EBV could produce specific antibodies to hepatoma carcinoma cell.Totally 13 types of light chain genes and 28 types of Fd genes were obtained by RT-PCR.The capacity of the primary phage library was 1.7?107pfu/mL.The percentage of recombinant clones was about 100%.Conclusion A human phage antibody library has been constructed successfully by means of EBV transformation technique.

Objective To investigate the clinical value of contrast-enhanced ultrasound(CEUS) in the diagnosis of postnatal placenta increta. Methods Twenty-six patients with postnatal placenta increta were examined by gray-scale and color Doppler ultrasound and CEUS. Then microvascular perfusion and enhanced features of lesions, myometrium and serous layer were observed. Arriving time (AT), time to peak intensity (TTP) and the lasting time of enhancement (LTE) were recorded. AT,TTP and LTE of enhanced lesions were compared with those of normal myometrium. Results Serous layer, lesions and adjcent myometrium,normal myometrium enhanced in turn. There was no obvious boundary between the lesions enhanced and adjcent myometrium. AT and TTP of the lesions enhanced were both less than those of normal myometrium ( P ＜0. 05). LTE of the part of lesions enhanced was more than that of normal myometrium ( P ＜0.05).Part of lesions never enhanced during the whole process. The serous layer of uterine was smooth and uninterrupted in 24 patients. These 24 patients all recovered after conservative treatment. The local serous layer adjcent lesions was not smooth, but no contrast agent leakage occurred in another 2 patients, and uterine lobectomy were performed in emergency because of massive hemorrhage during conservative treatment. Conclusions Microvascular perfusion and enhanced features of lesions,myometrium and serous layer could be showed clearly through CEUS.

Objective The present study investigated the expression of heat shock cognate protein 70 (Hsc70) in the synovial tissues and blood samples of patients with rheumatoid arthritis (RA) to determine the pathological role of this protein in the pathogenesis of the disease.Methods The expression of Hsc70 in synovial membranes was quantitatively analyzed by immunohistochemistry,real-time quantitative PCR and western blotting.The samples from osteoarthritis (OA) and ankylosing spondylitis (AS) were used as controls.The levels of Hsc70 in blood of patients with RA were determined using enzyme linked immunosorbent assay (ELISA) with the samples of the healthy subjects as controls.Statistical analysis was conducted with one-way ANOVA,LSD test and Spearmen's correlation.Results Immunohistochemistry showed that Hsc70 had significantly increased expression in synovial tissues of RA than in the samples of OA and AS.Real-time PCR and western blotting confirmed the above findings.ELISA detected significantly elevated level of Hsc70 in blood of patients with RA as compared with samples from the controls (P＜0.01).Conclusion The study suggests that the up-regulation of Hsc70 may be involved in the pathogenic process of RA.

Objective To improve the methods of making myocardial ischemia-reperfusion model and observe the changes of electrocardiogram and ultrastructure of myocardium in rats.Methods The chest of young male SD rats through the fourth intercostal space was opened,and the left coronary artery was tied with a silicagel tube,after 30 minutes,untied to perfuse.Changes of electrocardiogram were observed and recorded.After reperfusion,the levels of AST,LDH,and CK-MB were measured and the tissue samples of the infarct areas were examined by transmission electronic microscope.Results The 90 percent of total rats were made myocardial ischemia reperfusion model successfully.In myocardial ischemia reperfusion rats:the QRS wave of myocardial ischemia-reperfusion rats was much higher than that of control group;the level of cardiac enzymes increased;myocardial and vascular endothelial cells ultrastructure was damaged seriously.Conclusions The improvement of modus operandi is right.Ischemia reperfusion can cause evident damage of myocardial and vascular endothelial cells ultrastructure in rats,and damage of myocardial cells is more severe than vascular endothelial cells.

Objective To study the relationship between biofilm-forming ability,distribution of quorum sensing related genes and antibiotic resistance in clinical isolates of Pseudomonas aeruginosa.Methods The biofilm-forming ability of 94 clinical isolates was analyzed semi-quantitatively by crystal violet staining.The antibiotic resistance of the isolates was determined by K-B method.Quorum sensing related genes,lasI,lasR,rhlR and rhlI,were detected by PCR.The diffe,rences of drug resistance of Pseudomonas aeruginosa with different biofilm-forming ability and the effects of quorum sensing related genes on biofilm-forming ability were analyzed.Results Of the 94 isolates,89(94.7％) showed biofilm-forming ability.The 89 isolates consisted of 22(23.4％) isolates with weakly positive biofilm-forming ability,44 (46.8 ％) with positive biofilm-forming ability and 23 (24.5 ％) with strongly positive biofilm-forming ability.The strains of Pseudomonas aeruginosa with different biofilm-forming ability showed different drug resistance rates to amikacin,tobramycin and gentamicin (P ＜ 0.05).The drug resistance rate of the strains with strong positive biofilm-forming ability to amikacin was higher than that of the strains with positive and weakly positive biofilm-forming ability(P ＜ 0.05),and the drug resistance rates to tobramycin and gentamicin were higher than those of the strains with weakly positive biofilm-forming ability(P ＜ 0.05).Of the 94 isolates,91 strains carried lasI,lasR,rhlI and rhlR gene and 2 strains only lost lasR gene,and 1 strain lost all the 4 genes.The strains with only lasR gene deficiency or all the lasI,lasR,rhlI and rhlR gene deficiencies showed negative biofilm-forming ability,and were sensitive to conventional antimicrobial agents.Conclusion Most of the clinical isolates of Pseudomonas aeruginosa in this study showed strong ability of biofilm-forming ability which may correlate positively to partial antibiotic resistance.The quorum sensing related genes may affect biofilm formation of Pseudomonas aeruginosa.

Objective To study the causes of emergency department (ED) overcrowding and access block in Beijing.Methods This was a multi-center cross sectional study.The studied cohort of patients included all ED visiting patients from 18 municipal teaching hospital EDs in Beijing from 2012 to 2013.Patient' s characteristics and medical care settings were analyzed.Results The urgent care cases accounted for only 4.6 ％ (71 224/1 554 387) of the emergency annual visits in 2012 and 5.5 ％ (88 190/1 615 571) in 2013.The total number of observation patients in EDs was 185 277 and 211 900 in 2012 and 2013 respectively,with an increase of 14.4 ％ (P ＜ 0.01).The total ED-admission inpatients only accounted for 2.97％ and 2.89 ％ of total annual visits in 2012 and 2013 respectively.The average time of ED-admission took 37.1 hours and 36.2 hours in 2012 and 2013 respectively.The average time of ED stay for observation was 4.9 days and 5.4 days in 2012 and 2013 respectively.Upper respiratory tract infection was the leading illness in annual visits.The leading cause of ED stay for observation was bedridden with pneumonia.Conclusions The ED settings in Beijing are different from other countries.The EDs actually assume the task of the clinic and ED service for 24 hours thereby made EDs terribly overcrowded.The main causes are large number of non-emergency patients visiting the ED and patients in the ED are difficulty to be hospitalized.Patients with end-stage disease and multiple organ failure stayed in the ED due to nursing home shortage.

ObjectiveTo study the scope of excison in breast-conserving surgery for breast carcinoma.MethodsClinical data of 275 breast cancer patients undergoing breast-conserving surgery in t he First Affiliated Hospital of Nanjing Medical University,the Affiliated Zhenjiang Hospital of Jiangsu University and Changzhou Traditional ChineseMedicine Hospital were retrospectively analyzed.The operation procedure and postoperative adjuvant therapy were carried out with the same protocol.Local and general conditions of patients were followed up regularly.Results271 out of 275 patients got follow-up.The follow-up rate was 98.5％.The follow-up time ranged from 1 month to 117 months,median follow-up time was 34 months.Six patients died of distant metastasis,2 with local recurrence.The 1-year,3-year,and 5-year overall survival rates were 99.5％,98.1％,and 95.7％,respectively.ConclusionsIt is safe to excise 1 cm normal breast tissue with clear margin confirmed by frozen section,followed by postoperative adjuvant therapy,endocrine therapy,and radiotherapy,this improves the life quality of patients with breast cancer.It is safe and effective to determine whether the disease is multicentric or multifocal by mammogram plus clinical breast examination.