Objective To investigate the incidence of drug resistance among new and retreatment TB patients from special hospital.Methods Totally 500 smear positive TB patients from June 2013 to December 2014 in Beijing Chest Hospital were enrolled.Phenotypic susceptibilities to cultured isolates were analyzed in 15 anti tuberculosis drugs by MGIT 960,include Isoniazid (INH),Rifampicin (RFP),Streptomycin (STR),Ethambuto (EMB),Kanamycin (Km),Amikacin (Am),Capreomycin (Cm),Ofloxacin (Ofx),Levofloxacin (Lfx),Moxifloxacin (Mfx),Paza-aminosalicylate (PAS),Protionamide (Pto),Linezolid (Lzd),Ethionamide (Eto),Pyrazinamide (PZA).Results A total of 500 TB cases were enrolled.71 samples among these were NTM infection and 12 samples were contaminted.The rest of 417 of cases infected with Mycobacteriuma,and the rate of drug resistance was 47.2％ (192/417) and the MDR rate was 28.2％ (120/417).The retreatment was significantly higher than that of the new in any drug resistance rate and MDR rate (P =0.000).100 of the retreatment isolates and 50 of the new isolates with Mycobacteriuma were selected to do the drug susceptibility test in 11 subsequent anti tuberculosis drugs (include:PZA,Am,Km,Cm,Ofx,Lfx,Mfx,PAS,Pto,Lzd,Eto).Five cases were contaminated,and in the rest of the cases,48 was the new and 97was the retreatment.The rate of the drug resistance to PZA,Am,Km,Cm,Ofx,Lfx,Mfx for the retreatment were significantly higher than the new (P ＜ 0.05).The rate of drug resistance to PAS,Pto,Lzd and Eto for the new and reteartment were no markedly differential in statistics.Conclusion This study further confirmed the rate of drug resistance in retreatment cases is higher,and the management of tuberculosis patients should be further strengthened.

The effects of exogenous Na-DL-3-hydroxybutyate (3-HOBNa)and insulin(I) on skeletal muscle protein metabolism in rats inflicctcd with 37% TBSA full thickness scalding were studied It was found that the scrum acctoacctatc (AcAc) of the burned animals showed no significant difference from the control on the 4th day postburn,but the free fatty acid (FFA) decreased markedly and the urinary 3 - methylhistididne(3-MH) excretion and the protein de -gradation rate of the soleus muscle of the injured hind limb increased na kedly.Infusion of 3-HOBNa for 3 consecutive days following burns could lower the urinary 3-MH excretion and the protein,degradation rate of the soleus muscle with no significant influence on the skeletal muscle protein anabolism.Moreover,investigations revealed that there was no syncrgistic effect of insulin-kctone body combinalioan on the anti-catabolic capacity in burned rats.

Objective: To explore influence of nursing strategies based on evidence based medical theory on negative emotion and daily behavior in aged patients with coronary heart disease (CHD).Methods: A total of 88 CHD patients, who were treated in our department from Oct 2012 to Mar 2015, were selected.According to random number table, they were randomly and equally divided into routine nursing group and evidence based nursing group (received evidence based nursing based on routine nursing group).Unhealthy lifestyles, scores of self-rating anxiety scale (SAS) and self-rating depression scale (SDS), satisfaction for nursing and incidence rate of major adverse cardiovascular events (MACE) were measured and compared between two groups before and four months after intervention.Results: Compared with routine nursing group after four-week intervention, there were significant reductions in percentages of smoking (40.9% vs.22.7%), drinking (54.5% vs.38.6%), high-fat diet (43.2% vs.29.5%), physical inactivity (45.5% vs.25.0%) and overweight (52.3% vs.29.5%), scores of SAS [(50.4±3.3) scores vs.(45.8±3.2) scores] and SDS [(53.4±4.7) scores vs.(48.0±4.2) scores], and incidence rate of MACE (25.0% vs.11.4%), and significant rise in satisfaction for nursing (86.4% vs.97.7%) in evidence based nursing group (except for the P of overweight was <0.01, others were P<0.05 all).Conclusion: Evidence based nursing mode can improve unhealthy lifestyle and relieve negative emotional status in aged patients with coronary heart disease, which is worth extending in clinic.

Objective To do the environmental impact assessment for the water supply project of Mopan Mountain Reservoir in Harbin. Methods To collect the related data and to do the field-investigation and inspection in epidemiology, animals and insects, environmental quality sanitization and water quality, etc in the area of Mopan Mountain Reservoir and the surroundings. Results The main infectious disease in the development area of Mopan Mountain Reservoir was at the lower prevalence level and there was no fatal infectious disease such as plague , cholera in the recent ten years. Besides, there was no grievous public health emergency. There were no factories and collieries emitted poisonous chemical material in the catchment area. The results of water quality investigation showed that all the indexes were up to the related standards. Conclusion Monpan Mountain Reservoir project is not ease to cause the infectious diseases spread by water among the people. The water quality can meet the request for water source. The reservoir will not influence the ecological environment when the latent environment pollution factors are under control.

Objective To compare the differences of epidemiology, clinical characteristics, laboratory results and prognosis between patients with severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) infection and those with hemorrhagic fever with renal syndrome (HFRS).Methods Medical records of 16 hospitalized cases with SFTSV infection and 28 hospitalized HFRS cases from January 2012 to June 2016 were reviewed in affiliated Yijishan Hospital of Wannan Medical College.In details, the comparative analysis of patients between the two groups were conducted in sex, age, occupation, onset season, contact history, underlying diseases, fever duration, oliguria, bleeding (including petechiae, ecchymoses, gum bleeding, bloody stool and hematuria), secondary infection, consciousness disturbance, dialysis treatment, length of hospital stay, laboratory results and prognosis.Continuous variables of normal, non-normal distribution data were compared using two-sample t test and rank sum test, respectively.Categorical variables were showed in rate and compared using chi-square test.Results The differences between the two groups in age (t=2.585), occupation (χ2=4.914), onset season (χ2=4.325) and contact history (χ2=9.617) were all statistically significant (all P<0.05).In SFTSV infection group, the mean fever duration was (8.81±3.17) d.There were 2 cases of oliguria, 10 cases of bleeding, 7 cases of secondary infection, 5 cases of consciousness disturbance.No patient received dialysis.The average length of hospital stay was (13.44±7.91) d.In HFRS group, the mean fever duration was (5.96±2.20) d.In addition, there were 24 cases of oliguria, 25 cases of bleeding, 9 cases of secondary infection, 3 cases of consciousness disorder.Twelve cases received dialysis treatment in this group.The average length of hospital stay was (18.04±15.75) d.Furthermore, there were significant differences between the two groups in fever duration (t=3.511), oliguria (χ2=22.578), bleeding (χ2=4.490) and dialysis (χ2=7.392) (all P<0.05).The significant differences were also found in white blood cell count, blood urea nitrogen, serum creatinine, albumin, amylase, lipase, creatine kinase, serum sodium, chloride, calcium, carbon dioxide combining power and blood glucose between the SFTSV infection group and HFRS group (all P<0.05).However, there was no significant difference in prognosis between the two groups (Z=1.574, P=0.115).Conclusions There are differences in epidemiological history, clinical manifestations and laboratory findings between the SFTSV infection group and HFRS group, which may help differential diagnosis and treatment of these two diseases.

Case analysis method,which was a new teaching mode,was proposed for some problems in current traditional teaching mode.The concrete operation content of case analysis method in lemological teaching was described.The results of the survey analysis showed that the teaching effectiveness of the new teaching mode was obviously better than that of traditional teaching mode.

Objective To explore the changes of etiological factors,age of onset,misdiagnosis rates,length of stay and prognosis in central nervous system (CNS) infections between the near 2 decades.Methods A retrospective analysis was conducted between hospitalized patients with CNS infections in affiliated Yijishan Hospital of Wannan Medical College from January 1993 to December 2002 (group A,n =346) and from January 2003 to December 2012 (group B,n =412).The proportions of bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections between the 2 groups were comparable.Age,gender,underlying diseases and prehospitalization applications of immunosuppressant in two groups were analyzed.The data of prehospitalization misdiagnosis rates,length of stay and prognosis of the two groups were also compared.Measurement data were analyzed by variance analysis or t test,and enumeration data were analyzed by x2 test.Results The proportions of bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections in two groups were 24.3％ vs 20.1％,29.5 ％ vs 35.7 ％,6.6％ vs 11.4％ and 39.6％ vs 32.8％,respectively (x2 =10.61,P＜0.05).Compared with group A,patients in group B were older [(38.8±8.9) years vs (43.8±11.4) years,t=6.73,P＜0.05],with greater numbers of underlying diseases (1.21 ± 0.34 vs 1.72 ± 0.41,t=18.41,P＜ 0.05) and longer pre-use of immunosuppressants [(7.76 ± 3.58) d vs (12.43 ± 5.96) d,t =12.77,P＜ 0.05].There was no significant difference in sex distributions between the two groups (x2 =0.97,P＞0.05).In group A,the misdiagnosis rates for bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections were 9.5％,42.2％,69.6％ and 12.4％,respectively; average length of stay was (11.02±5.13) d,(19.18±8.34) d,(21.12±9.26) d and (8.24±3.17) d,respectively; and remission rates were 88.1％,60.8％,34.8％ and 80.3％,respectively.In group B,the misdiagnosis rates for bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections were 8.4％,29.3％,42.6％ and 11.1％,respectively; average length of staywas (10.13±4.25) d,(17.26±5.82) d,(23.05±7.97) d and (7.05±2.94) d,respectively; and remission rates were 90.4％,72.8％,61.7％ and 84.4％,respectively.The misdiagnosis rates and remission rates of Mycobacterium tuberculosis infections and Cryptococcus infections between group A and group B were of statistical significance (both P ＜ 0.05).Conclusions With the increase of underlying diseases and wide use of immunosuppressants,the causes of CNS infections are changing,among which Mycobacterium tuberculosis infections and Cryptococcus infections are increasing,with a tendency of misdiagnosis and poor prognosis.

Objective To evaluate the regulatory role of acetylcholine receptor in muramyl dipeptide (MDP)-induced activation of Nod-like receptor 2/receptor-interacting protein 2 (2NLR2/RIP2) pathway in macrophages of mice.Methods RAW264.7 cells at the logarithmic growth phase were seeded in 12-well plates (density 1 × 106 cells/ml,2 ml/well),a total of 108 wells.The cells were randomly divided into 3 groups (n =36 each) using a random number table:control group (group C),MDP group (group M),and GTS-21 (a7nAChR specific agonist) group (group G).The cells were routinely cultured in group C.MDP with the final concentration of 10 μg/ml was added to the culture medium in group M.MDP with the final concentration of 10μg/ml and GTS21 with the final concentration of 50 μg/ml were added to the culture medium in group G.The cells were incubated for 24 h.At 1,6 and 24 h of incubation with MDP,12 wells were chosen and the cell suspension was obtained for measurement of NLR2 mRNA expression (by real-time fluorescent quantitative PCR),RIP2 expression (by Western blot),and concentrations of tumor necrosis factor-alpha (TNF-α) and high mobility group box-1 (HMGB1) in the culture media (by ELISA).Results Compared with group C,the levels of NLR2 mRNA,RIP2,TNFα and HMGB1 were significantly increased at each time point in group M (P ＜ 0.05).Compared with group M,the levels of NLR2 mRNA,RIP2,TNF-α and HMGB1 were significantly decreased at each time point in group G (P ＜ 0.05).Conclusion Acetylcholine receptor can suppress MDP-induced transduction of NLR2/RIP2 pathway in macrophages of mice.

Objective To investigate the effect of the new polyamine analogue tetrabutyl propanediamine (TBP) on cell proliferation and the underlying mechanism. Methods MTT assay was performed to determine cell proliferation. Flow cytometry was performed to detect cell cycle transition. DNA fragmentation and mitochondrial membrane potential determinations were performed to detect cell apoptosis. The activity of key enzymes in polyamine catabolism was detected by chemiluminescence assay. Results TBP could significantly inhibit the proliferation of HL-60 cells by blockingcell cycle transition and by inducing apoptosis. The TBP-induced apoptosis of HL-60 cells was in a dose-dependent manner. The enzyme activities of SMO and APAO were also significantly increased in HL-60 cells after treatment with 100 μM TBP for 24 hours. Conclusions TBP, as a new putrescine analogue, could inhibit proliferation of HL-60 cells by increasing the enzyme activity of SMO and APAO and inducing apoptosis.

Objective To evaluate the safety and feasibility of injection test which is used to locate esophageal balloon catheter.Methods A prospective study was conducted. The patients undergoing invasive mechanical ventilation (MV) admitted to general intensive care unit (ICU) of Beijing Tiantan Hospital Affiliated to Capital Medical University from May 2015 and March 2017 were enrolled. The commercially available esophageal balloon catheter was modified to perform injection test. The catheter was withdrawn step by step and the injection test was repeated until the presence disturbance wave presented, which indicated that the balloon had just entered the esophagus. The position where disturbance wave appears was named 0 cm. End-expiratory occlusions were performed at the positions of+15,+10,+5, 0, -5, -10 and -15 cm, respectively, and the changes of esophageal pressure (Pes) and airway pressures (Paw) were measured in the spontaneous breathing and passive ventilation, and the ratio between the changes (ΔPes/ΔPaw) was calculated.Results A total of 20 patients were enrolled, of which 15 patients finished both the spontaneous and the passive ventilation parts, and 2 patients finished only the spontaneous part and 3 patients finished only passive part. ① Disturbance waves could be induced by injection test in all patients. The average depth of disturbance wave in spontaneous breathing was deeper than that in passive ventilation (cm: 42.4±3.8 vs. 41.8±3.3), but there was no significant difference between the two ventilation settings (P = 0.132). No adverse events occurred during the study period. ② Pes increased with the stepwise withdraw of esophageal catheter, reached the maximal value at+5 cm, and then decreased when the catheter was further withdrawn, no matter in the spontaneous or the passive ventilation. In spontaneous breathing, the ΔPes/ΔPaw was within the ideal range (0.8-1.2) at the positions of 0, -5 and -10 cm. The ΔPes/ΔPaw was closest to unity at the positions of 0 cm (0.98±0.15). The ΔPes/ΔPaw at -15 cm (0.66±0.26) was significantly lower than that at 0 cm (P < 0.05). For passive ventilation, the ΔPes/ΔPaw was within the ideal range at the positions of -5 cm and -10 cm, and the ΔPes/ΔPaw was closest to unity at the positions of-10 cm (0.94±0.12). The ΔPes/ΔPaw at 0 cm and -5 cm was significantly higher than that at -10 cm (1.43±0.31 and 1.12±0.14, respectively); while the ΔPes/ΔPaw at -15 cm (0.68±0.23) was significantly lower than that at -10 cm (allP < 0.01).Conclusions Ideal position of the esophageal balloon catheter could be determined quickly and easily by using injection test. The method is safe and clinically feasible.Clinical Trial Registration Clinical Trials, NCT02446938.