Objective To investigate the risk factors of bloodstream infections caused by multiple drug resistant Acinetobacter baumannii (MDRAB) and those associated with 30-day clinical outcomes of MDRAB patients. Methods A case-control study was designed to retrospectively analyze 49 cases of MDRAB-related bloodstream infections treated in our hospital during the period from January 2013 to December 2014. Additional 29 cases of non-MDRAB bloodstream infections were included as control group. Univariate and multivariate logistic analysis were used to identify the risk factors of MDRAB bloodstream infections. The prognostic factors were analyzed similarly for all the 78 cases of bloodstream infections by comparing the relevant factors between survival group (38 cases) and non-survival group (40 cases) based on the survival status 30 days after collecting blood samples. Results Univariate analysis revealed that the risk factors for MDRAB bloodstream infection included use of carbapenems, quinolones, or at least 2 antibiotics, mechanical ventilation, nasogastric tube, indwelled central venous catheter, and ICU stay prior to infection. Subsequent multivariate logistic analysis showed that ICU stay (OR=7.118) and prior use of at least 2 antibiotics (OR=8.073) were independent risk factors for MDRAB bloodstream infection. Univariate analysis revealed that ICU stay, mechanical ventilation,and MDRAB in blood sample were the prognostic factors of 30-day survival. Multiple logistic regression analysis showed that MDRAB infection (OR=5.837) and mechanical ventilation (OR=4.926) were the independent risk factors predicting of 30-day patient death. Conclusions ICU stay and prior use of at least 2 antibiotics were independent risk factors for MDRAB bloodstream infection. MDRAB infection and mechanical ventilation were the independent risk factors predicting 30-day patient death in MDRAB bloodstream infections.

Objective To understand the adverse reaction profile of linezolid during clinical treatment,especially lactic acidosis and pancytopenia.Methods One case of linezolid-induced lactic acidosis and pancytopenia was described in a patient receiving long-term treatment in our hospital.Similar cases were searched and identified from literatures reports both in China and abroad from 2000 to 2015 for further review.The data were analyzed in terms of patient age,sex,underlying conditions,as well as onset time,clinical characteristics,and outcomes of the adverse reaction.Results A total of 50 similar cases (male/female ratio:1.78∶1) were analyzed,42.0％ of which were old patients (at least 65 years old).Liver and/or renal insufficiency was found in 20 cases (40.0％).The onset of lactic acidosis was at 5.5 weeks after initiation of linezolid on average,and the onset of pancytopenia was at 3.5 weeks after initiation of linezolid.Conclusions Linezolid-induced lactic acidosis or pancytopenia is more frequently found in the elderly patients with hepatic dysfunction and long-term treatment.

Objective To explore the exercise risk of urban residents aged18 to 65 years old.MethodsHealth screening and cardiovascular risk stratification were performed among adults18 to 65 years old in 2010by using exercise risk assessmentrecommendedbyAmerican College of Sports Medicine.Result A total of15 498 subjects were recruited 9293 males and 6205 females,mean age (44.8 ±11.1) years,8929(57.6％ ) in the lower risk group,5323(34.3％ ) in the moderate risk group,and 1246(8.1％ ) in the higher risk group.The proportion of those in the higher risk group was increased with age.Conclusion Risk assessment and Physical Activity Readiness Questionnaires should be used before physical activity programme is initiated,especially in middle aged or elderly people.

Objective To study serum level of prostate specific antigen (PSA) by age and its relationship with positive prostatic biopsy.Methods A total of 8818 adults who underwent PSA scanning at Health Chek-up Center of Beijing Hospital during July 2009 and July 2010 were retrospectively studied,40 of whom performed prostatic biopsy.Linear regression was used to assess the relation of PSA with age,while Chi-square test was used to compare positive prostatic biopsy in different PSA groups.Results Serum PSA of more than 4 μg/L was more commonly seen in the elderly group (40 ～ year-old group 1.4％,50 ～ yearold group 1.9％,60 ～ year-old group 9.2％,70 ～ year-old group 15.5％,80 year-old group 17％ ; P ＜0.001 ; RR =0.196).In those whose PSA was ＞ 20 μg/L,6 (83.3 ％) were found to have positive prostatic biopsy; and the figure was 10 (50.0％) or 24 (24.0％) when PSA was ＜4 μg/L or 4-10 μg/L group (P =0.048).Conclusions Age was positively correlated with PSA,although no linear correlation was confirmed.Higher serum PSA level (＞ 4 μg/L) may be more common in elderly people and those with a positive prostatic biopsy.

Objective To investigate the age distribution of serum prostate-specific antigen (PSA) in middle-aged and aged people in Beijing. Methods From November 2006 to November 2008, the data of men, who visited Beijing Hospital for routine health examination and received a measurement of serum PSA level, were collected and analyzed retrospectively. The eligible men were classified into various age groups over 10-years interval, and the PSA distributions were analyzed in the groups. Results A total of 11557 men were enrolled in this study. Within the entire cohort, the median PSA level was 0. 89 μg/L. The median PSA levels in each age group were as follows: 0. 79 μg/L in 40-49 yrs age group, 0.85 μg/L in 50-59 yrs age group, 1.20 μg/L in 60-69 yrs age group,1.44 μg/L in 70-79 yrs age group and 1.52 μg/L in more than 80 yrs age group. The serum PSA level gradually increased along with age. A rapid increase of PSA level began from 60 yrs age. The percentile of men with PSA ＞4 μg/L were 1.3%, 2.6%, 8.8%, 15.4% and 14.4% according to age category. Conclusions The PSA level is positively correlated with age in middle-aged and aged people in Beijing. Especially from 60 years of age, the percentile of men with abnormal PSA increases dramatically. Our results can guide clinicians to understand the population-based distribution of serum PSA and to screen prostate cancer.

AIM:To investigate the synergistic anti-proliferation effect of aspirin and 5-fluorouracil on the co-lon cancer cells and its mechanism .METHODS: Colon cancer cells were divided into 4 groups: control group , aspirin group, 5-fluorouracil group and aspirin +5-fluorouracil group .Synergistic anti-proliferation effect of aspirin and 5-fluoroura-cil on the colon cancer cells was observed by MTT assay .Apoptosis-inducing effect and mechanism were detected by Hoechst 33258 staining, caspase activity assay and flow cytometry analysis .The mRNA and protein levels of apoptosis-re-lated proteins were evaluated by real-time PCR and Western blotting .RESULTS:5-Fluorouracil inhibited proliferation of HCT116 and SW620 colon cancer cells effectively , and low concentration of aspirin exerted synergistic inhibitory effect .5-Fluorouracil induced apoptotic morphology and increased caspase activity and sub -G1 phase in HCT116 cells.The synergis-tic effect of aspirin obviously enhanced apoptotic ratio and caspase activity .Moreover , 5-fluorouracil inhibited the mRNA and protein expression of Bcl-2, which was amplified by low concentration of aspirin .CONCLUSION:Aspirin and 5-flu-orouracil had a synergistic anti-proliferation effect on the colon cancer cells through apoptosis pathway .

OBJECTIVE:To study the inhibition effect of spinosin on 7 subtypes (CYP2B6,CYP2C8,CYP2C9,CYP2D6, CYP1A1,CYP2C19 and CYP3A4)of cytochrome P450(CYP450)enzymes from human liver microsomes in vitro. METHODS:Tak-ing 200.00,100.00,50.00,25.00,12.50,6.25,3.13,1.56,0.78,0.39 μmol/L spinosin and human liver microsomes for incuba-tion,using daktarin,bupropion,amodiaquine hydrochloride,diclofenac sodium,mephenytoin,dextromethorphan hydrobromide and midazolam as the specific probe drugs for above-mentioned 7 subtypes of CYP450 enzymes. UPLC-Q-TOF-MS was conducted to detect generation amount of 7 probe drug metabolites,and the half inhibitory concentration (IC50) of spinosin on 7 subtypes of CYP450 enzymes from human liver microsomes was calculated. RESULTS:IC50 of spinosin on 7 subtypes of CYP450 enzymes from human liver microsomes were 1714,1158,226.1,2288,80.59,101.1,1119 μmol/L,respectively,which were higher than 50μmol/L. CONCLUSIONS:Spinosin has no inhibition effect on above-mentioned 7 subtypes of CYP450 enzymes from human liver microsomes,with very low probability of inducing metabolic drug interactions.

Objective To assess the efficiency of an iontophoresis-based screening method (EZSCAN) in the detection of impaired glucose tolerance (IGT),diabetes mellitus (DM) and metabolic syndrome (MS).Methods A total of 166 subjects without medical history of dysglycaemia underwent fasting plasma glucose (FPG) and HbA1c measurement and oral glucose tolerance test (OGTT) by using traditional or EZSCAN method.Variance analysis (GLM),SNK analysis,logistic regression analysis,and ROC analysis were used to evaluate the diagnostic value of those screening techniques.Results DM,IGT,normal glucose tolerance (NGT) +MS,and NGT were found in 4,26,25 or 111 participants,respectively.For traditional test,FPG of 7.0 mmol/L showed a lower sensitivity to detect DM (0%).The sensitivity of EZSCAN to detect DM,IGT or MS was 50%,77% and 64%,respectively.Conclusions FPG may have lower sensitivity to detect DM,although EZSCAN could show higher sensitivity to detect IGT,DM,and MS.

Objective To investigate the relationship of lower urinary tract symptoms (LUTS)with ageing in elderly population of Beijing. Methods From January 2010 to July 2010, the males over 40 years of age, who came to take routine health examination in Beijing Hospital, received a questionnaire related to urinary symptoms. Eligible men were classified into age groups spanning 10 years, and the urinary symptoms of each group were analyzed. Results Among the 2357 males who were investigated, the incidence of urinary symptoms increased, and the satisfaction of urinate decreased with ageing. In 40-49 age group, 44.94 % of males owned at least one urinary symptom and 71.47% of males were satisfied with their symptoms. In over-80 age group, these figures were 94.97% and 27.67%, respectively. Each symptom was associated with the satisfaction. Nocturia was the commonest symptom in each age group. Conclusions LUTS are common in elderly males and the incidence increases with ageing. Nocturia is the commonest symptom in elderly males.

Background Accumulating evidence indicates that systemic inflammation response is associated with the prognosis of various cancers.The aim of this study was to investigate the neutrophil-lymphocyte ratio (NLR),which is one of the systemic inflammation markers,in the prognosis of hepatocellular carcinoma (HCC) after treatment of transcatheter arterial chemoembolization (TACE).Methods The clinical data of 178 HCC patients who received TACE were retrospectively analyzed.The optimal NLR cutoff was determined according to the receiver operating characteristic (ROC) analysis.All patients were divided into NLR-normal group and NLR-elevated group according to the cutoff,and the clinical features of these two groups were comparatively analyzed.Meanwhile,the overall survival and disease free survival (DFS) were analyzed using the KaplanMeier method.The risk factors of postoperative survival were investigated using univariate and multivariate Cox regression analyses.Results The optimal NLR cutoff was defined at 1.85 and 42 (23.6％) patients had an elevated NLR (NLR＞1.85).The median survival time was 9.5 months (range 1-99 months).The clinical data between the two groups were comparable,except for α-fetoprotein.Follow-up results showed that the median survival of patients with normal NLR was 17.5 months (range:1-99 months) compared with 8 months (range:8-68 months) of patients with elevated NLR.The 1,3 and 5-year overall survival of patients in the NLR-normal group and NLR-elevated group were 57.3％,44.1％,and 27.2％ and 42.1％,19.6％,and 9.5％ respectively (x2=194.2,P ＜0.001).Similarly,the disease free survival also has a significant difference (x2=39.3,P ＜0.001).Multivariate Cox regression analysis showed that a high NLR was an independent factor affecting the survival rate of HCC after TACE (P=0.04).Conclusion Preoperative NLR was an important prognostic factor to predict the prognosis of patients with intermediate HCC treated with TACE.