Objective To observe the effects of early postnatal exposure to low-dose m-tolyl methylcarbamate(MTMC) on neurobehavior and spatial learning and memory ability in adolescent and early adult mice,and to dertermine when to affect this ability.Methods ICR mice pups randomly divided into 5 groups received intraperitoneal injections(i.p.) of different doses of MTMC(5 mg?kg-1,0.5 mg?kg-1,0.05 mg?kg-1),DMSO solution and normal saline respectively every other day during postnatal days(PND) 3～13.The general physiological condition and neural development of mice during experiment were evaluated,and a battery of tasks,i.e.hole-board test,beam walking,open field,Morris water maze(MWM),was used to assess their neurobehavior and spatial learning and memory ability in different time.Results Scores were negatively correlated to the doses of MTMC by Spearman rank correlation analysis in beam walking on PND60(rs=-0.418,P

Objective To investigate the clinical value of serum procalcitonin (PCT) in diagnosis of urinary tract infection(UTI) in elderly patients.Methods 114 elderly patients with UTI in the department of infectious diseases of a hospital from January 2013 to December 2014 were analyzed retrospectively, clinical data of patients with abnormal and normal serum PCT were compared, PCT levels in patients with positive and negative blood cultures were compared, PCT receiver operating characteristic (ROC) curve for the diagnosis of bacteremia were drawn.Results Among 114 elderly patients with UTI, 46 were with abnormal PCT, 68 were with normal PCT.In abnormal PCT group, the proportions of patients with highest body temperature within 24 hours of admission, white blood cell count, neutrophil granulocyte percentage, C-reactive protein (CRP), blood urea nitrogen(BUN), creatinine(Cr), and urinary tract obstructive disease were all higher than those with normal PCT (all P<0.05).Among 42 patients with blood culture, PCT level in positive blood culture group(n=12) was higher than negative blood culture group(n=30)(1.93 [0.57-8.32] μg/L vs 0.36[0.15-1.01]μg/L, P=0.028).The area under the ROC curve (AUC) of the patients with bacteremia diagnosed by PCT was 0.72(95%CI:0.54-0.90),at the optimal value of 0.52 g/L, sensitivity, specificity, positive predictive value, and negative predictive value were 83.3%, 63.3%, 47.6%, and 90.5% respectively.Conclusion Serum PCT level can well reflect the severity of elderly patients with UTI, and is of great value in early diagnosis of bacteremia in elderly patients with UTI.

Objective To evaluate the application value with low-dose CT scan and quantitative analysis in airway disease of chronic obstructive pulmonary disease(COPD).Methods All subjects(34 control cases,88 cases of stable COPD patients)underwent low-dose CT chest scans,and 88 COPD patients underwent pulmonary function tests.Measuring the airway dimensions of 3th generation in apical bronchus of the right upper lobe,the posterior basal bronchus of the right lower lobe and left lower lobe.Results COPD patients with moderate to extremely severe airflow limitation demonstrated higher WA% and Pi10 in comparison with normal volunteers(all P<0.05),meanwhile patients with extremely severe airflow limitation demonstrated higher WA % and Pi10 in comparison with patients with mild airflow limitation(both P <0.05).COPD patients with severe airflow limitation demonstrated higher T/BSA and WA/BSA in comparison with normal volunteers and patients with moderate airflow limitation (all P<0.05).The WA % and Pi10 of COPD patients group were negatively correlated with ventilation indices and small airway indices(all P <0.01).Pi10 were positively correlated with lung volume indices (all P < 0.05 ).Conclusion Low-dose CT scan and quantitative analysis can provide an objective and quantitative method to evaluate the information about airway disease of COPD,inwich both WA % and Pi10 are objective indices.With the increase of air flow limitation,the bronchial wall thickness gradually increased.

Purpose To explore the CT manifestations and pathological features of pneumonia-type lung cancer, and to improve the diagnosis capability of pneumonia-type lung cancer. Materials and Methods CT and pathologic features of 33 cases of biopsy or surgical pathology confirmed pneumonia-type lung cancer patients were retrospectively analyzed and classified according to the new pulmonary adenocarcinoma classification. Results Among the 33 pneumonia-type lung cancer subjects, CT showed multiple distributions within both lungs in 22 cases, lateral lobe distribution in 9 cases, segmental distribution in 2 cases. Lung consolidation was found in all lesions, among them 21 cases appeared mainly as lower lobe consolidation, 32 cases as inflatable bronchial symptoms within the consolidation, including inflatable bronchoconstriction in 24 cases;consolidation with multiple pulmonary nodules found in 23 cases;ground glass shadowing around or distal to the consolidation found in 26 cases;combined with cysts or honeycomb lung symptom in 13 cases. Inhomogeneous mild enhancement of lung consolidation after enhancement found in 18 cases and inhomogeneous moderate enhancement in 15 cases;blood vessel branch shadow within the consolidation was visible in 21 cases. Pathology results revealed 26 cases of invasive mucinous adenocarcinoma, and 7 cases of invasive mucinous adenocarcinoma partial mixed with papillary or alveolar adenocarcinoma. Conclusion CT features of pneumonia-type lung cancer are single or multiple opacities, within which inflatable bronchial symptoms can be observed, with multiple nodules and ground glass shadowing, cysts or honeycomb symptom can also be found concomitant, the lesions expand, increase and spread to both lungs, taking its dynamic change features into consideration will also help to improve the diagnostic accuracy.

Purpose To investigate the value of three-dimensional quantitative measurement of spiral CT in evaluating tumor size and preoperative T stage in stage I non-small cell lung cancer (NSCLC). Materials and Methods The complete data of 125 patients with stage I NSCLC confirmed surgically and pathologically were compared in terms of maximum tumor diameter and T stage analysis by means of three-dimensional quantitative CT measurement, two-dimensional measurement and general pathology measurement. Results The mean maximum tumor diameter of these 125 patients measured by quantitative three-dimensional CT measurement, two-dimensional measurement and general pathology measurement were (26.21±8.14) mm, (27.03±9.90) mm and (25.60±9.31) mm, respectively. The difference in mean maximum tumor diameter by two-dimensional measurement and three-dimensional quantitative measurement was significant, and remained so when two-dimensional measurement and pathology measurement was compared (t=2.377, P<0.05;t=2.961, P<0.01), but that between three-dimensional quantitative measurement and pathology measurement was not significant (t=1.281, P>0.05). Bland-Altman analysis showed that three-dimensional quantitative measurement had higher consistency than two-dimensional measurement when compared with the gold standard pathology measurement. When three-dimensional quantitative measurement was taken to be the staging criterion, 20% results (25 cases) obtained by two-dimensional measurement proved to be inconsistent. Conclusion Compared with two-dimensional measurement, quantitative three-dimensional CT measurement can provide more accurate information in maximum tumor diameter and T stage for patients with stage I NSCLC, therefore can be applied as a more accurate criterion in preoperative staging and prognosis of stage I NSCLC.

Objective To explore airway remodeling and air trapping in asthmatic patients with low dose CT scanning and quantitative analysis. Methods 52 stable asthmatic patients in which 29 were severe and 23 were slight,and 20 healthy control cases were underwent low dose dual phase CT scanning. The LA/BSA, WA/BSA, TA/BSA, WA%and Pi10WA were analyzed as airway remolding indexes. The MLD of expiratory, VI-850 (%) of expiratory, MLD E/I, VI-850E-I (%) and VI-850/-950E-I (%) were analyzed as air-trapping indexes. One-Way ANOVA or H Kruskal-Wallis was used to analyze the above indicators. Results Airway remodeling indexes and LA/BSA were (9.6 ± 2.6), (11.0 ± 3.4) and (12.6 ± 3.0)mm2/m2 in severe asthmatics group, non-severe asthmatics group and healthy control group respectively, and there was significant difference between the three groups (F=5.60, P=0.006). WA%of each group was (65.1 ± 2.5)%, (63.3 ± 4.4)%and (62.0 ± 3.0)%, and there was significant difference between the three groups (F=5.53,P=0.006). The Pi10WA was (18.4±2.6), (17.7±3.1) and (16.4±1.4) mm2 respectively with significant difference between the three groups (F=3.59 ,P=0.033). Air-trapping indexes, MLD of expiratory of each group was-(771 ± 59),-(724 ± 43) and-(676 ± 60) HU respectively with significant difference (F=5.60, P=0.006). VI-850(%) of expiratory of each group was 30.79(30.45)%, 13.53(12.09)%and 2.85(6.87)%respectively with significant difference (H=17.20,P<0.001). Conclusions Low dose of CT scan and quantitative analysis can provide an objective and quantitative information for patients with airway disease of asthma, and both WA% and Pi10WA were objective indexes. The severe asthmatic patients were associated with obvious airway remodeling and air trapping compared with non-severe asthmatic patients.

Objective To investigate the antibiotic susceptibilities and the profiles of virulence genes of clinically isolated Salmonella enterica serovars Schwarzengrund ( S. Schwarzengrund) strains for bet-ter understanding the epidemiological trend of this type of non-typhoidal Salomonella and to provide guide-lines for the prevention and treatment of S. Schwarzengrund infection. Methods Stool samples and clinical data of patients with acute diarrhea who received treatment in the Second Hospital of Tianjin Medical Univer-sity during May, 2014 to October, 2014 were collected for this study. Enrichment culture and biochemical identification were used to isolate and identify the S. Schwarzengrund strains. The isolated strains were fur-ther analyzed with serotyping analysis, drug susceptibility test, pulsed field gel electrophoresis ( PFGE) and multiple locus sequence typing ( MLST ) . The representative genes carried by Salmonella pathogenicity islands (SPI) 1-5, SPI regulators and virulence plasmids were amplified by PCR. The coding genes of CdtB-islet, which were cdtB, pltA and pltB were amplified and sequenced. Results In total, 16 (14. 8%) out of 108 non-typhoidal Salmonella strains were identified as S. Schwarzengrund strains and all of them were sus-ceptible to 11 kinds of antibiotics such as fluoroquinolone, ampicillin, ceftriaxone and trimethoprim-sulfame-thoxazole. PFGE categorized the 16 S. Schwarzengrund strains into 3 clusters including A clone ( 14 strains), B clone (1 strain) and C clone (1 strain). The strains that isolated from 8 patients who ate the same food belonged to one cluster ( A clone ) , suggesting that it was an outbreak of infection. The 16 S. Schwarzengrund strains showed identical MLST type, which was ST241. The representative genes carried by SPI1-5 ( invA, sitC, hilA, sseL, sifA, mgtC, siiE and sopB) , the regulatory gene ( phoP) and the cytole-thal distending toxin islet (CdtB-islet) coding genes (cdtB, pltA and pltB) were positive, while the genes carried by virulence plasmids (pefA, prot6E and spvB) were negative. The similarities in CdtB-islet coding genes and amino acids sequences between Salmonella typhi and S. Schwarzengrund strains in this study were more than 97% and 98%, respectively. Conclusion In this study, polyclonal S. Schwarzengrund strains of ST241 type were isolated from the patients. They were susceptible to common antibiotics, but carried the virulence genes contained in SPI1-5 and CdtB-islet coding genes and might cause an outbreak of infection. Attention should be paid to the tendency and threat of clinical S. Schwarzengrund infection and continuous surveillance and investigation should be performed.

Objective To investigate the antimicrobial resistance ,molecular phenotypes ,virulence gene profiles of Salmonella A gona (S .A gona) isolated from patients with acute diarrhea ,and to better understand its epidemic trend ,prevention and treatment .Methods Clinical data and stool samples of patients with acute diarrhea during April to October in 2013 and 2014 from the Second Hospital of Tianjin Medical University were collected .Enrichment culture ,biochemical identification and serotyping analysis were used to isolate and identify S .A gona strains .The isolated strains were further analyzed with antibiotics susceptibility test ,pulsed field gel electrophoresis (PFGE) ,multiple locus sequence typing (MLST ) , Quinolone resistance determining region (QRDR) .Plasmid-mediated quinolone resistance (PMQR) and β-lactamases genes (TEM ,SHV ,OXA ,and CTX-M) were amplified by polymerase chain reaction (PCR) and sequencing .The representative genes carried by Salmonella pathogenicity islands (SPI) 1 — 6 ,9 — 12 and virulence plasmids were amplified by PCR .And the clinical characteristics of S .Agona infection were analyzed .Results Among 119 non-repetitive (non-typhoidal salmonella ,NTS) isolates during the two years ,eight isolates (6 .7％ ) of S .A gona were identified . The resistance rate of S .A gona strains to streptomycin was 100 .0％ , those to ampicillin and gentamicin were 62 .5％ ,to levofloxacin ,ciprofloxacin and nalicixic acid were 25 .0％ ,to chloramphenicol ,amoxillin/clavulanic acid and piperacillin tazobactam were 12 .5％ .The strains were susceptible to other drugs .All 8 isolates had the identical ST13 genotype .PFGE showed 5 clones ,and 4 out of 5 isolates had the exact same patterns of PFGE and drug susceptibility .Two (fluoroquinolones ,FQ) resistant strains carried gyrA mutation leading to amino acid substitutions at position 87 in GyrA ,and no PMQR genes was detected ,while one of which was sensitive to ciprofloxacin by K-B method .All five ampicillin-resistant isolates were positive for TEM-1b gene and one isolate of them was resistant to β-lactam/β-lactamase inhibitor complex .The representative genes carried by SPI 1 — 6 , 9 ,11 ,12 (hilA ,sseL ,mgtC ,siiE ,sopB ,pagN ,bapA ,pagC and sspH2) were 100 .0％ positive ,while the genes carried by SPI10 (sef A ) virulence plasmids (spvB , prot6E) were negative . Two patients with FQ resistant strains infection were clinically diagnosed with bacillary dysentery ,and the remaining six cases with FQ susceptible strains infection were clinically diagnosed with acute gastroenteritis .Conclusions FQs-resistant and multi-drug resistant S .A gonaisolates have emerged in clinical settings .These isolates carry a variety of virulence genes .Resistance to FQ of S .Agonamay cause more severe illness .ST13 might be the dominant genotype of S . A gona in China ,and we should try to prevent the infection outbreak of S .A gona .

Objective:To investigate the risk factors for intrahepatic cholangiocarcinoma (ICC) after hepatectomy for hepatolithiasis.Methods:The retrospective case-control study was conducted.The clinico-pathological data of 1 071 patients who underwent hepatectomy for hepatolithiasis at the Eastern Hepatobiliary Surgery Hospital of Navy Medical University between January 2010 and December 2011 were collected. There were 379 males and 692 females, aged (53±12)years, with the range of 12-86 years. Patients completed preoperative examinations. For regional hepatolithiasis, the anatomical hepatectomy was performed. For diffused hepatolithiasis, regional damaged lesions which confined to liver segment or lobe were resected. Hepaticolithotomy or cholangio-lithotomy was performed if necessary. When severe stricture of hilar bile duct affects biliary drainage, cholangiojejunostomy or biliary stricture plasty was performed. Observation indicators: (1) preoperative examination, surgical and postoperative situations; (2) follow-up; (3) risk factors analysis of ICC within the 5 years after hepatectomy for hepatolithiasis. Follow-up using outpatient examination and telephone interview was performed to detect the incidence of ICC after hepatectomy up to December 2019. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were described as M (range). Count data were described as absolute numbers or percentages. Continuous variables were converted into categorical variables according to the common clinical values or the best cut-off value of receiver operating characteristic curve. Binary logistic regression model was used for risk factors analysis. The factors with P<0.10 in univariate analysis were included for the multivariate analysis. Results:(1) Preoperative examination, surgical and postoperative situations. Results of preoperative examination: duration of hepatolithiasis-related symptoms of the 1 071 patients was 8.2 years(range, 0-27.0 years), the levels of CA19-9 and CEA were (163±87)U/mL and (5.0±2.1)μg/L, and stones located at left liver, right liver, bilateral sides, common hepatic duct or common bile duct were detected in 545, 245, 228, 53 patients. There were 226 patients complicated with biliary stricture and 172 with segmental atrophy. Of the 1 071 patients, 595 underwent anatomical hepatectomy, 272 underwent regional non-anatomical hepatectomy, 143 underwent cholangiolithotomy, and 61 underwent cholangiojejunostomy. Results of postoperative imaging examination showed residual biliary stricture in 26 patients and residual biliary stones in 74 patients. (2) Follow-up: 1 071 patients were followed up for (8.6±1.5)years. Of the 1 071 patients, 92 developed ICC, with an incidence of 8.590%(92/1 071). There were 32, 66, 90 patients developing ICC within 3, 5, 8 years after hepatectomy, with the incidence of 2.988%(32/1 071), 6.162%(66/1 071), 8.403%(90/1 071). (3) Risk factors analysis of ICC within the 5 years after hepatectomy for hepatolithiasis. The receiver operating characteristic curve of duration of hepatolithiasis-related symptoms for ICC within the 5 years after hepatectomy was constructed, and duration of hepatolithiasis-related symptoms was converted into categorical variable for following analysis using 7 years as the cut-off value based on Youden index. Results of univariate analysis showed that duration of hepatolithiasis-related symptoms>7 years, complication with metabolic diseases, segmental atrophy, postoperative residual stones were related factors for ICC within the 5 years after hepatectomy ( odds ratio=2.939, 2.654, 1.903, 2.361, 95% confidence interval: 1.582-5.460, 1.145-6.154, 1.068-3.390, 1.118-4.987, P<0.05). Results of multivariate analysis based on factors with P<0.10 in the univariate analysis showed that duration of hepatolithiasis-related symptoms>7 years, complication with metabolic diseases, segmental atrophy, postoperative residual stones were independent risk factors for ICC within the 5 years after hepatectomy ( odds ratio=2.843, 2.469, 1.922, 2.202, 95% confidence interval: 1.523-5.309, 1.042-5.851, 1.064-3.472, 1.021-4.747, P<0.05). Conclusions:There was risk of developing ICC after hepatectomy for cholelithiasis. The duration of hepatolithiasis-related symptoms >7 years, complication with metabolic diseases, segmental atrophy and postoperative residual stones are independent risk factors for ICC development within 5 years after hepatectomy.