OBJECTIVE To investigate the pathogenic causes of community acquired pneumonia(CAP) in the elderly and to guide experience antibiotic therapy.METHODS An etiological study was performed on 204 elder patients with CAP in the Cadres Medical Department of Beijing Shijitan Hospital from May 2005 to Apr 2008.The count scores were by CURB-65 scoring system.RESULTS Pathogens were identified in 204 patients: there were Mycoplasma pneumoniae(42,20.6%),Streptococcus pneumoniae(30,14.7%),Haemophilus influenzae(24,11.8%),Chlamydia pneumoniae(17,8.3%),Klebsiella pneumoniae(14,6.9%),Escherichia coli(7,3.4%),Pseudomonas aeruginosa(5,2.5%),Staphylococcus aureus(4,2.0%),Legionella pneumophila(2,1.0%),and Acinetobacter baumannii(1,0.5%).The score,by CURB-65 scoring system,of mixed infected patients was higher than single infections.CONCLUSIONS Atypical pathogens have important role in elderly CAP,the most common pathogenare Gram-negative bacilli,S.aureusand fungi.Mixed infection couldn′t be ignored.

Objective To study the impact of HBV/C gene G87 mutation on HLA-I expression of host cells. Methods HBV wild-type genome plasmid was reconstructed by site-directed mutagenesis technique and subcloning technique into expression vector of G87 mutant (EBO-G87) and expression vector of wild type (EBO-WT), which were transfected into HepG2 cells via liposome technique,respectively.The transfected cells were stained with murine mAb anti-HLA-ABC conjugated directly to FITC, and HLA-I expression on their membranes was analyzed by flow cytometry. Results The constructed vectors of EBO-WT and EBO-G87 were identified by restriction enzyme digestion and nucleotide sequencing. The mean fluorescence intensity of HLA-I expression on transfected cells with EBO empty vector was at low level(2.3). It was elevated remarkably to 18.8 by EBO-WT, while that of EBO-G87 was increased to 10.5. Conclusion Two strains of HBV may up-regulate the expression of HLA-I, and G87 mutation of C gene may affect the expression level of HLA-I on host cells.

Objective: To evaluate the effect of Shenfu Injection in treating vertigo of mild vertebrobasilar stenosis. Methods: From January 2005 to July 2008, 66 patients with the primary symptom of vertigo undergoing digital subtraction angiography (DSA) examination were diagnosed as mild vertebrobasilar stenosis (MVS) according to the North American symptomatic carotid endarterectomy trial (NASCET) criteria, and then randomly divided into Shenfu (SF) group (34 cases) and Danshen (DS) group (32 cases), the DS group acting as the control. Degrees of vertigo of the patients were evaluated by the screening version of the dizziness handicap inventory (DHI-S) and scoring system for the dizziness assessment rating scale (DARS) on the admitted day, the third and sixth day after treatment and discharged day respectively. The mean of blood ? ow velocity (Vm), resistance index (RI) of right and left vertebral arterys and basilar artery, hematocrit (Hmc) and fi brinogen (Fbg) level in serum were all examined on both the admitted and discharged days. Results: There was no signifi cant difference on the score of vertigo, the parameter of TCD and the index in serum between SF and DS groups at the admitted time. On the sixth day of treatment and the discharged day, the score of DHI-S and DARS in SF group were lower than those in DS group (P

Objective To investigate the clinical values of quantitative ultrasound elastography technique in detecting internal carotid artery thickness .Methods One hundred and forty healthy objects who have conducted physical examination in our hospital from February 2012 to August 2015 were selected ,and divided in to three groups:the healthy control group (n=40;IMT<0 .9 mm) ,the IMT thickening group (n=60;0 .9 mm≤ IMT < 1 .3 mm) and plaque group(n= 40 ;IMT ≥1 .3 mm) .All the three groups conducted routine ultrasound and quantitative ultrasound elastography ,and the clinical data investigation and laboratory ex‐amination were carried out at the same time .Results The TC ,LDL‐C values in the plaque group and intimal thickening group were significantly higher than the control group (P<0 .05) .The AC values in the plaque group and intimal thickening group were signif‐icantly higher than the control group (P<0 .05) ,while the AI and PWVβvalues were significantly lower(P<0 .05) .Linear corre‐lation analysis showed that IMT were positively correlated to the AI ,PWVβ (r=0 .512 ,P <0 .05 ;r= 0 .483 ,P<0 .05) ,and the AC were negatively correlated (r= -0 .713 ,P<0 .05);Logistic analysis showed that LDL‐C ,AC ,PWVβwere the major independ‐ent risk factors for IM T (P<0 .05) .Conclusion Ultrasound elasticity quantitative detection of neck vessels is safe and can non‐in‐vasive dynamically observe blood vessel wall changes during the progression of atherosclerosis ,thus it's helpful in the judge and i‐dentification of internal carotid artery thickness .

OBJECTIVE:To explore the effect of subarachnoid block anesthesia in endoulogy minimally invasive surgery of el-derly patients. METHODS:198 elderly patients underwent endoulogy minimally invasive surgery were randomly divided into obser-vation group (100 cases) and control group (98 cases). Observation group received subarachnoid block anesthesia,and control group received epidural anesthesia. The anesthesia onset time,anesthesia dose,surgery time,complete block time,satisfaction de-gree of anesthesia effect,the occurrence of ADR were compared between 2 groups. RESULTS:Anesthesia onset time and complete block time of observation group were (1.5 ± 0.6) min and (7.9 ± 3.9)min,which were significantly shorter than those of control group (4.5 ± 1.2) and (17.5 ± 4.3) min,with statistical significance (P<0.05). The anesthesia dose of observation group was (20.2 ± 4.8)mg,which was significantly lower than that of control group [(103.4 ± 20.1)mg],with statistical significance (P<0.05);the satisfaction degree of anesthesia effect was 95.0% in observation group,which was significantly higher than that of con-trol group(69.4%),with statistical significance(P<0.05);there was no statistical significance in surgery time and the incidence of ADR between observation group and control group(P>0.05). CONCLUSIONS:Subarachnoid block anesthesia consumes small dose,acts rapidly and shows significant anesthesia effect,it is used for endoulogy minimally invasive surgery of elderly patients.

Objective By using multi detector row spiral CT (MDCT), to investigate the CT imaging features of inflammatory diseases in retroperitoneal space with correlation of radiological anatomy.Methods The clinical and laboratory dada of 30 patients with proven inflammatory diseases of retroperitoneal space were collected. All patients underwent MDCT plain scanning and portal venous acquisition. CT imaging data generated at portal venous phase were processed with coronal, sagittal and oblique multi planar reformation (MPR) technique.Results Acute pancreatitis and various types of renal infection were the two main sources of retroperitoneal inflammation. Depending on the specific anatomic locations, retroperitoneal inflammation of different subspaces demonstrated characteristic imaging features. Spreading of inflammatory process across subspaces was also quite common.Conclusion MDCT is the imaging method of choice to depict comprehensively and clearly the inflammatory diseases of various retroperitoneal spaces.

Objective To explore the influence on cyclin and cyclin-dependent kinase inhibitor of cell cycle of Kasumi-1 cell-derived from t(8;21)/AML treated with histone deacetylase(HDAC)inhibitor valproic acid(VPA).Methods RT-PCR assay was applied to detect mRNA expression of regulation factor of cell cycle of Kasumi-1 cell with VPA at different concentration and different time. Results VPA could down-regulate mRNA expression of cyclinD1,cyclinE1 and cyclinB1,and up-regulate mRNA expression of p21 WAF1/CIP1 with no obvious variation of mRNA level of p27KIP1. Condusion VPA could regulate cell cycle through the regulation of cyclins and cyclin-dependent kinase,arresting Kasumi-1 cell at G0/G1 phase.

Objective To explore an accurate,objective and simple method for barrel distortion correction and lesion area measurement by assistance of computer.Methods The software of Panaroma tool was employed to correct barrel distortion of endoscopy and Image J to measure lesion size and manage the relative measurement error.Computed measurement in vitro of lesion area was established,firstly,by identification of correction factor of Panorama tool to minimize measurement error; then by determination of influence of object distance change between the lens and the image.This measurement was used on patients with gastric ulcer for focal area.Results were compared with those of traditional method.Results Number of 0.1was determined to be the correction factor for barrel distortion of endoscopy.Prior to the correction of the barrel distortion,the relative error of measurement gradually increased with the increasing distance between endoscopy and the image.However,different object distances did not exert influence on the relative measurement error when barrel distortion was corrected by Panaroma tool ( P =0.141 ).A total of 50 foci of gastric ulcer were measured,results from combinational treatment of Panorama tool and Image J showed the areas (35.0 ± 5.0) mm2 were significantly larger than those determined by traditional method [ ( 29.1 ± 4.1 ) mm2,P =0.000 ],with a correlation coefficient of 0.988.Conclusion Computed endoscopic lesion measurement is a relatively accurate,objective and simple method to determine the area of gastric lesions.

Objective To study the effects of Leptin on the expression of CD86 and HLA-DR in human monocytes.Methods The expression of CD86 and HLA-DR in THP-1 Cells and human primary monocytes were detected by flow cytometry.Results Expression of CD86 and HLA-DR in THP-1 cells was significantly increased after treatment with high-dose Leptin ( CD86Untreated group:8.78 ± 1.66,CD86leptin10:50.76 ± 4.29,CD86leptin100:95.20 ± 4.90; HLAUntreated group:20.75 ± 2.12,HLAleptin10:102.14 ± 5.75,HLAleptin100:104.32 ± 4.75;).The similar results were observed in human primary monocytes ( CD86Untreated group:17.91 ± 1.78,CD86leptin100:48.80 ± 3.60; HLAUntreated group:34.10 ± 2.76,HLAleptin100:88.86 ± 3.53).Conclusions By up-regulating CD86 and HLA-DR expression,Leptin might enhance the ability to present antigen in THP - 1 cells and human monocytes.

The significantly high prevalences of cholelithiasis in patients with spinal cord injury (SCI) are related to impaired sympathetic innervations to the gallbladder. Sonography before and after the ingestion of a standard fatty meal is usually applied in evaluation of gallbladder function. This paper reviewed the innervations of gallbladder, sonography application in evaluation of gallbladder function and the relationship between SCI and cholelithiasis.