AIM:To compare the mutant prevention concentration(MPC)of linezolid and vancomycin against methicillin resistant staphylococcus aureus(MRSA)and study the correlation between minimal inhibitory concentration(MIC)and MPC.METHODS:MICs and MPCs of two drugs against 35 MRSA clinical stains were determined by agar plates dilution method.The correlations between MIC and MPC were determined by linear regression.The ability to restrict the resistance was evaluated according the pharmacokinetics of two drugs.RESULTS:The MPCs of two drugs against MRSA were 16 and 8 ?g/mL and the MPC/MIC was 8.MPCs and MICs correlated poorly(R2 were 0.32 and 0.008,respectively).According to pharmacokinetics of two drugs,the concentration of linezolid was inside the MSW(mutant selective window)for the entire dosage interval,while the concentration of vancomycin exceeded the MPC for the most dosage interval.CONCLUSION:The capacity of vancomycin for restricting the selection of MRSA resistant mutants is stronger than that of linezolid.There is low correlation between MPC and MIC.

Objective To explore the application value of diffusion tensor imaging and diffusion tensor tractography in the benign lesion of spinal cord.Methods 30 cases with the benign lesions of spinal cord and 10 healthy volunteers underwent MRI and DTI scanning by 1.5T MR.Results Compared with normal control group,ADC values [(1.29±0.24)×10 -3 mm2/s]of extramedullary group-Ⅰwere increased slightly,and FA values (0.46±0.06)were decreased slightly(P <0.05).In extramedullary group-Ⅱ,ADC values [(2.03±0.19)×10-3 mm2/s]were significantly increased and FA values (0.37±0.03)decreased in the lesion level (P <0.05).The ADC values [(1.71±0.24)×10 -3 mm2/s]of intramedullary group was significantly elevated,and the FA values (0.30±0.06)was obviously reduced (P <0.05 ).The fiber tracts showed the abnormality of the white matter,including compression,sparseness, grow downwards,interruption and other changes.Conclusion The changes of the FA and ADC values,diffusion tensor imaging of the bundle can quantitatively evaluate the severity of spinal cord damage and stereo display fiber bundle damage.

Objective To discuss the clinical and electrophysiological characteristics of sleep related rhythmic movement disorder ( SRMD).Methods We studied the clinical and electrophysiological characteristics of 3 patients diagnosed as SRMD in the Electroencephalography Monitoring Center of Xijing Hospital, Xi′an, China.The 3 patients accorded with diagnostic criteria of SRMD that international classification of sleep disorders-3 edition recommended and were followed up for more than 1 year.Results These 3 male patients were ranging from 6 to 27 years old.The onset age of the patient 1 was 13 years,and the others were 1 year old.The patient 2 became symptom-free at the age of 7.The patient 3 relieved at 2-year-old, but recurred at the age of 21. There was no epileptic seizure discharge in video-electroencephalography of the 3 patients, but synchronous electromyography changes during the attack were mistaken for slow wave.Video-polysomnography showed that numbers of awakenings and arousals index were high.Two patients were treated with clonazepam.One had an obvious curative effect, the other had marked efficacy until added trazodone.Conclusions SRMD can occur not only in infants, but also in adolescents and adults.Patients who have the problems of the sleep quality should be treated.Clonazepam can obviously relieve symptoms and improve sleep quality.Patients who do not have a good effect with clonazepam can try to add trazodone.Video-electroencephalography monitoring and interpreting it correctly are important to the diagnosis of paroxysmal disease.

Objective To explore the effects of comprehensive nursing intervention on treatment compliance for patients with nephrotic syndrome taking hormone therapy. Methods A total of 94 patients with nephrotic syndrome who were treated in our hospital from September 2011 to September 2014 were randomly selected. They were evenly assigned to group A and group B, with 47 in each group. Patients in group A were only given regular nursing intervention after the treatment; patients in group B were given a series of comprehensive nursing intervention. Treatment compliance was compared between group A and group B, and causes for poor compliance were analyzed. Results After a series of com-prehensive nursing intervention in group B, proportion of patients with complete compliance was 78.72%, significantly higher than that of 46.81% in group A. The comparison between the two groups was P<0.05, and the difference was statistically significant. In addition, main causes for poor compliance were patients' lack of relevant basic knowledge and failure of effective drug use. Comparison of the causes between the two groups was P>0.05, and the differences were not statistically significant. Conclusion A series of comprehensive nursing intervention for patients with nephrotic syndrome taking hormone therapy is effective in promoting patients to comply with the treatment actively, and improv-ing their treatment compliance.

OBJECTIVETo investigate the clinical features and treatment in patients of marginal zone lymphoma (MZL)with monoclonal immunoglobulin (McIg).

METHODSThe clinical data of MZL patients with McIg, including 3 cases diagnosed and treated in Beijing Anzhen Hospital from Jan 2007 to Dec 2014 were retrospectively studied, meanwhile 36 patients searched from literatures were reviewed.

RESULTSOf a total of 39 patients, the ratio of male and female was 1.05∶1 with an average age of 65.1± 12.3 years old. 28 cases (71.8%)were with mucosa associated lymphoid tissue lymphomas (MALTL), 9 cases (23.1% )with nodal marginal zone lymphoma, and 2 cases (5.1%)with splenic marginal zone lymphoma. Nine cases (23.1% )were in the early stage, 30 cases (76.9%)in the advanced stage. The common initial symptom was non-mass lesions (65.5%), such as skin purpura, peripheral neuropathy; 13 patients (33.3% )were accompanied by autoimmune phenomenon, and most were with Sjogren's syndrome. Among MALTL patients, the common primary lesion was in non- gastrointestinal tract (17 cases, 60.7%). Most of patients with McIg were one with McIgM (82.0%); the others with McIgA, Mcκ-light chain, McIgG and double McIg. The level of plasma McIgM was (25.55±21.31)g/L, which was higher in advanced stage patients than in early stage ones [(29.85±20.60)g/Lvs (3.23±2.95)g/L,P= 0.008]. The complete remission (CR)rate was 56.0% and the overall response rate (ORR)92.0%, respectively in 30 patients treated by chemotherapy. At a median follow- up of 10 months, the 3- year progression free survival and the 3-year overall survival were 44.7% and 76.5%, respectively. The rates of ORR and CR in the patients received rituximab- included regimen were seemly better than those without rituximab one (100.0%vs 78.6%, 63.6%vs 50.0%;P>0.05), but no statistic differences were found. The CR rate in patients with McIgM was significantly higher than that with non- McIgM (P=0.026). The plasma McIgM level decreased after chemotherapy (P=0.002).

CONCLUSIONThe MZL with McIg, perhaps a kind of unique subtype, usually occurred in 60 years or older patients. It was often diagnosed in patients of advanced stage and susceptible to autoimmune phenomenon. MALTL in non- gastrointestinal tract was more prone to find McIg. In MZL patients with McIg, McIgM was more common and other McIg rare. Rituximab-included regimen produced a better therapeutic response.

Adult ; Beijing ; Disease-Free Survival ; Female ; Humans ; Lymphoma, B-Cell, Marginal Zone ; pathology ; Male ; Paraproteins ; metabolism ; Remission Induction ; Retrospective Studies ; Rituximab ; therapeutic use ; Sjogren's Syndrome ; complications ; Splenic Neoplasms ; pathology

Objective: To analyze the clinical characteristics of recurrent thrombosis in patients with polycythemia vera (PV) and essential thrombocythemia (ET) to probe the risk factors for recurrent thrombosis in patients with ET and PV. Methods: The clinical data of 104 ET and PV patients with thrombosis in Beijing Anzhen Hospital from February 2001 to November 2016 were retrospectively analyzed. Thrombosis reoccurred in 38 patients. Statistical analyses were performed by multivariate logistic regression for risk factors of recurrent thrombosis in ET and PV patients. Results: Recurrent thrombosis occurred in 36.5% of patients with ET/PV, the total incidence rate in ET and PV patients was 9.8% patient-years, 12.3% patient-years and 5.7% patient-years in ET and PV respectively. There were a total of 56 re-thrombotic events, and 42.1% of events occurred within 1 year after the first thrombosis. The arterial re-thrombosis was 97.4% (most of acute coronary syndrome, ACS), and venous events was 2.6%. The most common cases of re-thrombosis were ACS in ET patients (18 cases, 64.3%), and cerebral infarction in PV patients (7 cases, 70.0%). The number of PV patients with 2 times or more re-thrombotic events was significantly higher than that of ET patients (9 cases, 90.0% vs 7 cases, 25.0%). The proportion of the patients with WBC>12.5×10⁹/L or Hct>45%, and thrombosis history or splenomegaly and high risk thrombotic events were higher than those with a single thrombus (52.6% vs 31.8%; 50.0% vs 30.0%; 86.8% vs 13.6%; 84.2% vs 33.3%; 52.6% vs 15.2%; 94.7% vs 53.0%; P values were 0.036,0.046, <0.001, <0.001, <0.001 and <0.001, respectively). Logistic regression analysis showed that thrombosis history (OR=13.697, P=0.025), splenomegaly (OR=13.301, P=0.034) and high risk stratification of thrombotic events (OR=44.618, P=0.025) were independent risk factors for recurrent thrombotic events. Conclusions ET and PV patients had a higher risk of re-thrombosis. The incidence of re-thrombosis in ET was higher than in PV, ACS was more common cases of re-thrombotic events; but PV patients were more susceptible to multiple re-thromboses than ET ones, also with more cerebral infarction. Previous thrombus history, splenomegaly and high risk stratification of thrombotic events were independent risk predictors for re-thrombosis of ET and PV patients.

Objective:Improve the quality of clinical research at different stages for better protection of human subject.Methods:Introduce the operational and the administrative experiences of establishing the human research protection program in our hospital.Results:Establish human research protection program can promote the direct communication and cooperation among relevant departments of clinical research, strengthen the whole process management of clinical research.Conclusions:Developing comprehensive human research protection program and related policies play a positive role in promoting the high-quality development of clinical research in hospitals.

Objective:This paper aims to promote the standardization of ethics review of horizontal scientific research projects and improve the ethics review quality by analyzing the current ethics review practice in a certain tertiary hospital, identifying common problems during the review process, illustrating relevant causes and proposing corresponding solutions.Methods:Through introducing the current situation of ethics review of horizontal scientific research projects in a tertiary level hospital, the differences between the main points of ethics review of horizontal scientific research projects and government-funded scientific research projects were analyzed, so as to sort out the common problems and possible causes in the process of ethics review of horizontal scientific research projects, and then explore the possible corresponding solutions.Results:Based on the characteristics of horizontal research projects, ethics review should focus on their scientific and social values, potential conflicts of interest, protection of subjects′ rights and interests, and whole-process management and quality assurance. At present, there are still many problems, such as a large number of projects, but not many projects with high research value, inadequate project process management, and ineffective implementation of ethics review opinions.Conclusions:The hospital should further improve the management system of horizontal scientific research project approval, bring in more comprehensive review regarding to both scientific and ethics review, engage more experts at the outset of project funding decision-making, set up ethics specialists, strengthen the process management of horizontal scientific research projects, strengthen ethical publicity and education, and improve the ethical awareness of researchers to fully protect the rights and interests of subjects and promote the high-quality development of clinical research.

Objective To investigate the relationship between serum thyrotrophin(TSH)and dyslipidemia in subclinical hypothyroid and euthyroid subjects. Methods An epidemiological study on diabetes and thyroid diseases was performed in Dadong community, Shenyang city, in 2007. 110 subjects with subclinical hypothyroidism(SCH)and 1 240 euthyroid subjects were enrolled in the study. Neither history of thyroid diseases nor administration of thyroid-related and lipid-regulating medicines were reported in these subjects. The levels of serum thyroid hormones, lipids, fasting plasma glucose(FPG), and insulin were determined. Results (1)Patients with SCH had significantly lower HDL-C levels than those who were euthyroid.(2)According to the guideline of treatment of adult dyslipidemia in China, the lipid profiles were each categorized. Mean TSH levels were higher in subjects in the dyslipidemia subclass than subjects in the normal subclass. The differences were significant in high LDL-C subclass in overweight individuals. In euthyroid overweight women, mean TSH levels were significantly higher in high LDL-C subclass. In the euthyroid population, TSH was positively associated with total cholesterol in overweight population. The association was not modified by the homestasis model assessment for insulin resistance(HOMA-IR)values.(3)TSH was associated positively with serum triglycerides and negatively with serum HDL-C in women. TSH was positively associated with total cholesterol in overweight population and positively associated with total cholesterol and LDL-C in overweight women after adjustment for age, sex, and body mass index. Conclusion Raised serum TSH seems to be a risk factor of dyslipidemia in subclinical hypothyroid and euthyroid subjects, which is independent of insulin sensitivity.

Objective To explore the relationship between serum thyrotropin and the components of metabolic syndrome.Methods A total of 1534 adult inhabitants in Dadong district of Shenyang were asked to fulfill the questionnaires and have physical examination and oral glucose tolerance test(OGTT).The vein blood was drawn to measure thyrotropin(TSH),fasting plasma glucose(FPG),OGTT 2hPG,fasting insulin,triglyceride(TG) and high density lipoprotein cholesterol(HDL-C).Results Serum TSH in the MS group was higher than in the Non-MS group(2.54 vs 2.22 mU/L,P