Invasive pulmonary aspergillosis is valued in intensive care unit (ICU) patients, but in ICU patients, the diagnosis standard of the European Organization for Research on the Treatment of Cancer/Mycosis Study Group (EORTC/MSG) could easily lead to misdiagnosis and missed diagnosis. It’s imaging manifestations are diverse: halo sign, nodules or micro nodules, nodular shadow, pulmonary consolidation, wedge-shaped consolidation, voids, air crescent sign, ground glass shadow, and so on, and with the relative characteristic features. The sensitivity and specificity of galactomannan detection in bronchoalveolar lavage fluid (BALF) are high for diagnosis of invasive pulmonary aspergillosis in ICU patients, but the significance of the cultivation of lower respiratory tract specimens is limited.

Acupuncture Points ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Sleep Initiation and Maintenance Disorders ; therapy ; Young Adult

Objective The aim of this study was to assess the distribution histogram of arm circumference (AC) in adult hypertensives in Beijing area, and to establish which size of cuffs is most appropriate in clinical practice. Methods We conducted a cross-sectional survey in a cohort of 424 (male 61.6%) consecutive hypertensives patients. Arm circumference was measured at the mid-point of the right upper arm. Subjects were stratified in three groups: group 1 with AC between 22-26 cm (small size), group 2 AC between 27-34 cm(medium size), and group 3 AC great than 34 cm (large size). Using AC of 32 cm as cutoff point, patients were subdivided as group A (AC

BACKGROUND: Both pulse pressure (PP) and aortic stiffness are the predictors of coronary artery disease (CAD). The relationship between aortic PP and atherosclerosis may be bi-directional. Some investigations have tested the relationship between coronary arteriongraphy-diagnosed coronary heart disease and aorta pulse pressure (APP).OBJECTIVE: To observe the relationship between coronary atherosclerosis and APP in patients with primary hypertension.DESIGN: Case control observation.SETTING: Department of Cardiology, Xuanwu Hospital, Capital University of Medical SciencesPARTICIPANTS: A total of 300 patients with primary hypertension who received the treatment in the Department of Cardiology, Xuanwu Hospital, Capital University of Medical Science between July 2002 and January 2005. The patients were all untreated hypertensive patients who were referred for a first diagnostic coronary angiography. All of them met the diagnostic criteria of international hypertensive association. Secondary hypertension, myocardial disease, valvular disease of the heart (VDH), heart failure, liver and renal insufficiency and so on were excluded. The patients, 170 male and 130 female, were aged (61±11 )years. Informed consents were obtained from all the patients.METHODS: A total of 300 untreated hypertensive patients were recruited for a first diagnostic coronary angiography. According to whether having coronary artery disease (CAD), the patients were divided into CAD group (143 in total, 92 male, 64%) and non-CAD group (157 in total, 82 male, 52%). Informed consents were obtained from all the patients.The following data were collected: invasive intra-aortic systolic blood pressure (ASBP) and intra-aortic diastolic blood pressure (ADBP), extent of coronary artery disease, and basic clinical materials of the patients. All the observed index were expressed as Mean±SD. Independent sample t test was used in the comparison between two groups, and P ＜ 0.05was set as significant difference.MAIN OUTCOME MEASURES: ASBP, ADBP and BP, ratio of stroke volume (SV), which reflects aortic stiffness, to aortic pulse pressure (APP); The number of branch and stegnotic extent of coronary artery disease (Cases with stegnotic extent ＜ 50% were included in non-CAD group; Basic clinical indexes and routine biochemical indexes of patients after admission (including fasting blood glucose, serum creatinine, blood lipid and so on).RESULTS: The enrolled 300 patients with hypertension all participated in the result analysis. In the whole population, ASBP and PP were significantly higher in CAD group than non-CAD group [(150.3±26.5) vs. (145.6±23.3) mm Hg, P ＜ 0.05;(77.1±22.7) vs. (70.4±19.3) mm Hg, P ＜ 0.05)]. The ratio of APP to SV in CAD group was markedly higher than that in non-CAD group(1.20±0.44) vs. (0.96±0.33), P ＜ 0.05]. Fasting blood glucose of patients in the CAD group was significantly higher than that in the non-CAD group [(1.38±0.27) vs. (1.08±0.28) mmol/L, P ＜ 0.01]. Serum creatinine of patients in the CAD group was significantly higher than that of non-CAD group [(11.98±2.15) vs. (11.19±1.58) μ mol/L, P ＜0.01]. High-density lipoprotein cholesterol of patients in the CAD group was significantly lower than that in the non-CAD group [(0.54±0.13) vs. (0.62±0.18) mmol/L, P＜ 0.01].CONCLUSION: Atherosclerosis may further aggravate the aortic stiffness and then cause the increase of APP in patients with primary hypertension.

According to the study experience when the author was invited as a visiting scholar in Edinburgh Napier University,also based on the further discussion with local research team members of stroke,the author would like to introduce the multidisciplinary research team with same professional field being established in Scotland,finally in order to give us inspiration how to develop an efficient,long-term and stable research team in China,and which model whether local universities innovative research team or innovative regional research team is much more suitable for our country.The author had participated in stroke team research activities during the Edinburgh Napier University visit;and have some basic understanding to their research ideas and patterns of work after communication and exchanging ideas with team members.Particularly,multidisciplinary research collaboration model based on voluntary organization across entire Scotland is worth to learn for us.It also would inspire the university research terms in their construction in China.

Objective To discuss the distributions and drug resistance of gram-positive cocci and provide scientific basis for reasonable use of antimicrobial drugs.Methods One hundred and twenty-five strains were isolated and cultured in our department from January 2009 to December 2011.The drug susceptibility was tested by K-B method and the results were judged by the criteria guideline of CLSI 2009.Results The main strains of separated cocci were Staphylococcus aureus (68,54.4％),Enterococcus faecium (22,17.6％),coagulase-negative staphylococcus (CNS) (20,16.0％),Enterococcus faecalis (6,4.8％),Staphylococcus haemolyticus(7,5.6％)and other gram-positive cocci (2,1.6％).Methicillin-resistant S.aureus (MRSA) and Methicillin-susceptible S.aureus (MSSA) detected were 40 and 28 strains(accounted for 58.8％ and 41.1％ of S.aureaus).The results of drug susceptibility tests showed that the drug resistant rate of MRSA to Gentamicin,Clidamycin,Erythromycin and Ciprofloxacin was up to 87.5％-95.0％,and the drug resistant rate of coagulasenegative staphylococcus to Penicillin,Erythromycin,Clidamycin and Gentamicin was up to 65.0％-95.0％,besides,the drug resistant rate of E.faecalis and E.faecium to Erythromycin,high level Gentamicin and Ciprofloxacin were 86.4％-100％ and 50.0％-66.7％,respectively.No strains with drug resistant to Vancomycin,Teicoplanin and Linezolid were detected.Conclusion S.aureus was the main strains of nosocomial infection of gram cocci.The resistance of gram-positive cocci is severe,so clinicians should attaches great importance to high drug resistance of gram-positive cocci.

OBJECTIVEThis study aimed to investigate the effect of a lactoperoxidase-peroxidase-thiocyanate (LPO-H2O-SCN-) system with different concentrations of iodine (I-) on Streptococcus mutans (S. mutans), particularly on various parameters, including growth, adhesion, glucosyltransferase (GTF) enzyme activity, and insoluble exopolysaccharide synthesis.

METHODSS. mutans ATCC 25175 was used as experimental species. Clonal formation unit (CFU) were counted to investigate the inhibitory effect on bacterial growth. The inhibition rate of bacterial adherence was calculated to analyze the effect on adhesion. Anthrone method was used to determine the content of insoluble exopolysaccharides and the amount of reducing saccharides. GTF activity and enzyme activity were then determined.

RESULTSThe inhibitory ability of the LPO-H2O2-SCN- system with I- on the cariogenicinity of S. mutans was strengthened as I- concentration was increased. At I- concentration > or = 100 micromol x L(-1) the antibacterial effects were significantly increased compared with those of the control group (P < 0.05). At I- concentration > or = 1,000 micromol x L(-1), the antibacterial effects were significantly improved compared with those of the group with SCN-only (P < 0.05). At I- concentration > or = 100 micromol x L(-1), the inhibition rate of bacterial adherence was > 50%; insoluble exopolysaccharide synthesis and GTF enzyme activity were reduced (P < 0.05).

CONCLUSIONThe antibacterial effects of the LPO-H2O2-I- system were enhanced by adding I- to overcome the antagonistic effect of physiological SCN- concentration. LPO-H2O2-SCN- system with different concentrations of I- showed statistically significant inhibitory effects on growth, adhesion, insoluble exopolysaccharide synthesis, and GTF enzyme activity.

Objective: Oxidative modification of low density lipoprotein(LDL) plays an important role in the development of premature atherosclerosis in autoimmune disorders.Oxidized LDL(ox-LDL) reportedly forms stable complexes with ?2-glycoprotein I(?2-GPI),a major autoantigen for anticardiolipin antibodies,in circulation and the intima of atherosclerotic lesions. This study aims to investigate the serum ?2-GPI/ox-LDL concentration in Chinese patients with systemic lupus erythematosus(SLE),and clinical diagnostic value.Methods: The concentrations of ?2-GPI/ox-LDL complexes were analyzed in 47 SLE patients and 42 healthy controls by ELISA.Results: The serum ?2-GPI/ox-LDL concentrations were significantly higher in the SLE patients than in the controls(\U/ml vs\U/ml,P

Objective To evaluate the value of the differential diagnosis of peripheral pulmonary cancer using contrast-enhanced ultrasound (CEUS).MethodsTotally 59 patients selected with peripheral pulmonary lesions(27 primary lung cancer and 32 non-lung cancer cases including 12 pulmonary abscess,19 tuberculosis and 1 hemangioma subjects)were examined by traditional gray-scale sonography and color Doppler flow imaging (CDFI),the lesions shape,borders,echo characteristic and blood flow were recorded first,and then the contrast enhancedsonographicstudies were performed.The process of contrast enhancement and regression was observed and the parameters were quantitative analyzed by acoustic quantification analysis software (ACQ).Finally,surgery or biopsy were conducted.Results CEUS had higher detection rates of blood flow signals than CDFI( P ＜0.001 ).There were significant differences (P ＜ 0.01) between the primary lung cancer group and the non-lung cancer group regarding parameters peak intensity ( PI ) and enhanced intensity ( EI ).By drawing the ROC curve and obtaining the area under the curve:a cut-off value＞15.7 dB of PI in assessing lung cancer had higher sensitivity and specificity (66.7 ％,81.2％).A cut-off value＞ 10.77 dB of EI in assessing lung cancer had higher sensitivity and specificity (81.5％,68.8％).Conclusions CEUS is helpful to identify necrotic tissue in biopsy and improving the biopsy positive rate.The parameters of PI and EI can help to identify the primary lung cancer with the Nonlung cancer.

Objective To investigate the relationship between positive experience and social support of spouses' of community stroke patients.Methods 100 stroke patients and their spouses in two communities were conveniently selected and investigated about their positive experience and social support with General Information Questionnaire (GIQ),Modified Barthel Index(MBI),Positive Aspects of Caregiver (PAC),Perceived Social Support Scale (PSSS).Results The mean score of the spouses' positive experience was (22.74±5.85); the dimension of serf-affirmation was (15.82±3.84),higher than the dimension of life expectation(6.92±2.95).The scores of the spouses' positive experience were significantly different among age,gender,education of spouses and age and ability of daily life of stroke patients; the score of the spouses' positive experience was positively correlated with social support,subjective support,utility of support;multiple linear regression showed that age of spouses,ability of daily life of stroke patients and utility of support were influential important factors of spouses' positive experience.Conclusions The spouses' positive experience was below average level,we must pay more attention to improve it,utility of support can improve spouses' positive experience.