Respiratory tract infection remains a hot clinical topic.Disappointingly, routine microbiology tests do not meet the needs of target antimicrobial therapy.Widespread practice of antibiotic empiricism has lead to dramatic use of broad-spectrum antibiotics and antimicrobial resistance.The application of new clinical microbiology tests to identify the offending pathogen may allow administration of narrow spectrum antibiotic therapy.To do so,the full clinical microbiology armamentarium with newer point-of-care tests and polymerase chain reaction tests must be exploited.The return of the sputum gram stain and introduction of newer molecular tests would provide information for judicious selection of antimicrobials.

OBJECTIVE:To provide reference for rational use of antidepressant drugs in the clinic. METHODS:By DDD anal-ysis recommended by WHO,the utilization of antidepressant drugs in 34 hospital from Nanjing area during 2011-2014 were ana-lyzed statistically in respects of main type,consumption sum,DDDs and DDC,etc. RESULTS:The consumption sum and DDDs of antidepressants were increased year by year in 34 hospital from Nanjing area during 2011-2014,with the average annual growth rate of 18.21% and 19.25% respectively. The top 2 drugs by DDDs were paroxetine and setraline;DDC of tomoxetine,trazodone and dutoxetine took up the first 3 place;consumption sum of paroxetine,setraline,venlafaxine and escitalopram took up the first 4 places;consumption sum of paroxetine,mirtazapine and citalopram synchronized with their DDDs,and serial number ratio was close to or equal to 1.00. CONCLUSIONS:The use of antidepressant drugs in 34 hospitals from Nanjing area is rational in struc-ture and level;selective 5-hydroxytryptamine(5-HT)reuptake inhibitors(SSRI)and selective 5-HT noradrenaline reuptake inhibi-tor(SNRI)take up the predominant place;new type of antidepressant drugs are used widely and of great use potentiality in the fu-ture.

Animals ; Curcumin ; pharmacology ; therapeutic use ; Humans ; Liver Cirrhosis ; drug therapy

Expression of major histocompatibility complex class 1(MHC-1)and thyroid specific transcription factor-1(TTF-1)in thyroid follicular epithelia of Graves'disease and Hashimoto's thyroiditis measured by immunohistochemistry technique were all significantly increased as compared with those in normal controls,suggesting that TTF-1 and MHC-1 seem to contribute to the development of autoimmune thyroid diseases.

AIM: To analyze the clinical value of femtosecond laser in vitrectomy combined with phacoemulsification and intraocular lens (IOL) implantation.
METHODS: We selected 100 patients ( 102 eyes ) undergoing vitrectomy combined with phacoemulsification and IOL implantation in our hospital from October 31 2013 to October 31 2015. They were divided into routine operation group, 50 cases (52 eyes), and femtosecond laser group, 50 cases (50 eyes). The parameters were compared between the two groups, including total operation time, postoperative complications ( elevated intraocular pressure, uveitis, vitreous hemorrhage, and retinal detachment ), postoperative intraocular pressure and postoperative half of the visual acuity ( near visual acuity, visual acuity, uncorrected visual acuity, corrected visual acuity).
RESULTS: The difference on total operation time of the two groups was statistically significant ( P < 0. 05). The differences between the two groups on postoperative intraocular pressure, uveitis, vitreous hemorrhage, retinal detachment were not statistically significant ( P >0. 05). There were no significant differences on internal pressure, near visual acuity, far visual acuity, uncorrected visual acuity, corrected visual acuity at 6mo after surgery (P>0. 05).
CONCLUSION: Femtosecond laser in vitrectomy combined with phacoemulsification and IOL implantation has a high safety and efficacy with the advantages as accurate, efficient.

Objective The aim of this study was to investigate the diagnostic value of the intravoxel incoherent motion (IVIM) for discriminating nonmetastatic from metastatic mediastinal lymph nodes in lung cancer.Methods IVIM was performed preoperatively on 66 patients with lung cancer during October 2015 to June 2016 in Capital Medical University Affiliated Beijing Chaoyang Hospital.Preoperative examination including the chest MRI scan,chest CT,head MRI,bone scan-ning and the cardiopulmonary function.None of the patients was undergone any kind of treatment about the cancer before the examinations,the neoadjuvant chemotherapy or radiation therapy,immunotherapy and gene targeted therapy were included.Measured the short axis diameter and the IVIM parameters of the mediastinal lymph nodes,apparent diffusion coefficient(ADC),diffusion coefficient(D),pseudo-diffusion coefficient(D *),and perfusion fraction(f).All the patients underwent the lobectomy or wedge resection and lymph node dissection or systematic sampling.By comparing the IVIM parameters of the nonmetastatic and metastatic mediastinal lymph nodes according to the pathological examination,draw the ROC curves to find the best cutoff value for diagnosis.And 42 cases were used to comparing the value of the MRI and CT in differential diagnosis.Results MRI measured 184 groups mediastinal lymph nodes,including 164 groups without metastasis,20 groups with metastasis.The ADC,D,D *,f values and short axis diameter of the nonmetastatic lymph nodes(n =164) were(2.880 ± 0.785) × 10-3 mm2/s,(0.670 ± 0.179) × 10-3 mm2/s,(0.383 ± 0.123) × 10-3 mm2/s,0.422 ± 0.119,(6.546 ± 1.932) mm,respectively,and (1.897 ±0.657) × 10-3 mm2/s,(0.472 ±0.210) × 10-3 mm2/s,(0.354 ±0.130) × 10-3 mm2/s,0.412 ±0.090,(7.510 ± 2.773) mm respectively for the metastatic lymph nodes (n =20).The ADC and D value of the nonmetastatic lymph nodes were significantly higher than the metastatic lymph nodes(P ＜0.01).While the other paraneters(D *,f,and short axis diameter) between the two groups did not show significantly different.Optimal cutoff values(area under the curve,sensitivity,and specificity) for distinguishing metastatic from nonmetastatic lymph nodes were as follows:ADC =1.890 × 10-3 mm2/s (0.871,92.7％,80.0％);and D =0.648 × 10-3mm2/s(0.740,70.0％,84.1％).Conclusion IVIM is useful to distinguish metastatic from nonmetastatic lymph nodes in lung cancer.The ADC and the D values are significant higher in metastatic lymph nodes,which more sensitive than the other parameters(D *,f,and short axis diameter).As a result,IVIM can be used in the N-stage diagnosis of lung cancer.

Objective To explore economic valuation of the minimally invasive esophagectomy.Methods The cases undergone esophagectomy were studied retrospectively.Monofactorial analysis was done to evaluate the impact of various factors on the overall hospitalization costs.The correlated factors then were used as independent variables to carry out the multiple linear regression aimed at the hospitalization costs.Results The results of monofactorial analysis showed that the accompanying diseases,days during hospitalization,modes of esophagectomy,postoperative complications were correlated factors of the overall hospitalization costs.According to the multiple linear regression,it were sorted based on descending order duing to its effect of largenning the hospitalization costs:postoperative complications (β =0.439,P =0.000),days during hospitalization (β =0.397,P =0.000),accompanying diseases(β =0.257,P =0.000),modes of esophagectomy(β =0.132,P =0.000).The expenses caused immediately by the operations were statistically more of the minimally invasive surgery than that of the open procedures whatever the numerous or proportion of the overall costs (P =0.000).Conclusion Combined thoracoscopic and laparoscopic esophagectomy was more expensive than open operation.Nevertheless,impact of the other factors,such as postoperative complications,were more significant than that of the different procedure.h was a strategy to minimally invasive osophagectomy that hospitalization costs could be reduced by means of controlling complications and diminishing hospitalization days.

Objective: To establish a quality control method for Gene-Viral Therapy system CNHK200-hEndostatin. Methods: According to "The Guideline on Quality Control Methods of Human Gene Therapy Products", a quality control method for adenovirus was set up, which consisted of adenovirus protein identification, genomic identification, hEndostatin gene identification, hEndostatin protein quantitation, adenovirus particle quantitation, virus titer quantitation, determination of particle to PFU ratio, purity detection, AdWT detection, host cell DNA residue detectiong bovine serum protein residue detection, etc. The purified adenovirus product of CNHK200-hEndostatin was subjected to the above process. Results: We set up a SDS-PAGE method to identify the adenovirus protein and identified adenovirus genomic DNA by restriction endonuclease enzyme analysis. Human endostatin gene was identified by PCR method and its expression product was quantitated by ELISA. The number of adenovirus particle was quantitated by D260 method and HPLC method. The purity of adenovirus was determined by D260/D280 method and HPLC method. A PCR reaction was introduced to detect AdWT and hybridization method was used in host cell DNA residue detection. Bovine serum protein residue was detected by reverse indirect hemagglutination assay. All these methods were confirmed feasible in adenovirus quality control and our purified adenovirus sample was eligible in all test items. Conclusion: A series of basic methods have been successfully established for quality control of gene-viral therapy system CNHK200-hEndostatin. Our modified method for adenovirus particle quantitation by HPLC is more rapid and accurate than traditional method. The established methods have been approved in testing the purified adenovirus samples.

Objective:To detect the expression of microchromosome maintenance protein 4 (MCM4) in pancreatic ductal adenocarcinoma, and to explore the clinical prognosis of MCM4 and pancreatic ductal adenocarcinoma. To explore the possibility of MCM4 as a potential biomarker for pancreatic ductal adenocarcinoma.Methods:The mRNA level of MCM4 in pancreatic ductal adenocarcinoma and normal tissues adjacent to the cancer was analyzed by bioinformatics methods, and the relationship between its expression and the survival rate of patients with pancreatic ductal adenocarcinoma was analyzed. The clinicopathological data of 76 patients with pancreatic ductal adenocarcinoma who underwent surgical treatment were retrospectively analyzed. Immunohistochemical method was used to detect the expression level of MCM4 protein in pancreatic ductal adenocarcinoma tissue and normal tissues adjacent to the cancer, and to analyze its relationship with clinicopathological characteristics of patients with pancreatic ductal adenocarcinoma.Results:The results of bioinformatics analysis showed that MCM4 mRNA was significantly highly expressed in pancreatic ductal adenocarcinoma tissue, and was significantly correlated with the overall survival rate and disease-free survival rate of patients (all P<0.05). Immunohistochemical results showed that the expression of MCM4 in pancreatic ductal adenocarcinoma tissue was significantly higher than that in normal tissues adjacent to the cancer. The high expression of MCM4 in pancreatic ductal adenocarcinoma tissue was related to tumor size ( P=0.038), but not related to age, gender, and tumor grade (all P>0.05). Conclusions:MCM4 is highly expressed in pancreatic ductal adenocarcinoma tissues and indicates a poor prognosis, and its expression level is related to the tumor stage of pancreatic ductal adenocarcinoma. MCM4 may serve as a new potential biomarker for pancreatic ductal adenocarcinoma.