Bone Marrow Neoplasms ; Humans ; Leukemia, Myeloid ; Proto-Oncogene Proteins c-cbl

Objective To investigate antimicrobial resistance of clinical isolates from 15 hospitals submitted to Guangzhou Surveillance of Antimicrobial Resistance (GSAR) in 2007,and to learn the feature of bacterial resistance in Guangzhou.Methods Disc diffusion test (K-B methods) was employed to study the antimicrobial resistance.Results Of 18 500 clinical isolates,Gram negative bacilli and Gram positive cocci accounted for 68.4% and 31.6%,respectively,and 45.7% isolates in Gram negative bacilli belonged to non-fermentative bacilli.The detection rotes of methiciHin-resistant strains was 55.9% in Staphylococcus aureus and 75.9% in coagulase negative Staphylococcus.All of the Staphylococcus pneumoniae isolates were penicillin-susceptible (PSSP) according to 2008 CLSI criterion.One strains of Enterobacter faecium were identified as vancomycin-resistance (VRE).The resistant rates of Enterobacter to imipenem and merpenem were the lowest.The prevalence of ESBLs-producing strains in Enterobacter coli and Klebsiella spp.isolates was 43.8% and 39.8%,respectively.Against all the ESBLs strains in Enterobacter coli and Klebsiella spp,meropenem,imipenem,cefoperazone/sulbactam,and piperacillin/tazobactam showed the lowest resistant rates,ranging from 0 to 14.1%,20.4%,24.4% and 25.4% isolates of Pseudomonas aernginosa were resistant to efoperazone/sulbactam,piperacillin/tazobactam and meropenem,while 75.6%,72.4% and 63.2% isolates of Pseudomonas aeruginosa were susceptible to piperacillin/tazobactam,meropenem and cefoperazone/sulbactam,respectively.The resistance rates of Acinetobacter spp.to cefoperazone/sulbactam and meropenem were 2.6% and 5.1%,respectively.Some panresistant isolates of Pseudomonas aeruginosa (5.5%) and Ac/naobacter baumannii (1.5%) emerged.The resistance of Pseudomonas aeruginosa and Aeinetobacter baumannii isolated from sputum sample was higher than those from blood sample.Conclusions The increase of isolated rates of non-fermentative Gram-negative bacilli and the emerging bacterial resistance and oandrug resistance in Pseudomonas aeruginosa and Acinetobacter baumannii warrants further enbancing the local surveillance of bacterial resistance and characterization of panresistance mechanism to inform the rational use of anfimicrobial agents and containment of bacterial resistance.

Objective To investigate the value of peripheral blood for the prognosis of patients withbloodstream infection. Methods A retrospective analysis of patients with bloodstream infection was conducted inthe intensive care unit (ICU) of Mianyang Central Hospital of Sichuan from January 2012 to October 2016. Accordingto the 28-day survival, the patients were divided into survival group and death group. The white blood cell (WBC),neutrophils count (NEU), lymphocyte count (LYM), neutrophil/lymphocyte ratio (NLR), monocyte count (MO), eosinophilcount (EO), basophil count (BA), hemoglobin (Hb), platelet count (PLT) and procalcitonin (PCT) in peripheral bloodwere recorded when patients were diagnosed with blood infection. Receiver operating characteristic curve (ROC),Kaplan-Meier survival analysis and Cox regression were used to evaluate the value of these risk factors for predictingthe outcome. Results 305 patients were enrolled. 182 patients survived while 123 patients died during the 28-dayperiod. ① There was no significant difference in gender, age and comorbidities between the two groups. There was nosignificant difference in infection rate between the two groups except for fungal infection rate. The fungal infection ratein the death group was significantly higher than that in the survival group (9.8% vs. 3.3%, P = 0.019). ② The LYM,MO, EO and PLT in the death group were significantly lower than those in the survival group [LYM (×109/L):0.58 (0.29, 0.93) vs. 0.76 (0.44, 1.23), MO (×109/L): 0.47 (0.19, 0.80) vs. 0.58 (0.30, 0.94), EO (×109/L):0.00 (0.00, 0.01) vs. 0.03 (0.01, 0.09), PLT (×1012/L): 89 (47, 148) vs. 126 (82, 186), all P < 0.05]. The NLR in the death group was significantly higher than that in the survival group [17.09 (7.60, 33.51) vs. 12.86 (6.51, 24.85), P < 0.05]. There was no significant difference in the WBC, NEU, BA, Hb and PCT between the two groups. ③ It was shown by ROC curve analysis that the maximum area under the ROC curve (AUC) of EO was 0.755. When the best cut-off value was 0.015×109/L as a predictor of death in 28 days, the sensitivity was 80.3%, and specificity was 64.7%. ④ It was shown by survival analysis that the 28-day survival rate in the patients with EO < 0.015×109/L was significantly lower than that of patients with EO > 0.015×109/L [38.3% (62/162) vs. 83.9% (120/143), χ 2 = 56.999, P = 0.000]. ⑤ It was shown by Cox regression that EO was the independent factor for 28-day survival (β = 1.466, χ 2 = 39.535, P = 0.000). Risk of death was 4.331 times greater in patients with EO < 0.015×109/L than in those with EO > 0.015×109/L [hazard ratio (HR) = 4.331, 95% confidence interval (95%CI) = 2.743-6.840]. Conclusions Compared to other parameters in peripheral blood, EO has the best correlation with the prognosis of bloodstream infection. EO is the independent prognostic predictor for 28-day survival.

Objective: To investigate the changes of TRPM8 expression in dorsal root ganglion(DRG) in the rat model of chronic constriction injury(CCI) of the sciatic nerve. Methods: Seventy-two male SD rats weighing 250~280 g were randomly divided into 2 groups (n = 36 each): group I (CCI) and group II (sham operation). The threshold of cold hyperalgesia, heat hyperalgesia and mechanical hyperalgesia were measured before operation (baseline) and at 1, 4, 7, 10 and 14 d after operation. Six rats were killed at each time point in each group. The L5 DRGs ipsilateral to nerve injury were dissected out for determination of transient receptor potential melastatin 8(TRPM8) by immunohistochemical assay. Results: The thresholds of cold, thermal and mechanical stimuli started to decrease at 4 d after CCI in operation group and maintained at a relatively low level until the end of experiment. The cold and thermal hyperalgesia peaked at 10 d after operation and mechanical hyperalgesia at 14 d. Immunohistochemical assay demonstrated that expression of TRPM8 were increased in L5DRG on the operated side significantly at 4 d after CCI and reached the peak at 10 d and was maintained at a high level until the end of experiment. Conclusion: The upregulation of TRPM8 in DRG involved in the mechanism of neuropathic pain.

Objective To discuss the pathogenesis of cerebral hemorrhage in maintenance hemodialysis patients.Methods From Jan.2002 to Dec.2004all the 261 hemodialysis patients in changai Hospital were divided into two groups on the basis of with or without cerebral hemorrhage :(1)the control group,(2)the group of cerebral hemorrhage.Clinical data of 261 hemodialysis patients were retrospectively analyzed.Results In the group of cerebral hemorrhage,the incidence of high blood pressure was 81.1%:the blood pressure after medical therapy not up to standard was 83.8%;the usage of ordinary heparin was 78.4%;the average RRF was(3.8?1.9)and those of the control group were 62.5%,52.7%,52.7% and(7.1?3.3).There were significant differences between the two groups.Conclusion The maintenance hemodialysis patients with cerebral hemorrhage result from multiple factors.Positive control of the blood pressure,selection of appropriate anticoagulant and protection of RRF have important clinical significance.

Objective To investigate the role of local aldosterone system in oncofetal fibronectin ( oncofetal FN) mRNA expression and reactive oxygen species (ROS) production in human mesangial cells (HMCs) exposed to short-term intermittent high glucose and the effect of Fenofibrate.Methods The HMCs were divided into 8 groups:normal glucose(NG) ;osmotic fluctuation(OF) ;mean glucose load (MGL) ;stable high glucose (SHG),short-term intermittent high glucose (IHG) ; intermittent high glucose plus eplerenone (IHGE) ; intermittent high glucose plus fenofibrate(IHGF) ; and normal glucose plus fenofibrate (NGF) groups.The mRNA expression levels of Aldosterone synthase ( CYP11 B2 ),11 β-hydroxysteroid dehydrogenase type 2 ( 11βHSD2 ) and oncofetal FN were determined by RT-PCR.The expression of CYP11B2 protein was determined by western-blot.Aldosterone level in cell culture supernatant was detected by radioimmunoassay.The expression and translocation of mineralocorticoid receptor (MR)protein were assayed with confocal laser scanning microscopy. ROS levels were determined by Fluorescence microscopy and fluorescence microplate reader.Results ( 1 ) MGL,SHG,and IHG groups showed a 2.41,3.63,and 4.45 times increase in CYP11B2 mRNA expression,and a 1.83,2.15,and 2.78 times increase in CYP11B2 protein expression,respectively,compared with NG group (P ＜ 0.05 ).The aldosterone levels of HMCs culture supernatant in MGL,SHG,and IHG groups were also increased,being 1.49,2.04,and 2.54 times of that in NG group ( P＜0.05 ),and the degree of elevation in IHG group was more marked than that in SHG group( P＜0.05 ).MR was activated and translocated from cytosol to nucleus in MGL,SHG,and IHG groups.Quantitative analysis showed the ratioes of cytosol/nucleus fluorescence intensity in MGL,SHG,and IHG groups were 15％,38％,and 53％ decreased as compared with that in NG group,and the decrease was more marked in IHG group ( P＜0.05 ).(2) Oncofetal FN mRNA expression and ROS levels in MGL,SHG,and IHG groups were increased,being 1.54,2.31,3.65 and 1.26,1.91,2.48 times of those in NG group,respectively ( P＜0.05 ),and this increase was more marked in group IHG ( P＜O.05 ).Compared with IHG group,oncofetal FN mRNA expression and ROS levels in group IHGE were significantly decreased by 54％ and 53％,and in group IHGF by 45％ and 39％. ( 3 ) CYP11B2 mRNA,protein,and aldosterone levels in IHGF group were decreased by 74％,59％,and 50％,and the activation of MR in group IHGF was inhibited when the ratio of cytosol/nuclear fluorescence intensity was increased 1.88 fold as compared with that in group IHG ( P＜0.05 ).Conclusions Increased expressions of oncofetal FN and ROS by HMCs induced by short-term intermittent high glucose were nore marked than those induced by stable high glucose.The mechanism was associated with activation of local aldosterone system.Fenofibrate may inhibit the activation of local aldosterone system and alleviate the injury to HMCs induced by intermittent high glucose.

There are many subjects related to anesthesiology and the band between anesthesiology and clinical practicevery is close. So students can not be proficient in anesthesiology by traditional teaching methods. The use of three-dimensional case teaching method in anaesthesiology teaching is a good attemptment. three-dimensional case teaching method integrate case method, multimedia technology and clinical case. It can help medical students analyze and solve clinical problems, improvetheir academic performance and enhance their clinical basic skills.

Objective: To investigate the role of miR-199a-3p in children with severe mycoplasmal pneumonia (MP) and to study its effect on Th17 cells. Methods: Sixty children with severe MP (severe group), 50 children with recovery MP (recovery group) and 40 healthy children (control group) were enrolled. Venous blood samples were collected from all subjects, and the expression of miR-199a-3p in the peripheral blood leukocytes was detected by RT-PCR. The levels of IL-17a, IL-13, GM-CSF and IL-6 in serum were determined by enzyme-linked immunosorbent assay (ELISA). The effect of miR-199a-3p on the differentiation of Th17 cells was investigated by inducing differentiation of Th17 cells and transfecting miR-199a-3p mimics or inhibitors in vitro. Results: Compared with the control group, the expression of miR-199a-3p in peripheral blood leukocytes of children with severe MP was significantly decreased (P<0.05). The levels of IL-17a, IL-13, GM-CSF and IL-6 in serum were significantly higher than those in the control group (all P<0.05). High expression of miR-199a-3p inhibited the differentiation of Th17 cells in vitro. Conclusions The expression of miR-199a-3p is decreased in the pathogenesis of MP. Th17 cells are the target cells of miR-199a-3p, and their differentiation is regulated by miR-199a-3p. The high expression of miR-199a-3p significantly inhibites the differentiation of Th17 cells.

Adult ; Cholesterol, LDL ; blood ; Female ; Humans ; Insulin-Like Growth Factor Binding Protein 1 ; blood ; Male ; Reference Values

Objective To compare the mid- and long-term results of tricuspid valve (TV) repair with or without an annuloplasty ring. Methods Two hundred seventy-seven patients underwent TV repair at our division (Sep. 2001 to Sep. 2008) ,of which 203 had, predominantly, a De Vega or Kay procedure (non-ring group) and 74had an annuloplasty with an artificial ring (ring group). TV pathology mainly was functional (secondary) and several with rheumatic leaflets involvement. Concomitant procedures consisted of mitral valve surgery in all patients,aortic valve surgery in 81 ,and coronary bypass in 19. Clinical and echocardiographic data followed for 1.5 to 3.5years were obtained. Results Postoperationally,the mid-term(1.5 years) follow-up was 100% completed and the long-term follow-up for 3. 5 years was 89. 9%. The recurrence of TV regurgitation (TR) of moderate and lower degree was not significantly different(χ2 = 1.3128, P= 0.26) in the 1.5 years follow-up between the two group,whereas the recurrence of TR of moderate to severity degree was significantly less in the ring group (χ2 =5. 8159,P =0.023).In the long term follow up,the TR in the ring group (25%) was significantly lower than that of 15% in the non-ring group (χ2 = 4. 9328, P = 0.036) . There are higher proportion of patients developing to moderate TR in the non ring group(34%) than in the ring group (10%) (χ2 =7. 9120,P =0.005). The TR developed fast in the ring group,increasing from 18% at 1.5 years follow up to 10% at 3.5 years follow up (χ2 = 2. 1327, P = 0.016),whereas it was relatively stable in the non-ring group,with 7% at 1.5 year follow up and 10% at 3.5 year follow up. Conclusions Placement of an annuloplasty ring in patients undergoing TV repair could remarkably improved the mid and long terum outcome. In clinic practice, we should be more positive to the functional TR and prefer to the procedure with annuloplasty ring.