Objective To investigate the clinical characteristics of adult patients with community acquired pneumonia (CAP) caused by acute Mycoplasma pneumoniae (MP) infection, and provide evidence for early identification of MP infection. Methods A prospective, multicenter and cross-sectional study was conducted. 452 adult patients with CAP admitted to Beijing Friendship Hospital, Beijing Guangwai Hospital and Air Force General Hospital from August 2011 to October 2015 were enrolled. The diagnosis of adult MP infection was confirmed by the combined application of double serum antibody titer and MP-DNA nested polymerase chain reaction (PCR) through testing serum and throat swab samples from patients to identify acute infections, past infections, pathogen carrying, and non-MP infection. The clinical characteristics of patients with acute MP infection were summarized by analyzing the baseline data, clinical parameters and chest imaging findings in patients with non-MP infection and acute MP infection. Results Of 452 enrolling patients with CAP, 288 patients (63.7%) suffered from MP infection, and 164 patients (36.3%) with non-MP infection. There were 56 patients (12.4%) with acute infection, 10 patients (2.2%) with past infections, 222 patients (49.1%) with pathogen carriers in MP infective patients indicating susceptible to MP in adult patients. There were no significant differences in gender, age, fever extent, duration of fever, sputum production, shortness of breath, rales, underlying diseases, etc. between non-MP infection and acute MP infection patients, which suggested that the baseline data of the two groups were equilibrium. The acute infection rates of MP in summer and autumn (43.9% and 43.5% respectively) were more than those in spring and winter (13.3% and 12.3% respectively). It was shown by laboratory examination results that serum cardiac troponin T (cTnT) increased significantly in acute MP infectious patients more than that in non-MP infection patients (30.4% vs. 9.8%, P < 0.01), which indicated that patients with acute MP infection were more likely to have myocardial injury. While there were no significant differences in blood routine, blood electrolytes, blood glucose, as well as heart, liver and kidney function between the two groups. It was shown by chest imaging that the diffuse lesions (57.1% vs. 37.2%), mediastinal lymphadenopathy (60.7% vs. 37.8%) were less founded in the middle lobe of the right lung (12.5% vs. 32.9%), which were the main manifestations in patients with acute MP infection as compared with non-MP infection patients with statistical difference (all P < 0.01). There were no significant differences in the chest imaging performances of pulmonary ground glass shadow, lobar and segmental consolidation, patch shadow, a shadow, acinar nodules, grinding glass density nodules, the photic zone, hilar lymphadenopathy and pleural effusion occurrence between the two groups. Conclusion Adult CAP patients are easy to carry MP, myocardial damage is a common complication in acute MP infectious patients which are characteristic of image findings of diffuse lung disease, mediastinal lymphadenopathy and less founded in the middle lobe of the right lung.

Objective To investigate morbidity, mortality and survival of patients with adenocarcinoma of the pancreas who underwent pancreaticoduodenectomy with en bloc portal vein resection, and to evaluate its effect on radical resection of pancreatic carcinoma. Methods Between 1999 and 2003, 32 patients with ductal adenocarcinoma of the head of the pancreas who underwent pancreaticoduodenectomy with SMPV resection were retrospectively analyzed. Patients were divided into two groups with group A(n = 12) in which the wall of portal vein was surrounded by carcinoma without true invasion,and group B(n = 20) , by tumor transmural invasion. Results The overall morbidity was 31% , there was no operative mortality, the 1,3-year survival rate was 59% and 22% respectively. The mean survival time of patients with microscopically positive margin was 5. 6 months as compared with 20 months with microscopically negative margin. There was no difference in tumor size, margin positivity, nodal positivity, and 1,3-year survival rate between the two groups. Conclusions Pancreaticoduodenectomy combined with SMPV resection can be performed safely, without increasing the morbidity and mortality. SMPV resection should be performed only when a margin-negative resection is expected. SMPV invasion is not associated with histologic parameters suggesting a poor prognosis.

Objective To evaluate the surgical treatment of Nevin′s stage Ⅳ and Ⅴ gallbladder carcinoma. Methods A retrospective analysis was made on 62 cases of Nevin′s stage Ⅳ and Ⅴ gallbladder carcinoma patients undergoing surgical treatment from Jan. 1993 to Dec. 2002. Results There were 17 cases of stage Ⅳ and 45 of stage Ⅴ. Cholecystectomy was performed in 32 cases with a resection rate of 52%, 7 cases received radical resection, 10 extended radical resection and 15 palliative resection. The total surgical morbidity rate was 35.3%. Postoperative 1-, 3-, 5-year survival rate of radical and palliative resection were 61%, 31%, 11% and 27%, 13%, 0 respectively (P

OBJECTIVESeed dormancy mechanisms, breaking dormancy and the optimal germinating conditions were studied to improve reproductive efficiency and quality standard of Pseudostellaria heterophylla.

METHODThe P. heterophylla seeds were stratified into wettish sand for 65 days under the temperature of -2-3 degrees C, embryo length and germination dynamic change of seeds were measured in prophase every other 10 days and in middle every other 5 days. The influences on seed germination and seedling growth under different temperatures, germination beds were investigated.

RESULTThe P. heterophylla seeds embryo morphology was unchanged in stratification. The seeds could not germinate at stratification within the first 35 days. The germination rate and germination energy of seeds increased with the stratification time after 35 days. Germination rate, germination energy, plant height and fresh weight under the 10 degrees C were significantly higher than those under other temperatures. Germination rate, germination energy, plant height, fresh weight and dry weight of plant in sand bed were higher than those of plant in other beds, and seed mildew rate and abnormal seedling proportion of plant in sand bed were less than those of plant in other beds.

CONCLUSIONThe dormancy of P. heterophylla seeds is mainly the physiological post-maturation. The optimal germination conditions of seeds is 10 degrees C the culture of sand. The dormancy was broke under -2-3 degrees C of wettish sand for 45-50 days in practice.

OBJECTIVE: To improve the quality standard of Folium Mahoniae. METHODS: TLC was used for qualitative identification. The contents of moisture, ash and ethanol extract were determined. The content of berberine hydrochloride was determined by HPLC. The determination was performed on WondaSil C18 column with mobile phase consisted of acetonitrile-0. 05 mol/L monopotassium phosphate solution (25: 75, V/V) at the flow rate of 1. 0 mL/min. The detection wavelength was 264 nm, column temperature was 30 ℃, and sample size was 10 μL. RESULTS: TLC spots were clear and well-separated. The contents of moisture, total ash, acid-insoluble ash and ethanol extract were 3. 92％-7. 03％, 3. 65％-6. 95％, 0. 05％-1. 03％ and 10. 87％-33. 14％, respectively. The linear range of berberine hydrochloride was 0. 183-0. 915 μg(r=0. 999 9); quantitation limit and detection limit was 0. 143, 0. 095 μg, respectively. RSDs of precision, stability and reproducibility tests were lower than 2. 0％ (n=6); recovery was 95. 21％ -103. 10％ (RSD = 2. 95％, n=6). CONCLUSIONS: The content of moisture, total ash and acid-insoluble ash of medicinal materials is not exceed 8. 0％, 6. 0％ and 0. 4％, respectively. The content of ethanol extract and berberine hydrochloride is not less than 16. 0％ and 1. 0％, respectively. Established standard can be used for quality control of Folium Mahoniae.

OBJECTIVE: To determine the expression of DLK1 gene in acute leukemias (AL) and its function in erythroid differentiation of K562 cells. METHODS: We detected the expression of DLK1 gene in 65 different acute leukemia categories (a test group) and 34 normal bone marrow controls (a control group) with RT-PCR. DLK1 protein in 20 out of the 65 AL patients and 13 of the 34 controls was assayed by Western blot. The K562 cell line was induced to erythroid differentiation by hemin. We observed the relationship between its expression and erythroid differentiation. RESULTS: Both leukemia cells and normal marrow cells expressed DLK1. The expression of DLK1 mRNA in patients in the test group was higher than that in the control group (P=0.018), while there was no significance between acute lymphoblastic leukemia and acute myelogenous leukemia (P>0.05).The expression of DLK1 mRNA in the test group at onset had no relation with the WBC and platelet count in the total peripheral blood, and the same was true for blast cell rates in bone marrow cells.The level of DLK1 protein in the test group was higher than that in the control group, which was consistent with the mRNA expression (P=0.042). The expression of DLK1 mRNA decreased gradually with K562 cells towards hemin-induced erythroid differentiation. CONCLUSION DLK1 gene may be involved in leukemia,but the mRNA level of DLK1 has no relation with some clinical characteristics of AL patients at onset. DLK1 may inhibit the erythroid differentiation of K562 cells.
Acute Disease ; Adolescent ; Adult ; Aged ; Calcium-Binding Proteins ; Case-Control Studies ; Cell Differentiation ; drug effects ; genetics ; Cell Transformation, Neoplastic ; genetics ; Child ; Child, Preschool ; Erythroid Cells ; pathology ; Erythroid Precursor Cells ; pathology ; Female ; Humans ; Intercellular Signaling Peptides and Proteins ; genetics ; metabolism ; K562 Cells ; Leukemia ; genetics ; metabolism ; Male ; Membrane Proteins ; genetics ; metabolism ; Middle Aged ; RNA, Messenger ; genetics ; metabolism ; Young Adult

Objective To observe the protective mechanism of angiotensin-converting enzyme (ACE) 2 on lipopolysaccharide (LPS)-induced hepatocyte inflammation by inhibiting P38 mitogen activated protein kinase (MAPK)/activator protein (AP)-1 pathway.Methods Rat liver BRL cells after immortalized culture were randomly divided into five kinds of groups:control group,LPS (10 μg/ mL) group,LPS + recombinant(r) ACE2 (5,10,20 ng/mL rACE2 for 30 min before cells stimulated with LPS) groups,LPS+ACE2 inhibitor MLN-4760 (10-7,10-6,105 mmol/L MLN-4760 for 30 min before cells stimulated with LPS) groups,LPS + rACE2 (20 ng/mL rACE2 for 30 min before cells stimulated with LPS) + P38MAPK inhibitor SB203580 (10-5 mmol/L SB203580 for 30 min before cells stimulated with LPS) groups.The changes in protein levels of ACE2,P38MAPK,p-P38MAPK and AP-1 were detected by western blot after LPS exposure for 6,12 and 24 hours,and the mRNA expressions of P38MAPK,AP-1 and tumor necrosis factor-α were quantified by real-time RT-PCR.Results Compared with control group,the protein levels of ACE2,P38MAPK and AP-1 were up-regulated in LPS-induced hepatic cells in a time-dependent manner,peaking at 12 h after LPS stimulation (all P＜0.05).Compared with LPS group,the mRNA expressions ofAP-l,P38MAPK,p-P38MAPK and tumor necrosis factor-oα decreased significantly in rACE2 group (all P＜0.05).The dose of 20 ng/mL rACE2 had the best inhibitory effects on the mRNA expression of AP-1 (0.12±0.002 vs.0.04±0.005,P＜0.01),P38MAPK (0.17±0.02 vs.0.02±0.002,P＜0.01) and p-P38MAPK(0.29±0.01 vs.0.02±0.01,P＜0.01)compared with LPS group.The mRNA expressions of AP-1,P38MAPK and p-P38MAPK increased in MLN-4760 group in a concentration dependent manner (all P＜0.05).Furthermore,the inhibitory effects of rACE2 on AP-1 and tumor necrosis factor-α levels were cancelled by SB203580.Conclusion The rACE2 can alleviate the LPS-induced hepatocyte injury by down regulating the P38MAPK/AP-1 signaling pathway.

The safety of leachable substances in medical devices is an important guarantee of the safety of medical devices, and is also the focus of attention in the review of medical devices in recent years. Combined with the difficult issues in the study of leachable substances, the challenges in the study of leachable substances in medical devices were briefly described, and the counter-measures were briefly described for reference by relevant institutions and researchers.

Objective To discuss the influence of exogenous Gibberellin (GA3) and abscisic acid (ABA) on genetic expressions of key enzymes in ethylene synthesis in Taizishen (Pseudostillaria Root, Radix Pseudostellariae) , and provide reference for intelligent use of growth regulators during cultivation of Taizishen.Methods The genes of key enzymes in ethylene synthesis of Taizishen were screened and identified from transcriptome database by using local Blast method.Hai'ershen in full-bloom stage was treated with exogenous GA3 and ABA, and samples were collected at different time points (20 d, 40 d, 50 d and 60 d.The genetic expressions of key enzymes in ethylene synthesis of Taizishen were detected by using real-time fluorescence polymerase chain reaction (RT-PCR).Results There were totally 6 genes of key enzymes in ethylene synthesis in roots of Taizishen obtained, and they were named PhACO1, PhACO2, PhACO3, PhACS1, PhACS2 and PhSAMS.GA3 and ABA could regulated the expressions of above 6 genes, and expressions of PhACO1, PhACO2, PhACS1 and PhSAMS were up-regulated after treated with GA3, and expressions of PhACO3 and PhACS2 were up-regulated after 20 d to 40 d and down-regulated after 50 d to 60 d.The expressions of genes of key enzymes in ethylene synthesis in Taizishen showed down-regulation at first and then up-regulation after treated with ABA, but different genes had different demonstrations.The expression of PhACO1 was up-regulated after 20 d to 60 d, and down-regulated after 40 d to 50 d.The expressions of PhACO2 and PhACO3 were down-regulated after 20 d to 50 d, and up-regulated after 60 d.The expression of PhACS1 was down-regulated after 20, up-regulated after 40 d to 60 d.The expressions of PhACS2 and PhSAMS were down-regulated.Conclusion GA3 and ABA may control the ethylene signaling pathway to regulate plant growth through affecting the ethylene biosynthesis of Taizishen.It is speculated that Taizishen is treated with suitable concentration of GA3 in adventitious root growth period and treated with ABA treatment in root thickening period, the yield of Taizishen will be increased.

Objective:To lay a foundation for the continuous improvement of the birth cohort management in the future, and provides references for other hospitals in establishing the birth cohort through sharing the practice, experience and reflection of the establishment and management of the birth cohort of 500, 000 pregnant women.Methods:The present situation and data of the establishment and management of the birth cohort of 500, 000 pregnant women were summarized to describing the practice, experience and reflection.Results:The specific work regarding the establishment and management of the cohort include personnel investment, standards development, implementation process and quality control. Three phases of the management experiences were summarized which including explorative process implementation; standardize project implementation, and quality improvement along with the fast development of the birth cohort. Generally, the attention of leadership was one of the most important factors for the establishment and management of birth cohort in each research site.Conclusions:It is important that comprehensive considerations of factors including the personnel, standards, practical management process, quality control and the attention of leadership plays important role in improving the quality and efficiency of birth cohort establishment and management.