Bacteremia ; microbiology ; Female ; Humans ; Infant ; Pseudomonas Infections ; pathology ; Pseudomonas aeruginosa

Objective Analyze the clinical feature of patients failed for diagnosis through endobronchial ultrasound transbronchial needle aspiration(EBUS-TBNA).Optimize the indication and increase diagnosis rate of EBUS-TBNA.Methods A total of 669 patients failed for diagnosis of EBUS-TBNA were included.Fifty-three of them(7.92％) were not exactly diagnosed.Perioperation clinical data and clinical feature were collected and evaluated based on specific disease,lesion location,size and operator' s experience.Results The undiagnosis rate was higher in lymphoma (77.78％),tuberculosis (23.08％) and sarcoidosis(9.09％) when analyzed from specific diseases.If the lesion location was taken into consideration,15.38％ upper paratracheal lymph nodes(R2) could not be diagnosed exactly by EBUS-TBNA,and the bilateral hilar lymph nodes(15.00％ for right,11.54 for left) were followed.Size of the lesion was not associated with the diagnosis rate.The operator's experience could also affect the results.The undiagnosis rate was highest in the first 10 cases among all operators.After at least 10 EBUS-TBNA processes,the undiagonsis rate stayed near 7.50％,which was close to the average.Conclusion It is necessary to select suitable indications for EBUS-TBNA based on the disease,lesion location and operatior experience,and cooperate with mediastinoscopy to rise diagnosis rate.

Objective To study the correlation between novelty seeking(NS) personality of healthy young individuals and fractional anisotropy (FA) with voxel-based analysis (VBA) of diffusion tensor imaging(DTI),and explore the microstructure of white matter of personality.Methods Total 333 healthy right handed volunteers completed the Chinese version of the TPQ and the Beck Depression Inventory(BDI),and then finished 3D T1 structure scan,DTI scan.All preprocessed DTI datum was analyzed with SPM8 soft ware in partial correlation analysis,using age and depression scores as controlled variable.The correlation studied between NS and FA (a voxel significance threshold P ＜ 0.001 and a cluster extent threshold of 30 voxels).Results NS score of men and women were 14.55 ± 4.66 and 14.08 ± 5.42 points,and the difference between the two groups was not statistically significant (t =0.81,P=0.46).BDI score of men were higher than that of women (t =3.10,P=0.002),which were 9.23 ± 7.90 and 6.76 ± 5.79 points respectively.NS correlated negatively with FA of the right inferior frontal gyrus,and the right supramarg(i)nal gyrus(P ＜ 0.001).Conclusion NS personality has specific microstructure background of white matter.

Objective To investigate the imaging features of sarcomatoid carcinoma(SC)of lung on chest radiography and CT and to improve knowledge of SC.Methods The chest plain films,CT images and clinical data of all 7 cases of pathologically proved lung SC were retrospectively analyzed.Results All cases presented with a spheroid solid lung mass ranged from 3 to 11 cm in diameter(average 7 cm).All the lesions were located in middle and lower fields of the lung:3 lesions in right lower lobe,2 in right middle lobe,and the other 2 in left lower lobe.Among the 7 cases:6 cases were of peripheral type and 1 case was of central type.The peripheral-typed lesions of 5 cases had clear margin and 3 of them were lobulated.Three massess were homogenous in density,and the other 4 were inhomogeneous in density with formation of central cavity or calcification.After intravenous contrast administration.Three lesions showed homogeneous enhancement,and the other 4 lesions had inhomogeneous enhancement.The lesions with diameter larger than 6 cm showed marginal or patch-like enhancement.Five cases had pleural or chest walls invasion.Two cases had mediastinal lymph nodes metastases.One case had multiple remote metastasis.Conclusion There are some relatively specific features of lung SC on chest radiography and CT,which may be helpful for diagnosis.

The identiifcation of body lfuid and their tissue resource is an important part of forensic medicine research. Conventional methods have imperfections like high false positive rate and may destroy biomaterial, which should be replaced by a new conifrmatory test. Highly-differentiated cells express speciifc mRNA molecules that can be used for body lfuid identiifcation. These mRNA markers can identify body lfuids like peripheral blood, menstrual blood, semen, saliva, vaginal secretion, skin-contact stains. This method have favorable sensitivity, speciifcity and can be detected after years, made it a ideal way to identify current body lfuids in the future. This review focus on the application of mRNA in body lfuid identiifcation and tissue resource.

Objective To explore the effect and significance of clinical pathway guided teaching in the residency standard training program of respiratory medicine. Methods Total 47 resident physicians were selected and divided into clinical pathway group and control group from March 2014 to November 2014. The pathway group (n=24) was introduced into the teaching guided by clinical pathway management. The control group (n=23) was taught by traditional teaching method. All physicians were tested for the basic theory and the ability of case analysis after 4 weeks training. The ability of chemotherapy strategy ordered by residents independently and correctly was assessed each week during training. A satisfaction questionnaire survey was conducted to evaluate the effectiveness and satisfaction of teaching guided by clinical pathway. GraphPad Prism 5.0 was used and T test was done for comparison of data between groups. Results The medical records about basic theory and case analysis in the pathway group was higher than those in the control group with significant statistical difference (P<0.05). The records of resident physicians who could issue orders for chemotherapy independently and correctly were (70.75±2.79), (81.43±1.91), (85.23±1.3), (90.62±2.34) in the pathway group and (69.65±2.06), (77.11±2.21), (80.3±1.96), (87.78±2.21) in the control group at each week time point. There was statistical increase of the records in the pathway group than in the control group since the second week time point (P<0.05) The overall satisfaction of the pathway group was 95.84%(23/24), and the teaching satisfaction was higher than that of the control group(91.29%, 21/23). Pathway group doctors believe that the relevant teaching effectively improve the level of their knowledge , experience and ability. Conclusions The teaching method guided by clinical pathway is help-ful to standardize the teaching behavior, develop the standardized medical behavior of resident physicians, improve their clinical working ability efficiently, promote the relationship between teaching and studying, which is worth application in the residency standard training program of respiratory medicine.

Purpose To analyse the correlation between the Toll-like receptor 3 (TLR3) expression and clinic pathologic factors,stromal microenvironment in hepatocellular carcinoma (HCC).Methods The tissue microarrays of human HCC were prepared with self-owned patent technology.The expression of TLR3 in HCC cells as well as various indexes in HCC stroma was examined with immunohistochemistry of SP.The correlation between TLR3 expression with the clinic pathologic factors of HCC,and the correlation between TLR3 expression with the reaction of stromal cells in HCC microenvironment were analyzed by multi-factor correlation analysis.Results The positive expression rate of TLR3 in HCC was 71.57％.The expression of TLR3 in HCC had negative correlation with vascular invasion (P =0.001),cirrhosis (P =0.007),Edmondson's grades (P =0.001) and staging of TNM (P =0.000).It had positive correlation with hepatitis B surface antigen (HBsAg) (P =0.000).It had positive correlation with T cells (P =0.002) and natural killer (NK) cells (P =0.000).It had negative correlation with carcinoma-associated fibroblasts (CAFs) (P =0.000) and microvessel density (MVD) (P =0.000).Conclusion TLR3 has an important influence on the interstitial microenvironment of HCC.

The acute phase of ischemic stroke patients are often treated with both Chinese patent medicine:and western medicine therapies in clinical practice. This research included 27,678 cases of the acute phase of ischemic stroke came from 14 3A level hospitals. We collected data from patients with ischemic stroke who used both Chinese patent medicine and western medicine and were hopitalized within 14 days from hospital information system (HIS). Constructing complex network of Chinese patent medicine and western medicine were found to show scale-free network. Hierarchical structure of the core algorithm was used to analyze the characteristics of combined core Chinese patent medicine and western medicine in admission condition of "acute", "critically", and "general" of ischemic stroke acute phase patient within one day, 2-3 days, 4-7 days and 8-14 days. We found that the core Chinese patent medicine mainly used for activate blood and resolve stasis medicine, and phlegm eliminating brain refreshing medicine in all kinds of patients, but the phlegm eliminating brain refreshing medicine were used to reduce with time elapsing. The core western medicine mainly used for anti-platelet medicine, improve circulation medicine, neuroprotective medicine, anticoagulants medicine and dehydration medicine. The dehydration medicine as the core western medicine for critically patients within 14 days, but the patients for general admission as core western medicine within 3 days. The neuroprotective medicine was used to decreases after 7 days in hospital. Combination of Chinese patent medicine and western medicine were mainly for neuroprotective medicine + activate blood and resolve stasis medicine, and anti-platelet medicine + activate blood and resolve stasis medicine, and improve circulation medicine + activate blood and resolve stasis medicine. The phlegm eliminating brain refreshing medicine was mainly combined with neuroprotective medicine by urgent and general admission condition patients, and it was more combined with dehydration medicine by critically admission condition patients. This research found that the dynamic characteristics for the combination of Chinese patent medicine and western medicine of acute phase of ischemic stroke patients by big data analytics and complex networks modeling, and provide basis for acute phase of ischemic stroke patients, it provide basis for ischemic stroke treatment strategy making.
Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Brain Ischemia ; drug therapy ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Stroke ; drug therapy

Objective AMI is a prevalent global health condition.This study assessed the effects of PLGF and VEGF in a rat model of post-AMI.Methods Wistar rats underwent LAD ligation and injection of VEGF,PLGF,VEGF + PLGF,antiVEGFR1,anti-VEGFR2,anti-VEGFR1 + anti-VEGFR2,IgG2α,or saline,into the infarct border zone.We also set up a pseudo-operation group.Two weeks later,heart function was detected by hemodynamic and geometry,then the hearts were dis sected and HE stained.We assessed vW factor and α-SMA by immunohistochemistry and cardiomyocyte apoptosis rate by TUNEL.Results Rats in the VEGF + PLGF group performed significantly well in cardiac function,had weaker LV remodeling and less cardiomyocyte apoptosis.There were no obvious changes in VEGF group.The use of VEGFR1/VEGFR2 antibody didnt deteriorate the rat's cardiac function.More new-born arteries were seen in PLGF and VEGF + PLGF rats,and change wasnt found in other groups.Lastly,the most angiogenesis,the least left ventricular remodeling and the best heart function were observed in VEGF + PLGF group.Conclusion Earlier intervention with PLGF or VEGF + PLGF can improve heart function in rats with AMI; VEGF alone didnt improve heart function.VEGFR1/VEGFR2 antibody didnt aggravate the rat's heart function.This indicates that left ventricular and coronary remodeling may involve other factors.

In order to identify Aucklandiae Radix, Vladimiriae Radix, Inulae Radix, Aristolochiae Radix and Kadsurae Radix using ITS2 barcodes, genomic DNA from sixty samples was extracted and the ITS2 (internal transcribed spacer) regions were amplified and sequenced. The genetic distances were computed using MEGA 5.0 in accordance with the kimura 2-parameter (K2P) model and the neighbor-joining (NJ) phylogenetic tree was constructed. The results indicated that for Aucklandiae Radix (Aucklandia lappa), Vladimiriae Radix (Vladimiria souliei and V. souliei var. cinerea), Inulae Radix (Inula helenium), Aristolochiae Radix (Aristolochia debilis) and Kadsurae Radix (Kadsura longipedunculata), the intra-specific variation was smaller than inter-specific one. There are 162 variable sites among 272 bp after alignment of all ITS2 sequence haplotypes. For each species, the intra-specific genetic distances were also smaller than inter-specific one. Furthermore, the NJ tree strongly supported that Aucklandiae Radix, Vladimiriae Radix, Inulae Radix, Aristolochiae Radix and Kadsurae Radix can be differentiated. At the same time, V. souliei (Dolomiaea souliei) and V. souliei var. cinerea( D. souliei var. cinerea) belonging to Vladimiriae Radix were clearly identified. In conclusion, ITS2 barcode could be used to identify Aucklandiae Radix, Vladimiriae Radix, Inulae Radix, Aristolochiae Radix and Kadsurae Radix. Our study may provide a scientific foundation for clinical safe use of the traditional Chinese medicines.
Aristolochia ; classification ; genetics ; Base Sequence ; DNA Barcoding, Taxonomic ; methods ; DNA, Plant ; genetics ; DNA, Ribosomal Spacer ; genetics ; Drugs, Chinese Herbal ; chemistry ; classification ; Molecular Sequence Data ; Phylogeny ; Plants, Medicinal ; classification ; genetics ; Quality Control