Objective To analyze the CT characteristic of pulmonary inflammatory mass and peripheral lung cancer, and to look for the method of diagnosis solitary pulmonary nodule. Methods 28 patients of pulmonary inflammatory masses and 33 patients of peripheral lung cancers were included in the study,all patients conformed by pathology. The lesions were divided into typical and atypical masses according to morphology. Observing the signs of lesions and using the results ameliorate the morphological classification. Tested the method by ROC. Results According to the standard of morphology, the diagnosis sensitivity, specificity and accuracy of inflammatory mass are 64.3%, 72.7% and 68.9% respectively. The ameliorated sensitivity, specificity and accuracy are 75%, 81.8% and 78 7% respectively. Conclusion The method of making morphology as basement and sign as supplement can improve the sensitivity, specificity and accuracy of diagnosis.

Objective To evaluate the role of nucleotide‐binding oligomerization domain 2(NOD2) stimulation in innate immuni‐ty against M ycobacterium tuberculosis .Methods Plate counting as used to evaluate the effect of resisting M ycobacterium tubercu‐losis in human alveolar macrophages .Intracellular NOD2 expression were detected by flow cytometry .Quantitative real‐time PCR was performed to determine the NOD2 ,inducible nitric oxide synthase(iNOS) ,and DEF4B mRNA expression levels using the com‐parative threshold cycle method of relative quantitation .Reactive oxygen species(ROS) were detected by the DFCH probe .Results NOD2 stimulation enhanced the control of intracellular mycobacterial growth in human alveolar macrophages .Although ROS con‐centration did not changed ,the secretion of Nitro Oxygen and the expression of cathelicidin DEFB4 were significantly increased fol‐lowing NOD2 stimulation in human alveolar macrophages .Conclusion NOD2 stimulation may be involved in the early innate con‐trol of Mycobacterium tuberculosis primary infections inducing the generation of Nitro Oxygen and the peptides cathelicidin DEFB4 .

OBJECTIVE: To observe the effects of combined treatment using salmeterol / fluticasone propionate and lip shrinkage respiration on the treatment of patients with pneumoconiosis complicated with chronic obstructive pulmonary disease( COPD). METHODS: By random number table method,98 patients with stable pneumoconiosis complicated with COPD were divided into 3 groups: drug treatment group( 33 cases) was treated only with inhalation of salmeterol /fluticasone propionate( 50 μg /500 μg),twice a day; lip shrinkage respiration group( 34 cases) was treated with abdominal breathing and lip shrinkage respiration training,three times daily for 15 min per session; combined treatment group( 31 cases) was treated with both the above treatments. Before and after 6 months of treatment,the lung function,the 6-minute walk distance and the oxygen saturation( Sa O2) were detected. The modified Medical Research Council( m MRC) Respiratory Questionnaire was used to evaluate the degree of dyspnea. RESULTS: After 6 months of treatment,the forced vital capacity percentage( FVC%),percentage of forced expiratory volume in one second( FEV1%),maximum ventilatory volume( MVV),6-minute walking distance,m MRC degree and the Sa O2 improved in the patients of these 3groups compared with those before treatment( P < 0. 05). Compared with the drug treatment group or lip shrinkage respiration group after treatment,the FVC%,FEV1%,MVV,6-minute walking distance and the Sa O2 in the combined treatment group were higher( P < 0. 05),and the m MRC degree was lower( P < 0. 05). CONCLUSION: Salmeterol /fluticasone propionate combined with lip shrinkage respiration treatment had better therapeutic effect than single treatment in treating patients with pneumoconiosis combined with COPD.

Objective    To analyze the effect of 3D simulation technique in thoracoscopic lobectomy. Methods    From June 2015 to January 2018, 124 patients with left lower lobe resection underwent thoracoscopy with single-port thoracoscopic surgery, including 64 males and 60 females, aged 42–83 years. They were randomly divided into two groups including an experimental group (preoperatively given 3D simulation surgery in 59 patients) and a control group (preoperatively not given 3D simulation surgery in 65 patients). The clinical effect between the two groups was compared. Results    All patients recovered without any death during hospitalization. In the experimental group, the operation time, intraoperative blood loss and postoperative hospital stay were significantly less than those in the control group (P<0.05). There was no significant difference in postoperative drainage volume, and duration of drainage tube retention and analgesic drug usage between the two groups (P>0.05). Conclusion    3D simulation technique for thoracoscopic lobectomy has advantage in short operation time, minor trauma and quick recovery. It has a guiding role in the preoperative planning of lung cancer surgery and is worthy of popularization and application.

Palliative care is a way to help end-of-life populations improve their quality of life， and its development in practice cannot be separated from the level of education in palliative care. At present， some medical schools in palliative care education compared with western developed countries have problems such as imperfect construction of hospice curriculum system， lack of medical students’ hospice knowledge； insufficient interdisciplinary teaching faculty， weak palliative care awareness of medical students； single teaching evaluation mode； weak palliative care practice teaching links. To this end， it is necessary to improve the palliative care curriculum system， explore rich and diverse teaching methods； strengthen interdisciplinary teaching and faculty development， enhancing the awareness of palliative care among medical students；establish a scientific and effective evaluation method， carry out multi-dimensional dynamic assessment； expand the palliative care practice teaching base， and accurately improve the practical skills of medical students in palliative care， and other countermeasures to improve the level of palliative care education， and to help the strategy of Healthy China.

Objective To study the effects of Leptin on the expression of CD86 and HLA-DR in human monocytes.Methods The expression of CD86 and HLA-DR in THP-1 Cells and human primary monocytes were detected by flow cytometry.Results Expression of CD86 and HLA-DR in THP-1 cells was significantly increased after treatment with high-dose Leptin ( CD86Untreated group:8.78 ± 1.66,CD86leptin10:50.76 ± 4.29,CD86leptin100:95.20 ± 4.90; HLAUntreated group:20.75 ± 2.12,HLAleptin10:102.14 ± 5.75,HLAleptin100:104.32 ± 4.75;).The similar results were observed in human primary monocytes ( CD86Untreated group:17.91 ± 1.78,CD86leptin100:48.80 ± 3.60; HLAUntreated group:34.10 ± 2.76,HLAleptin100:88.86 ± 3.53).Conclusions By up-regulating CD86 and HLA-DR expression,Leptin might enhance the ability to present antigen in THP - 1 cells and human monocytes.

Objective To evaluate the effects of exposure to MALs on immunity against Mycobacterium tuberculosis in human alveolar macrophages .Methods Plate counting were used to evaluate the effect of resisting Mycobacterium tuberculosis in human alveolar macrophages .Culture supernatants were harvested and human TNF‐α was measured by ELISA kit .Total nitrite levels in the media were measured using the Griess reagent .Results MALs stimulation attenuated the control of intracellular mycobacterial growth in human alveolar macrophages .The production of proinflammatory cytokines TNF‐α and Nitric oxide in human alveolar macrophages induced by Mycobacterium tuberculosis purified protein derivatives tuberculin (Mt‐PPD) and human interferonγwere attenuated by pretreatment in vitro with MALs .Conclusion MALs attenuated the responses of human alveolar macrophages a‐gainst Mycobacterium tuberculosis ,which may provide the new evidence to explain the phenomena in which some component of Mycobacteria in environment impacts the immunity against Mycobacterium tuberculosis infection .

Objective To monitor the distribution of class 1 integrons of Acinetobacter baumannii and interpret the association of class 1 integrons with the resistance in clinical isolates.Methods Susceptibility to 14 different antimicrobial agents was determined by agar dilution method.DNA of all clinical isolates was extracted to detect class 1 integrons by PCR.Results The differences between integron-positive isolates and integron-negative isolates was significant in the resistance to all tested antibiotics except for Imipenem,Cefepime and Cefoperazone plus Sulbactam.Different types of class 1 integrons showed different resistance types.Conclusions There were some close relations of class 1 integrons with multi-drug resistance as well as resistance types in Acinetobacter baumannii.

Objective To summarize the clinical treatment experience of blood culture-negative infective endocarditis,and to explore the surgery chance and therapeutic strategy of blood culture-negative endocarditis. Methods One hundred and sixty-six patients who were diagnosed blood culture-negative endocarditis in the Aisa Heart Hospital of Wuhan from Jul. 2008 to Dec. 2012 were recruited in the study. Broad-spectrum antibiotics including cefuroxime axetil and levofloxacin were used before the result of blood culture,and sensitive antibiotics were selected to control patient's condition when getting the result of blood culture. But broad-spectrum antibiotics were continuously used to the blood culture-negative endocarditis until stable condition. When the conditions were stable,active preparation before surgery should be carried out. Thoroughly clear the vegetation and protect the cardiorespiratory function during operating. Kata-step antibiotics were used to control patient's condition until normal temperature,as well as the number of leukocytes decreased,blood sedimentation normalized and C-reaction protein decreased. Then,the narrow-spectrum antibiotics were selected including cephalosporin until discharged from hospital,and continued treatment of antibiotics for 4 - 6 weeks. Results Five patients died after the operation,including 1 case died of low cardiac output syndrome,2 cases died of multiple organ failure,1 case died of septicemia and the 1 case died of cerebral embolism. All the other patients discharged from hospital successfully. Conclusion The patients with blood culture-negative IE should be controlled rapidly. The duration and dose of antibiotics should be enough. Active operative preparation should be taken and then surgery timely. Thus,the hospital mortality could decrease and prompt the long-term outcome.

Surfactin has great potential applications in enhancing oil recovery, agriculture, pharmaceuticals, foods and beverages, and cosmetics due to its extraordinary surface activity, biodegradability, anti-bacterial activity and biocompatibility. Enhancing surfactin production by engineering surfactin-producer and optimizing culture conditions is the key of its industrial production and subsequent applications. In this study, the effect of fatty acid synthesis pathway on surfactin synthesis was investigated, and Bacillus subtilis THBS-2 and THBS-8 with high surfactin titer were constructed by overexpressing key genes involved in the fatty acid synthesis pathway. To optimize culture condition, the amount and adding time of isopropyl-beta-D-thiogalactopyranoside (IPTG) and amino acids were studied, and a two-stage culture method was obtained: IPTG (final concentration: 1.25 mmol/L) and leucine (final concentration: 5 g/L) were added at 3 h, leucine (final concentration 5 g/L) and condensed culture medium (5 mL) were added at 24 h. Applying this strategy, the surfactin titer of B. subtilis THBS-2 reached to 24 g/L in shake flask at 48 h and up to 34 g/L after 68 h fermentation in a 30-L fermentor. The results provide basis for large-scale production and broad application of surfactin.
Amino Acids ; Bacillus subtilis/metabolism* ; Culture Media ; Fermentation ; Lipopeptides ; Peptides, Cyclic