Objective To understand the etiology and clinical features of childhood bronchiectasis in China. Methods Data of 182 children diagnosed with bronchiectasis admitted in Children's Hospital of Chongqing Medical University from 1991 to May, 2015, and more than 20 cases in the Chinese literatures since 1990 were reviewed. Results The top three causes of bronchiectasis in 182 children (114 boys, 68 girls, median age:118 months) in Chongqing were post-infection, primary immunodeficiency and foreign body, with frequency of 29.7%, 7.7%, and 7.1%, respectively. Chronic wet cough was the most frequent feature. Diagnosis of bronchiectasis usually need to combine with chest CT findings, which showed that the lesions were at left lower lobe, right middle lobe and right lower lobe. The choice of antibiotics was based on bacterial cultures of respiratory secretions, and Streptococcus pneumoniae was the most frequently isolated bacteria in Chongqing. The most common three causes of bronchiectasis in children according to data of 572 cases ( 347 boys, 225 girls) in 7 cities of China including Chongqing were the same with that of Chongqing, 45.5%, 7.3%, and 5.6%, respectively. Conclusion Early diagnosis, identification of etiology and comprehensive management of bronchiectasis in children are benefitial for prognosis.

Primary ciliary dyskinesia (PCD) is an autosomal recessive or x-linked disorder of cilia structure and (or) function, with a morbidity of 1:10 000–1:50 000 from foreign reports, while epidemic data of PCD in China is not available yet. PCD is due to cilia biallelic gene mutations leading to impaired tissue structure and organ function. Clinical phenotypes include chronic infections of the respiratory tract, fertility problems, disorders of organ laterality, etc, and the percent age of Kartagener syndrome is about 50%. The frequently used diagnostic methods are nasal NO examination, high-speed video microscopy, electron microscopy, genetic tests, chest high-resolution computed tomography and spirometry at present. Each method has its highlights and disadvantages, meanwhile, effective diagnostic algorithm and therapeutic protocols are needed for further research.

Objective To explore the effects and its possible mechanism of Fluvastatin on carotid artery atherosclerotic plaque(CAAP) in elderly patients.Methods 92 patients with CAAP detected by Color Doppler Ultrasonography were divided randomly into group A(48 cases) which treated with Fluvastatin 40 mg/d and group B(44 cases) which treated with 80 mg/d respectively for 40 weeks after a washout period(Fluvastatin 40 mg/d for 8 weeks).The changes of CAAP areas,the levels of serum total cholesterol(TC),low-density lipoprotein(LDL),high sensitivity C-reactive protein(hs-CRP) were observed between the before and after treatment.Results There were 40 cases in each group completed the Fluvastatin treatment for 48 weeks.After treatment,the CAAP areas in group A and B were significantliy decreased from(0.20?0.18)cm2 and(0.20?0.19)cm2 to(0.12?0.15)cm2 and(0.11?0.12)]cm2(allP

Objective To investigate the change of neutrophil elastase and matrix metalloproteinase-9 in sepsis and determine significance in the early diagnosis and prognosis of multiple organ dysfunction syndrome.Methods The plasma levels of neutrophil elastase and matrix metalloproteinase-9 in 28 ICU patients with sepsis were examined by immunofluorescence.Results Compared with control group,the levels of NE and MMP-9 were significantly higher on the day of the diagnosis of sepsis(P

Objective To study the In vitro expansion of human CD8+ CD28- suppressor T cells and their immunological regulatory effect.Methods Human CD8 + CD28- suppressor T cells were expanded in vitro driven by the combination of cytokines and allogeneic antigen presenting cells (APCs).Flow cytometry was used to assess the development of CD28- subpopulation.Expanded CD8+ CD28- T cells were isolated by immunomagnetic microspheres and then added as third part modulators into mixed lymphocyte culture to assess their immunological regulatory characteristics.Results The combination of cytokines included IL-2,IL-7 and IL-15 and allogeneic APCs could increase the portion of CD8 + CD28- T cell subtype,and expansion fold of CD8+ CD28- T cell subtype was significantly increased as compared with others (P＜0.05).Expanded CD8+ CD28- T cells could suppress the proliferation of CD4+ T cells stimulated by allogeneic APCs.Moreover,this suppression had antigen specificity.Conclusion Human CD8 + CD28- suppressor T cells can be in vitro expanded in large amounts driven by the combination of cytokines and allogeneic APCs.Expanded CD8 + CD28- T cells in this study have antigen specific regulatory characteristics.

Objective To investigate the response of cryopreserved ovarian tissue after autologous implantation in mouse stimulated with gonadotrophin.Methods Thirty six female mice were randomly divided into three groups,with 12 mice in each group.In group of fresh ovarian tissue,fresh ovarian tissue was implanted into kidney capsule of mice:in group of cryopreserved ovarian tissue,ovarian tissue was implanted into kidney capsule of mice after cryopreserved by vitrification for two weeks.We investigated the response of ovarian tissue two weeks later after autologous implantation stimulated with gonadotrophin.Immunohistochemistry staining method was used to observe the expression of follicle stimulating hormone receptor.Results Before and after stimularian with gonadotrophin,the mature follicle rate of group of fresh ovarian tissue was 2.3%and 4.2%.that of group of cryopreserved ovarian tissue was 2.3%and 4.0%,and that of group of control was 2.6%and 5.8%.Regarding the percentages of mature follicle.there were significant differences after stimulation with gonadotrophin(P＜0.05).After stimulating with gonadotrophin the percentages of mature follicle were the same in the fresh tissue group,cryopreserved tissue group and control group(P＞0.05).The integrated optical density of follicle stimulating hormone receptor of fresh ovarian tissue in antrofollicle and pre-antrofollicle were 9408±2777 and 4531±1903.that of cryopreserved ovarian tissue were 9175±3093 and 4808±1386.and that of the control ovarian tissue were 8838±2064and 5516±1136 respectively.There was no significant difference between any two groups(P＞0.05).Conclusion The follicle stimulating hormone receptor is preserved by cryopreservation and transplantation,small pieces of ovarian tissue response to gonadotropin stimulation is normal.

Objective To investigate the effect of hydrogen sulfide postconditioning on the systolic function of left ventricle during myocardial ischemia-reperfusion (IR) in rats. Methods Part Ⅰ Adult male SD rats weighing 200-250 g were anesthetized with pentobarbital 40 mg/kg and heparin 250 U/kg. Their hearts were excised and perfused in a Langendorff apparatus with K-H solution saturated with 95% O2-5% CO2 at 37 ℃. Forty isolated rat hearts were randomly divided into 5 groups ( n = 8 each) after 20 min of equilibration: control group (group C); IR group; sodium hydrosulfide 1,10, 100 μmol/L postconditioning group (group SP1, SP10, SP100 ).In group Cthe hearts were perfused continuously for another 100 min. In group IR, the hearts were reperfused for 60 min after 40 min ischemia induced by 10 ml/kg ST. Thomas solution. In group SP1 , SP10 and SP100 the hearts were perfused with K-H solution containing sodium hydrosulfide 1, 10, 100 μmol/L for 2 min before reperfusion.LVDP and ± dp/dtmax were recorded at the end of equilibration and reperfusion. Part Ⅱ Cardiomyocytes were isolated from the male SD rats (weighing 200-250 g) and then cultured in CO2 incubator for 4 h. Sixty-four dishes of cultured myocytes were randomly divided into 4 groups( n = 16 each): control group (group C), hypoxia/reoxygenation group (group HR), hydrogen sulfide postconditioning group (group SP) and hypoxia postconditioning group (group HP). Group C were cultured continuously for 2 h. Group HR, SP and HP were exposed to 1 h hypoxia (95%N2-5%CO2 ) followed by 1 h reoxygenation. In group SP 10 μmol/L sodium hydrosulfide was added and the myocytes were then incubated for 2 min before reoxygenation. In group HP the cultured myocytes were expased to 3 min reoxygenation followed by 3 min hypoxia for 3 times before the 1 h reoxygenation. Mitochondrial membrane potential and F-actin expression were determined. Results Part Ⅰ Compared with group C, LVDP and ± dp/dtmax were significantly decreased at the end of reperfusion in group IR (P ＜ 0.05), while no significant difference was found in group SP1 , SP10 and SP100(P ＞0.05). Compared with group IR, LVDP and ± dp/dtmax were significantly increased in group SP ( P ＜ 0.05). There was no significant difference in LVDP and ± dp/dtmax among group SP1, SP10 and SP100(P ＞0.05). Part H Compared with group C, the mitochondrial membrane potential was significantly decreased in group HR and HP, and the expression of F-actin was significantly up-regulated in group HR, SP and HP ( P ＜ 0.05). Compared with group HR, the mitochondrial membrane potential was significantly increased and the expression of F-actin up-regulated in group SP and HP ( P ＜ 0.05 ). There were no significant difference in the mitochondrial membrane potential and expression of F-actin between group SP and HP ( P ＞0.05).Conclusion Hydrogen sulfide postconditioning can improve left ventricular systolic function during IR in rats by stabilizing mitochondrial membrane potential and promoting aggregation of F-actin.

BACKGROUND: Delirium is an acute organic brain syndrome caused by various reasons, and it is common in elderly patients. Antipsychotics treatment is an important method to control delirium.OBJECTIVE: To observe the efficacy of new antipsychotic agent of olanzapine and the traditional antipsychotic agent of haloperidol in treating senile delirium.DESIGN: A randomized controlled observation. SETTING: Mental Health Center, the First Affiliated Hospital of Chongqing University of Medical Sciences.PARTICIPANTS: Totally 175 inpatients with senile delirium were selected from the First Affiliated Hospital of Chongqing University of Medical Sciences from September 2001 to September 2003, they were randomly divided into olanzapine treatment group (n=74), haloperidol treatment group (n=72) and a control group(n=29). There were 111 males (63.4%) and 64 females (36.6%). Delirium had occurred for a duration of 30 minutes to 17 days, with an average of (3.02±2.71) days. The enrolled patients were classified according to the etiological factors of delirium: metabolic (n=68), toxic (n=47), structural (n=25) and infectious (n=35).METHODS: Different treatments were used in different groups. Control group (n=29): The patients were only given somatic treatment aiming at delirium, and not any drug for central nervous system was used. Olanzapine group (n=74): Besides the somatic treatment aiming at delirium, the patients were given olanzapine (Zyprexa, produced by Eli Lilly and Company,5 mg/tablet) taken orally or sublingually (fasted patients), the initial dosage was 1.25-2.5 mg per day, and then adjusted to 1.25-20 mg per day. Haloperidol group (n=72): Besides the somatic treatment aiming at delirium, they were treated with intramuscular injection of haloperidol (2.5-10 mg per day). The effects were prospectively observed for 1 week.The scores were observed before enrollment and at 1-7 days respectively,the severity of mental disorder and amelioration were evaluated by the clinical global impression scale-severity of illness (CGI-SI) and global improvement item of clinical global impression scale (CGI-GI). The dosage and time of administration was taken as the dosage and time to take effect when the CGI-SI baseline scores decreased by more than 1 point.MAIN OUTCOME MEASURES: The severity of mental disorder and amelioration were observed.RESULTS: ① The scores of CGI-SI after treatment were significantly decreased in the olanzapine group, haloperidol group and control group, and there were significant differences (P ＜ 0.01). ② The rates of marked effect in the three groups were 82.4%, 87.5% and 31.0%, respectively, and those in the two treatment groups were significantly different from that in the control group (P ＜ 0.01). ③ Both olanzapine and haloperidol began to take effect at small dosages, and it was the fasted in the olanzapine group, followed by the haloperidol group, and slowest in the control group.CONCLUSION: Olanzapine and haloperidol have similar effects in treating senile delirium. However, olanzapine is faster to take effect than haloperidol.

Objective To compame the lumbar hemp-epidural block anesthesia choose different combination puncture point in pregnancy on laboratory intraoperative anesthetic effect.Methods 110 maternals classified for ASA Ⅰ～Ⅱof lactation,according to random number tables were divided into two groups,Ⅰ group lumbar puncture points for L2-3 clearance,Ⅱ group of lumbar puncture points to L3-4 clearance.Both groups the waist hemp-epidural joint block anesthesia downlink cesarean section,and two sets of anesthesia effect-acting period,after the baby born of 1 min Apgar score before anesthesia,the average arterial blood pressure(MAP)change,the lowest rate,adjust the number,surgical operation bed at the start of the plane,need anesthesia epidural anesthesia,medication found during hypotension and breathing difficulties incidence,intraoperative nausea and vomiting adverse events were compared.Results The operations of the two groups were successful,and there were no complications in postoperation maternal and newborn.Difficulty breathing rate,hypotension incidence,the incidence of nausea and vomiting were obviously higher than Ⅱ groups was statistically significant lying-in woman,difference(2 cases,1 case,x2=14.7,11.5,all P＜0.01).Need to adjust surgery beds in the number,epidural drugs significantly higher than the average Ⅱ group Ⅰ group(38.2%,47.3%,25.5%,x2=12.5,14.8,18.4,all P＜0.01).Conclusion In cesarean section in the operation,lumbar hemp-epidural joint block anesthesia choose L3-4 puncture,can reduce anesthesia cause nausea,vomiting hypotension,spinal cord injury and taper adverse reactions such as the incidence,in safer surgery under general anesthesia successfully completed cesarean section.

Objective To investigate the distribution of acquired carbapenemases in carbapenemresistant strains of Klebsiella pneumoniae, and explore its role in epidemiology of nosocomial infection. Methods From November 2008 to March 2009, twenty clinical isolates of carbapenem-resistant Klebsiella pneumoniae were collected from children hospitalized in Wuhan children's hospital. MICs of antibiotics were tested by DNA of Klebsiella pneumoniae. Modified Hodge test was used to screen strains producing carbapenemases,combined imipenem(IPM)-EDTA , meropenem(MEM)- EDTA and ceftazidime(CAZ) - EDTA double-disk synergy test (DDST) were used to detect metallo-β-lactamase-producing. PCR amplification of the carbapenemase and integrase genes, and sequencing were performed. Plasmid conjugation transfer experiments and Southern hybridization were applied to study the mode of drug resistance transmission. Results Four types of Klebsiella pneumoniae were detected by PFGE, type A consisted of 5 strains, including 3 strains of type Al and 2 strains of type A2), type B (2 strains), type C (12strains) and type D (1 strain). Type A and C were the main drug resistant clones. Eight strains of Klebsiella pneumoniae carried both KPC-2 and IMP-4 genes, 10 strains carried IMP-4 gene, 2 strains carried KPC-2 gene. None of NDM-1 ,GIM, SPM, SIM, OXA-23, and VIM carbapenemase genes was detected in 20 isolates. All of 20 isolates carried lntl which were found to be located on bacterial chromosome by Southern blot. Conclusions KPC-2and IMP-4 genes are the major carbapenemase genes in Klebsiella pneumoniae isolated in Wuhan.Transmission of drug resistance is mainly through vertical transmission of type C resistant clone and horizontal transmission of Intl on bacteria chromosome.