The clinical features and lung CT findings of 174 heart failure patients,including 85 cases with normal left ventricular ejection fraction (LVEF) and 89 cases with reduced LVEF were reviewed.Patients with normal LVEF had a higher proportion of hypertension,diabetes and obesity than patients with normal LVEF; and cough and dyspnea were more common.The lung CT findings in patients with normal LVEF were frequently presented as interstitial lung edema,increased pulmonary texture,subpleural line,Kerley lines and diffuse ground-glass opacity.Patients with reduced LVEF had a higher proportion of coronary heart disease and clinical manifestations of acute left heart failure,and central alveolar edema presented in lung CT images.Results suggest that heart failure patients with normal LVEF usually have longer clinical history and occult symptoms,and have a different lung CT imaging features from those in heart failure patients with reduced LVEF.

16 and the distribution of severe trauma more than 2 anatomic parts.They were randomly divided into two groups:intensive insulin treatment group(n=31)and control group(n=31).Intensive insulin treatment group received insulin with insulin pump in order to maintain blood glucose levels at 4.0-6.1 mol/L,while the control group received routine insulin treatment in order to mmaintain blood glucose levels at 10.0- 11.0 mol/L.Plasma levels of TNF-?,IL-1,IL-6, CRP,APACHEⅡscores and cure rate were analyzed before and after the treatment.Data was expressed as mean?standard deviation.Two- tailed T test and ANOVA were used for comparison in SPSS 10.0,and changes were considered as statistically significant if P value was less than 0.05.Results After the intensive insulin treatment, patient's hemodynamic parameter apparently improved,APACHEⅡscores descended,and the levels of TNF-?, Ib-1,IL-6,CRP all declined,in comparison with control group,there were significant differences. Intensive insulin treatment might improve patient's general condition and decrease complications and mortality of severe multiple trauma.

OBJECTIVETo investigate the prevalence and antibiotic resistance of Shigella isolated from children with diarrhea for the guidance of clinical treatment and prevention and control of bacillary dysentery.

METHODA total of 156 strains of Shigella were isolated from feces of children with diarrhea in Zhejiang Xiaoshan Hospital from January 2008 to December 2010. The antimicrobial resistance of the strains was detected by disk diffusion method and the extended-spectrum beta-lactamases (ESBLs) in these isolates were determined using phenotypic confirmatory test; the isolates of ESBLs producing Shigella sonnei were analyzed by REP-PCR.

RESULTAmong 156 strains of Shigella isolated, the most common groups were Shigella sonnei (130 strains, accounting for 83.3%) and Shigella fleaneri (26 strains, accounting for 16.7%), and 81 (51.9%) strains were identified as ESBLs producers, and the positive rates in 2008, 2009 and 2010 were 32.0%, 41.4% and 59.8%, respectively. The results of antibiotic susceptibility test displayed that the resistance rates of ESBLs producing Shigella to ampicillin, cotrimoxazole, cefotaxime, piperacillin were higher than 90%. However, the resistance rates to cefepime, ceftazidime, levofloxacin and ciprofloxacin were low; The resistance of ESBLs producing strains to piperacillin (100% vs. 77.3%), cefotaxime (100% vs. 0), ceftazidime (14.8% vs. 0), cefepime (28.4% vs. 0), cotrimoxazole (95.1% vs. 86.7%) was significantly higher than that of non-ESBLs producing strains (χ(2) = 20.605, 156.000, 12.037, 24.979, 45.040, respectively; P < 0.05). No isolate was resistant to piperacillin/tazobactam and imipenem. There were 7 genotypes among 74 ESBLs producing Shigella sonnei, respectively type A (50), type B (12), type C (8), type D (1), type E (1), type F (1), and type G (1).

CONCLUSIONThe isolation rate of ESBLs-producing isolate was high in Shigella from pediatric patients with diarrhea, and the number is going up year by year, and these ESBLs producing Shigella sonnei strains in genotype A are dominant in recent years, Piperacillin/tazobactam is the drug of choice for children with ESBLs producing Shigella infection.

Adolescent ; Anti-Bacterial Agents ; pharmacology ; Child ; Child, Preschool ; Diarrhea ; drug therapy ; epidemiology ; microbiology ; Drug Resistance, Multiple, Bacterial ; Feces ; microbiology ; Female ; Genotype ; Humans ; Male ; Microbial Sensitivity Tests ; Molecular Epidemiology ; Penicillanic Acid ; analogs & derivatives ; pharmacology ; Piperacillin ; pharmacology ; Polymerase Chain Reaction ; Sequence Analysis, DNA ; Shigella ; classification ; drug effects ; genetics ; isolation & purification ; beta-Lactamases ; genetics ; metabolism

OBJECTIVETo understand the demography changes and behaviors in drug users.

METHODSelf-reported questionnaires was used and longitudinal investigation was conducted in one of the detoxication centers in Beijing in 1998 and 2000. Drug users were randomly chosen.

RESULTSResults showed that age of drug users tend to become younger with the numbers of drug users aged below 25, increased from 18.7% in 1998 to 28.2% in 2000. Majority of drug users remained males, but the proportion of females seemed to increase. Distribution of occupation showed that the largest increase fell among individual enterprisers, from 15.2% in 1998 to 25.9% in 2000. With educational back-ground, the proportion of lower than elementary education level, including illiterate, increased. Fifty percent of drug users were unmarried which increased from 40.8% in 1998 to 53.2% in 2000. Needle sharing was quite common, 16.5% in 1998 and 11.9% in 2000, but the decrease was not statistically significant (P > 0.05). Fifty-seven point three percent of the injecting drug users did not have constant partners to share equipments. Proportion of extra-marriage sexual practice increased from 12.5% in 1998 to 27.5% in 2000, and significant difference (Chi-square = 12.50, P < 0.001). Multiple partners in extra-married drug users was also found (mean = 2). Compared to 1998, condom use during every sexual practice increased in 2000, but 47.7% drug users still never used condom.

CONCLUSIONIn summary, as the quick increase of drug users, sharing of injecting equipment and high-risk sexual behavior, including multiple partners and unprotected sex, were quite common, with the possibility of HIV epidemic in drug users.

Adult ; China ; epidemiology ; Demography ; Female ; HIV Infections ; epidemiology ; Humans ; Longitudinal Studies ; Male ; Needle Sharing ; adverse effects ; Prevalence ; Risk Factors ; Safe Sex ; statistics & numerical data ; Substance Abuse, Intravenous ; epidemiology ; Surveys and Questionnaires

OBJECTIVETo observe the change of cytokine interleukin IL-1 beta, IL-6, IL-10, tumor necrosis factor-alpha (TNF-alpha) occurred in acute paraquat (PQ) poisoning rats and to investigate the mechanism of acute lung injury caused by paraquat (PQ) poisoning.

METHODSAll 72 healthy adult Wistar rats were random assigned into normal control groups, paraquat high dose group (120 mg/kg), paraquat middle dose (60 mg/kg) group, paraquat low dose group (30 mg/kg). Three observing periods of time included 8, 24, 72 h and the standards of TNF-alpha, IL-1 beta, IL-6, IL-10 were determined.

RESULTSEvery index of the PQ group was significantly higher than that in the NS group at the same period of time (P<0.05 or P<0.01). In the 72 h group, the high dose group was significantly higher than the middle and low dose group (P<0.05), and there was no significantly difference between the middle and low dose group (P>0.05). For the comparison of index in the same dose group, the group of 72 h was much higher than 8 h group and 24 h group (P<0.05), and there was no difference between the 8h group and 24 h group (P>0.05).

CONCLUSIONThe cytokine may play an important role in paraquat-induced acute lung tissue injury.

Acute Disease ; Animals ; Cytokines ; blood ; Disease Models, Animal ; Female ; Interleukin-10 ; blood ; Interleukin-1beta ; blood ; Interleukin-6 ; blood ; Male ; Paraquat ; poisoning ; Rats ; Rats, Wistar ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVETo investigate the changes in the expression level of sRNA SpR19 and its potential target protein GroEL in clinical isolates of Streptococcus mutans with different cariogenicity exposed to different pH conditions and explore the possibility of using these molecules as biomarkers for assessing the cariogenicity of the bacteria.

METHODSThe total RNAs were extracted from the clinical isolates of Streptococcus mutans with high (strain 17) and low cariogenicity (strain 5) for high-throughput sequencing for profiling of the differentially expressed sRNAs. The candidate sRNA, SpR19, was selected for further study on the basis of bioinformatics analysis considering the role of its potential target in the cariogenic process. The differential expression levels of SpR19 in the strains exposed to both pH5.5 and pH7 culture conditions were verified by quantitative real-time PCR. The expression of the potential target of SpR19, GroEL, was also investigated at both the protein and mRNA level using Western blotting and quantitative real-time PCR.

RESULTSBioinformatic analysis suggested multiple potential target sites of SpR19 both in GroEL mRNA and in the upstream and downstream inter-genic regions. Under different pH conditions, the highly cariogenic strain 17 expressed consistently low levels of SpR19 as compared with the strain 5 with a low cariogenicity; GroEL showed a reverse expression pattern in the 2 strains. An inverse correlation was found between the expressions of SpR19 and GroEL.

CONCLUSIONThe highly cariogenic strain 17 expressed low levels of SpR19 and high levels of GroEL in both acidic and neutral culture conditions. SpR19 may negatively regulate the cariogenicity of Streptococcus mutants by targeting at GroEL.

Adult ; Anti-Bacterial Agents ; therapeutic use ; Brucellosis ; diagnosis ; drug therapy ; pathology ; Central Nervous System Bacterial Infections ; diagnosis ; drug therapy ; pathology ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo evaluate the efficacy and safety of argon plasma coagulation (APC) in the treatment of large airway obstruction.

METHODSTotally 389 patients with treacheobronchial stenosis were treated with APC (ARCO3000 type) by bronchoscopy. The stenoses were caused by carcinomas (203 cases, 52.2%), metastatic tumors (67 cases, 17.2%), benign tumors (18 cases, 4.6%), granulomas (93 cases, 23.9%) and other lesions (8 cases, 2.1%). The rate of recanalization, relief of the symptoms, and complications were analyzed.

RESULTS1121 times of APC treatment were performed in the 389 patients. Complete recanalization was achieved in 138 cases (35.5%), partial in 143 (36.8%), mild in 55 (14.1%) and none in 53 (13.6%). The major complications included: super-ventricular tachycardia in 136 cases (34.9%), bleeding in 51 (13.1%), decrease in blood oxygen saturation in 48 (12.3%), asphyxia in 33 (8.5%), ventricular or super-ventricular arrhythmia in 24 (6.2%), short-term aggravation of airway obstruction in 18 (4.6%), and tracheal perforation in 3 (0.78%). All those complications were treated with various measures and no patient died of the complications during the procedure.

CONCLUSIONArgon plasma coagulation is effective and relatively safe in relieving the obstruction and dyspnea in patients with large airway obstruction caused by various reasons. However, for the patients with severe airway obstruction, argon plasma coagulation sometimes may cause severe or even lethal complications. Critical consideration of the indication, operators' skill and taking more precautions during the procedure are required to ensure the safety of argon plasma coagulation treatment.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Argon ; therapeutic use ; Bronchial Diseases ; etiology ; surgery ; Bronchial Neoplasms ; complications ; Bronchoscopy ; Constriction, Pathologic ; Electrocoagulation ; methods ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tracheal Neoplasms ; complications ; Tracheal Stenosis ; etiology ; surgery ; Young Adult

A 62-year-old woman with frequent occurrence of symptomatic atrial tachycardia with a foci located at the root of the upper crista terminalis was found to have right diaphragm paresis after receiving a total of 8 radiofrequency energy deliveries (40-60 W, 50-60ºC) and a total duration of 540 seconds of ablation therapy (7Fr 8 mm deflectable ablation catheter). The right diaphragm paresis remained resolved up to 14 months after the procedure as confirmed by repeated chest X-rays.
Catheter Ablation ; adverse effects ; Diaphragm ; injuries ; Female ; Humans ; Middle Aged ; Tachycardia, Supraventricular ; therapy

OBJECTIVESerum p53 protein overexpression was detected in population exposed to traffic exhaust gas to study the relation between traffic exhaust gas and the increased risk in p53 gene mutation.

METHODSSerum p53 protein expression was measured by enzyme-linked immunosorbent assay. Relationship between different types of job and serum p53 protein overexpression were studied by pearson Chi-square tests.

RESULTSResults on serum p53 protein overexpression on jobs outside of office (5.74%) were not significantly higher than jobs inside the office. However, it suggested that traffic police men (12.12%) working outside of office, with whose length of service longer than 30 years had a significant overexpression of serum p53 protein than the others (5.36%) whose length of service was less than 30 years (P < 0.05, OR = 2.43, 95% CI: 1.11 - 5.33). Overexpression rate of p53 protein appeared to be 6.89% in the group whose average weekly exposure hours were more than 40 hours, which was significant higher than the group whose exposed hours were less than 40 hours (P < 0.05, OR = 1.71, 95% CI: 1.03 - 2.81).

CONCLUSIONThe result suggested that traffic exhaust gas was likely to cause mutation of p53 gene and increasing the incidence of lung cancer.

Adult ; Aged ; Aged, 80 and over ; Female ; Genes, p53 ; Humans ; Lung Neoplasms ; etiology ; Male ; Middle Aged ; Mutation ; Occupational Exposure ; Tumor Suppressor Protein p53 ; blood ; Vehicle Emissions ; adverse effects