OBJECTIVETo investigate the mixed infection and analyze risk factors in children with severe adenovirus pneumonia.

METHODSA retrospective analysis was performed on the clinical data of 756 children with adenovirus pneumonia between June 2009 and June 2011. Pathogens and risk factors were studied in 216 severe cases.

RESULTSOf the 216 severe cases, 138 (63.9%) were aged from 6 months to 2 years, and 161 (74.5%) developed the disease in the winter and spring; 177 (81.9%) were affected by 1-4 pathogens besides adenovirus, including 74 cases (34.3%) infected with one pathogen as an addition. A total of 334 pathogen strains were identified from the respiratory secretions and sera of the 216 cases. Of them, 163 (48.8%) were bacterial strains, dominated by Gram-negative bacteria (124 strains), 108 (32.3%) were viral strains, and 40 (12.0%) were fungal strains. Multivariate logistic regression analysis indicated that congenital heart disease, congenital airway abnormalities, nutritional anemia, recurrent pulmonary infection, and surgical history were the independent risk factors for severe adenovirus pneumonia in children, with odds ratios of 3.3, 11.1, 7.2, 14.3 and 12.9 respectively (P<0.05).

CONCLUSIONSSevere adenovirus pneumonia is mostly seen in children aged from 6 months to 2 years and occurs frequently in the winter and spring. Many cases are also infected with other pathogens, most commonly Gram-negative bacteria. Congenital heart disease, congenital airway abnormalities, nutritional anemia, recurrent pulmonary infection and surgical history are the independent risk factors for severe adenovirus pneumonia in children.

Adenoviridae Infections ; epidemiology ; etiology ; microbiology ; Child ; Child, Preschool ; Coinfection ; epidemiology ; microbiology ; Female ; Humans ; Infant ; Infant, Newborn ; Logistic Models ; Male ; Pneumonia, Viral ; microbiology ; Retrospective Studies ; Seasons

OBJECTIVETo evaluate the relationship between plasma trough level of imatinib and clinical outcomes in Chinese CML patients.

METHODSPlasma trough levels in 416 CML patients who received imatinib orally in six general hospitals were assessed. The correlations of imatinib plasma trough level with baseline characteristics including age, weight and BSA, and clinical response were evaluated.

RESULTS(1) Effects of age, body weight and BSA on imatinib plasma trough levels were not to be clinically significant. (2) Median imatinib plasma trough levels was 1271 (109-4329). Imatinib plasma trough level was related to dose of imatinib administration. Plasma trough levels at imatinib of dose < 400, 400 and > 400 mg were (969 ± 585), (1341 ± 595) and (1740 ± 748) µg/L (P < 0.01), respectively. (3) There was no statistic difference in imatinib plasma trough level with complete cytogenetic response [CCyR (1337 ± 571) µg/L vs no CCyR (1354 ± 689) µg/L, P = 0.255]. (4) Imatinib plasma trough level might be important for a good clinical response in some CML patients.

CONCLUSIONThere was a large interpatient variability in imatinib plasma concentration in Chinese CML patients. No correlation of imatinib plasma trough level with CCyR was observed. However, higher doses of imatinib were shown to attain greater trough plasma concentration, suggesting that imatinib plasma trough level might be important for a good clinical response in some CML patients.

Adolescent ; Adult ; Aged ; Asian Continental Ancestry Group ; Benzamides ; blood ; therapeutic use ; Female ; Humans ; Imatinib Mesylate ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; blood ; drug therapy ; Male ; Middle Aged ; Piperazines ; blood ; therapeutic use ; Pyrimidines ; blood ; therapeutic use ; Treatment Outcome ; Young Adult

Objective To evaluate the correlation between the concentrations of matrix metalloproteinase-9 (MMP-9) and adiponectin (ADP) and postoperative delirium (POD) in perioperative serum of elderly patients undergoing lobectomy. Methods Seventy-three elderly patients undergoing lobectomy under general anesthesia, 38 males and 35 females, aged 65-80 years, BMI ＜ 24 kg/m2, falling into ASA physical status Ⅰ or Ⅱ, were selected in some suitable period. All patients were divided into POD group and non-POD group according to the Chinese Version of Consciousness Assessment Scale at 24 hours, 48 hours, and 72 hours after operation, and their blood samples were collected 5 minutes before induction of anesthesia (T0), at the time of tracheal extubation (T1) and at postoperative 24 hours (T2), 48 hours (T3), and 72 hours (T4) to determine the concentrations of MMP-9 and ADP in their serums. Results POD occurred in 19 patients, with the incidence rate of 17.8％. The concentrations of MMP-9 at T1-T4 were significantly higher than those before lobectomy in serums in POD group, while the concentrations of ADP in serums were significantly lower than those before lobectomy (P ＜ 0.05). The concentrations of MMP-9 in serums at T1 were significantly higher than those before lobectomy in non-POD group, while the concentrations of ADP in serums were significantly lower than those before lobectomy (P ＜ 0.05). In the comparison between the two groups, the concentrations of MMP-9 in POD group at T1-T4 were significantly higher than those in non-POD group, while the concentrations of ADP in POD group were significantly lower than those in non-POD group (P ＜ 0.05). Conclusion The serum level of MMP-9 is increased and ADP is decreased in perioperative, wich maybe involved in the pathophysiological process of POD in elderly patients undergoing lobectomy.

OBJECTIVETo explore the effects of manipulation and traction combined with Nimodipine on the blood flow velocity of vertebrobasilar artery (VBA) in cervical vertigo of high flow velocity,and to evaluate clinical therapeutic effects between two methods.

METHODSFrom March 2008 to Feburary 2009,70 patients who were diagnosed as high flow velocity of cervical vertigo were randomly divided into treatment group (35 cases) and control group (35 cases). Among 70 patients, 32 were male and 38 were female. The age ranged from 21 to 45 years with an average of 37.6 years. The disease course ranged from one day to two years with an average of 12.6 days. Patients of the treatment group were treated with manipulation for total three weeks, three times once week. The patients in the control group were treated with traction (weight ranged from 5 to 6 kg, 20 minutes each time, once every other day) and Nimodipine for total three weeks (three times each day, and with a dose of 40 mg each time). After three weeks, the changes of flow velacity of VBI and score before and after treatment were observed using transcranil Doppler (TCD) and Evaluation Scale for Cervical Vertigo. After six weeks, the therapeutic effects were assessed.

RESULTSThe mean velocity in left vertebral artery (LVA), right vertebral artery (RVA) and basilar artery (BA) were obviously lower than those before treatment in two groups (P < 0.01). The LVA, RVA and BA of the treatment group was lower than those of control group after 3 weeks (P < 0.01). There was significant difference in vertigo score after treatment between the two groups. The improvement rate of double-sides sign in X-ray image and the therapeutic effects of treatment group was superior to that of control group (P < 0.01).

CONCLUSIONThe effect of manipulation on flow velocity of VBA is superior to that of traction combined with Nimodipine, and there are better therapeutic effects in treating cervical vertigo of high flow velocity in comparison with traction combined with Nimodipine. But there are more higher demands for manipulation's application.

Adult ; Arteries ; physiopathology ; Blood Flow Velocity ; Cervical Vertebrae ; blood supply ; Female ; Humans ; Male ; Middle Aged ; Musculoskeletal Manipulations ; Vertigo ; physiopathology ; therapy ; Young Adult

OBJECTIVETo study the effects of benzo(a)pyrene (BaP) on the cell cycle distribution and activities of mitogen-activated protein kinase (MAPK) signal molecules (ERK1/2, JNK1/2 and p38) in human embryo lung cells (HELF), and to investigate the relationship between alterations of MAPK protein phosphorylation and the cell cycle distributions.

METHODSThe phosphorylation of MAPK were induced by exposing HELF cells to BaP at 0.1, 0.5, 2.5 and 12.5 micromol/L. The phosphorylation and protein expression levels of ERK1/2, JNK1/2 and p38 were determined through western-blotting assay. And the flow cytometry assay was used to measure the cell cycle effects in HELF cells after treatment with 2.5 micromol/L BaP for 24 h.

RESULTSThe phosphorylation levels of ERK1/2, JNK1/2 and p38 were significantly increased through BaP exposure. In addition, the phosphorylation of these three MAPKs has similar alteration pattern. We found that exposure of cells to 2.5 microM of BaP for 24 h resulted in a decrease of G(0) and G(1) population by 11.9% (F = 41.38, P < 0.01) and an increase of S population by 17.2% (F = 68.13, P < 0.01). Three chemical inhibitors of MAPK (AG126, SP600125 and SB203580) could significantly inhibit the cell cycle alteration because of BaP treatment.

CONCLUSIONERK1/2, JNK1/2 and p38 could positively regulate the BaP independently induced cell cycle alterations.

Benzo(a)pyrene ; toxicity ; Cell Cycle ; drug effects ; Cells, Cultured ; Fibroblasts ; drug effects ; metabolism ; Humans ; JNK Mitogen-Activated Protein Kinases ; metabolism ; Lung ; cytology ; embryology ; MAP Kinase Kinase 4 ; metabolism ; MAP Kinase Signaling System ; drug effects ; Mitogen-Activated Protein Kinase 1 ; metabolism ; Mitogen-Activated Protein Kinase 3 ; metabolism ; Mitogen-Activated Protein Kinase 8 ; metabolism ; Mitogen-Activated Protein Kinase 9 ; metabolism ; Signal Transduction ; drug effects ; p38 Mitogen-Activated Protein Kinases ; metabolism

OBJECTIVETo observe the specific cellular and humoral immune responses after immunization with recombinant adenovirus Ad5F35-LMP2 in rhesus monkeys.

METHODSSixteen rhesuses were immunized with Ad5F35-LMP2 through intra-muscular injection in three groups: high dosage group (1.5 x 10(10) TCID(50)/rhesus), medium dosage group (1.5 x 10(9)TCID(50)/rhesus), low dosage group (1.5 x 10(8)TCID50/rhesus) and the last group was control (PBS 4 ml/rhesus). They were totally immunized three times at intervals of one month. The EBV-LMP2 specific cellular immune responses were tested during the 0, 4, 8, 12 weeks by Elispot after immunization respectively. And the titers of anti-LMP2 antibody were tested by EIA at the same time.

RESULTSEBV-LMP2 specific cellular and humoral immune responses which were induced by recombinant adenovirus Ad5F35-LMP2 can be found in all the three dosage groups. The potency of immune responses was related with the dosage of immunization. Higher dosage elicited more potent immune response.

CONCLUSIONThe recombinant adenovirus Ad5F35-LMP2 could elicit LMP2 specific cellular and humoral immune responses in rhesus.

Adenoviruses, Human ; genetics ; Animals ; Cell Differentiation ; Herpesvirus 4, Human ; genetics ; Immunity, Cellular ; immunology ; Immunization ; methods ; Macaca mulatta ; Recombinant Fusion Proteins ; genetics ; immunology ; Viral Matrix Proteins ; genetics ; immunology

OBJECTIVETo study the molecular mechanism of the inhibitory effects of vitamin C on benzo[a]pyrene (B[a]P)-induced changes of cell cycle in human embryo lung fibroblast (HELF) cells.

METHODSThe stable transfectants, HELF transfected with antisense cyclin D1 and antisense CDK4, were established. Cells were cultured and pretreated with vitamin C before stimulation with B[a]P for 24 h. The expression levels of cyclin D1, CDK4, E2F1, and E2F4 were determined by Western blot. Flow cytometric analysis was employed to detect the distributions of cell cycle.

RESULTSB[a]P significantly elevated the expression levels of cyclin D1, E2F1, and E2F4 in HELF cells. Vitamin C decreased the expression levels of cyclin D1, E2F1, and E2F4 in B[a]P-stimulated HELF cells. Dose-dependent relationships were not found between the different concentrations of vitamin C (10, 100, 500, 1000, and 5000 micromol/L) and the expression levels of cyclin D1, E2F1, and E2F4 in HELF cells. The expression levels of cyclin D1, E2F1, and E2F4 in B[a]P-treated transfectants were lower than those in B[a]P-treated HELF cells. The expression levels of cyclin D1 and E2F4 treated with vitamin C and antisense cyclin D1 were decreased compared with those treated with antisense cyclin D1 alone. The effects of vitamin C combined with antisense CDK4 on the expression levels of cyclin D1 and E2F1/E2F4 were similar to those of antisense CDK4 alone. B[a]P progressed HELF cells from G1 to S phase. Both vitamin C and antisense cyclin D1 suppressed the changes of cell cycle progressed by B[a]P. However, antisense CDK4 did not attenuate the above changes. Vitamin C combined with antisense CDK4 markedly suppressed B[a]P-induced changes of cell cycle as compared with antisense CDK4. But the inhibitory effects of vitamin C combined with antisense cyclin D1 on B[a]P-induced changes of cell cycle were similar to those of vitamin C alone or antisense cyclin D1 alone.

CONCLUSIONSB[a]P progressed HELF cells from G1 to S phase via intracellular signaling pathway of cyclin D1/E2F. Vitamin C may modulate this signaling pathway to protect cells from injury caused by B[a]P.

Ascorbic Acid ; pharmacology ; Benzo(a)pyrene ; Blotting, Western ; methods ; Cell Cycle ; drug effects ; physiology ; Cells, Cultured ; Cyclin D1 ; metabolism ; Cyclin-Dependent Kinase 4 ; metabolism ; Dose-Response Relationship, Drug ; E2F1 Transcription Factor ; metabolism ; Fibroblasts ; cytology ; drug effects ; metabolism ; G1 Phase ; drug effects ; physiology ; Humans ; Lung ; cytology ; embryology ; RNA, Antisense ; genetics ; S Phase ; drug effects ; physiology ; Transfection ; methods

OBJECTIVETo explore the value of the technique of multiplex fluorescence in sit hybridization (M-FISH) combined with interphase fluorescence in situ hybridization (FISH) in the identification of the chromosomal aberrations in multiple myeloma (MM) and to investigate the frequency of 13q14 deletion, IgH translocations and 17p13 deletion.

METHODSSeven MM patients with complex chromosomal abnormalities (CCAs) were analyzed by combining the technique of conventional cytogenetics (CC) with M-FISH and FISH.

RESULTSM-FISH identified the aberrations which were undetected by CC, including twelve kinds of numeral aberrations and twenty-nine kinds of structural aberrations, In addition, abnormalities of chromosome 1, chromosomes 13 deletion and IgH translocations were the most frequent aberrations. Using the LSI D13S319 probe specific for 13q14, we observed a deletion of 13q14 in 6 MM patients; using the LSI p53 probe specific for 17p13, we observed p53 deletion in 4 MM patients; using the LSI IGHC/IGHV probe specific for 14q32, we observed a translocation involving 14q32 in 5 MM patients (43.5%), two translocations in two cases (case 6 and 7).

CONCLUSIONM-FISH combined with FISH could refine the cytogenetics of MM patients and detect the missed abnormalities or correct the misidentified abnormalities analyzed by CC. It provides an ideal method for the research of chromosomal aberrations in MM.

Adult ; Aged ; Chromosome Aberrations ; Chromosome Deletion ; Chromosomes, Human, Pair 1 ; Chromosomes, Human, Pair 13 ; Female ; Humans ; Immunoglobulin Heavy Chains ; In Situ Hybridization, Fluorescence ; methods ; Karyotyping ; Male ; Middle Aged ; Multiple Myeloma ; genetics ; Translocation, Genetic

Adolescent ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; drug therapy ; physiopathology ; surgery ; therapy ; Lumbar Vertebrae ; pathology ; Male ; Manipulation, Orthopedic ; Medicine, Chinese Traditional ; Recovery of Function ; Treatment Outcome

BACKGROUNDIn patients with chronic total occlusion (CTO) and multivessel coronary artery disease, the comparison of surgical and the percutaneous revascularization strategies has rarely been conducted. The aim of this study was to compare long term clinical outcomes of drug eluting stent (DES) implantation with coronary artery bypass surgery (CABG) in the patients with CTO and multivessel disease.

METHODSFrom a prospective registry of 6000 patients in our institution, we included patients with CTO and multivessel coronary artery disease who underwent either CABG (n = 679) or DES (n = 267) treatment. Their propensity risk score was used for adjusting baseline differences.

RESULTSAt a median follow-up of three years, propensity score adjusted Cox regression analysis showed that the rate of major adverse cardiac cerebrovascular events (MACCE) was lower in CABG group (12.7% vs. 24.3%, hazard ratio (HR) 1.969, 95%CI 1.219 - 3.179, P = 0.006) mainly due to lower rate of target vessel revascularization in CABG group than in DES group (3.1% vs. 17.2%, HR 16.14, 95%CI 5.739 - 45.391, P < 0.001). The incidence of cardiac death or myocardial infarction (composite end point) was not significantly different between these two groups. On multivariate analysis, the significant predictors of MACCE were only the type of revascularization. Age, left ventricular ejection fraction (LVEF), and complete revascularization were identified as significant predictors of composite end points.

CONCLUSIONSOur study shows that in patients with CTO and multivessel coronary disease, DES can offer comparable long term outcomes in cardiac death and myocardial infraction free survival in comparison with CABG. However, there is an increased rate of MACCE which results from more repeat revascularizations. Obtaining a complete revascularization is crucial for decreasing adverse cardiac events.

Angioplasty, Balloon, Coronary ; methods ; Chronic Disease ; Coronary Angiography ; Coronary Artery Bypass ; methods ; Coronary Artery Disease ; surgery ; therapy ; Coronary Occlusion ; surgery ; therapy ; Drug-Eluting Stents ; Humans ; Prospective Studies