Objective To evaluate the clinical efficacy and safety of injection azithromycin in the treatment of the acute bacteria pneumonia of infant. Methods A randomized controlled open trial was carried out. Erythromycin as a controll drug was compared the clinical efficacy and safety with azithromycin as a test drug. Results In azithro-mycin group,the clinical effective rate was 90.6% ;the fully recovered rate was 75.5%. While those of erythromycin group were 68.0% ,36.0% respectively. The incidence of adverse reaction was 9.3% and 30.4% respectively in two groups. Conclusion Injection azithromycin of new macrofides type is a kind of effective and safe anti-bacterial drug.

Objective To investigate the efficacy and safety of levofloxacin and rifapentine for elderly initial treatment pulmonary tuberculosis.Methods 120 cases of elderly initial treatment pulmonary tuberculosis patients January 2015 to January 2016 in our hospital were randomly divided into A,B,C three groups,with 40 cases in each group.Treatment regimen of group A: 2HRZE/4HR; treatment regimen of group B: 2Rft(rifapentine capsules)HZE/4HRft; treatment regimen of group C: 2Rft(rifapentine capsules)HELfx/4HRft.The clinical symptoms,signs and adverse drug reactions were compared between the three groups of patients,observation the changes of blood,urine,liver and kidney function,perform imaging and bacteriological examination to determine the treatment effect.Results Five cases in group A and one case in group B abandoned treatment because of liver damage and severe gastrointestinal reaction,but no one in the 40 cases of group C abandoned treatment.There was no statistically significant difference among three groups in sputum negative conversion rate and focus absorption.The number of cases presenting gastrointestinal reaction and liver damage in group C was significantly smaller than that in group A and group B(P<0.05).Rifampicin was replaced by levofloxacin in two cases of group A as a result of allergy,and no allergy occurred in the other two groups.Conclusion Levofloxacin and rifapentine have good efficacy and few side effects for elderly initial treatment pulmonary tuberculosis,initial treatment regimen for elderly pulmonary tuberculosis patients should be individualized,drugs with few side effects can be used to guarantee smooth proceeding of treatment.

Objective The analysis of correlation between the occurrence of tourette syndrome with one-child family environment. Methods The authors investigated home environment of two groups. One group included 200 patients with tourette syndrome and is the other group included healthy children of the same age in 3 different primary and secondary schools. By comparing with the home environmental factors, parenting styles and parent emotional factors between two groups. Results The instabilities of home environment included bad family relationship, separation between parents, divorce, scolding and even beating children. It showed that anxiety of the direct supervisors among the sickness group were higher than healthy control group as well. Among the ten factors of the Family Environments Scale, the significant differences showed in six factors of affection,cohesion,expressiveness, conflict, intellectual-culture orientation, active-recreational orientation, organization between the two groups. Conclusion So we concluded that ①There is a correlation between the parents relations,parenting styles and the incidence of tourette syndrome; ②An anxiety of the direct supervisor may initiate, even aggravate the incidence of tourette syndrome; ③It is important to convert the education mode and take family overall treatment in order to reduce the incidence and improve the effectiveness of tourette syndrome.

Objective To summarize the evaluation standard of cardiac death organ donation from Chinese first category donor heart application and experience of donor heart function maintenance.Method From Jan.2013 to Jan.2015,donor hearts for heart transplantation were obtained in 18 cases of Chinese first category cardiac death organ donors from 109 cases of organ donation donors through rigorous assessment and effective donor heart function maintenance.The diagnosis of brain death was based on the diagnosis of brain death criteria (adult) by the neurological department of internal medicine,department of neurosurgery,and intensive care unit with brain death qualification.Organ donation work followed the basic principles of voluntary,free,fair,equitable and technical access.Result Eighteen case of heart transplantations were all operated with double lumen venous anastornosis.The cold ischemia time was (125.5+ 18.7) min (61-60 min),and cardiopulmonary bypass time was (130.4+ 12.5) min (99-193 min).In 18 heart transplantations,16 cases survived,and 2 eases died of acute right heart failure.During the follow-u period,the quality of life in the survival recipients was satisfactory.Conclusion Using cardiac death organ donation from Chinese first category donor heart transplantation has achieved good results.The accurate assessment of donor hearts and effective donor heart function maintenance are the key factors to guarantee the success of heart transplantation.

Objective To investigate the isolation rate, distribution and trend of nontuberculous mycobacteria (NTM) in Wenzhou during 2014 to 2016.Methods Sputum or alveolar lavage specimens of patients with suspected pulmonary tuberculosis were collected for mycobacteria culture from January 2014 to December 2016.Mycobacterium culture positive strains were further identified by gene chip, 16S rRNA and hsp65 gene sequencing.SPSS 19.0 software was used to analyze the data.Results After excluding repetitive strains, 3 295 mycobacteria strains (MTB) were isolated from respiratory specimens, included 3 032 mycobacterium tuberculosis complex strains, 238 NTM strains, 20 Gordon genera strains, 3 Nocardia genera strains and 2 Tsukamurella genera strains.The proportion of NTM among confirmed mycobacteria was 8.5％ (86/1 006), 6.7％ (72/1 079) and 6.8％ (80/1 185) in 2014, 2015 and 2016, respectively (x2 =2.459,P ＞ 0.05).The overall prevalence of NTM was 7.3 ％ (238/3 270).There were 15 species of NTM, and the most common NTM strain was Mycobacterium intracellulare (52.5％,125/238), followed by Mycobacterium abscessus (22.7％, 54/238) and Mycobacterium avium (10.1％, 24/238), other species were only accounted for 14.7％ (35/238).The ranking of Mycobacterium avium went up rapidly from the fifth in 2014 to the second in 2016 (x2 =18.259, P ＜ 0.01), while proportion of Mycobacterium abscess, dropped from 34.9％ (30/86) in 2014 to 17.5％ (14/80) in 2016 (x2 =7.335, P＜0.01).Among patients from whom the NTM strains were isolated, 56.7％ (135/238) were male and most of them were aged 45 years or above (79.8％, 190/238).Conclusions In the past three years, the trend of NTM isolation rate in Wenzhou is steady.The most prevalent NTM species is Mycobacterium intracellulare, followed by Mycobacterium abscessus and Mycobacterium avium.Mycobacterium avium shows a continuously upward trend, while the separation of Mycobacterium abscessus shows a downward trend.

Objective To investigate the effect of oxytocin on the expression of MKP-1 level in the hippocampus of post-traumatic stress disorder rats.Methods Eighteen SD rats were randomly divided into the control group,administration group and the experimental group with 6 rats in each group.The administration group and the experimental group were treated with internationally recognized single prolongation stress (SPS) method to stimulate the rats in order to establish PTSD models.The 14-day oxytocin intervention was given to rats of the administration group after the SPS stimulation within 8 hours.And the behavioral changes of rats were observed by open-field test and Morris water maze test.The changes of MKP-1 mRNA in the hippocampus of rats were detected by real-time quantitative PCR (qRT-PCR),and the levels of MKP-1 Protein in the hippocampus of rats were detected by Western Blot.Results (1) Compared with the model group (2.50± 1.05 and 22.16±7.14),the times of the standing and crossing grid section quantities in the open-field test in the administration group(5.16± 1.17and 32.83±5.71) and control group (6.67±2.16 and 39.83± 4.62) significantly decreased (P＜0.05).Morris water maze showed that the incubation of the model group was markedly prolonged (P＜0.05) compared with that of the administration group,while in spatial probe test,the incubation period of the rats in administration group was prolonged,and the number of wearing stage decreased (P＜0.05).(2) Compared with the administration group (1.30±0.03),the expression of MKP-1 mRNA in hippocampus of rats in model group (4.04±0.46) was notably up-regulated (P＜0.05).And the protein level of MKP-1 in model group(1.95±0.68) was also increased compared with that in administration group (1.46±0.27) (P＜0.05).Conclusions Oxytocin can protect the learning and memory ability and reduce the stress-related performance of rats via regulating the expression of MKP-1.

Objective To elaborate the changes of the soluble B cell-activating factor of the tumor necrosis factor family (BAFF) in the peripheral blood of chronic human immunodeficiency virus (HIV)-infected patients ,and to study the correlation between the soluble BAFF in HIV-infected patients and the progressions of acquired immune deficiency syndrome (AIDS).Methods Fifty untreated HIV outpatients and 30 healthy controls were recruited .According to the counts of CD4+T lymphocytes ,HIV-infected patients were divided into three groups ,＜ 200 cells／μL group , (200 － 350 ) cells／μL group and ＞350 cells／μL group .B cell counts and the BAFF levels were compared among the three groups and the healthy controls .The correlation analysis was conducted for the levels of BAFF ,the counts of CD4+T lymphocytes and B cells ,and viral load in HIV-infected patients .The value of BAFF in staging of HIV disease was identified by receiver operating characteristic (ROC) curve.Results The B cell counts were (90.3 ± 43.1)cells／μL in ＜200 cells／μL group ,(114 .4 ± 28 .8) cells／μL in (200 －350) cells／μL group ,and (162 .1 ± 29 .5) cells／μL in ＞350 cells／μL group and (307.1 ± 97 .0) cells／μL in healthy controls ,which was significantly different among the four groups (F＝47.92 ,P＜0.05).The concentrations of BAFF in the four groups were (1 737.5 ± 719.7) ,(962.8 ± 341.1) ,(859.8 ± 270.4) ,and (456.9 ± 163.7) ng／L ,with significant difference among the groups (F＝36.72 ,P＜0.05).The level of BAFF was negatively correlated with both B cell counts and CD4+T lymphocyte counts (r＝ －0.722 and －0.568 ,respectively ;both P＜0.05) ,and positively correlated with viral load (r＝0.607 ,P＜0 .05).The area under the ROC curve was 0 .881.If the level of BAFF was 1 281.5 ng／L ,the sensitivity and specificity to predict the period of AIDS were 74 .1% and 87.0%,respectively .Conclusion The levels of soluble BAFF in HIV-infected patients are significantly increased and related with the reduction of B cell counts and disease progression.

Objective To investigate the resistance of second-line anti-TBdrugs to baseline strain in patients with multidrug-resistant pulmonary tuberculosis. Methods Atotal of 52 baseline strains in patients with multidrug-resistant pulmonary tuberculosis collected from March 2016 to May 2017 in our hospital were randomly selected. The sensitivity of the nine kinds of second-line anti-TBdrugs was tested, to analyze the proportion of different drug resistance and cross-resistance of similar drugs. Results Among the 9 second-line anti-TBdrugs, the ratio of drug resistance was ofloxacin =levofloxacin(59. 6％, 31/52)＞moxifloxacin(30. 8％, 16/52)＞ amikacin=kanamycin(both 9. 6％,5/52)＞paminosalicylic acid=cycloserine(both 7. 7％, 4/52)＞ capreomycin =prothionamide(both 9. 6％, 3/52). Ofloxacin was completely cross-resistant with levofloxacin, and its cross-resistant rate with moxifloxacin accounted for 51. 6％ (15/31). Amikacin was completely cross-resistant with kanamycin, and its cross-resistant rate with capreomycin accounted for 60％. Conclusion The baseline strains of patients with multi-drug resistant pulmonary tuberculosis are seriously resistant to fluoroquinolones. There is resistance to some extent for other second-line anti-tuberculosis drugs. Therefore, second-line drug susceptibility testing should be completed prior to establishing an effective MDR-TBtreatment regimen.

Objective To study the correlation between CD169 expression of monocytes and disease progression in human immunodeficiency virus (HIV )-infected patients .Methods Sixty HIV-infected patients and 30 healthy controls were recruited .According to the CD4 + T lymphocyte counts ,HIV-infected patients were divided into three groups including < 200 cells/μL ,200 — 350 cells/μL and > 350 cells/μL groups . The differences in monocytes counts ,the proportions of CD16 + and CD169 + monocytes were analyzed among the three groups and healthy controls .The correlations between proportion of CD169 + monocytes and CD4 + T lymphocyte counts ,viral load ,and proportion of CD16 + monocytes were analyzed .Results The monocyte counts in CD4 + T lymphocytes < 200 cells/μL group , (200 — 350 ) cells/μL group , >350 cells/μL group and healthy control group were (342 ± 99) ,(396 ± 145) ,(365 ± 80) ,and (404 ± 106)/μL ,respectively ,which were not significantly different (F= 2 .55 , P > 0 .05) .The proportions of CD16 + monocytes in the four groups were (19 .8 ± 8 .8)％ ,(14 .3 ± 2 .8)％ ,(9 .7 ± 2 .0)％ and (4 .0 ± 0 .8)％ ,respectively ,which were significantly different ( F = 30 .90 , P < 0 .05 ) . The proportions of CD169 + monocytes in the four groups were (72 .6 ± 11 .4)％ ,(59 .4 ± 14 .7)％ ,(33 .3 ± 14 .5)％ and (2 .6 ± 0 .8)％ ,respectively ,which were significantly different (F = 152 .40 , P< 0 .05) .The proportion of CD169 + monocytes was negatively correlated with CD4 + T lymphocyte counts (r = 0 .792 , P< 0 .05) , while positively correlated with both viral load (r= 0 .485 ,P< 0 .05) and proportion of CD16 + monocytes (r= 0 .395 , P< 0 .05) .Conclusions The CD169 expressions of monocytes in HIV-infected patients are significantly increased and correlated with both monocyte activation and disease progression .

Objective: To determine the clinical significance of nontuberculous mycobacteria (NTM) isolated from respiratory specimens. Methods: Clinical data of patients with NTM strains isolated from the respiratory tract between January 2014 and February 2017 were retrospectively analyzed. Clinical significance of NTM isolated strains was evaluated based on diagnostic criteria of NTM pulmonary diseases from American Thoracic Society (ATS). Quantitative data of two groups were analyzed by independent t test. Categorical data were analyzed by Pearson χ² test or Fisher exact test. Results: Totally 352 NTM strains from 257 patients had been isolated between January 2014 and February 2017. Among 15 identified NTM species, M. intracellular (51.7%, 182/352), M. abscessus (25.6%, 90/352), and M. avium (10.8%, 38/352) were predominant. Of the 157 patients with full clinical data involved in the analysis, 58 (36.9%) patients were determined to have definite disease, and 34 patients (21.7%) were designated as probable disease candidates, and 16 (10.2%) patients were regarded as uncertain disease, and 49(31.2%) patients were diagnosed as unlikely disease. The age of 58 patients with definite disease was (63.9±12.7) years, and 48.3% (28/58) were female. M. intracellulare (55.2%, 32/58) was the main cause of pulmonary NTM disease, followed by M. abscessus (25.9%, 15/58) and M. avium (12.1%, 7/58), while other NTM species only accounted for 6.8% (4/58). Definite cases with M. intracellulare, M. abscessus, M. avium, M. kansasii, M. marseillense, and M. columbia accounted for 35.2% (32/91), 57.7% (15/26), 7/15, 2/3, 1/3 and 1/2, respectively, among patients with corresponding isolations, while patients with other species of isolation did not meet the diagnostic criteria. Patients with clinical significant isolation of NTM were older than those without clinical significance (χ²=3.603, P=0.000), and proportion of anti-acid staining positivity of patients with clinical significance was higher than that of patients without clinical significance (χ²=18.815, P=0.000). The proportion of M. abscessus in patients with clinical significance was higher than that in patients without clinical significance (χ²=6.313, P=0.012). However, there was no significant difference between the two groups in the isolation of M. Gordon (Fisher exact test, P=0.028). The proportion of M. abscessus lung disease in women was 11/15, which was higher than that of M. intracellulare lung disease (41.5%, 17/41), and the difference between the two groups was statistically significant (χ²=4.462, P=0.035). There was no significant difference of clinical symptoms and underlying diseases in NTM lung disease among different groups (all P>0.05). In these patients with definite disease, 39.7% (23/58) of them manifested the upper lobe cavitary form, 53.4% (31/58) exhibited nodular bronchiectatic form, and only 6.9% (4/58) exhibited unclassified form. The upper lobe cavitary form (43.8%, 14/32) and the nodular bronchiectatic form (53.1%, 17/32) dominated in patients with M. intracellulare lung disease. M. abscessus lung disease was dominated by the nodular bronchiectatic form (11/15) while the upper lobe cavitary form only accounts for 3/15. There was no significant difference of image characteristics between NTM lung disease and other different groups (all P>0.05). Conclusions 36.9% of the patients with NTM isolates met the ATS diagnostic criteria for NTM lung disease. Different species have different clinical significance. M. intracellulare and M. abscessus are the most predominant NTM isolated species that cause NTM lung disease. Majority of patients manifest as the upper lobe cavitary form, followed by the nodular bronchiectatic form.