OBJECTIVE:To investigate the effects of aerosol inhalation of budesonide combined with Compound ipratropium bromide on therapeutic efficacy and safety of patients with pneumoconiosis during perioperative period of massive whole-lung la-vage (WLL). METHODS:One hundred and fifty male patients with pneumoconiosis receiving WLL under general anesthesia se-lected from our hospital during Dec. 2014-May 2016 were divided into treatment group and control group in accordance with ran-dom number table,with 75 cases in each group. Both groups received WLL under general anesthesia as well as pure-oxygen manu-al positive pressure ventilation alternating with negative pressure drainage keeping interval and respiratory rate of ventilator synchro-nization. Treatment group was given Budesonide suspension 2 mL,bid+ Compound ipratropium bromide solution 2.5 mL,tid,by aerosol inhalation from 3 d before surgery to 3 d after surgery. The levels of arterial blood gas indexes(pH,PaO2,PaCO2,BE)at different lavage stages,lung function indexes (FVC,MVV,FEV1/FVC),blood gas indexes and clinical symptom score 3 d be-fore surgery and 7 d after surgery were observed in 2 groups,and the occurrence of ADR was recorded. RESULTS:After two-lung ventilation for 20 min following unilateral/bilateral lung lavage,PaO2 of 2 groups were all increased significantly compared to be-fore surgery,with statistical significance (P<0.05);but there was no statistical significance between 2 groups (P>0.05). three days after surgery,FVC,MVV,FEV1/FVC and PaO2 of 2 groups were all increased significantly,PaCO2 and clinical symptom score were all decreased significantly. FVC,FEV1/FVC,PaO2 and clinical symptom score of treatment group were significantly bet-ter than those of control group,with statistical significance(P<0.05). The incidence of airway spasm,hypoxemia and airway pres-sure increasing in treatment group were significantly lower than in control group,with statistical significance(P<0.05). CONCLU-SIONS:During perioperative period of WLL,the aerosol inhalation of budesonide combined with Compound ipratropium bromide for patients with pneumoconiosis can improve clinical efficacy of WLL and reduce the occurrence of ADR during surgery.

Objective To understand the characteristics of malaria endemic situation in Dongtai City from 1999 to 2013. Methods The data of diagnosed malaria cases and related information of prevention and treatment were collected and analyzed with the epidemiological method. Results From 1999 to 2013 there were 27 malaria cases in total and among which 2 cases were local-infected with Plasmodium vivax 10 cases were imported P. vivax infections 13 cases were imported P. falciparum infections and 1 case was a mixed infections P. falciparum P. vivax and P. ovale . The imported cases accounted for 92.59%and local-infected cases accounted for 7.41%. There were no local-infected cases after 2003 and all the cases were overseas-im-ported. The main first-diagnosis points were town hospitals and village health stations accounting for 33.33%and 33.33%re-spectively. Totally 62.96%of cases visited the clinic in 1 day after the attacking the median of time-interval from the attacking to visiting the clinic was 1 day the median of time-interval from the attacking to confirmed diagnosis was 3 days and the max time from the attacking to confirmed diagnosis was 33 days. Conclusion The malaria cases are mainly imported cases in Dong-tai City from 1999 to 2013 and therefore the key of eliminating malaria should be the monitoring of the retuned exporting la-bors.

The surveillance of schistosomiasis in Dongtai City, Jiangsu Province from 2004 to 2008 showed that the achievements of schistosomiasis control in local were consolidated.

Objective To study the MR imaging characteristics of benign cerebellar astrocytomas(BCAs) in children. Methods The clinical and MR imaging data of twelve patients with BCAs were reviewed and analyzed retrospectively.Results Of 12 tumors, 7 cases were located in the cerebellar hemisphere, 4 in the vermis, and 1 in the IV ventricle. All children were in company with hydrocephalus rated as extensive (n=9) or moderate (n=3). The tumors ranged in diameter from 23 mm to 68 mm, mean diameter 42 mm. Solid tumors were found in 5 children, and cystic areas occurred in 7 of 12 patients.BCAs were hypointense on T 1-weighted in 10 cases, and hyperintense on T 2WI in 9 cases compared with that of normal brain parenchyma. After contrast injection, BCAs marked (n=2), moderate (n=5), or absent (n=5) enhancement. Hemorrhage and calcification were not common (n=1,0, respectively).Conclusion BCAs has relative characteristic features on MRI in children, and MRI plays an important role in diagnosing and evaluating these tumors preoperatively.

Objective To observe the influence of insulin therapy on the short-term prognosis of patients with acute ST-elevation myocardial infarction (ASTEMI) complicated with hyperglycaemia.Methods A total of 128 patients with ASTEMI complicated with hyperglycaemia were randomized into 2 groups:treatment group and control group.There were 64 patients(50.0％ )in the treatment group and 64 patients(50.0％ ) in the control group.All of the patients were given anticoagulants,antiplatelet drugs,statins,beta-receptor blockers,nitrates and angiotensin-converting enzyme inhibitors (ACEI)or angiotensin receptor blocker (ARB) Moreover,the patients in the treatment group were given extra 50 U insulin ( Novolin R) in 50 ml saline by venous infusion.In the treatment group,Venous blood samples were obtained before and 7 days after treatment to determine the fasting blood glucose and hs-CRP in serum; the levels of fasting blood glucose and hs-CRP and short-term prognosis were compared between the 2 groups.ResultsThe levels of fasting blood glucose in the treatment group were decreased significantly after treatment ( [ 5.4 ± 0.8 ] mmol/L vs [ 11.6 ± 2.3 ] mmol/L,P ＜0.01),but there was no significant change in the control group( [ 10.7 ± 2.1 ] mmol/L vs [ 11.2 ± 2.7]mmol/L,P ＞ 0.05 ).The levels of hs-CRP in both groups were decreased significantly after treatment (P ＜0.05),but it was much more obvious in the treatment group( [ 6.2 ± 1.5 ] mg/L vs [ 8.7 ± 1.8 ] mg/L,P ＜0.05).The incidence of major adverse cardiac events(MACE) during a 3 months′ follow-up in the treatment group was significantly lower than that in the control group ( 12.50％ vs 34.38％,P ＜ 0.05 ).Conclusion Insulin therapy can improve the short-term prognosis in patients with ASTEMI complicated with hyperglycaemia.

Objective To explore the method of Oncomelania hupensis snail surveillance in transmission?interrupted re?gions of schistosomiasis,so as to provide a new pattern for the surveillance of snail status in the transmission?interrupted areas. Methods In Dongtai County,north of Jiangsu Province where the transmission of schistosomiasis was interrupted,the surveil?lance of snail status was performed by means of the village?level general survey,village?level sampling survey,snail survey in key settings of township and county,and snail reporting by residents. In addition,quality?control snail sites were set up for quali?ty control. The effectiveness and cost of the four methods of snail surveillance was compared. Results A total of 163 079 set?tings and 22 785.62 hm2 were surveyed in Dongtai County from 2008 to 2013,and 89 residual snail breeding sites were found, with a snail area of 1.48 hm2. The patterns of village?level general survey,village?level sampling survey,and snail survey in key settings of township and county were employed for investigation of 94 550,45 033 and 23 496 settings,consisting of 57.98%, 27.61%and 14.41%of total settings,and 2,0 and 6 settings were found with snails,with 0.021/thousand,0,and 0.255/thou?sand detection rates of settings with snail breading sites,respectively. The pattern of snail survey in key settings of township and county was more effective than that of village?level survey to detect snail breeding sites(χ2 =19.158,P=0). The recovery rate of quality?control snail breeding sites was 52.56%,38.27%and 73.62%for the three patterns of snail survey,respectively,and the pattern of snail survey in key settings of township and county showed a higher quality for snail survey than that of village?lev?el survey(χ2 =111.597 and 85.991,both P=0). During the period from 2008 to 2013,289 person?times reported 279 sus?pected snail habitats and 1 501 living snails,and no Oncomelania snails were found. During the 6?year period,there were 1617.5,964.7 and 527.7 thousand RMB invested for village?level general survey,village?level sampling survey,and snail sur?vey in key settings of township and county,and the cost of snail survey per hm2 was 129.88,133.6 and 162.57 RMB/hm2,re?spectively. The cost of village?level general survey and snail survey in key settings of township and county to detect a snail?breed?ing site was 808 800 and 88 000 RMB,respectively(t=12.850,P=0.000),and the cost of snail survey in key settings of town?ship and county was 10.88%of that of village?level general survey. Conclusion The snail survey in key settings of township and county is a highly effective and high?quality method for snail surveillance,which may serve as a prior way for the surveil?lance of snail status in the transmission?interrupted areas of schistosomiasis.

Objective:To evaluate and compare the inpatient medical services of secondary public and private general hospitals by using disease risk adjustment model, and to explore the application of disease risk adjustment model in medical service evaluation of different ownership hospitals.Methods:Based on 1 032 865 front pages of medical records in Chengdu in 2017 and 2018, a regression model with mortality, average length of stay, total hospitalization expenses, medical service fees, drug costs and surgical consumables costs as dependent variables and related influencing factors as independent variables was established by using disease management intelligent analytic and evaluation system. The risk adjusted case mix index(ACMI) was calculated. The mortality, average length of stay, hospitalization expenses and other indicators were predicted. The ratio of observed value to expected value(O/E value) of each index in public and private secondary general hospitals was obtained and compared.Results:The ACMI value of secondary public general hospital was 4.63, slightly higher than that of private hospitals(4.55). The technical difficulty and resource consumption of the public hospitals were slightly higher than that of the private hospitals.From the O/E value, the management of disease mortality, medical service fees and inpatient drug costs of secondary public hospitals was generally good, and the O/E values of hospitalization expenses of each secondary private general hospital were quite different, and there was a possibility that the costs were unreasonable. The O/E value of surgical consumables cost in secondary public general hospital was 1.54, and there was room for improvement in cost management.Conclusions:The disease risk adjustment model fully considers the characteristics of different types and severity of diseases in different institutions, which can not be simply compared. Based on individual cases, it realizes the comparability of different ownership hospitals, and provides a new means for the evaluation of medical service ability and quality.

Triple-negative breast cancer is considered to be the most aggressive subtype of breast cancer. Due to its lack of expression of estrogen receptor (ER) , progesterone receptor (PR) and HER-2, there is still a lack of clear prognostic judgments and biomarkers that guide treatment. With the development of tumor immunology, the relationship between tumor immune microenvironment and tumor occurrence and development has gradually gained attention. More and more evidence suggests that the higher the level of tumor-infiltrating lymphocytes (TIL) infiltration in triple-negative breast cancer lesions, the better the prognosis of patients. However, TIL is not a single type of cell, and its different lymphocyte subpopulations have different prognostic effects in patients with triple-negative breast cancer. This article summarizes the relationship between different immune cell subgroups in the tumor immune microenvironment and the prognosis of TNBC patients.

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