Anti-Arrhythmia Agents ; therapeutic use ; Cardiomyopathies ; drug therapy ; etiology ; Child, Preschool ; Female ; Humans ; Moricizine ; therapeutic use ; Tachycardia ; complications ; drug therapy ; Treatment Outcome

Objective To investigate the mechanism of quinolone resistance in Psendomonas aeruginosa.Methods The minimum inhibitory concentrations (MICs)of ciprofloxacin and levofloxacin with and without carbonylcyainde-m-chlorophenylhydrazone(CCCP)were determined by agar dilution method.Polymerase chain reaction(PCR)and DNA sequencing were used to study the mutations in quinolone resistance-determining region of gyrA and parC genes.The strains were genotyped by enterbacterial repetitive intergenie consensus-PCR(ERIC-PCR).Results Sixteen quinolones-resistant Pseudomonas aeruginosa strains were obtained.The MICs of ciprofloxacin and levofloxacin were not reduced significantly by adding CCCP.Thr-83→Ile of gyrA and Ser-87→Leu of parC were found simultaneously in 16 strains of resistant Pseudomonas aeruginosa.Analysis of ERIC-PCR products indicated that 16 quinolone-resistant strains had an identical band pattern which was different from that seen in the sensitive strains.Conclusion Mutations in gyrA and parC may be the main mechanism of quinolone resistance in clinical isolates of Pseudomonas aeruginosa.

Objective To investigate the spectrum,diagnosis,time of therapy and management of the congeni-tal heart disease(CHD)in patients with Down′s syndrome(DS).Methods A retrospective report was undertaken of 96 cases in children with DS accompanied by CHD in Department of Pediatric Cardiology,Beijing Anzhen Hospital Af-filiated to Capital Medical University.Data were collected and analyzed about their clinical characteristics,and types of cardiovascular abnormalities,and the important laboratory examinations such as echocardiography and catheterization as well as the procedures of diagnosis and treatments were summarized.Then the interventions,complications and prognosis of different patients were estimated.Results (1)Single congenital heart disease was found in 33 cases (34.38%),a-mong which ventricular septal defect was the most common (14 cases,14.58%),followed by atrioventricular septal de-fect and atrial septal defect (equally,7 cases,7.29%).Multi -cardiovascular abnormalities were discovered in 63 ca-ses,and patent ductus arteriosus turned out to be the most common (42 cases,66.67%).(2)Cat-heterization was car-ried out in 18 cases of serious pulmonary arterial hypertension,and 8 cases were proved resistant pulmonary arterial hy-pertension without operation opportunity.The other 8 cases were estimated as high pulmonary arterial hypertension and medical therapy was suggested before reassessment to reduce surgical risks.(3)Operations were undertaken in 61 ca-ses,among which percutaneous interventional occlusion was performed in 7 cases and surgical interventions were per-formed in 54 patients,in which perioperation complications and death were found in 5 cases and 4 cases,respectively. Conclusions Operation interventions are practicable and most cases recovered well with systematic examinations and assessment in patients with DS and cardiovascular malformations.Early diagnosis and timely interventions are highly suggested.Also close attentions should be paid to follow -up and re -estimation after medical therapy.

Objective To study the clinical and immunologic features of 67 cases of patients with scrub typhus.Methods Epidemiological data,clinical manifestations,laboratory and image examination results and treatment of 67 cases of patients with scrub typhus hospitalized from January 2010 to December 2013 at the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed.Results Autumn-winter type scrub typhus was predominant in the 67 patents.The main clinical manifestations included hyperpyrexia (100％,67/ 67),eschar or ulcer (91.0％,61/67),rash (52.2％,35/67),lymphadenopathy (46.3％,31/67) and other non-specific symptoms.Laboratory test results:①80.6％ (54/67) of the patients had normal or decreased white blood cell count,62.7％ (42/67) of them with elevated lymphocytes (＞ 40％),thrombocytopenia was detected in 34.3％ (23/67) of the patients,the lowest platelets count was 14 × 109/L.②14 of 17 cases (82.4％) had normal percentage of CD3+ T lymphocytes,CD8+ T lymphocytes increased in 16 of 17 cases (94.1％),while the percentage of CD4+ T lymphocytes (14 of 17,82.4％) and B lymphocytes (15 of 17,88.2％) decreased in most of the patients.③C reactive protein (CRP),ferritin and erythrocyte sedimentation rate (ESR) were elevated in 95.2％ (59/62),93.8％ (45/48) and 89.1％ (49/55) of the patients,respectively.④Elevated alanine aminotransferase (77.6％,52/67) and aspartate aminotransferase (80.6％,54/67) were frequent findings.⑤94.6％ (35/37) of the patients had increased adenosine deaminase.⑥ Antinuclear antibody was positive in 31.0％ (13/42) patients.⑦Epstein-barr virus DNA was detected in 15.6％ (7/ 45) cases,77.6％ (38/49) was accompanied with chest radiographic abnormalities.Two cases had tuberculosis.All the patients recovered after therapy with doxycycline,levofloxacin or moxifloxacin.Conclusion Autumn-winter scrub typhus has typical clinical manifestations in the 67 patients,and it can cause patients' immune disorders.

Objective To observe the relationship of viral load,serum cytokines and tissue damage after severe fever with thrombocytopenia syndrome virus (SFTSV)infection,and to explore the impact of SFTSV levels on tissue injury and prognosis.Methods Twenty-four ambulatory and hospitalized patients who were infected with SFTSV were enrolled between May 2011 and July 2012 at Department of Infectious Disease, First Affiliated Hospital with Nanjiang Medical University. According to their prognosis,they were divided into cure and death group,while 32 healthy blood donators were also enrolled from center blood station in Nanjing as control.The serum SFTSV load was detected using fluorescence quantitative polymerase chain reaction (PCR).The serum T helper (Th)1/Th2/Th17 cytokines in patients with severe fever with thrombocytopenia syndrome (SFTS)were determined dynamically and quantitatively by flow cytometry.The relationships between viral load,cytokines and serum enzymes, white blood cell (WBC),platelet (PLT)counts were analyzed.Comparisons among groups were achieved by rank sum test and correlation analysis among serum cytokines,blood cell counts and tissue damage was done by Spearman correlation test.Results All of the 24 patients showed a positive reaction to SFTSV RNA.The SFTSV loads of 21 cured cases,those of 2 were > 7.0 lg copy/mL,and those of 3 death patients were 6.7 lg copy/mL,8.8 lg copy/mL and 9.8 lg copy/mL,respectively.Serum level of interleukin (IL)-6 (21 .76 pg/mL in day 5 and 7.12 pg/mL in day 7)and IL-10 (14.33 pg/mL in day 5 , 14.13 pg/mL in day 7 and 3.01 pg/mL in day 9)of cured patients were significantly higher than those of healthy controls (IL-6:2.82 pg/mL and IL-10:1 .56 pg/mL)(P <0.05 ).At day 7 and day 9,serum levels of IL-6 of death cases were 137.61 pg/mL and 1 450.83 pg/mL,respectively and serum levels of IL-10 were 50.26 pg/mL and 49.43 pg/mL,respectively.Both of the indicators in the death group were significantly higher than those of cure group (P <0.05 ).However,serum levels of IL-2 and IL-4 were significantly lower than those in healthy control group (P <0.05 ).In the cure group,WBC and PLT counts were lowest during the early course of the disease,and serum alamine aminotransferase (ALT), aspartate aminotransferase (AST ), lactic dehydrogenase (LDH ) and creatine kinase (CK ) were significantly higher than their upper limits of normal.The correlation analysis showed that serum IL-6, IL-10 levels were negatively correlated with PLT count (r=-0.390 and -0.608,respectively;both P <0.01),and positively correlated with SFTSV load (r=0.560 and 0.758,respectively),ALT (r=0.412 and 0.390,respectively),AST (r = 0.686 and 0.764,respectively),LDH (r = 0.633 and 0.677, respectively)and CK (r =0.527 and 0.636,respectively)(all P <0.01 ).Conclusions SFTSV load, IL-6,IL-10 and serum enzyme levels are closely related to the severity of the disease.The inflammatory and anti-inflammatory cytokine storm after SFTSV infection may be involved in the immune pathological injury in patients with SFTS.

Adolescent ; Cardiac Catheterization ; methods ; Child, Preschool ; Echocardiography, Transesophageal ; methods ; Female ; Heart Septal Defects, Atrial ; diagnostic imaging ; therapy ; Humans ; Treatment Outcome

Objective　To investigate vascular disease of patients in Outpatient and Emergency Department of Neurology.Methods　Carotid artery ultrasound combined with transcranial Doppler sonograply analysis vascular disease of the participants,that came from Outpatient and Emergency Department of Neurology,Peking University First Hospital from June 1,2019 to June 1,2020.Results　（1）Combined with Carotid artery ultrasound and transcranial Doppler ultrasound,the vascular stenosis rate of the patients was 11.3%,that is higher in males than females.The vascular stenosis rate of extracranial vessel is higher than intracranial vessel.The vascular stenosis rate of internal carotid artery is the highest.（2）There was statistical difference in the distribution of intracranial and extracranial vessel stenosis between the middle-aged group and the elderly group(P<0.05).The distribution of vascular stenosis varied with gender,and the difference was statistically significant (P<0.05).Conclusion　Combined with carotid artery ultrasound and transcranial Doppler ultrasound,the vascular stenosis rate of the patients is higher in males than females.The vascular stenosis rate of extracranial vessel is higher than intracranial vessel.The vascular stenosis rate of internal carotid artery is highest.The distribution of vascular stenosis varied with gender and age.

Coronary Vessel Anomalies ; diagnosis ; Electrocardiography ; Humans ; Infant ; Pulmonary Artery ; abnormalities

OBJECTIVESTo investigate the diagnosis, therapy and prognosis of renal oncocytoma.

METHODSThe data of 26 patients of renal oncocytoma in the department of urology of the Peking University First Hospital from 1999 to 2010 were collected. Retrospective analysis of renal oncocytoma clinical characteristics of patients including pathological characteristics and long term follow-up, treatment methods, and prognosis was undergone.

RESULTSThe mean age of these patients was (55 ± 14) years, mean tumor size was (4.1 ± 1.3) cm, corresponding to a mean tumor volume of (24.0 ± 21.1) cm(3). All of these cases were unilocular unilateral. All of these 26 patients received surgical treatment, 5 cases accepted partial nephrectomy while the other cases accepted radical nephrectomy. After a median follow-up time was (47 ± 34) months (range 4 - 144 months) for 25 patients who had been followed up, there was no disease recurrence, progression or death attributed to oncocytoma.

CONCLUSIONSRenal oncocytoma is an uncommon tumor. It exhibits numerous features which are characteristic but not necessarily unique.Preoperative renal mass biopsy is the only way for pre-nephrectomy histologic diagnosis of oncocytoma.

Adenoma, Oxyphilic ; diagnosis ; surgery ; Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; diagnosis ; surgery ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo investigate the correlation of the degrees of intravesical prostatic protrusion (IPP) measured by transabdominal ultrasound with the clinical evaluation parameters in BPH patients.

METHODSWe measured the length of IPP in the mid-sagittal section by transabdominal ultrasound in 275 BPH outpatients with lower urinary tract symptoms, and analyzed the correlations of the degree of IPP with the age, prostatic volume (PV), international prostatic symptom score (IPSS), maximum uroflow rate (Qmax), and postvoid residual urine volume (PVR) of the patients.

RESULTSThe degree of IPP was correlated positively with the age (r = 0.210, P < 0.01), PV (r = 0.534, P < 0.01) and PVR (r = 0.314, P < 0.01), but negatively with the Qmax (r = -0.364, P < 0.01) of the BPH patients. There was no significant correlation between the degree of IPP and IPSS (r = 0.064, P = 0.299).

CONCLUSIONThe degree of IPP may be associated with the age and prostatic volume of BPH patients. Transabdominal ultrasound measurement of IPP is a useful noninvasive method to assess the presence and severity of bladder outlet obstruction in BPH patients.

Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Prostate ; diagnostic imaging ; Prostatic Hyperplasia ; diagnostic imaging ; Ultrasonography ; Urinary Bladder Neck Obstruction ; diagnostic imaging