OBJECTIVE To analyze the profile of the pathogens and their drug resistance isolated from children with lower respiratory tract infection in Wenzhou area from Jan 2004 to Dec 2006.METHODS Lower respiratory tract secretions were obtained from children with lower respiratory tract infection for bacterial culture.The K-B method was applied for the antibiotic susceptibility test.RESULTS Total 1605 strains were isolated.The isolating rates of Gram-positive cocci,Gram-negative bacilli and fungi were 24.9%,61.2% and 14.0%,respectively.60.5%,and 54.6% of the isolates of Escherichia coli and Klebsiella pneumoniae produced extended-spectrum beta-lactamases(ESBLs).The rate of Penicillin-resistant Streptococcus pnenmoniae(PRSPN)was 30.6%.20.5% isolates of Staphylococcus aureus were MRSA.All isolates of Enterobacteriaceae and Gram-positive cocci were susceptible to imipenem and vancomycin in vitro.CONCLUSIONS Gram-negative bacilli are still the primary pathogens resulting in lower respiratory tract infection in children.Fungi and muti-drug-resistant bacteria are on the rise trend.

Objective To understand the zoonotic trematode species identified in domestic animals from Huainan area,An-hui Province,so as to supply the evidence for the prevention of zoonoses. Methods The livestock/definitive hosts were commer-cially available on category basis,and sacrificed for obtaining the parasitic samples via dissecting the viscera. The specimens were microscopically identified,with reference to the descriptions in the previous literature. Results By identification,sorting and classification,41 species of internal trematodes were found so far in the domestic animals fed in Huainan areas,in which 23 spe-cies were zoonotic trematodes and 18 were internally parasitic in livestock,belonging to 4 orders,12 families and 21 genera,and occurred in 9 definitive hosts including chicken,ducks,geese,pigs,cattle,buffaloes,sheep,goats and dogs,respectively. Con-clusion The findings suggest that the zoonotic trematodes belong to many kinds and prevalent in the domestic animals in Huainan areas,and such prevalence should call for high attention since it is urgent risk factors for zoonoses in this geographic area.

Objective To investigate the imaging diagnosis of vocal cord paralysis.Methods Of 58 patients,53 cases was unilateral and 5 bilateral.All patients underwent laryngeal tomography and 6 of them underwent CT.The imaging findings were analyzed.Results The tomography findings of unilateral vocal cord paralysis were as follows:dilated piriform sinus,41.5%;asymmetrical vestibule,39.6%;enlarged ventricle,71.7%;thinning cord,47.2%;paralyzed cord higher than intact cord,73.6%;cord fixed in adducent position during inspiration,100%;tilting of the thyroid cartilage,11.3%.The cord fixed in paramedian was the main appearance of bilateral vocal cord paralysis.The CT features of vocal cord paralysis included dilated piriform sinus(6 cases),enlarged laryngeal ventricle(4 cases),fixed cord in paramedian position(4 cases)and tilted anteromedially arytenoid cartilage(5 cases).Conclusion To evaluate the functional abnormality of larynx,tomography is useful and CT is well to display the laryngeal anatomic structures and changes,therefore,if the diagnosis is uncertain by tomography or the intrinsic lesions of larynx is suspected,CT is recommended.

Aim To study the mechanism of anti-tumor effect of PHⅡ-7 to K562 and K562/A02 cells.Methods The effects of individual and combined doxorubicin on K562 and K562/A02 cells were observed by MTT assay.The coefficient of drug interaction was used to analyse the synergistic effect of PHⅡ-7,obtaining the RNA from the cells stimulated by PHⅡ-7 with different doses to analyse the MDR1 gene expression level.Finally,the cumulation of doxorubicin was observed in K562 and K562/A02 cells after being coped with PHⅡ-7.Results PH Ⅱ-7 had anti-tumor effect with IC50 of (1.37?0.37) ?mol?L-1;(1.48?0.34) ?mol?L-1 for K562 and K562/A02,respectively.It could potentiate the anti-tumor effect of dororubicin with CDI of 0.22 and 0.09 for K562 and K562/A02,respectively.PHⅡ-7 could synergistically inhibit the proliferation of K562 and K562/A02 cells.The decrease of MDR1 expression level depended on the increase of dose of PHⅡ-7 acting on cells.PHⅡ-7 could also develop the cumulation of doxorubicin in cells.Conclusion PHⅡ-7 is not only a Cytotoxinic drug but also can synergistically inhibit the proliferation of K562 and K562/A02 cells with the decrease of MDR1 expression level,especially in K562/A02 cells.

Objective To investigate mutation and deletion of genes mecR1 and mecI in clinical methicillin-resistant staphylococci isolates and study the mutation and deletion have effect on gene mecA expression and drug resistance phenotype.Metheods PCR was used to detecte gene mecA and the regulatory genes mecR1 and mecI in staphylococci which were separated from clinical specimen in 2006,then the sequence of gene mecI was determined and compared with the sequence obtains from pre-MRSA strain N315(GI:BA000018).Results Gene mecA was detected in 60 strains of Staphylococcus aureus,58 strains of Staphylococcus epidermidis and 37 strains of Staphylococcus heamolyticus,but gene mecA in 6 strains of Staphylococcus epidermidis and 4 strains of Staphylococcus heamolyticus were only amplified by primer mecA2-F/R and not by primer mecA1-F/R.The percentage of gene mecR1 exist in Staphylococcus aureus was higher than Staphylococcus epidermidis and Staphylococcus heamolyticus,but the percentage of gene mecR1 exist in Staphylococcus epidermidis was not higher than Staphylococcus heamolyticus.The mutation and deletion of gene mecI were often seen,the wild type mecI was only detected in 14 strains,the point mutation of nucleotice 202 was detected in 36 strains.Conclusions Gene mecA expression in Staphylococcus aureus could be chiefly induced by mecR1,but which in coagulase-ngeative staphylococci could be other factors.The mutation and deletion of mecI were universal phenomenon in clinical strains,there could be a mechanism for overcoming the repressing of resistance caused by mecI in staphylococci.

Objective To evaluate the efficacy and safety of sunitinib as post-operative adjuvant therapy in patients with high-risk renal cell carcinoma (RCC).Methods A total of 60 patients with resected,histologically confirmed clear cell RCC were enrolled in this study.Patients received orally sunitinib either at a dose of 50 mg on treatment schedule (once daily for 4 weeks followed by 2 weeks off) or at a dose of 37.5 mg once daily for three 6-week cycles from 1 month after surgery.Results All the 60 patients tolerated Sunitinib treatment well and no patient discontinued treatment due to adverse events.Most adverse events were grade Ⅰ to Ⅱ.The most frequently reported adverse events were neutropenia (56.7％),thrombocytopenia (53.3％),leucopenia (48.3％),hand-foot syndrome (46.7％) and hypertension (36.7％).The most frequently reported grade 3 or 4 toxicities were thrombocytopenia (25.0％),neutropenia (15.0％),hand-foot syndrome (11.7％) and leucopenia (8.3％).The majority of adverse events occurred within the first 1-2 cycles of sunitinib treatment,and was ameliorated 1 month after 3 cycles finished.No irreversible adverse event was observed.As of April 5,2012,no recurrence occurred in patients except one death due to cerebrovascular accident unrelated to treatment,with both 6-month and 9-month disease-free survival rate of 100％.Conclusions Myelosuppression occurred less frequently in high-risk RCC patients treated with sunitinib as operative adjuvant therapy than in advanced RCC patients,with a better benefit trend.However,long-term follow-up data are needed to further confirm the efficacy of sunitinib in the adjuvant setting.

Objective To explore the independent risk factors of the prolonged time of retention ICU after type A aortic dissection operation,to establish a corresponding perioperative risk assessment system.Methods A total of 509 consecutive patients with type A aortic dissection were enrolled in the study from September 2011 to May 2016,among which,418 patients received emergency operation.The prolonged retention time of ICU was considered as endpoint event.A perioperative assessment system was established through the analysis of related risk factors of the most common complications after type A aortic dissection operation.The possible risk factors of prolonged retention time of ICU were introduced into a single factor analysis.The meaningful variables in the single factor analysis were introduced into logistic regression analysis.The independent risk factors which were obtained from logistic regression analysis were used to establish risk prediction modeL,and the ROC curve and Hosmer-Lemeshow goodness of fit test were used to evaluate the model.Results The perioperative mortality rate was 8.64％,the prolonged retention time of ICU was 5.06 days,and 98 cases exceeded 7 days.The results of logistic regression analysis showed that age,the history of stroke,obesity,emergency operation,cardiopulmonary bypass time,deep hypothermic circulatory arrest time,renal inadequacy,massive transfusion,hypoxemia,and pulmonary infection were the independent risk factors for prolonged retention time of ICU.Accordingly,a mathematical model was established.The area under ROC cure for prediction model(AUC) =0.761,Hosmer-Lemeshow goodness of fit test P =0.512.Conclusion The logistic model estabhshed in this study can successfully predict ICU retention time after type A aortic dissection operation,and the efficacy was predicted satisfactorily.

Objective: To observe the association between puberty development and thyroid function among school-aged girls in Minhang District of Shanghai, in order to explore the effect of puberty development on thyroid function. Methods: The study was based on a cohort of adolescent girls recruited in iodine-suitable areas of Minhang District, and the baseline and follow-up survey have been carried out from January to March 2019. The method of phased cluster sampling was used to select one junior high school in the east, south, north and middle of Minhang District, Shanghai, respectively. Finally, 464 new junior high school girls were included in the Cohort study for physical examination, and girls were followed up from January to March 2021. The Puberty Development Scale (PDS) was used to assess the stage of puberty. Serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) were determined for each participant. Thyroid homeostasis structure parameters (THSPs) was calculated. Changes of Thyroid hormones at baseline and follow-up were compared by Wilcoxon signed rank sum test. Multiple linear regression analyses were used to evaluate the associations of thyroid hormones (THs) and THSPs changes with pubertal develepment. Results: Serum TSH levels of female studentds decreased significantly, while their FT3 and FT4 levels increased significantly during the study period ( Z=-10.53, -4.71, -12.46, P <0.01). In multiple linear regression analysis after adjustment for co-variables (including baseline age, change of BMI and waist circumference), FT4 and thyroid feedback quantile-based index (TFQI) in the higher puberty category scores changes (△PCS) group were further reduced compared with those in the low △PCS group ( β =-0.66, -0.55 ). Compared to the late puberty at baseline and follow-up (BLFL) group, FT4 and TFQI showed higher decline in the pre-puberty at baseline and late puberty at follow-up (BPFL) group with the pre-puberty at baseline and end of puberty at follow-up (BPFT) group ( β =-0.55, -0.44)( P <0.05). There were no association of △TSH, △FT3, △FT4/FT3 and TSH index changes (△TSHI) with △PCS or the puberty pattern. Conclusion Serum TSH decreases while serum FT3 and FT4 increase among girls during puberty. Both the initial stage and the velocity of pubertal development are related to thyroid hormone fluctuations.

We constructed and expressed an anti-CD3/anti-Pgp (P-glycoprotein) diabody previously. However, the two chains of diabody are associated non-covalently, resulting in being capable of dissociating. The aim of this study is to enhance the stability of the diabody. We introduced cysteine residues into the CD3 or Pgp V-domain to covalently lock the two chains together. The disulphide crosslinked diabody were expressed by Escherichia coli (E. coli) 16C9 and purified by a cation exchange column and an anti-Etag affinity chromatography. The purified proteins were verified through SDS-PAGE. Flow cytometry (FCM) was used to analyse the binding properties, competitive binding capacity and stability in vitro. The dsPpg-diabody failed to form disulphide bond properly. The designed disulphide bridge between the different chains of dsCD3-diabody was formed correctly. FCM demonstrated the dsCD3-diabody has specific antigen binding activity, the same binding activity and competitive binding activity as its parent diabody. The dsCD3-diabody retained the full activity even after 72 h incubation at 37 degrees C in human serum, in contrast, the parent diabody began to lose activity after only 1 h and lose all its activity 24 hours later. The induced disulphide bond in the CD3 V-domain effectively enhanced the stability of anti-CD3/anti-Pgp diabody. The method of stabilizing a diabody by introducing a disulphide bond into is practical.
ATP Binding Cassette Transporter, Sub-Family B ; immunology ; Antibodies, Bispecific ; biosynthesis ; chemistry ; genetics ; immunology ; Binding, Competitive ; CD3 Complex ; immunology ; Cell Line ; Disulfides ; chemistry ; Drug Stability ; Escherichia coli ; genetics ; metabolism ; Humans

Purpose: To investigate the safety and efficacy of hypofractionated radiation therapy (HFRT) in patients with non-small cell lung cancer who are unfit for surgery or stereotactic body radiation therapy (SBRT) at our institution. Materials and Methods: From May 2007 to December 2018, HFRT was used to treat 68 lesions in 64 patients who were unsuitable for SBRT because of central tumor location, large tumor size, or contiguity with the chest wall. The HFRT schedule included a dose of 50–70 Gy delivered in 10 fractions over 2 weeks. The primary outcome was freedom from local progression (FFLP), and the secondary endpoints included overall survival (OS), disease-free survival, and toxicities. Results: The median follow-up period was 25.5 months (range, 5.3 to 119.9 months). The FFLP rates were 79.8% and 67.8% at 1 and 2 years, respectively. The OS rates were 82.8% and 64.1% at 1 and 2 years, respectively. A larger planning target volume was associated with lower FFLP (p = 0.023). Dose escalation was not associated with FFLP (p = 0.964). Four patients (6.3%) experienced grade 3–5 pulmonary toxicities. Tumor location, central or peripheral, was not associated with either grade 3 or higher toxicity. Conclusion HFRT with 50–70 Gy in 10 fractions demonstrated acceptable toxicity; however, the local control rate can be improved compared with the results of SBRT. More studies are required in patients who are unfit for SBRT to investigate the optimal fractionation scheme.