Objective To analyze the clinical characteristics and therapy of levofloxacin-induced prolonged Q-T interval in patients with multi-drug resistant tuberculosis ( MDR-TB) . Methods Clinical materials of 6 patients with MDR-TB who developed prolonged Q-T/QTc interval caused by levofloxacin therapy were analyzed. Those cases were collected from the Tuberculosis Prevention and Control of Wuhan City form April 2010 to August 2014. Results The proportion of patients with levofloxacin-induced prolonged Q-T interval was approximately 3.0%.The condition occurred 2-8 months after the administration. The initial value of QTc interval ranged from 397 ms to 439 ms, while the average was (410.17±14.62) ms.The value of QTc interval was extended to 470-486 ms after treatment of levofloxacin, while the average was (476.33±6.16) ms.The increase of QTc interval was 47-85 ms, while the average was ( 66 ± 11. 48 ) ms. None of them developed Tdp. Conclusion The application of high dosage and long treatment course of levofloxacin in patients with MDR-TB could result in the extension of the Q-T/QTc interval, which should arouse our serious attention. In order to detect the abnormal Q-T/QTc interval in early stage, electrolyte level examination as well as ECG examination should be considered as routine tests before initiation of treatment and during the follow-up treatment.

Objective To investigate the clinical efficacy of hydrocortisone sodium succinate for treatment of septic shock patients and their prognoses. Methods A prospective case control study was conducted. 49 patients with septic shock in the Department of Emergency of the First Affiliated Hospital of Xi'an Jiaotong University were enrolled from January 2010 to January 2012,and the patients were sequentially divided into two groups,the treatment group(24 cases)and the control group(25 cases),by the difference in odd or even number. All patients in the two groups accepted the conventional treatment. The treatment group additionally received hydrocortisone sodium succinate injection 200 mg,once a day for 5 days. The levels of serum procalcitonin(PCT),C-reactive protein(CRP)were measured in all the patients before treatment and 24 hours,72 hours and 7 days after treatment. The mortalities were compared in 14 days between the two groups. Results The levels of PCT,CRP before and 24 hours after treatment were not statistically significant different from those of pre-treatment in two groups(all P>0.05). PCT and CRP were decreased at 72 hours and 7 days after treatment in the two groups,and on the 7th day the decline was more significant, and compared with the control group,the levels of PCT and CRP in treatment group were reduced more markedly at 72 hours and on the 7th day〔PCT(μg/L):72 hours 9.73±2.10 vs. 12.36±2.56,7 days 5.33±2.05 vs. 8.76±1.78;CRP(μg/L):72 hours 69.12±13.61 vs. 109.68±16.16,7 days 20.16±9.64 vs. 42.32±13.16,all P<0.05〕. But the mortality in 14 days was not statistically significant different between control group and treatment group(52.0%vs. 45.8%,P>0.05). Conclusion The treatment with hydrocortisone sodium succinate can reduce the inflammation of patients with septic shock,thus it has clinical value in the improvement of the disease situation.

AIM To study the effects of growth inhibition of different concentrations of diallyl trisulfide(DATS) on gastric cancer MGC 803 cell line in vitro. METHODS The influence of different concentrations of DATS were examined by MTT assay, clonal formation rates and cell growth curve. RESULTS Suppression and decrease of MGC 803 cell proliferation was found after treatment by DATS in vitro. The inhibitory rates on MGC 803 cell growth of different concentration of DATS,4, 8, 12, 16 and 24 mg?L -1 , were 26%,46%,65%,76% and 89% respectively, and its half inhibitory concentration (IC 50 ) was 8 2 mg?L -1 . The clonal formation rates and clonal formation relative counts of 8, 12, 16 and 24 mg?L -1 were 32 4% and 58 7%,24 8% and 42 5%,19 0% and 33 5%?8 8% and 15 1% respectively.There was significant correlation between dose and effect in all, and the cell growth culve became lower and flatter when concentration of DATS increase gradually. CONCLUSION The effect of growth inhibition of DATS for gastric cancer MGC 803 cell in vitro is remarkable.

AIM: To study the relationship between the activity of phospholipase A 2 (PLA 2) and pulmonary structural remodeling with the model of chronic isobaric hypoxic pulmonary hypertension. METHODS: 29 healthy Sprague-Dawley rats were randomly divided into normal control group, chronic hypoxic group and hypoxia plus Polidatin (PD) group. By diameter, the arteries were divided into two groups: arteries of group I (30 ?m-100 ?m) and group II (101 ?m-200 ?m). The mean pulmonary arterial pressure (mPAP) was measured by inserting a microcatheter into the pulmonary artery. The PLA 2 activity was measured with modified microtitrimetic method. The pulmonary tissue and arterioles morphology changes were examined under light microscope. RESULTS: It was found that after 21 days hypoxia, the mean pulmonary arterial pressure (mPAP), the PLA 2 activity in blood and lung homogenate increased significantly. The media thickness of group I arteries increased (P

Objective To study the relationship between extracellular signal-regulated kinases（ERK）phosphorylation and indirect activa-tion of the epidermal growth factor receptor（EGFR）in cultured cerebellar granule neurons induced by homocysteine.Methods We pri-marily cultured 7-day-old CD-1 mouse cerebellar granule neurons for 7 days and treated with different agents（saline,AG1478,Hcy and AG1478＋Hcy）.The phosphorylation of ERK was analyzed by Western blot,and apoptotic rate by flow cytometry.Results Compared with saline and AG1478 groups,the phosphorylation of ERK was increased in Hcy group（P 〈 0.05）.When we pretreated the cells with tyr-phostin AG1478,an inhibitor of EGFR,there was no difference in the activation of ERK compared with the control group.We found obvious neuronal apoptosis when 7-day-old CD-1 mouse cerebellar granule neurons were cultured for 7 days and treated with Hcy for 6 hours,and the apoptosis induced by Hcy was aggravated when the neurons were pretreated with AG1478（P 〈 0.05）.No apoptosis was found in the saline and AG1478 groups.Conclusion The role of Hcy on ERK activation suggests the involvement of an indirect activation process of EGFR,which has neural potentially protective effect.

Abstract: Objective　To investigate the clinical characteristics of silicosis complicated with active pulmonary tuberculosis. Methods A retrospective analysis of 36 patients with silicotuberculosis and 100 patients with active pulmonary tuberculosis was performed from January 2018 to December 2021 at Beijing Chest Hospital，Capital Medical University. The patients were confirmed by etiology or pathology. The patients with silicotuberculosis were designed to observation group and the patients with active pulmonary tuberculosis were designed to control group. The enumeration data were expressed as percentage and were treated with the chi-square test and the nonnormal distribution data is expressed as M(P25, P75). The difference was significant with P<0.05. Results　In the observation group, there were 7 cases (19.4%) of silicosis in stage Ⅰ, 14 cases (38.9%) in stage Ⅱ and 15 cases (41.7%) in stage Ⅲ. 25 cases (69.4%, χ2=17.099) had a course of TB more than 12 months. 32 cases (88.9%, χ2=16.722) with cough, expectoration and dyspnea as the main symptoms. 32 cases (88.9%, χ2=16.722) had nodular lesions, and 30 cases (83.3%, χ2=19.900) had mediastinal and hilar lymphadenopathy as the main imaging manifestations on chest CT. 17 cases (47.2%, χ2=7.481) were misdiagnosed. Compared with the control group, the difference was significant in these aspects (P<0.05). 27 cases in the observation group were followed up, 1 case died after 5 months of treatment. The negative conversion time of Mycobacteria growth indicator tube (MGIT) liquid culture in sputum was within 2 months in 17 cases (65.4%), between 2 and 12 months in 5 cases (19.2%) and over 12 months in 4 cases (15.4%), and a significant difference was observed comparing with the control group (P<0.05). Conclusions　The patients with silicotuberculosis are mainly in stage Ⅱ and stage Ⅲ with long duration of TB, cough, expectoration and dyspnea as the main symptoms. Chest CT shows that nodules, mediastinal and hilar lymphadenopathy are the main imaging manifestations. And the silicotuberculosis was easily misdiagnosed. At the same time, screening for latent tuberculosis infection in silicosis patients indispensable due to the poor prognosis of anti-tuberculosis treatment.

Objective To evaluatate the impact of different anastomotic location and preventive ileostomy on postoperative anastomotic fistula in rectal cancer patients.Methods The clinical data of 316 cases of rectal cancer patients after total mesorectal excision from January 2015 to January 2016 were analyzed retrospectively.Patients were divided into anterior resection (AR) group,low anterior resection (LAR) group,uhra-low anterior resection (ULAR) group according to the anastomotic location.There were 33 cases of anastomotic fistula with preventive ileostomy or without and anastomotic leakage varied from mild to severe as grade A,B,C.Results There was no statistically significant difference in the incidence of anastomotic fistula between the different anastomotic location (x2 =3.829,P =0.147).In anterior resection group and low anterior resection group,there was no statistically significant difference in the incidence of anastomotic fistula whether or not a preventive ileostomy was performed (x2 =0.606,1.096,P =0.436,0.326).While in uhralow anterior resection group,preventive ileostomy helped dicrease the incidence of anastomotic fistula (x2 =11.667,P =0.001),and once happened the severity of the anastomotic fistula tended to be less severe.Conclusion The incidence of anastomotic fistula does not vary with anastomotic level in our study.Preventive ileostomy reduces the incidence of anastomotic fistula in patients with ultralow anterior resection.

[Summary] Diabetic nephropathy is one of the major chronic microvascular complications of diabetes ,which is the leading cause of end‐stage renal disease ,as well as the main cause of death in diabetic patients. Glomerular endothelial cell is an important component of the glomerular filtration barrier ,which is directly related to the materials of circulation ,and it can be easily damaged by glucose ,lipid and inflammatory factors. Under the hyperglycemia ,the PKC pathway ,the polyol pathway and oxidative stress were activated ,producing an excess of advanced glycation end products and reactive oxygen species ,which damage the endothelial nitric oxide synthase ,reduce the generation of nitric oxide ,while produce a large number of Ang Ⅱ. Ang Ⅱ damage the endothelial cell. In addition ,there are crosstalk between glomerular endothelial cells and endothelial cells ,which also cause endothelial cell injury. Here ,we reviewed the role of endothelial cell injury in the pathogenesis of diabetic nephropathy.

Objective To investigate the efficacy of jet endotracheal tube (JET) designed by Wei (WEI JET) for tracheal intubation.Methods One hundred and two ASA Ⅰ-Ⅲ and Cormack & Lehane grade Ⅰ-Ⅳ patients of both sexes,aged 15-50 yr,weighing 40-99 kg,requiring tracheal intubation under general anesthesia,were randomly allocated into 2 groups (n =51 each):conventional tracheal tube group (group C) and WEI JET group (group WJ).Groups C and WJ were further divided into 2 subgroups according to Cormack & Lehane grade:difficult airway subgroup (n =16) and non-difficult airway subgroup (n =35).The patients were tracheal intubated with the common Kendall endotracheal tube in group C.Jet ventilation (driving pressure 100 kPa,frequency of ventilation 15 bpm,I∶ E =1∶2) was performed and the patients were simultaneously tracheal intubated with WEI JET of the same internal diameter in group WJ.PETCO2 was recorded immediately after mechanical ventilation.The success rate of tracheal intubation at first attempt and time spent were recorded.The complications were also recorded within 24 h after extubation.Results Compared with group C,the intubation time was significantly prolonged,and the success rate of tracheal intubation at first attempt was increased in patients with a difficult airway than that in the patients without difficult airways in group WJ (P ＜ 0.01).There was no significant difference in PETCO2 recorded immediately after mechanical ventilation,intubation time and the success rate of tracheal intubation at first attempt between the patients with a difficult airway and the ones without difficult airways in group WJ (P ＞ 0.05).PET CO2 recorded immediately after mechanical ventilation was significantly higher and the success rate of tracheal intubation at first attempt was lower in the patients with a difficult airway than in the patients without difficult airways in group C (P ＜ 0.01).No severe barotrauma such as pneumothorax,mediastinal emphysema and subcutaneous emphysema occurred in group WJ.There was no significant difference in the incidences of laryngospasm,sore throat,and flatulence between the two groups (P ＞ 0.05).Conclusion WEI JET can not only provide adequate ventilation safely and effectively in patients requiring tracheal intubation under general anesthesia,but also increase the probability of successful tracheal intubation in patients with a difficult airway.

Objective To study the anti-tumor effects of pEgr-1-endostatin-TNF-α generadiotherapy on mice bearing Lewis lung carcinoma, and to explore the mechanism involved. Methods 240 mice with Lewis lung carcinoma were randomly divided into four groups, including control group,irradiation group, liposome group, and liposome combined irradiation group. The plasmids packed by liposome were injected locally into the tumors of the mice, and the tumors of liposome combined irradiation group were irradiated with 10 Gy γ-rays 24 h later. The expression levels of TNF-α and endostatin in mouse serum were measured by ELISA. Then the tumor growth rates at different time were observed. Tumor angiogenesis density were estimated on frozen sections stained with CD31 by using the Chalkley counting method to vessel hot-spots. The tumor inhibition rates were also calculated. Results Radiation induced the expression of pEgr-1-endostatin-TNFα. The endostatin and TNF-α were expressed steadily for about 4 weeks. The highest levels of expression of the endostatin and TNF-α were (52. 64 ±4. 19)and( 12. 01 ±0. 87 ) ng/ml at 2 week. The expression levels of TNF-α and endostatin were higher in combined therapy group than those in other groups( F = 29. 726,P ＜ 0.05 ). Compared with the control group, the density of tumor angiogenesis were depressed [ (4.7 ± 0. 8 ) vs ( 10.0 ± 1. 2)/field, t = 14. 063, P ＜ 0.05 ] and tumor growth were significantly inhibited compared to the control group and irradiation group [ (5907. 2 ±78.6), (4653.4±32.8) and (763.5 ± 12.3) mm3, F= 16.415,P ＜0.05)]. Conclusions The expression of pEgr-1-endostatin-TNFα could be induced by irradiation in dose- and time-dependent manner. The effect of antitumor and angiogenesis inhibition may be more significant than irradition.