ObjectiveTo observe the effect and safety of arsenic trioxide (ATO) combined with all-trans retinoic acid (ATRA) in treating patients with acute promyelocytic leukemia (APL).Methods Eighty-three cases with APL treated for the first time were divided into two groups by random digits table method:observation group with 48 cases was received combination induction treatment of ATO and ATRA,control group with 35 cases was treated with combination induction treatment of ATRA and chemotherapy.The clinical effect and adverse reaction between two groups were compared.ResultsThe effective rate and early death rate were 100.0％( 48/48 ) and 0 in observation group,97.1％(34/35 ) and 2.9％( 1/35 ) in control group,which had no significant difference between two groups(P ＞ 0.05 ).The incidences of bone marrow suppression,infection,liver and kidney damage,cardiac toxicity and gastrointestinal symptoms were 8.3％ (4/48),10.4％ (5/48),12.5％ (6/48),6.2％ (3/48) and 18.8％ (9/48) in observation group,while 97.1％(34/35),65.7％(23/35),45.7％(16/35),37.1％(13/35) and 100.0％(35/35) in control group,which had significant differences between two groups (P ＜ 0.05).ConclusionCombination treatment of ATO and ATRA in APL has an obvious effect and few adverse reaction,which can be applied in clinic.

A 16-year-old male presented with a 11-year history of progressively enlarging erythema and crusting on the right cheek.Physical examination revealed an irregularly shaped,sharply marginated,dark erythematous patch sized 6 cm x 10 cm and plaques with mild verrucous proliferation.There were strip-like scar at the margin of lesions and multiple ulcers measuring 0.5 to 1 cm in diameter with firm crusts.No small jellycolored nodules were observed.Direct microscopy of multiple scrapings under the crusts showed many light brown,septate,branching and irregular hyphae.Olivaceous-black woolly colonies grew at 25 C and 35 C on Sabouraud's dextrose agar and potato dextrose agar; flask-shaped conidiogenous cells with funnel-shaped collarettes and ellipsoidal conidia arranged in flower-like shape were observed microscopically.PAS staining showed numerous septate and branching hyphae,pseudohyphae and yeast-like cells.There was a 99.73％ similarity in the species-specific rDNA sequence between the isolate and phialophora verrucosa standard strain CDC-B2152.The patient was diagnosed with cutaneous phaeohyphomycosis caused by Phialophora verrucosa.The lesion subsided after treatment with amphotericin B and itraconazole,but recurred after drug withdrawal.Itraconazole and terbinafine were administered for the retreatment of this patient.

OBJECTIVETo investigate the pathogen distribution and drug resistance in coal workers' pneumoconiosis associated with pneumonia and to provide a scientific basis for early guidance for rational clinical application of antibacterial agents.

METHODSSeventy-six patients with coal workers' pneumoconiosis associated with pneumonia who were admitted to our hospital from June 2011 to June 2014 were enrolled as subjects. The sputum specimens were aseptically collected for bacterial culture and drug sensitivity tests.

RESULTSIn 245 sputum specimens collected from 76 patients, a total of 218 strains of pathogens, including 163 strains of Gram-negative bacilli (74.77%), 39 strains of Gram-positive cocci (17.89%), and 16 strains of fungi (7.34%) were isolated by bacteriological tests. The main Gram-negative bacilli had high rates of resistance to amoxicillin/clavulanic acid, ampicillin, cotrimoxazole, cefotaxime, and aztreonam, and were sensitive to amikacin, imipenem, and meropenem. The main Gram-positive cocci had high rates of resistance to penicillin, erythromycin, amoxicillin/clavulanic acid, ampicillin, cefotaxime, and clindamycin, and were sensitive to vancomycin and teicoplanin.

CONCLUSIONThe main pathogens in these patients with coal workers' pneumoconiosis associated with pneumonia are Gram-negative bacilli, which are highly resistant to common clinically used antibacterial agents. The pathogen distribution and drug resistance should be well understood, and the antibacterial agents should be rationally selected according to the results of drug sensitivity tests.

Anthracosis ; microbiology ; Anti-Bacterial Agents ; pharmacology ; Coal Mining ; Drug Resistance, Bacterial ; Gram-Negative Bacteria ; drug effects ; Humans ; Imipenem ; pharmacology ; Microbial Sensitivity Tests ; Occupational Exposure ; adverse effects ; Pneumonia ; microbiology ; Thienamycins ; pharmacology

Objective To investigate the correlation of the 24?hour ambulatory systolic blood pressure (SBP) and carotid intima?media thickness(CIMT) in the elderly. Methods A total of 2 464 who were more than or equal to 60 years old participants were selected with random sampling in accordance with the inclusion criteria from the retired workers in Tangshan Kailuan Company. Dynamic blood pressure monitoring, neck vascular ultrasound and other examination were performed for the participants. . Multivariable linear regression analysis was used to analyze correlation between the SBP of 24?hour, daytime and nightime with CIMT, respectively. Results ( 1) The observation population was divided into three groups according to the tertiles of SBP of 24?hour, daytime and nightime, respectively. With the levels of different SBPs inceasing, CIMT values thickened markedly ( P<0. 01 ) . ( 2 ) Multivariable linear regression analysis showed that after adjusting for confounding factors,the SBP of 24?hour,daytime and nightime associated with CIMT positively and linearly(P<0. 05),and regression coefficient(95%CI) were 0. 022(0. 009-0. 035), 0. 021(0. 008-0. 035), 0. 019 ( 0. 006-0. 032) respectively. In addition,clinic SBP step into the multivariable linear regression,and regression coefficient ( 95%CI ) were 0. 016 ( 0. 003-0. 029 ) , 0. 016 ( 0. 003-0. 030 ) , 0. 019 ( 0. 007-0. 032 ) , respectively. Conclusion The effect of increased 24?hour ambulatory SBP on CIMT was greater than the clinic SBP. Active monitoring of 24 h ambulatory blood pressure and maintaining a low level of blood pressure is essential for preventing and delaying atherosclerosis.

Objective To explore the relationship between WT1 and prognosis of patients with acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL), and to evaluate the possibility of WT1 as a potential marker for monitoring the minimal residual disease (MRD). Methods Bone marrow mononuclear cells from 58 patients with primary AML, 32 patients with primary ALL, 40 patients with AML-complete remission (CR), 28 patients with ALL-CR and 31 patients with trilineage hyperplasia (control group) were collected. Real-time fluorescent quantitative PCR method was used to detect the expression of WT1 in all patients. The expression threshold of WT1 in each group was established. WT1 copy number/ABL copy number ratio×100%denotes the relative expression level of WT1 gene. Results Median relative expression level of WT1 in the control patients was much lower than that in primary AML patients [0.026%(0-0.240%) vs. 20.880 % (3.550 %-48.500 %), Z=-7.74, P<0.000 1]. Relative expression level of WT1 between AML-CR patients [0.102%(0-5.380%)] and primary AML patients had significant difference (Z=-8.34, P<0.000 1). Moreover, the relative expression level rate of the first course in AML patients with higher WT1 expression level (>20.880 %) was 60.7 % (17/28), while the CR rate was 76.7 % (23/30) in those with lower WT1 expression. WT1 expression was increased dramatically in recurrent AML patients. Relative expression level of WT1 was significantly higher in primary ALL patients [0.350 % (0.021 %-10.780 %)] compared with that in the control group Z=-2.58, P<0.05. There was no significant difference in relative expression level of WT1 between ALL and ALL-CR patients [0.038 % (0-2.800 %), P=0.065]. Conclusion WT1 expression level in AML patients is relatively high, which could be used as an effective index of prognosis evaluation and MRD monitoring for AML patients, but not for ALL patients.

Objective To evaluate the inhibitory effect of geniposide on the oxidative damage to in vitro cultured human melanocytes,and to explore the role of PI3K-Akt signaling pathway in this inhibitory effect.Methods Epidermal melanocytes were isolated from the circumcised foreskin of healthy adolescent males,and then subjected to culture.Melanocytes at passage 2-3 were divided to six groups:control group receiving no treatment,geniposide group treated with 125 μmol/L geniposide alone,LY294002 group treated with 5 μmol/L LY294002 alone,H2O2 group treated with 250 μmol/L H2O2 alone,geniposide + H2O2 group firstly treated with 125 μmol/L geniposide for 24 hours followed by 4-hour treatment with 250 μmol/L H2O2,and geniposide + LY294002 + H2O2 group treated with 125 μmol/L geniposide for 24 hours,then with 5 μmol/L LY294002 for 1 hour,followed by 4-hour treatment with 250 μmol/L H2O2.After the above treatment,methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the cellular proliferative activity,Western blot analysis to determine the protein expression of Akt,phosphorylated Akt (p-Akt),heme oxygenase1 (HO-1) and glutathione peroxidase (GPx-1),and flow cytometry to detect the level of cellular reactive oxygen species (ROS),and biochemical methods were used to evaluate the activity of superoxide dismutase (SOD) and catalase (CAT).Statistical analysis was carried out by one-way analysis of variance (ANOVA) for intergroup comparison,and Student-Newman-Keuls-q (SNK-q) test for multiple com-parisons.Results Compared with the control group,the H2O2 group showed significantly decreased cellular proliferative activity (P ＜ 0.01),protein expression of p-Akt (P ＜ 0.01),HO-1 (P ＜ 0.01) and GPx-1 (P ＜ 0.05),SOD activity (P ＜ 0.01) and CAT activity (P ＜ 0.01),but significantly increased ROS level (P ＜ 0.01).Compared with the H2O2 group,the geniposide + H2O2 group showed significantly increased cellular proliferative activity (72.98％ ± 8.92％ vs.50.53％ ± 10.85％,P ＜ 0.05),up-regulated protein expression of p-Akt (P ＜ 0.05),HO-1 (P ＜ 0.01) and GPx-1 (P ＜ 0.01),increased SOD activity (6.82 ±1.03 U/mg vs.1.29 ± 0.43 U/mg,P ＜ 0.05) and CAT activity (46.08 ± 4.16 U/mg vs.18.71 ± 3.09 U/mg,P ＜0.05),but decreased ROS level (1 284.33 ± 110.64 vs.2 158.00 ± 222.75,P ＜ 0.01).The proliferative activity of melanocytes was significantly lower in the geniposide + LY294002 + H2O2 group (44.35％ ±14.85％) than in the geniposide + H2O2 group (P ＜ 0.05).In addition,the geniposide + LY294002 + H2O2 group showed significantly decreased protein expression of p-Akt (P ＜ 0.01),HO-1 (P ＜ 0.05) and GPx-1 (P ＜ 0.01),SOD (1.31 ± 0.65 U/mg,P ＜ 0.05) and CAT activity (23.25 ± 5.56 U/mg,P ＜ 0.05),but significantly increased ROS level (1 668.00 ± 62.03,P ＜ 0.05)compared with the geniposide + H2O2 group.Conclusion Through the PI3K-Akt pathway,geniposide can promote the protein expression of HO-1 and GPx-1 in melanocytes,enhance SOD and CAT activity,and antagonize the oxidative damage of melanocytes.

Objective To evaluate the efficacy of preoperative pulmonary rehabilitation in patients with lung cancer. Methods We searched Cochrane Library, Web of Science, Pubmed, Embase, CNKI, Wan Fang Date, Vip Date and CBM to collect randomized controlled trials (RCTs) or quasi-experimental study about perioperative pulmonary rehabilitation applied in lung cancer patients, the retrieval time was from 1990 to 2017. The data was analyzed by RevMan 5.3 software after two researchers independently screened the literature, extracted the data, and evaluated the biased risk of inclusion studies. Results A total of 16 studies were included, including 904 patients, and 8 of them were RCT, and 8 quasi-experimental studies. The results of meta-analysis showed that patients after preoperative pulmonary rehabilitation their the first-second forced expiratory volume (FEV1) was increased (MD=0.20, 95%CI: 0.02-0.37, P=0.03), preoperative forced vital capacity (FVC) was increased (MD=0.22,95%CI:0.05-0.38,P=0.009), preoperative distance of 6-minute walking test (6MWT) was increased (MD=44.07, 95%CI: 33.88-54.27, P<0.001), the postoperative hospital stay in the preoperative pulmonary rehabilitation group was shortened (MD=-2.28, 95%CI: -2.77-1.79, P<0.001) and the incidence of postoperative pulmonary complications was reduced (OR=0.32,95%CI:0.22-0.49, P< 0.001). Conclusions Preoperative pulmonary rehabilitation can improve lung function of patients with lung cancer, shorten the time of postoperative hospitalization and reduce the incidence of postoperative pulmonary complications.

Objective:Iron accumulation is related to the occurrence of postmenopausal osteoporosis. Meanwhile, autophagy abnormality of bone marrow hematopoietic cells is observed in hip osteoporotic fracture. This study is performed to investigate correlation between iron accumulation induced bone loss and hematopoietic autophagy dysfunction to explore the new risk factor of osteoporosis.Methods:Male iron accumulation mice model was established by intraperitoneally injecting ferric ammonium citrate. Serum ferritin and osteogenic indicator P1NP were tested by ELISA. Bone mineral density was measured by micro-CT. Femur and tibia bone marrows were collected for hematopoietic stem and progenitor cells proportion and cell apoptosis analysis. Autolysosome formation was measured by image flow cytometry. We used conditional mouse model Atg7 flox/flox; Vav-Cre(Atg7 -/-) in which Atg7 had been genetically deleted in the hematopoietic system. Bone marrow hematopoietic stem and progenitor cells were collected for RNA sequence. micro-CT scan was conducted for Atg7 -/- femur. Results:Ferritin level of iron accumulation mice was significantly higher than control group( P<0.05). Iron accumulation inhibited P1NP and induced decreased bone mineral density( P<0.05). Iron accumulation bone marrow displayed enhanced hematopoietic stem and progenitor cells proportion( P<0.05), with more cell apoptosis( P<0.05). Hematopoietic autophagy was deteriorated in iron accumulation bone marrow. Transcriptomic profiling showed up-regulation of iron activity in Atg7 -/- mice, with increased iron homeostasis and iron membrane transporter genes, including Lcn2, Tfr2, Slc40a1(Fpn1), Steap3, and Cpox. micro-CT revealed severe bone loss and decreased bone mineral density in Atg7 -/- mice( P<0.05). Conclusion:Iron accumulation induced bone loss is related to inhibition of hematopoietic cells. Hematopoietic autophagy dysfunction is associated with bone loss.

Objective To investigate the effect of miR-132-3p on the proliferation of endothelial progenitor cells and its regulatory mechanism in order to provide a new theoretical basis for the treatment of deep venous thrombosis. Methods Real-time quantitative PCR (qPCR) was used to detect the expression of miR-132-3p in the plasma and endothelial progenitor cells of 27 healthy volunteers and 22 thrombus patients, and in endothelial progenitor cells under normoxic and hypoxic conditions. The miR-132-3p analogue and the specific siRNA were transferred into endothelial progenitor cells by the electroporation method. The effect of miR-132-3p on the proliferation of endothelial progenitor cells was detected using MMT and Cell Counting Kit-8 (CCK-8) methods. The effects of miR-132-3p on the expression of FOXO1 in endothelial cells were analyzed using the luciferase assay and western blots. Results The expression of miR-132-3p in clinical patients with thrombosis was significantly decreased to 0.45 ± 0.05 times of that of the healthy volunteers (P＜0.05). The expression of miR-132-3p in endothelial progenitor cells under hypoxia was down-regulated to (0.23 ± 0.13) times of that of under normoxia (P＜0.05). The expression of miR-132-3p of experiment group under hypoxia was up-regulated to (15.72 ± 2.06) times of that of control group (P＜0.05). MMT assay showed that the proliferation of cells in the experimental group under hypoxic condition was up-regulated to (7.79 ± 1.37) times of that in the control group (P＜0.01). CCK-8 assay showed that cell proliferation in experimental group was up-regulated to (6.46 ± 0.38) times of that in the control group (P＜0.01). Software analysis showed that FOXO1 was a direct target of miR-132-3p. Luciferase activity of miR-132-3p mimics transfected endothelial progenitor cells under hypoxic conditions were 0.47 times of that in siRNA treatment group. Western blot showed that the expression of FOXO1 protein in endothelial progenitor cells transfected with miR-132-3p mimics in hypoxia was 0.18 times of that in siRNA treatment group. Conclusions Compared with healthy volunteers, miR-132-3p expression in the blood of patients with thrombosis was significantly reduced that can promote transcription of the FOXO1 gene (and protein expression) and inhibit the proliferation of endothelial progenitor cells. It could be closely related to the formation of venous thrombosis.

Objective To evaluate the scientific research performance of a third-grade maternal and child health hospital in Guangxi from 2007 to 2016,and to understand the situation of scientific research in past 10 years,and provide decision-making basis for strengthening the scientific research management of hospitals.Methods According to the statistical reports of the hospital's scientific research data,7 indexes were used to evaluate the quality of the scientific research performance of the hospital,and the close value method was used to evaluate the quality of the scientific research during 2007-2016.Results According to the Close-value method analysis,the overall quality of the scientific research performance showed a upward trend in recent ten years;according to the ranked order of the Close-value,the research performance of the institute in 2016 was the smallest while the quality of scientific research was the best.In 2009,the Institute's scientific research performance was the closest,however,the scientific research performance was the worst.Conclusions The result of comprehensive evaluation of Close-value method is consistent with the actual situation of scientific research in this hospital.It has reference significance for the evaluation of hospital scientific research quality.