Objective To understand Shenzhen Longgang,guangming and longhua new district four district hospital ICU pa-tients with secondary pulmonary tuberculosis merger lower respiratory infection of pathogenic bacteria distribution and drug resistance status of provide a reference for clinical diagnosis and rational use of antibiotics therapy.Methods Random selec-tion from February 2013 to October 2015 in the three district hospital ICU diagnosis of secondary pulmonary tuberculosis patients with lower respiratory infection in 593 cases of sputum specimen pathogenic bacteria culture and drug susceptibility results were retrospectively analyzed.Results 593 cases of ICU secondary pulmonary tuberculosis patients with respiratory tract infection of the communist party of China isolated 617 strains of pathogenic bacteria,fungi accounted for 49.6% (306/617),gram negative bacilli accounted for 40.4% (249/617),gram positive cocci accounted for 10.0% (62/617).Fungal in-fection main pathogens for white smooth candida yeast and candida yeast,respectively accounted for 44.2% (273/617)and
4.5% (28/617),gram negative bacillus mainlyKlebsiellaPneumoniae,Pseudomonasaeruginosa,and H.influenzae,respec-tively accounted for 16.7% (103/617),12.0% (74/617)and 7.3% (45/617),gram-positive cocci mainly for Saphylococcus aureus and Epidermisstaphylococcus and Hemolyticstaphylococci,respectively accounted for 4.5% (28/617),3.2% (20/617)and 0.9% (5/617).Pathogenicbacteria isolated from the multiple drug resistant bacteria,present different levels of resistance to commonly used antimicrobial agents.Conclusion ICU patients with secondary pulmonary tuberculosis merger of lower respiratory tract infection pathogens to fungi and gram-negative bacilli,the most commonWhite candida,Klebsiella pneumoniae,and Pseudomonasaeruginosa,and different levels of resistance to commonly used antimicrobial agents.

ObjectiveTo investigate the effects of different time administration of propofol on cytochrome c (Cyt c) in the cytoplasm in rat hippocampal neurons with hypoxia-reoxygenation (H/R) injury.MethodsPrimary cultured hippocampal neurons were randomly divided into 5 groups ( n =5 each):control group (group C),model of H/R injury group (group M),and different time administration of propofol groups (group Ⅰ,Ⅱ,Ⅲ ).In groups M,Ⅰ,Ⅱ and Ⅲ,the neurons were exposed to 95％ N2 + 5％ CO2 for6 h followed by 12 h reoxygenation.In groups Ⅰ, Ⅱ,Ⅲ,propofol was added to the culture medium before hypoxia,immediately after reoxygenation and at 2 h of reoxygenation (T0-2) respectively,with the final concentration of 20 μmol/L.The cell apoptosis was observed at T1,2 and at 24 h of reoxygenation ( T3 ) and the concentration of Cyt c in the cytoplasm was detected at T1-3.ResultsCompared with group C,the concentration of Cyt c in the cytoplasm was significantly increased at T1-3 in group M and at T1,2 in groups Ⅰ,Ⅱ,Ⅲ (P ＜ 0.05).Compared with group M,the concentration of Cyt c in the cytoplasm was significantly decreased at T1-3 in group I and at T1,2 in groups Ⅱ and Ⅲ ( P ＜0.05).The concentration of Cyt c in the cytoplasm was significantly higher at T1,2 in groups Ⅱ and Ⅲ than in group Ⅰ,and at T2 in group Ⅲ than in group Ⅱ ( P ＜ 0.05).The neuronal apoptosis was significantly decreased in groups Ⅰ,Ⅱ and Ⅲ as compared with group M.ConclusionDifferent time administration of propofol can reduce the mitochondrial Cyt c release to the cytoplasm,inhibit apoptosis in hippocampal neurons,and reduce H/R injury in rats,with better effect when given before hypoxia.

OBJECTIVETo establish and compare three in vitro screening models of angiotensin converting enzyme inhibitors (ACEI), and provide methodological basis for screening ACEI drugs from Chinese herbal medicine.

METHODThree screening models were established using rat serum, pure angiotensin converting enzyme (ACE) and crude extract enzyme from rabbit lung as enzyme sources, respectively, with corresponding testing methods, and captopril as the positive drug.

RESULTThe IC50 of captopril was 2.30 nmol x L(-1) using rat serum as the enzyme; and 1.04 nmol x L(-1) for ACE pure enzyme; and 1.40 nmol x L(-1) for crude extract enzyme from rabbit lung.

CONCLUSIONResults from the three screening models were all in accordance with literature reports. These models can be applied to in vitro pharmaceutical screening. The selection of suitable screening model depend on the experimental situation and the inherent characters of models.

Angiotensin-Converting Enzyme Inhibitors ; analysis ; pharmacology ; Animals ; Drug Evaluation, Preclinical ; methods ; Drugs, Chinese Herbal ; analysis ; pharmacology ; Male ; Models, Animal ; Peptidyl-Dipeptidase A ; blood ; Rabbits ; Rats ; Rats, Sprague-Dawley

Objective: To evaluate the safety of enterovirus 71（EV71）inactivated vaccines produced by Wuhan Institute of Bio Products through learning the incidence of adverse events following immunization（AEFI）in children aged 6 months to 3 years old after vaccination. Methods: According to the national requirement for vaccine safety monitoring program，data of AEFI cases after inoculated EV71 vaccines from September 2017 to October 2018 in Zhejiang Province was collected by combining active and passive monitoring. Demographic characteristics，space distribution，dose and incidence of AEFI were analyzed. Results: A total of 107 503 children were included in this study，of which 27 173 were actively monitored and 80 330 were passively monitored. The monitoring results showed that 288 cases of AEFI occurred after inoculated EV71 vaccines，the reported incidence rate was 267.90/100 000. Of 288 cases，266 cases had common reactions（247.43/100 000），14 cases had abnormal reactions（13.02/100 000）and 8 cases had complications（7.44/100 000）；145 cases were passively monitored（180.51/100 000）and 143 cases were actively monitored（526.26/100 000）；150 cases were males and 138 cases were females，with the males to females ratio of 1.09∶1. The AEFI of EV71 vaccines were reported in all the cities of Zhejiang Province，with Jinhua，Taizhou and Hangzhou ranking the top three and accounting for 50.69% of all the reported cases. About 202 cases of AEFI（70.14%）occurred after the first dose of EV71 vaccines，and 163 cases（56.60%）occurred on the day of inoculation.Most of common reactions were fever，swelling and sclerosis. The harm of the reported abnormal reactions was mild，with 8 cases of anaphylactic rash and no other serious abnormal reactions were found. Conclusion The reported incidence rate of AEFI of the domestic EV71 vaccine in children aged from 6 months to 3 years is 267.90/100 000，without serious abnormal reactions，suggesting that the EV71 vaccine is safe.

OBJECTIVE:To provide reference for rational drug use in elderly patients with depression. METHODS:A total of 96 elderly outpatients and inpatients with depression were selected from 39 mental health institutions of Hebei province during Jul. 2nd to 9th,2012. The drug use were surveyed by using self-made questionnaires on the basis of prescriptions/medical orders. The results of investigation were analyzed statistically. RESULTS:In this study,96 questionnaires were distributed and all were collect-ed with effective recovery rate of 100%. Among 96 respondents,95 elderly patients used a new type of antidepressants,mainly by selective serotonin reuptake inhibitors(SSRIs),accounting for 75.0% of the total. The top 5 drugs in the list of use frequency were sertraline(23 cases,24.0%,daily dose:25-200 mg),paroxetine(22 cases,22.9%,daily dose:20-60 mg),escitalopram(20 cas-es,20.8%,daily dose:5-40 mg),venlafaxine (13 cases,13.5%,daily dose:75-300 mg),mirtazapine (12 cases,12.5%,daily dose:8-30 mg). Among all respondents,22 patients (22.9%) were treated with mono-antidepressant and the other 74 patients (77.1%) were treated with drug combination therapy among which 47 cases were treated with two antidepressant drugs,22 were treated with three drugs,4 were treated with four drugs and 1 was treated with five drugs. 6 cases combined with mood stabilizers, 21 cases with antipsychotic,50 cases with benzodiazepine(6 of them combined with two benzodiazepine),2 cases with other hyp-notic drugs,14 cases with anxiolytic drugs and 2 cases with anticholinergic drugs. CONCLUSIONS:The drug use of elderly pa-tients with depression in mental health institutions of Hebei province basically in line with current trends. However,there are still the phenomenon of irrational drug use as drug dose meets or exceeds the prescribed maximum dose;many varieties are used in combination therapy;route of administration is improper.

Objective:To understand the knowledge, attitude and behavior of volume management of maintenance hemodialysis patients, so as to provide a basis for standardizing volume management and carrying out refined individual care.Methods:By means of convenience sampling, 608 patients from 4 hospitals who received regular dialysis treatment in Xuzhou and Yancheng hemodialysis rooms in October 2021 were selected as subjects. Patients were surveyed by a self-designed knowledge questionnaires of volume management, Maintenance Hemodialysis Patients′ Capacity Management Behavior Scale and Self-Efficacy Scale. Questionnaires were collected through the questionnaire star.Results:A total of 608 valid questionnaires were collected. The knowledge dimension scored 8.21 ± 2.27 , atitude dimension scored 7.36 ± 2.06 and behavior dimension scored 15.07 ± 4.22. Multiplelinear regression analysis showed that age, dialysis age and self-care ability were predictors of volume management knowledge score ( t=-2.07, 2.35, -3.90, all P<0.05 ). Medical insurance type was a predictor of volume management attitude score ( t=-2.17, P<0.05). Education level was a predictor of volume management behavior score ( t=3.04, P<0.05). Conclusions:The capacity management knowledge and capacity management attitude of maintenance hemodialysis patients is in the medium level, but with poor volume management executive ability. It is suggested that medical staff carry out health education related to volume management according to different characteristics of patients, and effectively improve patients′ volume management ability.

Objective To analyze pathological and ultrasound imaging features of breast cancer in young women. Methods The pathological and ultrasound imaging data of 42 young female breast cancer patients(≤35 years old,the young group)between January 2016 and October 2017 from the Fourth Affiliated Hospital of China Medical University were retrospectively analyzed. Meanwhile, 62 elder female breast cancer patients (> 60 years old, the elder group) simultaneously diagnosed by pathology (age≥60 years) were randomly selected as the control group. Results The vessel carcinoma embolus rate and lymph node metastasis positive rate in the young group were higher than those in the elder group [31.0 % (13/42) vs. 29.0 %(18/62),59.5 %(25/42)vs.38.7 %(24/62)],and there was no difference between the two groups(χ2=16.187, χ2= 5.749, both P< 0.05). Compared with the elder group, the expression of estrogen receptor (ER) in the young group was lower (χ2= 11.598, P = 0.001). The positive rates of Ki-67 and human epidermal growth factor receptor-2 (HER-2) in the young group were higher (χ2= 5.396, P = 0.024; χ2= 5.166, P =0.026). Inhomogeneous internal echo of breast cancer, microcalcifications, flow classification (grade Ⅱ-Ⅲ) and resistance index (RI) ratio in the young group were higher than those in the elder group [83.3 % (35/42) vs. 59.7 % (37/62), P = 6.576; 57.1 % (24/42) vs. 22.6 % (14/62), P = 12.899; 78.6 % (33/42) vs. 58.1 % (36/62), P = 4.716; 83.3 % (35/42) vs. 59.7 % (37/62), P= 6.578], and the differences were statistically significant (all P < 0.05). Conclusion The young female breast cancer patients have a higher rate of malignancy,invasion and metastasis rate compared with the elder breast cancer patients.

Objective:The morbidity of malignant melanoma keeps increasing annually.It has high risks of metastasis,drug resistance,and poor prognosis in clinics.Moreover,the available medicines used commonly,such as dacarbazine,temozolomide,the v-Raf murine sarcoma viral oncogene homolog B1(BRAF) inhibitor vemurafenib,and the programmed cell death protein 1 inhibitor pembrolizumab,have some limitations at some extent.Therefore,a more effective therapeutic strategy is still urgently necessary.Methods:In this study,Brucea javanica(L.)Merr.globulins were hydrolyzed with pepsin,then ultra-filtrated to collect small molecular peptides (≤3 kDa).The peptides were then analyzed by anti-proliferative assay,cell-cycle distribution,apoptosis assay,and in vitro wound-scratch assay.Finally,western blotting was conducted to elucidate the underlying anti-melanoma mechanism.Results:The small molecular peptide from B.javanica significantly inhibited malignant melanoma cell proliferation with the IC50 of 2.72 μg/mL for 72 h.Further analysis indicated that B.javanica peptides arrested cell cycle at the S and G2/M phases and induced apoptosis by upregulating p21,p53,Bax,caspase-3,and cleaved PARP while downregulating Bcl-2 expression.The inhibitory migration effects were also confirmed by wound-healing assay.Conclusion:The small molecular biopeptides from B.javanica may be a promising bioactive agent candidate for melanoma treatment.

Objective To analyze the clinical and electrophysiological features in a family with spinal muscular atrophy (SMA), and assess the probable causative gene mutations for the family. Methods To identify the nosogenesis of the proband with weakness and atrophy in the double lower proximal limbs, clinical data of his 12 family members were collected, and the proband and his mother were selected for clinical examinations, including laboratory tests, electromyogram (EMG), F-wave, H-reflex, X-ray of the spine and double lower limbs, brain and spinal cord magnetic resonance imaging, etc. Moreover, human whole exome sequencing was performed on blood sample from the proband, then its deleterious effects were assessed according to the Standards and guidelines for the interpretation of sequence variants, a joint consensus recommendation of the American College of Medical Genomics (ACMG) and the Association for Molecular Pathology (AMP). Subsequently, the strong pathogenic mutation was validated by Sanger sequencing. Results Familial investigation showed seven of 12 family members presented with weakness in the double lower proximal limbs. Among them, three had the main manifestation of atrophy in the double lower proximal limbs, one had high arched foot as the main presentation, and the others had weakness in the double lower proximal limbs. EMG studies showed the abnormal results in the anterior horn of the spinal cord. The strong pathogenic mutation in DYNC1H1 gene (exon8, c.2327C＞T, p.P776L) was identified from the proband according to ACMG and AMP guidelines. Sanger sequencing revealed six patients had this variant and it was passed mainly from his maternal grandmother. Conclusions A pathogenic mutation of the DYNC1H1 p.P776L in six Chinese pedigrees which cosegregated with SMA was identified. There existed individual differences in clinical presentations. This finding may have important implications for the study of SMA in Chinese patients.

Lung transplantation is the only effective treatment of most end-stage lung diseases. Airway anastomotic complications are the main obstacles affecting the postoperative survival and quality of life of lung transplant recipients. Airway anastomotic stenosis is the most common airway anastomotic complication after lung transplantation. In recent years, improvements in the recipient selection, organ preservation, surgical techniques, postoperative intensive care management, immunosuppression, antifungal and endoscopic treatment have decreased the incidence of airway anastomotic stenosis and improved the surgical efficacy of lung transplantation and the survival of the recipients. In this article, the pathogenesis, risk factors, diagnosis and treatment of airway anastomotic stenosis after lung transplantation were reviewed, aiming to provide novel ideas for clinical research, diagnosis and treatment of airway anastomotic stenosis following lung transplantation.