Abstract: Objective　To investigate the diagnostic efficacy of rifampin-resistant real-time fluorescent quantitative nucleic acid amplification detection technology (GeneXpert MTB/RIF) in bronchoalveolar lavage fluid (BALF) combined with peripheral blood tuberculosis infection T cell spot test (T-SPOT) and tuberculosis antibody (TB-Ab) in smear-negative pulmonary tuberculosis. Methods　The clinical data of 114 cases of clinically diagnosed smear-negative pulmonary tuberculosis, 80 cases of non-tuberculous pulmonary diseases and 22 cases of smear-positive pulmonary tuberculosis in our hospital from January 2019 to January 2021 were retrospectively analyzed. The detection results of peripheral blood T-SPOT, TB-Ab and BALF GeneXpert in the three groups were analyzed. The sensitivity, specificity, negative predictive value, positive predictive value, false negative rate, false positive rate and Youden index of the three detection methods were compared. The differences in the positive detection rate of smear-negative pulmonary tuberculosis between the separate detection and the combined detection of the three methods were compared. The receiver operating characteristic curve (ROC) was performed to calculate the area under the curve (AUC). Results　The sensitivity of BALF GeneXpert and peripheral blood T-SPOT and TB-Ab was 66.91%, 80.88% and 90.44%, respectively. The specificity was 98.75%, 73.75% and 41.25%, respectively; the diagnostic coincidence rates were 78.70%, 78.24% and 72.22%, respectively, which were higher than 70.00%. In the smear-negative pulmonary tuberculosis group, the positive detection rates of these three methods in the smear-negative pulmonary tuberculosis group were 63.15%, 79.82% and 90.35%, respectively, and the differences were statistically significant compared with those in the non-tuberculosis pulmonary disease group (all P<0.01). The positive detection rate of the three combined methods in the smear-negative pulmonary tuberculosis group was 96.49 %, which was significantly higher than that of TB-GeneXpert method and T-SPOT, and the differences were statistically significant (χ2=37.283, P<0.01; χ2=13.612, P<0.01); the Youden index of combined detection was significantly higher than that of single detection, and the AUC of combined detection was 0.977, which was significantly higher than that of single detection. Conclusion　BALF GeneXpert combined with peripheral blood T-SPOT and TB-Ab can significantly improve the diagnostic rate of bacterial-negative pulmonary tuberculosis, providing a strong basis for guiding clinical treatment.

OBJECTIVETo evaluate the clinical efficacy and safety of phosphodiesterase 5 (PDE-5) inhibitors for erectile dysfunction (ED) in patients with diabetes mellitus and provide some evidence for the clinical treatment of the disease.

METHODSWe searched MedMed, EMbase, Cochrane Library, CNKI, Wan Fang Data, VIP and ZADL for randomized controlled trials on PDE-5 inhibitors for ED in diabetic men and evaluated the methodology of the included trials with the Jadad scale. We used the erectile function domain in the IIEF (IIEF-EF), IIEF questions (IIEF-Q) 3 and 4, SEP-2 and -3, and Global Assessment Questions (GAQ) as the main evaluation indexes and employed the Review Manager 5. 1. 0 software for meta analysis.

RESULTSA total of 13 studies were included, which were all high quality trials with Jadad score > 3. The IIEF-EF scores in 10 of the included studies were subjected to meta analysis using the random-effect model (REM), with a weighted mean difference (WMD) of 5.64 (95% CI 4.41 - 6.83, P < 0.001). The fixed-effect model (FEM) analysis of the IIEF-Q scores in 6 of the studies showed the WMD to be 0.96 (95% CI 0.83 -1.08, P < 0.001) for IIEF-Q3 and 1.11 (95% CI 0.98 - 1.25, P < 0.001) for IIEF-Q4. FEM analysis of the SEP-2 scores showed WMD = 17.67 (95% CI 12. 38 - 22. 97, P < 0.001) in 2 of the studies, and that of the SEP-3 scores WMD = 23.64 (95% CI 17. 49 - 29.79, P < 0.001) in 5 of the studies. The GAQ scores in 11 of the studies were subjected to REM analysis, with OR = 6. 20 and 95% CI 3.65 - 10.52 (P < 0.001). REM analysis was performed on the adverse reactions in 11 of the studies, with OR = 7.43 and 95% CI 4.11 - 13.44 (P < 0.001).

CONCLUSIONPDE-5 inhibitors can effectively and safely improve erectile function in patients with diabetes mellitus.

Diabetes Mellitus ; Erectile Dysfunction ; drug therapy ; Gangliosides ; Humans ; Male ; Penile Erection ; Phosphodiesterase 5 Inhibitors ; therapeutic use

Objective To establish a radioresistant cell subline from a human A549 lung cancer cell line and investigate the mechanism of radioresistance. Methods Two proposals were applied for the non-small cell lung cancer A549 cells irradiated with X-rays:A group of A549 cell line was irradiated five times, the fractionated dose was 600 cGy, and the other group was exposed 15 times, the fractionated dose was 200 cGy. After the completion of irradiation, two monoclones were obtained from the survival of cells and named the subline A549-S1 and A549-S2. The radiosensitivity and cell cycle distribution of these two clones,together with its parental A549 cells were measured by clone formation assay and flow cytometry.The mRNA and protein levels of Notch1 in A549 cell line and the sublines were determined by RT-PCR and Western-blots. Results Compared with the parental A549 cells, A549-S1 cells showed significant resistance to radiation with D0, Dq and N values increased, and a broader initial shoulder as well as 1.38-fold increased value of SF2. The A549-S1 subline also showed higher percentage of cells in S phase and G2/M phase, but lower percentages in G0/G1 phase (P<0.05). The expression of Notch1 in A549-S1 was enhanced obviously than in A549 cells. But for A549-S2 the radioseasitivity was slightly increased compared with the parental cells with D0, Dq and N values decreased and a curve initial shoulder. The ratio of cells in S and G0/G1 phase ratio was lower than that in parental A549 cells, but that in G2/M phase ratio was higher significantly (P<0.05) .The expression of Notch1 had no marked change compared to A549 cell. Conclusions The radioresistance of the A549 cell subline is correlated with the irradiation program. The cell subline shows a different cell cycle distribution from their parental line. The cell cycle distribution has a close correlation with the expression of Notch1.

Objective To assess the clinical value of high-frequency electrocautery in the treatment of massive hemorrhage of presacral venous plexus. Methods The clinical data of 8 patients with presacral venous hemorrhage treated with high-frequency electrocautery from February 2005 to March 2008 were analyzed. Once the presacral venous hemorrhage happened, the bleeding site was pressed with a gauze or finger and the accumulated blood was aspirated. Then, while simultaneously withdrawing the gauze or finger over the bleeding sites, high-frequency electrocautery was applied with a power of 80-100 W to coagulate all the bleeding sites. Results High-frequency electrocautery was used to stop bleeding in the 8 patients, and no electrocautery related complica-tions occurred postoperatively. Conclusions High-frequency electrocautery for massive hemorrhage of presacral venous plexus is simple, efficient and safe.

AIM To establish an HPLC method for the simultaneous content determination of four constituents in Xiaojie'an Capsules (Forsythiae Fructus,Leonuri Herba,Spatholobi Caulis,etc.).METHODS The analysis of chloroform extract of this drug was carried out on a 30 ℃ thermostatic Diamond C1scolumn(250 mm ×4.6 mm,5 μm),with the mobile phase comprising of acetonitrile (A)-0.05 mol/L monosodium phosphate (B) flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 278 nm.RESULTS Berberine hydrochloride,palmatine chloride,phillyrin and rutin showed good linear relationships within the ranges of 0.033 7-0.337 2 μg (r =0.999 1),0.054 8-0.548 3 μg (r =0.999 0),0.025 9-0.258 8 μg (r=0.999 2) and 0.008 4-0.084 2 μg (r =0.999 6),whose average recoveries were 98.8％ (RSD =1.3％),99.8％ (RSD =0.7％),98.8％ (RSD =1.3％) and 96.8％ (RSD =1.0％),respectively.CONCLUSION This sensitive and accurate method can be used for the quality control of Xiaojie'an Capsules.

OBJECTIVE:To explore the role of clinical pharmacists participating in anti-infective treatment for a child with complex infection. METHODS:Clinical pharmacists participated in treatment process of one child with pulmonary infection and brain abscess after a near-drowning incident,assisted physicians to adjust antibiotics therapy plan,and put several suggestions as the adjustment of anti-gram-positive and anti-gram-negtive bacterium drugs,the dosage adjustment of vancomycin,vancomycin-induced ADR and disposal,the selection of anti-Pasteurella pneumotropica drugs,the enhancement of anti-fungal infection therapy,accord-ing to pathogen characteristics,treatment effect and ADR. RESULTS:Physicians partly adopted the advice of clinical pharmacists, the child’s pulmonary and brain infection were controlled effectively and ADR disappeared after 5 times of adjusting anti-infective the rapy plan. CONCLUSIONS:Clinical pharmacists participate in the treatment process of one child with complex infection,and assist physicians to formulate safe and effective anti-infective plan according to the results of etiological examination;dispose ADR timely and carry out efficacy evaluation of antibiotics and pharmaceutical care,that can give positive effects on patient treatment.

OBJECTIVETo investigate the expression of T lymphoma invasion and metastasis inducing factor 1 (Tiam1) in breast carcinomas, and explore its association with the clinicopathological features of breast carcinoma.

METHODSImmunohistochemistry was used to detect Tiam1 expression in normal breast tissue and 126 breast carcinoma tissues, and the expression levels of Tiam1 mRNA and protein were detected by reverse transcriptase polymerase chain reaction (RT-PCR) and Western blotting, respectively.

RESULTSThe expression of Tiam1 was significantly higher in breast carcinomas than in normal breast tissue (P<0.05). Tiam1 expression was not correlated to the age of the patients or the histological type (P>0.05), but to lymph node metastasis and clinical stages of the tumor (P<0.01). Tiam1 mRNA and protein expressions were stronger in breast carcinoma cell line MDA-MB-435 with high metastatic potential than in breast carcinoma cell line MCF-7.

CONCLUSIONTiam1 is closely related to the metastasis of breast carcinoma, and may play an important role in promoting metastasis of breast carcinoma.

Adult ; Aged ; Breast Neoplasms ; metabolism ; pathology ; Cell Line, Tumor ; Female ; Guanine Nucleotide Exchange Factors ; genetics ; metabolism ; Humans ; Lymphatic Metastasis ; Middle Aged ; RNA, Messenger ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; T-Lymphoma Invasion and Metastasis-inducing Protein 1

OBJECTIVETo evaluate the effect and safety of Chinese herbal medicine Lingdankang Composite (LDK) combined dendritic cell-cytokine induced killer cells (DC-CIK) in treating leukemia.

METHODSSubjects were selected from leukemia patients who achieved hematological complete remission (HCR) but not achieved molecular biological remission (MBR), or with minimal residual leukemia (MRL) positive. Twenty patients, 19 of acute leukemia and 1 of chronic myelocytic leukemia, were enrolled. DC and CIK from patient's peripheral blood monocyte were separated respectively by blood cell separator, then DC-CIK was obtained through respective culture followed with mixed cultivation of them, and was infused back to the patient self via intravenous injection. The back infusion of DC-CIK was performed once every 15-20 days for 4-6 times in total. Meantime, LDK was administered orally every day.

RESULTSIn the 20 patients treated, 4 case of HCR achieved MBR, the negatively reversed marker gene was AML1/ETO in 1 case, CBFbeta/MYH11 in 1, bcr/abl in 1, and the other 1 was IgH gene rearrangement; 3 patients with positive MRL were reversed to negative. The 3-year CR rate was 75% with a medium CR period of 25 months (10-37 months). Except transient fever and chill in 5 cases, no other remarkable adverse reaction happened during or after DC-CIK infusion.

CONCLUSIONThe combined treatment of LDK and autologous DC-CIK in treating patients with HCR shows an obvious effect of clearing MRL, it is the appropriate choice for curing leukemia of HCR, and is safety for intravenous infusion, so it has potential clinical prospect.

Adolescent ; Adult ; Cell Differentiation ; Cells, Cultured ; Combined Modality Therapy ; Cytokine-Induced Killer Cells ; cytology ; transplantation ; Dendritic Cells ; cytology ; transplantation ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Leukemia ; immunology ; therapy ; Leukocytes, Mononuclear ; cytology ; Male ; Middle Aged ; Phytotherapy ; Young Adult

Objective To explore the most accurate T staging and optimal surgical method of lung adenocarcinoma of trans-lobe type, and to provide supportive diagnosis as well as therapeutic evidences for this disease. Methods A total of 192 postoperative patients, hospitalized in Tianjin Medical University General Hospital from January 2008 to June 2013, who were diagnosed with lung adenocarcinoma were recruited. Patients were divided into three groups according to the 7th edition of TNM staging criteria issued by the IASLC in 2009. A total of 163 patients with T2 stage were selected as Group T2, and 12 patients with T3 stage were selected as Group T3, both of which were considered as control groups. Other 17 pa?tients who were diagnosed as trans-lobe type of lung adenocarcinoma, were Group trans-lobe. The clinical data and progno?sis were compared between three groups. The trans-lobe type of lung adenocarcinoma was diagnosed based on imaging and pathological examination. Subtypes of trans-lobe lung adenocarcinoma were identified by referring to 2011 international mul?tidisciplinary classification standard of lung adenocarcinoma. Kaplan-Meier method was used to analyze the prognosis of dif?ferent subtypes and surgical modus in patients with lung adenocarcinoma of trans-lobe type. Results By comparison, the postoperative survival rate was significantly lower in patients diagnosed with trans-lobe type of lung adenocarcinoma than that of Group T2 (P<0.05), and no significant difference in survival rate compared with Group T3 (P>0.05). There were no significant differences in survival rates between different surgical modus (P<0.05). Seventeen patients with trans-lobe type of lung adenocarcinoma consisted of four subtypes, including 8 solid predominant, 5 acinar predominant, 3 papillary predomi?nant and 1 invasive mucinous adenocarcinoma. There were no statistical significances in postoperative survival time and sur?vival rates between four subtypes. Conclusion The clinical stage of trans-lobe type of lung adenocarcinoma should be clas?sified as stage T3. Both pulmonary bilobectomy and lobectomy combined with resection of proximal invaded lobe can be used as effective surgical therapies for trans-lobe type of lung adenocarcinoma.

Adhesins, Escherichia coli ; genetics ; Bacterial Typing Techniques ; Escherichia coli Proteins ; genetics ; Fimbriae Proteins ; genetics ; Genes, Bacterial ; Genotype ; Uropathogenic Escherichia coli ; classification ; genetics