Objective To analyze risk factors of nosocomial pneumonias due to ESBL-producing Klebsiella pneumoniae.Methods From July 2001 to December 2004,38 patients with ESBL-producing K. pneumoniae and 63 patients with non-ESBL-producing K. pneumoniae were enrolled. ESBL-producing strains were detected by confirmed test.Results Hospital duration,ICU stay,tracheal intubation or tracheotomy,indwelling catheters,mechanical ventilation and use of cefotaxime were found to be risk factors in the acquisition of K. pneumoniae with ESBLs by univariate analysis. Cefotaxime use remained as risk factors by multivariate analysis with logistic regression. Conclusion The reasonable use of cefotaxime is an important measure to control the prevalence of ESBLs-producing strains of Klebsiella pneumoniae.

Kushenhuangqi Injection is made from Chinese herb medicine flavescent sophora and astragalns roots.Seventy-one patients with malignant pleural effusion were randomly divided into two groups: 36 patients were treated with both intrathoracic Kushenhuangqi Injection and chemotherapeutic agent cisplatin (treatment group) and 35 patients were treated with cisplatin alone.The response rate of treatment group was significantly higher than that of control group (31/36 vs 20/35,u=3.020,P<0.01).The rate of adverse reaction (leucopenia,nausea,vomiting etc.) in treatment group was significantly lower that that of control group.The results indicate that Kushenhuangqi Injection can enhance the therapeutic effect of chemotherapeutic agent and reduce its adverse reaction in treatment 0f malignant pleural effusion caused by carcinoma of the lungs.

Objective To explore the role of intercellular adhesion molecule-1(ICAM-1) in the metastasis of lung cancer.Methods The expression of ICAM-1 in the tissue and the serum ICAM-1(sICAM-1) level in the 52 cases of primary lung cancer were detected with immunohistochemical staining method(SP) and enzyme linked immunosorbent assay(ELISA),with 20 cases of adjacent non-cancerous tissue as the control.Results The positive rate of ICAM-1 expression in lung cancer was significantly higher than that of adjacent non-cancerous tissue.The expression of ICAM-1 in the cases with lymph node metastasis was higher than that of no lymph node metastasis.The expression of ICAM-1 in stage III+IV was higher than that of stage I+II,and that in adenocarcinoma was higher than that of squamous cell carcinoma.The level of sICAM-1 in patients with lymph node metastasis was higher than that without lymph node metastasis.The sICAM-1 level in patients of adenocarcinoma was higher than that of squamous cell carcinoma,and that in patients with positive expression of ICAM-1 in tissue was higher than that of negative expression of ICAM-1.Conclusion The expression of ICAM-1 may be associated with the metastasis in lung cancer.The sICAM-1 level reflects the expression of ICAM-1 in tissue and may be used as a tumor marker of metastasis and prognosis in lung cancer.

Object To report the one arm external fixator with skeletal traction of calcanus in treatment of comminuted fractures of tibia and fibula. Method 186 cases of fractures of tibia and fibula were treated by the one arm external fixator with skeletal traction of calcaneus. 42 cases were open fractures, and 142 cases were closed fractures.185 cases were followed up. Results 183 cases of fracture united, and the average healing time was 6 months. By Johner Wrichs score 113 were rated as excellent, 69 good, 2 poor. The infection rate was 17.5%. Conclusion It is convenient and effective to use one arm external fixator with skeletal traction of calcaneus to treat comminuted tibia and fibula fractures.

AIM: To investigate the effect of hypoxia on the invasion and migration of lung carcinoma cells. METHODS: Lung carcinoma cell H128 was exposed to normoxia (air, 5% CO 2), hypoxia (5% O 2,5% CO 2,90% N 2) or anoxia (95% N 2,5% CO 2) conditions for 48 hours. The migration ability of the cells was assayed by wound healing methods. The invasiveness ability was determined with HABM-HEM model. The cells exposed to hypoxia were inoculated under skin in nude mice, and then the growth of the tumor and the rate of metastasis to lymph node or lung were observed. The expression of E-cadherin and ?1-integrin on the cells were also assayed by flow cytometry. RESULTS: Compared with normoxic group, the invasiveness and migration in hypoxic group were increased. The rates of tumorgenesis and metastasis to lung in anoxic group were evidently decreased. The expression of E-cadherin was decreased, and the expression of ?1-integrin was increased in hypoxic group. In anoxia group, the invasiveness, migration, the expression of E-cadherin and ?1-integrin were all decreased. CONCLUSIONS: Moderate hypoxia down-regulated the expression of E-cadherin, up-regulated the expression of ?1-integrin, and increased the invasiveness and metastasis of carcinoma cells. Serious hypoxia decreased the expression of adhesive molecules, and the proliferation, invasiveness and migration were also decreased.

Objective To determine the nutrients contents in muscle of Culter erythropterus and evaluate its nutritive value. Method The nutrients composition was analysed by general method. Results The contents of moisture, crude protein, total fat, total sugar and ash were 78.29%, 18.31%, 0.97%, 1.18% and 1.17%, respectively. The total amount of AA, EAA, NEAA and FTAA was 71.93%, 31.61%, 40.32% and 25.57%, respectively. 26 kinds of FA were identified. There were 6 kinds of SFA, 20 kinds of UFA. The contents of SFA, MUFA and PUFA were 26.26%, 29.61% and 39.91%, respectively. The contents of DG, TG, FFA, Cho and PL were 3.69%, 11.71%, 23.60%, 0.54% and 60.46%, respectively. Conclusion The crude protein and PUFA were high in muscle of Culter erythropterus. It was beneficial for health to eat it regularly.

Objective To evaluate the effects of curcumin on the activity of NR2B and NR1 in the spinal dorsal horn in a rat model of diabetic neuropathic pain (DNP).Methods Diabetes mellitus was induced by high-sucrose and high-fat diet and intraperitoneal streptozotocin 35 mg/kg,then confirmed by fasting blood glucose level ≥ 16.7 mmol/L 3 days later in male Sprague-Dawley rats.DNP was confirmed by the mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) measured on day 14 after streptozotocin administration ＜ 80％ of the baseline value.The rats were then randomly divided into 3 groups (n =27 each) using a random number table:DNP,DNP+ curcumin group (group DCur)and DNP + solvent control group (group DSC).Curcumin 100 mg· kg-1 · d-1 and corn oil 4 ml· kg-1 · d-1 were injected intraperitoneally for 14 consecutive days starting from 14 days after administration of streptozotocin in DCur and DSC groups,respectively.Another 27 normal male Sprague-Dawley rats served as control group (group C) and were fed with normal forage.At 3,7 and 14 days after curcumin injection,MWT and TWL were measured and the lumbar segments (L4-6) of the spinal cord were removed.The expression of pTyr1472-NR2B and pSer896-NR1 in the spinal dorsal horn was determined by immunohistochemistry and Western blot.Results Compared with group C,MWT was significantly decreased,TWL was shortened,and the expression of pTyr1472-NR2B was up-regulated at each time point in group DNP.Compared with group DNP,MWT was significantly increased,and TWL was prolonged at 7 days after curcumin injection,and the expression of pTyr1472-NR2B was down-regulated at 3 days after curcumin injection in group DCur.There was no significant difference in each parameter between DNP and DSC groups,and in the expression of pSer896-NR1 between the four groups.Conclusion The mechanism by which curcumin mitigates neuropathic pain in type 2 diabetic rats may be related to inhibition of up-regulation of pTyr1472-NR2B expression,while unrelated to pSer896-NR1 expression in the spinal dorsal horn.

BACKGROUND: The different level of proteins regulating cell cycle and theircorrelation is the main criteria to differentiate the benign and malignant cellular proliferation.OBJECTIVE: To investigate the expression status of p21waf1 and p53 in lung cancer as well as proliferating cell nuclear antigen (PCNA)DESIGN:A case-control study.SETTING: Department of Respiratory Medicine, Renmin Hospital ,Wuhan UniversityPAITICIPANTS:This case-control study involved 135 patients who underwent lobectomy or fiberoptic bronchoscopy for primary lung cancer or benign chronic pulmonary diseases at Renmin Hospital of Wuhan University from October 1996 through May 1999. They were divided into two groups: lung cancer group (76 patients, including 56 men and 20 women,aged 18-74 years of age) and chronic pulmonary diseases group (59 cases,including 42 men and 17 women, aged 16-70 years of age).METHODS: Phosphate buffer solution replaced the first antibody as the negative control. Immunohistochemistry was performed using a modified streptavidin-biotinylated peroxidase technique according to the manufacturer's recommendations (Maxim Corporation). For p21waf1 staining, we used hydrated autoclaving as a pretreatment. Antigen retrieval was performed in a standard microwave unit for p53 staining. PCNA staining did not need The ratio of the positive cells indicated by yellowish brown nucleus due to staining was counted for 5 successive high-fold microscopic fields: when it was≥ 10%, it was taken as positive; when it was ＜10%, it was regarded as high-fold microscopic fields for the percentage of the positive cells indicated by yellowish brown nucleus due to staining in each field, and the average value of the five fields was taken as labeling index (LI) for proliferated nuclear antigens.MAIN OUTCOME MEASURES: The expression leyels of p21waf1, p53and PCNA in lung cancer.cancer were 75% (57/76) and 47%(36/76) respectively. The labeling index of PCNA in lung cancer group was significantly higher than that of the chronic pulmonary diseases group (0.44±0.32 vs 0.09±0.14, respectively).significantly higher than that of small cell lung cancer (0.51 ±0.33 vs in lung cancer tissues. In chronic pulmonary diseases group, the expression of p21waf1 and p53 showed a close relationship with PCNA.CONCLUSION: It was found that p21waf1 and p53 were obviously upregulated in lung cancer and the degree of cellular proliferation in lung cancer was rather high. The capacity of DNA damage repair in squamous lung cancer may be stronger than that in small cell lung cancer.

Objective To explore the value of combining pulmonary rehabilitation with heat and magnetic vibration (HMV) therapy and tiotropium for patients with stable but severe chronic obstructive pulmonary disease (COPD). Methods This was a paralleled, controlled, randomized study. Thirty-seven patients with stable severe COPD were enrolled and divided into two groups at random. One was the tiotropium group (T group) , while the other combined tiotropium therapy with HMV (the T + HMV group). The time span was 4 weeks. The examinations were performed at week 0, week 2 and week 4. The examinations included pulmonary function tests, arterial blood gas analysis, the 6 minute walking test (6MWT) , Borg's score and St George's Respiratory Questionaire (SGRQ). Results Inspiratory capacity (IC) increased in both groups. Forced expiratory volume in one second ( FEV1.0) , percent predicted FEV1.0 and FEV1.0/forced vital capacity ( FVC) increased significantly only in the T + HMV group. The average parameters of the pulmonary function test in the T + HMV group were significantly higher than in the T group. In both groups, alveolar PO2 ( PaO2) improved but alveolar PCO2 ( PaCO2 ) did not change and in this there was no significant difference between the groups. The 6 minute walking distance increased and the average Borg score decreased in both groups, and there was no difference between the groups. SCRQ dropped more than 4 scores in both groups, but the decrease in the T + HMV group was significantly greater. Conclusions Tiotropium can play an important role in the rehabilitation of patients with stable severe COPD. The combination of tiotropium with HMV therapy is superior to tiotropium alone in pulmonary rehabilitation for stable but severe COPD patients.

Objective To explore the effects of different initial treatment protocols on the prognosis of pneumonia in the kidney transplant recipients. Methods Sixty-seven cases of pneumonia following kidney transplantation were divided into case group (34 cases) and control group (33 cases).The patients in case group were treated with Imipenem and Cilastatin, SMX/TMP and ganciclovir,and those in control group received routine treatments. Mortality and length of stay in hospital (LOS)were analyzed. Results Mortality (5.9 % ) and LOS (15 days) in case group were reduced as compared with those in control group ( 18. 2 %, 23 days, respectively) (P＜ 0. 05). Among the patients without severe pneumonia, the mortality and incidence of LOS beyond 21 days in case group (3. 4 %, 1/29; 3. 4 %, 1/29) were lower than those in control group (17. 2 %, 5/29; 37. 9 %, 11/29, respectively) (P＜0. 05). Whether the patients were admitted to hospital sooner or later, the incidence of LOS beyond 21 days in case group was lower than that in control group (P＜0. 05).Whether the etiologies were determined or undetermined, the incidence of LOS beyond 21 days in case group was lower than that in control group (P＜0. 05). The incidence of LOS beyond 21 days in case group was lower than that in control group among the patients with cardiopulmonary disease (P＜0. 05). Conclusion The initial appropriate treatment would improve the prognosis of pneumonia in the kidney transplant recipients.