The rates of chronic obstructive pulmonary disease ( COPD) and lung cancer morbidity in Xuanwei city of Yunnan province are among the highest nationwide , and COPD is an major risk factor for lung cancer .The concur-rence of COPD and lung cancer is a common disease .There are common causative environmental risk factors and pathogenic processes between the two diseases , which provides new ideas for the research , prevention and treatment of both diseases .Additionally the discussion of the relationship between COPD and lung cancer can provide refer -ences for further studies of both diseases .

OBJECTIVE To investigate the characteristic of multidrug resistant organisms(MDROs) in hospital or community-acquired infection,so that it can approach effective infection management.METHODS Patients infected by Staphylococcus,Enterococcus,Escherichia coli,Klpneumoniae and A.baumanni were investigated in a Hospital from June 2008 to May 2009.RESULTS Among total 929 strains of bacilli from patients,367 were MDROs infection,the detection rate of MDROs,CA-MDROs or HA-MDROs was 39.5%,35.6% and 51.4% respectioety infection;The detection rate of MDROs from HAI patients was significantly higher than that from CAI patients(?2=19.2 P=0.00).There were differences between HA-MDROs and CA-MDROs in different departments.MRSA,ESBLs-kp And PDR-AB were isolated mostly from sputum of patients,and ESBLs E.coli mostly from urine of CAI patients.CONCLUSIONS It is important to analyze the characteristic of HA-MDROs or CA-MDROs in the treatment of infection or use of antibiotics from experience.MDROs control is full of difficulties as a result of high CA-MDROs rates.

OBJECTIVE To analyze the effect of the disposable over-shoes for the control of nosocomial infection of the intensive care units(ICU). METHODS The effects of the disposable over-shoes for the environment contamination and nosocomial infection control of the surgical ICU were investigated. RESULTS The mean of air bacteria colony counts when disposable over-shoes were worn was lower than that when without their use by healthcare workers (P0.05). The rates of nosocomial infection beteen them were 21.5‰ and 17.1‰,respectively. CONCLUSIONS The use of disposable over-shoes can't improve the environment quality and is not benefit for the control of nosocomial infection of surgical ICU.

Objective:To compare the therapeutic effects between sequential therapy of external-internal fixation and internal fixation alone in the treatment of high-energy pilon fracture.Methods:A total of 61 patients with high-energy pilon fracture were enrolled by our team for this retrospective analysis who had been treated from January 2015 to July 2017. They received sequential therapy of external-internal fixation (the sequential group) or internal fixation alone (the internal group). In the sequential group of 26 cases, there were 19 males and 7 females (aged from 18 to 65 years), 4 cases of type C1, 8 cases of type C2 and 14 cases of type C3 by the OTA classification, and 7 cases of closed injury and 19 cases of open injury. In the internal group of 35 cases, there were 25 males and 10 females (aged from 19 to 64 years), 6 cases of type C1, 13 cases of type C2 and 16 cases of type C3 by the OTA classification, and 21 cases of closed injury and 14 cases of open injury. The 2 groups were compared in terms of postoperative infection, fracture reduction, fracture union time, nonunion, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, short form 36 health survey questionnaire (SF-36) and reduced range of motion between healthy and affected ankles.Results:There was no significant difference between the 2 groups in gender, age, fracture type, injury cause or follow-up time ( P>0.05), but a significant difference in soft tissue injury favoring the sequential group ( P=0.010). There were no significant differences between the 2 groups in postoperative infection rate [15.4% (4/26) versus 17.1% (6/35)], fracture reduction, fracture union time [(7.4±3.4) months versus (6.5±3.2) months], nonunion rate [7.7% (2/26) versus 8.6% (3/35)], AOFAS ankle-hindfoot score (71.7±29.4 versus 74.4±19.5), or SF-36 (83.1±9.9 versus 83.8±7.9) ( P>0.05). The reduced range of motion between healthy and affected ankles at 6 months postoperation in the sequential group (34.6°±7.2°) was significantly greater than that in the internal group (23.7°±5.1°) ( P<0.05), but there was no significant difference between the 2 groups in the reduced range of motion between healthy and affected ankles at 2 years postoperation (26.0°±11.1° versus 21.8°±11.3°) ( P>0.05). Conclusion:Although both sequential therapy of external-internal fixation and internal fixation alone can lead to fine clinical efficacy in the treatment of high-energy pilon fracture, the former may be more suitable for the patients with severe soft tissue injury.

Animals ; Animals, Newborn ; Astragalus Plant ; Doxorubicin ; adverse effects ; Drugs, Chinese Herbal ; pharmacology ; Mice ; Mice, Inbred BALB C ; Myocardium ; pathology ; ultrastructure

Objective To prepare the 99Tcm-labeled human epidermal growth factor receptor type 2 (HER2) affibody molecule ZHER2:342 and evaluate its receptor binding specificity in vitro.Methods The molecular ZHERa:342 was labeled with 99Tcm using the ligand exchange method.The labeling efficiency and radiochemical purity were measured by HPLC.The major factors,such as the mass of SnC12 and NaOH and reaction time were analyzed,and the optimal method was summarized.Cell binding kinetics and cellular retention of the probe were investigated in HER2-expressing SKOV-3 cells and MDA-MB-231 cells with low HER2 expression respectively.HER2 binding specificity of 99Tcm-ZHER2:342 was analyzed by a pre-injection of excess unlabeled ZHER2:342 to saturate HER2 receptors.One-way analysis of variance and two-sample t test were used.Results The optimal labeling procedure was as follows:5 μg (1 g/L) of ZHER2:342 was mixed with 5 μg of NaOH (1 g/L),then 8.8 μg SnC12(1 g/L,solution) was added,followed by 150 μl (37 MBq) 99TcmO4-solution,and finally the mixture was slightly vortexed and incubated for 1 h at room temperature.99TcmZHER2:342 was stable in vitro with a high labeling efficiency of (98.10± 1.73)％.The radiochemical purity was ＞ 98％,and was more than 85％ after the incubation for 24 h in saline and fresh human serum.The cell binding of 99Tcm-ZHER2:342 with HER2-expressing SKOV-3 cells gradually increased over time with a peak of (9.95± 1.02)％ at 6 h.The binding of 99Tcm-ZHER2:342 in SKOV-3 cells was significantly higher than that in MDA-MB-231 cells at every time point (5.68-9.88 vs 0.56-2.11 ; t:from-34.50 to-13.14,all P＜0.01).The labeled molecular probe retained the capacity to bind specifically to HER2-expressing SKOV-3 cells since the cell binding decreased from (9.95 ± 1.02) ％ to (2.11 ±0.27) ％ after receptor saturation (t =-13.14,P＜0.01).Conclusions 99Tcm-ZHER2:342 has a high labeling efficiency,good stability and optimal binding specificity.These characteristics enable it to be a promising molecular probe for HER2-targeting imaging.

Glutathione S-transferase (GST) gene, PcgstA was cloned from the penicillin producing strain Penicillium chrysogenum,which is important for understanding the industrial fermentation process. PcgstA gene has an open-reading-frame of 840 bp in length,which is interrupted by two introns. The deduced amino acid sequence shows about 50% identity to several characterized filamentous fungi GSTs. The recombinant PcGSTA in Escherichia coli were overexpressed and purified. Enzymatic assays showed that the recombinant PcGSTA had a specific activity with 1-chloro-2, 4-dinitrobenzene of (0.159±0.031) μmol/(min· mg). It was found that the expression level of PcgstA in the penicillin producing medium supplemented with phenylacetic acid, the side chain precursor of penicillin G, was significant down regulated than that in medium without phenylacetic acid. This result suggested that PcGST may be related to phenylacetic acid metabolism in the penicillin producing strain.

BACKGROUND:Clinical trials have shown that oral administration of valsartan can decrease in-stent restenosis after stent implantation.But whether valsartan used locally also has the sanle effect and the possible mechanism should be validated.OBJECTIVE:To observe the effect of valsartan-eluting stents on collagen deposition in neointima and AT2 receptor expression after implanting valsartan-eluting stents into rabbit abdominal orta.DESIGN:Randomized and controlled animal experiment.SETTING:Beijing Friendship Hospital.MATERIALS:The experiment was performed at the Laboratory of Beijing Friendship Hospital between October 2004 and March 2006.Fifteen New Zealand white rabbits,irrespective of gender,weighing 2.75-3.25 kg were selected(Animal Laboratory of Beijing Friendship Hospital).The rabbits were adaptively fed for one week.All the operations of rabbits during the experiment were accorded with animal ethical standards.Valsartan powder was presented as a gift by Novartis.China;Reagent of MASSON was provided by Department of Pathology of Beijing Friendship Hospital;1%picrosirius solution was provided by the Department of Pathology of China-Japan Friendship Hospital:Mice-anti-rabbit monoclonal AT2 antibody was product of Santa Cruz Biotechnology (USA);Envision reagent was purphased from Dako;primers were synthesized by SBS Genetech(SBS).METHODS:①The animals were randomized into bare-metal stent group,carrier-eluting stent group and valsartan-eluting stent group with 5 animals in each group.All rabbits were implanted with corresponding types of above-mentioned stents into abdominal aortas down below renal artery.②Quantitative angiography before,immediately after and 3 months after stent implantation were performed to compare vascular diameters of the aortas.③Three months Iater,the rabbits were executed after anaesthesia.The vessels with stents were processed with HE staining.Indices of the vascular neointimal formation,I.e. iBrier and external elastic membrane luminal area,the maximal intimal thickness,neointimal area and stenosis area percent were measured.④The collagen deposition in neointima was observed through MASSON staining,and the type of collagen was identified through picrosirius stain.⑤The expressions of AT2R mRNA and proteins were also compared by RT-PCR and immunohistochemistry among three groups.MAIN OUTCOME MEASURES:①The diameters of aorta with stent at different time;②Inner and extemal elastic membrane luminal area,the maximal intimal thickness,neointimal area and stenosis area percent;③Collagen deposition and type of collagen of the aorta with stent;④AT2R mRNA and protein expressions.RESULTS:Of 15 rabbits selected in the experiment,1 rabbit of the bare-metal stent group died during stent implanting,and 1 of the carrier-eluting stent group died during breeding after stenting.Finally,13 rabbits were included in final analysis.①There were no significant differences in the mean aortic diameters between any two of the three groups before,immediately after and 3 months after stent implantation(P＞0.05).②A larger 1uminal area and a less neointimal hyperplasia in valsartan eluting-stents group were found compared with the other two groups(P＜0.01).③MASSON staining showed that collagen deposition was rich in neointima of bare-metal stent group and carrier-eluting stent group while rare in neointima of valsartan eluting stent group.Pierosirius staining suggested that the deposited collagen was type Ⅲ collagen predominantly accompanied by type Ⅰ collagen around stents struts;the type Ⅲcollagen deposition was obviously decreased in valsartan eluting stent group.④AT2R protein only expressed in adventitia of bare-metal stet group and arrier-eluting stent group while expressed in all layers of valsartan eluting-stents group.The AT2R mRNA/a-Actin mRNA of valsartan eluting stent group was significantly higher than that in the other two groups(P＜0.01).CONCLUSION:Valsartan eluting-stents inhibits neointimal hyperplasia after stenting by decreasing collagen deposition.especially collagen Ⅲ.The mechanism may be related with the upregulation of AT2R mRNA and protein expressions by valsartan-eluting stent.

Here we reported a research project based on Black-board to integrate medical curriculum .The key points of this research is application of clinical cases as teaching data and facilitate learning of knowledge following the principle of learning by doing and , input the concept of precision medicine and informatics in learning process with an individually designed framework of learning .The learning outcome is evaluated with big data tech-nology and thus creates a student-centered pathway of medical education .

BACKGROUND:Acel ular dermal matrix has good biocompatibility and absorbability and exhibits superiority in the guided bone regeneration. OBJECTIVE:To compare the histological changes and osteogenic effects in bone defects after guided bone regeneration with acel ular dermal matrix and Bio-Gide membrane. METHODS:Mandibular second, third and fourth premolars and the first molars bilateral y were extracted from 12 beagle dogs. Three months later, four three-wal bone defect models in the mandible of each dog were made, and randomized into acel ular dermal matrix plus bone graft group (acel ular dermal matrix group), Bio-Gide plus bone graft group (Bio-Gide group), bone graft group, and blank control group (no treatment). In the former two groups, acel ular dermal matrix and Bio-Gide were used to cover the bone grafts, respectively. RESULTS AND CONCLUSION:After surgery, al the beagle dogs recovered wel . Al the groups except the control group showed dramatical improvement in histological changes and percentage of new bone area, and this improvement was more significant in the Bio-Gide and acel ular dermal matrix groups. Moreover, there was no significant difference between the Bio-Gide and acel ular dermal matrix groups. Therefore, the acel ular dermal matrix can be a candidate for bone repair instead of Bio-Gide membrane in the clinical practice.