OBJECTIVETo study the epidemiology of Acinetobacter baumannii infection in patients with ventilator-associated pneumonia (VAP).

METHODSProspective clinical study was carried out with 176 episodes of VAP with etiologic diagnosis being followed in two groups.

RESULTSTwenty-six episodes were caused by Acinetobacter baumannii and one hundred-fifty episodes were caused by "other" organisms. Using logistic regression analysis, the risk of VAP due to Acinetobacter baumannii was found to be high in patients with head trauma [odds ratio (OR) = 4.20, 95% confidence interva (CI): 2.72 to 6.48], surgery (OR = 2.88, 95% CI: 1.78 to 4.66), acute respiratory dispnea syndrome (OR = 2.81, 95% CI: 1.19 to 6.64), and large-volume pulmonary aspiration (OR = 6.71, 95% CI: 3.91 to 11.50).

CONCLUSIONSAcinetobacter baumannii pulmonary infection in incubated patients had an epidemiological pattern that different from "other" organisms. Patients with high risk identified in our study might mark the existence of cross-infection during airway manipulation.

Acinetobacter ; classification ; isolation & purification ; Acinetobacter Infections ; epidemiology ; etiology ; Aged ; Aged, 80 and over ; China ; epidemiology ; Cross Infection ; epidemiology ; etiology ; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Male ; Middle Aged ; Pneumonia, Bacterial ; etiology ; microbiology ; Prospective Studies ; Respiration, Artificial ; adverse effects ; Respiratory Distress Syndrome, Adult ; complications ; Risk Factors ; Time Factors ; Ventilators, Mechanical ; adverse effects

From a view point of an anesthesiologist, the article points out some design issues of modern monitors and anesthesia machines. User interface problems such as auto-adjusted amplitude display, excessively complicated menus, unreasonable switch arrangement, unsuitable alarm settings or identical cylinder connectors, may affect patient safety and increase anesthesiologists' workload or mental burden.
Anesthesiology ; instrumentation ; Equipment Design ; Monitoring, Intraoperative ; instrumentation ; Safety

Apoptosis ; Down-Regulation ; Electron Transport Complex IV ; chemistry ; genetics ; metabolism ; Humans ; Mitochondria ; metabolism ; Mutation ; Neoplasms ; genetics ; metabolism ; pathology

Objective To analyze the diagnostic value of 4 serum autoantibodies in nasopharyngeal carcinoma patients (anti-Rho-GDI-2, -HSP70, -CK19 and -LAP3 antibodies) using a serological proteomic approach. Methods The conditions for blocking, antigen concentrations and serum dilution were optimized to establish the ELISA method for detection of serum autoantibodies for Rho-GDI-2, HSP70, CK19 and LAP3. The serum concentrations of these autoantibodies were detected by the established method in 36 NPC patients, 20 other cancer patients and 20 healthy individuals. The statistical analysis was used to evaluate the diagnostic value of the 4 serum autoantibodies. Results The concentrations of 4 serum autoantibodies in the NPC patients were significantly higher than those in the healthy individuals(A450 values in NPC group of CK19, Rho-GDI-2, HSP70, LAP3 were 0. 188 8 ±0.047 3, 0.240 5 ± 0.024 7, 0. 116 8 ±0.025 3, 0.276 9 ±0.044 2 repectively. A450 values in healthy control group were 0.010 5 ±0.004 4, 0. 105 3 ±0. 016 9, 0. 098 6 ± 0. 014 0, 0. 149 8 ± 0. 033 1 respectively. F values were 4. 869, 15. 919, 10. 331,6. 369, respectively. P values were 0. 010, 0. 000, 0. 000, 0. 003, respectively). The sensitivities of antiRho-GDI-2, anti-HSP70, anti -CK19 and anti -LAP3 autoantibodies for diagnosis of NPC was 85.0%,75.0%, 75.0% and 75.0%, respectively, and the specificities were 58.9%, 80. 4%, 58. 9% and 57. 1%, respectively, anti-Rho-GDI-2 and anti-HSP70 achived the highest sensitivity and specificity respectively when single marker was analyzed. The sensitivity and specificity were 94. 4% and 95. 0%respectively when 4 markers was combined for analysis. Conclusion Detection of serum anti-Rbo-GDI-2,anti-HSP70, anti-CK19 and anti-IAP3 auotantibedios by ELISA may be of help in the screening and diagnosis for NPC.

Objective To systematically evaluate the application of problem-based learning (PBL)in the teaching process of health management major in China.Methods Databases including CNKI (1979 to December the 2015),VIP (1989 to December the 2015),Wanfang (1982 to December the 2015) and PubMed were systematically retrieved.Any literature about PBL of health management major was included.Seffdeveloped data extraction form was used for collecting the information.Data were input and analyzed using Excel 2007.Results 15 papers were included in the analysis.The first author mainly came from the northeast region of China (7).Most (10) papers did not get the funding support.No paper was published in the journals contained in the Guide to the Core Journals of China.6 papers of experimental studies compared the performance difference of students of the PBL and lecture-based learning (LBL),which was statistically significant.Conclusion PBL is superior to the LBL.However,due to the large difference in the quality of literature,more studies were needed to determine the effect of PBL.Moreover,we should pay attention to the combination of PBL and LBL.

Objective To analyze the effectiveness of antithymocyte globulin(ATG) combined with cyclosporin(CSA)in treatment of pediatric severe aplastic anemia(SAA).Methods Seven children with SAA were treated with ATG and CSA,ATG 4-5 mg/(kg?d),5 days,methyprednisone 2-3 mg/(kg?d) to reduce anaphylaxis,CSA 3-5 mg/(kg?d),assisting with transfusion and G-CSF.Results The complete remission rate was 28.57%(2/7),the partial remission rate was 14.29%(1/7),and the obvious improvement rate was 28.57%(2/7),1 child died.The overall response rate was 71.43%.Transfusion volumes in 4 to 6 months post treatment decreased obviously comparing to the first 3 months(P

Objective To investigate HR-MR imaging characteristics of non-Hodgkin lymphomas (NHL) of the orbits in extraconal compartment. Methods The HR-MR images of 16 patients with NHL of the orbits identified pathologically were retrospectively analyzed. MRI of the orbit at a 1.5 T scanner was performed with 4-cm surface coil, thin slice, suitable bandwidth, small FOV, and large matrix. T1-weighted (before and after i.v. bolus injection of contrast medium) and fast spin-echo T2-weighted sequences were acquired in all patients. All cases were performed with fat suppression techniques. The analyzed criteria of imaging appearance included location, number, size, shape, margins, extension, adjacent structures, and signal intensity of the lesions. Results The lesions in 13 of 16 cases located in anterior part of extraconal compartment, posterior to the orbital septum, and with irregular cast shape. The other 3 patients showed diffuse lesions with infiltration in extraconal compartment and with irregular shape. Eleven lesions had the large volume above 3.0 ml, 4 lesions with medium volume ranging from 1.0 to 3.0 ml, and only one with small volume less than 1.0 ml. 13 cases had a poor-defined margin with infiltration of extraocular muscles, but without mechanical shift of the muscles. 7 patients had infiltration of eyeball, but only 3 cases with exophthalmos. Destruction of orbital bone was evident in 2 cases with diffuse lesions but never in isolated orbital lymphoma. On the T_1-weighted images, the signal intensity of the lymphoma was isointense compared with that of the muscle in all patients. The T_2-weighted fast SE images showed a hyperintense signal in 13 cases and intermediate in 3 cases. All lesions enhanced after intravenous Gd-DTPA administration, 15 cases with homogeneous enhancement, and 10 cases with reliably visible enhancement in the T_1-weighted fat-suppressed sequences. Conclusion Most NHL of the orbits in extraconal compartment have the characteristic findings on HR-MR imaging, including anterior part of extraconal compartment location, posterior to the orbital septum, irregular cast shape, large volume, poor-defined margin with infiltration but without mechanical shift of extraocular muscles, uniform signal characteristics and marked enhancement after injection of contrast medium, and without bony destruction in isolated orbital lymphoma. The understanding of HR-MRI features of orbital NHL in extraconal compartment is very useful for making the differential diagnosis with other orbital diseases.

Objective : Objective To investigate the demand for health management and influencing factors among occupational population at high risk of stroke, so as to provide insights into the development of stroke health management strategies among occupational population. Methods: Occupational population aged 40 to 60 years who participated in health examination were sampled from three tertiary hospitals in Luzhou City, Sichuan Province using a quota sampling method in the ratio of 4∶1∶1, from August to December 2020. Participants' blood biochemistry tests and health examination were collected through the examination reports, and the participants at high risk of stroke were screened using the assessment criteria for high-risk of stroke. Participants' general information and demand for health management were collected using questionnaire surveys. In addition, factors affecting the demand for health management were identified using a multivariable logistic regression model. Results: A total of 3 003 people who participated in health examination were investigated, and 1 062 participants met the assessment criteria for high risk of stroke, accounting for 35.36%. There were 1 000 men (94.16%) and 62 women (5.84%), with a mean age of (49.26±4.97) years. There were 414 professional and technical staff (39.50%). There were 709 participants (66.76%) with demand for health management, with the top three in the demand as health checkups (915 participants, accounting for 86.16%), health consultation (601 participants, accounting for 56.60%) and exercise guidance (560 participants, accounting for 52.73%), and 210 participants (19.77%) received health management. Multivariable logistic regression analysis showed that occupational population at high risk of stroke who received health management were more likely to have the demand for health management (OR=2.158, 95%CI: 1.479-3.149). Conclusions The occupational population at high risk of stroke have the demand for health management. Having received health management may affect the demand for health management among occupational population at high risk of stroke.

Maturity onset diabetes of the young (MODY) is a monogenic autosomal dominant inherited disease. Its clinical manifestations are asymptomatic with slightly elevated fasting blood glucose and few complications. This paper reports a novel mutation W257R in glucokinase () gene from a Chinese patient with MODY. Heterozygous mutation c.769T>C (p.W257R) in exon 7 of gene (Chr744187343) was found in the proband, her father and brother. This W257R mutation was first reported in Chinese population.
China ; Diabetes Mellitus, Type 2 ; genetics ; Female ; Glucokinase ; genetics ; Humans ; Male ; Mutation ; Pedigree

OBJECTIVETo construct a recombinant bacillus Calmette-Guérin vaccine (rBCG) secreting human interferon-alpha 2b (IFN alpha-2b).

METHODSBCG Ag85B signal sequence and IFN alpha-2b gene were amplified from the genome of BCG and of human peripheral blood by polymerase chain reaction (PCR), respectively. IFN alpha-2b gene was cloned in E. coli-BCG shuttle-vector pMV261 to get pMV261-IFN alpha-2b. A new recombinant plasmid pMV261-IFN alpha-2b was constructed by inserting BCG Ag85B signal sequence into pMV261-Ag85B-IFN alpha-2b. Then, BCG was transformed with this recombinant plasmid by electroporation, and designated as rBCG-IFN alpha-2b. The DNA and protein expressions of IFN alpha-2b gene in rBCG were determined by PCR and Western blot respectively. Also the quantity of IFN alpha-2b protein secreted by rBCG in culture supernatants was determined by enzyme linked immunosorbent assay (ELISA).

RESULTSBy partial nucleotide sequencing, the DNA sequences of human IFN alpha-2b and BCG Ag85B were consistent with that in the Gene Bank, and were correctly inserted into the shuttle expression vector pMV261 to construct recombinant plasmid pMV261-Ag85B-IFN alpha-2b. BCG was successfully transformed with this recombinant plasmid by electroporation and the recombinant BCG (rBCG-IFN alpha-2b) was capable of synthesizing and secreting cytokine IFN alpha-2b. The concentration of IFN alpha-2b in culture supernatants was quantified by ELISA and calculated to be approximately 301.45 pg/ml.

CONCLUSIONSRecombinant BCG secreting human IFN alpha-2b (rBCG-IFN alpha-2b) was constructed successfully and the specific IFN alpha-2b protein can be expressed highly and steadily by rBCG vaccine.

BCG Vaccine ; genetics ; immunology ; metabolism ; Gene Expression ; Genetic Vectors ; Humans ; Interferon-alpha ; genetics ; metabolism ; Plasmids ; genetics ; Recombinant Proteins ; Transformation, Bacterial