Objective To explore the value of diagnostic and differential diagnostic with the Neutrophil‐lymphocyte count ratio (NLCR) and C‐reactive protein cmmunity‐acquired pneumonia(CAP) .Methods The NLCR ,as well as white blood cell counts , neutrophil count ,lymphocyte count and the concentration of CRP were measured in 40 patients with bacterial pneumonia ,40 pa‐tients with mycoplasma pneumonia ,40 patients with viral pneumonia and 40 healthy subjects ,and the results was analyzed by statis‐tical methods .Results In bacterial group ,the NLCR and the concentration of CRP were significantly higher than those in myco‐plasma group ,viral group and normal controls(P<0 .05) .According to the results of ROC curve analysis in the diagnosis of bacte‐rial CAP ,the areas of NLCR and CRP under ROC curve are 0 .911 and 0 .896 ,respectively ,which have good diagnostic sensitivity and specificity .Conclusion The NLCR and CRP in peripheral blood have great significance in diagnosis and differential diagnosis of bacterial community‐acquired pneumonia .

OBJECTIVE To investigate the bacteriologic feature and the spectrum of drug resistance in lung cancer patients who got nosocomial nonfermenters bacteria infection,and to conclude the experience and how to prevent and control the nosocomial infection.METHODS A rectrospective analysis of the composition of the pathogens,the feature of drug resistance and the prognosis of 109 lung cancer inpatients with nosocomial infection was made.RESULTS Nosocomial nonfermenters bacteria infections were most happened in hospital lung cancer patients.Main strains included Pseudomonas aeruginosa 55(49.5%),Acinetobacter baumannii 23(20.7%),and Stenotrophomonas maltophilia 8(7.2%).The sensitive rate of P.aeruginosa to imipenem was 100%,but to Cotrimoxazole,the resistant rate was 100%.The sensitive rate was relatively high to ticarcillin,piperacillin and their compounds.The antimicrobial resistance rate of A.baumannii was higher than P.aeruginosa.Stenotrophomonas were resistant to most antibiotics,and the resistance rate to imipenem was 100.0%.CONCLUSIONS The resistance rate of nosocomial nonfermenters bacteria infection is high.The treatment is difficult and the prognosis is bad.The mortality of multiple infection is high.

Objective To discuss the psychological behavior intervention methods on reducing the violence behavior of schizophrenia patients. Methods 120 schizophrenia patients were admitted from January to December, 2007 and randomly assigned into the behavior intervention group (group A), the psy-chological support group (group B), the health education group (group C) and the control group (group D) with 30 cases in each group. Group A received routine nursing plus behavior intervention, group B was giv-en routine nursing plus psychological support, group C adopted routine nursing plus health education, group D only received routine nursing. The intervention effect was evaluated with MOAS and the relapse rate of violence behavior went through statistics. Results After intervention, the scores of MOAS decreased sig-nificantly in group A, B, C and D compared with those before intervention. The reduction of MOAS scores in group A, B and C was significantly higher than that of group D, with the highest reduction score in group A and group B and C followed subsequently. The relapse rates of the violence behavior in group A, B and C were significantly lower than those of group D. Conclusions Routine nursing, health education, psycho-logical support and behavior intervention can all reduce and decrease the violence behavior and the inci-dence of the violence behavior, among which behavior intervention proves to be the most effective, and psy-chological support and health education go subsequently.

[Abstract ] Objective To understand the identification and in vitro antifungal susceptibility of Penicillium marneffei(PM)in yeast phase,and guide clinic antifungal application.Methods Strains isolated from blood and bone marrow of 23 patients infected with PM in a hospital between 2009 and 2016 were collected,colony morpholo-gy of PM in yeast phase was observed,susceptibility to itraconazole,voriconazole,amphotericin B,and fluconazole were detected with E-test method.Results Colony morphology of PM were as follows:direct microscopic examina-tion of Wright’s staining of tissue specimens found visible oval or round spore with apparent septum,and mainly lo-cated in macrophage;Gram staining of blood culture specimens found that strains were with bulbous and slightly curved ends,occasionally branched and with septum. PM was dimorphic fungi,presented mycelium at 28° C,pro-duced red pigment and diffused into medium;PM presented yeast form at 35° C,there were typical colony morpholo-gy. Minimum inhibitory concentrations (MICs)of itraconazole,voriconazole,amphotericin B,and fluconazole to PM in yeast phase were 0.002-0.016,0.012-0.125,0.002-0.500,and 0.500-16.000μg/mL respectively. Conclusion Typical colony morphology and fungal spore of PM in bone marrow and peripheral blood are important features for identification. PM is most susceptible to itraconazole,followed by voriconazole and amphotericin B, while fluconazole is less susceptible.

Objective To investigate the the efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in the treatment of acute non-ST-segment elevation myocardial infarction patients with heart failure.Methods 80 patients with heart failure caused by acute non-ST-segment elevation myocardial infarction were chosen,they were divided into the observation group and control group based on a random number table,each group included 40 patients.The observation group were treated with intravenous injection of recombinant human brain natriuretic peptide,the control group were treated with intravenous nitroglycerin.vital signs,dyspnea,brain natriuretic peptide (BNP),associated hemodynamic changes and adverse reactions of two groups were compared before and after treatment.Results The total effective rate in observation group was 87.5％ (35/40),which were significantly higher than 50.0％ (20/40) of the control group,there were significant difference (x2 =13.09,P ＜ 0.05).In the observation group,after treatment,the left ventricular ejection fraction (LVEF) and average hourly urine output were significantly higher than those of before treatment (t =26.40,3.22,all P ＜ 0.05),and the brain natriuretic peptide (BNP) concentration levels were significantly lower than those of before treatment (t =14.11,all P ＜ 0.05).The control group before and after treatment LVEF,BNP and changes in urine levels were not significantly.Conclusion In the treatment of heart failure caused by acute non-ST-segment elevation myocardial infarction,the recombinant human brain natriuretic peptide (rhBNP) has significant effect,feasible and safe with few side effects,which has a high clinical value.

Background and purpose: Cyclin-dependent kinase 4 (CDK4) is a kind of protein kinases regulating the cell cycle progression, which has been reported to be overexpressed in endometrial carcinoma tissues. But the role of CDK4 in endometrial carcinogenesis and relative mechanisms has not been identiifed yet. In this study, we used a small interfering RNA targeting CDK4, and explored the effects of CDK4 on endometrial cancer cells HEC-1B biological function and relative mechanisms.Methods:The chemically synthesized small interfering RNA targeting CDK4 (si-CDK4) was transiently transfected into HEC-1B cells;the quantitative real time-PCR assays and Western blot assays were performed to explore the mRNA and protein expression levels of CDK4 and its downstream genes, Rb and p-Rb, in HEC-1B cells upon transfection;Moreover, the CCK-8, lfow cytometry (FCM) and invasion assays were performed to indentify the effects of si-CDK4 on the proliferation, cell cycle distribution, apoptosis and invasion abilities of HEC-1B cells, respectively. Results:The results showed that the mRNA and protein expressions of CDK4 were suppressed in HEC-1B cells upon transfection with si-CDK4 (P<0.01);Suppression of CDK4 inhibited cell proliferation and invasion of HEC-1B cells;the number of cells migrating through the transwell membrane in si-CDK4 group was 117±21, which was much fewer than the cells in si-control (269±39) and untreated groups (262±35) (P<0.01);the early apoptosis rate of cells treated with si-CDK4 [(21.7±3.5)%] was much higher than the untreated [(12.4±2.1)%] and si-control groups [(11.8±1.9)%] (P<0.01);moreover, suppression of CDK4 increased cells in G1 phase (P<0.01) and correspondingly decreased cells in S phase (P<0.01);further Western blot results showed that suppression of CDK4 down-regulated the expression of p-Rb in cells, but did not inlfuence the expression of total Rb. Conclusion:CDK4-siRNA speciifcally and efifciently blocks the constitutively activated CDK4 in human endometrial cancer cells HEC-1B, resulting in tumor suppression.

OBJECTIVE:To investigate protective effects of different doses of atorvastatin pretreatment on non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients underwent percutaneous coronary intervention (PCI). METHODS:A total of 81 NSTE-ACS patients in a hospital during Jan. 2014-Apr. 2016 were divided into high-dose group(40 cases)and low dose group(41 cases)according to random number table. High-dose group was given Atorvastatin calcium tablet 80 mg 12-24 h before PCI,and then 40 mg 2 h before PCI. Low-dose group was given Atorvastatin calcium tablet 10 mg 12-24 h before PCI. Fractional flow reserve(FFR),coronary flow reserve(CFR)and index of microcirculation resistance(IMR)after surgery were all observed in 2 groups. The levels of creatine kinase(CK),creatine kinase myocardial band(CK-MB)and high sensitive C-re-active protein (hs-CRP) were compared between 2 groups before and after surgery. RESULTS:There was no statistical signifi-cance in FFR and CFR after surgery between 2 groups (P>0.05);IMR of high-dose group was significantly lower than low-dose group,with statistical significance(P<0.05). There was no statistical significance in CK,CK-MB or CRP between 2 groups before surgery(P>0.05). After surgery,the levels of CK-MB and CRP in low-dose group were significantly higher than high-dose group,with statistical significance(P<0.05). There was no statistical significance in CK level between 2 groups after surgery (P>0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:During PCI,pre-treatment with high-dose of atorvastatin(80→40 mg)could effectively improve microcirculatory disturbance and inhibit inflammatory reaction of NSTE-ACS patients.

Objective To investigate the effect and mechanism of necrostatin-1 (Hec-1) on the level of HMGB-1 protein in liver of rats with hemorrhagic-traumatic shock.Methods A number of 96 male SD rats were divided into sham-operated group,dimethyl sulfoxide (DMSO) group and Nec-1 group (n=32in each) by randomized number method.Rat model of hemorrhagic-traumatic shock was made by fracture of femoral bone and tibia bone and exsanguination from femoral vein until 30 mmHg and maintained at 30-40 mmHg for 90 min,then the shed blood was transfused back with Ringer's solution.The rats in shamoperated group were only under anesthesia for separating and ligating blood vessels,without exsanguination to induce hemorrhagic shock and without replenishment with blood.Rats in Nec-1 group were given 1 mg/kg Nec-1 through femoral vein 5 min before replenishment with blood and Ringer' s solution,while the rats in DMSO group were given equal volume of DMSO solution instead.Eight rats in each group were sacrificed separately at 2 h,8 h,16 h and 24 h after replenishment.The serum and liver tissues of rats in each group were collected to detect serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST),and to observe the pathological changes in liver with hematoxylin-eosin (HE) staining.The level of HMGB-1 in serum was detected by using ELISA.The cytoplasm protein and total protein expressions of HMGB-1 were assessed by using western blot analysis.Results Compared with DMSO group,levels of serum ALT at 8 h (P ＜0.05),16 h (P ＜ 0.01) and 24 h (P ＜ 0.01) in Nec-1 group were significantly lower.Level of serum AST in Nec-1 group were lower compared with DMSO group at 8 h (P ＜ 0.01),16 h (P ＜ 0.01) and 24 h (P ＜0.01).Compared with DMSO group,levels of serum HMGB-1 at 8 h (P ＜ 0.05),16 h (P ＜0.01) and 24 h (P ＜ 0.01) in Nec-1 group were significantly lower.Under light microscopy and transmission electron microscope,hepatic lobule destroyed,the blood extravasated,the immunocyte infiltrated and cellular organelle destroyed were found.Compared with DMSO group,the level of HMGB-1 protein in cytoplasm protein in Nec-1 group were significantly decreased at 8 h (P ＜ 0.01),16 h (P ＜0.01) and 24 h (P ＜0.01).The level of HMGB-1 protein in total protein in Nec-1 group were significantly decreased 8 h (P ＜ 0.05) and 24 h (P ＜ 0.05).Conclusions Nec-1 can remarkably protect the liver of rats with hemorrhagic-traumatic shock,decrease the level of HMGB-1,and protect the hepatocyte effectively.

Objective To evaluate the safety and efficacy of overlapping sirolimus-eluting stent (SES) for long lesions during primary percutanous coronary intervention(PCl) in elderly patients with ST-segment elevation myocardial infarction (STEMI).Methods Seven hundred and seventy-five elderly patients with STEMI who underwent primary PCI were enrolled and followed up. Patients with two or more SES implanted for long lesions during PCI were taken as long lesion group and patients with single stents implanted were regarded as control group. The safety endpoints were in-hospital and follow-up death and stem thrombosis, and the clinical endpoints were the incidence of restenosis and target vessel revascularization rate during in-hospital follow-up and 6 months" follow-up.Results Among 775 patients, 62 patients had 64 long lesions. The average number of stents was 2. 2, and the average lesion length and stent length implanted were (45.3±10. 4)mm and (52.2±11.0)mm, respectively. During the 6 months' follow-up, the incidence of angiographically documented stent thrombosis were 1.6% in long lesion group and 1.1% in control group, respectively. No death or myocardial infarction occurred in two groups. There was no significant difference in the incidence of restenosis and target vessel revascularization rate between long-lesion group and control group (8. 1 vs. 4.8%, 6.9% vs. 3. 7%, both P>0.05). Conclusions Overlapping implantation of homemade SES is safe and effective for STEMI patients with long lesions in short-term period.

Objective To evaluate the correlation of epicardial adipose tissue volume (EATV)with coronary plaques in patients with a coronary artery calcium score of zero.Methods 183 patients with a coronary artery calcium score of zero were selected.They were divided into plaque group and control group according to the findings of CT coronary angiography.Independent t test was used to analyze the difference of EATV between two groups.Results ①EATV was significant higher in plaque group than that in control group (P <0.05).②EATV was non-significant higher in plaque group than that in control group for female individuals (P >0.05), while it was significant higher in plaque group than that in control group for male individuals (P <0.05).③EATV was significant higher in plaque group than that in control group for the individuals with age< 50 years (P <0.05 ),meanwhile it was significant higher in plaque group than that in control group in age≥50 years(P <0.05).Conclusion EATV is correlated with coronary plaques in male patients with a coronary artery calcium score of zero while there is no correlation with female patients.EATV is correlated with coronary plaques in different age patients with a coronary artery calcium score of zero.