Objective To investigate the distribution and antimicrobial resistance of pathogens causing pneumonia in acute stroke patients,and guide clinical antimicrobial use.Methods Patients with stroke-associated pneumonia (SAP)admitted to a tertiary first-class hospital from 2008 to 2013 were investigated retrospectively,distribution and antimicrobial susceptibility testing results of pathogens from sputum were analyzed.Results A total of 98 pa-tients with SAP were investigated,124 stains were isolated from sputum specimens,75 strains (60.48% )were gram-negative bacteria,44 (35.49% )were gram-positive bacteria,and 5 (4.03% )were fungi. There were 21 cases of mixed infection (21.43% ),bacterial alterations during treatment process existed among 23 cases(23.47% ).The top 4 isolated pathogens were Staphylococcus aureus (S. aureus,n= 43,34.68% ),Klebsiella pneumoniae (K. pneumoniae,n= 19,15.32% ),Pseudomonasaeruginosa(P. aeruginosa,n= 18,14.52% ),and Acinetobacterbau-mannii(A. baumannii,n= 18,14.52% ). Antimicrobial resistance rates of K. pneumoniae were all <32% ,and susceptibility rates to ceftazidime,piperacillin/tazobactam,imipenem,ciprofloxacin,levofloxacin,amikacin,and tobramycin were all 100% . Both A.baumannii and P.aeruginosa showed severe multidrug resistance. Resistance rates of A.baumannii to ceftazidime was >80% ,resistance rates of P.aeruginosa to imipenem was 33 .33% . No resistant strains were detected among fungi.Conclusion The main pathogens causing SAP in this hospital are S.au-reus,K.pneumoniae,A.baumannii,and P.aeruginosa,except K.pneumoniae,the other strains are severely re-sistant to antimicrobial agents,clinicians should choose antimicrobial agents according to the distribution character-istics and antimicrobial susceptibility testing results.

Objective : To assess the health risks of polycyclic aromatic hydrocarbons（PAHs）exposed through cereal,fried and grilled foods in Hangzhou. Methods : A cross-sectional study was conducted to collect food consumption data of three inconsecutive days among 1 769 subjects selected by probability proportional to size sampling method from two districts in Hangzhou.Fifty samples of fried and grilled food and twenty samples of cereal were collected from five districts in Hangzhou. They were tested for B（a）P,PAH2,PAH4 and PAH8 by high performance liquid chromatography coupled with triple quadrupole gas chromatography-tandem mass spectrometry. The probabilistic models were established for the evaluation of PAHs exposure by @risk software and then margin of exposure（MOE）was calculated. Results : The contents of B（a）P in one sample of fried and grilled food exceeded the limit. The median contents of PAHs ranged from 0.20 to 3.64 μg/kg. The median exposures of B（a）P,PAH2 and PAH4 from both two kinds of foods were 1.54,3.54 and 8.13 ng/（kgbw·d）in the mixed model,1.61,3.76 and 8.09 ng/（kgbw·d）in the non-parameter model. The MOEs of≤95% PAHs exposure level in one kind of food or ≤90% PAHs exposure level in both kinds of foods were more than 10 000. The MOEs of ≥97.5% exposure level of B（a）P,≥95% exposure levels of PAH2 and PAH4 in both kinds of foods in the mixed model,and ≥95% exposure levels of B（a）P,PAH2,PAH4 in both kinds of foods in the non-parameter model were less than 10 000. Conclusion The health risk of PAHs exposure was very low in more than 90% of the population in Hangzhou. However,for high-end consumers,97.5% or 99% exposure level in one kind of food and 95% exposure level in both kinds of foods had a potential health risk.

Objective To explore the relationships between resistin rs1477341 , rs3219175 and type2 diabetes mellitus (T2DM) in Guangdong. Methods 180 patients of diagnosed T2DM in the Second Affiliated Hospital of Guangzhou Medical University from January 2013 to December 2014 were enrolled in the study as the treatment group and another 180 subjects taking health examination as the control group. The genotype distributions of rs1477341 locus A/T, rs3219175 locus A/G were compared and the relationship between the genotypes and T2DM were anlysed by the logistic regression. Results The frequencies of the rs1477341, rs3219175 locus genotype reached the genetic equilibrium, showed their representativeness of a population group. The frequency distribution of rs1477341 genotype was statistically insignificant across the two groups (P > 0.05). The frequency of rs3219175 genotype AA+AG was decreased while genotype GG increased significantly compared to the control group (P < 0.05). The logistic regression results suggest genotype GG may increase disease risk of T2DM which the morbidity rate of AG homozygote was 0.630 times as high as that of GG homozygote (OR =0.630, 95%CI:0.405 ~ 0.980, P < 0.05) and the morbidity rate of GG homozygote was 1.551 times as higher as that of AA+AG homozygote (OR = 1.551, 95%CI:1.016 ~ 2.368, P < 0.05). Conclusions rs1477341 genotype has no correlation with T2DM among the population in Guangdong , but rs3219175 genotype does. GG may have a higher susceptibility to T2DM.

Objective To explore the effect of invigorating splcen and kidney methods on the pregnancy outcome of the intrauterine insemination (IUI) in infertile men with asthenospermia.Methods a total of 78 male infertility patients with spleen and kidney deficiency type were collected,all cases were randomly allocated into three groups,group A using methods of invigorating spleen and kidney,group B using Antioxidant therapy,and group C as the blank group.There are 26 cases in each group.One course of treatment lasts for 12 weeks.Before and after treatment,the changes of sperm quality index were analyzed by computer assisted sperm analysis (CASA) and sperm morphology.The pregnaucy outcome after IUI was followed up.Results After the treatment,sperm motility and sperm forward movement (PR) difference before and after treatment in group A with was statistically significant (P ＜ 0.05).The differences between patients with semen volume,sperm concentration,sperm morphology and sperm motility parameters before and after treatment in three groups were not statistically significant (P ＞ 0.05).Clinical pregnancy rate and cumulative pregnancy rate and the live birth rate in group A were higher than that of group B and group C,but the difference was not statistically significant (P ＞ 0.05).Conclusion Invigorating spleen and kidney method can improve the sperm motility and forward movement speed of the type of patients for the treatment of male infertility patients with asthenospermia,and it is helpful to improve the pregnancy outcome of the IUI.

Polymeric micelles have exhibited attractive properties as drug carriers, such as high stability in vivo and good biocompatibility, and been successfully used to dissolve various drugs of poor aqueous solubilities. In this study, we developed a new type of polymeric micelles with mannose-mediated targeting and pH-responsive drug release properties for anticancer drug delivery. The polymeric micelles were prepared from an amphiphilic polymer, poly (glycidyl methacrylate)-g-mannose (PGMA-Mannose). An anticancer drug, doxorubicin (DOX), was encapsulated into the micelles during the micellization, and could be released rapidly under acidic condition. The specificity of cellular uptake of the micelles by two different cell lines was studied using confocal laser scanning microscopy and the MTT assay. DOX-loaded micelles were efficiently trapped by mannose-receptor-overexpressing cancer cells MDA-MB-231, whereas mannose- receptor-poor cells HEK293 showed much lower endocytosis towards the micelles under the same conditions. Thus, DOX-loaded micelles displayed higher cytotoxicity to MDA-MB-231 cancer cells as compared with free DOX. The present study demonstrates that PGMA-Mannose micelles are a promising targeted drug delivery system for cancer therapy.
Cell Line, Tumor ; Doxorubicin ; pharmacology ; Drug Delivery Systems ; HEK293 Cells ; Humans ; Lectins, C-Type ; metabolism ; Mannose ; chemistry ; Mannose-Binding Lectins ; metabolism ; Micelles ; Receptors, Cell Surface ; metabolism

Objective To investigate the incremental value of 99Tcm-MIBI SPECT/CT imaging in the preoperative diagnosis of PHPT.Methods Forty-one patients (13 males,28 females,age range:14-82 (50.0± 13.2) years)with PHPT were retrospectively enrolled.99Tcm-MIBI dual-phase planar scan,SPECT/CT imaging,CT and neck ultrasound were performed before surgery.All patients had pathological results.McNemarx2 test was used to compare the detection rates of the four imaging methods.ROI method was applied to calculate the uptake ratio (T/NT) and Pearson correlation analysis was used to evaluate correlation between T/NT and serum intact PTH,Ca,the lesion volume measured after parathyroidectomy.Results A total of 42 parathyroid lesions were confirmed by pathology.There were 39 patients with parathyroid adenoma (2 with double adenomas,and 37 with single adenoma containing 2 ectopic adenomas) and 1 patient with parathyroid carcinoma.The detection rate of planar scan,SPECT/CT imaging,CT and neck ultrasound were 78.0％ (32/41),92.7％ (38/41),73.2％ (30/41) and 70.7％ (29/41) respectively.Detection rate of SPECT/CT imaging was significantly higher than that of planar scan,CT or ultrasonography (x2 =4.17,4.90,5.82,all P＜0.01).However there were no remarkable differences between the detection rate of planar scan and that of CT or ultrasonography (x2=0.08,0.36,both P＞0.05).Detection rates of CT and ultrasonography were not significantly different either (x2 =1.90,P＞0.05).T/NT in delayed planar imaging were significantly correlated with PTH,Ca and the lesion volume measured after parathyroidectomy (r =0.56,0.54,0.56,all P＜0.01).Conclusions Compared with 99Tcm-MIBI dual-phase planar scan,CT and ultrasonography,SPECT/CT imaging could be of important clinical value for preoperative localization of PHPT because of its higher detection rate and accurate anatomical localization ability.

Objective: To investigate the relationship of obsessive beliefs and obsessive-compulsive symptoms in medical students and to provide evidence for prevention and intervention of obsessive-compulsive symptoms in medical students. Methods: Medical students were enrolled from a medical college in Hangzhou and were selected among 3 to 6 classes from Grade One to Grade Four using stratified cluster sampling method. The students were assessed with Obsessive Beliefs Scale-44 （OBD-44） and Obsessive Compulsive Scale Revised （OCD-R）. Linear regression model was conducted to analyze the association between obsessive beliefs and obsessive-compulsive symptoms in medical students. Results: As 592 medical students were surveyed and 544 responses were valid, the response rate was 91.89%. The median score of OCD-R of medical students was 15,and 28.86 of them had obsessive-compulsive symptoms. Concerning OBD-44, the total score of medical students was 154.11±36.05, the scores of responsibility/threat, perfectionism/certainty and importance/control of thoughts were 61.12±14.53, 58.68±14.31 and 32.90±10.76, respectively. The Linear regression analysis demonstrated that gender could predict checking,washing,obsessing and neutralizing; responsibility/threat estimate predicted hoarding and obsessing ;perfectionism/certainty was the most significant predictor of checking,ordering,washing, neutralizing;and importance/control of thoughts predicted hoarding,checking,ordering,washing and obsessing（all P<0.05）. Conclusion Gender, importance/control of thoughts and perfectionism/certainty have significant impact over most of obsessive-compulsive symptoms in medical students.

Objective To study apoptosis and antigen presentation changes of monocytes in HBV-related acute-on-chronic liver failure (ACLF) patients under immune dysfunction state.Methods Peripheral blood samples of 26 HBV-related ACLF patients (ACLF group),20 active chronic hepatitis B patients (CHB group) and 18 healthy individuals (control group) were collected.The changes of apoptosis and proliferation (Ki67) in monocytes and the expression of surface markers including human leukocyte antigen (HLA)-DR and B7 molecules (CD86) of monocytes were analyzed by flow cytometry. Results The percentage of Annexin V expressed monocytes of ACLF group (64％) was significantly higher than that of CHB group (28％) and control group (20％),and the difference was statistically significant (x2 value was 11.75 and 27.23 ; both P＜0.01),which indicated that monocytes apoptosis increased.The Ki67 expression in monocytes of ACLF group was lower than that of CHB group and control group,and the difference was statistically significant (x2 value was 4.71 and 4.83; both P＜ 0.05),which indicated that activated monocytes reduced. The mean fluorescence intensity (MFI) of HLA-DR and CD86 of monocytes in ACLF group was 22.85 and 11.63,which was significantly lower than that of CHB group and control group,indicating the antigen presentation ability of monocytes injured. The percentage of Annexin Ⅴ positive monocytes in survivals (62 ％ ) was significantly higher than that of dead patients (46 ％ ) in ACLF group.Conclusion In HBV-related ACLF patients under immune dysfunction state,the apoptosis of peripheral blood monocytes increased,and the quantity of activated cells reduced,resulting in the decline of the antigen presentation ability of monocytes.

Objective:To investigate the regulating molecules and acting mechanism of TAB182 in HR pathway.Methods:TAB182 in human breast cancer MCF-7 cells was knocked down by shRNA strategy, the TAB182 knockdown MCF-7 as the TAB182 knockdown group, and the MCF-7 cell using the shRNA negative control as the TAB182 negative control group. RNA sequencing and qRT-PCR were performed to screen and verify the differentially expressed genes of HR pathway related to TAB182 depression. Western blot was used to detect protein expression. Immunofluorescence staining of nuclear RAD51 and BrdU was used to check the 3′ ssDNA formation by the end resection. The cell cycle arrest and apoptosis were measured by flow cytometry. Cloning formation assay was used to evaluate the sensitivity TAB182-knockdown cells to radiation.Results:Both quantitative RNA sequencing and qRT-PCR assays showed that TAB182-knockdown significantly decreased the mRNA expression of RPA2( t=17.97, P<0.05). Compared with the TAB182 negative control group, the protein level of RPA2, the number of RAD51 foci, and the 3′ ssDNA-binding nuclear protein marker BrdU in TAB182-knockdown cells were significantly reduced. At 4, 8, and 12 h after actinomycin D treatment, the attenuation of RPA2 mRNA in the TAB182-knockdown cells was accelerated ( t=5.37, 3.79, 3.69, P<0.05). Compared with the TAB182 negative control group, the radiosensitivity and radiation-induced apoptosis in the TAB182-knockdown group were increased ( t=3.48, 11.05, P<0.05), and at 24 h after irradiation, the cell cycle block time was prolonged ( t=8.40, P<0.01). Conclusions:TAB182 plays a role in maintaining RPA2 mRNA stability, thereby promoting HR repair. TAB182 knockdown cells are highly sensitive to ionizing radiation.

Malignant tumors are one of the main causes of death from chronic diseases in China,and their incidence and mortality rates show an in-creasing trend year by year.Advanced non-surgical treatment of malignant tumors is an important means of improving patients'prognosis and en-hancing their quality of life.The traditional Chinese medicine Ganoderma lucidum has anti-tumor ef-fects and plays a role in the treatment of many ma-lignant tumors.In this paper,a systematic review of the effects of Ganoderma lucidum active ingredi-ents on tumors has been conducted at home and abroad in the past five years to explore the anti-tu-mor mechanism of Ganoderma lucidum active in-gredients and to lay a theoretical foundation for the application of Ganoderma lucidum active ingre-dients in clinical practice.