Objective To construct a new intubation method with an otoscope and establish a murine model of Acinetobacter baumannii pneumonia with this method.Methods Part I:The Hallowell Intubation Pack for mice (Braintree Scientific Inc., USA)was used to construct a new intubation method with an otoscope.Part II:Twenty-four female ICR mice were randomized into 3 groups including control (group 1),immunosuppression (group 2)and infection after immunosuppression groups (group 3),with 8 mice in each group.The mice were treated with cyclophosphamide (CTX)by peritoneal injection to posterior orbital venous plexus.The total number of white blood cells,the number of neutrophils and the percentage of neutrophils were determined.Four mice were sacrificed at 0 h and 48 h after inoculation in each group.Then the lungs from each mouse were aseptically collected for quantitative culture and histopathology.Results Part I:Ten mice were successfully intubated using the new method and none of the mice was dead.Pulmonary bacterial culture at baseline (0 h)was (2.91×107-5.32×107 )CFU/g tissue,while the mean± standard deviation was (4.05 × 107 ± 0.82 × 107 )CFU/g tissue.The results showed that this new method had a perfect repeatability.Part II:Over 48 h,2 mice were dead in group 3,while no mouse was dead in other 2 groups.For group 3,the average pulmonary bacterial culture was 4.13×107 CFU/g tissue at 0 h and reached 3.62×1010 CFU/g tissue at 48 h (increased appropriate 1 000 times,P <0.01).The histopathologic changes in lung showed local granulomas and abscess in the alveolar space.Conclusions Intubation under the guidance of otoscope had the advantages of high repeatability and easy to operate.Additionally,the method provided stable and consistent bacterial inocula into lungs.The murine model of Acinetobacter baumannii pneumonia was successfully established with a new intubation method under the guidance of otoscope.

Objective:To assess the efficacy of terbinafine combined with fluconazole in the treatment of recurrent vulvovaginal candidiasis(RVVC).Method:94 patients with recurrent vulvovaginal candidiasis were randomly divided into three groups.30 cases in the terbinafine monotherapy group were treated with an oral 250mg-dose of terbinafine once daily; 31 cases in the fluconazole monotherpy group were treated with an oral 150mg-dose of fluconazole once daily;33 cases in the combined therapy group were given terbinafine and fluconazole together,and the usage and dosage were the same as those of the monotherapy groups.The treatment period of the three groups was 7 days.The efficacy was evaluated in the second week,sixth month and twelfth month after the treatment.Result:In the second week or sixth month or twelfth month after the treatment,the clinical cure rate,clinical effective rate and fungous clearance rate of the combined therapy group were higher than those of the monotherapy groups,which had statistically significant difference.Conclusion:The combined therapy with terbinafine and fluconazole can effectively improve the clinical signs and symptoms of RVVC patients and eliminate candida,which is more effective than the monotherapy with terbinafine or fluconazole.

Objective To understand the clinical features of candidemia.Methods A retrospective analysis was performed based on the data of 88 candidemia cases treated in Huashan Hospital during the period from 2007 to 2012.The clinical data were re-viewed in terms of species distribution,underlying diseases,clinical manifestations,treatment and outcomes.The prognostic factors were analyzed by chi-square test or Fisher exact probability test.Multivariate analysis was conducted by multiple Logis-tic regression.Results Candida albicans (40/88,45.5%)was the most common pathogen isolated from these candidemia ca-ses,followed by Candida tropicalis (20/88,22.7%),Candida parapsilosis (17/88,19.3%),Candida glabrata (10/88, 11 .4%),and Candida krusei (1/88,1 .1 %).Solid malignancy,diabetes,and surgical procedure were the most frequently identified underlying diseases.Fatal or deteriorative outcome was reported in 28 cases.The attributable mortality was 18.2%. Multivariate prognostic analysis indicated that presence of central venous catheter (OR:6.322,95% CI :1 .055-37.891 ,P =0.044)was independently correlated to increased mortality.Appropriate antifungal therapy was an independent predictor of de-creased overall mortality (OR:0.137,95% CI :0.039-0.480,P =0.002).Conclusions The pathogen distribution of candi-demia has changed slightly.Appropriate antifungal therapy plays a key role in the treatment of candidemia.

Objective To investigate the effect of isoflurane anesthesia during early pregnancy on the cognitive function of offspring rats.Methods Thirty SD rats at 5-7 day gestation were randomly divided into 3 groups ( n =10 each):control group (group C) and 2 isoflurane groups (groups Ⅰ1,Ⅰ2).Groups Ⅰ1 and Ⅰ2 inhaled 1.4％ isoflurane in O2 for 4 and 8 h respectively while group C inhaled 95 ％ O2 for 8 h.At 20 and 30 days after birth,offspring rats from 5 pregnant rats were tested for learning and memory abilities using Morris water maze.The offsprings were sacrificed at 7 days after test and their hippocampi were isolated for determination of N-methyl-D-aspartate receptor subunit 2B (NR2B) mRNA and protein expression.Results There were no significant differences in the results of Morris water maze test and NR2B mRNA and protein expression among the three groups.Conclusion Isoflurane anesthesia during early pregnancy has no effect on the cognitive function of the offspring rats.

AIM: To study the effects of Rhodiola(Rho), nitric oxid e (NO), hem oglobin (HB) on the multiple organ dysfunction syndrome(MODS) in early stage aft er burn in rabbits. METHODS:The rabbits were divided into the sh am burn group (SB), burn group (B), orally taken Rho group (R), burn and Rho therapy group (BR ). The changes of hemodynamics were monitored. The index of pulmonary permeabili ty was calculated. These data reflected separately the functions of heart, live r, lung, kidney and blood coagulation system were also determined. NO contents i n ser um and bronchoalveolar lavage fluid (BALF) were measured by Griess method. The l e vels of serum HB were measured. RESULTS:① The dysfunctions of hear t, liver and kidney achieved the criterion of MODS in group B at 48 h postburns (B 48 h ). The N O content of group B significantly increased in serum and BALF at B 48 h . ② The cardiac index (CI) and creatine phosphokinase (CK), urea nitrogen (BUN) markedly raised or decreased in group BR at 48 h postburns (BR 48 h ) than B 48 h . The NO cont ents in serum and BALF markedly raised. ③ HB contents in serum markedly raised in group B and BR at 0 h postburns (B 0 h , BR 0 h ) than group SB, B 48 h , R, BR 48 h , but NO was reverse. CONCLUTIONS: ① HB contents in serum markedly raise d at 0 h post burns, but NO was reverse. ② Rho promoted the increases of NO synthesis and the blood perfusion of organs, which might be one of mechanisms to prevent the devel opment of MODS.

Background The fibrosis of filtering area caused by proliferation of human Tenon fibroblasts (HTFs) is one of failure causes following glaucoma surgery.Researches revealed that hydroxycamptothecin can induce the apoptosis of HTFs,but its influence on autophagy of HTFs is unclear.Objective This study attempted to investigate whether hydroxycamptothecin can cause an alteration of autophagic activity in HTFs.Methods Human Tenon capsular tissue was obtained from 3 patients during strabismus correction surgery under the informed consent of patients and their parents for the primary culture and passaged of HTFs in DMEM containing 10％ fetal bovine serum.The generation 3 to 6 cells then were incubated with 0.0,0.5,1.0,4.0,10.0 mg/L hydroxycamptothecin for 24 hours,respectively.A cell counting kit-8 (CCK-8) was used to detect the cell viability in different treated groups.The autophagic activity of HTFs was evaluated by a Cyto-ID autophagy detection kit,and then the autophagic flux was evaluated by counting the Cyto-ID positive cells under a fluorescence microscope,and the green fluorescence intensity was determined by flow cytometry.Quantitative reverse transcriptase PCR (qRT-PCR) and Western blot analysis were employed to assay the relative expressions of autophagic-associated genes and their proteins in HTFs,including Beclin-1,autophagy related gene 5 (ATG-5) and light chain 3 (LC-3).Results The cell viability of HTFs in the 0.0,0.5,1.0,4.0 and 10.0 mg/L hydroxycamptothecin groups were (100.00 ± 6.44) ％,(91.70 ± 6.36) ％,(81.47 ± 6.00) ％,(68.43 ± 6.69) ％ and (59.97 ± 6.98) ％ respectively,showing a gradually declining trend with the increase of hydroxycamptothecin doses,with a significant difference among them (F=19.040,P＜0.001),and the viability of HTFs in the 1.0,4.0 and 10.0 mg/L hydroxycamptothecin groups were significantly decreased than the control group (P＜0.05,P＜0.01,P＜0.01).qRT-PCR analysis revealed that the relative expression levels of Beclin-1 mRNA,ATG-5 mRNA and LC-3 mRNA in 4.0 mg/L hydroxycamptothecin group were (3.225 ±0.346),(2.839 ±0.418) and (3.761±0.224) folds higher than those of the control group.The expressions of Beclin-1 and ATG-5 proteins were significantly increased in the 4.0 mg/L hydroxycamptothecin group in comparison with the control group,and the expression intensity ratio of LC-3-Ⅱ/Ⅰ was 0.965±0.159 in the hydroxycamptothecin group,which was significantly higher than 0.275 ±0.860 of the control group (P =0.003).Cyto-ID staining showed that the percentage of autophagic cells increased dramatically from (11.333±4.010) ％ to (55.000±9.013) ％ upon the exposure of HTFs to 4.0 mg/L hydroxycamptothecin (P=0.002).Flow cytometry analysis showed that the green fluorescence intensity in the 4.0 mg/L hydroxycamptothecin group was (3.037 ±0.513) fold relative to that in the control group,showing a significant difference between the two groups (P =0.003).Conclusions Hydroxycamptothecin can induce autophagy in HTFs in vitro.

Objective To evaluate the value of cerebral CT and MRI in prediction of the recovery of comatose patients after severe traumatic brain injury.Methods Cerebral CT and MRI were performed in 98 comatose patients after severe traumatic brain injury. CT and MRI were reviewed by three neuroradiologists for the number, sizes, and location of brain lesions. Three neurologists assessed the patients at admission and 1 month after injury. The correlation among the neuroimaging finding, clinical examination index and the prognosis of the patients was analyzed.Results Clinical characteristics, such as initial score on the Glasgow Coma Scale, age, and pupillary abnormalities failed to predict recovery. Cerebral CT did not predict future recovery from post-traumatic coma. The patients in persistent vegetative state(PVS) revealed a significantly higher frequency of corpus callosum, corona radiate, and dorsolateral brainstem injuries than did patients who recovered within 1 month.Conclusion Cerebral CT findings in the acute stage after head injury can not predict the outcome of the post-traumatic PVS. There is a significant association between MRI findings and PVS: patients in coma with lesions in the corpus callosum, corona radiata or dorsolateral brainstem.

This study investigated the correlation between surfactant protein-A (SP-A) polymorphism and the susceptibility of chronic obstructive pulmonary disease (COPD) in Xinjiang Uighurs. Genomic DNA was extracted from peripheral blood of 194 COPD smokers and 201 healthy smokers of Uighur who were hospitalized in or paid a visit to one of the four Xinjiang-based hospitals involved in the study, from March 2009 to December 2010. Single nucleotide polymorphisms (SNPs) were studied at aa62 (CCA/CCG rs1136451) and aa219 (CGG/TGG, rs4253527) in SP-A. Genotypes were determined by using the TaqMan polymerase chain reaction (PCR). Our results showed that genotype frequencies were different between the COPD and normal smokers in aa62 (x (2)=6.852, P=0.033). There were also significant differences in allele genotype frequencies between the COPD and the control and allele G might decrease the risk COPD (x (2)=6.545, P=0.011; OR=0.663; 95% CI: 0.484-0.909). The result suggested that polymorphism of aa62 (CCA/CCG, rs1136451) of SP-A may be associated with the susceptibility to COPD in Xinjiang Uighurs.

Objective To investigate the effect of recipient's pre-transplant triglyceride (TG) abnormalities on early graft function (EGF) after kidney transplantation.Methods According to the inclusion and exclusion criteria,154 identified living-kidney transplant recipients in the 309 Hospital of Chinese PLA from Jan.2011 to Dec.2014 were enrolled in present study,including 124 males and 30 females,and aged of 31.9 ± 8.4 years.The cohort was divided into two groups:TG normal group (0.40＜TG≤1.70mmol/L,n=107) and TG abnormalities group (TG＞l.70mmol/L or require lipid lowering therapy,n=47).The incidences of poor early graft renal function (PEGF),slow graft function (SGF) and delayed graft function (DGF) were compared between the two groups,and then the serum creatinine (Scr) levels were compared among the patients showing immediate graft function (IGF) at 3rd,7th and 30th day after transplantation.The ROC curve was drawn up taking TG as diagnosis index to explore the optimal cut-offvalue for predicting PEGF,SGF and DGF after transplantation.Results Compared with the TG normal group,the TG abnormalities group showed significantly higher incidence of PEGF and DGF (P＜0.05).Among the IGF patients,the TG abnormalities group showed higher Scr level at the 7th and 30th day after transplantation (P＜0.05).The area under ROC curve (AUC) reflected TG levels for PEGF,SGF and DGF were 0.774,0.704 and 0.818,respectively (P＜0.05).The optimal cut-offvalues were all 1.37mmol/L.Conclusions Recipients with abnormal pre-transplant TG level may have worse EGF after renal transplantation.The risk of developing PEGF,S GF and D GF tends to emerge when pre-transplant TG level is higher than 1.37mmol/L.

Objective The aim of this study was to compare recent clinical efficacy between a novel guidance method for percutaneous pedicle screw placement and the conventional fluoroscopic method for long segments thoracolumbar vertebral fracture without nerve injury. Methods A total of 38 patients with thoracolumbar vertebral fracture in our hospital from September 2010 to December 2012 were divided into group A and group B.Eighteen patients in group A underwent 200 percutaneous pedicle screw fixation by conventional fluoroscopic meth-od.Twenty patients in group B underwent 210 percutaneous pedicle screw fixation by a novel guidance method.All the operation for 38 cases were performed by the same surgeon.The time of insertion,radiation exposure,and accuracy of the screw placement between the two groups were compared.The accuracy of screws was evaluated and graded by two consecutive postoperative CT of operation segment for two groups. Results The mean time for a single pedicle screw placement was (13.11 ±2.32)minutes in group A and (10.35 ±1.92)minutes in group B,respectively.The average radiation exposure was (8.11 ±1.15)s in group B and (13.07 ±2.06)s in group A respectively.The differ-ences were statistically significant for both screw placement and radiation exposure times (P <0.05).A total of 172 screws (86.00%)in group A and 185 screws (88.09%)in group B were perfectly located within the pedicle.The statistical difference of grade A between two groups was not significant(P >0.05).Conclusion The novel guidance system can significantly reduce the insertion time and radiation expo-sure for long segments percutaneous pedicle screw placement,which provides the same accuracy for screw placement compared with the con-ventional method.