Child ; Community-Acquired Infections ; microbiology ; Humans ; Pneumonia, Bacterial ; microbiology

Objective To build the theoretical system model and research assessment indicators for equalization of basic medical and health services of both urban and rural residents.This aims at providing a theoretical and empirical basis for advancing basic medical health system covering rural and urban residents.Methods Literature research and Delphi expert consultation are used to build the indicator model and structure.The extremal standard method,health resources sharing by geography method,Gini coefficient method and other statistical analysis were used for an empirical analysis and test in an eastern provincial capital city.Results The indicator system comprises three dimensions of opportunity,process and result,as well as seven second-level indicators of health financing,resource allocation,accessibility etc.and twenty-seven third-level indicators.The grand mean value of the urban and rural regional indicators for H city in 2010 was calculated as 63.53,while the mean values for urban and rural were 74.75 and 45.58 respectively.Conclusion The assessment indicators focus on three combinations:basic public health services and basic medical services,service supply and demand,as well as the number and quality of services.This approach can help with the assessment of equalization of basic medical and health service for urban and rural areas and policy making.

ObjectiveTo investigate clinical risk factors and coronary angiographic features in young men with acute myocardial infarction (AMI).MethodsWe retrospectively studied 200 young men with AMI and compared with 104 non-CHD men,89 old men with AMI.All patients were admitted to hospital from January 2009 to December 2010 and undergone coronary angiography,and the clinic and coronary angiographic features were assessed.The relation between body mass index (BMI),smoking history,familial history of early coronary artery disease,essential hypertension,type 2 diabetes mellitus,hyperlipidemia,serum uric acid ( UA),lipids,hemoglobin (Hb),fasting blood glucose (FBG) with coronary artery disease and its severity was observed.The severity of CAD was diagnosed by the number of diseased vessel.Results In young men with AMI group,the factors such as smoking history,obesity,essential hypertension,type 2 diabetes mellitus,familial history of early coronary artery disease were remarkably different ( P ＜ 0.05 ) ; body mass index,fasting blood glucose,total cholesterol,triglyceride,low density lipoprotein cholesterol were higher than the control group ( P ＜ 0.05 ),hemoglobin was lower than the control group ( P ＜ 0.05 ).Applying Logistic regression analysis,obesity ( OR =11.020),type 2 diabetes mellitus ( OR =5.805 ),essential hypertension ( OR =4.428 ),familial history of early coronary artery disease ( OR =2.883 ),smoking history ( OR =2.153 ) and lower concentration hemoglobin ( OR =1.034) are independent risk factors (P ＜ 0.05) for young men with AMI. According to coronary angiography in young men with AMI,there were 14 cases with zero-vessel disease,109 cases with singlevessel disease (54.50％,69 cases involved with left anterior descending artery) and 42 cases with twovessel disease,35 cases with three-vessel disease.The ratio of single vessel disease involved left anterior desending artery in young men was higher than that of old men with AMI ( P ＜ 0.05 ).Conclusions Obesity,type 2 diabetes mellitus,essential hypertension,familial history of early coronary artery disease,smoking history and lower concentration of hemoglobin are risk factors of young men with AMI ; Single vessel coronary disease is seen more frequently in young men with AMI.

Objective To investigate the role of directly constitutive activation of p38 mitogen-activated protein kinases(p38MAPKs)signaling in ?-globin gene expression and fetal hemoglobin(HbF)induction,and provide direct data for the relationship between phosphorylation of p38 and erythroid differentiation of human K562 erythroleukemia cells.Methods The human K562 erythroleukemia cells were transfected with pCDNA 3.1-MKK3(Glu)and pCDNA 3.1-MKK3(Ala)recombinant plasmids by lipofectamineTM 2000.Then,the stable cell lines overexpressing constitutively active p38 and constitutively inhibitive p38 activation were established by the addition of G418 to select single cell G418-resistant clones and identification with reverse transcriptase-polymerase chain reaction(RT-RCR)and Western blot assays,named K562-MKK3(Glu)and K562-MKK3(Ala)cells,respectively.Furthermore,the direct effects of constitutively active p38 on the ?-globin gene expression and HbF induction were analyzed by RT-PCR and benzidine staining,respectively.Results The results of RT-PCR and Western blot showed that there were no evident changes in the mRNA and protein levels of p38 for various cell models,but compared with K562,K562-vect,and K562-MKK3(Ala)cells,the phosphorylation of p38 and expression of ?-globin levels in K562-MKK3(Glu)cells were significantly up-regulated.The results of benzidine staining displayed that the mean percentages of positive cells stained by benzidine in K562,K562-vect,K562-MKK3(Ala),K562-MKK3(Glu)cells,and K562-MKK3(Glu)cells treated with SB203580 were(3.2?1.4)%,(3.7?1.2)%,(2.8?0.9)%,(32.6?5.3)%,and(7.8? 2.3)%(q = 7.56 P

1)which represented 340 genes and 171 down-regulated(SLR

Objective To explore the clinical significance of the blood lactic dehydrogenase(LDH), ?_2-microglobulin(?_2-MG),D-dimer measuring in the diagnosis and treatment of Non-Hodgkin lymphoma. Methods In 40 cases with NHL,LDH was measured by L-P continuous monitoring method,?_2-MG was measured by luminescent immunoassay,D-dimer was measured by immunoturbidimettic assay.Results The levels of the blood LDH,?_2-MG and D-dimer in patients with NHL were higher than those of in the controls(P 0.05).Con- clusion The levels of blood LDH,?_2-MG,D-dimer can be taken as an auxiliary clinical index to diagnose, classify the phase,evaluate the effectiveness of treatment and prognosis in the NHL patients,and have impor- tant clinical significance.

Objective To analezk thk altkrations in blood urka nitrogkn( BRN)and skrum crkatinink( Scr) in childrkn with rktinoblastoma( Ab)bkfork and aftkr chkmothkrape and thk clinical significanck of thk chkmothkrape kffkct,and to providk thk kvidknck for thk furthkr improvkmknt of thk safkte of trkatmknt. Methods L total of 280 chil-drkn with Ab wkrk knrollkd in thk stude,and kach of thkm was trkatkd with CEV( Carboplatin+Etoposidk+Vincris-tink)mkthods. Thkrk subjkcts includkd 153 malks and 127 fkmalks,with a mkan trkatmknt of 4. 5 ceclks(rangk 2 to 12 ceclks)and a mkan agk of 21. 5 months(rangk 1 to 84 months). Lmong thkm,149 casks wkrk diagnoskd clinicalle,131 casks wkrk diagnoskd pathologicalle. Eight casks wkrk in thk kxtraocular stagk,3 casks wkrk in glaucoma and 269 casks in intraocular pkriod(101 casks of singlk keks and 168 casks of doublk keks). BRN and Scr wkrk dktkctkd bkfork thk first coursk of chkmothkrape and aftkr thk last coursk of chkmothkrape. ResuIts BRN and Scr valuks wkrk analezkd bk-fork and aftkr chkmothkrape. BRN was 3. 05 mmol╱F bkfork chkmothkrape and 3. 46 mmol╱F aftkr chkmothkrape in thk group agkd from 4 months to lkss than 12 months(73 casks),thk valuks of BRN aftkr chkmothkrape was highkr than that bkfork chkmothkrape,and onle in this group thk changk was statisticalle diffkrknt(t﹦ -2. 829,P﹦0. 006),but all BRN valuks in this group wkrk not bkeond thk highkst rkfkrknck valuk(1. 70 mmol╱F-7. 10 mmol╱F). Bkfork initial chkmothkrape,149 patiknts( 53. 2﹪)had Scr bklow thk rkfkrknck rangk( malk:30 -104 μmol╱F,fkmalk:30 -84 μmol╱F),and 20 casks(7. 0﹪)had thk BRN bklow thk rkfkrknck valuk. In 2 casks,BRN(7. 25 mmol╱F and 7. 34 mmol╱F, rkspkctivkle)bkfork thk initial chkmothkrape was slightle highkr than thk normal valuk,but thk valuk was normal(5. 01 mmol╱F and 4. 98 mmol╱F,rkspkctivkle)aftkr thk last chkmothkrape. In onk cask,thk BRN(5. 62 mmol╱F)was normal bkfork thk initial chkmothkrape,but it was klkvatkd(7. 33 mmol╱F)aftkr thk last chkmothkrape. In anothkr onk cask,thk BRN was normal bkfork and aftkr chkmothkrape,but thk valuk aftkr chkmothkrape was 4. 69 timks highkr than that bk-fork chkmothkrape. ConcIusions Aknal function of Ab childrkn bkfork trkatmknt is normal. Skvkn pkrcknt of thksk patiknts havk BRN undkr thk BRN rkfkrknck rangk,and 53. 2﹪ of thksk patiknts havk Scr undkr thk Scr rkfkrknck rangk. It suggkstkd that thk rkfkrknck valuks of BRN and Scr nkkd to bk adjustkd. BRN of infant Ab mae incrkask signifi-cantle aftkr chkmothkrape,but it doks not mkkt thk currknt diagnostic critkria of mild nkphrotoxicite. Still,thk karle rknal damagk nkkds to bk notickd.

Objective To establish a REDE-DHPLC method for detecting the EGFR and KRAS mutations in plasma DNA from tumor patients, and investigate its clinical significance. Methods Restriction endonucleases Mse Ⅰ , Msc Ⅰ , BstN Ⅰ and Bgl Ⅰ were used to digest the wild type fragments of exon 19,exon 21 of EGFR gene and coden 12, 13 of KRAS gene for enriching the mutation fragments, and REDE-DHPLC method was established to detect EGFR and KRAS mutations. The sensitivities of REDE-DHPLC and conventional DHPLC were analyzed by using a series of plasmids containing 50%, 10%, 5%, 1% and 0. 1% mutation genes. Then, Plasma samples and paraffin-embedded tissue samples of 120 NSCLC patients and 120 colorectal cancer patients were detected by REDE-DHPLC. Compared with conventional DHPLC and sequencing, the diagnostic efficiency of REDE-DHPLC method was evaluated by detecting the mutation status of 2 genes in plasma of NSCLC and colorectal cancer patients. Results The sensitivity values of REDE-DHPLC and conventional DHPLC for detecting mutations in 4 loci were 0. 1% and 1%respectively. Plasmid DNA containing 0.1% mutation gene was detected to be positive continually for 2 to 3 times by REDE-DHPLC. EGFR mutation rates of 120 plasma from NSCLC patients detected by REDE-DHPLC, conventional DHPLC and sequencing methods were 27. 5%, 16. 7% and 12.5% respectively, and KRAS mutation rates of 120 plasma from colorectal cancer patients were 38. 3%, 25. 8% and 16. 7%,respectively. The positive rates of EGFR and KRAS mutation detected by REDE-DHPLC were significantly higher than conventional DHPLC(x2 = 4. 092, 4. 301, all P ＜ 0. 05 ) and sequencing method (x2= 8. 438,14. 127,all P ＜ 0. 05 ). In comparison with conventional DHPLC, the sensitivities of REDE-DHPLC for detecting EGFR and KRAS mutation were 100% (20/20,31/31), the specificities were 87. 0% (87/100)and 83. 2% (74/89). In comparison with sequencing method, the sensitivities of REDE-DHPLC were 100%( 15/15,20/20), the specificities were 82.9% (87/105)and 74. 0% (74/100). The coincidence rate of the two methods for detecting EGFR and KRAS mutation were 89. 2% ( 107/120, Kappa = 0. 690, P ＜ 0. 05 ) and 87.5% ( 105/120, Kappa= 0. 718, P ＜ 0. 05 ). The Consistency of EGFR and KRAS mutation status in plasma and tissues detected by REDE-DHPLC were 91.7% (33/36, Kappa =0. 939,P ＜0. 05)and 90. 2 %(46/51, Kappa = 0. 914, P ＜ 0. 05 ), respectively. Conclusions The REDE-DHPLC method is highly sensitive and specific for detecting EGFR and KRAS mutations in plasma DNA from tumor patients. The results are easy to be interpreted without missing homozygous point mutation, which indicate that the detection of EGFR and KRAS mutations in plasma DNA by REDE-DHPLC could therefore extend to be usedin clinical laboratory.

AIM:To investigate the clinical effect of anti-vascular endothelial growth factor (VEGF) drugs combined with laser photocoagulation for diabetic macular edema (DME).METHODS: Totally 94 patients (141 eyes) with DME from June to December 2015 in our hospital were selected and randomly divided into combined group of 47 cases (68 eyes, ranibizumab combined with laser therapy) and the control group of 47 cases (73 eyes, laser treatment).The levels of best corrected visual acuity (BCVA), macular central retinal thickness (CRT), total macular volume (TMV) and macular edema level were compared between the two groups at different time after treatment.RESULTS: The mean values of BCVA in the combined group were higher than those in the control group at 2, 6 and 12wk, and the difference was statistically significant (P<0.05).At 2, 6 and 12wk after treatment, the CRT and TMV values of the combined group were lower than those of the control group, the difference was statistically significant (P<0.05).After treated for 12wk, patients with macular edema of combined group was 80.9% in mild level, 17.7% in moderate level, 1.5% in severe level, those of the control group was 60.0%, 31.5%, 5.5%, the difference between the two groups was statistically significant (P<0.05).CONCLUSION: The effect of anti-VEGF drugs combined with laser therapy for DME patients is better than that of single laser therapy alone.

Objective The aim of the present study was to evaluate the clinical application of 2 μm thulium laser in pulmonary nodules resection under VATS.Methods 61 patients,undergoing thoracoscopic resection of pulmonary nodules in thoracic department of Xuanwu Hospital,were identified between January and December of 2016.Of those,30 underwent 2μm thulium laser dissection and 31 were treated with standard technique by using staplers.In terms of clinical characteristics,including gender,age and smoking history,there is no significant difference between the laser group and the stapler group,but the lesion size was slightly larger in the stapler group compared with the laser group.The lesions of the two groups were almost evenly distributed on the five lobes.Results All the procedures were performed successfully under VATS.The intraoperative evaluation of air leaks demonstrated that less than or equal to 2 grade air leaks were observed in 28 cases in the laser group and in 30 cases in the stapler group.Grade 3 air leaks requiring a rescue treatment were observed in 2 cases in the laser group and in 1 case in the stapler group.There were no significant differences in the postoperative hospital stay and total hospital stay between two groups.Chest tube duration was lower in the laser group compared with the stapler group even if it was not statistically significant (2.71 vs 3.55 days).Hospitalization costs was significantly lower for the laser group.Conclusion The use of 2um thulium laser to prevent intra-and postoperative air leaks and bleeding is effective and makes patients recover quickly,which allows a minimally invasive,accurate and safe application during thoracoscopic resection of pulmonary nodules.