Objective To exPlore the effect of mammalian target of raPamycin ( mTOR ) inhibitor eVerolimus on radiosensitiVity of human non_small cell lung cancer cell line in vitro by using eVerolimus to inhibit mTOR signaling Pathway of A549. Methods Human non_small cell lung cancer cell line A549 was subjected to radiation alone or in combination with eVerolimus treatment. The 50%inhibition concentration ( IC50 ) of eVerolimus in A549 cells was detected by methylthiazol tetrazolium ( MTT) assay in vitro. EVerolimus at the 20%inhibition concentration ( IC20 ) was used to Pretreat A549 cells for 24 h. Cells were then irradiated by X_ray with 2,4,6,8 Gy. The cell surViVal fraction was comPuted by clone formation. Cell surViVal curVe was fitted by multitarget one_hit model, and mean lethal dose ( D0 ), dose quasithreshold ( Dq ), surViVal fraction at 2 Gy ( SF2 ), and sensitization enhancement ratio (SER) were calculated. The exPression ofγ_H2AX was determined by Western blotting and then the relatiVe gray Values were analyzed. Results EVerolimus significantly imProVed the sensitiVity of A549 cells to radiation. The D0 , Dq and SF2 of eVerolimus+irradiation grouP were significantly lower than those of irradiation grouP. The SER was 1. 36. The residual amount of γ_H2AX Protein in the eVerolimus + irradiation grouP was significantly higher than that of the irradiation grouP. Conclusion EVerolimus inhibiting mTOR signaling Pathway can increase the radiosensitiVity of A549 cells.

OBJECTIVETo study the effect of multiglycosides of Tripterygium wilfordii (MTW) for treatment of proteinuria in kidney transplant recipients.

METHODForty-five kidney transplant recipients with proternuria were randomized into 3 groups (n=15) and received full daily dose (1 mg/kg) MTW, half dose (0.5 mg/kg) MTW or no MTW (control) in addition to immunosuppressant therapy. The 24-hour urinary protein (24 h Upro), blood urea nitrogen (BUN), serum creatinine (Scr), dose of ciclosporin and the adverse effects of MTW were recorded.

RESULTSMTW at both the full dose and half dose significantly reduced the 24 h Upro as compared to exclusive immunosuppressant therapy (P<0.05). The therapeutic dose of ciclosporin in patients with full and half dose of MTW was significantly lower than that in the control group (P<0.05), and the patients receiving full dose MTW showed greater adverse effects than those having half dose MTW (P<0.05).

CONCLUSIONSMTW can significantly ameliorate proteinuria, reduce the therapeutic dose of ciclosporin and protect the renal function in kidney transplant recipients. While producing similar therapeutic effect to routine full dose, long-term use of half dose MTW may reduce the adverse effect associated with MTW.

Adult ; Aged ; Female ; Glycosides ; therapeutic use ; Graft Survival ; immunology ; Humans ; Kidney Transplantation ; adverse effects ; immunology ; Male ; Middle Aged ; Proteinuria ; drug therapy ; etiology ; Tripterygium ; chemistry ; Young Adult

Objective To describe the clinical characteristics of hypervirulent Klebsiella pneumoniae (hvKP) infection.To analyze the antibiotic susceptibility of hvKP to provide the empiric antibiotic options.To investigate capsule serotype and sequence type (ST) of hvKP and their correlation with clinical profiles.Methods hvKP was defined as bacteria isolated from patients with community-acquired pyogenic liver abscess (CA-PLA) with co-infection sites outside liver or a bloodstream infection in a host without underlying biliary tract diseases.Patients with CA-PLA hospitalized in the First Hospital of China Medical University were retrospectively analyzed from January 2011 to December 2017.Antibiotic susceptibility was detected by automatic bacterial identification and antibiotic susceptibility analysis system in vitro.Polymerase chain reaction method and gene sequencing were used to detect the main capsule serotype and ST.Results A total of 140 cases with hvKP infection were enrolled.The co-infections outside liver abscess included 98 bloodstream infections,53 pneumonia,11 perianal abscess,10 urinary system infections,3 subphrenic abscess,3 endophthalmitis,2 spleen abscess,and other miscellaneous infections including 1 peritonitis,1 skin and soft tissue infection,1 myelitis,1 colitis,1 psoas major abscess and 1 myocardial abscess.Among the 140 cases,106 presented with single co-infection site,32 with 2 sites,and 2 with 3 sites.HvKP manifested high antibiotic susceptibility up to 80％ for most commonly used antibiotics.Capsule serotyping of 4,3 revived isolates indicated that K1 serotype accounted for 53.49％ (23/43),K2 34.88 (15/43),K54 2.33％ (1/43),K57 2.33％ (1/43),and other serotypes 6.98％(3/43).There was no significant distribution among K1,K2,K54,and K57 of hvKP capsule serotypes in patients with or without diabetes mellitus (P＞0.05).Multilocus sequence typing (MLST) suggested that ST23 and ST65 were predominant accounting for 39.53％ (17/4.3) and 25.58％ (11/4.3) respectively.No serotype or ST predominance was seen in any of the clinical infections.Conclusion HvKP is related to a wide spectrum of infectious diseases,including multiple extrahepatic sites and bloodstream infections besides CA-PLA with high antibiotic susceptibility.K1 and K2 are the predominant capsule serotypes,and ST 23 and ST65 are the predominant sequence types.

BACKGROUND: Intestinal and lymphoid tissues constitute an important part of intestinal immunity, which plays an important regulatory role in spleen deficiency and hydronephrosis. OBJECTIVE: To observe the effect of acupuncture on T lymphocyte subsets in lymph nodes of rats with spleen deficiency, and to investigate the correlation of spleen deficiency with intestinal immunity and the mechanism of acupuncture for spleen deficiency syndrome. METHODS: Thirty-six female Sprague-Dawley rats were randomly divided into three groups: model, acupuncture and blank control groups. The rat model of spleen deficiency was established by fatigue-induced spleen injury plus abnormal diet for 31 days. Afterwards, the rats in the acupuncture group received acupuncture at Zusanli(ST 36).Urine D-xylose excretion rate was detected during modeling and treatment.Then, the mesenteric lymph nodes were removed, and the changes in T lymphocyte subsets in the mesentericlymph nodes were observed by immunohistochemistry. RESULTS AND CONCLUSION: Urine D-xylose excretion rate under spleen deficiency in the modeling and acupuncture groups was significantly lower than that in the blank control group (P < 0.05 or P < 0.01); after acupuncture, the urine D-xylose excretion rate was significantly increased compared with the modeling group (P < 0.01), but still lower than that in the blank control group (P < 0.05). The count of CD4+T lymphocytes, count of CD8+T lymphocytes and ratio of CD4+/CD8+T lymphocytes were ranked as follows: blank control group >acupuncture group>modeling group(P<0.01 or P<0.05).These results suggest that acupuncture at Zusanli can improve the urine D-xylose excretion rate, regulate the balance of T lymphocyte subsets in mesenteric lymph node of rats with spleen deficiency, thus improving the intestinal immune function, spleen deficiency systems, disorder of intestinal digestive function, intestinal digestion and absorption, as well as anorexia, loose stool, diarrhea and other symptoms of the digestive system.

OBJECTIVETo analyze the susceptibility genes of a Parkinson's Disease (PD) family.

METHODSThe blood samples of a four-generation classic idiopathic PD family were collected. Two-point LOD score method was applied to analyze the linkage disequilibrium between the disease locus and microsatellite markers.

RESULTSWe studied 13 markers near the 9 genes that had been reported to be associated with PD. No obvious evidence showed that the selected markers had anything correlation with PD locus.

CONCLUSIONThese 9 genes are not the susceptibility genes of PD in this family.

Adult ; Aged ; China ; Female ; Genetic Linkage ; Genetic Predisposition to Disease ; Genotype ; Humans ; Microsatellite Repeats ; Middle Aged ; Parkinson Disease ; genetics ; Pedigree

OBJECTIVETo assess the value of positron emission tomography (PET) with (11)C-choline (CH), (11)C-methionine (MET), (18)F-fluorothymidine (FLT), and (11)C-acetate (AC) in diagnosis of pulmonary abnormalities and the features of pulmonary abnormalities in PET.

METHODSFrom June 2002 to June 2007, 100 patients with pulmonary nodules or masses confirmed by CT scans received PET with special tracers. Fifty-eight patients received CH-PET, 16 patients received MET-PET, 22 patients received FLT-PET, 4 patients received AC-PET. PET data was analyzed by visual method and semiquantitative method with standard uptake value (SUV). Diagnoses were compared with pathology and follow-up survey.

RESULTSFor identification of pulmonary neoplasms with CH-PET, the sensitivity, specificity and accuracy were 84.2% (32/38), 57.9% (11/19) and 75.4% (43/57). In cancer cases, SUV had no correlation with tumor size or age. For identification of pulmonary neoplasms with MET-PET, the sensitivity, specificity and accuracy were 6/7, 6/9 and 75.0% (12/16). In cancer cases, SUV had not correlation with tumor size or age. For identification of pulmonary neoplasms with FLT-PET, the sensitivity, specificity and accuracy were 85.7% (12/14), 2/8 and 63.6% (14/22). In cancer cases, SUV had not correlation with tumor size or age. In AC-PET, only 1 case of pulmonary metastasis of kidney clear cell carcinoma showed acetate avid. Two squamous cell carcinoma and 1 adenocarcinoma didn't appear abnormal in AC-PET.

CONCLUSIONCH, MET, FLT, AC are valuable in diagnosing but also lead to false positive and false negative.

Choline ; Diagnosis, Differential ; Dideoxynucleosides ; Female ; Humans ; Iodoacetates ; Lung Diseases ; diagnostic imaging ; Male ; Methionine ; Positron-Emission Tomography ; methods ; Sensitivity and Specificity

Objective To determine the awareness, treatment and control of hypertension and its determinants in the elderly hypertensive patients of Dean nationality so as to explore the associated determinants. Methods This was a cross-sectional, population-based survey. A total of 939 persons aged 60 years and older sampled by stratified sampling method from the elderly population of Dean nationality were examined from July to September 2016. Meanwhile, the data of medical history and examination were collected. Results There were 353 elderly patients with hypertension in the 939 subjects. The awareness, treatment and control of hypertension in the elderly hypertensive patients (EHP), which was 47.3％, 36.5％and 22.1％respectively, were higher than the results of previous national study and had the upward trends with the increasing age (<0.05) . In comparison with the reference group, EHP living in middle economic level area had the higher awareness, treatment and control of hypertension (<0.05) . The results of covariate-adjusted multilevel logistic regression model indicated that there was a cross-level interaction effect between middle economic level area and dyslipidemia on the awareness and treatment of hypertension respectively, and a cross-level interaction effect between middle economic level area and low fat diet on the control of hypertension ( <0.05) . The individual level covariates, age (OR=1.3412, 1.3144, 95％ CI 1.0217-1.7609, 1.0030-1.7225) and diabetes ( OR=2.6735, 2.3078, 95％ CI 1.0721-6.6672, 1.0240-5.2007), had the positive association with the awareness and treatment of hypertension;age (OR=1.4740, 95％CI 1.0034-2.1654), non-drinking (OR=3.2056, 95％CI 1.5554-6.6066) and low salt diet (OR=3.6969, 95％CI 1.7996-7.5946) had the positive association with the control of hypertension. Conclusion The awareness, treatment and control of hypertension in the EHP of Dean nationality were higher than those of the national level, and the dominant factors were economic level, age, dyslipidemia, diabetes, non-drinking, low fat diet and low salt diet, etc.

Objective To investigate pathogenic bacteria distribution and drug resistance of the bacteria isolated from Chinese young and mid-age patients (14-65 years).Methods Collect and monitor the isolates from young and mid-aged patients (14-65 years) in 557 mem-ber hospitals of Grade three between January 1 and December 31 in 2012.Disk diffusion and automatic machine method are applied to anti-biotic resistance test.The data were analyzed and processed with software WHONET 5.6.Results There are 383443 isolates from young and mid-aged patients in 557 hospitals of Grade three.Gram-negative bac-teria is account for 69.33%, the major strains are Escherichia coli of 78915, Klebsiella pneumoniae of 48698, Pseudomonas aeruginosa of 36239 and Acinetobacter baumannii of 27858, respectively;Gram-posi-tive bacteria is account for 30.67%, Staphylococcus aureus of 33328, Staphylococcus epidermidis of 18818, Enterococcus faecalis of 13114 and Enterococcus faecium of 8517 are the top four.It was not found that Staphylococcus spp.were resistant to vancomycin and linezolid, and there were teicoplanin resistant oagulase -negative Staphylococcus account for 3.4%, Vancomycin resistant Enterococcus faecium 3.2%, Vancomycin resistant Enterococcus faecalis 1.5%.Frequen-cy of extended spectrum beta lactamase ( ESBLs) in Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis are separately 58.4%, 33.6%and 24.9%, which increase resistance to imipenem as 2.8%, 6.5%and 4.1%contrast to last year.Rate of carbapenem resistant to Acinetobacter baumannii was about 50%, only polymixin B has better ac-tivity 96.7%.Haemophilus were isolated less among the young and mid-aged patients, but were sensitive to most an-tibiotic.Conclusion Antibiotic resistant rate of young and mid-aged patients in China are more serious, especially increase of ESBLs producing Enterobacteriaceae, multi drug resistant non-fermenting bacteria and vancomycin resistant Enterococcus.Meanwhile, the resistant trend is various by time, so that it is important and tedious work to monitor the antibiotic resistance.

Objective To compare the characterization of coronary atherosclerotic plaques in patients with unstable angina pectoris (UAP) and stable angina pectoris (SAP) by optical coherence tomography (OCT). Methods OCT was performed in 47 patients (23 UAP and 24 SAP) undergoing coronary angiography. Lipid-rich plaque (defined by ≥ 2 quandrants of the cross-section area), thin cap fibroatheroma (TCFA), thickness of fibrous cap, plaque rupture, calcification and thrombus visualized by OCT were compared between UAP and SAP patients. Results OCT imaging was successfully in 44 out of 47 patients (22 UAP, 22 SAP). Proportion of lipid-rich plaques was similar between UAP and SAP groups [91% (20/22) vs, 73% (16/22),P =0. 741]. The minimum thickness of fibrous cap in the UAP group was significantly thinner than that in SAP group [(69.5±34.7) μm vs. (141.1±68.5) μm, P = 0.000] and the rate of fibrous cap erosion in the UAP group was significantly higher than that in the SAP group [59% (13/22) vs. 9% (2/22), P=0.000]. Percents of TCFA [73% (16/22) vs. 14% (3/22) ,P = 0.000] and plaque rupture [50% (11/22) vs.9% (2/22) , P = 0.003] were significantly higher in UAP group compared those in SAP group. Incidence of thrombus and calcification were similar between two groups. Conclusions OCT imaging can clearly define plaque characterization of coronary atherosclerosis. UAP patients have thinner fibrous cap, higher incidences of fibrous cap erosion, plaque rupture and TCFA compared patients with SAP.

Objective:To investigate the epidemiological characteristics of community acquired pyogenic liver abscess (CA-PLA) as a reference for its early identification, early diagnosis and rational antibacterial treatment.Methods:A single center retrospective study was carried out in patients with CA-PLA hospitalized in First Hospital of China Medical University from January 2011 to December 2017.The symptoms, signs and treatment results were concluded. The underlying diseases and onset symptoms of the cases were grouped by year, and the change trend of the disease characteristics was analyzed. The etiology results were grouped according to whether the patients had underlying diseases of biliary tract, and the etiology characteristics were analyzed. Statistical analysis was performed by using chi-square test.Results:A total of 1 063 CA-PLA cases were included in this study. The analysis on underlying diseases grouped by year showed that the number of patients admitted to the hospital increased annually, and the percentage of patients with underlying hepatobiliary diseases decreased from 17.3% (19/110) in 2011 to 7.3% (14/191) in 2017, the difference was statistically significant ( χ2=13.648, P=0.034), while that of patients with diabetes mellitus kept high at 31.6% to 46.5% in the past seven years without increasing trend. There were 274 patients (25.8%) with extrahepatic manifestations. Totally 445 cases were microbiologically diagnosed, among which single Klebsiella pneumoniae infection was found in 371 cases (83.4%). Klebsiella pneumoniae was the leading pathogen in patients without underlying hepatobiliary diseases (91.6%, 362/395), in contrast to 18.0%(9/50) in patients with underlying hepatobiliary diseases. The other pathogens were Escherichia Coli (32.0%, 16/50) and mixed infection (18.0%, 9/50). The susceptibility rate to second generation and above cephalosporins of clinically defined hypervirulent Klebsiella pneumoniae was ≥97.5%, and that to carbapenems was 100.0%. Most patients had good prognosis, and 1 049 cases were cure or improvement discharged, six cases left hospital voluntarily, and eight cases died. Conclusions:Most of the CA-PLA patients have no underlying hepatobiliary diseases, and more than half of patients have no history of diabetes mellitus. Most of the pathogens are Klebsiella pneumoniae, which are relatively sensitive to antimicrobial agents.