OBJECTIVE To study the prevalence of atypical pathogens in patients with community acquired pneumonia(CAP) and the distribution of serotypes of Legionella pneumophilia.METHODS A prospective study was performed on 257 consecutive adult patients with CAP between Dec 2003 and Nov 2004.Antibodies of the paired serum samples to Mycoplasma pneumoniae,Chlamydia pneumoniae and Legionella pneumophilia serotypes 1 to 14 were detected.RESULTS The etiology of CAP was identified in 82(31.9%) patients.The distribution of causal agents was as follows:M.pneumoniae 63(24.5%),C.pneumoniae 17(6.6%),and L.pneumophilia 11(4.28%).Serotype 12 of L.pneumophilia was the predominant one,responsible for 21.8%(56/257).CONCLUSIONS Atypical pathogens especially M.pneumoniae have an important role in CAP;serotype 12 of L.pneumophilia is the predominant one in northern area of China.

To explore relationship of body mass index (BMI), waist circumference (WC), blood lipid level with non-alcoholic fatty liver (NAFL) to provide evidence for its early intervention. Methods Data of 13 532 people living in Beijing undergone regular physical examinations at Beijing Hospital, including liver-ultrasonic scanning, measurements of blood lipid, height, weight, waist circumference and BMI during January to December 2007 were statistically analyzed. Results Totally, 4 807 people were diagnosed as NAFL by B-type ultrasonic scanning, with a mean age of (54 ± 14) years and median age of 53 years. Prevalence of NAFL significantly increased with changes in body building (normal weight, overweight and obesity) and age groups (X2 = 1640.394, P<0.01 ). There was statistical significance in prevalence of NAFL between groups with normal weight and overweight at varied ages ( X2 = 172.618 and 31.928, respectively, P < 0.01 ), with the highest at ages of 51 - 60 years. No statistical difference in prevalence of NAFL between varied age groups was found in those with obesity (X2 = 6.194, P =0.402). Mean of WC, BMI, serum levels of triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) were significantly higher in NAFL group than those in those without NAFL, but mean serum level of high-density lipoprotein cholesterol (HDL-C) was significantly higher in the former than that in the latter ( P < 0.05 ). Prevalence of dyslipidemia was significantly higher in NAFL group than that in those without NAFL ( X2 = 112. 974 - 895. 500, respectively, P < 0. 01 ), with the highest of hypertriglyceridemia, accounting for 54. 36 percent. Prevalence of NAFL was significantly higher in those with larger WC than that in those with normal WC in the normal weight and overweight group (X2 = 120.982 and 45.327, respectively, P<0.01). Results of logistic regression analysis showed that WC, BMI, TG and LDL-C all were risk factors for NAFL both in men and women, and HDL-C was a protective factor for NAFL only in women. Conclusions Overweight, obesity and dyslipidemia closely correlate with occurrence of NAFL Control of body weight and blood lipid level are essential for decreasing prevalence of NAFL.

Objective To investigate the relationship between frailty and serum biomarkers in the elderly. Methods A total of 371 elderly individuals aged 60 years and above with complete medical data were recruited during health examinations. Frailty phenotype assessment and comprehensive geriatric assessment were conducted.Serum levels of interleukin-6 (IL-6 ) ,high sensitivity C-reactive protein(hs-CRP) ,tumor necrosis factor-α(TNF-α) ,homocysteine(Hcy) ,insulin-like growth factor-1(IGF-1) ,25-hydroxyvitamin D[25(OH)D] ,folic acid and vitamin B12(VitB12) were detected by enzyme-linked immunosorbent assays ( ELISA ) and chemiluminescence immunoassays. Associations between frailty and the above factors were analyzed. Results Serum levels of IL-6 ,TNF-α ,Hcy and IGF-1 were significantly elevated along with progressive increase in frailty severity(all P＜0.05).There were a downward trend in serum 25(OH)D levels and an upward trend in serum hs-CRP ,folic acid and VitB12 levels as frailty severity increased ,but the changes did not amount to any statistical significance(all P＞0.05).Logistic regression analysis showed that ,after adjusting for age ,gender ,body mass index (BMI)and some clinical aspects (hearing loss ,urinary incontinence ,pain ,malnutrition ,cognitive dysfunction ,decreased activities of daily living ,depression , insomnia ,and anemia) ,serum levels of IL-6(OR=1.012 ,95% CI=1.005-2.041 ,P=0.033) ,IGF-1 (OR= 1.017 ,95% CI = 1.011-1.118 ,P= 0.021)and Hcy (OR= 1.007 ,95% CI :1.002-1.073 ,P=0.047)were significantly associated with frailty status. Conclusions Serum levels of IL-6 ,Hcy and IGF-1 are related to frailty status and may be used as potential biomarkers for the assessment of frailty in older adults.

OBJECTIVE To study the protective effects of twin drugs of tetramethylpyrazine-scutellarein （TMSC4） on cerebral ischemia-reperfusion injury （CIRI） model rats and its mechanism. METHODS One hundred and five SD rats were randomly divided into sham operation group， model group， scutellarein group （0.7 mmol/kg）， tetramethylpyrazine group （0.7 mmol/kg）， and TMSC4 low-dose， medium-dose and high-dose groups （0.35， 0.7， 1.4 mmol/kg）， with 15 rats in each group. Sham operation group and model group were given constant volume of normal saline intragastrically， and other groups were given relevant drug intragastrically， once a day， for consecutive 14 d. Except for sham operation group， all other groups were treated to establish the CIRI model using the thread occlusion method. After 2 hours of ischemia and 22 hours of reperfusion， the brain index and brain water content of the rats were measured. Serum levels of interleukin 1β （IL-1β）， IL-6 and tumor necrosis factor α （TNF-α）， the levels of superoxide dismutase （SOD）， malondialdehyde （MDA）， glutathione peroxidase （GSH-Px） and catalase （CAT） in brain tissues， the situation of neuronal cell apoptosis， and the protein expressions of B-cell lymphoma 2 （Bcl-2）， Bcl-2-associated X protein （Bax） and cleaved-caspase-3 were evaluated. RESULTS Compared with sham operation group， the brain index， brain water content， the serum levels of IL-1β， IL-6 and TNF-α， the levels of MDA in brain tissues， the brain cell apoptosis and the protein expressions of Bax and cleaved-caspase-3 in model group were significantly increased （P＜0.05）； the levels of SOD， GSH- Px and CAT and the protein expression of Bcl-2 in brain tissues were significantly decreased （P＜0.05）. Compared with model group， the above indexes of rats were reversed significantly in administration groups （P＜0.05）， while the reverse effects of TMSC4 medium-dose and high-dose groups were significantly better than those of scutellarein group and tetramethylpyrazine group （P＜0.05）. CONCLUSIONS TMSC4 has a certain protective effect in CIRI model rats， the mechanism of which may be related to relieving inflammatory reaction and oxidative stress， inhibiting cell apoptosis.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.